ABSTRACT
As práticas pedagógicas precisam ocupar um novo lugar no ensino superior, que ainda está muito voltado àvalorização e produção de conhecimentos aplicados a cada área. Fizemos então este estudo com o objetivo deidentificar novas práticas pedagógicas na percepção dos docentes de enfermagem de um curso de enfermagemda Região Centro-Oeste. Trata-se de uma pesquisa exploratório-descritiva em que se utilizaram entrevistasabertas e grupos focais com os docentes do curso estudado. Como resultado, observamos que já ocorremalgumas mudanças e inovações no contexto da formação na faculdade e tivemos depoimentos de váriosdocentes que afirmam vir repensando e renovando as suas estratégias pedagógicas. Há a substituição da práticapedagógica tradicional por práticas mais dinâmicas, ensino mais horizontal e estímulo maior ao trabalho nocampo de práticas básicas de saúde. Isso tem levado o aluno a ser mais responsável pelo seu aprendizado,relacionando suas vivências práticas com as teorias que as explicam, e assim conseguem aperfeiçoar seusconhecimentos. Essas experiências inovadoras não são gerais, mas indicam mudanças na formação profissionaldo enfermeiro na perspectiva de contribuir para uma melhor compreensão dos princípios do Sistema Único deSaúde (SUS) nos seus variados níveis de atenção.
The pedagogical practices should have a new role in higher education, which is still too related to recognition andproduction of knowledge applied to each area. We made this analysis aiming to identify new pedagogicalpractices in the perception of nursing school professors. It is a descriptive exploratory research and it is based onopen interviews and focal groups with these professors. As a result, we could notice that some changes andinnovations in the context of graduation are already happening and we collected testimonies from severalprofessors that declared to be reconsidering their pedagogical strategies. The traditional pedagogical practice isbeing replaced by others considered to be more dynamic, like horizontal teaching and incentive to practical workon health. It makes the student more responsible by his education, because he is able to relate his personalexperiences with the theories that explain them and improve his knowledge. These new experiences are notgeneral, but they indicate some changes in the professional development of nurses and help them to betterunderstand the Single Health System (SUS) principles on its several levels of attention.
Las prácticas pedagógicas necesitan ocupar un nuevo lugar en la enseñanza superior, que aún trata más arespecto de la valoración y producción de conocimientos aplicados a cada área. Hicimos este estudio con elobjetivo de identificar nuevas prácticas pedagógicas en la percepción de los docentes de enfermería de un cursode enfermería de la Región Centro-Oeste. Se trata de una investigación exploratorio-descriptiva en que seutilizaron entrevistas abiertas y grupos focales con los docentes del curso estudiado. Como resultado,observamos que ya ocurren algunos cambios e innovaciones en el contexto de la formación en la facultad ytuvimos declaraciones de varios docentes que afirman que están repensando y renovando sus estrategiaspedagógicas. Hay la sustitución de la práctica pedagógica tradicional por prácticas más dinámicas, enseñanzamás horizontal y estímulo mayor al trabajo en el campo de prácticas básicas de salud. Eso ha levado el alumno aser más responsable por su aprendizaje, relacionando sus vivencias prácticas con las teorías que las explican, yasí consiguen perfeccionar sus conocimientos. Esas experiencias innovadoras no son generales, pero indicancambios en la formación profesional del enfermero en la perspectiva de contribuir para una mejor comprensiónde los principios del Sistema Único de Salud (SUS) en sus variados niveles de atención.
Subject(s)
Humans , Male , Female , Faculty , Education, Nursing , TeachingABSTRACT
To study the prevalence and the patterns of peripheral neuropathy in patients with chronic renal failure. The study was conducted on 40 patients with chronic renal failure [CRF] and 20 healthy subjects of matched age and sex [control group]. Patients were divided into 2 groups. Group]: those with chronic renal failure treated conservatively [n=20] and Group II. those with end stage renal disease treated by hemodialysis [n=20]. Patients were selected randomly. The presence of polyneuropathy and its severity was assessed in all participants hi clinical, neurological examination and the following electro-physiological methods: 1] motor nerve conduction of the median, ulnar, tibial and peroneal nerves, 2] sensory nerve conduction studies of the sural, ulnar and radial nerves 3] F-wave study of the median, ulnar, tibial and peroneal nerves; and 4] Soleus H-reflex. The prevalence of polyneuropathy in group 1 and group 2 were 60% and 65%, respectively [with no significant difference between them]. Polyneuropathy was evident clinically in 37.5% of CRF patients and subclinical neuropathy [diagnosed only on electrophysiological basis] was found in 25% of GRE patients. Electrophysiological abnormalities suggested that the pathology was mainly axonopathy as there was a significant reduction of the CMAP amplitudes. The pattern of uremic neuropathy was axonal, affecting sensory fibers more than motor ones. It seemed that the most sensitive tests in detecting uremic neuropathy would be the H reflex, sural sensory nerve conduction, the peroneal and tibial F wave studies and the median, peroneal and tibial motor conduction studies
Subject(s)
Humans , Male , Female , Electrophysiology , PolyneuropathiesABSTRACT
Comparative analysis of problems encountered between patients of elective caesarean section and patients for whom elective caesarean section was planned but ended up in emergency caesarean section. Descriptive prospective analysis. Gynae Unit-II, Services Hospital, Lahore. One year, 1 st January 2006 to 31st December 2006. A prospective study of 100 patients who presented for antenatal care [ANC] and for whom elective caesarean section [CS] was planned was done. Patients evaluation was done on a designed performa that included demographic, social and obstetrical histories. Problems encountered in the preparatory stage, logistic problems, administrative problems, problems encountered during surgery, maternal, fetal mortality and morbidity were noted. The patients were divided into two categories. Categories I: included patients who had elective CS and category II: included patients who ended up in emergency CS. Numerous problems were encountered for category II patients. In the preparatory phase there was difficulty in arranging medicines for 32 patients. [59.2%], arranging blood for 28 patients [51.8%], obtaining consent for 1 patient [1.85%]. Logistic problems included non-availability of operation theatre for 15 patients [27.75%], nonavailability of anaesthetist for 9 patients [16.65%], and non-availability of paediatrician for 38 babies [17.3%]. None of the emergency CS were done with in the recommended 30 minutes interval. Despite this, there was no significant coloration between the decision delivery interval [DDI] and perinatal outcome. In our study like threatening cases were operative within 60 minutes. Intra operative problems in the category II patients included adhesions in 40 patients [74%] vs 10 patients [21.7%] of category I, partial dehiscence in 16 patients [29.6%] of category II vs 4 patients [8.68%] of category I. Excessive hemorrhage in 8 patients [14.8%] of category II vs 2 patients [4.34%] of category I. Among the post operative complications anemia was present in 20 patients [43.4%] of category I vs 45 patients [83.25%] of category II patients. Blood transfusion was required for 16 patients [29.6%] of category II vs 4 patients [8.68%] of category I and all patients were given iron supplement. Major wound infection were seen in 9 patients [16.65%] of category II vs 2 patients [4.34%] of category I. Resuturing was done after appropriate antibiotic cover and daily. antiseptic dressing. Minor wound infections were seen in 22 patients [40.7%] of category II vs 12 patients [26.04%] of category I. Urinary Tract Infections [UTI] was seen in 6 patients [11.1%] of category II vs 1 patient [2.17%] of category I. Respiratory Tract Infection [RTI] was seen in 5 patients [9.25%] of category II vs 2 patients [4.34%] of category I. All these were treated by appropriate antibiotic cover. Regarding the neonatal outcome 16 babies [29.6%] of category II were kept under observation in neonatal nursery [NNU] as compared to 6 [13.02%] babies of category I. Admission for 2-10 days in NNU were 8 babies [14.96%] of category II vs 2 babies [4.34%] of category I. 2 babies [3.74%] of category II expired later while none of category I. Patients for whom elective CS was planned but who ended up in emergency CS, the DDI was prolonged and there was increase risk of maternal morbidity, fetal morbidity and mortality as compared to those patients who had elective CS
Subject(s)
Humans , Female , Cesarean Section/methods , Emergency Treatment , Elective Surgical Procedures , Postoperative Complications , Blood Transfusion , Anemia/etiology , Pregnancy Outcome , Prospective Studies , PregnancyABSTRACT
To find out maternal and fetal outcome in induction of labour compared with expectant management for prelabour rupture of membranes at term. Open randomized comparative study. Gynae Unit- II Services Hospital, from 1st April 2007 to 30 September 2007. 100 patients at > 37 weeks with ruptures membranes with no contraindication to vaginal delivery were enrolled in the study. 50 patients were in the expectant group while 50 patients were in the induction group. Both groups had the same general characteristics but the Misoprostol group had a significantly shorter latancy period [10-16 hour Vs 20-24 hours], shorter period of hospitalization, lesser LSCS rate [24% Vs 34%] lesser need of augmentation [40% Vs 62%], choroamnionitis [3% Vs 7.8%], and postpartum fever [1% Vs 1.8%] when compared with expectant group. Rate of infected wound after LSCS were compared in induction and expectant groups [2.2% Vs 2.6%], also there was no difference between them regarding neonatal morbidity and nursery admission. So it was concluded that there was slightly high maternal complications in expectant group but no long-term maternal morbidity. Both groups have no effect on neonatal morbidity and mortality however the duration between PROM and delivery effect the neonatal admission in nursery and antibiotic requirements.
Subject(s)
Humans , Female , Pregnancy Outcome , Chorioamnionitis , Fetal Distress , Disease ManagementABSTRACT
To analyse the fetal and maternal outcome in patients with placenta previa. Descriptive prospective analysis. Gynae Unit I, Jinnah Hospital, Lahore. Duration: One year, 1st July1996 to 30th June 1997. A prospective study of 50 patients with sonographically proven placenta previa was done. Patient/s evaluation was done on a designed performa that included demographic. social and obstetric history. amount and duration of blood loss, presence or absence of fetal heart sounds and duration of gestation. Maternal, fetal mortality and morbidity was noted Maternal morbidity was considerable among the unhooked patients. Two [4%] patients required caesarean hysterectomy due to abnormally adherent placenta. Anemia was present in all patients. Forty-four [88%] patients needed blood transfusion Hence majority needed multiple blood transfusions and later iron supplements. Wound infection was seen in 28[56%] patients, and was treated by appropriate antibiotic cover. Partial wound breakdown was seen in 8 [16%] patients Resuturing was done after appropriate antibiotic cover and daily antiseptic dressing. Urinary tract infection was seen in 5[10%] patients and was managed accordingly. Two [4%] patients had respiratory tract infection and were treated with appropriate antibiotic cover. There was no maternal mortality. Out of 50 births, 25[50%] were preterm and 25[50%] were term babies. Forty three [86%] patients had alive babies. 7[14%] were IUD on admission while 5[10%] of the preterm babies had neonatal deaths. Fetal morbidity included prematurity related effects alives RDS hypothermia hypoglycemia and jaundice. All were treated accordingly. Pregnancy with placenta previa is a high risk pregnancy for both the mother and the fetus. Timely diagnosis quick efficient resuscitation and timely ceasarean section results improved maternal and perinatal outcome even in unbooked patients. Expectant management is cost effective rewarding, safe and decreases perinatal morbidity