Objective: To determine the perception of pregnant patients regarding the COVID pandemic, preventive measures taken by the patients during the pandemic, and the impact of COVID on their Natal, Intrapartum, and Postpartum Care.Materials and Methods: This study included 850 patients presenting in the Obstetrics and Gynaecology department for antenatal care, inpatient care (delivery and caesarean section), and postpartum complications. Percentages were calculated for descriptive variables like demographic factors, source of information, and opinion of patients about COVID-19, preventive measures are taken by the patients, their Antenatal, Natal, and Postnatal fears. An independent t-test was applied and a p-value of ˂0.05 was taken as statistically significant.Results: We enrolled 850 patients in this study with a mean age of +28 years,mean gravidity of +3, 50% were matriculated and 75% of our patients belonged to middle-class families.. Among our patients, 96% were in fear of getting infected along with their fetus, if they visited the hospital for antenatal care, which is why a majority of them did not visit the hospital for antenatal care and a statistically significant percentage (80%) of them missed antenatal care for 5 months. While the same number of patients (96%, p-value ˂0.05) shared their fear regarding contracting the infection from the hospital during delivery and postnatal care in the hospital, and the same percentage were of the opinion that the baby would get infected during and after delivery in a hospital.Conclusion: Antenatal care is a basic right of every pregnant female. During emergencies like pandemics ways and means should be devised, not only to provide care but, also, to address the fears of pregnant females to prevent complications during this important phase of life.
This study is an attempt to trace the impacts of socio-political conditions in the formation and evolution of drama and theatre traditions in Pakistan. It provides the genesis of theatre and drama in Pakistan intertwining it with the past and present situations of this genre of literature. It also ventures at the inert position of drama and theatre in English in Pakistan. Qualitative textual analysis is conducted to analyze and highlight the major available critical acumen in the genre of Pakistani drama and theatre. The methodology adopted is interpretive of the theatrical performances by major theatre groups, and the contributions of key playwrights in cementing the foundation of drama and theatre traditions. The major findings are related to the socio-political situations prevalent since the inception of Pakistan and their significance in shaping both dramas in writing and drama in performance. It also examines the role of pioneer theatrical groups and their projects that carved a niche in the theatrical landscape of Pakistan. As compared to fiction theatre and drama remained sporadic and lackluster affair in Pakistan, it is vital to have a deeper understanding and clarity of the socio-political issues that shaped resistance &political theatres and later commercial theatre groups.
Objectives: To focus on the benefits of focal resection of the lower uterine segment as compared to obstetric hysterectomy in patients with morbidly adherent placenta.Study Design: Quasi-experimental study.Place and Duration of Study: Combined Military Hospital Okara, Oct 2019 to Nov 2020.Methodology: Fifty-two women between 34 to 38 weeks of gestation were operated for morbidly adherent placenta. Group-I women (focal resection of the lower uterine segment) and Group-II (obstetric hysterectomy) were twenty-six each. In Group-I, hemostasis was secured by a figure of 8 sutures, purse-string sutures or continuous sutures. In Group-II, hemostasis was secured, and internal iliac artery ligation was done as required. Results: Group-I undergoing focal resection of lower uterine segment hemostasis was addressed by the figure of 8 sutures in 21 (80%) women and purse-string sutures in 7 women (27%). Hemostasis of the posterior uterine wall was done in 12 (47%) women. Balloon tamponade was used in 10 (40%) women and B-Lynch suture in 5 (20%) women. Internal iliac artery ligation was done in 4 (11%) women, and the bladder was injured in 10 (40%) women. Group-II undergoing obstetric hysterectomy hemostasis was secured for leftover placental tissue in 5 (18%) women, and internal iliac artery ligation was done in 9 (35%) women. Bladder repair was done in 12 (47%) cases. Conclusion: Although time-consuming, focal resection of the lower uterine segment and hemostasis are associated with less morbidity.
Objective: To find the appropriate timings for intervention in women with intrahepatic cholestasis of pregnancy. Study Design: Prospective observational study. Place and Duration of Study: Gynaecology and Obstetrics Department Combined Military Hospital Okara, from Oct 2019 to Nov 2020. Methodology: Patients between 34-40 weeks of gestation with intrahepatic cholestasis were included in the study. With clinical and biochemical findings patients were monitored and conventional treatment was given. Intervention by delivery was done when required. Maternal and fetal outcome were followed. Results: Out of 380 patients with pruritus between 34-40 weeks of gestation, intrahepatic cholestasis was found in 53 patients. Most of the patients 27 (51%) were delivered at 37-completed weeks. At 35-weeks of gestation 6 (11%) patients were delivered, at 36-weeks 8 (15%) patients were delivered, while 2% patients delivered at 39 and 40 weeks of gestation. The number of intrauterine deaths was 1 at 34 weeks of gestation and 2 at 35 weeks of gestation. Transient tachypnea of newborn was observed in 23% neonates. Respiratory Distress Syndrome was observed in 6 (12%) newborns. Neonatal sepsis was observed in 5 and hyperbilirubinaemia was observed in 4 (8%) neonates. Conclusion: Patients with intrahepatic cholestasis should be preferably delivered between 37 to 38 weeks for a better foetal outcome.
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