Outcomes of induction in trial of labor after cesarean delivery

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring

Twisted ovarian cyst in pregnancy: a case report

Ovarian cysts are frequently encountered during pregnancy due to the use of routine prenatal ultrasound. Most of them are benign but in some cases, complications can occur such as torsion, rupture and malignant change. In pregnancy risk of torsion increases 5-fold. It carries significant risk to a pregnant woman and her intrauterine foetus. Here we are reporting a 30-year-old female G3 P1+1L2 with 15 weeks of gestation who presented to antenatal OPD with complain of dull aching abdominal pain for 1 month and nausea and vomiting for 5 days. On ultrasound bilateral ovarian cysts were found, with one of the cyst with multiple septations. She underwent laparotomy, a right sided twisted ovarian cyst was found for which salpingoophrectomy was done. Left sided cyst was simple where cystectomy was done. Her histopathology report showed a bilateral benign serous cystadenoma. Her pregnancy was followed up. She delivered a healthy male baby at term. Ovarian cyst diagnosed in pregnancy can be followed up with serial ultrasound but if associated with complication such as torsion then urgent surgical intervention has to be done

DEVELOPMENT OF THE GENERAL EMOTIONAL LABOR SCALE – URDU (GELS – U)

The purpose of the current research is to develop a scale thatmeasures Emotional Labor in Urdu and the study describes theprocedure followed to develop the General Emotional Labor Scale– Urdu (GELS – U). The process of scale development was brokenup into different phases. The first phase of scale construction dealtwith item generation and the second involved conducting a pilotstudy. The sample for the pilot study consisted of 308 individuals.Based on the results of the pilot study the items of the scale werereduced from 49 to 30 using factor analysis and item-totalcorrelations. The last phase of the study entailed normsdevelopment and establishing the reliability of GELS – U. For thispurpose, the sample consisted of 505 individuals. The internalconsistency of GELS – U was found to be 0.810, and the test-retestreliability was 0.871. Thus, the General Emotional Labor Scale –Urdu was developed as a measure of emotional labor in the nationallanguage of Pakistan – i.e. Urdu. Such a scale can be useful fornot just researchers but for organizations in the service sector aswell. This will help understanding in the performance of emotionallabor, its effects on employees and the possibility of trainingemployees who might need to perform such labor

Eclampsia: an enigma

Background: Eclampsia is the commonest cause of convulsions in pregnancy next being epilepsy. Incidence varies from 1 in 100 to 1 in 2000 pregnancies. Eclampsia accounts for 24% of all maternal deaths in India. Eclampsia is a significant cause of perinatal mortality and morbidity in non-industrialised countries (up to 40% perinatal deaths).Methods: We are reporting a retrospective study on the patients of eclampsia attending a tertiary care hospital. The study included 3907 deliveries conducted in VCSG Govt. Medical Science & Research Institute, Srinagar, Pauri Garhwal, Uttarakhand from April 2012 to Sep. 2014.Results: The total number of eclampsia cases was 98. The antepartum eclampsia cases were 87 and the postpartum eclampsia cases were 11.The incidence of antepartum eclampsia was 2.22% (87/3907) at our center. The total number of maternal deaths due to eclampsia was 6. The total Case Fatality Rate was 11.11% (6/57). There were 6 early neonatal deaths most commonly due to prematurity. There were 20 (22.99%) intrauterine deaths.Conclusions: Early prediction and diagnosis requires high index of suspicion and comprehensive training of health professionals at all levels of health care. The answer to poor management of eclampsia lies in better education and training of all obstetricians, anesthetists, midwives, and general practitioners in the diagnosis and treatment of severe pre-eclampsia and eclampsia

Gender differences in self-esteem in young adolescents of Karachi

The purpose of this research was to explore the self-esteem trends in adolescents of Karachi, Pakistan with regard to gender differences. The insights from previous literature helped to form the hypothesis that there will be a significant gender difference on the self-esteem of adolescents variable. There were a total 224 (96 male and 126 female) adolescents chosen for this study and the Multidimensional Self-Esteem Scale: a 36 item and a 3 Likert response scale was adapted for this study with the consent of the author. The data analysis revealed that there is a significant gender difference on the variable of self-esteem of the chosen adolescent

Leiomyoma in the space of Retzius: a rare location

Extrauterine locations of leiomyomas are extremely rare clinical conditions as in the case of space of Retzius. Space of Retzius is a small anatomical compartment located posterior to the pubic symphysis and anterior to the urinary bladder. Here authors report a very unique case of 22-year-old woman presented to the study hospital with complaints of inability to conceive and difficulty in urination. Clinical examination and imaging of pelvis suggest leiomyoma of uterus located between lower part of anterior uterine wall and bladder. An attempt to remove the tumour laparoscopically was taken but later it was converted into open laparotomy due to unusual location of leiomyoma. Histopathology revealed the tumour to be a leiomyoma

Role of postpartum Kegel exercises in the prevention and cure of stress incontinence

Background: Urinary incontinence in the post partum is a significant health problem in women with serious physical, psychological, and social consequences. The objective of this article is to educate women the correct method to do Kegel exercises, to assess their improvement and to introduce Kegel exercise regimen in every women in the postpartum period.Methods: 72 women in postpartum period with genuine stress incontinence (GSI) included in the study from January 2012 to July 2014 in the department of Obstetrics and Gynecology of VCSGGMSRI Srinagar, Pauri Garhwal, India. Women divided into 2 groups, first group of supervised Kegel exercises and second group was of women doing pelvic floor exercises at home. To monitor improvement, monthly assessment of pelvic floor function (vaginal palpation and observation) and measurement of PFM strength (vaginal squeeze pressure) by physician and patient both, done in the 2 groups.Results: The women were in the age group of 18-39 years. There were 15 % patients in dry category, 52 % had good improvement and 21 % had fair results. In the supervised exercise group the patients with good clinical response were 80% in the cured and borderline responder category. In the non-supervised group patients in the cured and borderline responders group were (6) 16% and (12) 33% respectively.Conclusions: The high cure rate depends on the factors like how correctly the Kegel exercises were instructed, how correctly the patients learned and performed them

Nostalgia: A Possible Source of Behavioral Intention to use AI Technology

We want to study the effect of Nostalgia on the adoption and usage of Artificial Intelligence Enabled Personal Assistants (AIEPA). We discuss the factors that cause resistance to the adoption and use of these AIEPAs. We also explore if Nostalgia can help overcome the resistance to adoption and use of the AIEPA. We collect data and carry out an analysis to extend the existing body of knowledge. We also discuss possible implications at the theoretical and managerial levels

Prevalence of paternal postpartum depression

Background: Postpartum Depression is a type of mood disorder associated with childbirth, which can occur in both parents. It is a major public health concern because it produces insidious effects on the well-being of new born as well as on the whole family. Objective: This study aims to determine the prevalence of postpartum depression among fathers in Karachi, Pakistan. Methods: This cross sectional survey was conducted among fathers, purposive convenient and snowball sampling was used to approach 120 participants after obtaining permission from Al-Khidmat Hospital and Combined Military Hospital (CMH).Participants were aged between 20-50 years, had a newly born child between the past 6 weeks to 1 year. Each participant was required to fill an informed consent, demographic form and Edinburgh Postnatal Depression Scale’s (EPDS), translated Urdu version. The data was collected and statistically analyzed. Results: The study findings show that 28.3% fathers experienced depressive symptoms, out of which 25.8% experienced mild while 2.5% experienced severe depressive symptoms. Conclusion: Paternal postpartum depression is quite prevalent among new fathers in Karachi. Depression among fathers is an area of substantial significance as it may enhance the risk of mental health problems among children. Health services should support new fathers by providing information about this major transition. These results clearly show that there is a need to assess expectant and new fathers for depression. Prevention, early identification and intervention of paternal post- partum depression are immensely required

The influence of menopause on urinary incontinence in the women of the community: a cross-sectional study from North India

Background: Urinary incontinence is defined as the complaint of any involuntary loss of urine that is a social or hygienic problem.  Worldwide, over 200 million people are living with urinary incontinence and as the life expectancy of women is increasing, more number of women are bound to suffer from it. The aim of the present study is to find out the effect of menopause on the occurrence of Urinary Incontinence in women and to find out risk factors in post-menopausal women associated with Urinary Incontinence.Methods: It was a community based cross-sectional study involving post-menopausal women living in the urban and rural areas registered under Community Medicine, J.N. Medical College, Aligarh, India. A total of 530 women were taken for this study. Descriptive statistics as well as simple proportion were calculated with SPSS 20.0. Tests of significance and Binary Logistic regression analysis were used for analysis.Results: Significant differences were found in the association of Urinary Incontinence with increasing age groups and consequent years spent in menopause, rural area of residence, illiteracy, lower socio-economic class, inadequate housing standards, obesity, smoking, parity, history of hysterectomy, and co-morbidities such as Urinary Tract Infection and Pelvic organ prolapse.Conclusions: From a public health perspective, there is considerable opportunity to improve women's quality of life by increasing health education about urinary incontinence and its treatment by taking steps for life style modifications