I feel honoured to comment upon the extraordinary and well researched paper of Prof. Jim Dornan, our International Scientific Editor, based upon the theme of “Plight and status of girls and women through the ages: current situation and need of today”, published under the section of HISTORY in this issue of our journal, through his courtesy.
It is a pleasure reading this philosophical account on factual happenings with appropriate examples and artistic figures. Thus justifying the placement of obstetric and gynaecological history in a clinical scientific journal of this nature, very much like we have been devoting the section of history to such ventures, right from its inception.
He goes on to state that these days there is hue and cry for lack of funds, although simple obstetric remedies can save lives.
Furthermore he stresses on the women`s position in the society and survival of the weakest.
Very appropriately, in reference to the context, he has laid stress on the fulfilment of Millennium Goal 3 i.e. “Promotion of gender equality and empowerment of women. He also mentions weaknesses of and threats to this goal and states that sadly “most women remain Poor, Powerless or Pregnant,” (the 3Ps, as I call them). He, further re-iterates that “Women also want and NEED Millennium Goal 3 implemented worldwide, right now”.
He has also pointed out that since the last 3500 to 3000 years, Mother Earth has been a man`s world and that life is out of balance, a situation demanding quiet contemplation.
Generally considering the absence of literature and records from pre-historic era, ART has been a source of information and inspiration he says, showing respect for women, a fine example of which, quoted by him is that of the Venus of Willendorf, which has also been described by us in vol.2, No.1.p.14 of this journal.
Interestingly enough he mentions that the pre-historic and ancient civilizations of Mesopotamia, Egypt and Anatolia were ‘matrilineal’ and ‘matriarchal’.
This natural state being destroyed over the length of time, plunged into unnatural ‘patriarchy’ thus subjugating the women to a position of dutiful wives, house keepers and articles of beauty, submissive and subservient to men.
He therefore sates that its high time that the XY endowed men should back off.
In the same context, in a recent Newspaper, an article entitled “Decline and Fall of the human male”, stated that “A lot of things are going to change in the course of this century”. Some expected and others unexpected, amongst which the “decline of human male” whose dominance has been nasty, brutish and far too long. The days of man-the-hunter are over and the days of man-the-hunted have arisen on the horizon, “under the unrelenting barrage of feminist fire”.
I would however say that it is high time that women are liberated from the clutches of men, given the human rights of equality and be saved from domestic violence and horrific practices like acid thrown on their faces and they being made to succumb to honour killing, where ever its going on, in particular in Pakistan.
Commenting upon the article of Col. Ambreen Anwar and other authors on Recurrent Pregnancy Loss (RPL) it is worth mentioning that it is a good and welcome move towards the achievement of goals laid down for this journal, your own journal and the first one of the Society`s own since the inception of the latter in 1957.
It is an excellent tricentre research paper expressing sound knowledge with use of good general and scientific language. This remark should by no means be taken as a pointer of discouragement by the other worthy and great contributors to JSOGP, but rather as an encouragement.
It was a randomized controlled trial, not a double blind trial though originally meant to be so, on account of institutional restriction. Comparing the type of treatment offered to the two groups of patients suffering from RPL, oral low dose aspirin (LDA) 75mg daily from first trimester was found to be equally efficacious in improving the perinatal outcome, with avoidance of local pain and bruising caused by low dose Heparin 5000 IU, subcutaneously twice daily in combination with LDA. Furthermore the cost of the former being only Rs 300 for a 28 weeks course as compared to Rs 6300 for the latter, is an essential cost effectivity factor for a resource limited country like ours`.
More over there is paucity of local studies over this issue and thus the authors conclude that wide spread use of heparin in RPL is not justified until the results of further studies come through.
Hence it is suggested that before any further loss of time well planned, randomized, controlled and unbiassed multicentre trials should begin at country wide level. Thus providing material for meta analysis and collection of local Evidence. This is turn would help to formulate robust National Guide Lines.
I would sum up by stating that the topic researched and discussed is of great clinical and socio-psychological significance. For it is only the woman (and the man), loosing yet another pregnancy, who know what sadness and emptiness prevail!
Mentioning about the case of Advanced Abdominal Pregnancy reported by Dr. Nabeela Waheed and Prof. Fehmeeda Shaheen, it has entailed a lot of good work. However the point to be made here is that the non-structured abstract before the case description is a welcome routine, like many other authors having done so in previous issues of this journal. It is therefore suggested that the future contributors of case reports to JSOGP should consult the latest addition to the ‘Instructions to Authors’ with reference to this context in the current issue of our journal.