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OBJECTIVE: To find the causes of occurrence and outcome of acute renal failure in women during peripartum period. METHODOLOGY: This prospective study was conducted in department of Gynae & Obsts. in collaboration with urology department at Liaquat University of Medical & Health Sciences Jamshoro from February 2015 to January 2017. Sample size was 90, overwhelming patients coming from peripheral area. Data was analyzed in SPSS version 21.0. Mean and standard deviation for quantitative variables such as age, gravidity & parity, frequency and percentages were calculated for qualitative variables; pre-eclampsia, eclampsia, hemolysis, post and antepartum hemorrhages, high liver enzymes, puerperal sepsis, low platelets, disseminated intravascular coagulation and outcomes like complete, partial and non-recovery. T-test was applied to evaluate the causes and outcomes. P value (P < 0.05) was considered as significant. RESULTS: Causes of 90 patients, which includes pre-eclampsia, eclampsia 11(12.22%), Postpartum hemorrhage 9(10%), Ante-partum hemorrhage 10(11.11%), 27 (30%) Hemorrhage, HELLP Syndrome 3 (3.33%), purpeural sepsis and disseminated intravascular coagulation 7(7.77%), Ruptured Uterus 4 (4.44%), hemolysis, elevated liver enzyme and Low Platelets Syndrome 5(5.55%), disseminated intravascular coagulation 4(4.44%), Dehydration 4(4.44%) and Obstructed Labor 6(6.66%). Outcome of acute renal failure in women during peripartum period, includes maternal outcome, delayed complete recovery, partial recovery, non-recovery, referred for dialysis. CONCLUSION: We concluded that the frequently causes were peripartum haemorrhage, eclampsia pre-eclampsia, puerperal sepsis and these sources were risk factors to increase morbidity and mortality. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine Clinical presentation and risk factors of Ectopic pregnancy to highlight and drawing attention for early diagnosis and prompt management. METHODOLOGY: This retrospective study was conducted in Department of Gynecology and Obstetrics at Liaquat University Hospital Hyderabad from January 2018 to December 2018. During one year of study period, 25 cases of ectopic pregnancies were enrolled in the study. In all cases age, parity, gestational age, risk factors, signs and symptoms, site of ectopic pregnancy and surgical intervention were noted on Performa and data was analyzed, results depicted in charts and tables. RESULTS: Most patients aged between 20-30 years with gestational age of 2 months, in parity 08 were primigravida, 06 were gravida 1, 05 were gravida 2, 03 in each gravida 3 and 4. One patient had a history of miscarriage, 02 underwent infertility treatment, 03 had previous ectopic pregnancy, 02 patients with previous cesarean section, while 08 patients given the history of pelvic inflammatory diseases. Six patients were diagnosed clinically while 15 cases through abdominal ultrasound and 4 through transvaginal ultrasound. Amenorrhea was present in 22 patients, vaginal bleeding in 20 cases and lower abdominal pain in 18 cases, while 08 patients presented in shock. CONCLUSION: Early diagnosis prevents complications such as rupture of ectopic pregnancy, which end up with excision of fallopian tube or ovary badly affecting fertility. [ABSTRACT FROM AUTHOR]

Background: Birth asphyxia is the failure to initiate and sustain breathing at birth as a result of hypoxia and ischemia, assessed on Apgar score of 0-3 at 5 minutes or later, acid base status by fetal scalp pH. Objective: To determine the frequency of maternal factors responsible for birth asphyxia. Material and Methods: This cross sectional descriptive study has been conducted at department of perinatology, National Institute of Child Health, Jinnah Postgraduate Medical Center, Karachi. From 28th January 2015 to 27th July 2015. A total of 196 mothers of asphyxiated newborn babies of either gender were enrolled. A detailed clinical history with possible factors leading to asphyxia along their biodata including age, parity and education were taken on predesigned proforma. Results: The mean maternal age was 32.53±7.23 years with mean parity was 2.68±1.29 and gravidity was 3.30±1.48. The mean no. of antenatal visits was 7.32±1.11. Multiple pregnancies were observed in 11.2% mothers, vaginal bleeding was observed in 56.1% mothers, meconium stained liquor in 71.9% mothers, prolong rupture of membrane >18 hours was found in 86.7% mothers, presentation other than cephalic was positive in 26.0% mothers, anemia was positive in 41.8%, edema in 10.7%, and hypertension in 14.3% mothers. Conclusion: The maternal risk factor for the birth asphyxia observed more frequent were improper antenatal visits, maternal age, prolonged rupture of membrane, meconium stained liquor, anemia, vaginal bleeding, and caesarian section. [ABSTRACT FROM AUTHOR]

Objective: To determine knowledge and different attitudes towards menstruation among young women. Methodology: A descriptive study was carried out at Isra University Hyderabad and villages around the Isra University Hospital, from 1st April 2005 to 31st March 2006. Five hundred women from villages around Isra University Hospital and students of Isra University Hyderabad were selected by non-probability sampling who were of menstruating age irrespective of their marital and literacy status. Women with menstrual irregularities or any other gynecological or psychological problem were excluded. All information was recorded on a questionnaire Performa and analyzed on SPSS version 15.0. Results: Out of 500 participants, 438 (87.6%) regarded menstruation as a natural process; whereas, 62 (12.4%) perceived it as a disease and curse from God. Out of 500, 415 (83%) of the participants responded that the menstruation process is good for health; however, 85 (17%) felt this process not healthy for themselves. Conclusion: Ignorance, false perceptions and unsafe practices regarding menstruation are not uncommon among young women, hence the importance of health education particularly of women living in rural areas. Then they will be better prepared emotionally to experience menstruation and will have less negative reactions. [ABSTRACT FROM AUTHOR]

Introduction Protein-energy wasting is a prevalent condition in patients with chronic kidney disease. Our goal was to validate the risk assessment tool (Hashmi's tool) in multiple centers, developed in 2018, as it was easily applicable and cost-effective. Methods The following variables were scored as 0, 1, 2, or 3 as per severity: body mass index, HD vintage in years, functional capacity, serum albumin, serum ferritin, and the number of co-morbid conditions (diabetes mellitus, hypertension, ischemic heart disease, and cerebrovascular disease). This scoring system was applied to maintenance hemodialysis patients in six different centers. The patient's record was evaluated for two years. Patients were divided into low-risk (score <6) and high-risk (score ≥6). We compared the two groups using the chi-square test for the difference in hospitalization and mortality. Results A total of 868 patients' records were analyzed, and the maximum score was 13 with the application of Hashmi's tool. Four hundred twenty-nine patients were in the low-risk group, and 439 patients fell into the high-risk group. Four hundred sixty-seven patients were male, and 401 were females; 84% had hypertension, and 54% had diabetes mellitus. In the high-risk group, we identified more females. Patients' likelihood of being in the high-risk group was higher if they had diabetes mellitus, hypertension, or ischemic heart disease. Hospitalization due to vascular or non-vascular etiologies was more common in the high-risk group (p=0.036 and p<0.001, respectively). A total of 123 patients died during the study period, 92 from the high-risk group as compared to 31 from the low-risk group. This was three times higher and statistically significant (p<0.001). Conclusion Using a simple and cost-effective tool, we have identified malnourished patients who are at risk of hospitalization and mortality. This study has validated the previous work at a single center, which has now been reflected in six dialysis units across Saudi Arabia., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Hashmi et al.)

Background: Sub-fertility is inability to ensure child bearing when it is wanted. Prevalence of sub-fertility in industrialised countries has been quoted as 20%, and seems to be on the rise. Traditional way to assess the uterine cavity, tubal structure and tubal patency was hysterosalpingography but it has now been largely superseded by laparoscopy and hysteroscopy. The objective of this study was to highlight the role of laparoscopy in establishing diagnosis of female infertility., Methods: This descriptive study was conducted in Gynaecology Unit of Liaquat University of Medical Health Sciences, Hyderabad, Pakistan from 28th August 2000 to 1st July 2001. Total 200 sub-fertile patients attended the gynaecology OPD. Out of these 30 patients were selected for laparoscopy and dye test who were suspected cases of endometriosis, abnormal HSG and unexplained infertility. Those patients who had medical disorders and contraindication for laparoscopy were excluded from study. Detailed history of every patient was recorded on a proforma and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle. Data were analysed using SPSS 11. Frequency and percentages were calculated to describe the results., Results: Out of 200 sub-fertile patients total 30 patients were selected for laparoscopy. Twenty (66%) patients were in primary infertility group while 10 (33%) patients were in secondary infertility group. Eleven (55%) patients of primary infertility belong to age group of 18-25 years while 6 (60%) patients of secondary infertility belong to age group of 26-33 years (TABLE 1). Mean duration of sub fertility at time of presentation in primary infertility group was 1.95 years while in secondary infertility was 2.70 years (Table 2). In primary infertility group main associated symptoms were dysmenorrhoeal in 8 (40%), irregular cycles 5 (25%), and dyspareunia in 4 (20%). In secondary infertility group 3 (30%) patients had dysmenorrhoeal and dyspareunia while 2 (20%) had irregular cycles. The commonest cause observed in patients with primary infertility was endometriosis spots which accounted for 11 (55%). In secondary infertility tubal occlusion was more common which accounted for 3 (30%)., Conclusion: Laparoscopic procedures are less invasive, more convenient and more precise for diagnosis of sub-fertility in women.