The modified Robson criteria for Caesarean Section audit at Mother and Child Health Center Pakistan Institute of Medical Sciences Islamabad.

OBJECTIVE: To determine the rates of lower segment Caesarean Section and their indications using modified Robson criteria. METHODS: The retrospective study was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised review of records from October 1, 2016, to September 30, 2017,related to all Caesarean Sections. The data was classified according to Robson's Ten Group Classification System. SPSS 21 was used for data analysis. RESULTS: Of the 6155 deliveries, 2052(33.3%) were caesarean sections. According to the criterion used, the major contributor to overall Caesarean Section rate was Group 5 which entails previous Caesarian delivery, single, cephalic, >37 weeks. CONCLUSIONS: Women with previous scar should be assessed and offered trial of labour after caesarean section, where appropriate.

High burn out among doctors working in a tertiary care hospital; a wakeup call.

OBJECTIVE: To determine the frequency of burnout and its associated factors among doctors in a tertiary care setting. METHODS: The descriptive study was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from October 1, 2016, to January 31, 2017, and comprised doctors working there regardless of age, gender and professional experience. A self-reported questionnaire with demographic data and Maslach Burnout Inventory was used. Levels of each component of and composite burnout score were calculated and associated with each independent variable. Data was analysed using SPSS 21. RESULTS: Of the 365 doctors, 238(65.2%) were females, 200(54.8%) were single, and the overall mean age was 28.68}4.58 years. Besides, 172(58%) subjects were postgraduate residents, 77 (21%) belonged to Obstetrics and Gynaecology, 198(54.2%) had 1-in-4 rota, and 123(33.7%) had job duration of 1-4 years. High burnout was reported by 49(13.5%) and moderate burnout by 227(62.2%) doctors respectively. Severe burnout frequency was the highest in Anaesthesia department 9(36%) followed by 18(23.4%) doctors in Obstetrics and Gynaecology. Overall, 140(38%) doctors reported high degree of emotional exhaustion, 100(27%) had high degree of depersonalization and 208(57%) had severely reduced personal accomplishment. Of the total, 120(33%) doctors wanted to leave their jobs. CONCLUSIONS: Different levels of burnout were found in doctors. Amongst the three components of burnout, severely reduced personal accomplishment was the highest.