ABSTRACT
Objectives: The purpose of the study was to identify the sequence of violence that ensues after breaking bad news and develop a contextual model of breaking bad news and develop a model contextual for Pakistan
Methods: A qualitative exploratory study was conducted using Six FGDs and 14 IDIs with healthcare providers working in the emergency and the obstetrics and gynecology departments of tertiary care hospitals of Karachi, Pakistan. Data was transcribed and analyzed to identify emerging themes and subthemes using thematic content analysis
Results: Impatience or lack of tolerance, lack of respect towards healthcare providers, unrealistic expectations from healthcare facility or healthcare staff were identified as main reasons that provoked violence after breaking bad news. A conceptual five step model was developed to guide communication of bad news by the health care providers. On initial testing the model was found to be effective in deescalation of violence
Conclusion: Communication of bad news requires application of specific approaches to deal with contextual challenges for reducing violence against healthcare
ABSTRACT
Objective: Frequency of thyroid dysfunction in high risk pregnancies
Settings: Department of Obstetrics and Gynecology, Allied Hospital Faisalabad
Study design: Cross-sectional study
Duration of study: 16-06-2014 to 15-12-2014
Methodology: A total of 245 patients were included in this study. On the basis of TSH, T3, T4 reports thyroid dysfunction [hypothyroidism/hyperthyroidism] was observed
Results: Mean age of the patients was 29.43+/-5.21 years. Mean gestational age was 36.45 +/- 2.72 weeks. Thyroid dysfunction was observed in 63 patients [25.7%]. Out of theses 63 cases, Hypothyroidism fond in 44 [69.9%] and Hyperthyroidism in 19 patients [30.1%]. High risk pregnancy factors were IUGR in 85 patients [34.7%], GDM in 100 patients [40.8%], preeclampsia in 52 patients [21.2%] and IUFD in 8 cases [3.3%]. Distribution of high risk pregnancy factors in cases of thyroid dysfunction [n=63] were as follows: IUGR in 17 cases [27.0%], GDM, 20 cases [31.7%], preeclampsia in 18 cases [28.6%]. IUFD in 8 cases [12.7%]. Stratification of effect modifiers was carried out
Conclusion: The rate of thyroid dysfunction is increased in pregnant women with high-risk pregnancy. Under the currently recommended screening method, the majority of thyroid dysfunctions may be missing. With a full awareness of high incidence of thyroid dysfunction in pregnant women with obstetrical or medical complications, consideration should be given regarding the screening efficiency during pregnancy
ABSTRACT
Cuscuta reflexa Roxb. [Convolvulaceae] has medicinal applications used in treating wide range of diseases including cancer. The methanolic extract of C. reflexa Roxb. [MECR] grown on host Nerium oleander L.] and its pure compounds namely, odoroside H [1], neritaloside [2] and strospeside [3] were assessed for genotoxicity using mitotic meristematic root tip cells of Allium species [A. cepa and A. sativum] and meiotic pollen mother cells from Tradescantia pallida var purpurea. The effect of pure compounds were also evaluated in human non-small cell lung cancer cell line [NCI-H460] on tumor suppressor gene [p53] and epidermal growth factor receptor [EGFR] expression using agarose gel electrophoresis. The MECR between 0.1 and 1 mg/ml was ineffective in mitotically dividing cells, whereas in meiotic pollen mother cells, higher concentrations [5-20 mg/ml] caused significant induction of micronuclei [MN]. In both mitotic and meiotic cells, odoroside H and neritaloside induced significant rise in MN frequency, however, strospeside had no effect. The genotoxic potential in both cells was in the order of: [1] = [2] > MECR > [3]. MECR and odoroside H [1] caused dose dependent growth inhibition in NCI-H460 cells with GI50 of 0.92 +/- 0.04 microg/ml and of 0.08+/-0.01 microg/ml, respectively. The antiproliferative action of MECR [1 microg/ml], odoroside H [1] [0.14 microM], neritaloside [2] [.16 microM] and strospeside [3] [0.5 microM] in comparison to control, significantly downregulated expression of epithelial growth factor receptor [EGFR] by two fold with no affect on p53 gene expression. This study clearly demonstrates that MECR is genotoxic at higher doses and should be taken into account if used for medicinal purposes. The mitotic cells of Allium species were more sensitive [2x] in MN formation than meiotic cells of T. pallida pu. Furthermore, MECR and pure compounds possesses antiproliferative activity against NCI-H460 cells that might be mediated through EGFR-dependent but p53-independent pathways?
ABSTRACT
To identify the diagnostic factors of ovarian cancer. Department of Obstetrics and Gynaecology Nishtar Hospital, Multan. All those women who were diagnosed to have ovarian cancer were initially recruited for the study purpose. A proforma was filled by each patient with help to assess the time lag between the initial symptoms experienced by the patient and their referral to the tertiary centre. Course followed by the patient to reach the tertiary centre was also assessed. At the end the data was analyzed to highlight the various caused of delay. Various caused of late presentation were:-Vague and non-specific symptoms. Initial presentation to general practitioners having little awareness. Presentation to non-professional personals. Early detection of ovarian cancer will continue to challenge the skill of astute clinicians as well as their accumulated scientific acumen
Subject(s)
Signs and Symptoms , DiagnosisABSTRACT
To find out the proportion of young girls having premenstrual syndrome in Multan city and the relationship of age with the occurrence of the symptoms. Descriptive study. Intermediate and Degree classes of the Government Degree College for Women, Multan, Six months from 25th August 2004 to 28th February 2005. 1500 young girls [college students] were selected by using non probability convenience sampling, after fulfilling the inclusion and exclusion criteria. The questionnaire was discussed with the students. Students were counselled and their consent was taken. The questionnaire was filled by the students and collected on the spot. 60% of the recruited girls were suffering from premenstrual syndrome with peak age distribution in late teens among the group of 16-22 years. Amongst the cluster of symptoms extreme fatigue, irritability, tension, and depressed mood were the behavioral symptoms, and abdominal bloating, headache, and breast tenderness were the somatic symptoms. Daily activities of 47% of the girls were affected due to symptom severity. 77% never sought medical advice for the symptoms. With the increasing level of mothers' education the occurrence of the disease in daughters decreased. Amongst the girls with the disease 73% had indoor activities. 60% of the young girls in Multan city had premenstrual syndrome with peak age distribution 17-19 years
Subject(s)
Humans , Female , Premenstrual Syndrome/diagnosis , Behavioral SymptomsABSTRACT
To find out the Magnitude and nature of dysmenorrhoea in adolescent age group girls of Multan city and to find out the relationship of dysmenorrhoea with mothers education and hobbies. Secondary schools and intermediate classes of colleges of Multan City Pakistan. Girl students of age 12-18 yrs studying in secondary schools and intermediate classes of Multan city They were randomly picked from the list of students provided by the headmistress principal, A questionnaire was discussed with the girls. It was filled on the spot, collected, screened, edited. and finally those who fitted according to the inclusion and exclusion criteria Were selected for analysis. 72% of the girl students from age 12-18 yrs had primary dysmenorrhoea, Maximum prevalence is at the age of 14-16 yrs, 8% had severe form of dysmenorrhoea 78% of the girls took some form of treatment for this problem. Girls who were involved in sports had less pain than others. Primary dysmenorrhoea is a very common problem of adolescence, As gynecologists we have to address this issue so that a disease state can be differentiated from a physiological condition