This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.

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Objective:Ensuring competence in communication skills amongst trainees is essential in health professions education. Involving faculty members for the same is a challenge in Obstetrics and Gynecology (OBGYN) due to their clinical commitments. The present study compares scores of OBGYN faculty, non-OBGYN faculty and simulated patients (SPs) on communication skills of postgraduate trainees during formative Objective Structured Clinical Examination (OSCE).Methods:This is a psychometric study conducted in Feburary 2017 at the Aga Khan University Medical College (AKU-MC). All thirty-two postgraduate trainees of OBGYN gave consent. Each trainee was assessed by OBGYN faculty, non-OBGYN faculty and SP on communication skills at six stations using nine-point itemized rating-scale during formative OBGYN OSCE. The scores were reviewed using descriptive statistics, reliability was calculated using Cronbach’s alpha and inter-rater reliability was analyzed using Pearson correlation and intra-class correlation coefficient.Results:The score reliability of each of the examiners was >0.7. The mean scores showed that OBGYN faculty were most stringent while SPs were lenient examiners, however, non-OBGYN faculty scored in between. The inter-rater reliability among any two of the OBGYN, non-OBGYN and SP examiner was >0.84 using Pearson correlation and >0.9 using intra-class correlation.Conclusion:The SPs and non-OBGYN clinical faculty can also be used to assess communication and counseling skills on OBGYN OSCEs after required training as examiners.

BackgroundThe South Asian region has the second highest risk of maternal death in the world. To prevent maternal deaths due to sepsis and to decrease the maternal mortality ratio as per the World Health Organization Millenium Development Goals, a better understanding of the etiology of endometritis and related sepsis is required. We describe microbiological laboratory methods used in the maternal Postpartum Sepsis Study, which was conducted in Bangladesh and Pakistan, two populous countries in South Asia.Methods/DesignPostpartum maternal fever in the community was evaluated by a physician and blood and urine were collected for routine analysis and culture. If endometritis was suspected, an endometrial brush sample was collected in the hospital for aerobic and anaerobic culture and molecular detection of bacterial etiologic agents (previously identified and/or plausible).DiscussionThe results emanating from this study will provide microbiologic evidence of the etiology and susceptibility pattern of agents recovered from patients with postpartum fever in South Asia, data critical for the development of evidence-based algorithms for management of postpartum fever in the region.

Background and Objective: Sepsis is one of the leading causes of direct maternal mortality in Pakistan. It is recommended that the first three hours after the presentation are crucial. During this time implementation of surviving sepsis campaign resuscitation bundles reduces maternal mortality. Our objective was to assess the factors contributing to puerperal sepsis and the compliance of “surviving sepsis campaign resuscitation bundles in puerperal sepsis” for the management of puerperal sepsis. Methods: This was a retrospective record review for five years from January 2011-December 2015. All women who fulfilled the inclusion criteria of puerperal sepsis were included and data from their files were collected and entered in SPSS version 19.0. Mean and standard deviations were calculated for continuous variables while for categorical variable proportion and percentages were used. Results: This retrospective record review in five years showed the 396 patients had P-sepsis, among them 44 patients had severe sepsis with organ dysfunction. The culture was positive in 26(59%) with trend of E-coli in 9(20%) Among them 12(27%) had serum lactate more than ≥4mmol/L. Central venous pressure monitoring with fluid resuscitation was done as per protocol of survival bundle given to all 12(100%), Vasopressin was needed in half of these patients 6(50%). Amid 44 patients of severe sepsis 29(66%) were admitted to special care, while 15(34%) required intensive care admissions. Our 7(16%) patients failed to survive. All of them had multi-organ failure. Conclusion: There was moderate adherence of modified surviving sepsis campaign resuscitation bundles. Further improvement in compliance is warranted. doi: https://doi.org/10.12669/pjms.38.1.3992 How to cite this:Yousuf F, Malik A, Saba A, Sheikh S. Risk factors and Compliance of surviving sepsis campaign: A retrospective cohort study at tertiary care hospital. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.3992 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.