Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis

Background Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists. Methods We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines. Results Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42–62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37–54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods. Conclusion Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice. Systematic review registration PROSPERO CRD42019125628 Graphical abstract

Prevention of Nursing Interruption Disputes in Obstetrics and Gynecology Based on Nursing Process Reengineering

During the nursing administration process, including preparation, management, and documentation, there is a high proportion of work interruption that results in nursing administration errors that consequently affect the safety of patients, increase the occurrence of nursing risks, and cause adverse reactions. To investigate the impact of nursing on drug withdrawal disputes in obstetrics and gynecology and reduce medical disputes are of great importance. In this study, documents related to medical disputes are collected and linked to relevant professional information systems for data collection and consultation. The patients are divided into groups and treated with different nursing methods, and then the correlation between nursing methods and disputes in different groups is computed. The results show that, based on the proposed nursing process, medical disputes caused by the cessation of nursing can be effectively reduced. Compared with traditional nursing methods, when the proposed nursing procedures are followed, the dispute rate is reduced by more than 10% and the possibility of serious disputes is also reduced with a reduction rate of about 15%. This shows that, based on the proposed nursing process, reengineering can play an effective preventive role in stopping obstetrics and gynecology nursing disputes.

Frequency of Genital Tuberculosis in Patients Undergoing Diagnostic Laparoscopy for Infertility

OBJECTIVES: To determine the frequency of genital tuberculosis in patients undergoing diagnostic laparoscopy for infertility. METHODOLOGY: It is a descriptive (cross-sectional) prospective study. The study was performed within the duration of six months i.e., February 12th, 2020 to August 12th, 2020 at the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar. A total of 196 patients were observed by using 47.1% proportion of genital tuberculosis in infertility, 95% confidence interval with margin of error 7%, using software of WHO for sample size calculation. Further, sample collection was performed using non-probability (consecutive) sampling techniques. RESULTS: The mean age of the patients in our study was 30 years (SD+3.92). Fifty seven percent of cases were having primary infertility and 43% of patients were having secondary infertility. The incidence of genital tuberculosis undergoing infertility was 45%. CONCLUSION: Our study concludes that the incidence of genital TB in infertility in our setup was 45%.

Blood Transfusion in Obstetrics and Gynecology: A Retrospective Analysis in Government Naseerullah Babar Hospital Peshawar

OBJECTIVES: To evaluate the indications of blood transfusion in the Obstetrics and Gynecology Department of Government NaseerUllah Khan Babar Memorial Hospital. METHODOLOGY: This retrospective observational study was performed on indoor gynecology and obstetrics patients for the period of one year, a total of 100 patients were included in this study that received blood transfusion. Samples were collected by non-random convenience sampling after getting approval from the hospital ethical committee. Data was analyzed by using SPSS version 20. RESULTS: In this study a total of 100 patients who received blood transfusion were analyzed, out of 100 patients 78% of patients received transfusion due to obstetrical causes and 22% patients got transfused for gynecological causes. Most common blood group transfused was B+ and O+ and mean hemoglobin level at which patients received blood transfusion was 9.7g/dl. Blood components preparation can provide components to treat two to three patients from a single donor. The use of packed cell transfusion should be promoted instead of whole blood transfusion that is not even needed in most of the cases. CONCLUSION: Blood transfusion practice has been used aggressively in gynecology and obstetrics in some cases even without proper indications. There is a need to modify this practice by correcting anemia through drugs to avoid the inappropriate use of blood. Use of blood components should be encouraged.

A Preliminary Study on the Design of C-Section Props

A cesarean section (c-section) is a surgical procedure aimed to deliver a baby by opening the abdominal wall and uterus. Now, c-section is one of the choices that are often chosen by mothers when giving birth. The knowledge and skills of c-section are important in education that focuses on obstetrics and obstetrics, especially for prospective specialist doctors taking the title of Specialist in Obstetrics and Gynecology (SpOG). Residents are required to be able to understand the procedure of c-section both in theory and practice. To train and improve c-section skills, one of the methods used is to use c-section props. This study aims to design and manufacture c-section props that resemble actual conditions and can be used repeatedly. The cesarean section props consist of three main parts, namely the abdominal body, the uterus, and the synthetic skin layer of the abdomen. The product master uses 3D printer results with PLA filament material. The props are made of RTV-48 silicone rubber and Polyurethane Foam with a mold made of fiberglass composite using the Hand Lay-UP method. The c-section props produced can provide an overview of the general cesarean surgery procedure.