<p><strong>Background and Objective:</strong> Vaginal delivery (VD) is the safest delivery option for the mother and is associated with quick recovery and minimal maternal morbidity and mortality. However, one of the commonest fears among women about VD is pain. This study aims to assess the effectiveness of diclofenac suppositories (per rectum) compared to the intramuscular diclofenac for the pain relief in females after VD.<br /><strong>Methods: </strong>This prospective comparative was study conducted at the Emergency Section (labor room) of Obstetrics &amp; Gynecology Department in one of the tertiary care teaching hospitals of Lahore, Pakistan. A total of 182 female patients undergoing VD were selected and further divided into group A and group B. Group A was administered rectal analgesia in the form of rectal suppositories (100 mg) immediately after perineal tear (first and second degree only) repair and repeated after 6 hours. While group B received one injection of intramuscular diclofenac, immediately after perineal tear repair. The pain score was measured on a graphical score using Graphic Rating Scale, immediately at rest, during movement, and during urination. The pain score was reassessed after 6 hours with the same parameters and compared between both groups.<br /><strong>Results:</strong> The overall pain score was significantly lower immediately (p = 0.004) and 6 hours (p = 0.002) after VD in group A at rest, during movement, and during urination as compared to group B.<br /><strong>Conclusion:</strong> The use of rectal diclofenac suppositories is a simpler and more effective and acceptable method of reducing the pain experienced by the women following perineal trauma after vaginal childbirth.</p>

<p><strong>Background and Objective:</strong></p> <p>Domestic violence has been identified as a very serious problem that affects women and children at all levels of society, regardless of race, financial status, religion, and level of education. Domestic violence in Pakistan is a very sensitive issue keeping in mind the psychological, religious, and social aspects. The aim of the study was to assess the level of knowledge and perception about domestic violence amongst gynecologists working in the tertiary care teaching hospitals of Lahore city, Pakistan.</p> <p><strong>Methods:</strong></p> <p>It was a cross-sectional survey study carried out among the doctors working in the Gynecology departments in different tertiary care teaching hospitals of Lahore. A total of 154 doctors of the Gynecology departments participated in this study.</p> <p><strong>Results:</strong></p> <p>Most of the participants (53.4%) had suboptimal knowledge regarding the screening tools for domestic violence against the women reporting in Gyneacology clinics. A significant association was found between awareness regarding domestic violence and an agreement for introducing a formal training course (P&lt;0.05). &nbsp;</p> <p><strong>Conclusion:</strong></p> <p>The knowledge and perception of health care providers to screen the cases of domestic violence is the basic key to identify such victims. However, a proper training of the staff handling such patients needs to be implemented at Government level.</p>

Misoprostol and oxytocin are two common medications used to prevent PPH and other pregnancy related complications, particularly in pregnancy loss. Both of these drugs can be administered through different routes and have different effectiveness. So this study was done to compare the effectiveness of these drugs. Objective: To compare the outcome of rectally administered misoprostol and oxytocin infusion for management of 3rd stage of labour in 2nd trimester pregnancy loss. Material & Methods: The randomized control trial was conducted at department of Obstetrics and Gynaecology, Lady Willingdon Hospital, Lahore. Then patients were randomly divided into two groups by using lottery method. In group A, 600 μg tablets of misoprostol was used rectally at the time of delivery of foetus. In group B, 20 IU of oxytocin was given I/V infusion at the time of delivery of foetus. For comparison independent sample t-test was used to compare blood loss in both study groups. P-value<0.05 was taken as significant. Results: In our study the mean age of the patients was 27.35±6.35 years and the mean gestational age was 18.21±3.95 weeks, the mean blood loss was 369.28±87.26 ml. Retained placenta was observed in 48(17.1%) patients and the PPH was found in 15% patients. Statistically there is significant difference was observed between the study groups and retained placenta of the patients i.e. p-value=0.011. Conclusion: The results of our study concluded that the use of misoprostol is an effective and feasible drug in blood loss, PPH and Retained placenta as compared to oxytocin drug in the managmenet of 3rd stage of labour in 2nd trimester pregnancy loss

Background Polycystic ovary syndrome (PCOS) is a significant gynecological problem manifested by raised androgen level, menstrual irregularities, and/or one or both ovaries having small cysts. Metformin has shown to have promising effects on PCOS and its several metabolic aspects. The metformin used as therapy in these patients during pregnancy have beneficial effects regarding development of GDM. Objective To determine the frequency of efficacy of metformin in pregnant female with PCOS with regards to development of Gestational Diabetes Mellitus Material and methods Setting: The study was conducted in Jinnah Hospital, Lahore Study design: Descriptive cross sectional study Study duration: Six months from: 04-06-2018 to 04-12-2018 Data collection procedure: A total of 220 cases fulfilled the inclusion/exclusion criteria were enrolled. All cases were followed up till delivery for presence/absence of GDM. The frequency of efficacy in patients with PCOS was noted; all this information was recorded on a pre-designed proforma. Data was entered and analyzed in SPSS version for 16.0. Results The mean age of patients was 30.50±6.08years. About 36 (16.4%) females had parity 0, 51 (23.2%) had parity 1, 59 (26.8%) had parity 2, 42 (19.1%) had parity 3 and 32 (14.6%) had parity 4. The mean BMI of patients was 26.81±4.55kg/m2. Efficacy of metformin was achieved in 190 (86.4%) cases while in 30 (13.6%) cases efficacy could not be achieved. Conclusion It has been inferenced that metformin is effective in 86.4% cases in controlling blood sugar level among pregnant females.