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Background: Laparoscopic hysterectomy literature showed varied results regarding outcome of laparoscopic hysterectomy. Moreover, there is no local evidence which could help us to determine the outcome of laparoscopic hysterectomy in females having uterine pathology. Methods: This descriptive case series was conducted in the Department of Obstetrics & Gynecology, Imran Idrees Teaching Hospital Sialkot for a period of 11 months from 1-1-2022 to 30-11-2022. Total 175 patients fulfilling selection criteria were enrolled in the study from emergency. Then all females underwent laparoscopic hysterectomy under general anesthesia. During surgery, operative time was noted. During surgery, bladder injury was noted if occurred (as per operational definition). Patients were shifted in post-surgical wards and were discharged from there after recovery. Results: In this study the main outcome variables were operative time, hospital stay and bladder damage. Mean operative time and hospital stay for patients who underwent laparoscopic hysterectomy was 170.93±49.18 minutes and 2.63±0.60 days. None of the patients had bladder damage. Practical implication: Laparoscopic hysterectomy is a safe, effective, and reproducible technique that can be adopted after completing a period of training required to standardize the technique. It has been associated with lesser blood loss, shorter stay in hospital, quick return to normal activity, and fewer surgical site infections when compared with abdominal hysterectomy. This approach must be established in our real, day-to-day clinical practice. Conclusion: Laparoscopic hysterectomy is an effective procedure for benign uterine pathology in terms of minimal complication rate (bladder injury), shorter hospital stay and an average mean operative time. Hence showing very promising results and a better outcome for the patients Keywords: Laparoscopic Hysterectomy, Benign Uterine Pathology, Operative time, Hospital Stay

Objective: To recognize the barriers in different modes of e learning, from the medical student’s perspective during the period of Covid 19 pandemic. Study Design: Quantitative, Descriptive survey. Place and duration of Study: This study was conducted in Islamic international medical college and Islamabad medical and Dental College. Material and Methods: This study was conducted at Islamic international medical college and Islamabad medical and Dental College after taking permission of ethical committees. A questionnaire was designed for data collection. Common barriers were identified along with the factors underlying these problems. In this study, sample size was 400 medical students belonging to tertiary institutions of Rawalpindi and Islamabad district. Simple random sampling technique was applied for selecting the respondents. A questionnaire comprising of closed ended questions was designed and its content validity was checked after presenting it to at least five faculty members and then it was presented to the participants. Data collection was done and results composed using SPSS. Results: The final sample size for responses was 417. Competency in the usage of technology and internet is the key to the E- learning. Only 18.5% of students were competent to practice the technology and internet form. 47.7% of students were never competent. 32.4% answered with sometimes. The 26.4 % of students found that the E-learning system was useful to fulfill their academic learning demands. 36 % of students answered that it is not and 36.2% answered with sometimes. The E-learning system being used was found, compatible with the course contents by 26.2 % of students. 45.8 of students answered that it is not compatible. 26.6% answered with sometimes. Only 18.7 % of students found the E-learning system being practiced in their institution was well planned to satisfy their learning objectives. 38.4% answered with sometimes. 41.5 % responded with the answer that it was not well planned to satisfy their learning objectives. 25.6 % of students felt comfortable with the features of E-learning system being used. 41.7 % of students answered that it was not. 31.2% answered with sometimes. The e-learning system provides sufficient learning resources to control their distinct learning was found by 25.6% of students, 38.4 % of students answered that it is not satisfying for them. 34.5% answered with sometimes. The design and interface of the e-learning system used is smart and suitable was found by 21.1% of students. 46.3 % of students answered with not. 31.2% answered with sometimes. 25.1 % were able to identify their personal learning preferences on an e-learning course”. 33.4 % of students answered that they were not able and 40.0% answered with sometimes. 13.9 % of students needed guidance to select their personal learning choices for an e-learning course. 43.9 % of students answered that they don’t need it. 40.8% answered with sometimes. 22.8 % found the E learning system was against their learning preference. 41.7% answered that it is not against their learning preference and 34.1% answered with sometimes. . 22.1 % of students, found that E-learning is less interesting as compared to conventional learning. 48.2 % of students considered it interesting most of the times and 28.3% answered with sometimes. 20.4 % of students found that E-learning resulted in lack of interaction among the colleagues and was less creative. 50.4% of students answered that it was not resulting in lack of interaction among the colleagues and less creative, 27.8% answered with sometimes. Regarding the motivation of students by the use of E-learning, to use computers and the internet and in turn ease their access towards latest knowledge, and 20.9 % agreed with it. 46.8 % of students answered that it was not. 30.9% answered with sometimes. 21.1 % of students found that use of technology leads to tiredness and decline in working capacity. 52.0 % of students answered responded that it did not and 25.4% answered with sometimes. 18.5 % of students found that Interruptions in the internet connectivity affect the learning process leading to distraction”. 60.5 % of students answered that it was not. 20.1% answered with sometimes. E-learning saves time and is cost effective and can save costs on transport and time consumed in travelling along with its stresses 22.3 % of students agreed with it. 47.2% of students did not agree with it. While 29.0% answered with sometimes. Regarding the concern about the validity of online teaching and assessment, 21.1% of students agreed and thought it was valid. 39.5% of students answered that it was not. 37.9% answered with sometimes. Conclusion: Medical students were not very much useful to this type of teaching so they found it less interesting and faced problems due to lack of competency in using the gadgets and had difficulties in understanding of the course content as well as solving their queries regarding the syllabus. Their peer learning was also effected further leading to decreased understanding and losing their interest in the course. In spite of the fact that they had found this type of learning cheaper in view of transport charges and time consumption but still they do not seemed to be completely satisfied with this type of learning. Students also expressed their concerns regarding assessment of such type of learning.

Background: Assessment has been shown in studies to have a significant impact on the learning process. There has been a lot of interest in making assessment an important element of the learning process for students. Senior medical students may be able to assist teachers with peer evaluations. There is little evidence to support the idea that peer examiners should be officially trained before taking on the job. Aim: To find the difference in teaching faculty scores of untrained and trained peer examiners in Obstetrics & Gynecology OSCE. Study design: Cross-sectional (analytical) study Place and duration: The study was conducted at Sialkot Medical College Sialkot” affiliated with Imran Idrees Teaching Hospital in Obstetrics /Gynecology department over the period of 6 months from January 2022 to June 2022 Methodology: One hundred and five medical student of 4th year were enrolled for practice of OSCE examination. Forty final year medical students took part in the assessment program as peer examiners. One group of examiners were given 2-hour training session describing about the assigned OSCE stations, marking method, evaluation, and feedback methods. Other group was given only checklist to read with no prior training. Using the checklist and a global rating, senior faculty and peer student examiners (both trained and untrained groups) simultaneously assessed students in basic Obstetrics /Gynecology clinical skills at 4 OSCE stations. Every station ran for five minutes (3 minutes of evaluation while 2 minutes of feedback). A comparison between the check list and global rating scores of trained and untrained peer student examiners was made. SPSS version 21 was used to calculate intra-rater reliability was assessed to build the consensus of faculty examiners with the trained and untrained peer examiners according to checklist scores and global rating. Results: Student examiners found sitting at OSCE stations as a useful learning experience. Observing different performances at OSCE stations was so absorbing and it gave them awareness about examination procedure. Practical implication. Peer assessors in a formative OSCE could be successfully implemented in the curriculum of a large medical school with more than 100 students annually. They can be trained to conduct undergraduate assessments of their junior peers and can prove to be very reliable and effective assessors. Conclusion: Peer markers who underwent the formal training session showed the capacity to assess fourth-year students with suitable consistency and devotion. Hence training helped to improve peer marker consensus with faculty. Keywords: Peer examiners, OSCE, trained peer examiner, untrained peer examiner.

Objective: To explore the experiences of struggling undergraduate medical students (mentees) with formal mentoring program at a private medical college in Rawalpindi. Methods: A qualitative exploratory study was carried out from March to August 2019. Data was collected from a purposive sample of sixteen struggling undergraduate students. Validated interview guide was utilized to conduct semi-structured one-to-one interviews. Interviews were audio recorded and transcribed accurately. Confidentiality and anonymity were ensured to the participants due to the sensitive nature of the data. Various measures were taken to achieve trustworthiness in the study. Manual thematic analysis was performed and consensus among all authors was built regarding themes and subthemes. Results: Four themes and twelve subthemes emerged from the data. Participants were satisfied with the psychosocial outcomes of the mentoring program such as emotional, moral, and psychological support, and personal and professional development. Mentees told that mentors were their best guides who shared their life experiences. Moreover, mentors provided guidance on Islam, research methods, and case-based learning. Further, mentees said that mentors provide solutions to their problems. Useful suggestions were provided by the mentees regarding betterment in the present mentoring program such as recruitment of committed staff, the need for verbal feedback from mentees about their mentors, need for career counselling and one-to-one mentoring sessions. Conclusions: Majority of the mentees were satisfied with the formal mentoring program. Mentoring focuses on personal and professional development of all medical students. In addition to the useful suggestions provided by the mentees, there is a need for the addition of specific strategies to deal with students struggling with personal or professional problems. doi: https://doi.org/10.12669/pjms.39.3.7114 How to cite this: Aziz A, Shadab W, Siddique L, Mahboob U. Exploring the experiences of struggling undergraduate medical students with formal mentoring program at a private medical college in Rawalpindi. Pak J Med Sci. 2023;39(3):815-819. doi: https://doi.org/10.12669/pjms.39.3.7114 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.

Aim: To compare students perception towards use of video tutorial versus conventional power point presentation for online medical teaching Study design: Comparative descriptive survey Place and duration of study: The online study was conducted in the Department of Gyne. & Obs., Islamic International Medical College Rawalpindi & Sialkot Medical College Sialkot on Ms-Teams from 21st July 2020 to 21st October 2020 Methods: One hundred and one students from 4rth year MBBS participated in the study. Students were taught a given topic on power point presentation and then through a video tutorial online on Ms -Teams. Data was collected using a validated questionnaire. Students were inquired to express their perceptions & attitudes regarding the online teaching method, using a five point Likert scale. All the data was analyzed on SPSS version 20. Results: Out of 101, there were 38 males and 63 female students with ages ranged between 22 to 26 years. The mean score for video tutorial was higher than the mean score for Power Point in content understandability. There was a statistical difference in content understandability, effectiveness of teaching technique and attitude towards two teaching techniques (P< 0.05). Students had more positive attitude towards watching an online video than PowerPoint, which implied it was more entertaining, engaging and effective. Discussion was more spontaneous with a video tutorial as compared to Power Point. Students were involved more and enjoyed higher level of interaction. Conclusion: Online video tutorials were more effective as compared to the power-point presentations in content understandability of students and their learning processes. Keywords: Online teaching, Covid 19, Video tutorial, power point presentation

Background: Iron overload-related complications are the main concern in patients who must often receive blood transfusions. The only way to treat iron overload in these patients is by chelating agents. Owing to the high cost and adverse effects of chelating agents use of naturally present chelators is under study. Aim: To compare the protective effects of two commonly used herbs Nigella Sativa and Cassia Senna in iron-overloaded mice. Study Design: Experimental randomized controlled trial. Setting: Zoology department of Govt College University Lahore during six months period. Method: A total of forty-eight mice were divided into four groups (n = 12). Group one was normal to control while group 2, 3, and 4 were overloaded with iron by intravenous injection of iron dextran (0.1 ml/kg body weight) daily for fifteen days. After 15 days iron overload was confirmed by blood testing. For additional 15 days, group three mice were provided with Cassia Senna (100 mg/Kg body weight) while group four mice were permitted to feed on Nigella sativa (200 mg/Kg body weight). Animals were sacrificed on day 32 and organs were preserved to check the iron levels. Blood sampling was done on days 0, 15, and 31 to analyze serum iron levels. Results: The protective effect of Nigella Sativa was more marked than cassia senna in iron 0verloaded mice. Conclusion: The addition of Nigella Sativa instead of cassia senna in iron-laden patients as an adjunct therapy can be more beneficial in preventing the damaging effects of iron overload. Keywords: iron overload, Nigella Sativa, Cassia Senna

Objective: This study aimed to assess the medical students’ opinions and views on undertaking SLICE as a formative assessment. Methods: This was a qualitative, exploratory study. Purposive sampling technique was used to select final year medical students who have undertaken a formative assessment through SLICE in their clerkship rotation. Total 32 students participated in this study .Four sets of focus group discussions (FGD) were conducted from medical students who had recently gone through their clinical clerkship modules for Pediatrics, General Medicine, General Surgery and Gynecology& Obstetrics. Each recorded FGD was transcribed verbatim. Thematic analysis was conducted manually. Themes were identified from the transcribed data, coded and analyzed. In order to achieve adequate coding and researcher reliability, investigator triangulation was performed. The initial thematic analysis was performed by the primary investigator. Thereafter, two more investigators independently analyzed the data. Before the data was finalized, all the three investigators reached a final consensus upon the themes that had emerged, ensuring triangulation of the analyzed data. Results: A four staged thematic analysis was conducted, in which five major themes and five sub-themes emerged. The main themes being: Purpose, Learning, Timing, Relevancy and Fairness of SLICE. Conclusion: The students generally thought that SLICE was effective in enhancing their clinical skills learning and should be conducted more frequently with minor adjustments. Continuous...

The purpose of this qualitative study was to investigate the professional challenges faced by lady surgeons in Pakistan. This qualitative exploratory phenomenological study was conducted from April 2019 to June 2019. Four lady surgeons participated in in-depth interviews, based on four questions: challenges during training; perceptions of gender-based professional treatment; perceptions of relationships with peers; and perception of gender on the quality of training. Four main themes with ten sub-themes were developed. Family support is identified as major facilitating factor. Participants experienced gender-based discrimination at workplace, long exhausting duty hours with lack of quality time for their families and social gatherings. With the passage of time, these problems diminished as the surgeons gained a work-life balance with their motivation. Key Words: Barriers, Career progression Challenges, Lady surgeons, Gender.

Preterm delivery (before 37 completed weeks of gestation) is a major determinant of infant mortality. The objective of study was to determine the efficacy of 17-alpha hydroxyprogesterone in preventing delivery before 37 weeks of gestation in high risk women.This study, a randomized controlled trial was conducted in Obstetrics OPD, observing all scientific and ethical protocols. The women with less than 20 weeks gestation and with a past history of preterm delivery were included. A total of 132 women fulfilled the study requirements. Two groups made were as follows: Group A (Treatment group received intramuscular 17-alpha hydroxy-progesterone) and Group B served as control (The control group revived intramuscular Neurobion). A total of 66 women were assigned to each group. The data was recorded on a specially designed proforma for statistical analysis and comparison following the standard procedure.The criterion was strictly observed. The results showed a statistically significant (p0.01) difference between group A as compared to group B.17-α- Hydroxyprogesterone was found to be an effective drug in preventing delivery before 37 weeks in women at risk.