The analgesic efficacy of ultrasound-guided transversus abdominis plane block vs. local anesthetic infiltration technique in major gynecologic surgery: A randomized controlled trial.

Background And Aim: Transversus abdominis plane (TAP) block and local anesthetic infiltration (LAI) technique are used as part of the multimodal analgesic regimen after abdominal surgery. Postoperative opioid consumption and analgesic efficacy was compared using TAP and LAI techniques in patients undergoing gynecologic surgery in a randomized, controlled clinical trial.

Material And Methods: Total of 135 patients scheduled for major gynecological surgeries were allocated into three groups: group T received bilateral TAP block with bupivacaine 0.

Pyridoxine (vitamin B6) supplementation during pregnancy or labour for maternal and neonatal outcomes.

Background: Vitamin B6 plays vital roles in numerous metabolic processes in the human body, such as nervous system development and functioning. It has been associated with some benefits in non-randomised studies, such as higher Apgar scores, higher birthweights, and reduced incidence of pre-eclampsia and preterm birth. Recent studies also suggest a protection against certain congenital malformations.

Maternal genital tract colonisation by group-B streptococcus: a hospital based study.

Objectives: To determine the prevalence of Group B Streptococcus genital tract infection in pregnant women and to determine the risk factors for its colonisation.

Methods: The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi and Sobhraj Hospital, Karachi, from May to August 2007. Pregnant women at 35-37 weeks gestation attending antenatal clinic at these hospitals constituted the study population.

A Review of Comparison of Complications of Vaginal Hysterectomy with and without Concomitant Surgery for SUI: A 5 Years' Experience at a Tertiary Care Hospital of Pakistan.

Objective. The study was performed to review the complications of surgery for POP with or without surgery for SUI. This included the need for second procedure two years after the primary surgery.

Administration of misoprostol by trained traditional birth attendants to prevent postpartum haemorrhage in homebirths in Pakistan: a randomised placebo-controlled trial.

Objective: to determine if misoprostol is safe and efficacious in preventing postpartum haemorrhage (PPH) when administered by trained traditional birth attendants (TBA) at home deliveries.

Design: a randomised, double-blind, placebo-controlled trial.

Setting: Chitral, Khyber Pakhtunkhwa Province, Pakistan.

Misoprostol in addition to routine treatment of postpartum hemorrhage: a hospital-based randomized-controlled trial in Karachi, Pakistan.

Background: Postpartum hemorrhage (PPH) remains a major killer of women worldwide. Standard uterotonic treatments used to control postpartum bleeding do not always work and are not always available. Misoprostol's potential as a treatment option for PPH is increasingly known, but its use remains ad hoc and available evidence does not support the safety or efficacy of one particular regimen.

Women's health in developing countries.

Healthcare priorities are different in developing and developed countries. A more effective resource allocation, complemented by efforts to implement only those practices that are effective, should be a priority for improving reproductive health services in developing countries. A large burden of gynaecological disease exists in developing countries and it is difficult to envisage serious reforms and improvements without an increase in public-sector spending.

Massive primary postpartum haemorrhage: setting up standards of care.

Objective: To review practice of massive primary postpartum haemorrhage management and develop a protocol.

Methods: Cross-sectional study conducted at the Department of Obstetrics and Gynaecology at Aga Khan University Hospital, Karachi between January 1, 2003 and July 31, 2004. Women with primary postpartum haemorrhage and had blood loss > or = 1000ml were included in the study.

Assisted reproductive technology : experience with IVF/ICSI.

Objective: To analyze success rates of assisted reproduction techniques ART (IVF/ICSI) in couples experiencing subfertility, and factors which may help in predicting treatment outcome.

Design: A prospective cohort follow-up study.

Place And Duration Of Study: Study was conducted at Concept Fertility Centre, Karachi, between July 1, 2000 and December 31, 2002.

Critical appraisal of endometriosis management for pain and subfertility.

Objective: To critically appraise current best available management of pain and subfertility ascribable to endometriosis.

Methods: Medline and specialist computer databases were searched along with reference lists of known reviews and primary articles to identify cited articles not captured by electronic searches. We included all studies pertaining to treatment of pain and subfertility ascribable to endometriosis.

Increased risk of cervical canal infections with intracervical Foley catheter.

Objective: To evaluate the effect of intracervical Foley catheter insertion, for the induction of labor, on cervical canal infection.

Design: A prospective interventional study with paired analysis.

Place And Duration Of Study: The study was conducted in the department of Obstetrics and Gynecology at the Aga Khan University, Karachi, between June 1 and August 31, 2002.

Clinical governance in the management of induction of labour.

Objective: To determine whether dissemination of explicit guidelines, developed in consensus with stakeholders, for the processes of induction of labour (IOL), results in reduction of variability in clinical practice.

Design: A prospective behaviour modification interventional study.

Place And Duration Of Study: The study was conducted in the department of Obstetrics and Gynaecology at the Aga Khan University, Karachi, between January 1 and August 31, 2002.

Uterine atony at a tertiary care hospital in Pakistan: a risk factor analysis.

Objectives: To identify risk factors for uterine atony following assisted or unassisted vaginal delivery.

Design: This hospital based case control study was done at The Aga Khan University Karachi, Pakistan. Cases were defined as all women with uterine atony within 24 hours of an assisted or unassisted vaginal delivery.

Effect of prepregnancy body mass index and gestational weight gain on birth weight.

Objective: Nutritional status of women has been considered an important prognostic indicator of birth outcome. The study aims to show the effect of various prepregnancy Body Mass Index (BMI) categories and corresponding gestational weight gain on newborn birth weight.

Methods: Two hundred women were included in the study.

A comparison of severe pre-eclampsia/eclampsia in patients with and without HELLP syndrome.

Background: The relationship of Haemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) syndrome with maternal and perinatal health and its presentation in Pakistani population is not known.

Purpose: To determine the mode of presentation along with maternal and perinatal outcome of patients with HELLP syndrome.

Methods: Case records of patients with severe hypertension in pregnancy who delivered between January 1, 1989 and December 31, 1994 at The Aga Khan University Hospital, Karachi.