Objective: To evaluate the pros and cons of an online course from medical students' standpoint. Study Design: Cross Sectional study. Setting: At Al-Tibri Medical College and Hospital. Period: January 2020 to May 2020. Material & Methods: After taking ethical approval, 200 students were equally divided into basic medical sciences and clinical sciences based on convenient sampling. The participants, after taken verbal consent, filled a self-designed questionnaire. The data were analyzed through SPSS version 21.0 and presented in the form of frequency and percentage. The Chi-square test was applied, and the level of significance was taken P=<0.05. Results: Both medical and clinical medical science students were well-motivated in learning online through online courses. However, the lack of internet facility, poor IT skills, and improper facilitation by the faculty hindered their progress towards achieving good online education. Conclusion: Improvement in the way online courses are delivered and taught by the faculty is crucial in increasing student motivation towards online learning, but issues such as poor IT skills and lack of internet facility must be addressed to provide an equal form of e-learning for students.

Objective: To determine efficacy of misoprostol given in 4 hourly versus 6 hourly intervals in second trimester for termination of pregnancy. Study Design: Cross sectional study. Setting: Study was conducted at the department of Obstetrics and Gynecology of Jinnah Medical and Dental College Karachi Allied Hospital. Period: March to August 2020. Material & Methods: Pregnant ladies in second trimester, requiring abortion due to medical reasons, were planned for termination of pregnancy. Two groups were made. Patients in Group-A were given misoprostol 4 hourly and those in Group-B were given misoprostol 6 hourly. Similar dose of drug (200ug) was given in both groups and monitoring was done. If abortion done in 48 hours, it was considered effective abortion and if not happened in 48 hours, it was considered a failed abortion. Consent was taken from all ladies in study group. Ethical approval was taken from ethical review committee. Results: Total 140 cases were studied, 70 cases in each group, A & B. Age range of cases was 16-40 years with mean age of 26.4±3.5 years. Most of the cases were having age between 20-30 years (63.5%). Group-A (N=70) was given misoprostol 4 hourly, where abortion was done in 94.3% cases while abortion failed in 5.7% cases. In Group-B (N=70) misoprostol was given 6 hourly, induced abortion in 82.8% and failed in 17.1% cases. Conclusion: Misoprostol dose of 20ug given via vaginal route is much effective drug for medical termination of pregnancy when given 4 hourly instead 6 hourly, with low failure rate.

bjective: To assess the preferred teaching strategies for undergraduate medical students of clinical sciences. Study Design and Setting: -This cross-sectional study was conducted among the 4th and 5thyear students of clinical sciences at Al-Tibri Medical College and Hospital Isra University. Karachi campus. Methodology: All medical students of 4th and 5th year were enrolled and included for this study from May 2018 to June 2018 and absentees were excluded. A questionnaire was given to students in which they opted for the best teaching aid and strategy. Data was collected and analysed by principle Investigator. Demographic variables included were gender and year of M.B.B.S. Descriptive statistics was carried out via frequency and percentages. Results: A total of 166 Students, 82 from 4th year and 84 from 5th year were reviewed. Among 4th year students; preference in academic teaching aids were white boards and multimedia and were equally preferred and for clinical teaching the most preferred aid was Out Patient Department (OPD)/clinical rotation. Among 5th year medical students’ multimedia was most preferred for academic teaching and for clinical teaching the most preferred teaching aid was clinical based learning, i.e. 32 (38.1%). Conclusion: White board, multimedia, were the most preferred teaching methods for academic teaching and bed side teaching and clinical based learning were highly preferred teaching method for clinical teaching among both cohorts of 4th and 5th year medical students. Therefore, approaches for improvement of the preferred teaching methods and establishing better facilities for students can be improve both knowledge and skills among clinical students

Aim: To evaluate factors that are associated with re-laparotomy after cesarean section. Study design: Retrospective study Place and Duration: This study was conducted at Sheikh Zaid Hospital Quetta, Bolan Medical Complex Hospital Quetta, Jinnah Medical and Dental College karachi, Sandeman Provincial Hospital Quetta, Mekran Medical College Teaching Hospital Turbat Kech, Pakistan from the year 2019 to 2021 Methodology: For this research interview sessions with patients were conducted. Clinical examinations were done and Bed Head ticket (BHT) was used for examining the medical history of patients. All the information related to age, parity, indications of caesarian section, and gestational age were observed including time interval of re-laparotomy from caesarian section. Furthermore, information related to clinical features of re-laparotomy, duration of re-laparotomy, and outcomes were also kept for statistical analysis. Results: Over two years, we observed 22192 cases of caesarian deliveries. Out of these 37 emergency caesarian required re-laparotomy procedure. We observed non-progress of labor as a major indication of LUCS in the primary caesarian section comprised of 21.62% of cases. Another dominion indication of the caesarian section was reported as CPD (5.40%), meconium stained liquor (MSL) with Bradycardia (10.81%), and PROM in 10.81% of cases. Rectus sheath hematoma was a major indication of re-laparotomy in 29.7% of cases while 27.02% of cases in our study reported peritoneal hemorrhage. Conclusion: Findings of our study revealed that unnecessary usage of caesarian surgery on patient leads to severe complications resulting in re-laparotomy. Factors like rectus sheath hematoma, Intra-peritoneal hemorrhage and abscess are the dominant reasons for re-laparotomy. Keywords: Caesarian section, Gynecology, Re-laparotomy