Objective: To highlight the rising trend of caesarean section and strategies to reduce the caesarean section rate in an urban setting. Methods: The qualitative, phenomenological study was conducted at the Lady Aitchison Hospital, Lahore, Pakistan, from October 16 to November 30, 2020, and comprised obstetrics and gynaecology practitioners principally responsible for making decisions related to caesarean sections. Data was collected through face-to-face detailed interview with each subject. The interviews were transcribed manually and codes were formed that led to themes. Results: Of the 10 subjects interviewed, 1(10%) was the department head, 2(20%) were associate professors, 2(20%) were assistant professors and 5(50%) were senior registrars. Main indications of caesarean section in primigravida were foetal distress, failed induction, failure to progress, social demand, malpresentation, eclampsia and antepartum haemorrhage. There were 5-7 themes that fell under each of these seven codes. Conclusion: With proper implementation of uniform decision-making strategies, the rate of caesarean section in primigravida can be lowered with proper antenatal assessment, cardiotocographic monitoring, obstetric skills teaching, specialists; involvement in decision making and counselling of patients. Key Words: Caesarean section, Primigravida, Phenomenology, Analysis.
Background: Hepatitis E Virus (HEV) is the major cause of morbidity and mortality in pregnancy. The virus was detected about three decades ago. The incidence and severity during pregnancy vary widely around the world.Material & Methods: This observational retrospective study was conducted from March 2019 to February 2020 in Obstetrics & Gynecology Department of Lady Aitchison Hospital, Lahore. 70 pregnant women with hepatitis E were subjected to detailed history taking. The diagnosis was based on positive Hepatitis E IgM (Anti HEV IgM) antibody on laboratory test in current pregnancy in antenatal period up to 42 days post partum were included.Results: Out of 70 pregnant women with Hep E IgM+ve, 3 (4.3%) women had Obstetrical hysterectomy as complications, with mean age of 26.0 ± 4.69 years. The mean gestational age when infection occurred was 31.12 ± 5.18 weeks. Among all females 9 (13%) patients expired due to fulminant hepatic failure, 12 (17.14%) females gave birth via spontaneous vaginal delivery (SVD),17(24.2%) females gave birth via C-Section. 30 (42.8%) females were manage conservatively.Conclusion: Hepatitis E viral infection in pregnant females is a life threatening condition. The study showed that pregnant women with jaundice and hepatitis E virus infection had a high mortality rate during third trimester. Early diagnosis and management will help in the control of the disease and prevents its complications.
Background: The concept of feedback is central to medical education. There is gradual shift from sandwich feedback to Pendleton feedback which is learner centred. Pragmatic worldview was proposed in this study. Certificate in Medical Teaching (CMT) programme was initiated at King Edward Medical University (KEMU) Lahore since 2019.The study objective was to improve learning outcome. Methods: Mixed Method research design was chosen, out of all mixed method procedures “Convergent parallel mixed method design” was followed collecting simultaneously quantitative and qualitative data, then results were analysed and compared separately. This study was carried out from 01-06-2020 to 31-03-2021 at King Edward Medical University Lahore. Sample size of 43 participants from CMT (Certificate in Medical Teaching) Batch 1 and 2 took part in this study. Doctors from clinical side, demonstrators and personnel of Allied health sciences attended this course. A predesigned proforma designed on google form was sent to each participant via e-mail.. Results: Quantitative data collected was interpreted as percentages and in form of tables and presented as pie charts. Qualitative data collected was analysed by segregating data into codes. Corresponding themes were made of each code and presented in tabular form. Conclusion: On the basis of feedback and mixed method approach, it can be concluded that certificate in medical teaching is a new teaching program at king Edward Medical University Lahore which can serve as basis to start master’s degree at this institution. Keywords: Feedback, medical teaching, KEMU
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