Met and unmet need of family planning and associated factors in a remote rural area of Sindh, Pakistan

To determine the met and unmet need of family planning among married women of Taluka Golarchi, District Badin, Sindh, Pakistan. Secondary objective was to assess the knowledge and practices of modern contraceptive methods and associated factors. It is a cross sectional community based survey done from 1[st] May to 31[st] May 2008 in Taluka Golarchi, District Badin, Sindh, Pakistan. A structured questionnaire was used to interview 300 eligible women of reproductive age. Stratified cluster sampling was done to collect information on met and unmet need of family planning, knowledge and practice of modern contraceptive methods and associated factors. Nearly two third of respondents were housewives and illiterate. Most of them 71% [213] were multiparous having more than four children. Current contraceptive practice was 42%, out of which 39% were using modern methods of contraception. Oral contraceptive pills were commonly used method. Unmet need of Family planning was 19%. Lady Health Workers were the prime source of knowledge and provision of family planning methods. Husbands' co-operation and approval is influential factor for modern contraceptive use. Fear of side effects is the main hurdle for non use of modern contraceptive methods. Modern methods of contraception are gaining popularity in rural Sindh. In addition to sustained lady health worker programme, involvement of males should be incorporated in future family planning initiatives

Hyperhomocysteinemia in Pakistani women suffering from uexplained subfertility

Hyperhomocysteinemia [hhcy] has been considered as a risk factor for several obstetrical complications such as early pregnancy loss, pre-eclampsia and IUGR. Recently is association with infertility has been underscored in IVF failure; however limited information is available about the relationship of hhcy and subfertility. To find out the association between unexplained subfertility and hhcy in Pakistani women. This observational study was conducted in Department of Obstetrics and Gynaecolocy, Liaquat University Hospital Hyderabad from 1[st] April 2008 to 31[st] March 2009. Study group consisted of all those women who were subfertile for more then one year, have body mass index less than 25, regular menstrual cycle, normal pelvic examination findings and no past history of pelvic inflammatory disease. Exclusion criteria was male factor subfertility, endocrine and ovulatory dysfunction and tubal blockage. Evaluation was done by semen analysis, pelvic ultrasound scan, hysterosalpingography and hormonal assays. Fasting serum levels of homocysteine were determined using a fluorescence polarization immunoassay. In total, 61 subjects were enrolled in the study including 49 subfertile women and 12 healthy women. Among subfertile women, 39 [80%] were suffering from primary subfertility while 10 [20%] were complaining of secondary subfertility. Majority of the subjects were young, house wives and residents of Hyderabad city. Mean serum fasting homocysteine levels were significantly higher in women suffering from unexplained subfertility as compared to controls [12.8 +/- 5.1 versus 9.7 +/- 1.7, p-value=0.04]. Hyperhomocysteinemia was observed in women suffering from unexplained subfertility. However large scale clinical studies are required to confirm the association