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Introduction: Stress urinary incontinence is defined as involuntary loss of urine on physical exertion like coughing, sneezing, laughing or jumping. This condition in women is very distressing and it is usually kept disguised, so women remain untreated. This condition also causes feeling of inferiority and depression. There are different risk factors identified in causing urinary stress incontinence like constipation, traumatic and operative vaginal births, pelvic organ prolapse, abdominal mass, smoking, obesity, old age and menopause. The present study is design to know the actual magnitude of stress incontinence. There by strategies could be devised to reduce this morbidity. Objective: To determine the frequency of urinary stress incontinence in women after vaginal delivery Setting: This study was conducted at ISRA University Hospital, Hyderabad. Duration: Six months from Jan 2020 to June 2020. Design: Descriptive cross sectional. Subject and Methods: There were 141 women with history of urinary incontinence within 40 days of vaginal delivery were included in this study. Patient who fulfill the inclusion and exclusion criteria and came within forty days after vaginal delivery. The final outcome that is urinary stress incontinence was labeled as positive or negative on approved proforma. Results: The average age of the patients was 26.75±5.72 years. Frequency of urinary stress incontinence in women after vaginal delivery was observed in 14.18% (20/141). Conclusion: Results of this study suggest that the mechanical strain during labor may add to the risk associated with pregnancy itself. Prenatal counseling about routes of delivery should provide a balanced account of the advantages and disadvantages for mother and child. The information from this study provides important information for clinicians, patients, and policymakers regarding childbirth and incontinence. Keywords: Stress Urinary Incontinence, Vaginal Delivery, Operative Vaginal Births

OBJECTIVE: The purpose of the study was to assess relationship between the clinical periodontal parameters and gingival crevicular blood glucose levels and to determine the relation of severity of periodontitis with glycemic levels. METHODOLOGY: A total number of 348 patients with chronic periodontitis participated in this cross-sectional study. After recording the number of teeth and plaque percentage, the participants were assessed for severity of periodontitis according to clinical periodontal parameters of periodontal pocket depth, gingival recession, clinical attachment loss and gingival bleeding. Gingival crevicular blood glucose was assessed via glucometers and random blood glucose levels were recorded for each patient. SPSS version 20 was used for data analysis. The correlation between periodontal parameters and glycemic levels was assessed via Pearson's correlation coefficient. Multiple regression analysis was used to predict the association of glycemic levels with periodontal parameters. Analysis of variance was used to compare the glycemic levels in patients with mild, moderate and advance periodontitis. RESULTS: Age, bleeding on probing and clinical attachment loss showed significant positive correlation while number of teeth showed significant negative association with crevicular blood glucose levels. Multiple regression analysis indicated that crevicular blood glucose has significant linear association with bleeding on probing and clinical attachment loss. Gingival crevicular blood glucose levels were found to be increasing with severity of periodontitis. There was significant difference (p

OBJECTIVE: The aim and objective of this study was to assess if gingival crevicular blood could be utilized for blood glucose evaluation in patients with periodontitis and to check the reliability of this screening method. METHODOLOGY: The study was conducted at the department of Oral Medicine, Ziauddin Dental Hospital, Karachi. The sample size involved 348 participants with chronic periodontitis. The gingival crevicular blood produced during periodontal probing was collected on a glucometer strip to assess random glucose levels. Glycemic levels were also checked by finger capillary blood via a glucometer. Intravenous blood glycated hemoglobin A1c test was performed in patients found with blood glucose levels in pre-diabetic or diabetic range. RESULTS: The results of this study demonstrate a strong correlation (0.987, p< 0.001) between gingival crevicular blood and finger capillary blood glucose values and good correlation (0.709, p

Objective: To assess, the type of obstetrics and gynaecological cases referred to tertiary care hospitals.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was carried out at the Department of Obstetrics and Gynecology Unit 2 of Isra University Hospital Hyderabad, Pakistan from May 2022 to July 2022.Materials and Methods: The patients who were referred to the Department of Obstetrics and GynaecologyUnit 2 at Isra University Hospital during the study duration from various primary, secondary, tertiary, andprivate hospitals for any obstetric or gynaecological emergency were the primary source of data. Theconfidentiality of each patient was carefully respected. This study evaluated the prevalence of various obstetricand gynaecological conditions for which patients were usually referred to Isra University Hospital within thestudy duration as well as the management options provided to these patients.Results: The bulk of referrals (71%) were for gynaecological cases, according to the results of our study. Patients under 20 years of age comprised 31% of the total. The majority of patients (20%) were multipara and in their third trimester (18%). Vesicovaginal fistula (VVF) was the most common gynaecological reason for referral(27%) and the least were ectopic pregnancy and UV prolapse 9% each. Placenta previa (13%), was the mostcommon obstetric referral in our study and at least 2% were placental abruption, preterm labour, and preeclampsia. Furthermore, 24% of VVF patients were successfully managed transvaginal while only 4% weremanaged transabdominal. All gynaecological malignancies were treated with total abdominal hysterectomywith bilateral salpingo-oophorectomy and omentectomy. Laparotomies were done for ectopic pregnanciesand 5 patients of UV Prolapse underwent vaginal hysterectomy whereas only 1 had pessary insertion. Amongstobstetric cases 7% cases of placenta previa/accreta had Cesarean section, 4% had Cesarean section along withbladder repair and 2% of cases necessitated myometrial excision. Compression sutures were the mostfrequently used form of treatment (5%) for postpartum hemorrhage patients, followed by hysterectomy (4%)and medical management (2%). Preterm labour was monitored, whereas placental abruption and preeclampsiarequired caesarean procedures.Conclusion: The majority of patients both gynaecological and obstetric referred to Isra Tertiary Care Hospitalthroughout a 3 months period had either an urgent need for treatment or a serious condition that necessitateda specialist's expertise and the availability of the appropriate resources. Therefore, it can be concluded thatthere is a critical need to upgrade our health system infrastructure, particularly in the area of maternal and child health care, in order to make it simple to provide timely and appropriate management to a variety of health conditions and lower the likelihood of any mishaps involving the mother or the fetus. Additionally, this will also benefit patients by avoiding unnecessary travel from distant regions and helps reduce the burden on tertiary care health system.

To evaluate the association of tooth mobility with glycaemic levels in patients with periodontitis.The cross-sectional study was conducted at the Department of Oral Medicine, Ziauddin Dental Hospital, Karachi, from December 2018 to May 2019, and comprised patients of either gender with chronic periodontitis. After recording demographic details and dental charting, tooth mobility scores were correlated with gingival crevicular blood glucose, finger capillary blood glucose and glycosylated haemoglobin levels using Pearson's correlation. Linear regression was applied to assess the inter-relation between the variables. Data was analysed using SPSS 20.Of the 348 patients, 202(58%) were females and 146(42%) were males. The overall mean age was 43±10.4 years. The mean number of teeth in patients with glucose levels180mg/dl was 25.5±2.5 compared to 23.2±2.9 in individuals with glucose levels200mg/dl. A moderate positive correlation (r=0.658) was seen between gingival crevicular blood glucose levels and tooth mobility. Finger capillary blood glucose levels also showed good correlation (r=0.653) with tooth mobility scores. Glycosylated haemoglobin scores showed a strong positive correlation(r=0.733). Linear regression confirmed increased glycaemic levels as a risk factor for tooth mobility (p0.001).Tooth mobility and glycaemic levels were found to be strongly interrelated.

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p

Obesity is the major threat to social and medical wellbeing in Pakistan and worldwide. Increased BMI poses certain risks to mother as well as fetus. The objective of this study is to assess the maternal and fetal morbidities in women presenting with increased BMI during pregnancy. Study Design: Descriptive cross sectional study. Setting: Isra University Hospital. Period: 1st June 2017 till Nov 2017. Materials and Methods: 100 Patients with singleton pregnancy were included in this study. Results: . Conclusion: It was concluded that there are complex and noteworthy socio- statistic imbalances related to different age groups, parity status and BMI. It was also concluded that increased no of patients are at high risks of maternal and fetal complication rates and require proper access to antenatal care. Facilities and interventions should be provided to improve both maternal and fetal health care and reduce the risks of adverse effects of increased BMI.

Objectives: To determine frequency of different mode of deliveries andassociated maternal complications in primigravidas in tertiary care setup. Study Design: Caseseries study. Setting: Department of Obstetrics and Gynaecology (Liaquat University Hospital)Hyderabad, Sindh, Pakistan. Period: 6 months from Jan 2009 till June 2009. Methodology: Allthe primigravidas underwent delivery by any means i-e emergency\elective caesarean sectionor spontaneous vaginal delivery\instrumental vaginal delivery and developed postpartumcomplications up till 7 days after delivery were included. Data was analyzed on pre- designedprofoma and was analyzed through software program SPSS version 10. Results: In this studymost frequent mode of delivery were found to be spontaneous vaginal delivery 46(36.8%)and emergency caesarean section 29(23.2%) while forceps 8.8%, vacuum 20% and electivecaesarean section 1.2%. Complications associated with mode of deliveries included postpartumhemorrhage were reported to be 51.2%, abdominal wound infection 11.2%, perineal woundinfection 17.6%, retained products of conception 28% and puerperal sepsis 16.8%. Conclusion:Deliveries in our setup are mostly conducted by dais (birth attendants) without any asepticmeasures and without assessing the abnormalities that will leads to emergency caesareansection or instrumental vaginal deliveries and in the consequence of these entire patientsdevelop postpartum complications.

Introduction: Pregnancy is a high risk factor not only for the mother but for the fetus as well. Certain oral changes especially bleeding gums, loosening of teeth, bad breath altered taste etc occurs secondary to factors like hormonal changes, lack of oral hygiene maintenance, diet, failure to visit dentist despite of having problems. Now a day along with that some other serious issues like low birth weight, pre-term labour, pre- eclampsia and certain oral infections have also been noticed. A study was conducted to evaluate the knowledge of pregnant patients regarding their oral health status, issues and the complications reported to the fetus so that necessary measures could be taken in addition to antenatal care for the health and benefit of mother and the fetus. Objectives: Assess the general and oral health status of expectant mothers along with their knowledge regarding the associated complications to fetus. Study Design: Random cross - sectional study design. Setting: Isra University Hospital. Period: August 2017 to January 2018. Methodology: A self-administered questionnaire was used to assess the general and oral health status of expectant mothers along with their knowledge regarding the associated complications to fetus. Collected data was statistically analysed by using spss version 17. Conclusion: This study provided an invaluable awareness regarding knowledge of pregnant females. Majority of them were poorly educated, did not know even about simple methods of oral hygiene maintenance, refused to visit dentists rather of having problems and above all were completely unaware about the possible risks and hazards to their baby secondary to oral health issues. Thus it was felt deemed necessary to aware and educate expectant mothers regarding routine oral checkup during antenatal period.

Transposition is a dental anomaly characterized by the exchange of position between two adjacent teeth, especially in relation to their roots, or development and eruption of a tooth in a position normally occupied by a nonadjacent tooth. Transposition of the maxillary canine and first premolar has a low prevalence in the population and it primarily affects maxillary canines and premolars. The aetiology of the transposition remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. If uncorrected, the results are often both functionally and esthetically unsatisfactory. This case report presents treatment of a female patient with complete bilateral transposition of maxillary canine and premolar. The patient was treated orthodontically with non-extraction fixed mechanotherapy by simulation of maxillary first premolar as canine bilaterally.

The aim of this study was to develop a prediction equation for estimating the total widths of the mandibular permanent canines and premolars (TCPW) using the total widths of the mandibular first permanent molars and incisors (TWFMI). The sample comprised 288 mandibular dental casts of orthodontic patients (106 males and 182 females, average age 13.8 and 14.4 years, respectively). A digital vernier calliper was used to measure the mesiodistal tooth widths from the mandibular right to the left first permanent molar. An independent t-test was used to determine any gender difference and a multiple linear regression equation to predict TCPW using TWFMI. A paired t-test was used to compare the actual and predicted values of the canines and premolars. The results showed a statistically significant difference (P < 0.01) between the mesiodistal tooth widths of males and females. A moderate correlation and determination coefficient between TCPW and TWFMI was found (r = 0.64 to r = 0.67 and r(2) = 0.41 to r(2) = 0.44, respectively). There was no significant difference between actual and predicted values for males and females. The regression equations proposed are a good prediction method to determine TCPW.

To compare different craniofacial patterns with pharyngeal widths.Cross-sectional analytical study.Orthodontic Clinic at the Aga Khan University Hospital, Karachi, from June 2002 to June 2010.Data were collected using pre-treatment records including orthodontic files and pre-treatment lateral cephalographs of 360 orthodontic patients. The inclusion criteria were subjects of Pakistani origin, aged between 14-20 years and having no pharyngeal pathology or complaints of nasal obstruction at the initial visit. The sample comprised a total of 360 subjects divided into 2 groups: skeletal Class I (n=180) and skeletal Class II (n=180) subdivided according to the vertical pattern into normodivergent, hyperdivergent and hypodivergent facial patterns. Upper and lower pharyngeal airways were measured using McNamara's airway analysis. The intergroup comparison of upper and lower airways was performed with oneway ANOVA and the Tukey test as the second step.There were 172 males and 188 females with average ages of 15.3±1.3 and 15.4±0.8 years respectively. Hyperdivergent facial pattern subjects belonging either to skeletal Class I or Class II malocclusion showed a statistically significant narrow upper pharyngeal airway width as compared to normodivergent and hypodivergent facial patterns. However, no statistically significant difference was found in lower pharyngeal airway widths in sagittal and various vertical facial patterns.Sagittal malocclusion type does not influence upper pharyngeal width. However, hyperdivergent subjects have statistically significant narrower upper pharyngeal width when compared to other two vertical patterns.

To compare the actual sum of canine and premolars and that predicted from three mixed dentition prediction methods in orthodontic patients at the Aga Khan University Hospital (AKUH), Karachi.Cross-sectional comparative study.Orthodontic clinic at the Aga Khan University Hospital from June 2002 to December 2007.Data were collected using pretreatment records including orthodontic files and plaster casts of 121 orthodontic patients. Digital caliper was used to measure the mesiodistal widths of permanent teeth from 1st molar to 1st molar in mandibular arch, and central incisors and 1st molars in maxillary arch. The methods of Tanaka and Johnston, Moyers, and Bernabé and Flores-Mir were used to predict the mesiodistal widths of the canine and premolars. Comparison between the actual and predicted sum of the mesiodistal widths of canine and premolars was made for each prediction method, using paired sample t-test.There were 45 males and 76 females with average ages of 13.3+/-1.3 and 13.4+/-0.8 years respectively. For males statistically significant differences were found for Moyers at the 75th percentile and Bernabé and Flores-Mir method whereas for females only the Bernabé and Flores-Mir's method showed significant results. However, no significant difference was found in both genders for Tanaka and Johnston method.In the studied orthodontic patients for males Moyers 50th percentile and Tanaka and Johnston methods could be used; while for females Moyers 75th percentile and Tanaka and Johnston methods were applicable for mixed dentition analysis.