BackgroundThalassemia is a blood disorder passed down through families (inherited) in which the body makes an abnormal form of hemoglobin. This disorder results in excessive destruction of red blood cells, and there is no effective treatment. Patients require lifelong blood transfusion, usually started within 6 to 12 months of birth of patient, which on other hand has its own complications. It is a chronic disease that manifests so early in life that it leads to psychological and social problems for parents . We focused on parents to assess the impact of their child’s disease.ObjectiveTo determine the psychosocial problems of parents of thalassemic children.MethodsThis cross sectional study was conducted among the parents of thalassemic children attending THALASSEMIA CENTRE, BAHAVAL VICTORIA HOSPITAL (BVH), BAHAWALPUR, PAKISTAN during the year 2011. A self designed questionnaire was used that contained questions regarding psychological and social aspects. Patient Health Questionnaire-9 (PHQ-9) was used to assess the depression of parents of thalassemic children.ResultsOf the 100 parents interviewed, the majority were mothers (71%) , with a mean age of 32 ± 8.07 years for both sexes. 29 percent of the parents had moderate to severe depression, 16 percent had sleep disturbances. 56 percent were downgraded by relatives. There was a significant relationship between respondent education and depression (p < 0.05).ConclusionA substantial number of parents have psychosocial problems due to the disease of their child. Parent counseling is needed on regular basis.

Objective: Main purpose of this study is to determine the effects of pandemic disease COVID-19 on first and second trimester pregnancies. Study Design: Cross-sectional/Descriptive study Place and Duration: Study was conducted at Gynae and Obs department of Jinnah International Hospital, Abbottabad for duration of 10 months from January to October, 2021. Methods: Total ninety pregnant women of ages 18- 35 years were presented in this study. All the presented women had pandemic disease COVID-19. Women had first and second trimester pregnancies. Patients’ age, body mass index, parity, education status, socio-economic status and residency were calculated after taking informed written consent. Chi square and t-test was performed to differentiate between symptomatic and asymptomatic cases. Outcomes were assessed in terms of stress, depression among mothers and low birth weight of infants, perinatal death, preterm delivery, and C-section. Data was analyzed by SPSS 23.0 version. Results: Among 90 pregnant women 40 (44.4%) patients had first trimester pregnancies and 50 (55.6%) females had second trimester pregnancies. Mean age of the patients was 29.16±6.34 years and had mean BMI 22.13±5.16 kg/m2. Majority of the patients 52 (57.8%) had parity primipara. 44 (48.9%) patients were educated and majority of the patients were financially weak 62 (68.9%). 55 (61.1%) females were from urban areas. 54 (60%) females were symptomatic and 36 (40%) were asymptomatic. Frequency of depression among females was 68 (75.6%) and depression was found in 61 (67.8%) cases. Low birth weight was found in 22 (24.4%) cases, prevalence of preterm delivery was among 38 (42.2%) cases, number of C-section among cases was 47 (52.2%). Perinatal death was found in 7 (7.8%) cases. Majority of the patients with infants were instantly discharged after delivery 75 (83.3%) and 8 patients were admitted because of severity of pandemic disease. Conclusion: We determined in this study that Covid-19 among females with trimester first and second pregnancies were highly affected and had severity of psychotic disorders at start of disease but had lower adverse outcomes with low perinatal mortality. Majority of the females were recovered and discharged safely after delivery. Keywords: Pregnancy, Trimester, C-section, Coronavirus, Outcomes

Aim: To evaluate factors that are associated with re-laparotomy after cesarean section. Study design: Retrospective study Place and Duration: This study was conducted at Sheikh Zaid Hospital Quetta, Bolan Medical Complex Hospital Quetta, Jinnah Medical and Dental College karachi, Sandeman Provincial Hospital Quetta, Mekran Medical College Teaching Hospital Turbat Kech, Pakistan from the year 2019 to 2021 Methodology: For this research interview sessions with patients were conducted. Clinical examinations were done and Bed Head ticket (BHT) was used for examining the medical history of patients. All the information related to age, parity, indications of caesarian section, and gestational age were observed including time interval of re-laparotomy from caesarian section. Furthermore, information related to clinical features of re-laparotomy, duration of re-laparotomy, and outcomes were also kept for statistical analysis. Results: Over two years, we observed 22192 cases of caesarian deliveries. Out of these 37 emergency caesarian required re-laparotomy procedure. We observed non-progress of labor as a major indication of LUCS in the primary caesarian section comprised of 21.62% of cases. Another dominion indication of the caesarian section was reported as CPD (5.40%), meconium stained liquor (MSL) with Bradycardia (10.81%), and PROM in 10.81% of cases. Rectus sheath hematoma was a major indication of re-laparotomy in 29.7% of cases while 27.02% of cases in our study reported peritoneal hemorrhage. Conclusion: Findings of our study revealed that unnecessary usage of caesarian surgery on patient leads to severe complications resulting in re-laparotomy. Factors like rectus sheath hematoma, Intra-peritoneal hemorrhage and abscess are the dominant reasons for re-laparotomy. Keywords: Caesarian section, Gynecology, Re-laparotomy