Cleansing the birth canal with chlorhexidine 0.25% wipes prior to elective CS appears to be effective in reducing rates of post-CS infectious morbidity mainly endometritis.

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Background:Infertility is defined as inability of couple to conceive after one year of unprotected intercourse. The prevalence of infertility in Pakistan is 21.9%. The most common cause of medically treatable infertility is polycystic ovarian syndrome (PCO). This study was conducted to see the frequency and outcome of treatment in PCOs related infertility in infertile couples coming to Mohammad Medical College Hospital, Mirpurkhas, Sindh.Methods:This prospective observational study was conducted at Muhammad Medical College for three years from 2005 to 2008. Total 1289 infertile couples were included in this study.Result:The frequency of PCOs in female related infertility was 38.5%. Other causes of female infertility were in the frequency of 44% pelvic inflammatory disease, 12.3% endometriosis, 2.9% hyperprolactenemia, and 1.35% hypothyroidism. Patients with PCOS were given different treatment modalities. One hundred fifty patients with PCO were given ovulation induction with clomephene citrate and out of them 109 (72%) conceived. Sixty three women were given combination of clomephene citrate and Metformin. Out of them 50 (79%) conceived. Five patients were given gonadotrophins, Out of them 2 (40%) patients conceived. Five patients had laparoscopic drilling out of them 3 (60%) conceived.Conclusion:In contrast to the literature review Polycystic Ovarian Syndrome turned out to be the second most common cause of female related infertility. But as the international literature shows it had very good out come after medical and /or surgical treatment.

Objective: to determine the association of test anxiety on OSCE performance of medical students in Taif Medical College. Study Design: The survey research design was used to conduct the research. Place and Duration of study: This was a comparative cross sectional study conducted on the 3rd, 4thand 5th year medical students in Taif Medical College of Taif University KSA. Materials & Methods: A ten item questionnaire developed by Nist and Diehl (1990) for determining mild or severe levels of TA experienced by students was used in the study. Results: A total of 518 students participated in the survey. The majority of the sample population was male 319 (61%) and 199 (39%) were females. Our results showed that a greater proportion (21%) of the male students, as compared to their counterparts, were in the group having high level of anxiety during test. It was observed that the 3rd year students performed poorly on TA and scored high on the scale. The difference observed in proportions was also statistically significant (Chi square 65.97, p value 0.000001). There was a significant negative correlation between the test anxiety and students performance in oral structured examination (OSCE). Pearson correlation coefficient of -0.45 and a p value < 0.0001 was observed. Conclusion: We conclude that test anxiety is experienced by a large number of undergraduate medical students of Taif Medical University. Anxiety has a negative effect on overall academic performance; female students were also more affected compared to their male counterparts. Key Words: Test anxiety, gender, medical students, academic performance

Introduction: Ante partum hemorrhage is defined as any vaginal bleeding from the 24 th week of gestation till delivery. The number of cases of placenta previa and placenta accrete are increasing with the increasing caesarean section rate.Ante-partum hemorrhage is an important cause of maternal and fetal morbidity and mortality, despite modern improvement in obstetric practice and transfusion service. Placenta previa has been well documented to be associated with adverse maternal outcomes as well as neonatal outcomes. The indication for emergency peripartum hysterectomy in recent years has been changed from traditional uterine atony to abnormal placental implantation. The incidenceplacenta previais on rise because of the increasing rate of caesarean section being performed, and a trend of child bearing at a later age among the women , with the sametime the dangerous complication placentaaccreta which is associated with placenta previa and prior caesarean deliveries has also been increased in frequency 16. Material and Methods: This retrospective study was designed to see the incidence of placenta previa , ultrasound finding, management and maternal outcome in women suffering from placenta previa .in region of Taifkingdom of Saudi Arabia. Result: In two year total no of deliveries was 17757 out of that 213 was cases of placenta previa that makes the 1.19 % of placenta previa out of total deliveries .Out of 5498 L.S.C.S, 213 cases were because of placenta previa which make about 3.8 %.out of 213 lscs 62 cases were done in emergency (29.1%).and 151 was done as elective cases(70.8). as far as age women's were concerned highest percentage of placenta previa was seen in age group of 31-36 years (35.2%) followed by age group of 26-30years (26.2%..Out of 213 women of placenta previa 144 (67.74%)women suffered from antepartum hemorrhage from moderate to severe bleeding .All women had lower segment caesarean section as mode of delivery whether in emergency or as an elective procedure dependent upon amount of bleeding ,gestational age and condition of mother. All patent had ultrasound done to confirm the localization of placenta and to exclude placenta accreeta or percreeta. 14 patient underwent bilateral uterine ligation and because of bleeding and severe nature of placental adherence out of 213 women 56 (26.29%) had caesarean hysterectomy and 6 patient received injuries to urinary tract in form of bladder injury or uretric injury which could be because of adhesion, excessive bleeding or difficult c/hysrectomy .By the bless of God there was no maternal death recorded in this period of study Conclusion: In summary, history of previous lower segment caesarean section were found to be associated increased rate of placenta previa and its severe form i.e. placenta accreta.It is also concluded that with good antenatal care we can pick patient who are at high risk of placenta previa and its related risk.

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Objective: To identify the efficacy of oral misoprostol (600 µg) for the management of missed abortion. Method: