Objective:To observe the pre-Ramadan health seeking behavior, fasting trends, eating pattern and, sleep cycle in pregnant women.Methods:It is a cross-sectional observational study, from July to September 2017, conducted at Tertiary Care Hospital in Karachi. The tool used for data collection was interviewer based closed ended questionnaire, 279 pregnant women who fasted during Ramadan were included in the study.Results:One to ten days of fasting was observed by 85.7% (198) of women. About 72.4% (202) never consulted any doctor for pre-Ramadan advice regarding fasting in pregnancy. Pregnant women 81.7% (228) believed that fasting would not cause any harm to their unborn child, while 42.7% (119) of family members feared about the health of mother and unborn child. Seventy four percent (208) of respondents had a reduced sleep cycle of about 3-4 hours. The food items consumed at Sehri and Iftar were rich in carbohydrates and fats.Conclusions:Pre-Ramadan medical consultation regarding safety of fasting during pregnancy should be structured and customized for women and their families. Gaps in knowledge identified in this study may help healthcare professionals to address these issues.

Objectives: Female sexual dysfunction (FSD) with chronic diseases such as diabetes has received little attention globally. The aim of this study is to assess the frequency of sexual dysfunction (SD) in women with diabetes; an aspect of female health that has not been explored in our population. Materials and Methods: This cross-sectional observational study using non-probability convenient purposive sampling technique was carried out at three health facilities of Karachi, for a duration of 1 year. One hundred women with diabetes who consented to participate in the study were included. Pregnant, divorced, widowed, and unmarried females were excluded. Modified female sexual function index (FSFI) was used to gather information. Results: Out of 100 women, 88 women with diabetes completed the interviewer-based modified FSFI survey questionnaire. Among 88 women, 38 (43.2%) reported to have SD, whereas 50 (56.8%) were found to have no significant sexual issues. Partner's age and occupation were significantly associated with FSD. All parameters of modified FSFI, i.e., sexual desire, arousal, lubrication, orgasm, and dyspareunia, were significantly associated (P < 0.001) with diabetes. Conclusion: Women with diabetes are at increased risk of SD and often do not volunteer information about their sexual issues. The most common cause of SD was dyspareunia, followed by lubrication, orgasm, lack of sexual arousal, and sexual desire. The healthcare providers should be aware to initiate and facilitate the discussion and need to develop their own comfort to talk about sexual issues.

Objectives: To compare the reliability of non-fasting oral glucose tolerance test (OGTT) versus fasting OGTT for screening of hyperglycaemia in pregnancy (HIP). Methods: This cross sectional analytic study was conducted by the Department of Obstetrics & Gynaecology, Isra University Karachi Campus from October 2016 to April 2017. A total of 225 pregnant women irrespective of gestational age were included in the study. They underwent non fasting 75 grams OGTT. Venous plasma glucose was done 02 hours after the glucose load. Same women were advised to come again within three to seven days for fasting OGTT. Venous plasma glucose (VPG) was estimated in fasting and 2 hours post glucose load. Results: Using the non-fasting OGTT, out of 204 women, 32 were diagnosed with hyperglycemia. All these 204 women were again called for fasting OGTT three to seven days after the initial non-fasting OGTT. Only nine were diagnosed with hyperglycemia, out of these nine women, seven women who were screen positive on non-fasting OGTT were found to be screen positive on fasting OGTT as well. However, only two women were additionally diagnosed with hyperglycemia who were initially screen negative on non-fasting OGTT. The non-fasting OGTT has diagnosed HIP with sensitivity of 77.7%, specificity of 87.1%, positive predictive value of 21.8% and negative predictive value of 98.8%. Conclusion: The use of the non-fasting OGTT at first antenatal visit may be a practical approach to detect the HIP as screening and diagnostic tool in the resource constrained settings. doi: https://doi.org/10.12669/pjms.37.4.3979 How to cite this:Masood SN, Lakho N, Saeed S, Masood Y. Non-fasting OGTT versus Fasting OGTT for screening of Hyperglycaemia in Pregnancy (HIP). Pak J Med Sci. 2021;37(4):1008-1013. doi: https://doi.org/10.12669/pjms.37.4.3979 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To determine the frequency of repeat caesarean sections among women presenting at the tertiary care Hospital. Subjects and Methods: This cross-sectional study was done at the Department of Obstetrics and Gynecology, Shaikh Zaid Women Hospital, SMBBMU Larkana. A total of 345 women older than 18 years with a history of at least one previous caesarean section regardless of gestational age or parity were included. After taking a clinical examination and history, the patients were evaluated according to the frequency of repeated caesarean sections. The data was controlled on a pre-designed proforma, and SPSS version 26 was used for the data analysis. Results: The average age of the patients was 25.83±4.15 years, average gestational age was 35.18+3.38 weeks; and the average parity was 2.09+0.35. Out of 345 cases, 28.7% were urban and 71.3% were rural resident. Most of the cases were booked. Out of all women, 57.1% were obese, and 51.59% had diabetes. The frequency of repeated caesarean sections was observed in 66.96% (231 out of 345) of the women. The frequency of the repeated caesarean sections with respect to maternal age and obesity was statistically significant (p-<0.05), while it was statistically insignificant according to gestational age, residency, booking status, and diabetes (p->0.05). Conclusion: In conclusion, the frequency of repeated caesarean sections was observed to be highly prevalent. Effective implementation of caesarean section reduction efforts may be influenced by the social and cultural context, as well as associated beliefs and behaviours. Keywords: Recurrent, Caesarean section, frequency

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