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Misoprostol in obstetrics and gynaecology — benefits and risks
G Essilfie-Appiah, GJ Hofmeyr, J Moodley
South African Journal of Obstetrics and Gynaecology , 2005,
Abstract: Misoprostol is currently being used for induction of labour at or near term and also for termination of pregnancy. Its use without proven dosage regimens is possibly associated with an increase in the incidence of uterine hyperstimulation, preterm labour, induced abortion above 20 weeks' gestation, meconium-stained liquor in the latent phase of labour, fetal distress and cases of uterine rupture as demonstrated by these case reports and literature review. Its use for these purposes must be under controlled circumstances, using minimum doses. South African Journal of Obstetrics and Gynaecology Vol.11(1) 2005: 9-10
Leadership in Obstetrics and Gynaecology and Contribution to the Millenium Development Goal 5  [PDF]
DJ Taylor
Nepal Journal of Obstetrics and Gynaecology , 2012, DOI: 10.3126/njog.v7i2.11131
Abstract: DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11131 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 1-2
Chlamydia trachomatis Prevalence in Iranian Women Attending Obstetrics and Gynaecology Clinics
Leili Chamani-Tabriz,Mahmood J. Tehrani,Mohammad Mehdi A. Akhondi,Alireza Mosavi-Jarrahi
Pakistan Journal of Biological Sciences , 2007,
Abstract: This study was designed to estimate the prevalence of Chlamydia infection in women attending Obstetrics and Gynaecology clinics in Tehran, during May 2003 to October 2003. Women attending Obstetrics and Gynaecology clinics aged 15-42 were recruited by Sequential Random Sampling. Those who had not passed urine in the last hour were eligible. Informed consent was obtained and a questionnaire completed after being interviewed by a midwife. First void urine was collected and after DNA extraction from urine specimen, PCR tests were performed; urine DNA samples were tested by strand displacement amplification (SDA) for Chlamydia confirmation. 12.6% (133/1052) tested positive for Chlamydia by PCR. Of these PCR positive samples, 86 were available for re-testing by SDA and 67 were positive giving a correlation between the tests of 78%. This gave an overall true prevalence of 6.4% which is however, underestimated. No statistical differences were seen between patient age groups, details of personal and reproductive history and combined PCR and SDA positivity for C. trachomatis. A 12.6% prevalence of Chlamydia trachomatis was found by PCR testing which is cost effective to screen and treat. Despite limitations in re-testing PCR-positive samples by SDA, a 78% correlation between tests confirms a high prevalence of C. trachomatis. Non-invasive screening of women was therefore a success in this group of patients. As this was the first time that more sensitive molecular methods were used for detection of C. trachomatis, prevalence in such a big sample size, the results are considerable. However, we suggest further such testing.
The quality of reporting of primary test accuracy studies in obstetrics and gynaecology: application of the STARD criteria
Tara J Selman, R Katie Morris, Javier Zamora, Khalid S Khan
BMC Women's Health , 2011, DOI: 10.1186/1472-6874-11-8
Abstract: The included studies of ten systematic reviews were assessed for compliance with each of the reporting criteria. Using appropriate statistical tests we investigated whether there was an improvement in reporting quality since the introduction of the STARD checklist, whether a correlation existed between study sample size, country of origin of study and reporting quality.A total of 300 studies were included (195 for obstetrics, 105 for gynaecology). The overall reporting quality of included studies to the STARD criteria was poor. Obstetric studies reported adequately > 50% of the time for 62.1% (18/29) of the items while gynaecologic studies did the same 51.7% (15/29). There was a greater mean compliance with STARD criteria in the included obstetric studies than the gynaecological (p < 0.0001). There was a positive correlation, in both obstetrics (p < 0.0001) and gynaecology (p = 0.0123), between study sample size and reporting quality. No correlation between geographical area of publication and compliance with the reporting criteria could be demonstrated.The reporting quality of papers in obstetrics and gynaecology is improving. This may be due to initiatives such as the STARD checklist as well as historical progress in awareness among authors of the need to accurately report studies. There is however considerable scope for further improvement.In obstetrics and gynaecology there has been a rapid growth in the development of new tests and primary studies of their accuracy. These studies generate a comparison of the result from an index test against an accepted reference standard [1]. The accuracy of the index test is usually expressed as sensitivity and specificity or other measures like the diagnostic odds ratio (DOR), likelihood ratio (LR) or area under a receiver-operator characteristics curve [2]. These allow clinicians to judge the usefulness and suitability of testing in clinical practice. It is imperative that such studies are reported with transparency allowin
Application of PBL Bilingual Teaching Method in Clinical Probation of Gynaecology and Obstetrics  [PDF]
Yan Zhang
Creative Education (CE) , 2017, DOI: 10.4236/ce.2017.84051
Abstract: Objective: To explore the effect of the problem-based learning (PBL) bilingual teaching model in clinical probation of gynecology and obstetrics. Method: Students in grade 2013 and grade 2014 in the gynecology and obstetrics department were enrolled in this study. 37 students in grade 2013 received a lesson taught using the traditional bilingual teaching model, in which the teacher leads the course. 42 grade 2014 students were taught a similar lesson using the PBL bilingual teaching model in which student group discussions drive the class. In this model, students receive a lecture a week before receiving an English case study. The students discuss the case studies within smaller groups, present the case to the class and then discuss the case with other groups in a classroom discussion. The teachers provide supplemental information as needed. Following the lesson, the effectiveness of each teaching method was evaluated by written theoretical examination and questionnaire survey. Results: Students taught with the PBL bilingual method scored significantly higher in basic knowledge, case analysis and treatment selection than students taught with the bilingual method alone (P < 0.05; Table 1). Students taught with the PBL bilingual method reported experiencing greater interest in learning, and improved independent learning, English speaking, and collaboration skills than those taught with the bilingual teaching method (P < 0.05). There was no statistical difference between the two teaching methods with respect to critical thinking and problem-solving skills (P > 0.05; Table 2) Conclusion: The PBL bilingual teaching model improves the learning and comprehension, strengthens critical thinking and problem solving skills and improves English speaking skills in gynecology and obstetrics medical students.
Methodological quality of test accuracy studies included in systematic reviews in obstetrics and gynaecology: sources of bias
Rachel K Morris, Tara J Selman, Javier Zamora, Khalid S Khan
BMC Women's Health , 2011, DOI: 10.1186/1472-6874-11-7
Abstract: A prospective protocol was developed to assess the impact of QUADAS on ten systematic reviews performed over the period 2004-2007.We investigated whether there was an improvement in study quality since the introduction of QUADAS, whether a correlation existed between study sample size, country of origin of study and its quality. We also investigated whether there was a correlation between reporting and methodological quality and by the use of meta-regression analyses explored for items of quality that were associated with bias.A total of 300 studies were included. The overall quality of included studies was poor (> 50% compliance with 57.1% of quality items). However, the mean compliance with QUADAS showed an improvement post-publication of QUADAS (54.9% versus 61.4% p = 0.002). There was no correlation with study sample size. Gynaecology studies published from the United States of America showed higher quality (USA versus Western Europe p = 0.002; USA versus Asia p = 0.004). Meta-regression analysis showed that no individual quality item had a significant impact on accuracy. There was an association between reporting and methodological quality (r = 0.51 p < 0.0001 for obstetrics and r = 0.56 p < 0.0001 for gynaecology).A combination of poor methodological quality and poor reporting affects the inferences that can be drawn from test accuracy studies. Further compliance with quality checklists is required to ensure that bias is minimised.Obstetrics and gynaecology have seen rapid growth in the development of new tests [1-4]. For instance, tests designed to detect small for gestational age fetuses and to improve the staging of cancers have grown in recent years [5-9]. A key aspect of research on these is presented in the form of test accuracy studies [10], which generate a comparison of measurements made by an index test against those of an accepted reference standard test - the "gold standard". These comparisons enable an assessment of the accuracy of an index test,
In search of work/life balance: trainee perspectives on part-time obstetrics and gynaecology specialist training
Amanda Henry, Sarah Clements, Ashley Kingston, Jason Abbott
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-19
Abstract: An email-based anonymous survey was sent to all Australian obstetrics and gynaecology trainees in April 2009, collecting demographic and training status data, data on personal experiences of PTT and/or trainees, and attitudes towards PTT.105 responses were received (20% response rate). These indicated strong support (90%) from both full-time (FT) and part-time (PT) trainees for the availability of PTT. PT trainees were significantly more likely than FT trainees to be female with children. Improved morale was seen as a particular advantage of PTT; decreased continuity of care as a disadvantage.Although limited by poor response rate, both PT and FT Australian obstetric trainees were supportive of part-time training. Both groups recognised important advantages and disadvantages of this mode of training. Currently, part-time training is accessed primarily by female trainees with family responsibilities, with many more trainees considering part-time training than the number that access it.Part-time trainees represent a small but increasing number of Australian obstetrics and gynaecology (RANZCOG) trainees, from 2% in 2006 to 7% in 2009 [Unpublished data, RANZCOG Training Services Department]. RANZCOG specialty training is a six-year full-time equivalent course, which a trainee usually commences in PGY3 or PGY4. Training includes 4 years of hospital-based training in both obstetrics and gynaecology, and 2 years of Elective training during which time special interest areas may be pursued in a variety of training settings, subject to prospective approval [1]. Assessments are based on both workplace performance and external examination.Demand among the wider Australian medical workforce for improved work/life balance, including flexible training options, is high among both men and women, and often unmet [2]. Data on training outcomes for part-time training (PTT) regardless of specialty is scant. The data that do exist supports good outcomes for PTT in both the short and long
Attitudes of Academic Staff and Students towards the Objective Structured Clinical Examination (OSCE) in Obstetrics and Gynaecology  [PDF]
Alexander Emeakpor Omu, Majedah Komaikh Al-Azemi, Florence Emadinwe Omu, Jehad Al-Harmi, Michael Fidelis Esiekpe Diejomaoh
Creative Education (CE) , 2016, DOI: 10.4236/ce.2016.76093
Abstract: Introduction: The Department of Obstetrics and Gynaecology first implemented the Objective Structured Clinical Examination (OSCE) in the final examinations in 2003 academic year to replace the long case and oral examination on short cases and to evaluate the attitude of staff and medical students towards OSCE as a method of clinical assessment. Methods: Three main groups were evaluated: 1) 96 medical students at their final examination in Obstetrics and Gynaecology and were assessed with OSCE; 2) 30 Kuwait trained doctors who were assessed with OSCE during their undergraduate training; 3) academic staff made up internal faculty staff (12) and external examiners. Results: Perception of examination was highly positive among the students: Quality of instruction and organization (96%), transparency of the process (96%), method of assessing clinical skills (90%), patients’ care (89%), assessment of knowledge (84%) and communication skills (84%). Significantly, more of the trainee doctors that had OSCE during their training (92%) had positive perception of OSCE than those trainees (65%) that did not (P < 0.05). Both the internal and external examiners had an equally high perception of OSCE (83% versus 92%; P = 0.85), citing less examiner fatigue and more enjoyable for examiners and students. Conclusion: OSCE may be a more appropriate choice for graduation examinations of compared to the conventional clinical examination. It is expensive in terms of manpower requirement. There should be continuing research to reduce stress to students and examiners.
Individual patient data meta-analysis of diagnostic and prognostic studies in obstetrics, gynaecology and reproductive medicine
Kimiko A Broeze, Brent C Opmeer, Lucas M Bachmann, Frank J Broekmans, Patrick MM Bossuyt, Sjors FPJ Coppus, Neil P Johnson, Khalid S Khan, Gerben ter Riet, Fulco van der Veen, Madelon van Wely, Ben WJ Mol
BMC Medical Research Methodology , 2009, DOI: 10.1186/1471-2288-9-22
Abstract: In this study we will examine these potential benefits in four clinical diagnostic problems in the field of gynaecology, obstetrics and reproductive medicine.Based on earlier systematic reviews for each of the four clinical problems, studies are considered for inclusion. The first authors of the included studies will be invited to participate and share their original data. After assessment of validity and completeness the acquired datasets are merged. Based on these data, a series of analyses will be performed, including a systematic comparison of the results of the IPD meta-analysis with those of a conventional meta-analysis, development of multivariable models for clinical history alone and for the combination of history, physical examination and relevant diagnostic tests and development of clinical prediction rules for the individual patients. These will be made accessible for clinicians.The use of IPD meta-analysis will allow evaluating accuracy of diagnostic tests in relation to other relevant information. Ultimately, this could increase the efficiency of the diagnostic work-up, e.g. by reducing the need for invasive tests and/or improving the accuracy of the diagnostic workup. This study will assess whether these benefits of IPD meta-analysis over conventional meta-analysis can be exploited and will provide a framework for future IPD meta-analyses in diagnostic and prognostic research.Ancient Egyptian medical papyri (1550 BC) already emphasised diagnosis by physical examination as the cornerstone of the decision to treat or not to treat an ailment [1]. Today, the clinical assessment of the probability of a disease comes from a series of implicitly and explicitly performed tests. In addition to the implicit diagnostic information from history (risk factors and symptoms) and clinical examination (signs), many additional diagnostic imaging or laboratory tests are available. The accuracy of such tests requires to be appropriately assessed before they can be used i
Herbal Medicines: Socio-Demographic Characteristics And Pattern Of Use By Patients In A Tertiary Obstetrics And Gynaecology Unit
V N Addo
Journal of Science and Technology (Ghana) , 2007,
Abstract: Herbal medicines are used by patients, mostly without the knowledge of their Doctors and other Health providers. The presentation, course and outcomes of the patient's condition may thus be affected. There has been a lot of concern recently about the use of herbal medicines. The Ghana Food and Drugs Board has come out with a strong campaign aimed at regulating the advertisement of medicinal products, especially herbal medicines. Unfortunately, little is known about the pattern of use of herbal medicines by patients attending our hospitals. This cross-sectional descriptive survey with in depth interviews was carried out to determine the socio-demographic characteristics and the pattern of herbal medicine use by patients in the Obstetrics and Gynaecology Department in Komfo Anokye Teaching Hospital. More than 50% of those interviewed said they used herbal medicines with liquid preparations being the most frequently used. About 25% of these preparations were administered orally and the rectal and vaginal routes were also used. It is recommended that documentation of herbal medicine use is done whenever patients are seen in health institutions. Further studies are needed to find out about the use of herbal medicines in the general population since it would play a major role in the Ghana Ministry of Health's goals of integrating herbal medicine use into health delivery and providing comprehensive health services for all. There is also the need for collaboration between the Department of Herbal Medicine and other Departments in the College of Health Sciences at the Kwame Nkrumah University of Science and Technology. Journal of Science & Technology (Ghana) Vol. 27 (3) 2007: pp. 149-155
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