Parenting stress in mothers of children with disabilities: a comparative study

This study aimed to explore the differences in the level of parenting stress among the mothers of children with hearing impairment [C-HI], mothers of children with intellectual disabilities, mild [C-ID], and mothers of children without any disability [C-WOD]. The sample comprised of 145 niothers of children divided into: mothers of C-HI, [N=56]; mothers of C-ID [N= 37]; and mothers of C-WOD [N=52]. Parenting Stress Index [Abidin, 1995] was administered to measure the stress related to parenting. One Way ANOVA indicated that there is significant difference in the level of parenting stress between mothers of C-HI, mothers of C-ID and mothers of C-WOD. Post hoc comparisons using Tukey 's HSD indicated higher level of parenting stress in both mothers of C-HI and mothers of C-ID in contrast to mothers of C-WOD. However, the mean difference between mothers of C-HI and mothers of C-ID was found to be insignificant. These findings are suggestive of higher parenting stress in mothers of children with disabilities. Limitations and avenues for future research were suggested

Impact of antenatal diagnosis and management strategies in morbidity adherent placenta

To study the pattern, demography and management options in placenta accreta in a tertiary care centre. 1st January 2004 to 15 August 2008 at Military Hospital, Rawalpindi and between 1[st] Sep 2008 to 30[th] Oct 2009 at Combined Military Hospital, Multan. All cases of placenta accreta seen during the study period were included in the study. Placenta accreta was defined as placenta being adherent to uterine wall without easy separation. Patient's demography, presence or absence of prenatal diagnosis and the management strategy i.e. conservative or otherwise was documented on a proforma. Success or failure of surgical approach used was noted. Assessment of maternal morbidity in the form of amount of blood/blood product transfused and early and late complications was made and compared with other cases that were antenatally diagnosed or were undiagnosed. A total of 28 cases were analyzed during study period. The incidence of placenta accreta was 6.3/10000. Mean maternal age was 30.7 years. Placenta praevia obstetrical hysterectomy was performed in 17 [61%] cases and had to be backed up by internal iliac artery ligation in 7[25%] Requirement for blood transfusion in antenatally diagnosed cases was almost 50% less than those of undiagnosed cases and the same was true for fresh frozen plasma [3.75 +/- 4.18 versus 6.75 +/- 5.41], platelet transfusion [P=0.04], stay in intensive care unit [1.56 +/- 1.82 versus 3.41 +/- 3.28] and use of mechanical ventilation [7% versus 11%]. There was no mortality in this series. Intra-operative internal iliac artery ligation reduces blood loss before and after hysterectomy and should be done in cases with placents accreta to reduce morbidity and mortality

Locus of control: an important determinant of self esteem and perceived life satisfaction of married women

The study aims to determine the effects of internal and external locus of control upon self-esteem and perceived life satisfaction of married women. It was hypothesized that Married women with internal locus of control will have higher perceived self esteem and perceived life satisfaction than married women with external locus of control. To find out the difference between both the groups, the sample comprised of 82 married women with age range of 25 to 40 years. They were approached individually and consent was taken for their participation as a sample. After gathering demographic information, Rotter's Internal-External Locus of Control Scale [Rotter, 1966a], Self Esteem Scale [Rosenberg, 1965] and Satisfaction with Life Scale [Diener, Emmons, Larsen and Griffin, 1985] were administered, t' test was applied in order to find out the difference between women with internal and external locus of control. Results reveal significant difference in the level of self-esteem [t =-3.203, df= 80, p< .01] and life satisfaction [t = -3.285, df = 80, p< .01], between women with internal [Self esteem X - 32.34 and life satisfaction X=20.02] and external [Self esteem X =29.60 and life satisfaction X= 17.34] locus of control. It is clear that the self-esteem and life satisfaction of women with internal locus of control is significantly higher than women with external locus of control. Hence, it is interpreted that internal locus of control helps to develop better self-esteem and contribute in the development of higher level of life satisfaction than external locus of control. Avenues for future research have also been given

comparison of sevoflurane with midazolam to provide sedation to patients for surgery under locoregional anaesthesia

To compare the quality, speed of recovery, and side effects of sevoflurane sedation compared with intravenous midazolam. Quasi experimental, double-blind, comparative study. Operation theatre complex, Combined Military Hospital Rawalpindi from 1st June 2006 to 31st Dec 2006. Total of sixty patients, American Society of Anaesthesiology I-III aged 18-70 years undergoing surgery under locoregional anaesthesia were divided into two equal groups by convenient sampling. Group A: [n=30] received Sevoflurane sedation. Group B: [n=30] received Midazolam sedation. The patients were sedated gradually during the procedure and maintained at Observer`s assessment of alertness and sedation [OAAS] score of 3. At recovery the OAAS score was measured at 5, 10 and 30 minutes after stopping the drug administration. Subjective assessment of quality of recovery was measured by visual analog scale [VAS] determined at baseline and 5, 10, and 30 min of recovery. On observer`s assessment of alertness and sedation score no significant difference was observed between the two groups in the first 10 min after drug discontinuation but after 30 min allpatientsin group A and 26 out of 30 patients in group B had returned to an OAAS of 5 [p= 0.039]. Subjective recovery as assessed by VAS scores showed that patients were more awake, had higher energy level, were less confused and better coordinated in group A sedation at 10 and 30 min post-procedure as compared to midazolam group B. Sevoflurane for sedation produced faster recovery as compared to intravenous midazolam measured by OAAS score and subjective assessment on VAS scale. However, sevoflurane is complicated by a high incidence of intra-operative excitement