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Background Antenatal corticosteroids (ACS) have long been regarded as a cornerstone intervention in mitigating the adverse effects of a preterm birth. However, the safety and efficacy of ACS in hospitals in low-resource countries has not been established in an efficacy trial despite their widespread use. Findings of a large cluster-randomized trial in six low- and middle-income countries showed that efforts to scale up ACS use in low-resource settings can lead to harm. There is equipoise regarding the benefits and harms of ACS use in hospitals in low-resource countries. This randomized controlled trial aims to determine whether ACS are safe and efficacious when given to women at risk of imminent birth in the early preterm period, in hospitals in low-resource countries. Methods/design The trial design is a parallel, two-arm, double-blind, individually randomized, placebo-controlled trial of ACS (dexamethasone) for women at risk of imminent preterm birth. The trial will recruit 6018 women in participating hospitals across five low-resource countries (Bangladesh, India, Kenya, Nigeria and Pakistan). The primary objectives are to compare the efficacy of dexamethasone with placebo on survival of the baby and maternal infectious morbidity. The primary outcomes are: 1) neonatal death (to 28 completed days of life); 2) any baby death (any stillbirth postrandomization or neonatal death); and 3) a composite outcome to assess possible maternal bacterial infections. The trial will recruit eligible, consenting pregnant women from 26 weeks 0 days to 33 weeks 6 days gestation with confirmed live fetuses, in whom birth is planned or expected within 48 h. The intervention comprises a regimen of intramuscular dexamethasone sodium phosphate. The comparison is an identical placebo regimen (normal saline). A total of 6018 women will be recruited to detect a reduction of 15% or more in neonatal deaths in a two-sided 5% significance test with 90% power (including 10% loss to follow-up). Discussion Findings of this trial will guide clinicians, programme managers and policymakers on the safety and efficacy of ACS in hospitals in low-resource countries. The trial findings will inform updating of the World Health Organization’s global recommendations on ACS use. Trial registration ACTRN12617000476336. Registered on 31 March 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3488-z) contains supplementary material, which is available to authorized users.

To describe the frequency and spectrum of different types of gynecological malignancies.An observational study.Department of Obstetrics and Gynaecology, Liaquat University of Medical and Health Sciences, Jamshoro, from January 2014 to December 2015.All patients with gynecological malignancies, admitted at the study place, whether previously diagnosed or need to establish the diagnosis on the basis of EUA, biopsy, staging and for surgery during the study period were included. All patients with benign gynecologic masses were excluded. Studied variables were age, marital status, parity, education, socioeconomic status, clinical presentation, clinical diagnosis, tumor site and surgical procedure. The diagnosis and type of malignancy was confirmed on the histopathology report of the specimen taken.There were a total of 65 patients (6.39%) with gynaecological malignancies. The median age was 15 years (46.26%). Ninety-four percent were married. Seventy-one percent had a poor socioeconomic status. Cervical cancer was most common as seen in 27 (41.5%) followed by ovarian malignancy in 21 (32.3%) of cases, uterine caners in nine (13.8%), vaginal cancer in six (9.2%), and vulval cancer in three (4.6%) of cases. The common histopathological type of cervical cancer was moderately differentiated squamous cell carcinoma (n=19, 29.2%), papillary serous cyst adenocarcinoma in ovarian (n=13, 20.0%), and squamous cell carcinoma in vagina and vulva. There was no case of primary fallopian tube malignancy.Gynecological malignancies are common in younger age group. The need is to strengthen screening practices, making it easy and cost-effective for all the general and at risk population, so that early detection and treatment can be possible to control the female genital tract cancers.

To compare the days and spells of sickness absence among males versus females and Saudi nationals versus expatriate employees of King Khalid University Hospital, Riyadh, and to identify the cause of sickness absence.The cross-sectional, descriptive study comprised 3117 King Khalid University Hospital employees. Records of physician-certified sickness absence from January 1 to June 30, 2009, were obtained from the employee health clinic's register. Absence rate, frequency, duration and severity were assessed and compared between genders and nationalities, and causes were noted. SPSS version 16 and student's t test were used for statistical analyses and comparison.A total of 377 (12.1 %) employees had 416 spells of sickness absence with 639 sick-off days (mean: 1.54 +/- 0.85). The probability of sickness absence was higher among Saudi (OR=1.33) and female (OR=1.39) employees. The association of sickness absence was not found among the absentees with either gender (p= 0.335) or nationality (p = 0.086). Almost all spells of sick-off days were of short duration. Longer spells were mainly due to chicken pox which was found to be more among the expatriates. Heavy absenteeism was found only among the Saudis. The most common causes of sickness absence were acute upper respiratory infection, diseases of musculoskeletal system and the digestive system.The rate, frequency and duration of absence due to sickness in the study were higher among Saudi and female employees. The rate of absence, with passage of time, has increased significantly among Saudi nationals.