Obstructed labor though being a well-known entity, cephalopelvic disproportion is the most common cause causing labor dystocia.Urethral diverticulum stone is a rare cause of obstructed labor.We report a case of urethral diverticulum stone obstructing the labor in a primigravida where cause of obstruction was confirmed by sonographic modality.
Background: World health organization estimates that 25 million low birth weight (LBW) babies are born annually worldwide and 95% occur in developing countries. Low birth weight is a major public health problem of Bangladesh. So an attempt was made to study the incidence of low birth weight (<2.5kg) and also the associated risk factors of low birth weight among the new born babies born to Dhaka Medical College Hospital.Aims: To determine the Prevalence of low weight among the babies born and to determine the relationship of low birth weight with maternal factor like maternal weight, height, gestational period, antenatal checkup, heavy physical work during pregnancy, hypertension, age of the mother and parity, in Obs. & Gynae Department, DMCH.Method: This descriptive cross sectional study was done in Gynecology and Obstetrics Department of Dhaka Medical College Hospital. Five hundred (500) samples were selected for the study. The study was done from 1st January 2006 to 31 December 2006. Data processing and questionnaire are processed manually using scientific calculator and by computer using SPSS programmers version-16. All abortions, still born, gross congenital abnormalities were excluded from this study. The cut off point used for low birth weight is 2.5 kg.Results: A total of 500 women were interviewed. The incidence of low birth were found 21.6%. Younger than 20 yrs (31.25%) and more than 40 years (35.71%) mother delivered more low birth weight babies. The primigravida and multigravida (>4 parity) showed more low birth weight babies. Women from low socioeconomic condition produced significantly larger number of low birth weight babies as well as short stature. Low maternal height, less educated, illiterate, manual worker mother delivered more low birth weight babies. Preterm birth comprises larger number of low birth weight (LBW 35%). Low height of new born babies also associated with low birth weight. Female babies were higher than the male babies. Preterm babies were lighter (LBW) than the full term babies.Conclusion: The study finds out the incidence of low birth babies, the figure close to the developing countries. The study revealed that maternal age, gestational age, parity, socioeconomic status, maternal weight and disease condition have strong relations with birth weight of babies. Occupation and antenatal check up also affects birth weight of babies.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 16-22
High infant and maternal mortality rates are one of the biggest health issues in Pakistan. Although these rates are given high priority at the national level (Millennium Development Goals 4 and 5, respectively), there has been no significant decrease in them so far. We hypothesize that this lack of success is because the undergraduate curriculum in Pakistan does not match local needs. Currently, the Pakistani medical curriculum deals with issues in maternal and child morbidity and mortality according to Western textbooks. Moreover, these are taught disjointedly through various departments. We undertook curriculum revision to sensitize medical students to maternal and infant mortality issues important in the Pakistani context and educate them about ways to reduce the same through an integrated teaching approach. The major determinants of infant mortality in underdeveloped countries were identified through a literature review covering international research produced over the last 10 years and the Pakistan Demographic Health Survey 2006-07. An interdisciplinary maternal and child health module team was created by the Medical Education Department at Shifa College of Medicine. The curriculum was developed based on the role of identified determinants in infant and maternal mortality. It was delivered by an integrated team without any subject boundaries. Students' knowledge, skills, and attitudes were assessed by multiple modalities and the module itself by student feedback using questionnaires and focus group discussions. Assessment and feedback demonstrated that the students had developed a thorough understanding of the complexity of factors that contribute to infant mortality. Students also demonstrated knowledge and skill in counseling, antenatal care, and care of newborns and infants. A carefully designed integrated curriculum can help sensitize undergraduate medical students and equip them to identify and address complex issues related to maternal and infant mortality in underdeveloped countries.
Aim: To evaluate the association of altered lipid levels and development of adverse maternal and fetal outcomes. Materials and methods:Women attending outpatient department (OPD), antenatal care (ANC) and in patient department (IPD) of the
Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method.
Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight.
Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis.
Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight.
Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality.
J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38
Objective
To use different teaching tools and study their effectiveness by assessing changes in
knowledge, attitude and management skills of fourth year medical students about breast
feeding.
Methods
A six hour course, spread over three days was designed using Guidelines from
Breastfeeding Counseling; A Training Course, WHO/CDR 93.3 and UNICEF/NUT 93.1..
Lectures and large group interactive sessions, small group discussions and role playing
were used to teach different components of the course. Participants were evaluated by pre
and post test of the same set of multiple choice questions. Six questions dealt with
contents taught in the form of lectures, four covered small group contents and another
four questions evaluated the contents taught in role playing.
Results
Out of a total of 80 students, 68 completed the course. Mean score before the course was
7.86±2.37 which increased to 11.37±1.26 after the course. Percentage change in Pre and
post test scores for lectures, small group sessions and role playing were 18.34%, 25.5%
and 35.75% respectively.
2
Conclusion
All teaching strategies were found to be effective in increasing knowledge, changing
attitude and providing management skills necessary for promoting breast feeding.
Maximum gain was seen with the role playing. (Rawal Med J 2009;34: ).
Background: Genitourinary prolapse is a common gynecological problem, especially in developing country. Causes and risk factors for uterine prolapse are complex and deeply embedded in the cultural, economic and social conditions of women. Prevalence of depression is higher among women with advanced stages of prolapse. Hence this study aimed to assess the socio-demographic factors among patients with genitourinary prolapse. Methods: A cross-sectional study was conducted from January to December, 2013 among 120 women with genital prolapse who attended at Gynae wards of Dhaka Medical College Hospital, Shaheed Suhrawardy Medical College Hospital, and Mitford Hospital in Dhaka. Women who were admitted with complaints of protruding mass per vagina and diagnosed as case of uterine prolapse were assessed and staged accordingly. A semi-structured questionnaire was used to obtain socio-demographic data and prolapse related data by face to face interview. After collection, data were compiled, summarized, and analyzed using SPSS software. Results: In this study, out of 120 genitourinary prolapsed patients, 31.7% were 40-45 years age group, majority of 79.2 % were illiterate and almost two third had no monthly income. Among all respondents, 64.2 % had more than four children, maximum 96.7% had history of home delivery, and 91.7% history of heavy work during pregnancy or just after delivery. Conclusion: Genitourinary prolapsed patients were illiterate, multipara, economic insolvency, heavy work during pregnancy and home delivery. A holistic management approach is recommended for women having prolapse. JOPSOM 2021; 40(2):26-31
Objective: Prevalence of anemia in Pakistan is high. Magnitude of anemia is well studied in
pregnant woman and infants in Pakistan, but we do not have enough data on school age
children. The aim of this study was to find the frequency of anemia in apparently healthy
primary school age population in Islamabad and its suburban area.
Material and Methods: All children between the ages of 5 and 14 years attending
participating non-formulary schools in Islamabad and its suburbs were enrolled in the study.
Children attending these schools belong to low to lower middle socioeconomic status.
Hemoglobin level was determined in all subjects and a level
Introduction: The importance of faculty development programs (FDP) to improve teaching effectiveness has been emphasized in recent years. Our endeavors to improve teaching ways at Shifa College of Medicine, include development of student feedback mechanisms, professional development programs, and research into teaching. New trends taking place in academic medicine were accommodated by modification of faculty development model.
Methods: With an aim to assess the perceptions of faculty about FDP at Shifa College of Medicine we gathered views of faculty, by administering questionnaire, conducting focus group and individual interviews.
Results: More than half of faculty (51%-83%) agreed with various items related to teaching and learning concepts, 79% believed that they learned assessment methods. 73% agreed that it was a source of introduction to new educational strategies. Sixty-eight percent agreed that FDP helped to improve skills in teaching of ethics and professionalism. Results of focus group discussion show that faculty found program helpful in their grooming and development and it made them more knowledgeable. Views from individual interviews stated that faculty development program has contributed towards learning.
Conclusion: In conclusion FDP at Shifa College of Medicine is valued by faculty. It has contributed towards excellence in teaching. This program should be continued with an endeavor to improve it further.
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