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Papers by Rubina Sohail

International journal of gynaecology and obstetrics, Jul 17, 2023

IAHS Medical Journal

not available IAHS Medical Journal Vol 5(1), June 2022; 1-2

International Journal of Gynecology & Obstetrics

Annals of King Edward Medical University, 2015

Introduction: Episiotomy is an incision through the perineum made to enlarge the diameter of th... more Introduction: Episiotomy is an incision through the perineum made to enlarge the diameter of the vulvae outlet and assist childbirth. As it is noted that long-term complications after episiotomy repair are com-mon so that I used vicryl which is polyglactin and it causes less tissue reaction and is absorbed by hydro-lysis in comparison of vicryl in comparison of vicryl rapide chromic catgut is manufactured from collagen and causes an inflammatory response into the tissues as it is broken down by proteolytic enzymes and pha-gocytosis. There is controversy in results which is bet-ter suture material. That is why we designed this study to compare vicryl rapide and chromic catgut. Objectives: The objective of my study is to compare the frequency of analgesia requirement in primigra-vidas undergoing episiotomy repair with Chromic Cat-gut versus Vicryl Rapide. Methodology: This study was conducted at the Depa-rtment of Obstetrics And Gynaecology, Unit-II, Servi-ces Institute of Medic...

SSRN Electronic Journal, 2022

Annals of King Edward Medical University, 2017

Although induced abortion is common in early pregnancy and termination of pregnancy but very rare... more Although induced abortion is common in early pregnancy and termination of pregnancy but very rarely after 2nd trimester. Retention of fetal bone after termination of pregnancy is an uncommon Gynecological condition which may be symptomatic. We present a case of 26 years old P0+1 presented in OPD with complaint of foul smelling vaginal discharge pain lower abdomen and urinary incontinence for 7months. She gave history of induced abortion at 7months of amenorrhea by dai after that she underwent a laparotomy due to abdominal distension and suspicion of intestinal obstruction by surgeon and pus was drained. But no obstruction was found after that she had complaint of vaginal discharge pain lower abdomen & incontinence. On examination abdomen soft non tender cervix not visualized 4x5 cm whitish colour foreign body impacted in cervical region. Uterus mobile normal size, 4x5cm irregular stony hard foreign body impacted in cervix and projecting laterally and anteriorly urine dribbling anter...

Address of Correspondence: Prof Rubina Sohail is Professor of Obstetrics & Gynaecology at Service... more Address of Correspondence: Prof Rubina Sohail is Professor of Obstetrics & Gynaecology at Services Institute of Medical Sciences, Lahore. She is President of South Asian Federation of Obstetricians & Gynaecologists. Email address - rubina95@gmail.com Pakistan has witnessed a rapid increase in population since independence in 1947. A country with a population of 33 million in 1947 has reached 207 million in 2017 – a massive population explosion.(1) Besides this, Pakistan, with the exception of Afghanistan has one of the highest fertility rates in the region with the growth rate of 1.89% and the lowest rate of contraceptive use. The high fertility rate and the rapidly increasing population has contributed in making Pakistan the sixth most populous country in the world after China, India, USA, Indonesia and Brazil - all of which are countries with a vast area. Comparing Pakistan’s 310,401square miles to 741,096 square miles of India and 3,286,470 of Brazil demonstrates the scarcity of ...

Pakistan’s latest estimated population is 207,774,520 (excluding autonomous regions Azad Kashmir ... more Pakistan’s latest estimated population is 207,774,520 (excluding autonomous regions Azad Kashmir and Gilgit). This makes Pakistan the fifth most populous country in the world, just behind Indonesia and slightly ahead of Brazil. Women form around half of the population of the country. Pakistan particularly struggles with high maternal mortality ratios, adolescent birth rates and unmet need for contraception. Pakistan has the third highest burden of maternal, fetal and child mortality globally. According to WHO, fertility is considerably higher in rural communities than in urban areas. On average, most rural women have 4 children. Contraceptive prevalence rate remains low at 35 per cent, meaning that most people are not using birth control methods. Even though 96 per cent of married Pakistani women are aware of at least one modern contraceptive method, but only 26% are using modern method of contraception. Major gaps remain at both service delivery and policy level, preventing adequat...

Ab s t r Ac t Aim: To apply the Robson Ten Group Classification System (TGCS) in major South Asia... more Ab s t r Ac t Aim: To apply the Robson Ten Group Classification System (TGCS) in major South Asian hospitals to begin making recommendations to optimize cesarean section (CS) rates. Materials and methods: This cross-sectional study was conducted from September 2018 to February 2019 at public sector hospitals in five South Asian countries. We analyzed the pooled data for all five hospitals. The data were then stratified by the study hospitals. We utilized a Pearson χ2 test to assess differences in CS by group. And p values <0.05 were considered statistically significant. Statistical analysis was performed using STATA 16. Results: A total of 37,251 women delivered in the five participating hospitals during the 6-month study period. Of these, 13,592 women were delivered by CS with a composite CS rate of 36% (range, 22–53%). Women in groups 1, 2, and 5 were the largest contributors to the overall CS rate in the participating hospitals. Statistically significant differences in CS rate...

Annals of King Edward Medical University, 2018

International Journal of Gynecology & Obstetrics

Ensuring universal access to sexual and reproductive healthcare services is Target 3.7 of the Uni... more Ensuring universal access to sexual and reproductive healthcare services is Target 3.7 of the United Nations Sustainable Development Goals (SDG). Refugee and migrant women and children are at particular risk of being forgotten in the global momentum to achieve this target. In this article we discuss the violations of sexual and reproductive health and rights (SRHR) of particular relevance to the refugee and migrant reality. We give contextspecific examples of denial of health services to vulnerable groups; lack of dignity as a barrier to care; the vulnerability of adolescents; child marriage; weaponized rape; genderbased violence; and sexual trafficking. We discuss rights frameworks and models that are being used in response to these situations, as well as what remains to be done. Specifically, we call for obstetricians and gynecologists to act as individual providers and through their FIGO member societies to protect women's health and rights in these exposed settings.

Objectives: To determine the prevalence of anemia in pregnant women attending antenatal clinic an... more Objectives: To determine the prevalence of anemia in pregnant women attending antenatal clinic and to asses the cause of anemia. Study Design: Temporal sampling technique. Place and Duration of Study: Antenatal clinic Unit II, Department of Obstetrics and Gynecology of Services hospital, Lahore from 01.03.2001 to 01.03.2002. Subjects and Methods: Hemoglobin estimation was done in all subjects. Blood indices, peripheral smear, malarial parasite and stool examination were carried out in women with values less than 11gm/dl. Serum electrophoresis was done if the hemoglobin was less than 7gm/dl. Results: It was found that 66% of the pregnant women were anemic. Anemia was more common in women with lesser education, low socioeconomic group and increasing parity. Iron deficiency anemia was found in 72.7% of anemic women. Conclusion: Effective steps should be taken to diagnose anemia early in pregnancy.

Objective: To compare the efficacy and safety of low and high dosage regimens of vaginal misopros... more Objective: To compare the efficacy and safety of low and high dosage regimens of vaginal misoprostol for induction of labour at term. Design: A non-blinded randomized controlled trial. Setting: Labour room of Gynae unit I, Services Hospital/SIMS, Lahore. Participants: Two hundred pregnant women at term requiring induction of labour. Method: The women were randomized to receive 50μg (group A) and 100 μg (group B) of misoprostol vaginally every four hours to a maximum of five doses. Main outcome measures: Induction to delivery interval, need for oxytocin augmentation, mode of delivery, uterine hyperstimulation, failed induction and neonatal outcome. Results: The mean induction to delivery interval was significantly shorter in the 100μg group-high dosage (group B) with a mean difference of 7 hours and a p value <0.05. There was a significantly reduced need for oxytocin augmentation in the high dosage group B (4% vs 20%) and the incidence of failed induction was less in the high dosa...

The Professional Medical Journal

Objective: To analyze various clinical presentation and the surgical management of ovarian pathol... more Objective: To analyze various clinical presentation and the surgical management of ovarian pathology in young girls ranges from 15-25 years. Design: Case series. Setting: Gynae Department 1, Lahore General Hospital Lahore. Period: From January 2008 to December 2009. Patients and Methods: All young girls in the age group mentioned above having an ovarian pathology and managed during study period were included. Age of patients, presenting symptoms, USG findings, surgical management and finally histological diagnosis were noted. Results: There were 20 cases with ovarian lesions. Most of patients presented at the age of 20-25 years (55%). Mass abdomen seen in (30%) cases, followed by pain abdomen in (20%). Lapratomy was done in most of cases and main aim was toward ovary sparing surgery as Cystectomy was done in (50%) cases and Oophorectomy was done in (30%) cases. 85% cases were benign on histology report and 15% were malignant. Conclusions: Ovarian tumors are rare in young age group. ...

Acta Obstetricia et Gynecologica Scandinavica

BMJ Case Reports

In recent years, the number of patients undergoing liver transplant has increased. Successful tra... more In recent years, the number of patients undergoing liver transplant has increased. Successful transplant has resulted in better quality of life and improved fertility in younger women. This is a case study a 31-year-old woman, who had history of Budd-Chiari syndrome and underwent liver transplantation in 2014 with uneventful postoperative course. She was clinically stable on tablet tacrolimus and coumarin with no episode of allograft rejection since transplantation. The patient conceived spontaneously, after 4 years of transplant and during pregnancy, she was managed by multidisciplinary team. During the initial period, the graft and pregnancy continued without complications. However, at 33 weeks, the patient presented with sluggish fetal movements, amniotic fluid index of 3.4 and SD ratio of 3.31 for which she underwent caesarean section. She delivered a healthy female baby of 1.4 kg. This case study concludes that vigilant monitoring of fetal growth is pivotal for optimal fetal ou...

BMJ Case Reports

Each year approximately 20 million low birthweight babies are born globally. Prematurity is a lea... more Each year approximately 20 million low birthweight babies are born globally. Prematurity is a leading cause of neonatal mortality in developing countries and results in 60%–80% of neonatal deaths. Neonatal mortality is the major contributor to under-5 mortality. According to Pakistan Demographic and Health Survey 2017–2018, neonatal mortality in Pakistan is 42 per 1000 live births and under-5 mortality is 74 per 1000 live births. One out of every 22 newborns dies in Pakistan, which is an alarming figure. Majority of these deaths are preventable. They can be prevented by well-trained midwives, safe delivery, early initiation of breast feeding within an hour after birth and skin-to-skin contact. Pakistan is among the top 10 countries with the highest number of preterm births and with limited resources to manage the burden. Kangaroo mother care (KMC) is a safe and economical alternative to provide preterm care in developing countries. In babies at gestational age less than 37 weeks or ...

BMJ Case Reports

Endometrial stromal sarcoma (ESS) is an uncommon and challenging condition comprising 10% of all ... more Endometrial stromal sarcoma (ESS) is an uncommon and challenging condition comprising 10% of all uterine sarcomas and found in women 42–58 years of age. ESS is difficult to diagnose in young women as it masquerades as a leiomyoma. We report this tumour in a 20-year-old woman presenting with heavy and prolonged menses and urinary retention. She was not sexually active and did not give consent for pelvic examination. A preoperative diagnosis of a submucous leiomyoma with an adnexal mass was made. At laparotomy, the leiomyoma was found to be wedged between the cervix and the vagina, and was removed vaginally. A 5–6 cm retroperitoneal mass was adherent to the right pelvic wall, which was also removed. Histopathology of both specimens revealed ESS. The final diagnosis according to the International Federation of Gynaecology and Obstetrics classification was stage IV ESS. After oncology consult, she was referred for chemotherapy. She is now on follow-up.

BMJ Case Reports

The rupture of a brain cranial arteriovenous malformation (bAVM) has been associated with pregnan... more The rupture of a brain cranial arteriovenous malformation (bAVM) has been associated with pregnancy; however, due to scarcity of data about this rare condition, management still remains a dilemma both for obstetricians and neurophysicians. The management plan is decided after weighing the benefits of bAVM treatment against the risk of bleeding in pregnancy. There is consensus on deciding the treatment of ruptured brain AVM during pregnancy based on neurological and not obstetrical indications. The management is decided using a multidisciplinary approach.We report the case of a primigravida who presented at 15 weeks of gestation with intracranial haemorrhage secondary to ruptured bAVM, which was managed by glue embolisation. However, she presented again after 9 days in a moribund condition with fever, vomiting and malaise. The family was very concerned about the patient. The multidisciplinary team after evaluation of patient decided for hysterotomy based on the deteriorating maternal...

International journal of gynaecology and obstetrics, Jul 17, 2023

IAHS Medical Journal

not available IAHS Medical Journal Vol 5(1), June 2022; 1-2

International Journal of Gynecology & Obstetrics

Annals of King Edward Medical University, 2015

Introduction: Episiotomy is an incision through the perineum made to enlarge the diameter of th... more Introduction: Episiotomy is an incision through the perineum made to enlarge the diameter of the vulvae outlet and assist childbirth. As it is noted that long-term complications after episiotomy repair are com-mon so that I used vicryl which is polyglactin and it causes less tissue reaction and is absorbed by hydro-lysis in comparison of vicryl in comparison of vicryl rapide chromic catgut is manufactured from collagen and causes an inflammatory response into the tissues as it is broken down by proteolytic enzymes and pha-gocytosis. There is controversy in results which is bet-ter suture material. That is why we designed this study to compare vicryl rapide and chromic catgut. Objectives: The objective of my study is to compare the frequency of analgesia requirement in primigra-vidas undergoing episiotomy repair with Chromic Cat-gut versus Vicryl Rapide. Methodology: This study was conducted at the Depa-rtment of Obstetrics And Gynaecology, Unit-II, Servi-ces Institute of Medic...

SSRN Electronic Journal, 2022

Annals of King Edward Medical University, 2017

Although induced abortion is common in early pregnancy and termination of pregnancy but very rare... more Although induced abortion is common in early pregnancy and termination of pregnancy but very rarely after 2nd trimester. Retention of fetal bone after termination of pregnancy is an uncommon Gynecological condition which may be symptomatic. We present a case of 26 years old P0+1 presented in OPD with complaint of foul smelling vaginal discharge pain lower abdomen and urinary incontinence for 7months. She gave history of induced abortion at 7months of amenorrhea by dai after that she underwent a laparotomy due to abdominal distension and suspicion of intestinal obstruction by surgeon and pus was drained. But no obstruction was found after that she had complaint of vaginal discharge pain lower abdomen & incontinence. On examination abdomen soft non tender cervix not visualized 4x5 cm whitish colour foreign body impacted in cervical region. Uterus mobile normal size, 4x5cm irregular stony hard foreign body impacted in cervix and projecting laterally and anteriorly urine dribbling anter...

Address of Correspondence: Prof Rubina Sohail is Professor of Obstetrics & Gynaecology at Service... more Address of Correspondence: Prof Rubina Sohail is Professor of Obstetrics & Gynaecology at Services Institute of Medical Sciences, Lahore. She is President of South Asian Federation of Obstetricians & Gynaecologists. Email address - rubina95@gmail.com Pakistan has witnessed a rapid increase in population since independence in 1947. A country with a population of 33 million in 1947 has reached 207 million in 2017 – a massive population explosion.(1) Besides this, Pakistan, with the exception of Afghanistan has one of the highest fertility rates in the region with the growth rate of 1.89% and the lowest rate of contraceptive use. The high fertility rate and the rapidly increasing population has contributed in making Pakistan the sixth most populous country in the world after China, India, USA, Indonesia and Brazil - all of which are countries with a vast area. Comparing Pakistan’s 310,401square miles to 741,096 square miles of India and 3,286,470 of Brazil demonstrates the scarcity of ...

Pakistan’s latest estimated population is 207,774,520 (excluding autonomous regions Azad Kashmir ... more Pakistan’s latest estimated population is 207,774,520 (excluding autonomous regions Azad Kashmir and Gilgit). This makes Pakistan the fifth most populous country in the world, just behind Indonesia and slightly ahead of Brazil. Women form around half of the population of the country. Pakistan particularly struggles with high maternal mortality ratios, adolescent birth rates and unmet need for contraception. Pakistan has the third highest burden of maternal, fetal and child mortality globally. According to WHO, fertility is considerably higher in rural communities than in urban areas. On average, most rural women have 4 children. Contraceptive prevalence rate remains low at 35 per cent, meaning that most people are not using birth control methods. Even though 96 per cent of married Pakistani women are aware of at least one modern contraceptive method, but only 26% are using modern method of contraception. Major gaps remain at both service delivery and policy level, preventing adequat...

Ab s t r Ac t Aim: To apply the Robson Ten Group Classification System (TGCS) in major South Asia... more Ab s t r Ac t Aim: To apply the Robson Ten Group Classification System (TGCS) in major South Asian hospitals to begin making recommendations to optimize cesarean section (CS) rates. Materials and methods: This cross-sectional study was conducted from September 2018 to February 2019 at public sector hospitals in five South Asian countries. We analyzed the pooled data for all five hospitals. The data were then stratified by the study hospitals. We utilized a Pearson χ2 test to assess differences in CS by group. And p values <0.05 were considered statistically significant. Statistical analysis was performed using STATA 16. Results: A total of 37,251 women delivered in the five participating hospitals during the 6-month study period. Of these, 13,592 women were delivered by CS with a composite CS rate of 36% (range, 22–53%). Women in groups 1, 2, and 5 were the largest contributors to the overall CS rate in the participating hospitals. Statistically significant differences in CS rate...

Annals of King Edward Medical University, 2018

International Journal of Gynecology & Obstetrics

Ensuring universal access to sexual and reproductive healthcare services is Target 3.7 of the Uni... more Ensuring universal access to sexual and reproductive healthcare services is Target 3.7 of the United Nations Sustainable Development Goals (SDG). Refugee and migrant women and children are at particular risk of being forgotten in the global momentum to achieve this target. In this article we discuss the violations of sexual and reproductive health and rights (SRHR) of particular relevance to the refugee and migrant reality. We give contextspecific examples of denial of health services to vulnerable groups; lack of dignity as a barrier to care; the vulnerability of adolescents; child marriage; weaponized rape; genderbased violence; and sexual trafficking. We discuss rights frameworks and models that are being used in response to these situations, as well as what remains to be done. Specifically, we call for obstetricians and gynecologists to act as individual providers and through their FIGO member societies to protect women's health and rights in these exposed settings.

Objectives: To determine the prevalence of anemia in pregnant women attending antenatal clinic an... more Objectives: To determine the prevalence of anemia in pregnant women attending antenatal clinic and to asses the cause of anemia. Study Design: Temporal sampling technique. Place and Duration of Study: Antenatal clinic Unit II, Department of Obstetrics and Gynecology of Services hospital, Lahore from 01.03.2001 to 01.03.2002. Subjects and Methods: Hemoglobin estimation was done in all subjects. Blood indices, peripheral smear, malarial parasite and stool examination were carried out in women with values less than 11gm/dl. Serum electrophoresis was done if the hemoglobin was less than 7gm/dl. Results: It was found that 66% of the pregnant women were anemic. Anemia was more common in women with lesser education, low socioeconomic group and increasing parity. Iron deficiency anemia was found in 72.7% of anemic women. Conclusion: Effective steps should be taken to diagnose anemia early in pregnancy.

Objective: To compare the efficacy and safety of low and high dosage regimens of vaginal misopros... more Objective: To compare the efficacy and safety of low and high dosage regimens of vaginal misoprostol for induction of labour at term. Design: A non-blinded randomized controlled trial. Setting: Labour room of Gynae unit I, Services Hospital/SIMS, Lahore. Participants: Two hundred pregnant women at term requiring induction of labour. Method: The women were randomized to receive 50μg (group A) and 100 μg (group B) of misoprostol vaginally every four hours to a maximum of five doses. Main outcome measures: Induction to delivery interval, need for oxytocin augmentation, mode of delivery, uterine hyperstimulation, failed induction and neonatal outcome. Results: The mean induction to delivery interval was significantly shorter in the 100μg group-high dosage (group B) with a mean difference of 7 hours and a p value <0.05. There was a significantly reduced need for oxytocin augmentation in the high dosage group B (4% vs 20%) and the incidence of failed induction was less in the high dosa...

The Professional Medical Journal

Objective: To analyze various clinical presentation and the surgical management of ovarian pathol... more Objective: To analyze various clinical presentation and the surgical management of ovarian pathology in young girls ranges from 15-25 years. Design: Case series. Setting: Gynae Department 1, Lahore General Hospital Lahore. Period: From January 2008 to December 2009. Patients and Methods: All young girls in the age group mentioned above having an ovarian pathology and managed during study period were included. Age of patients, presenting symptoms, USG findings, surgical management and finally histological diagnosis were noted. Results: There were 20 cases with ovarian lesions. Most of patients presented at the age of 20-25 years (55%). Mass abdomen seen in (30%) cases, followed by pain abdomen in (20%). Lapratomy was done in most of cases and main aim was toward ovary sparing surgery as Cystectomy was done in (50%) cases and Oophorectomy was done in (30%) cases. 85% cases were benign on histology report and 15% were malignant. Conclusions: Ovarian tumors are rare in young age group. ...

Acta Obstetricia et Gynecologica Scandinavica

BMJ Case Reports

In recent years, the number of patients undergoing liver transplant has increased. Successful tra... more In recent years, the number of patients undergoing liver transplant has increased. Successful transplant has resulted in better quality of life and improved fertility in younger women. This is a case study a 31-year-old woman, who had history of Budd-Chiari syndrome and underwent liver transplantation in 2014 with uneventful postoperative course. She was clinically stable on tablet tacrolimus and coumarin with no episode of allograft rejection since transplantation. The patient conceived spontaneously, after 4 years of transplant and during pregnancy, she was managed by multidisciplinary team. During the initial period, the graft and pregnancy continued without complications. However, at 33 weeks, the patient presented with sluggish fetal movements, amniotic fluid index of 3.4 and SD ratio of 3.31 for which she underwent caesarean section. She delivered a healthy female baby of 1.4 kg. This case study concludes that vigilant monitoring of fetal growth is pivotal for optimal fetal ou...

BMJ Case Reports

Each year approximately 20 million low birthweight babies are born globally. Prematurity is a lea... more Each year approximately 20 million low birthweight babies are born globally. Prematurity is a leading cause of neonatal mortality in developing countries and results in 60%–80% of neonatal deaths. Neonatal mortality is the major contributor to under-5 mortality. According to Pakistan Demographic and Health Survey 2017–2018, neonatal mortality in Pakistan is 42 per 1000 live births and under-5 mortality is 74 per 1000 live births. One out of every 22 newborns dies in Pakistan, which is an alarming figure. Majority of these deaths are preventable. They can be prevented by well-trained midwives, safe delivery, early initiation of breast feeding within an hour after birth and skin-to-skin contact. Pakistan is among the top 10 countries with the highest number of preterm births and with limited resources to manage the burden. Kangaroo mother care (KMC) is a safe and economical alternative to provide preterm care in developing countries. In babies at gestational age less than 37 weeks or ...

BMJ Case Reports

Endometrial stromal sarcoma (ESS) is an uncommon and challenging condition comprising 10% of all ... more Endometrial stromal sarcoma (ESS) is an uncommon and challenging condition comprising 10% of all uterine sarcomas and found in women 42–58 years of age. ESS is difficult to diagnose in young women as it masquerades as a leiomyoma. We report this tumour in a 20-year-old woman presenting with heavy and prolonged menses and urinary retention. She was not sexually active and did not give consent for pelvic examination. A preoperative diagnosis of a submucous leiomyoma with an adnexal mass was made. At laparotomy, the leiomyoma was found to be wedged between the cervix and the vagina, and was removed vaginally. A 5–6 cm retroperitoneal mass was adherent to the right pelvic wall, which was also removed. Histopathology of both specimens revealed ESS. The final diagnosis according to the International Federation of Gynaecology and Obstetrics classification was stage IV ESS. After oncology consult, she was referred for chemotherapy. She is now on follow-up.

BMJ Case Reports

The rupture of a brain cranial arteriovenous malformation (bAVM) has been associated with pregnan... more The rupture of a brain cranial arteriovenous malformation (bAVM) has been associated with pregnancy; however, due to scarcity of data about this rare condition, management still remains a dilemma both for obstetricians and neurophysicians. The management plan is decided after weighing the benefits of bAVM treatment against the risk of bleeding in pregnancy. There is consensus on deciding the treatment of ruptured brain AVM during pregnancy based on neurological and not obstetrical indications. The management is decided using a multidisciplinary approach.We report the case of a primigravida who presented at 15 weeks of gestation with intracranial haemorrhage secondary to ruptured bAVM, which was managed by glue embolisation. However, she presented again after 9 days in a moribund condition with fever, vomiting and malaise. The family was very concerned about the patient. The multidisciplinary team after evaluation of patient decided for hysterotomy based on the deteriorating maternal...