Objectives: To find out the personal, professional, and educational challenges in training by the post-graduate residents of Obstetrics and Gynecology in the three tertiary care hospitals of Peshawar during the Covid-19 Pandemic. Methods: This was a web-based cross-sectional study conducted among the postgraduate residents of Gynecology and Obstetrics in the three main teaching hospitals of Peshawar, from 1st April 2020 to 31st July 2020. A structured survey using Google forms was distributed among 98 postgraduate residents through emails and social media platforms. The challenges faced and their severity was assessed using the Likert Scale. Results were analyzed in Microsoft Excel. Results: Total number of participants was 98, with 99% being female. The mean age was 28.3±1.8 years. Their worst fear was of the family getting infected (86.7%). Their greatest challenge was the inability to practice social distancing due to the nature of their work (85%) amidst a lack of PPEs (51%). Their training suffered due to inadequate opportunities for elective surgeries (78%). Conclusion: Post-graduate residents in Gynaecology/Obstetrics faced substantial personal, professional, and educational challenges while training during the covid-19 pandemic. Keywords: training, challenges, Covid-19, postgraduate residents, Obstetrics and Gynecology
Aim: to determine how successfully transvaginal ultrasonography can be used to identify endometrial cancer in postmenopausal bleeding patients.. Methods: The Khyber Teaching Hospital Peshawar Radiology department performed this cross-sectional study from January 2015 to January 2016. TV-tested endometrial-thickness women were included. The endometrial cavity was examined colonially and sagittal from the internal Os to the fundus. D&C transmitted biopsy samples to the hospital pathology lab for histopathology and TVS comparison. A preform had all this info. Spss 26 analyzed data. Results: The patients' average age was 64.82 + 07.84 years. On average, menopause lasted 10.45 07.73 years. When endometrial thickness was assessed with tvs, the average thickness was 05.564.26 mm; 45 (32.8%) of the ladies did not have an endometrial thickness of 04 mm. Histopathological examination of endometrial cancer revealed ninety four (66.5%) females with the disease and forty six (32.8%) without. The sensitivity, specificity, npv, ppv, and diagnostic accuracy of tvs were determined to be [93.1%], [86.5%], [91.4%], [94.6%], and [93.6%], respectively. Conclusion: According to the study's results, tvs is an effective diagnostic tool for ruling out postmenopausal hemorrhage and sparing patients from intrusive treatments. Keywords: Transvaginal ultrasonography, endometrial carcinoma, diagnosis, accuracy, positive-predictive-value, negative predictive value
Caudal duplication syndrome (CDS) is a rare congenital anomaly in which a wide spectrum of malformations ranging from partial or isolated to complete duplication of caudal organs in the gastrointestinal tract (GIT), genitourinary tract (GUT), and spinal and neural systems occur. Its exact cause is unknown, however various factors such as genetic disorders and conjoined twinning are mentioned in the etiology of CDS. Secondtrimester anomaly scan can diagnose this anomaly prenatally.This case report describes a primi postnatal patient with CDS without any neurological symptoms. She gave birth to a healthy baby girl by cesarean section with breech presentation as an indication.
OBJECTIVES The aim of our study is to determine the exact timing of the decision to the delivery interval in grade I caesarean sections, the factors contributing to the delays and the indications of those caesarean sections. METHODOLOGY This descriptive(cross-sectional) study is conducted in the Gynae B unit of Khyber Teaching Hospital, Peshawar from 1st April 2020 to 30th September 2020 over a span of 6 months. It is a consecutive non-purposive sampling. All women of any age or parity who underwent an emergency grade I caesarean section were included in the study. Age, gestational age, booking status, obstetrical history, the decision to delivery interval, an indication of caesarean, and mode of anesthesia was noted and entered in predesigned proforma. RESULTS 114 patients underwent grade I caesarean in the study period.61(54%) were 21-30 years age group and 48(42%) were in the 31-40 years age group.26(23%) patients were not delayed.31(27%) got delayed as Operation Theatre table was not available,18(16%) could not arrange Caesarean medication and consumables in time,17(15%) could not provide preop investigations in time, in 13(11%) cases patient’s attendants were not available. Fetal distress was the most common cause (33%) of delayed caesarean sections, followed by previous scars in labour (20%), placenta previa with APH (13%), obstructed labour (12%), placental abruption and CPD in labour in 8% each. Spinal anaesthesia was given in 79% and General anaesthesia was given in 21% of cases. CONCLUSION 26(23%) patients were not delayed and their decision to deliver interval was less than 30 minutes. The decision to the delivery interval in Khyber Teaching Hospital was far longer than recommended. The leading causes are delayed arrangement of the OT table, OT stuff and investigations.
Objective: To compare the effectiveness of intracervical foley’s catheter with prostaglandin E2(PGE2) and PGE2 alonein achieving vaginal delivery in a patient having full-term pregnancy and its impact on maternal and fetal outcome.Study design and setting: This Comparative cross sectional study was conducted in the Department of Obs & Gynae, inJanuary-December 2021.Methodology: A detailed history of the patients was obtained, and a physical examination was performed. Patients wererandomly allocated into two groups A (cervical Foleys and PGE2) and group B (PGE2 alone).Results: In Group A, 176 (90.7%) patients showed effective results in achieving vaginal delivery out of which 68.0% werespontaneous and 22.7% instrumental, while in Group B, 172 (88.7%) patients delivered vaginally out of which 48.5%spontaneous and 40.2% instrumental with P<0.01.Conclusion: This study demonstrated that intracervical foley’s catheter with PGE2 yielded significantly better and moreeffective results in terms of improved maternal and fetal outcomes as compared to PGE2 alone in terms of achieving vaginaldelivery and duration of active phase labour
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