Background: Hysterectomy is one of the main gynecological procedures which affect a woman's life in numerous ways, including physically, psychologically, socially, and sexually. Following hysterectomy, these effects on the women's physical and mental health are contradictory, despite improvements in their biopsychosocial function. The aim of the current study is to explore the lived experience of hospitalized women undergoing hysterectomy. Design: A phenomenological qualitative research design was utilized to achieve the aim of the study. Sample: A purposive sample of fifteen women who had a hysterectomy. Tools for data collection: three tools were used for data collection; a structured interviewing questionnaire; an unstructured interviewing questionnaire; the digital voice recorder and field notes. Setting: The interview was conducted at the high-risk pregnancy unit and gynecological inpatient department at Obstetrics and Gynecological Hospital which is affiliated with Cairo University Hospitals. Results: The overall experience as perceived by the participants could be described, within a framework of time sequences, as the following: 1) The immediate reaction towards hysterectomy was reflected by different feelings such as acceptance of the diagnosis, shock, sadness, and depression; 2) Early post-procedure suffering due to physical and psychological factors; 3) Expected later concerns and actual needs such as concern about family and children, sexual concern, need for affections and support from husband, needs for education; 4) Late post-procedures complaints due to fatigability, weight loss, social effects, loss feminine role, anxiety, altered sexual behavior and excitement. Conclusion: The current study concluded that hysterectomy has negative physical, psychological, and social impacts on women's lives in this study sample. Recommendation: Before women are discharged from the hospital, healthcare professionals in postoperative departments must address these potentially distressing psychological and physical consequences of hysterectomy.
Pandemics create unprecedented public health challenges that require comprehensive and coordinated responses from health care systems and can, thereby, cause substantial and prolonged disruption to residency training. The coronavirus 2019 (COVID-19) pandemic has impacted medical education worldwide. Currently, there is a gap in the literature from the trainee's perspective, and little advice on resuming post-pandemic operations. As internal medicine residents serving on the frontlines of a COVID-19 designated government hospital in the United Arab Emirates, we also faced significant challenges and uncertainties during the pandemic. We are fortunate to have overcome the initial surges and have spent the past 6 months navigating a new reality. We believe that the COVID-19 crisis provides an opportunity for graduate medical education programs worldwide to implement targeted changes that can lead to sustainable improvements in the system. In supporting learning during these times, our residency program has adopted flexible scheduling, focused on frequent and transparent communication, incorporated different strategies to build community and promote psychological wellbeing, and advanced virtual teaching modalities. The aim of this article is to share the strategies that have helped us to move forward in the aftermath of the first phases of the pandemic, whilst we prepare for the uncertainty of the future. We hope that the lessons we have learned can help inform other programs as they react and adapt to the global after-effects of this crisis.
Background: labour is a stressful event for the fetus but is well tolerated by most fetuses. However, in some infants stress of labour in terms of metabolic acidosis can lead to Hypoxic Ischemic Encephalopathy (HIE). HIE around term remains a major cause of neonatal mortality and morbidity with lifelong chronic disabilities. Such insults are not limited to high risk pregnancies but can also occur in about 50% of low risk pregnancies. On current evidence, it is estimated that in about 10 of brain damaged infants, the cause is hypoxia during labour.There has been considerable interest in magnesium sulfate (MgSO 4) because magnesium alleviates excitotoxic damage by binding to the magnesium site on the NMDA (N-methyl-Daspartate) glutamate channel. Aim of the Work: magnesium sulphate (MgSo4) for fetal neuroprotection in patients presenting by intrapartum fetal distress at term. Patient and Methods: this is a randomized controlled trial (RCT). The current study was conducted to single term pregnant women who developed intrapartum fetal distress (as defined later) and need emergency CS (ceaseran section) according to Ain Shams protocol. This study was carried on 200 pregnant females, recruited from observation and labour wards of Ain Shams University Maternity Hospital. The current study was conducted to single term 200pregnant women who developed intrapartum fetal distress and needs emergency CS (cesarean section) according to Ain Shams protocol to examine the effects of administered magnesium sulphate .patient were invited to participate in the study after providing clear explanation of the study and its expected values. Result: patients were invited to participate in this study after providing clear explanation of the study and its expected values. The demographic data of included women showed no significant difference between groups in the age and gestational age There was a significant difference in Apgar score at 5 min between MgSo4 and placebo.MgSo4 had significantly lower the risk of decrease Apgar score < 7 at 5min(p:0.029) .Mgso4 also had significantly lower seizure attacks (p:0.002) and had highly significantly reduce NICU admission rate (MgSo4 group 20(20%) and placebo group 43(43%)(p: 0.001)).In MgSo4 group, 23 women reported adverse reactions associated with procedure. Among them, 16 (16%) reported only flushing and 7 (7%) reported only nausea. In placebo group, were 8 (8%) reported flushing and 2 (2%) reported nausea. Conclusion and Recommendation: magnesium sulfate is effective in reducing risk of Apgar score <7 at 5min. Magnesium sulfate appear to be effective in reducing seizure and NICU admission. Magnesium sulphate is associated with maternal morbidity rather than non exposure in the form of nausea and flushing. The improvement in short-term outcomes without significant increase in side effects indicate the need for further trials to determine if there are long-term benefits of magnesium and to confirm its safety.
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