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Background: Non-Technical Skills (NTS) of post graduate residents (PGR) are as important as their clinical skills. Other than direct observation of supervisors, the feedback of caregivers provides an objective assessment of medical residents’ ability to effectively deal with patients. Our research objective was to test the validity and reliability of an instrument named “PARENTS Tool” in a local environment and its use to evaluate NTS of residents at the hospital. Methods: This multi-phase mixed-method study used an Instrument Design Model called PARENTS Tool to assess NTS of residents. The PARENTS tool was translated into Urdu for our local environment and administered in the emergency department of Children’s Hospital and The University of Child Health Sciences. Results: The authors collected data from 471 parents and coded them for analysis in AMOS and SPSS. Both tests met acceptance criteria to establishes the validity and reliability of the Urdu version of PARENTS tool. Results showed that parents were satisfied with the knowledge and skill of residents but less satisfied with the patience or empathy that the residents showed towards the children under their care. Conclusion:PARENTS has shown to be valid and reliable tool for measuring the NTS of residents from the patient’s perspective. Medical administrators can use PARENTS as a performance measurement tool for monitoring the soft side of patient care.

Aims:Germ cell tumors (GCT) are uncommon in children and adolescent but when they appear, gonads are the most frequent site. Testicular tumors constitute 1-2% of all pediatric solid tumors among them 84% are GCT. Incidence of ovarian GCT is 67%. This study from a single center focus on highlighting clinical features, investigations, treatment and outcome of GCTs in children to look for peri operative challenges and long term prognosis.MethodsA prospective study of 45 patients with GCTs was done from March 2018 to January 2022. The detailed data of each patient was scrutinized including history, physical examination, investigations, management, and follow-up. Forty-five patients presented during this period. Fifteen male (33.3%) and 30(66.7%) female with median age of 4.8 years. Twenty-eight( 62.2%) patients presented with abdominal mass, 15(34.88%) with scrotal swelling and 2(4.65%) with acute abdomen. Hematological and radiological investigations were done in all patients. α-fetoprotein level was high in 30 patients. All patients were managed combinedly with Paediatric Oncology. After being discussed in multidisciplinary tumor board, surgical excision was done.Results:On gross, 75% were mixed and 25% were solid tumors. Median size of testicular tumors ranged from 3cm to 8cm while ovarian tumors ranged from 5cm to 23cm. on histology, Twenty six(57.8%) were mature teratoma, 6 (15.5%) immature teratoma, 8(17.7%) yolk sac tumors, while 1(2.32%) mixed stromal tumor, 1 (2.32%) sex cord tumor and 1(2.2%) Leydig cell tumor also reported. Neo-adjuvant chemo was given in 4 (8.88%) patients while 6 (13.33%) patients received chemotherapy postoperatively. Rest of the patients didnot receive chemotherapy as they had stage I & II disease. Thirty-three patients are doing fine, 11 had lost follow up and 1 patient expired due to sepsis. Long term follow-up with tumor markers and radiological investigations showed no recurrence in majority of patients (73%).ConclusionGCTs in Pediatric population are not uncommon. However good prognosis can be expected if diagnosed at early stage. Majority of tumors doesn’t require post-operative chemotherapy. Tumor markers especially alpha-fetoprotein seems reasonable prognostic marker on follow up in centers where other genetic studies aren’t available due to limited resources.