Journal of Sheikh Zayed Medical College (JSZMC)

Frequency of Undiagnosed Gestational Diabetes Mellitus and its association with Maternal age and Parity

Sadia Shakir — 2025-08-11

Background: Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy that poses significant risks to both mother and fetus if left undiagnosed. Despite known risk factors, routine screening practices remain inconsistent in many healthcare settings, particularly in low-resource areas. Objective: To determine the frequency of undiagnosed gestational diabetes mellitus among pregnant women consulting for antenatal care and to assess its association with maternal age and parity. Methodology: This cross-sectional study was conducted at the Gynecology & Obstetrics Outpatient Department of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, from June to December 2024. A total of 196 pregnant women between 24 and 28 weeks of gestation, with no prior diagnosis of diabetes, were enrolled using a consecutive non-probability sampling technique. GDM was diagnosed using the 75g oral glucose tolerance test (OGTT) and International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Data on maternal age, parity, and BMI were collected and analyzed using SPSS. Chi-square tests and logistic regression were performed to determine associations, with p < 0.05 considered statistically significant. Results: The frequency of undiagnosed GDM was 29 (14.8%). Maternal age >30 years (p = 0.016; aOR = 2.0) and BMI ≥25 kg/m² (p = 0.031; aOR = 1.9) were significantly associated with GDM. Parity showed no statistically significant association (p = 0.140). Conclusion: Undiagnosed GDM is prevalent among pregnant women, with advanced maternal age and elevated BMI identified as significant independent risk factors. Targeted screening of high-risk groups is essential for early diagnosis and prevention of complications.

Association between antenatal care visits and birth preparedness among pregnant women

Dr. Rubina Atta — 2025-08-08

Background: Maternal mortality remains a significant public health concern, particularly in low- and middle-income countries. Antenatal care (ANC) plays a vital role in reducing maternal and perinatal morbidity and mortality by promoting birth preparedness and complication readiness. Despite the availability of services, many women still do not attend the recommended number of ANC visits or make adequate preparations for childbirth. Objective: To determine the association between antenatal care visits and birth preparedness among pregnant women and to identify socio-demographic factors influencing birth preparedness. Methodology: A cross-sectional analytical study was conducted at Bahawal Victoria Hospital, Bahawalpur, from January 2024 to December 2024. A total of 259 pregnant women with gestational age ≥28 weeks were enrolled using non-probability consecutive sampling. Data were collected through face-to-face interviews using a pre-tested structured questionnaire. Birth preparedness was assessed using the WHO BPCR module. Descriptive statistics and chi-square tests were used for analysis. Results: The mean age of participants was 26.7 ± 4.8 years. About 62.2% attended four or more ANC visits, and 64.5% had adequate birth preparedness. Women who attended ≥4 ANC visits were significantly more likely to be adequately prepared compared to those with fewer visits (82.0% vs. 35.7%, p < 0.001). Early initiation of ANC and higher maternal education were also significantly associated with better birth preparedness. Conclusion: Regular antenatal care attendance is strongly associated with improved birth preparedness. Efforts should focus on increasing ANC uptake and integrating birth planning education into routine maternal health services, especially for less educated and rural women.

Frequency of undiagnosed Hydrocephalus in Patients presenting with Headache to the Emergency Department

Malik liaqat Ali Jalal — 2025-06-04

Background: Headache is one of the most common reasons for emergency department (ED) visits. Hydrocephalus, although rare, can present with non-specific symptoms like headache, nausea, and altered mental status, often leading to delayed diagnosis. Objective: To determine the frequency of undiagnosed hydrocephalus among adults presenting with headaches to the ED and to identify associated clinical features. Methodology: A cross-sectional analytical study was conducted at Nishtar Medical University, Multan, Pakistan, from January 2023 to December 2023. A total of 381 adult patients presenting with headache as the primary complaint and undergoing neuroimaging (CT or MRI) were included. Patients with known neurological conditions, traumatic head injury, or subarachnoid hemorrhage were excluded. Data on demographic and clinical features were collected using a structured tool. Hydrocephalus was diagnosed radiologically and classified as obstructive or non-obstructive. Univariate and multivariate analyses were performed to identify predictors of undiagnosed hydrocephalus. Results: Out of 381 patients, 5 (1.3%) were diagnosed with hydrocephalus, previously undiagnosed. Among these, 3 (60%) had obstructive hydrocephalus and 2 (40%) had a non-obstructive type. All cases were detected incidentally through neuroimaging. On univariate analysis, altered mental status and gait disturbance were significantly associated with hydrocephalus. Multivariate analysis confirmed that altered mental status was an independent predictor (OR = 4.6; 95% CI: 1.5–13.9; p = 0.007). Conclusion: Undiagnosed hydrocephalus was identified in many adult ED patients presenting with headache. Altered mental status emerged as a significant clinical predictor.

Coagulation Profile in Patients with Liver Disease: A Cross-Sectional Study from a Tertiary Care Hospital

Faiza Sarwar — 2025-08-11

Background: Liver disease is a major public health issue globally, and it significantly impacts coagulation due to the liver’s role in synthesizing clotting factors. Coagulopathy in liver disease increases the risk of bleeding and thrombosis, complicating clinical management. Despite its importance, data on coagulation profiles among patients with liver diseases are limited in Pakistan. Objective: To assess the frequency and severity of coagulopathy in patients with liver diseases presenting to Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, and to determine its association with disease severity. Methodology: A cross-sectional study was conducted from January to June 2024 at Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. A total of 100 adult patients (≥25 years) diagnosed with various liver diseases were enrolled. Complete blood count (CBC), prothrombin time (PT), and activated partial thromboplastin time (aPTT) were assessed. Disease severity was evaluated using the Child–Pugh classification. Data were analyzed using SPSS version 25. Results: Of the 100 participants, 58% were male and 42% female. Thrombocytopenia was observed in 70% of patients, prolonged PT in 59%, and prolonged aPTT in 42%. Coagulopathy was more frequent in patients with higher Child–Pugh scores. Severe thrombocytopenia (<50,000/µL) was present in 34% of patients, while 26% had PT >18 seconds. Significant associations were found between coagulation abnormalities and disease severity (p < 0.05). Conclusion: This study demonstrates a high prevalence of coagulopathy in patients with liver diseases, especially in those with advanced liver dysfunction. Routine assessment of coagulation parameters should be integrated into the management of liver disease patients to guide clinical decision-making and improve outcomes.