The overall frequency of CS approximates to WHO recommendations, although there is appreciable variation among the four hospitals. When it comes to perception towards CS, women had limited information. There is a need to provide mothers with education during the antenatal period, especially those with limited education, to accept CS where needed.
The occurrence ofpsychiatric complications following the administration of ACI'H and corticosteroids is well recognized. Psychiatric disturbances usually take the form of euphoria or elation in mood. Dc pression is less likely, and irritability or aggressiveness may occur. In about 5 per cent ofcases the alteration in mood may be accompanied by clouding of con sciousness, delusions, hallucinations and disorienta tion. This picture of an organic confusional state is said to result from high doses and prolonged therapy with corticosteroids and ACTH. The latter is recog nized to cause psychiatric sequelac more often than the corticosteroids (Truelove and Witts, 1959).Disturbances may appear within six to seven hours of initial therapy (Goolker and Schein, 1953), after prolonged administration, or even after complete withdrawal of the hormone therapy. CASE REPORTA 41-year-Oldmarried man, a rubber moulder by occupation, was admitted to a psychiatric hospital with a history of disturbed behaviour at a rehabilita tion centre for the physically handicapped. Appa rently he had been admitted to this centre for treat ment of his rheumatoid arthritis.On admission to the psychiatric ward he was found to be restless and overactive. He looked perplexed, his speech was disjointed and his thought processes were slow and tedious. His attention and concentia tion were impaired and he had phases of clouding of consciousness. He exhibited delusions of grandiosity, e.g. that he had suddenly become famous, his name was all over the newspaper headlines and a television crew were making a film about him. Hallucinations of a visual and auditory nature were present; he could see ‘¿ animals running acrossthe lawn' and ‘¿ hidden cameras' were clicking around him. All these features became more pronounced at night, and he had insomnia throughout the initial disturbed phase.Physical examination revealed swelling and tender ness of the small joints of the fingers and the elbow, shoulder and knee joints. There were no positive signs in any other system. He gave a history of polyarthritis of four monthsdurationwhich had been diagnosedas rheumatoid arthritis. He had been treated with phenylbutazone ioo mgm. t.d.s. initially. Three weeks before his admission he was started on prednisolone 2 @ 5 mgm. t.d.s. and he took this for a total of 12 days. However, he felt that his joints became more painful and was therefore adVised to tail off the steroids over the next few days. He recalled taking the last prednisolone tablet eight days before admission. Apart from previous operations for varicose veins and vasectomy, the patient had remained healthy throughout his life. There was no past history of a psychiatric disorder.The patient's mother had a history of crippling rheumatoid arthritis of 12 years duration. His wife had suffered from an obsessive-compulsive neurosis over a period of 14 years and had received various forms of psychiatric treatment. There were two sons of the marriage, aged 14 and io. The younger son was mentally retarded and was at...
BackgroundQuality of Life (QoL) and its determinants are significant in all stages of life, including pregnancy. The physical and emotional changes during pregnancy affect the QoL of pregnant women, affecting both maternal and infant health. Hence, assessing the QoL of pregnant women is gaining interest in literature. We, therefore, aimed to describe the QoL of pregnant women during physiological pregnancy and to identify its associated predictors in women attending a public healthcare institute of Quetta city, Pakistan.MethodsA cross-sectional study was conducted at the Obstetrics and Gynecology Department of Sandeman Provincial Hospital Quetta city, Pakistan. The respondents were asked to answer the Urdu (lingua franca of Pakistan) version of the Quality of Life Questionnaire for Physiological Pregnancy. Data were coded and analyzed by SPPS v 21. The Kolmogorov–Smirnov test was used to establish normality of the data and non-parametric tests were used accordingly. Quality of Life was assessed as proposed by the developers. The Chi-square test was used to identify significant associations and linear regression was used to identify the predictors of QoL. For all analyses, p < 0.05 was taken significantly.ResultsFour hundred and three pregnant women participated in the study with a response rate of 98%. The mean QoL score was 19.85 ± 4.89 indicating very good QoL in the current cohort. The Chi-Square analysis reported a significant association between age, education, occupation, income, marital status, and trimester. Education was reported as a positive predictor for QoL (p = 0.006, β = 2.157). On the other hand, trimester was reported as a negative predictor of QoL (p = 0.013, β = −1.123).ConclusionImproving the QoL among pregnant women requires better identification of their difficulties and guidance. The current study highlighted educational status and trimester as the predictors of QoL in pregnant women. Health care professionals and policymakers should consider the identified factors while designing therapeutic plans and interventions for pregnant women.
Background: In addition to the psychiatric and societal misery, terrorism places an exceptional burden while delivering healthcare services. Accordingly, a responsive and well-prepared healthcare system ensures effective management of terrorism-related events. Within this context, with a strong historic grounding in addressing situations of societal crisis nurses are well-placed in contributing to the global arena of humanitarian policy and social research. Therefore, assessing their response and preparedness is vital in effective management of a terrorism-related disaster. For that very reason, we aimed to evaluate nurses' preparedness and response toward terrorism-related disaster events in Quetta city, Pakistan.Methods: A qualitative design was adopted to explore nurses' response and preparedness of terrorism-related disaster events. By using a semi-structured interview guide through the phenomenology-based approach, in-depth, face-to-face interviews were conducted. Nurses practicing at the Trauma Center of Sandeman Provincial Hospital (SPH), Quetta, were approached for the study. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework.Results: Fifteen nurses were interviewed and thematic content analysis revealed five themes. All nurses have experienced, responded to, and managed terrorism-related disaster events. They were prepared both professionally and psychologically in dealing with a terrorism-related disaster. Among limitations, space and workforce were highlighted by almost all the respondents. Lack of disaster-related curricula, absence of a protocol, recurrence of the disaster, and hostile behavior of victim's attendants during an emergency were highlighted as a key barrier toward terrorism-related disaster management.Conclusion: The skills and expertise needed to address a terrorism-related disaster are well-understood by the nurses but are lacking for various reasons. In addition to the review and adaption of the nursing curriculum specifically for terrorism-related disaster management, collaboration and dialogue between various stakeholders is required to efficiently manage terrorism-related disaster events.
Background: Pregnancy induced hypertension is a fetal disease resulting into morbidity and mortality of female as well as its neonate. Objective: To find the incidence of pregnancy induced hypertension in Pakistani women. Study Design: Cross sectional study Place and Duration of the Study: Department of Obstetrics & Gynaecology, Sandeman Provincial Hospital, Quetta from 1st March 2019 to 31st March 2021. Methodology: Seven hundred and twenty eight females were identified with pregnancy induced hypertension from all the pregnant women attending the outdoor were enrolled. Each female was checked for their protein urea as well as systolic and diastolic blood pressure according to standard operating protocol. Socio-demographic, clinical and family history were documented. Results: Among all pregnant women, 150 were identified as pregnancy induced hypertensive with a 20.6% incidence of pregnancy induced hypertension. The mean value systolic blood pressure value was 144.3±5.2 and of diastolic as 83.1±5.2 in pregnancy induced hypertension women. Conclusion: Family history, obesity and renal diseases are the main factors associated with pregnancy induced hypertension with an incidence of 20.6% among pregnant women. Keywords: Pregnancy induced hypertension, Body mass index, Pregnant women, Hypertension
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