Complications during postpartum period
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Complications during postpartum period Complications during postpartum period Document Transcript

  • Research report complication During postpartum periodUniversity of Gujrat Internship Agency Complications during postpartum period A Case Study of Tehsil Gujrat INTERNSHIP REPORT At AZIZ BHATI HOSPITAL GUJRAT (15 JULY TO 31 AUGUST) BY Aroj Bashir Muhammad Qasim Page 1
  • Research report complication During postpartum period Master in Population Sciences 2nd semester Table of Content Contents Page # Introduction 1. Personal Biography 2. Session 3. Taught Courses 4. My career Interest 5. Motivation/ Reason for internship Host Institute 1. Introduction 2. Ongoing Programs 3. Specialties 4. Working mechanism 5. Goals /Target 6. Salient Achievements Focal Person 1. Name 2. Behavior toward Internee 3. Level of cooperation during work 4. Guidance to Complete Tasks Project /Assignment Research Project: 1. Name Of Project 2. Introduction 3. Literature 4. Objectives Page 2
  • Research report complication During postpartum period 5. Method 6. General Findings 7. Statistical Tests 8. Discussions 9. Conclusion 10. References Relationship of Internship with Taught Courses Individual Benefits gained from internship Lesson Learned from Internship Conclusion of Internship Page 3
  • Research report complication During postpartum periodTable of Contents PageChapter: 1 Introduction Personal biography………………………………………………………….. 07 Session……………………………………………………………………… 07 Taught courses……………………………………………………………… 07 My career interests…………………………………………………………… 08 Motivation/reason for internship……………………………………………. 08Chapter: 2 Host Organizations/ Institute Introduction…………………………………………………………………. 09 Ongoing programs…………………………………………………………… 09 Specialties……………………………………………………………………. 10 Working mechanism………………………………………………………… 11 Goals/target………………………………………………………………….. 11 Chapter: 3 Focal Person / Immediate Boss / Senior Name………………………………………………………………………... 12 Behavior toward internee…………………………………………………… 12 Level of cooperation during work…………………………………………... 12 Guidance to complete tasks…………………………………………………. 12 Page 4
  • Research report complication During postpartum periodChapter: 4 Project Assignment Name of the project………………………………………………………… 13 Introduction………………………………………………………………... 13 Literature review…………………………………………………………… 17 Objectives………………………………………………………………….. 19 Method…………………………………………………………………….. 19 General findings…………………………………………………………… 20 Discussions…………………………………………………………….....29 Conclusion……………………………………………………………..…29 References………………………………………………………………...30 Relationship of Internship with Taught Courses………………………………31 Individual Benefits gained from internship……………………………………31 Lesson Learned from Internship………………………………………………31 Conclusion of Internship………………………………………………….…32 Page 5
  • Research report complication During postpartum period AcknowledgementMy report is based on internship at “Aziz Bhatti Hospital Gujrat.”I am very grate full to Sir Wajjid Tahir who gave me an opportunity to learn topic of “post-partum complications among women” So, this topics teach me the complications during post-partum period.At Aziz bhatii hospital Gujrat all doctors were very cooperative me mostly I thanks full to DrFouzia Arshad, gynecologist she guide me during my internship. She gave me full help relatedto our field visit.In the end I am really indebted to university of Gujrat which provided me the opportunity towork in any organization in order to sharpen my skills and implement my knowledge in practicalfield. Page 6
  • Research report complication During postpartum period CHAPTER#1IntroductionPersonal BiographyMy name is Aroj Bashir student of” Population Sciences at University of Gujrat”.Student Of MPS 2nd semester.Session Session (2010_2013)Taught Courses 1. Introduction to population sciences 2. Gender and reproductive health 3. Information education and communication 4. Population and social Statistics (1) 5. Population and social Statistics (2) 6. Information technology 7. Introduction to social sciences 8. Planning and Management of Population Program 9. Introduction to Technique of Population Program 10. Population & Development Page 7
  • Research report complication During postpartum periodMy career InterestsPakistan is a developing country and facing a lot of social, economic, demographic, heath andSecurity problems. Social issues are the basis of all problems, so I decided to choose the socialsciences field. Being a social Scientist I want to do some thing for the betterment of our country.Through my demographic field I can point out the social, heath, and demographic anddevelopment problems of the Pakistani peoples, that can help the policy makers to make theirpolicies according to problems of the people and the country.I am student of population Scienceand interested in research work and I want to enhance my research Work by learning qualityresearch tools so in this regard my internship remain veryHelpful for me and I conduct research on the topic “complication during postpartum periodTehsil Gujrat” and during this work, I learned a lot about the research work tools.Reason for Internship:My internship is the part of my course of second semester. This is my learning process. Throughthe internship. I gain more knowledge about our study. I will be able to know the real meaning ofour study and gain the confidence. Through internship I gain experience about the research workand practical work in the field. I seen the problems and issues of the people in the field. Page 8
  • Research report complication During postpartum period CHAPTER#2 Host OrganizationIntroduction:Name: Aziz Bhati Shaheed Hospital (DHQ) GujratHistory:The DHQ Hospital Gujrat was established in 1963 and renamed as Aziz Bhati Shaheed Hospitalin 1966 after war against India. It is sited on the north of Gujrat city. The hospital has beenattached with the Nawaz Sharif Medical College as the teaching hospital. It is not only cateringto the health care needs of local people, but also of the people of neighbouring districts andtowns such as Bhimber, Mandi Bahauddin and Lalamusa. Initially it was started with onehundred beds and some departments. With the passage of time the number of beds and facilitieswas increased and now 452 beds hospital. The pediatrics Department has the capacity of 30 beds.Almost fifty six doctors and ninety nurses are working there. The hospital currently has 5 majordepartments . The major departments are;  General surgery  General medicine  Gynecology  ENT department  Eyes department And with some other departments  Orthopedics  Pediatrics  Physiotherapy  Radiology  Urology/Dialysis Unit  Tele-Medicine  Cardiology  DentistryOngoing programs:The basic purpose of organization is accrue &treatment of the patient and provides them bestmedication facility. In addition to treatment of the patient the hospital’s ongoing programs are Page 9
  • Research report complication During postpartum periodVaccination of child, Hepatitis B,C treatment, vast management(preset), Dialysis(artificialkidney facility and the training of dispensers and receives the emergency. This hospital is also providingroutine care services to the prisoners of District Jail, Gujrat.Specialties:There are sixteen specialties of the hospitable  General OPD  General medicine  Surgery  Pediatrics  Eye  ENT  Orthopedics  Psychiatry  Dental  Skin  OB/GYN  Emergency/Casualty  Home Cases  Tibb/Unani Shifa Khana OPD cases  Cardiology  Other Page 10
  • Research report complication During postpartum period Working Mechanism: Medical Superintendent is the head of organization. All the management of the hospital is operates by the medical superintendent. He makes policies and arrangements for the hospital. The hospital has a deputy medical superintendent, that makes check and balance of doctors, nurses, paramedics, clerks and other staff of the hospital. Medical superintendent (MS) ↓ ↓ Nursing Superintendent Deputy Medical superintendent ↓ . DNS (1) ↓ ↓ Paramedics Head Nurses(13) ↓ ↓ Dispenser (13) → Lab/Tech (4) → Lab/Att (3) Staff Nurses (78) ↓ X-ray/Tech (3) → OTA (4) → Driver (6) MD/Wife-2 LHV’s-2 Goals/targets: Our goal and targets are continuous improvement in…  Visibility  Competitiveness  Accessibility  Communication  Education  Total Health Management   Promote the highest level of rehabilitation and independence through restorative nursing care using a team approach and collaborating with therapy disciplines as appropriat  Provide quality care by teaching and monitoring client’s response.  Provide high quality health care services in a cost-effective manner  To provide the best health care services to the people of Gujrat and adjoining areas Page 11
  • Research report complication During postpartum period CHAPTER#3 Focal person/immediate boss/seniorName: Dr Fouzia ArshadBehavior towards Me:She is very nice, humble, and kind. Her behavior towards me is very nice. she taught me all thework very efficiently and greatly. she helped me in every matter related to my work. she guidedme at every step.Level of Cooperation During work:Level of cooperation is very nice. e cooperates with me maximum and gives me maximum ofher time. she cooperated to me in every matter related to my survey on “postpartumcomplication. she told me about the diseases and socially and medically reasons behind thecomplications. she helped me in every stage where I needed their help.Guidance to Complete Tasks:She very truly wants me to learn every aspect of my internship. She also gives short lectures meto complete my work. she encouraged me to complete my task. She also appreciates my surveywork. She guided me at every step during internship. Page 12
  • Research report complication During postpartum period CHAPTER#4Project /assignmentName of project Complications during postpartum periodIntroductionThe postpartum period is the time immediately after a woman delivers her baby. It is the timewhen the mothers body is changing back to the non-pregnant state. It lasts approximately 6weeks or until the reproductive organs return to normal size. During the postpartum period, awoman can expect a variety of symptoms ranging from physical discomfort to emotional upsets.“Postpartum hemorrhage is traditionally defined as blood loss greater than 500 mL during a va-ginal delivery or greater than 1,000 mL with a cesarean delivery. However, significant blood losscan be well tolerated by most young healthy females, and an uncomplicated delivery often re-sults in blood loss of more than 500 mL without any compromise of the mothers condition.”Feeling overwhelmed with the responsibility of caring for an infant is a normal postpartumsymptom. Other emotions may include sadness, feeling helpless, and a "let down" feeling. “Dis-comfort in the perineum (area between the rectum and vagina) is expected and may cause diffi-culty with sitting or walking. It is common for the breasts to be swollen and painful.”The newmother may feel tired, experience hot flashes and sweating, and may be constipated.. All thesesymptoms are normal, a temporary reaction to childbirth.“Treatment for complications varies depending on the source of the problem. Infection usuallyresponds to antibiotic treatment.” Other special medications and procedures are available fortreating postpartum problems.A new mother who experiences one or more of these symptoms should contact her provider im-mediately.There are some things which avoid postpartum complications and health problems. “Before babyis born, eat a healthy diet thats high in leafy green vegetables, red meat, or legumes to avoidiron-deficiency anemia.”“During the immediate postpartum period, high levels of oxytocin in blood are helping uterusreturn to its prep regnant size. “Stress creates adrenaline, which can make it more difficult for thehormones to do their job.” Stay in bed and partner or a friend or relative (or paid help, if neces-sary) care for mother.Eat nutritious foods and drink plenty of water. Dont lift anything heavierthan baby, and just try to rest and relax as much as can. Limit visitors. Page 13
  • Research report complication During postpartum periodPostpartum infections are caused by bacteria entering the the urinary tract, or the site of an inci-sion or tear. But there are also other kinds of infections that can occur during postpartum, such asbreast infections . Since infections can be serious, its important to be on the lookout for feverand other signs of infection during postpartum.“The more objects enter vagina during labor or after birth, the more risk there is that infection-causing bacteria could be pushed upward toward uterus. Limit internal exams during labor .Its normal to lose some blood after giving birth. When the placenta separates from the uterinewall, the resulting wound bleeds until the blood vessels close off with help from your contractinguterus. And since bodys blood volume increases by about 50 percent during pregnancy, someblood loss wont affect health.But sometimes, women bleed too much after giving birth, which is called a postpartum hemorr-hage. This happens in up to 5 percent of all births, and is most likely to happen while the pla-centa is separating or soon afterward Postpartum hemorrhage can be divided into 2 types: earlypostpartum hemorrhage, which occurs within 24 hours of delivery, and late postpartum hemorr-hage, which occurs 24 hours to 6 weeks after delivery. Most cases of postpartum hemorrhage,greater than 99%, are early postpartum hemorrhage. most women are still under the care of theirdelivering provider during this time. With many women delivering outside of hospitals and earlypostpartum hospital discharge being a growing trend, postpartum hemorrhage that presents to theemergency department may be either early or late..“Sometimes, a mother will hemorrhage days or even weeks after birth. This rare but serious con-dition is called a late or delayed postpartum hemorrhage and is usually caused by retained mem-branes or tissue in the uterus.” If experience unexpected heavy bleeding days or weeks postpar-tum, lie down, stay warm, nurse baby if possible,About 1 out of every 8 women has postpartum depression after delivery. It is the most commoncomplication among women who have just had a baby. Changes in the womans hormones afterdelivery probably cause postpartum depression. Womenwho have been depressed before are at increased risk for postpartum depression. Postpartum de-pression can begin at any time within the first 3 months after delivery. It canseriously threaten both the woman and her baby. Since the mother is seriously ill, she maynot be able to care for her baby as she would if she were well. The disease may make it hardfor the mother to breastfeed or bond with her baby. For these reasons, postpartum depressionis a threat to newborns.Postpartum depression can be treated in several ways. Support groups may help. Some womengo to therapy or counseling with a mental health professional. This professional may talk withthe woman about the risks and benefits of antidepressant medications.“After the baby is born, many new mothers have the "postpartum blues" or the "baby blues." Theword "blues" is not really correct since women with this condition are happy most of the time.But compared to how she usually feels, the new mother. Postpartum depression is not the same Page 14
  • Research report complication During postpartum periodas the "postpartum blues," a condition that is morecommon and less serious. Postpartum blues usually ends by the tenth day after the baby isborn. The postpartum blues peak three to five days after delivery.” They usually end by the tenthday after the babys birth. Although the postpartum blues are not pleasant, the woman can func-tion normally. The feeling of the "blues" usually lessens and goes away over time.Feeling overwhelmed with the responsibility of caring for an infant is a normal postpartumsymptom. Other emotions may include sadness, feeling helpless, and a "let down" feeling.Thereare symptoms that are not normal and may be considered postpartum complications. Contacthealthcare provider immediately if one of more of these symptoms develop:  Chills  Nausea Or Vomiting  Moderate To Strong Abdominal Or Back Pain That Is More Than Just An Ache  Increased Pain, Swelling, Redness, Or Drainage From The Episiotomy Or C-Section Inci- sion  Bleeding Through More Than One Pad Per Hour  Blood Clots The Size Of A Plum  A Foul Smelling Vaginal Discharge  Chest Pains  Increasing Tenderness In The Lower Abdomen  Red, Warm To The Touch, Painful Breasts  A Severe Headache In The Forehead And Behind The Eyes, Accompanied By Extreme Pain While Sitting Or Standing  Feeling Depressed Or Blue For More Than 3 Days  Severe Weakness  Extreme Paleness Or  A Rapid, Racing Pulse  Postpartum Hemorrhage  Shock  Infection In Blood Septicemia  Anemia  Genital InfectionTreatment for complications varies depending on the source of the problem. Infection usuallyresponds to antibiotic treatment. Other special medications and procedures are available fortreating postpartum problems. Page 15
  • Research report complication During postpartum periodLiterature review:  Nupur Chaudhury ( 2003) argued that women who suffered from postpartum depres- sion after the birth of her fourth child, and that she attempted suicide twice for this very disorder One in ten women experience postpartum depression , a condition that often goes undiagnosed, and occurs in women after childbirth. A reason for the lack of diagnosis of postpartum depression is a milder, more common form of depression after childbirth, often known as the "baby blues". The baby blues occur in mothers three to five days after childbirth .  MLA,( 2002) The writer reveals that postpartum depression is on the rise in the United States, due to increasing stress, and contends that more responsibility needs to be taken to ensure that women are prepared to handle the challenges that will come their way. The writer also hopes that more states will pass laws that mandate education and screening with women after delivery. Postpartum depression is a significantly under diagnosed pregnancy complication, which can have serious consequences. Sadness following the birth of a baby is believed to be as high as 85 percent in new mothers and normally lasts under two weeks. Postpartum depression may last as long as 18 months. The condition is thought to be caused by hormonal changes and the condition can worsen if the woman is suffering additional stresses. Many women experience some mood changes after childbirth.  Stanley Poulos (2008) Women are more likely than men to suffer from depression, especially during their reproductive years. Rates of depression are higher where stressful circumstances exist such as poverty, lack of education, sexual inequality, poor social support and in pregnancy. Single and adolescent pregnant women are especially at risk  Abbas Mohila (2007,) ) conducted a study in Bangladesh and said A large proportion of these deaths are preventable by appropriate measures through the periods of antenatal, delivery and postnatal care . Complications of pregnancy and childbirth are still the leading causes of death and disability among women of reproductive age in developing countries common were weakness, anemia, and lower abdominal pain the main direct 1causes of severe maternal morbidity in West Africa were hemorrhage, obstructed labor, eclampsia, and sepsis .  Vallely, Ahmed(2005) Information on the extent of postpartum maternal morbidity in developing countries is extremely limited. In many settings, data from hospital-based studies is hard to interpret because of the small proportion of women that have access to medical care. However, in those areas with good uptake of health care, the measurement of the type and incidence of complications severe enough to require hospitalization may provide useful baseline information on the acute and severe morbidity that women experience in the early weeks following childbirth. An analysis Page 16
  • Research report complication During postpartum period of health services data from Lusaka, Zambia, is presented. the maternal referrals in the first 24 hours after delivery were for retained placenta and just over one-third were for pregnancy- related hypertension or eclampsia Three referrals were for postpartum hemorrhage. There were no maternal deaths in this group.  Shane.(2001) There are an estimated 14 million cases of pregnancy-related hemorrhage every year; at least 128,000 of these women bleed to death.6 Most of these deaths occur within comprehensive emergency obstetric services. These services often are available only at a referral hospital and may require that the woman be transported a long distance, again increasing her risk of death. Women who survive PPH often suffer from severe anemia if the condition is not managed appropriately.4 Lifesaving blood transfusions are associated with risks of transfusion reactions and transmission of infections. Surgery, such as hysterectomy, carries its own risks from infection, anesthesia, and other complications, as well as high financial costs. Page 17
  • Research report complication During postpartum period0bjectives:  To study the postpartum complication among women  To study in which age women have most postpartum complication  To study education status of gujrat districtMethod: This research based on both primary and secondary data. Primary data is collected from the women patient of aziz bhati hospital which is facing postpartum complication through face to face interview and secondary data from the register of aziz bhati hospital gujrat. In the study researcher selected the respondent by non probability sampling because list of patient of the postpartum complication are difficult to find so this sampling technique was thought to be the best to select the respondents. Page 18
  • Research report complication During postpartum periodGeneral Findings Table No. 1 Age of Respondents Categories Frequency percent 15-19 10 10.0 20-24 27 27.0 25-29 24 24.0 30-34 19 19.0 35-39 20 20.0 Total 100 100.0 The table shows that majority of women (27%) are in age group of20-24 years. It indicates that the women in age group of 20-24 years arefacing more complications. Page 19
  • Research report complication During postpartum period Table No. 2 Area of Respondents Categories Frequency percent urban 43 43.0 rural 57 57.0 Total 100 100.0 This table shows that majority of women belonged to rural area.And 43% women belonged to urban area.Table No. 3 Husband Occupation Categories Frequency percent govt. job 13 13.0 private. sector 23 23.0 own. business 36 36.0 agriculture 28 28.0 Total 100 100.0This table shows that majority of men (36%) have their own business, Page 20
  • Research report Diseases Among Elder people Table No. 4 Husband Education Categoreis Frequency Percent 18 18.0 primary middle 18 18.0 metric 29 29.0 intermediate 15 15.0 graduation 14 14.0 master 6 6.0 Total 100 100.0 This table shows that majority of men (29%) have donematriculation and (18%) have done middle. Page 21
  • Research report Diseases Among Elder people Table No. 5 Delivery Condition Categories Frequency Percent Normal 43 43.0 C-section 57 57.0 Total 100 100.0 This table shows that majority of women had C-section deliverywhich is 57% and normal deliveries were 43%. Table No. 6 Respondents Blood pressure Categories Frequency Percent Normal 33 33.0 High 29 29.0 Low 37 37.0 Total 100 100.0 This table shows that majority of women had low blood pressure(37 %.) and the patients of hypertension were 29%. Page 22
  • Research report Diseases Among Elder people Table No. 7 Chill Fever Vomiting Categories Frequency Percent yes 25 25.0 no 4 4.0 Total 29 29.0 System 71 71.0 Total 100 100.0 This table shows that 25% women had chill fever and vomitingduring postpartum period. Table No. 8 Abdominal or Back Pain Frequenc Categories y Percent yes 37 37.0 no 18 18.0 Total 55 55.0 System 45 45.0 Total 100 100.0 This table shows that 37% women had abdominal and back painduring postpartum period. Page 23
  • Research report Diseases Among Elder people Table No. 9 More bleeding and Blood Clots Frequency Percent Categories yes 41 41.0 no 8 8.0 Total 50 50.0 System 50 50.0 Total 100 100.0 This table shows that 41% women had more bleeding and bloodclots as compare to others, during postpartum period.Table No. 10 Headache Categories Frequency Percent yes 40 40.0 no 23 23.0 12 1 1.0 21 1 1.0 Total 65 65.0 System 35 35.0 Total 100 100.0This table shows that 40% women had headache during postpartumperiod. Page 24
  • Research report Diseases Among Elder people Table No. 11 Feeling Depressed Categories Frequency Percent yes 45 45.0 no 40 40.0 11 2 2.0 Total 87 87.0 System 13 13.0 Total 100 100.0 This table shows that 45% women felt depressed duringpostpartum period. Table No.12 Weakness. Paleness .Rapid Pulse Categories Frequency Percent yes 50 50.0 no 25 25.0 Total 75 75.0 System 25 25.0 Total 100 100.0 This table shows that 50% women had weakness, paleness andrapid pulse during postpartum period. Page 25
  • Research report Diseases Among Elder people Table No.13 Postpartum Hemorrhage Categories Frequency Percent yes 37 37.0 System 63 63.0 Total 100 100.0 This table shows that 37% women had postpartum hemorrhageduring postpartum period. Table No.14 Shock Categories Frequency Percent yes 14 14.0 System 86 86.0 Total 100 100.0 This table shows that 14% women had shock during postpartumperiod. Page 26
  • Research report Diseases Among Elder peopleTable No.15 Infection in blood and septicemia Categories Frequency Percent yes 10 10.0 System 90 90.0 Total 100 100.0 This table shows that 10% women had infection in blood andsepticemia during postpartum period. Table No.16 Anemia Categories Frequency Percent yes 21 21.0 System 79 79.0 Total 100 100.0 This table shows that 21% women were anemic during postpartumperiod. Page 27
  • Research report Diseases Among Elder peopleTable No.17 genital infection Categories Frequency Percent yes 11 11.0 System 89 89.0 Total 100 100.0 This table shows that 11% women had genital infection duringpostpartum period.DiscussionThe women living in Gujrat who came for medical checkup or treatment at Aziz BhattiShaheed (DHQ) Hospital, Gujrat were facing various complications during postpartumperiod i.e. abdominal pain, bleeding, feeling depressed, postpartum hemorrhage, shockconditions, septicemia, anemia, and genital infections. The women from rural areaswere at high risk of complications and had more visits to DHQ, Hospital for medicalcheckup and treatment purposes than urban women. The majority of women reportedlow blood pressure. Many women were facing nutritional deficiencies and relevantdiseases. It seems that the other socio-economic factor have strong influence onwomen health in Gujrat. Mostly women belonged to rural area and their husband haveown business and agriculture. the education level is also t high so they do notawareness about health.Conclusion:There are many villages attached to gujrat. Most patient of aziz Bhatti Shaheed hospitalbelong to rural areas. During the pregnancy and after pregnancy women go throughmany complications. There are many genetic changes occur in their body due to whichthey often get depression. so no one behave rude with her and particularly take care oftheir nutrition as to maintain their and also child health. Page 28
  • Research report Diseases Among Elder peopleReference:Francis 2007 Tips for a Healthy Postpartum Period retrieved fromhttp://www.netplaces.com/postpartum-care/postpartum-complications-and-health-concerns/tips-for-a-healthy-postpartum-period.htmYaa A B Yiadom2010 Postpartum Hemorrhage in Emergency Medicine retrieved fromhttp://emedicine.medscape.com/article/796785-overviewDimes 2006Postpartum depression retrieved fromhttp://www.marchofdimes.com/postpartum_depression.htmlHawkins Drive 2002 Postpartum complications retrieved fromhttp://www.uihealthcare.com/topics/pregnancyandchildbirth/preg4879.htmlNupur Chaudhury ( 2003) Postpartum Depression retrieved fromhttp://serendip.brynmawr.edu/bb/neuro/neuro03/web2/nchaudhury.htmlMLA,( 2002) Postpartum Depression retrieved fromhttp://www.academon.com/Research-Paper-Postpartum-Depression/118600Stanley Poulos (2008) Postpartum Depression retrieved from http://www.xanax-effects.com/Mirza Abbas Mohila Degree College, Shahjahanpur, 2007 Journal of Applied SciencesResearch, 3(11): 1320-1326,2007, INSInet Publication retrieved fromhttp://www.aensionline.com/jasr/jasr/2007/1320-1326.pdfVallely, Ahmed(2005) Centre for International Child Health, Institute of Child Health, UniversityCollege London, London, UK retrieved from http://www.biomedcentral.com/1471-2393/5/1Shane.(2001) preventing postpartum hemorrhage volume 13 Seattle, Washington 98109-1699 U.S.A.Retrieved from http://www.reproline.jhu.edu/english/2mnh/2articles/otlkpph.pdf Page 29
  • Research report Diseases Among Elder peopleRelationship of internship with taught courses:The courses which I taught during session have a strong relation with my internship. I taughtreproductive health in course as my internship topic is “complication during during postpartumso it helps me a lot to understand my topic. we were taught skills of research work and ininternship I implemented those learned research tools practically to conduct a research project.So taught courses remain helpful throughout my project work and I was guided at every step ofresearch by my studied courses.Individual’s benefits gained from internshipI have learnt from this internship about research programs and counseling of patients. I havelearnt that how to communicate and counsel the patient. I got awareness about complicationsafter pregnancy and their management. I understood how we can educate and aware thewomen about their health problems so that these complications can be reduced.Lesson learned from internshipI have done my internship in Aziz Bhatti Shaheed Hospital Gujrat, I have seen that doctors andstaff do not perform their duties honestly due to which patient gets into trouble. No one attendspatient carefully or attentively, if all the doctors and staff perform its duty honestly then manyproblems can be solved out. Patient can get better treatment and better compliance. I havelearnt from this internship that we should perform our duties honestly, carefully and attentively,we should not be harsh or rude to patients, as some one’s life is dependant on us, so we shouldnot keep ignorant attitude as if we are in life saving profession. As QURAN says“If anyone saved a life of a man it would be as if he had saved the life of whole mankind”May ALLAH guide us on right path. Page 30
  • Research report Diseases Among Elder peopleConclusion of internshipThe conclusion of this internship is that small or little mistakes can bring about big mishaps orupsets. Little ignorance can cause serious complications. Our home environment, education ofthe women and economic condition effects women health. I have observed during thisinternship that the women who belongs to rural areas shows more postpartum complications ascompare to those who lives in urban areas. The reason is lack of awareness regarding theirhealth problems. Education is also a key point concerning the health problems because aneducated woman can take good care of not only her as well as her family’s health, but illiteratewoman fails to do so due to lack of awareness. Another reason is depression which badlyeffects women health. Women whom delivery is carried out by mid-wives are at more risk tohave genital infections. Page 31