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Objectives This study was conducted to determine impact of insulin resistance using Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score and BMI in non-hypoxemic out-patients with COPD on FEV1 using linear and polynomial regressions and to determine their correlation. Methods COPD patients of both genders were included after informed consent. Fasting blood sugar and serum insulin were done to calculate HOMA-IR, which were segregated into two groups of ≥ 3 and Results A total of 273 subjects were inducted after informed consent. There was a linear correlation between HOMA-IR and BMI (r2 0.498, p 60 predicted, but a clear negative association below that. Significant increase in HOMA-IR was seen from GOLD-2 to 3 and from GOLD-3 to 4 classes. The impact of HOMA-IR on FEV1 was 49.9% (p Conclusions The results indicate that there is a high prevalence of IR in non-hypoxemic COPD. A non-linear association is present between FEV1 & HOMA-IR which is most evident with FEV1

AIM: The aim of this study was to identify the risk factors for perinatal deaths in Pakistan where perinatal mortality is still very high. MATERIALS AND METHODS: This prospective cohort study was conducted in Sindh Government Lyari General Hospital Karachi from 1 May 2006 to 30 April 2008. During this period all perinatal deaths and each live infant delivered following every perinatal death (which were taken as controls) were enrolled. Demographic information birthweight booking status associated obstetric risk factors stillbirth or neonatal death and the cause of death were recorded. Univariate logistic regression was used to determine the effect of categorized weight booking status sex and the obstetric risk factors on perinatal death. RESULTS: A total of 1103 deliveries were conducted during this period with 119 perinatal deaths. Stillbirths constituted 68.9% while there were early neonatal deaths in 31.1% cases. Booking status gestational age weight of fetus and the presence of obstetric risk factors were found to have significant (P-value < 0.05) association with perinatal deaths. Among the obstetric risk factors abruptio placentae was the commonest (13.4%) and the commonest cause of death was identified as birth asphyxia (44.5%). There was a strong association between birthweight and perinatal death. CONCLUSIONS: The high perinatal death rate in this study is comparable to other hospital-based studies and indicates the poor health status inadequate prenatal and intranatal care and lack of services in our setup. In order to achieve the Millennium Development Goals-4 much work is needed to improve the quality of care to identify high-risk cases and to carry out their proper management. (c) 2011 The Authors. Journal of Obstetrics and Gynaecology Research (c) 2011 Japan Society of Obstetrics and Gynecology.