Comparison between oxytocin, ergometrine and misoprostol in active management of the third stage of labour: a randomized controlled trial

Background: The aim of the present study was to compare the effectiveness of sublingual misoprostol, intravenous infusion of oxytocin, and intravenous infusion of Ergometrine in reducing blood loss during the third stage of labor.Methods: This is a no-random trial study conducted in in Ribat University Hospital, Khartoum among 150 laboring ladies with a healthy singleton pregnancy. After obtaining their written informed consent to participate in the study, they were randomly assigned to one of three possible treatment groups: 400 μg of sublingual misoprostol; 10 IU of intravenous infusion oxytocin; and 0.5 mg of intravenous infusion of Ergometrine. Blood loss was estimated by weighing the collected blood and converting the weight to milliliters.Results: The shortest mean duration of the third stage of labor was seen in patients who received misoprostol (3.89±0.37 min), followed by oxytocin (4.6±0.9 min), and Ergometrine (5.45±0.9 min). The lowest mean blood loss was seen in the patients who received 400 µg misoprostol (168.36±24.83 ml), followed by those who received 10 IU oxytocin (205.56±34.82 ml), and 0.5 mg Ergometrine (214.49±35.97 ml).Conclusions: Present study showed that 400 µg sublingual misoprostol was more effective than the conventional parenteral uterotonics in reducing the amount of the blood loss during the third stage of labor and has comparable effect to that of 10 IU intravenous oxytocin in shortening the duration of third stage of labor. It also showed that the use of misoprostol reduces the need for extra-uterotonics and blood transfusion

Online Anatomy Education in the COVID-19 Pandemic:Challenges and Suggested Practices as Per Student and Faculty Experiences in the Saudi Arabia and United Arab Emirates

Anatomy was studied through e-learning as a social distancing measure to prevent the spread of COVID-19. This study explored anatomy educators' and learners' experiences with online learning in two Middle Eastern countries in terms of instruction, engagement and assessment. The study employed a cross-sectional, mixed-methods approach using a validated questionnaire to collect data from students in 14 medical schools in Saudi Arabia and the United Arab Emirates on their experience with online teaching, engagement strategies and assessment in anatomy courses. The Delphi technique was used to explore faculty challenges and recommended solutions. Six hundred and sixty-six students completed the questionnaire. Less than half (41.74%) reported that their interaction with the instructor was easier and more comfortable than during face-to-face lectures. In addition, less than a quarter (21.32%) believed it was better to adopt online rather than face-to-face anatomy instruction. Faculty members described challenges and provided suggestions to enhance online teaching, including faculty and staff development, technical support, appropriate software to increase student engagement and curriculum development to suit the new normal. They also suggested improving assessment design and construction as well as adopting measures to eliminate cheating, train faculty and staff and properly select software. In conclusion, the student and faculty experiences with e-learning in anatomy were generally positive. Both faculty and staff identified many challenges with an emphasis on the loss of face-to-face teaching. Accordingly, faculty development, technical support, appropriate software to enhance student engagement and reformed curricula to suit online teaching are needed in online anatomy education.</p

Correlation of ultrasonographic estimated fetal weight with actual birth weight at a rural setting

Background: Ultrasound estimation of fetal weight in term pregnancies is used to determine fetal growth. The objective of this study was to assess the precision of sonographic estimation of fetal weight in normal vaginal deliveries at a rural setting.Methods: The study was cross-sectional. A group of 74 pregnant women delivered normally in Muglad hospital in West Kordofan, Sudan, were considered in the study. Fetal weight was estimated by Hadlock and shephards formulae within one week prior to delivery and then newborn weight was taken within 24 hours after delivery. Data were collected by a questionnaire and medical examination as well as sonographic examination. Data analysis was done by SPSS version 23 and Kruskal Wallis Test (post-hoc analysis) Pearson’s correlation coefficient within 95% confidence interval. p value <0.05 was considered as statistically significant.Results: The correlation, by Paired sample, to assess fetal weight was as follows: between Hadlock and shephards was 0.901 (p < 0.001), between Hadlock and AFW was 0.908 (p < 0.001) and between Shephards and AFW was 0.781 (p < 0.001).Conclusions: Estimation of fetal weight by Hadlock has been more correlated with actual fetal weight (AFW) than that done with shephards. The study recommends using Hadlock formula which is more accurate in estimation of fetal weight by sonography

Gum Arabic in renal disease (GARDS Study): Clinical evidence of dietary supplementation impact on progression of renal dysfunction

Administration of Gum Arabic (GA) was associated with an increase in estimated Glomerular filtration rate (eGFR) at three months (pre 24.64 ± 8.89 vs 26.20 ± 10.1p = 0.02). Subsequently there was no significant fall in eGFR. This translated to positive change in Δ eGFR within quarter at three months, (Δ eGFR 4.89 ml/min/year p=<0.001 vs pre) and six months (Δ eGFR 0.79 ml/min/year, p < 0.001 vs pre) compared to pre-intervention values. At 9 and 12 months although the mean Δ eGFR in quarter was negative, this rate of decline in renal function remained significantly less than prior to intervention (9 months Δ eGFR −1.27 ml/min/year, p= <0.001 vs pre, 12 months delta Δ eGFR −1.54 ml/min/year, p < 0.001 vs pre). Similarly, mean reciprocal creatinine, declined by 11% in the pre-intervention period but was no different to the pre-intervention values for the duration of intervention. In conclusion oral administration of Gum Arabic attenuates the rate of decline in renal function

Comparison between oxytocin, ergometrine and misoprostol in active management of the third stage of labour: a randomized controlled trial

Background: The aim of the present study was to compare the effectiveness of sublingual misoprostol, intravenous infusion of oxytocin, and intravenous infusion of Ergometrine in reducing blood loss during the third stage of labor.Methods: This is a no-random trial study conducted in in Ribat University Hospital, Khartoum among 150 laboring ladies with a healthy singleton pregnancy. After obtaining their written informed consent to participate in the study, they were randomly assigned to one of three possible treatment groups: 400 μg of sublingual misoprostol; 10 IU of intravenous infusion oxytocin; and 0.5 mg of intravenous infusion of Ergometrine. Blood loss was estimated by weighing the collected blood and converting the weight to milliliters.Results: The shortest mean duration of the third stage of labor was seen in patients who received misoprostol (3.89±0.37 min), followed by oxytocin (4.6±0.9 min), and Ergometrine (5.45±0.9 min). The lowest mean blood loss was seen in the patients who received 400 µg misoprostol (168.36±24.83 ml), followed by those who received 10 IU oxytocin (205.56±34.82 ml), and 0.5 mg Ergometrine (214.49±35.97 ml).Conclusions: Present study showed that 400 µg sublingual misoprostol was more effective than the conventional parenteral uterotonics in reducing the amount of the blood loss during the third stage of labor and has comparable effect to that of 10 IU intravenous oxytocin in shortening the duration of third stage of labor. It also showed that the use of misoprostol reduces the need for extra-uterotonics and blood transfusion

Medical students' opinion toward the application of complementary and alternative medicine in healthcare

Context: An accelerated approach to popularize complementary and alternative medicine (CAM) in healthcare services has led to the need to assess medical students' knowledge of CAM. Furthermore, their attitude toward its efficacy and usage will determine its growing popularity in healthcare. Another key idea is to integrate CAM with conventional medical teaching to make it a part of the mainstream medical curriculum. The objectives were to assess the medical students' perceptions about integrating CAM with conventional medicine and to assess the attitude of prescribing different CAM modalities to patients presenting with a particular disease or health disorder. Settings and Design: This is a descriptive, institutional based study conducted on undergraduate 3rd year medical students. Materials and Methods: Data were collected by a structured and pretested questionnaire to be filled in by the participants in the presence of the investigator. Statistical data were entered in SPSS software, and descriptive analysis was conducted. Results: Most of the students (74%) agreed that conventional and CAM therapy can be integrated to achieve a better health care outcome. Forty-eight percent of the participants were positive that knowledge of CAM is important since many patients still prefer this option, particularly for chronic illnesses. Conclusions: The students were receptive to the introduction of a new treatment method in their curriculum, which although unconventional, presents an alternative and traditional form of treatment even if it does not have major backing from the scientific community. The participants felt that more knowledge is required to make an informed opinion about its usefulness to the community as a whole

Satisfaction, self-use and perception of medical students in Majmaah University, Kingdom of Saudi Arabia, towards Complementary and Alternative Medicine

AbstractObjectivesComplementary and Alternative Medicine (CAM) is a growing industry in the health care system, and the use of CAM is rapidly evolving. In the Kingdom of Saudi Arabia (KSA), little research has addressed the satisfaction, use and perception of medical students towards CAM. The objectives of the current study were to assess the level of medical students' satisfaction and perception towards studying CAM and to determine their self-use of different modalities of CAM.MethodsThis descriptive study was conducted by administering a questionnaire to the first and second batches of the medical students studying the CAM module at the College of Medicine, Majmaah University KSA. The instrument used in this study was a validated self-administered questionnaire, and the retrieved data were analysed using SPSS.ResultsThirty students (43%) were satisfied with studying CAM as a part of the medical curriculum. The rest of the students were either dissatisfied (32%) or neutral (25%). The most important CAM modalities self-used by the medical students were prayers (46 students or 66.7%), herbal products (42 students or 60.9%) and massage (32 students or 46.4%). Forty-three students (62%) showed a positive perception towards practicing CAM in the future.ConclusionThis study has shown that there is an overall low satisfaction among the medical students regarding CAM as a part of the medical curriculum. The most common self-use CAM modalities by the medical students were prayers, herbal products, massage, nutritional supplements and acupuncture