Lady Aitchison Hospital

Pakistan is a country where the nursing profession still has to get a good working environment as it is directly related to improved patient care. The nursing practice environment is a key factor that contributes to retention. Bearing in mind the importance of the issue the present study is designed to know the current state of the nursing practice environment. The data were collected from the nurses working in the medical wards and critical care units in the Pakistan Institute of Neurosciences, Lahore. Convenience sampling was used to select the respondents and collect the data. A total of 150 questionnaires were distributed among the nurses and 110 questionnaires were used for the data analysis in Statistical Package for Social Sciences. Frequency, descriptive statistics, reliability, and validity analyses were performed. As per the results of the study, the questionnaire used in the study was reliable and valid. Additionally, the results of the study established that the nursing practice environment is poor asking for concrete steps to make it better for improved patient care delivery. Nurse leaders can dedicate their efforts to the improvement of the nursing practice environment to improve the nurse job outcomes. Further, they can also arrange the trainings for the professional development of the nurses to ensure the better healthcare services delivery. The perceptions of the good nursing practice environment can be fostered among the nurses by having their active participation in the hospital matters and decision making because they are also the key staff in the hospital environment.

Objectives To highlight the rising trend of caesarean section and strategies to reduce the caesarean section rate in an urban setting. METHODS The qualitative, phenomenological study was conducted at the Lady Aitchison Hospital, Lahore, Pakistan, from October 16 to November 30, 2020, and comprised obstetrics and gynaecology practitioners principally responsible for making decisions related to caesarean sections. Data was collected through face-to-face detailed interview with each subject. The interviews were transcribed manually and codes were formed that led to themes. RESULTS Of the 10 subjects interviewed, 1(10%) was the department head, 2(20%) were associate professors, 2(20%) were assistant professors and 5(50%) were senior registrars. Main indications of caesarean section in primigravida were foetal distress, failed induction, failure to progress, social demand, malpresentation, eclampsia and antepartum haemorrhage. There were 5-7 themes that fell under each of these seven codes. CONCLUSIONS With proper implementation of uniform decision-making strategies, the rate of caesarean section in primigravida can be lowered with proper antenatal assessment, cardiotocographic monitoring, obstetric skills teaching, specialists; involvement in decision making and counselling of patients.

Introduction: Atypical pneumonia known as coronavirus disease (COVID-19), which is caused by the SARS-CoV-2 virus, is highly infectious and is currently spreading rapidly around the globe. Objectives: The main objective of the study is to analyses the impact of COVID-19 on pregnancy outcomes among local population of Pakistan. Material and Methods: This cross sectional observational study was conducted in Lady Aitchison Hospital during September 2019 to August 2020. The data was collected through systematically designed questionnaire. Clinical characteristics, examination results, and treatment course were extracted from their medical records. For mothers, we collected socio demographic data, educational attainment, and occupation, maternal parity, medical history records, laboratory tests, and intensive care unit [ICU] admission. Results: The data was collected from 685 patients. The two groups of pregnant women were compared in terms of severe preeclampsia, gestational diabetes, premature rupture of membranes, fetal distress, maternal mortality, IUD, fecal staining of amniotic fluid, premature birth, neonatal asphyxia, Abruption or other compression sutures, and there was no significant difference Significance (all P >0.05); the proportion of IUD in the COVID-19 group was higher than that in the non COVID-19 group, and the difference between the two groups was statistically significant. Conclusion: It is concluded that those patients who visited the hospital during COVID-19 pandemics have high rate of IUD, placenta abruption and maternal death. Keywords: IUD., COVID-19

OBJECTIVE The objective of the study was to compare the effectiveness of sublingual misoprostol in reducing intraoperative and postoperative blood loss with that of intravenous (IV) oxytocin infusion in the first two hours at cesarean delivery. STUDY DESIGN Randomized controlled trial PLACE AND DURATION OF STUDY The study was conducted in Lady Aitchison Hospital, Lahore unit IV-King Edward Medical University, and the duration of the study was one year. MATERIALS and METHODS Eighty-two women with term singleton pregnancy undergone elective cesarean section under spinal anesthesia were randomly allocated to receive either misoprostol 400 µg sublingually or IV infusion of 20 units oxytocin in 1000ml of normal saline soon after delivery of the baby. Estimated blood loss at the surgery and within the first 2 h post-operation were measured in both groups. Side effects in both groups were also recorded. RESULTS Mean blood loss with misoprostol was significantly less as compared to that of oxytocin. Post-operative hemoglobin was decreased by -4.95% in sublingual misoprostol and in the oxytocin group it was decreased by -9.33%. Blood transfusion and additional uterotonic therapy were significantly higher in the oxytocin group as compared to that of misoprostol. Nausea, vomiting, and hypotension was significantly higher in oxytocin group as compared to that of the misoprostol group. On the other hand, pyrexia and shivering were significantly higher in the misoprostol group. CONCLUSION The results of this trial showed that sublingual misoprostol is more effective as compared to intravenous oxytocin infusion in terms of reduction of blood loss in the first two hours at the cesarean section. It offers several advantages over oxytocin including long shelf life, stability at room temperature, and oral administration which makes it a suitable uterotonic agent in low-resource areas.

Background: Diabetes Mellitus (DM) is frequent in chronic liver disease and there is an increased association of DM with Hepatitis C andhepatic encephalopathy (HE), In our setup such studies are not published and we do not have the updated knowledge of the above mentioned phenomena. Objectives: To determine the frequency of DM in HCV cirrhotic patients and association of HE in HCV Cirrhotic patients with DM Materials And Methods: This Analytical cross-sectional study was conducted in Medicine Department, Mayo hospital, Lahore,100 patients with HCV associated cirrhosis were included using non-probability purposive sampling. Patients were stratified as diabetic and non-diabetic according to ADA criteria and presence of HE was determined clinically. Frequency and percentage of HE & diabetes were calculated and odds ratio was calculated to determine association. P-value <0.05 was considered significant. Results: The mean age of patients was 44.43 +/- 10.16 years and there were 66% males and 34% females. 34% among HCV cirrhosis patients were diabetic, HE was seen in 31(91.2%) of the diabetic patients and in 48(72.7%) of non-diabetic patients with odds ratio of 3.875 (p-value 0.016) Conclusion: There is a significant association between diabetes mellitus and HE among patients with HCV associated cirrhosis.