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Reported here is a rare near-miss case of stroke in pregnancy presented to the Department of Obstetrics and Gynaecology. A 38 years gravida 8 was referred from a private hospital on 18 November 2022 with hemorrhagic stroke, a known case of chronic hypertension at 37 weeks of gestation with previous cesarean section and acute kidney injury. At a private hospital computed tomography head was done it showed intracerebral haemorrhage. On cesarean, intraoperatively it was a live female with thick meconium. The patient was kept in intensive care with a mechanical ventilator, antihypertensives, antibiotics, and analgesics. Serum creatinine was increasing daily. Suture was cut on the 7th postoperative and two times dialysis was done on the 8th and 9th postoperative days. Stroke in pregnancy is a rare diagnosis and it could have been prevented by regular antenatal visits and early referral antenatally along with a multidisciplinary approach.

Conjoined twins (Siamese twins) represent the rarest form of twin pregnancy. Reported here are two rare cases of conjoined term twins presented to the department of Obstetrics and Gynaecology within 3 months. The first case, 32 years of gravida 6 parity 5 referred from periphery after full trial of labour following multi-organ dysfunction and term intrauterine dead twins. Intraoperatively it was dead conjoined thoraco-omphalopagus females. The patient died after 3 days following multiorgan dysfunction syndrome and disseminated intravascular coagulation. The second case, 22 years gravida 2 parity 1 also referred from periphery in second stage of labour with diagnosis of 39 weeks intrauterine dead twins with obstructed labour, delivered by caesarean with intraoperative conjoined dead females of thoracophagus type. Twins are high-risk pregnancy. This rare diagnosis with complications could have been prevented by regular antenatal checkups, ultrasonography performed by radiologists and early referral antenatally in labour along with multidisciplinary approach.

Objective: To explore the mediating role of temperament traits in parenting styles and Attention Deficits Hyperactive Disorder (ADHD) symptoms in young adults. Study design: A Cross-sectional research design was used. Place and Duration of Study: This study was carried out in Lahore from September 2019 to March 2020. Materials and Methods: A sample of 310 university students (men 38%, and women 63%) with the age range of 18-24 were given Demographic Performa, Attention Deficits Hyperactive Symptoms Scale (ADHSS)21, Student Temperament Scale (STS)4 and My memories of upbringing (EMBU-A).22 Pearson Correlation was used to find the association among parenting styles, ADHD symptoms, and temperament traits and mediation analysis was used to investigate the mediating role of temperament traits between parental overprotection and ADHD symptoms and model 4 was used. The level of significance was taken as p

Introduction: Caesarean section is one of the most common obstetric operations performed. Primary caesarean section in multiparous women means the first caesarean section done in the multiparity who had previously delivered vaginally. This study aimed to find out the prevalence of primary caesarean section among multiparous pregnant women visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among multiparous women in a tertiary care centre from 15 June 2020 to 14 June 2021. Ethical approval was obtained from the Institutional Review Committee (Registration number: F-NMC/420/075/076). Demographic data were collected using predesigned proforma in parous women who had a previous vaginal delivery. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 1158 multiparity, primary caesarean section was found in 155 (13.39%) (11.43-15.35, 95% Confidence Interval). Most women 62 (40%) belong to 21-25 years and the majority were second gravida 51 (32.90%). The emergency caesarean section was done in 149 (96.12%). Indications for primary caesarean section were fetal distress 63 (40.63%), non-progress of labour and breech 12 (7.74%). Post-operative complications were uneventful in 110 (70.96%) cases. Conclusions: The prevalence of primary caesarean section in multiparous women was found to be higher than the other studies done in similar settings.

OBJECTIVE: To find out ADHD symptoms in a sample of young adults. To develop ADHD symptoms in a sample of young adults METHODOLOGY: A mixed-methods design was used. The study was carried out from July 2019 to February 2020 in series of phases. In phase I, 20 university students of BS Hon (11 women, 9 men) age range 18-24 were interviewed and a list of 77 items for scale was finalized. In phase II, Content Validity Index (CVI) was established and 54 items for the scale were retained and further piloted study on 20 university students of BS Hon (10 Men 10 women) through purposive sampling from 2 private and 2 government universities of Lahore in Phase III. University students of M.A/ MSc, MS, and other programs were excluded from the study. Finally, in Phase IV, a final list of 54 items for the scale (Attention Deficits Hyperactive Symptoms Scale), Adult ADHD Self-Report Scale (AASR-VI. I), and Student Problems Checklist (SPCL)was given to the sample of 727 university students of BS Hon (293 (40%) men and 434 (60 %) women) with the age range of 18-24 years (M= 19.86, SD= 1.51). After collecting all data SPSS 21 version and AMOS 21 version was used for analyzing the data. RESULTS: Exploratory Factor Analysis produced 3 factors which were confirmed through Confirmatory Factor Analysis inattention, hyperactivity, and proactive. The scale was found high internal consistency α=.84, split-half reliability r=.84, and test-retest reliability r=.84, concurrent validity, and construct validity. CONCLUSION: ADHSS found cultural specific with high psychometric properties and useful for identifying the symptom of ADHD.

Objective: To evaluate the changes caused by Ramadan fasting on body weight and serum leptin level in normal, overweight and obese individuals. Methods: This prospective observational study was conducted from June to July 2014 among individuals who fasted throughout the month of Ramadan and had no known chronic disease. All individuals were categorized according to Body Mass Index (BMI) categories for Asians, i.e., normal weight (18.5-22.9 Kg/m2), overweight (23-24.9 Kg/m2) and obese (>25Kg/m2). Anthropometric measurements and blood samples were obtained at irst day of Ramadan (Pre Ramadan) and during the last week of Ramadan (Post Ramadan). Leptin hormone was analyzed by Human ELISA kit. Paired t-test was used for comparison, pvalues

Hypertensive disorders of pregnancy are a serious and life-threatening condition often complicating the pregnancy leading to preeclampsia, eclampsia, maternal and neonatal mortality and morbidity. Preeclampsia is myriad of diseases starting from improper remodeling of spiral arteries, poor placentation leading to fatal consequences of intrauterine fetal and maternal death due to uncontrolled blood pressure. Thirty-three preeclamptic women in Group 1 and thirty-three healthy pregnant in group 2 has been taken in this research. Statistical analysis and evaluation were performed by utilizing SPSS version 23.0. Result of our research show significant decrease in serum apelin and elabela and association of these hormones with parity, body mass index (BMI), C-reactive protein (CRP) , systolic and diastolic blood pressure in preeclamptic women as compared to healthy pregnant while no significant association with age.

Objectives: The aim of present study was to investigate the effect of fasting during Ramadan on plasma adiponectin and TNF-α levels., Methods: This is a cross sectional study, conducted at Federal Urdu University of Arts, Science & Technology (FUUAST), Karachi, comprising a total of 55 (50%) females and 55 (50%) males whose ages ranged between 20 and 40 years, and fasted during Ramadan (June-July 2014) were enrolled in the study. Subjects were separated into normal weight, overweight and obese males and females. Anthropometric measurements and Fasting venous blood samples were taken at first and last (29 th ) day of Ramadan. Plasma adiponectin and TNF-alpha levels were assayed with ELISA kits. All values were calculated and presented as mean ± standard error of the mean (SEM) and by using analysis of variance (ANOVA) for repeated measures. P values < 0.05 were accepted as significant., Results: Body mass index (BMI) (Kg/m2) in over-weight and obese male subjects exhibited considerable reduction (P<0.05; P<0.05), post Ramadan when compared to their respective pre Ramadan fasting weights. Noticeable and significant reduction was also observed in BMI of obese females (P<0.05). Post Ramadan Overweight Males (P<0.05) and Post Ramadan Obese Males (P<0.001) exhibited significantly elevated plasma adiponectin (μg/mL) values. While plasma adiponectin mean concentration of only obese females were significantly improved at last week of Ramadan (P<0.01). Fasting in Ramadan significantly decreased TNF-α (pg/mL) levels of post obese males and females than Pre-Ramadan-groups (P<0.05; P<0.01) respectively., Conclusion: The study reports of noticeable changes with Ramadan fasting resulting increase of plasma adiponectin and decrease of TNF-α levels as well as body weight. The study strongly suggests further investigations on larger sample sizes with possible association of dietary restrictions and weight loss on mechanism of enhanced adiponectin and reduced TNF-α in obese and overweight persons who fast on Ramadan pattern.