BackgroundProfessionalism is a core competency in the medical profession worldwide. Numerous studies investigate how this competency is taught and learned. However, there are few reports on the students’ views and experiences with professionalism especially in the Arab world. Our aim was to explore the experiences and views of Kuwait final-year medical students on professionalism.MethodsThis was a questionnaire study of final-year medical students at Kuwait University (n = 95). Open- and close-ended questions were used to determine the students’ experiences and views on: definition, teaching, learning, and assessment of professionalism.ResultsEighty-five of the students completed the questionnaire (89.5%). A total of 252 attributes defining professionalism were listed by our respondents. The majority (98.0%) of these attributes were categorized under the CanMEDS theme describing professionalism as commitment to patients, profession, and society through ethical practice. The most helpful methods in learning about professionalism for the students were contact with positive role models, patients and families, and with their own families, relatives and peers. The students’ rating of the quality and quantity of teaching professionalism in the institution was quite variable. Despite this, 68.2% of the students felt very or somewhat comfortable explaining the meaning of medical professionalism to junior medical students. Almost half of the students felt that their education had always or sometimes helped them deal with professionally-challenging situations. Majority (77.6%) of the students thought that their academic assessments should include assessment of professionalism and should be used as a selection criterion in their future academic careers (62.3%). Most of the students discussed and sought advice regarding professionally-challenging situations from their fellow medical students and colleagues. Seventy-five (88.2%) students did not know which organizational body in the institution deals with matters pertaining to medical professionalism.ConclusionThis study highlights the influence of the curriculum, the hidden curriculum, and culture on medical students’ perception of professionalism. Medical educators should take in account such influences when teaching and assessing professionalism. Future research should aim at creating a framework of competencies that addresses professionalism in a context suitable for the Arabian culture.

Objective: To compare the successful outcome in medical versus expectant management in patients with unruptured tubal pregnancy having β-hcg 1000-3000 IU/L. Materials & Methods: In this randomized controlled trial, total 90 patients of ectopic pregnancy having age 18-40 years and having size of ectopic mass< 4cm were selected from the Department of Obstetrics & Gynecology Combined Military Hospital, Bahawalpur from March 20 to September 20. Group A included patients in which expectant management was done while Group B included the patients in which medical management (single intramuscular injection of methotrexate in a dose of 50mg/m2) was done. After one week, successful outcome was compared between the both groups. Results: Total 90 women with tubal ectopic pregnancy were selected for this study. Comparison of successful outcome between the bot study groups was done. Mean age of the patients was 31.66 ± 6.44 years, mean gestational age was 7.83 ± 2.33 weeks and mean β-hcg levels 1565.45 ± 517.89 IU/L. In study group A, outcome was found successful in 40 (88.89%) patients and 31 (68.89%) patients of group B was found with successful outcome. After applying chi-square test, difference of successful outcome between the both groups was found statistically significant with p value 0.037. Conclusion: This study concluded that expectant management is associated with better outcome (β-hcg levels negligible i.e. <10 IU/L and complete resolution on ultrasonography (absence of adnexal mass, pelvic free fluid, gestational sac) within one week) as compared to medical management in women with tubal ectopic pregnancy having β-hcg between 1000-3000 IU/L Keywords: Ectopic pregnancy, methotrexate, expectant, resolution

Objectives: To compare the perinatal outcome (low birth weight, preterm delivery) in women with <6 month versus 12-17 months of interpregnancy birth interval. Material and methods: This Cohort study was conducted at Department of Obstetrics and Gynecology, Lahore General Hospital Lahore from March 2020 to September 2020. Total 420 patients with age range 18-40 years, singleton pregnancy, women with previous live birth, parity 1-4 and Gestational age > 28 weeks assessed on LMP were selected for this study. Patients were divided into two groups (A & B) according to their inter-pregnancy interval i.e. <6 months group labelled as A group and 12-17 months group labelled as B group. All patients in both groups will be followed till delivery and the perinatal outcome i.e. preterm delivery (birth occurred before completion of 37 weeks of gestation) and low birth weight (those babies whose weight less than 2.5 Kg at the time of birth) were noted. Results: The mean age of women in group A was 26.73 ± 6.56 years and in group B was 26.73 ± 6.56 years. The perinatal outcome was preterm delivery in 189 (90.0%) and low birth weight babies in 143 (68.10%) women of <6 months while in 12-17 months interpregnancy interval, it was noted in 111 (52.86%) and 102 (48.57%) women respectively Conclusion: Our study concluded that appropriate inter pregnancy interval could reduce the rate of preterm delivery and low birth weight babies and optimal interval associated with the lowest risk of adverse perinatal outcome was 12-17 months. Keywords: Birth spacing, short interval, preterm delivery, low birth weight.

Imperforate hymen is a very rare anomaly of female reproductive system due to failure of complete canalization of endoderm of urogenital sinus thus obstructing the vaginal opening1, The condition is often diagnosed late due to its low incidence, nonspecific presentation & insufficient physical examination. The teenage girls with imperforate hymen generally present with cyclical lower abdominal pain without the menstruation being established, urinary retention or constipation and sometimes as lower abdominal mass.Diagnosis is clinical and confirmed by ultrasound. It is treated surgically. Keywords: Primary amenorrhea, imperforate hymen, haematocolpos