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Objective: To compare the effectiveness of two types of haemostatic sutures to secure bleeding in thinned out caesarean section scars. Study Design: Comparative Interventional Study. Setting: CMH Okara, Pakistan. Period: September 2019 to September 2021. Material & Methods: Patients were divided in four categories. Category I was previous one scar patients while category II was previous two scars patients. Similarly, categories III and IV were previous three and four scar patients respectively. In each category hemostasis was secured either by purse string suture or transverse mattress sutures. Hemostasis whether achieved with difficultly or without difficulty was assessed and time utilized was also calculated. Results: In patients with previous one caesarean section 3 out of 15 (20%) had haemostatic difficulty with both purse string suture and horizontal mattress suture. In patients with previous two caesarean sections the number was 5 (33.33%) and 6 (40%) in both purse string and horizontal mattress suture respectively. In patients with previous three caesarean sections there were 7 (46.66%) women who had difficulty in haemostasis in both group I and II. The average time to achieve the procedure in group I (purse string suture) was 3.25 minutes while it was 7.5 minutes in group II (Horizontal mattress sutures). There was two times difference in time consumption between two groups. Conclusion: Purse string suture is more effective, convenient and quicker to apply as compared to transverse mattress sutures for haemostasis in thinned caesarean section scars. [ABSTRACT FROM AUTHOR]

Objective: To compare the conventional ways of teaching to new teaching methodologies thus finding their efficacy. It also highlights the significance of incorporating technology into teaching thereby creating a rich learning experience for students. Study Design: Cross-sectional Survey. Setting: Different Medical and Nursing Colleges and Universities of Punjab, Pakistan; Faisalabad Medical University Faisalabad, University Medical and Dental College Faisalabad, Ameer-uddin Medical College Lahore, Nishtar Medical and Dental College Multan, Shareef Medical and Dental College, Continental Medical College Lahore. Period: June 2020 to August 2020. Material & Methods: Was conducted amongst 1600 medical, dental and nursing students from various medical and dental colleges across Pakistan. A questionnaire was circulated among students after briefing them about the objective of the study. Result: Out of 1600, 816 were MBBS students, 715 were BDS and 69 were nursing students. About various teaching methods, 53% in MBBS, 56.78% in BDS and 30.43% of nursing students were aware about new teaching methodologies. Tutorials were least known by MBBS students, online classes for BDS students whereas both methods of teaching were least popular amongst nursing students. A significant percentage of students were more in favor of group discussion as an effective method of teaching. Conclusion: This study concluded that student-centered learning should be focused on and new technologies should be incorporated in order to make medical education more interactive and interesting. [ABSTRACT FROM AUTHOR]

Objective: To determine the fetal and maternal outcome among pregnant women who are diagnosed positive for co-occurrence of Ureteric Stones and Urinary Tract Infections during their third trimester. Study Design: Cross Sectional Analytical study. Setting: Urology and Gynecology Department of Mukhtar A Sheikh Hospital Multan. Period: 6th February 2020 to 6th July 2020. Material & Methods: Pregnant women in their third trimester were confirmed for the presence of ureteric stones and urinary tract infections through imaging and urine culture studies. Cases confirmed for the disorders were then evaluated for any complications during the remaining gestational period. The diseased group was compared with healthy pregnant women. Results: Out of 200 selected women, 60 (27.7%) were positive for comorbidity of two illnesses. Among pregnancy outcomes, Preterm Labor (46.6%) has the highest rate of incidence followed by Preeclampsia (41.6%), Oligohydramnios (10.6%), Abortion (1.6%), Operative Intervention (cesarean section) (36.6%), Acute Renal Failure (5%), Acute Respiratory Distress Syndrome (11.6%), and Septicemia (1.6%) among the study group. Similarly, fetal outcomes such as fetal demise (1.6%), Low birth weight babies (58.3%), and premature babies (51.3%) were statistically significant in the study group than the control group. Conclusion: The coexistence of ureteric stones and UTIs is largely affecting pregnant population and this co-morbid condition has a significant impact on fetomaternal health. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the frequency of semen parameters in male partners of in sub-fertile couples. Study Design: Cross-sectional study. Setting: Department of Gynaecology, Bakhtawar Ameen Hospital, Multan. Period: July 2019 to July 2020. Material & Methods: Infertile couples from at least 12 months were selected for study. A team of Gynaecologist, andrologist and endocrinologist assessed the couples. In male partner, general physical examination, endocrine factor, genetic assessment, accessory gland infection and testicular dysfunction were evaluated. Semen sample was sent to laboratory for semen analysis. Results: In a total of 169 sub-fertile couples, the mean age of male and female partner were 37.98±4.54 years and 32.51±3.78 years respectively. Mean duration since marriage was 5.17±4.51 years. Abnormal semen parameters such as azoospermia, oilgo-azoospermia, asthenozoospermia, teratozoospermia and aspermia were noted 21 (12.4%), 26 (15.4%), 48 (28.4%), 18 (10.7%) and 10 (5.9%) subjects respectively. There were 46 (27.2%) subjects with normal semen parameters. Conclusion: Most of the male sub-fertile subjects had asthenozoospermia. More than one fourth of the subjects had normal semen parameters. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of L-Arginine versus placebo in the prevention of pre eclampsia in high-risk pregnancies. Study Design: Randomized Control Trial. Setting: Department of Obstetrics and Gynecology, Nishtar Hospital Multan. Period: November 2019 to February 2019. Material & Methods: A total of 130 women were included in the study. 65 patients were in L-arginine group or Group A while 65 patients were in placebo group or Group B. In group A, women were prescribed L-arginine 300 grams (Amino Whey Sachet) once a day until delivery and in group B; women were given homologated placebo (starch) once a day until delivery. Efficacy (no preeclampsia occurs during pregnancy) was noted from both groups and recorded. Mean ±SD was presented for quantitative variables like age, gestational age, parity, duration of chronic hypertension, weight, height and BMI. Variables such as age, parity, hypertension, body mass index, gestational age and duration of hypertension were stratified to assess their effect on efficacy. Chi square test was used to make comparison of the efficacy in both groups as well as for post-stratification for both groups. A p value of less than or equal to 0.05 was taken as significant. Results: In L-arginine group efficacy was 92.3% as compared to 69.2% in placebo group (p< 0.000) Table-IV. Conclusion: It can be concluded that L-arginine when given orally at the dose of 300g daily has a considerable role in prevention of pre-eclampsia in pregnant patients with high risk and also has a role in reduction of severity of pre-eclampsia. [ABSTRACT FROM AUTHOR]

Objectives: To determine the number of patients with low back pain who have low serum Vitamin-D levels along with associated risk factors in our local population. Study Design: Descriptive Study. Place and Duration: At the Department of Orthopedics, Benazir Bhutto Hospital, Rawalpindi, for a duration of 01 year from 20th March 2016 to 19th March 2017. Patients and Methods: 600 patients were included in the study who met the inclusion criteria, i.e. patients presenting to the Out Patient Department (OPD) with low back pain for a duration of less than six months aged between 15 to 55 years. Venous blood withdrawn and serum levels of Vitamin-D measured. According to serum Vitamin-D levels, categorized as deficient, sufficient or excess. Results: Mean age of patients included in the study 44.21 ± 11.92 years. Out of the total, 337 (56.17%) were males and 263 (43.83%) females. Out of the total, 20.67%, 26.17% and 28.83% had mild, moderate and severe Vitamin-D deficiency, respectively. Predominantly patients with severe Vitamin-D deficiency presented in winters (October - February) (17.16%) as compared to other seasons. The most pre-dominant risk factor in patients with low Vitamin-D levels was smoking (21.33%). Conclusion: Vitamin D plays a crucial role in the musculoskeletal framework of the body. The deficiency is more prevalent in the youth due to sedentary lifestyle and indoor preference. [ABSTRACT FROM AUTHOR]