Predictors of Contraceptive practice in married women of Punjab, Pakistan.

Objective: Pakistan is the sixth most populous country in the world. Current contraceptive use in Pakistan is only 26% despite being one of the leading countries in Asia to launch National family planning programs. Major constraint of acceptability among women is the lack of awareness and implementation of contraceptive methods. The objective of this study was to explore the reasons behind this behavior. Methods: A cross-sectional survey was conducted with non-probability convenient sampling with sample size of 400 married women attending Fazle-Omar Hospital, Chenab Nagar, Punjab, having age between 15 to 60 years from August 2019 to February 2020. To assess the awareness of respondents about contraception, a questionnaire was made after testing its internal consistency. Data was analyzed via SPSS-21; nominal data was expressed as frequencies and percentages, quantitative as mean and standard deviation. Binary logistic regression analysis was carried out to determine predictors for contraception practice. P-value < 0.05 was considered significant. Results: Our respondents mean age was 30.73±5.9 years. Majority of responders (65%) were educated and (61%) belonged to low socio-economic class. Mean awareness score was 65 ± 26. Out of 400 respondents, 260 (65%) were practicing contraception. Relatives and media were major sources of awareness while clinics and LHVs were contributing less. Condom was the most practiced method of contraception. Low socio-economic class, increase number of kids, responders' education and awareness score were the predictors of contraception practice. Conclusion: The education of women and awareness score are independent predictors of contraceptive practice in women. Hence by educating mothers and increasing awareness through various means, practice of contraception can be increased. There is much room to improve the working of family health clinics and LHV.

Efficacy of linking Breast Awareness Clinics in Gynecology and Obstetrics departments: A pilot project in Zubaida Bani Wing, Fazle-Omar Hospital, Chenab Nagar, Pakistan.

Objectives: Pakistani female population has the highest incidence of Breast cancer among the women belonging to all other Asian countries. This contributed to 28.7% of all new cases of malignancies in 2020 and is also the cause of uppermost cancer mortality in Pakistani females. The number of deaths can be reduced by promoting breast cancer screening, according to recommended programs for high-risk populations. Methods: In order to encourage breast self-examination in women, 12 Breast Cancer Awareness Clinics were set up in Gynecology and Obstetrics outdoor, Zubaida Bani Wing, Fazle Omar Hospital, Chenab Nagar, Pakistan, from September 2019 to February 2020. A total of 238 women with a mean of 29.97±8.9 years were examined and trained to perform the breast self-examination. Results: Around 41% of 222 valid responded women reported that they had knowledge that breast cancer is the major threat to their health in Pakistan. Only 20% were aware of breast cancer screening but poor cognizance about the recommendations for Pakistani women. Knowledge about Breast Self-Examination was recorded in 15 %, whereas only 5.4 % of all the women included in the present study reported to practice it. Moreover, eighty-six percent of the respondents were reported to be hesitant to visit the male doctor. Three cases of most suspected malignancies were referred to specialist consultants and few cases were endorsed for immediate mammograms. Conclusion: Setting up breast awareness and screening clinics at gynecology outdoors with trained female assistants can be effective in promoting Breast Self-Examination and elaborating screening programs countywide to obtain long term benefits in a high-risk population of Pakistan.

Homozygous mutation in the NPHP3 gene causing foetal nephronophthisis.

We present a case of a foetal sonographic finding of hyper-echogenic kidneys, which led to a strategic series of genetic tests and identified a homozygous mutation (c.424C > T, p. R142*) in the NPHP3 gene. Our study provides a rare presentation of NPHP3-related ciliopathy and adds to the mutation spectrum of the gene, being the first one from Pakistani population. With a thorough literature review, it also advocates for molecular assessment of ciliopathies to improve risk estimate for future pregnancies, and identify predisposed asymptomatic carriers.