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Objective: To determine the frequency and association of coping strategies with different levels of anxiety and depression. Methods: A cross-sectional study was carried out in private hospitals of Karachi, from January to May 2017. Data was collected from pregnant women willing to participate in the study by using non-probability convenient sampling. A questionnaire was used to gather socio-demographic and obstetric data after informed consent from pregnant women. Hospital anxiety and depression scale (HADS) was used to identify different levels of anxiety and depression. Coping strategies were assessed by using brief inventory results which were assessed on SPSS 16. Results: Study group included 400 women between the ages of 18 to 38 years with a mean age of 27.08 ± 4.074. The adaptive strategies were used by 23.3% of the study group. Maladaptive strategies were adopted by 17.9% of women and 58.9% were using both adaptive and maladaptive strategies. There was a significant association of adaptive strategies and women appearing normal on HADS scale (p-value= 0.000, OR= .077) whereas there was negative association with maladaptive strategies and normal behaviour (p-value= 0.032, OR= 1.747). Women with borderline anxiety were using only combination of both types of strategies. Women using maladaptive strategies were having significant association with abnormal level of anxiety (p-value= 0.000, OR= 3.369) with borderline depression (p-value= 0.012, OR= .420) and abnormal depression (p-value= 0.000, OR= -6.657). Active coping (OR 5.952 and 6.679), instrumental (OR 4.138 and 6.679), planning (OR 10.300 and 6.646),) and positive reframing (OR 1.735 and 3.765) were protective for abnormal anxiety and abnormal depression. Religious practices were protective for abnormal anxiety only (OR= 4.289). Conclusion: Adaptive strategies are associated with normal mental status and are protective for anxiety and depression whereas maladaptive strategies are the risk factors for anxiety and depression. Pregnant women should be encouraged to adopt adaptive strategies to reduce the adverse outcome associated with anxiety and depression. [ABSTRACT FROM AUTHOR]

Introduction: Fibroids are the commonest benign tumors and it is estimated that they occur in 20-40% of women during their reproductive years. Reported risk factors consistent with the hormonal hypothesis include premenopausal status, younger at menarche, and obesity. Reported protective factors include parity and oral contraceptive use. This study was designed to give us the burden of fibroid and factors leading to fibroid. Objectives: To determine the frequency and factors leading to fibroid in women presenting with menorrhagia in outpatient department of gynae unit-I Civil Hospital Karachi. Study design: Cross sectional study. Setting: Department of Obstetrics and Gynaecology- I, Civil Hospital, Karachi. Duration of study: Six months from 12thMarch, 2011 to 11th September, 2011. Subjects and methods: A total of 121 patients meeting the inclusion criteria were enrolled in study. History was taken regarding duration and severity of menorrhagia and the factors leading to fibroid including age, parity, obesity and family history, women with a weight of 50kg or more were taken as obese. If findings consistent with fibroid as per operational definition were found on ultrasound then it was termed as -----fibroid +ve. Results: Mean (±SD) age was 27.9 (±5.3) years. Frequency of fibroid was found in 68 (56.2%) patients with menorrhagia. Family history fibroid was found in 51 (42.1%) women out of which fibroid was found positive in 30 (58.8%) women, that was the most common factor leading to fibroid in this study, followed by obesity 28 (35.4%) and nulliparous 10 (25.6%). Conclusions: Frequency of fibroid was found in 56.2% patients with menorrhagia. Family history of fibroid was most common risk factor leading to fibroid found in 58.8% women. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to find out the frequency, indications and the associated risk factors for peripartum hysterectomy in a tertiary care hospital. Material and Methods: This retrospective study was carried out from January 2008 to December 2010 in civil hospital, Karachi. Demographic data including age, parity, booking status and gestational age were noted. Indication of hysterectomy, associated risk factors and number of blood transfusion recorded. Mean and standard deviation calculated for continuous variables and the categorical variables mentioned in frequency. Association of risk factors with booking status determined by logistic regression. Results: A total of 38 emergency peripartum hysterectomy carried out and the the frequency was 4.58/1000 deliveries. The mean age and parity was 30.5±4.3 years and 3.0±1.7 respectively with a mean gestational age of 36.2±3.6 weeks. Majority of patients were unbooked and 60.5% women underwent hysterectomy following cesarean section. Uterine atony was the commonest indication (47.4%) followed by placenta praevia, ruptured uterus and morbidly adherent placenta. Previous cesarean section, placenta praevia, grand multiparity and prolonged or obstructed labour were major associated risk factors found in this study. Unbooked patients had significantly increased association of risk factors ( P-value < 0.05). All the patients received massive blood transfusion and three maternal deaths occurred during this study. Conclusion: Despite advances in the management of primary postpartum haemorrhage, frequency of postpartum hysterectomy is still high . Major identified risk factors are previous cesarean section, placenta praevia, ruptured uterus and morbidly adherent placenta. [ABSTRACT FROM AUTHOR]