Background: To compare the effectiveness of postpartum intrauterine contraceptive device (PPIUCD) with interval IUCD in terms of effectiveness, expulsions, bleeding pain and other complications at Tertiary care Hospital.Methods: Current study was conducted among 224 women, at Gynaecology and Obstetrics of Reproductive Health Services-A (RHS-A) Centre of Jinnah Post Graduate Medical center, Karachi, for a period of Six months. Approval from Ethical committee and informed consent was taken from women and her husband before starting the study. The WHO medical eligibility criteria for contraceptive use (MEC) were followed and IUCD was inserted in 112 women in PPIUCD group and in 112 women in interval IUCD group. These cases were followed at 15 days, 6 weeks and 6 months. Results of PPIUCD group were compared with interval IUCDs group. Data was analyzed by using SPSS version 18.0. Continuous variables like age, parity, hemoglobin level were analyzed as mean±standard deviation. Frequencies and percentages were calculated for infection, expulsion, bleeding per vagina and effectiveness. Chi-square was applied to assess the difference between the categories. p value <0.05 was taken as significant.Results: The two groups were identical in mean ± SD age, parity, residence and baseline hemoglobin level. PPIUCD (Group-A) was more effective i.e., 87.5% as compared to interval IUCD (Group-B) i.e., 83.9%. Pain, PID, bleeding and expulsion of IUCD were more prevalent with interval IUCD (Group-B) than PPIUCD (Group-A) patients. Stratified analysis showed that age, parity & mean baseline hemoglobin were non-significant effect modifiers on the effectiveness among the two groups.Conclusions: Postpartum IUCD use was found to be a safe, simple, inexpensive and reversible procedure with higher chances of retention for a longer period. Additionally, there is decreased risk of complications and lower expulsion rates when compared with interval IUCD.

Background: Most of the complications are developed after modified radical mastectomy in breast cancer patients, hence to avoid and reduces the postoperative complications, this study is performed to identify the frequency of early post-operative complications of modified Radical Mastectomy within the period of four weeks.Methods: Cross-sectional case series using non-probability convenient sampling technique was conducted in surgical unit I of Tertiary care hospital, for 1 year from 15 January 2018 to 14 January 2019. 89 patients FNAC proved breast cancer were included, patients that received neoadjuvant chemo or radiotherapy or with inflammatory breast cancer, metastasis and with co-morbid were excluded. After taking consent patients were operated by senior consultant. Follow up was taken daily 7th post-operative day and then followed in OPD on weekly basis fourth week and final outcome was noted. SPSS version 23 was used for data analysis. Quantitative data was reported as frequency in percentages.Results: Total 31 patients developed complications during the study, accounts 34% of total patients. The most common complication was breast seroma in 12(13.48%) of cases with an increased risk in cases of age >50 yr, size of tumor >8 cm, weight >70 kg and increased number of lymph nodes [3 or above] palpable after wards hematoma in 6(6.74%), lymphedema in 5(5.62%), wound infection 4(4.49%) and shoulder dysfunction in 4(4.49%) patients, no patient was found scar hypertrophy.Conclusions: Seroma formation, hematoma were found most common early complications after modified radical mastectomy, lymphedema, wound infection and shoulder dysfunction were observed in small number of patients.

Objectives: To determine the status of ALK immunostaining in female breast cancer and to find out the relationship of ALK expression with clinicopathological variables. Study Design: Cross Sectional study. Setting: Department of Pathology Al Tibri Medical College and Hospital Karachi and BMSI Jinnah Post Graduate Medical Centre, Karachi. Period: October 2016 to March 2017. Material & Methods: Total of 110 female cases with breast carcinoma by using non-probability purposive sampling technique. After taking informed consent from the patients, tissue samples were taken from received specimen of mastectomy for hematoxylin and eosin stain. The immunohistochemistry for ALK was assessed by using a DAKO monoclonal antibody using the paraffin embedded blocks of the diagnosed cases of breast carcinoma. Chi square test was used to find out the significance of differences among the variables. Results: Total of 110 cases with different histological classifications of breast cancer were observed i-e invasive ductal carcinoma 95(86%), invasive lobular carcinoma 9(8%), invasive medullary carcinoma 4(3.6%) and papillary carcinoma 2(1.8%). ALK expression was positive in 71(64%) and negative in 39 (35%) patients. Significant association was observed between ALK expression with histological grade (p=0.003), lymph node involvement (p=0.042) and skin involvement (p=0.025). Conclusion: Present study shows higher positive ALK expressions. Present study also indicates significant relationship of ALK with histological grade, lymph node involvement and skin involvement.

Background: Diabetes, hypertension, oxidative stress, obesity, adipocytokine dysfunction, and dyslipidemia are causative factors in development of Chronic Kidney Disease (CKD). Adiponectin secreted from adipose tissue, has Reno protective effect against development of albuminuria in animal studies. The previous studies investigated the relationship between serum adiponectin level and urinary albuminuria in kidney disease patients, but the results are conflicting.Methods: The pre diagnosed kidney disease patients were divided into microalbuminuria and macroalbuminuria groups, while control subjects were called as normoal buminuria group. The pre diagnosed adult kidney disease patients of both genders with age matching control subjects with no known comorbidity were included in the study. Whereas pregnant female patients and the patients with comorbidity were excluded from the study. The demographic data and the anthropometric data of control and kidney patients were recorded. The blood was analyzed for Glycosylated Hemoglobin (HbA1c), electrolytes, glucose, calcium, total protein, albumin, urea, creatinine adiponectin and malondialdehyde. The Urine was analyzed for Creatinine and albuminuria. The glomerular filtration rate was estimated.Results: The blood pressure, blood urea, creatinine, glycated hemoglobin, malondialdehyde, adiponectin levels were higher in albuminuric kidney patients as compared to normal control subjects. The mean glomerular filtration rate was lowest in macroalbuminuric patients as compared to micro and normoalbuminuric patients. The serum adiponectin and serum malondialdehyde both showed positive correlation with serum creatinine, and with albuminuria/urinary creatinine ratio.Conclusions: The study concludes that, positive correlation of serum malondialdehyde with adiponectin and albuminuria.

The transsexual phenomenon has been mentioned from time to time in recorded history. Indian mythology has in it, many references to altered sexual states 1 • The name Ardhanarishwara refers to God, who is half man and half woman, an androgynous deity. In various versions of Ramayana, there is reference to King Ila,who spent half his life as man and half as woman. In Mahabharata, Arjuna,one of the fiercest warriors of his time, spent a year of his life in intersexed condition. There is also reference to King Bangasvana, who was changed into a woman by Lord Indra, whom he had offended. Another reference