Perceptions of students of the learning environment studying an integrated medical curriculum

To assess the learning environment perceived by medical students of a college employing modular, organ-based integrated curriculum. A cross-sectional descriptive study. The study was conducted in July 2012 among students of first year M.B.,B.S of Shaheed Mohtarma Benazir Bhutto Medical College, Lyari, Karachi. Among students of first year M.B., B.S. the Dundee Ready Education Environment Measure [DREEM] Questionnaire, which has worldwide face validity, was used to assess the learning environment as perceived by students. The English version of the DREEM inventory was administered to all the students. The participation was voluntary and the questionnaire was anonymous. The return of the completed questionnaire was taken as their implied consent. The overall DREEM score was 121.07 [out of 200]. The students' perception of educational environment was found to be more positive. They also considered the overall atmosphere of college comfortable and reported better-than-average social lives. Nevertheless, the study also revealed that there was a lot of room for improvement in a newly established medical college. The study showed that the students perceived a positive learning environment at the college. Although the students were experiencing a considerable amount of stress, their social life on the campus was quite satisfactory

Pattern of aetiological and predisposing factors regarding carcinoma breast

To study the pattern of aetiological and predisposing factors regarding Carcinoma Breast. Prospective, descriptive study from Jan. 2001 to Jan. 2006. Surgical Unit IV, Civil Hospital, Karachi. All the biopsy proven cases of Carcinoma Breast were included. The relevant data regarding history, risk factors, examination and treatment was recorded and analyzed. The total number Carcinoma Breast cases were 54. Out of these 37[68.5%] were under the age of 50 years and 45[83.3%] belonged to the lower socio-economic group. The mean age at menarche was 13.4 years and at menopause 45.13 years. Nine [16,6%] patients had a positive family history of breast carcinoma or other malignancies, and four [7.4%] patients were nulliparous. None of them had a history of long term use of hormonal therapy i-e oral contraceptives or hormone replacement therapy. The established risk factors like early menarche, late menopause, old age, nulliparity, family history, low socio-economic status differed from the international data. It, therefore, seems worthwhile that a larger scale, multicentric study should be conducted to verify and explain these patterns in our population

Bowel injuries secondary to induced abortion: a dilemma

To study the pattern of bowel injuries incurred by induced abortion, and the morbidity and mortality associated with them. Prospective descriptive study from December 2002 to December 2005. Surgical Unit three Gynaecology and Obstertrics Unit two, Civil Hospital, Karachi. All patients with bowel injuries due to induced abortion. Detailed data of all the patients was collected and analyzed. A total of 22 patients, mostly young with an average age of 26.86 years, presented with bowel injuries following induced abortion. Severe hemorrhage occurred in 8[36.4%] patients while 11[50%] had ileal perforation; 9[40.9%] underwent primary repair and 2[9.1%] ileostomy formation. Two [9.1%] patients with jejunal perforation had primary repair, whereas two with both jejuna and ileal perforations underwent resections with anastomosis in one and ileostomy in another. Seven [31.8%] with large gut involvement had colostomy formation. Septicemia and wound infection occurred in 7[31.8%] patients each, faecal fistula and abdominal wound dehiscence in 3[13.6%], and pelvic abscess in 1[4.6%] patients. The total mortality in this series was 6[27.3%] patients. Iatrogenic injuries during induced abortion, most commonly caused by quacks, can be minimized substantially if the procedure is performed by qualified medical personnel in proper health care facilities. There is a need for radical overhauling of the mind set in our society together with legislation

Frequency of congenital anomalies and associated maternal risk factors in the lower socio-economic group

To determine the frequency of congenital abnormalities in the lower socio-economic group and to identify associated maternal risk factors. Prospective descriptive study from January 2002 to December 2004. Out-Patient Department [OPD] of Gynae. and Obstetrics [Unit II] and Labour Room, Civil Hospital, Karachi. All patients in the lower socio-economic group who were detected to have or delivered abnormal babies. Women with an abnormal baby in-utero were identified from the Antenatal Clinic of the Gynae. And Obstetrics [Unit II] OPD or were inducted into the study after the delivery of an abnormal baby. These patients were further evaluated by taking a detailed history of the risk factors for congential abnormality. General physical examination of the mother was carried out, with detailed physical examination of the baby born with congenital abnormality. Investigations of the mother carried out included Blood Group, Blood CP and Random Blood Sugar. During the study period 246 patients delivered babies with congential malformation, making a frequency of 28/1000 deliveries. Neural Tube Defects, mainly Hydrocephalus, was the commonest congenital abnormality seen in 54.6% cases. Consanguineous marriage was found in 63.3% of cases, constituting as the leading risk factor for congential abnormalities. The incidence of congential abnormalities is high due to increased number of consanguineous marriages and non-availability of early prenatal diagnostic facilities. There is a need to improve public awareness regarding problems related to maternal age and consanguineous marriages

frequency of complications of fibroid during pregnancy

The aim was to study the prevalence of complications in pregnant women with .fibroid and their outcomes. A cross sectional comparative study from Jan.2001 to Dec.2004. It was conducted at the high-risk pregnancy clinic of obstetrics OPD Gynae CHK. 50 patients were included in the study that had been diagnosed either before or during pregnancy or as an incidental finding or referred from other health care centers and private clinics. The methodology adopted was to identify patients having pregnancy with fibroid. The patients were evaluated by taking detailed history and then regularly followed in OPD for antenatal checkup. A routine Ultrasound was performed in 2nd trimester for site of myoma and placental localization and in 3rd trimester, for malpresentation and size of myoma. During the study period 50 patients were admitted with the diagnosis of fibroid with pregnancy. Among these 12 pts [24%] were primigravida, 14[28%] were multigravida, 6 patients .[24%] were admitted with acute abdominal pain, 20 [40%] delivered vaginally 6[12%] and pregnancies ended up in abortion. The results indicate that presence offibroid leads to various complications during pregnancy but with proper care, early referral to a tertiary care unit and appropriate management and provision of healthy baby in the hand of a healthy mother is possible

Effects Of Maternal Anemia On Fetal Outcome i.e. APGAR score and birth weight

To determine the effects of maternal anemia on fetal outcome i.e. birth weight and fetal Apgar score at birth and at five minutes.Cross sectional comparative study from February 2002 to February 2005.Gynaecology Unit II, Civil Hospital, Karachi.150 pregnant women with anemia and 150 pregnant women without anemia, who were admitted in the labour room of Gynae. Unit II for delivery, were included in the study.These pregnant women were evaluated by taking a detailed history, doing examination and investigations like complete blood picture, random blood sugar and ultrasonography of pelvis for fetal well being and gestational age. The newborns of all these women were followed after delivery to record their birth weight and Apgar score at birth and after five minutes.The mean fetal birth weight was 2.47 +/- 0.331 Kg in the anemic women and 3.31 +/- 0.297 Kg in the non-anemic group, with a p-value of 0.000. The mean Apgar score of newborn at one minute in the anemic group was 6.29 +/- 0.93 and in the non-anemic group was 6.77 +/- 0.42, with a p-value of 0.000. The mean Apgar score of newborn at five minutes was 8.54 +/- 0.74 in the anemic group and 8.81 +/- 0.39 in the non-anemic women, with a p-value of 0.007. The mean fetal mortality in the anemic women was 9.3%, but it was zero in the non-anemic women. There was a significant difference between the two groups with a p-value of 0.007 on chi square test.This study show that anemic pregnant women who have haemoglobin levels of <11.0 GIdl deliver low birth weight babies with a high mortality rate and with a significant difference in Apgar scores of the new barns as compared to non-anemic pregnant women who have Hgb levels > 11.0 gm/dl