change in trainee physicians' knowledge and comfort levels with obstetric emergencies following ALSO training

The Advanced Life Support in Obstetrics [ALSO] is a course in emergency obstetrics to help physicians and other health care providers develop and maintain the knowledge and skills to effectively manage potential obstetric emergencies. This course was held for the first time in Pakistan at the Aga Khan University in September 2003. This study was conducted to evaluate the improvement in knowledge and comfort level of physicians-in-training [interns, family medicine, obstetric and emergency room residents] in dealing with emergency obstetrics after undergoing the course. After informed consent, study subjects were administered a written test and asked to complete a questionnaire 10 days before and immediately after taking the ALSO course. Level of comfort in handling obstetric emergencies was assessed using a three-point Likert scale. A total of 38 trainees participated in pretest, ALSO course and subsequent post-test. Eleven were males and 27 were females. The comparison of the pre-test and post test showed a significant increase in the knowledge. The mean difference between the scores was 24 and the paired t-test done showed there was a highly significant difference between the scores [t=18.8, p= <0.001]. There was also a significant improvement in the comfort level for handling emergency obstetrics. Following the ALSO course all participants said they would recommend the course to others. The ALSO course is a valuable teaching intervention that improves not only knowledge but also perceived comfort levels of emergency obstetrics among interns and residents in a developing country

Evaluation and management of neck pain in primary care

Neck pain is a common and a disabling problem in primary care setting. About 10 percent of adult population suffers from neck pain at any one point in their life; in majority the cause is axial neck pain. Localized neck pain generally points to muscle strains, ligament sprains, and degenerative facet or disc processes. Pain that radiates into the upper limbs frequently stems from nerve involvement. A family physician can effectively diagnose and manage neck pain on most occasions through a problem oriented history and a well directed physical examination without the need of extensive diagnostic testing or referral. Most of the cases are managed conservatively with painkillers, posture modification, physical therapy and early return to normal activity

Post polio syndrome: Case report and review of literature

Post-polio syndrome is a constellation of symptoms, such as generalized fatigue, muscle pain and respiratory insufficiency, which occur many years after the acute episode of poliomyelitis. This syndrome is believed to occur primarily because of overburdened motor units which lead to metabolic stress. Diagnosis is essentially clinical. In managing patients with post-polio syndrome, a multi-disciplinary approach needs to be adopted. The role of non-fatiguing exercises in improving the strength of the muscles and alleviating pain without damaging motor units has been supported by a number of studies. Other salient features of management include weight loss, use of supportive devices at joints and using positive pressure ventilation for those with respiratory insufficiency

Distribution of lower urinary tract symptoms [LUTS] in adult women

To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms. Design: Cross-sectional analytical study. Place and Duration of Study: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002. Subjects and A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center. Fifty-two% of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence was the highest reported complaint [38.4%] followed by burning [34.4%], frequency [26%], painful micturition [20.4%], urge incontinence [18.8%], incomplete emptying of bladder [14.4%], dribbling [12.4%] and poor stream [8.4%]. Forty-three% of the women with LUTS never consulted a health care provider for their problem. Although the distribution of LUTS among females was found to be high, the patients did not consider it important enough to consult a health care provider. There is a need to create awareness among females regarding LUTS and the need to consult a health care provider for their problems