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Background: Duplex ultrasound (DUS) has become one of the main assessing methods for carotid diseases. Duplex ultrasound uses two techniques, traditional B-mode ultrasound and Doppler US. The screening of carotid artery stenosis using ultrasonography is essential for not only daily clinical settings but also management of patients with stiffness in carotid artery through the cross sectional area of the carotid artery. By comparing the people of rural and urban area, we will know about the stiffness caused by pollution. Objective: To compare the Carotid Artery Stiffness in adults belonging to Urban and Rural areas of Punjab by ultrasonography. Methodology: It was cross-sectional analytical study conducted in Department of Diagnostic Radiology, at Nishtar Hospital, Sehat Medical Complex, Lahore. Duration of study was 7 months. Total sample size was 135. Result: In urban areas, the mean RCC stiffness was notably higher at 324.13 compared to the rural population's lower mean of 222.20. Similarly, the LCC stiffness in urban adults exhibited a higher mean of 329.52, while rural adults showed a lower mean of 239.34. The diameter measurements during systole and diastole also displayed variations between urban and rural settings. RCC diameter during diastole showed a statistically significant difference with an urban mean of 0.27 compared to the rural mean of 0.24. Conclusion: Urban populations exhibited significantly higher RCC and LCC stiffness compared to rural counterparts. Additionally, urban individuals demonstrated larger RCC diameters during systole and diastole. [ABSTRACT FROM AUTHOR]

Background: Maternal mortality ratio (MMR) in Pakistan is quite high 186 deaths / 100,000 live births, Provincial and Federal Government trying to reduce it 70 deaths / 100,000 live births up to 2030. This is only possible by reducing unwanted pregnancies and educating women regarding Emergency Contraception. Objectives: To assess knowledge, mental att itude and drilling of emergency contraception in women of reproductive age. Material and Methods:A quantitative cross sectional study was carried out in Obstetrics and Gynecology department, of Al-Aleem Medical College att ached with Gulab Devi Educational Complex Lahore, from 5th February 2021 to 5th June 2021 after approval from IRB. A total of 200 willing married and child bearing women coming to family panning/Gynae OPD for routine check -up were recruited in the study, unmarried and unwilling were excluded, nonprobability convince sampling technique was used. Data was collected by using 21 items selfadministered questionnaire to access knowledge, mental att itude and drilling regarding EC. Results: 200 women were included in this study. Majority of the women 56.50% were between 26-35 years, mean age was 30.5±1.5 years. Among these 53.50% were multigravida and 34.50% were grand-multigravida. Major chunk 64.50% was under matric/matric, only16.50% were graduate and 19.50% had technical education. 68% were housewives. Almost all the women belong to low middle and poor class. The questionnaire submitt ed to women att ending obstetric and gynaecological department showed prevalence of knowledge, mental att itude and drilling about emergency contraception. P-Value was statistically significant in mental attitude of the women towards EC < than 0.05 was found in 62.5%. Conclusion: Att itude of the reproductive women was favorable towards EC but their there is a clear gape in knowledge and drilling, so there is a dire need to educate women regarding available methods and its proper utility. Emphasis should be given to support and strengthen the Lady Health Program which was started in 2012 in Pakistan to enhance the knowledge and drilling of EC. [ABSTRACT FROM AUTHOR]

Objectives: To determine the factors responsible for repeat caesarean section. Material and Methods: It was a retrospective descriptive study, conducted at department of Obstetric and Gynecology of Al-Aleem Medical College att ached with Gulab Devi Educational Complex Lahore, over a period of two years from October 2018 to September 2020 after approval from Institutional Ethical Committ ee. A total of 70 pregnant women fulfilling the inclusion criteria were included in the study. Results: In this study a total of 70 women were included, only 40% had successful VBAC and 60% ended into caesarean delivery. Majority of the women (78.56%) were between 20-30 years and mean age was 24.05±2.15 years. 60% women were multiparous. Inter-pregnancy interval less than two years was observed in 67.14%. In 52.85% women BMI was less than 24 kg/m2. Factors responsible for repeat caesarean sections were observed in women, 35.71% > 30 years of age, previous unsuccessful vaginal birth after cesarean in 64.28%, inter-pregnancy interval <2 years in 73.80%, BMI > 24 kg/m2, Bishop score <5 cm 71.42% and fetal weight > 3 k.g in 59.52%. Conclusions: Several factors responsible for repeat caesarean section in this study were considered as negative predictors for successful vaginal birth after cesarean. [ABSTRACT FROM AUTHOR]

Objectives: To determine the factors responsible for failed induction of labour. Study design: Retrospective cross sectional Study. Study Sett ing: Obstetric and Gyne Department of Al-Aleem Medical College, Gulab Devi Educational Complex. Duration of study:One year from 1st October 2019 to 30th October 2020. Material and Methods: During this period total 690 births were carried out. A total of 301 pregnant women fulfilling inclusion criteria were included in this study who were induced. Data like age, parity, BMI, gestational age, ruptured membranes, amniotic fluid volume on US, Bishop's score and fetal weight were recorded on pre designed proforma. Results:A total of 301 women met the inclusion criteria, failed induction occurred in 123 women (40.86%). The mean age of the women was 28.3 ±1.9 years. Factors responsible for failed induction of labour in the study were observed as women > 30 years 64.22%, primigravida 69.91%, BMI more than 24 k.g/m2 78.86%, gestational age > 41 weeks 40.65%, ruptured membranes > 12 hours 66.66%, Bishop score < 5 cm 69.91%, AFI on USG 56.09% and fetal weight > 3 kg 60.97%. The P-value was extremely statistically significant (< 0.0001) was observed in two factors ruptured membranes more than 12 hours and poor Bishop's score. Conclusions: In our study induction of labour failed in 40.86%. Poor Bishop's score < 5cm and ruptured membranes more than 12 hours at admission were observed extremely statistically significant factors. [ABSTRACT FROM AUTHOR]

Objectives: To ascertain the prevalence of stress and anxiety disorders in Health Care Providers during Pandemic of COVID-19, and to provide appropriate suggestions to deal it. Material and Methods: This Cross sectional study was conducted at AL-Aleem Medical College, Lahore att ached with Gulab Devi Educational Complex, over a period of three months from September 2020 to November 2020 after approval from Institutional Review Board (IRB). Non probability convenience sampling technique was used, a total of 100 willing Health Care Providers (doctors, nurses and paramedics) were included in the study. The data was collected by handing over "The 7-item Generalized Anxiety Disorder Scale (GAD-7)" performa, it was entered and then analyzed by SPSS version 23. This scale is from 1 to 21. i describes no anxiety and 21 severe anxiety. Results: The total prevalence in health care providers (HCP) was 86%, 33% were suffering from mild anxiety, 48% and 5% were suffering from moderate and severe anxiety respectively, p-value was 0.041. The mean age of the participants was 29.86 years, the mean age of doctors, nurses and paramedical staff was 30.30, 34.07 and 35.90 years respectively. There were 55% female and 45% male. Conclusions:Significantly high level of stress and anxiety disorders (86%) were found in health care providers during pandemic of COVID-19, doctors, nurses and paramedics are equally affected in the study. This is an alarming issue and need of the hour to deal both at government and community levels, in order to keep psychological wellbeing of all health care providers. [ABSTRACT FROM AUTHOR]