ABSTRACT... Objectives:To determine the frequency of factors leading to tubal blockage in subfertile women evaluated by laparoscopy. Study Design: Cross-sectional study. Period: Six months from 1 February 2015 to 31 July 2015. Setting: Department of Obstetrics & Gynaecology of Nishter Hospital Multan. Methods: Two hundred and eighty (280) married primary subfertile females presenting with primary and secondary subfertility of age more than 20 and less than 40 years were included. Laparoscopy was done in every patient. Data was analyzed by SPSS 19. Descriptive statistics was used to calculate mean+SD for continuous variables. Frequencies and percentages was calculated for qualitative variables. P value < 0.05 was consider significant. Results: Mean age of the patients was 30.52±5.72 years. Out of 280 patients, 175 (62.5%) were Nulliparous, 77 (27.5%) were of parity status 1 and 28 (10%) were of parity status 2. Intraoperative findings of laparoscopy revealed tubal blockage in 51 (18.2%) women. The most common cause of tubal blockage was Neisseria Gonorrhea diagnosed in 17 (33.4%) patients, Pelvic Inflammatory disease was diagnosed in 14 (27.4%) patients, Chlamydia Trachomatis in 17 (21.6%) patients and Endometriosis in 9 (17.6%) patients. Conclusion: The incidence of tubal blockage in sub fertile women is 18.2%. Neisseria Gonorrhea infection, Pelvic Inflammatory disease, Chlamydia trachomatis infection and endometriosis are common factors responsible for tubal blockage. Key words:subfertility, Laparoscopy, Tubal blockage, Hysterosaplingography.
Objectives: This article is designed for comparison and contrast of item response theory measurement with classical measurement theory (Classical Measurement Theory) as well as to determine the various advantages offered by item response theory in the setting of medical education. Summary: Classical measurement theory is being impartial and inherent, is used more often than other models in medical education. However, there is one restriction encountered in the use of classical measurement theory that is it sample dependent and the data is bewildered in the specified sample that the researcher has assessed. Whereas, the score in item response theory separate from the sample or stimuli of assessment. Item Response Theory is consistent, it allows for easy evaluation of examination scores enabling the score to be placed in constant measurement scale and compare the change in students’ ability with time. There are various models of Item Response Theory out of which three are discussed along with their statistical assumptions. Conclusions: Item Response Theory being a capable tool is able to simplify a major issue of Classical Measurement Theory, i.e. bewilderment of skill of examinee with item characteristics. The Item Response Theory measurement inscribes the problems in medical education like removing rater mistakes from evaluation.
ABSTRACT… Introduction: Subarachnoid block has been in practice for below umbilical surgery more than 110 years.1 in recent era all over the world most of cesarean sections are being done under subarachnoid block because of high mortality rate associated with general anesthesia due to failed intubation and aspiration pneumonia. Objectives: To compare the efficacy of phenylephrine versus ephedrine in the treatment of hypotension during cesarean section under subarachnoid block. Study Design: Randomized control trial. Setting: Department of Anesthesiology Nishter Hospital Multan. Period: March 2014 to August 2014. Materials and Methods: A total 80 patients included in the study and patients were divided into two equal groups. Phenylephrine group (P group) and Ephedrine group (E group), 40 patients in each. Results: A total of 80 (100%) patients included in the study. As concern to the age of patients, mean age in group E was 30.50 and standard deviation was 5.383, similarly in group P mean age was 30.75 and SD was 5.921. As concern to the efficacy in group E, 7 were having good efficacy and 33 were have poor efficacy. In group P 30 had good efficacy and 10 had poor efficacy. P=0.000 a significant value. Conclusion: Phenylephrine is more effective than ephedrine for the treatment of hypotension due to subarachnoid block during cesarean section. Key words:Cesarean Section, Spinal Anaesthesia, Subarachnoid Block, Phenylephrine, Ephedrine. Article Citation: Nabeel SH, Furqan A, Fayyaz A, Akhtar R. Subarachnoid Block; Comparison of efficacy of phenylephrine versus ephedrine in the treatment of hypotension during subarachnoid block in C-Section. MBBS, MCPS
Objectives: To evaluate conventional lecture method and problem based learning using the cases notes prepared by new graduates. Study Design: Cross-sectional study. Setting: Departments Anesthesia, Gynecology and Obstetrics of Nishtar Medical University and Hospital, Multan. Period: December 1st, 2018 to April 30st, 2019. Material & Methods: Total 138 patients’ files were selected, 69 anesthesia files for PBL and 69 gynecology files for CLM. All the files were analyzed for date and time when the doctor saw the patients, physical examination, review of systems, personal and social history, family history, diagnosis, investigations and filing the results, drugs given at the time of admission and at discharge. Data was put in the SPSS 23 and compared between the two groups. Percentages were compared by applying Chi-square test and p≤0.05 was taken as statistically significant. Results: The CLM group was significantly better in the documentation of the date and time, review of the systems, medication at the time of admission and the time of discharge. The PBL group performed significantly better in taking drug history and smoking, making final diagnosis and requesting specific investigation. Conclusion: Both PBL and CLM systems are efficient selectively, but a combination of both these system will be more efficient approach.
ABSTRACT… Objectives:To compare maternal outcome in planned induction of labor versus expectant management in pregnancy induced hypertension between 36 to 40 weeks of gestation. Study Design: Randomized controlled trial. Setting: Obstetrics and Gynecology Unit II of Nishter Hospital Multan. Period: January 2016 to July 2016. Materials and Methods: One hundred and thirty six (136) women with diagnosis of mild pregnancy induced hypertension, having gestational age 36 to 40 weeks were selected for this study. The selected patients were allocated randomly into two equal groups i.e. Group A (Induction group) & Group B (Expectant group). The primary outcomes of this study were rate of cesarean section delivery and development of severe pre-eclampsia. Independent sample t-test was used to compare age between the groups. Chi-square test was used to compare age groups and study endpoints between the groups. Results: Mean gestational age at the time of delivery was 38.3 ± 0.75 weeks for group A and 39.2 ± 0.55 weeks for group B (P-value >0.05). Mode of delivery was 52 (76.47%) patients by vaginal and 16 (23.53%) by caesarean section in group A. While in group B, out of 68 deliveries, 40 (58.82%) patients delivered by vaginal and 28 (41.18%) by caesarean section (p-value <0.05). Regarding maternal outcomes, severe pre-eclampsia occurred in 05 (7.35%) women of group A while in group B, it was noted 15 (22.05%) women (p-value<0.05). The final outcome was considered satisfactory in 76.47% patients in Induction group regarding vaginal delivery and severe pre-eclampsia while in Expectant group satisfactory outcomes were achieved in only 23.53% women (p-value <0.05). Conclusion: Induction of labour is associated with improved maternal outcome in terms of caesarean section and pre-eclampsia in women with mild PIH beyond 36 weeks of gestation as compared to the expectant management.
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