Many modifications have been introduced in the field of medical education in recent past with a shift from didactic to more student focused teaching strategies. Modular study system for final year MBBS students was introduced in the subject of Obstetrics and Gynecology in 2018 session. Objectives: To determine the students′ perception about modular teaching and various instructional strategies through feedback in the subject of Obstetrics and Gynecology at undergraduate level. Study Design: Cross sectional study. Setting: University Medical and Dental College, Faisalabad. Period: 1st January to 30th October 2018. Material & Methods: Eight modules were designed in the subject of obstetrics and gynecology for final year MBBS students. In order to ascertain the quality of teaching and to monitor the effectiveness of teaching methodologies, feedback was obtained. A written questionnaire was designed to collect feedback. Interpretation of collected data was performed on SPSS 20. Results: Total 136 students participated in study by giving back properly filled questionnaire. Modular teaching was appreciated as an effective method by 93.4% students. Case based teaching, small group sessions and problem based learning were considered most favored teaching methods (97.7%, 97.1% and 94.85%) respectively by the students. Conclusion: Modular teaching was found to be an interesting and a useful teaching - learning experience by majority of students. Almost all students showed positive acceptance for various teaching methods. Students’ feedback was also useful in identifying course components that need improvement so that appropriate measures can be made to improve the overall quality and effectiveness of the course in future.
Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria. Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al. In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.
Background: Polycystic Ovarian Syndrome (PCOS) affects approximately 5-10% females of reproductive age worldwide. Recent research shows that this syndrome is associated with psychological upset and devastating effects on women′s mental health and wellbeing. Lack of clinicians′ awareness of adverse psychological effects is a major concern in developing countries to provide standard care and to improve overall health outcomes.Purpose of study was to determine the frequency of anxiety and depression among women with PCOS in order to promote awareness among clinicians about psychological complications of disease.Methods: Present study was conducted in the department of Obstetrics and Gynaecology/ University Medical and Dental College, from October 2018 to March 2019. Sixty patients with diagnosis of PCOD and sixty participants without this disease were included in the study. Participants having other endocrine or metabolic disorders were excluded from study. Hospital anxiety and depression scale was used to detect anxiety and depression among both groups. SPSS version 16 was used for data analysis. Chi- square test was applied to compare prevalence of anxiety and depression in both groups, p-value ˂0.05 was taken as statistically significant.Results: Women having PCOD exhibited statistically significant prevalence of anxiety (78.3% vs 35%) and depression (60% vs 30%) with p value of 0.0001 and 0.001 respectively.Conclusions: It is highly recommended that initial evaluation of these patients should include assessment of psychological domain of disease to provide more comprehensive treatment to improve overall health related quality of life.
Objectives: The objective of this study was to evaluate the diagnostic accuracy of saline infusion hysterosonography for detection of uterine cavity abnormalities using Hysteroscopy as the gold standard. Study Design: Analytical Quasi Experimental study. Setting: Obstetric and Gynaecology Department Madina Teaching Hospital Faisalabad. Period: July 2017 to December 2017. Materials and Methods: Sixty patients presented with abnormal uterine bleeding were included in the study. Transvaginal ultrasound, SIS and hysteroscopy performed for evaluation of the uterine cavity for any abnormality. Results: SIS helped in detection of intacavitary abnormalities in 39 out of 60 patients indicating sensitivity of 88. 64 % and specificity of 100 % as hysteroscopy confirm the findings in all the patients. The NPV is 76 % and PPV of 100 % taking hysteroscopy as gold standard. The diagnostic accuracy of saline infusion sonography is 91%. Conclusion: The addition of SIS to TVS significantly improved the sensitivity and specificity for detecting intracavitary pathology. It can be used as an alternative procedure whenever hysteroscopy is not available.
Objective: To compare the adequacy of endometrial sampling with pipelle versus conventional dilatation and curettage in patients with abnormal uterine bleeding. Study Design: Randomized Control Trial. Settings: Department of Obstetrics and Gynecology Madina Teaching Hospital affiliated with University Medical and Dental College Faisalabad. Period: July 2019 to June 2020. Material & Methods: A total of 90 patients with abnormal uterine bleeding were included in the study. Patients in Group A underwent endometrial sampling in OPD without anesthesia using pipelle. Patients in Group B were admitted, dilatation and curettage was done in operation theatre under anesthesia, endometrial tissue sent for histopathology. Patients were called in OPD on follow up visit with histopathology report. Results: Comparison of adequacy of endometrial sampling with pipelle versus conventional dilatation and curettage in abnormal uterine bleeding shows that 84.44% (n=38) in Group A and 91.11% (n=41) in Group B have adequate sample. P value was 0.33, showing insignificant difference. Conclusion: Pipelle has acceptable adequacy for endometrial sampling as compare to dilatation and curettage. It is an outpatient procedure, no need of anesthesia and cervical dilatation. Pipelle can be safely used as an alternative to conventional dilatation and curettage.
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