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Objectives: The aim of our study is to determine the effectiveness of uterinemassage with active management and compare it with active management alone, in primarypostpartum hemorrhage prevention. Study Design: Randomized control trial. Period: 8months from September 2014 to April 2015. Setting: Tertiary Care Hospital in Karachi, Pakistan.Method: The study population consists of n=118 patients, both emergency and elected cases,who came to the gynecology and obstetrics ward at our hospital. The patient population wasdivided into two groups, group I received active management of labor ( third stage ) while groupII received active management of labor (third stage) in addition to the uterine massage (for a 2hrduration), the outcome was measured by measuring the amount of blood loss and the need foruterotonic agents. A p value of less than 0.05 was considered significant. Results: The studypopulation consisted of n=118 patients, undergoing spontaneous labor, and divided into twogroups, the mean blood loss in group I (control group) was 211.4mls and in group II (massagegroup) was 167.8mls (p value= 0.015). In group I n=15 patients required additional uterotonicsupport, while in group II only n=3 patients required it (p value= 0.00058). Conclusion:According to the results of our study, uterine massage in addition to the active managementof labor reduces post-partum hemorrhage, and it also reduces the requirement for additionaluterotonic agents for the control of hemorrhage.

ABSTRACT… Objectives:The aim of our study is to compare the efficacies of Pap smear cytology, colposcopy and histopathology, in diagnosis of cervical diseases. Study Design: Cross sectional cohort study. Period: One year from June 2013 to June 2014. Setting: Tertiary care hospital in Karachi, Pakistan. Method: The patient population n=145 consisted of women ranging from age 18 to 80 years old, who had come to the outpatient clinics for a variety of symptoms. Pap smear, colposcopy and histopathology was done for women who had symptoms like recurrent vaginal discharge, postcoital bleeding and other diseases of the cervix. Findings were noted on a proforma and all the patients signed a duly informed consent. Data was analyzed using SPSS version 23. Results: The mean age was 45 +/-9 years (between 24 -75 years), the parity was 5 +/-4, normal colposcopy findings were found in n= 66 women, while abnormal findings were found in n=79 women. In the abnormal colposcopic finding group n=63 had abnormal histopathology (p<0.001) abnormal histopathology was found in n=11 women who had normal colposcopic findings (16.67% false negative), the calculated sensitivity and specificity of colposcopy was determined to be 86% and 79%. For pap smear abnormality was found in n= 49 patients, out of which n=29 had abnormal findings on histopathology as well. And for colposcopy and pap smear out of n= 78 patients who had abnormal colposcopic findings, abnormal pap smear was found in only n= 28 patients. And out of those who had normal colposcopy n= 67, n= 21 had abnormal pap smear (False positivity of 31.34%) similarly out of those who had normal pap smear n= 96, n= 44 had abnormal histopathology (false negativity of 45.83%). The calculated sensitivity and specificity of pap smear was 38.8% and 71.8% respectively. Conclusion: We have concluded that there is a strong correlation between findings of colposcopy and histopathological diagnosis, but when it comes to the diagnosis made by pap smear and colposcopy and pap smear and histopathology the correlation is weak and not consistent. Key words:Pap smear, colposcopy, histopathology, cervix, correlation, cancer. Article Citation: Lakhwani MB, Yasir R, Amjad A, Ali Z. Cervical diseases; to compare the efficacies of pap smear cytology, colposcopy and histopathology, in gynaecological diagnosis.

Objectives: The aim of our study is to compare the efficacies of Pap smearcytology, colposcopy and histopathology, in diagnosis of cervical diseases. Study Design:Cross sectional cohort study. Period: One year from June 2013 to June 2014. Setting:Tertiary care hospital in Karachi, Pakistan. Method: The patient population n=145 consistedof women ranging from age 18 to 80 years old, who had come to the outpatient clinics for avariety of symptoms. Pap smear, colposcopy and histopathology was done for women who hadsymptoms like recurrent vaginal discharge, postcoital bleeding and other diseases of the cervix.Findings were noted on a proforma and all the patients signed a duly informed consent. Datawas analyzed using SPSS version 23. Results: The mean age was 45 +/- 9 years (between24 – 75 years), the parity was 5 +/- 4, normal colposcopy findings were found in n= 66 women,while abnormal findings were found in n=79 women. In the abnormal colposcopic finding groupn=63 had abnormal histopathology (p<0.001) abnormal histopathology was found in n=11women who had normal colposcopic findings (16.67% false negative), the calculated sensitivityand specificity of colposcopy was determined to be 86% and 79%. For pap smear abnormalitywas found in n= 49 patients, out of which n=29 had abnormal findings on histopathology aswell. And for colposcopy and pap smear out of n= 78 patients who had abnormal colposcopicfindings, abnormal pap smear was found in only n= 28 patients. And out of those who hadnormal colposcopy n= 67, n= 21 had abnormal pap smear (False positivity of 31.34%) similarlyout of those who had normal pap smear n= 96, n= 44 had abnormal histopathology (falsenegativity of 45.83%). The calculated sensitivity and specificity of pap smear was 38.8% and71.8% respectively. Conclusion: We have concluded that there is a strong correlation betweenfindings of colposcopy and histopathological diagnosis, but when it comes to the diagnosismade by pap smear and colposcopy and pap smear and histopathology the correlation is weakand not consistent.