clinical examination long case the most valid test in a medical school

This article includes [1] the basic contents of clinical examination long case [ii] the strengths of the examination with justify labeling it as the most valid [iii] guidelines for conduction of the examination [iv] guidelines for marking [v] the place of the short case and objective structured clinical examination [OSCE] in the end of course examination

Malaria in pregnancy -Wad Medani Maternity Teaching Hospital

This is a prospective hospital - base study conducted in Wad Medani Maternity Teaching Hospital, during the period from 5[th] of October 2003 to 30[th] of December 2003. The objective of this study were to assess the status of malaria in the wards in Wad Malani Maternity Teaching Hospital, to determine the effects of malaria on the mother as well as on pregnancy outcome, and also to test the National Protocol for Treatment of Malaria during Pregnancy using Wad Madani Maternity Teaching Hospital. All pregnant women with malaria admitted to the hospital during that period were included in the study. Malaria was diagnosed by thick and thin blood film, Gimsa's stain. Severe falciparum malaria was diagnosed according to WHO criteria. National Protocol for Treatment of Malarial during Pregnancy was adopted in the management of all women. Patients were consider to be cure if symptoms and signs disappeared. The results were analysed using SPSS. The total number of pregnant women included in this study was 210. The main results of the study were: [i] severe falciparum malaria [73.4%], [ii] anaemia [98.6%] of whom 20%] was severe and [11%] was very severe, [iii] hyperparasitaemia [46.7%], [iv] dehydration [33.3%] and [v] jaundice [20.5%]. Complications on the fetus were: [i] preterm labour [44.1%], [ii] low Agars score < 7 [55.9%], [iii] low weight K 2.5 [44.1%] and [iv] perinatal death [5.5%]. Quinine was the main drugs used, Pregnant women admitted to the hospital need intensive care. Although there was no mortality but morbidity was high. The current protocol is adequate in reducing mortality. Intervention to reduce poor pregnancy outcomes must reduce the burden of malaria in pregnancy

Instrumental [Operative] vaginal deliveries: vacuum extraction compared with forceps delivery at Wad Medani Teaching Hospital, Sudan.

The risks to the mother and newborn associated with the use of vacuum extractor [V.E.] in comparison with those associated with the use of low delivery forceps [L.D.F.] were studied prospectively. Sixty-nine women were enrolled into the study, all with single, term [37 weeks or more] babies, with cephalic presentation, required assisted vaginal deliveries. They were randomized to either vacuum group [38] or forceps [31]. Third degree perineal tears, vaginal and cervical lacerations, requirement of blood transfusion were observed less frequently in the group delivered by V.E., the differences were not statistically significant. One baby in the vacuum group developed cephalohaematoma. The vacuum group had a less stay in hospital [more than 48 hours] than the forceps group and the difference is statistically significant. There were no significant differences in the mean birth weight, Apgar scores and the numbers of babies admitted to the intensive care unit. One baby delivered by forceps died shortly after birth. There was no maternal death in either group

Post - caesarean section infection.

Post-caesarean infection continues to be a major cause of maternal morbidity and mortality. Understanding the various aspects of this grave complication has improved our approach to its management and prevention. We review the present knowledge about post-caesarean infection regarding: incidence, risk factors, diagnosis, causative organisms, antibiotics and prophylaxis. We conclude that the incidence ranges between 5 - 85% depending on the population studied; the main risk factors are labour, ruptured membranes and repeated vaginal examinations, the diagnosis is mainly clinical, the infection is polymicrobial, the antibiotics of proven value are gentamycin/clindamycin, ureidopenicillins and third generation cephalosporins. Antibiotics prophylaxis is recommended in all women undergoing elective or non-elective caesarean section