Journal of Peoples University of Medical & Health Sciences Nawabshah. (JPUMHS)

INNOVATIONS IN MEDICAL EDUCATION: TRANSFORMING LEARNING IN THE DIGITAL AGE.

Anwar Ali jamali — Mon, 30 Sep 2024 00:00:00 +0200

Medical education has undergone significant
transformations over the last decade through
leaps in technological advancements and
evolutionary
pedagogical
philosophies.
Healthcare delivery has become increasingly
complex;
hence,
future
healthcare
professionals must be able to handle such
challenges. The most significant development
has been the embracing of new digital tools,
competency-based curricula, and simulation
based learning in medical education, all of
which will revolutionize old teaching modes.

THRIVING BEYOND CHANGE: FREQUENCY, SEVERITY, AND ASSOCIATION OF SYMPTOMS WITH CLINICODEMOGRAPHICS OF POSTMENOPAUSAL WOMEN OF KECH, TURBAT.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUNDFor women, the menopause is a normal and significant life transition, but it's also commonly linked to
stigmas and misconceptions. The major health problems that postmenopausal women encounter were to be identified, along
with the knowledge, attitudes, and practices surrounding seeking medical attention for these problems, as well as the
utilization pattern and any barriers to using these services. METHODS: From March 2023 to March 2024, a cross-sectional
study was carried out at the Turbat Teaching Hospital at KECH at the Department of Gynecology and Obstetrics. Following
the acquisition of written informed consent, all postmenopausal women visiting the OPD were chosen one after the other. A
pre-made survey was employed to assess the behavior of individuals seeking medical attention. In tables and graphs, the
results were presented as percentages and frequencies. Where appropriate, the logistic regression analysis and chi-square
test were used. A significance level of p≤0.05 was deemed to exist. RESULTS:Participants in the study ranged in age from
40 to 80 years old, with a mean age of 61.47±8.28. 188 29.1% were from rural areas and 130 40.9% were residents from
rural. Maximum patients were rom nuclear families who stays away from relatives 212 66.7% who smokes hookah 148
46.5% and eats gutka 12 3.8%. Post-menopausal women had variety of symptoms to report as in current 270 84.9% of the
women presented with joint pain and stiffness followed by vaginal dryness 262 74.2% and hair changes 258 81.1%. Table:
01. While looking towards the attributes 246 77.4% of the women know or they heard about the process and physiology of
menopause and they were aware about the process among them 172 54.1% felt comfortable to discuss the phenomenon and
its related issues with their friends, fellows or peers. Majority of the participants were not taking the menopause as disease
happened at old ages 238 74.8% while 228 71.7% thought that it makes women fat. CONCLUSION:Women around the
world experience menopause differently due to a range of biological, psychological, social, and cultural factors that affect
their views, values, and attitudes around menopause. The present study clearly shows that postmenopausal symptoms and
other gynecological problems are very common in our study setting. Joint stiffness and pain were the most common
menopausal symptoms in our study group, followed by vaginal dryness and irritation. Women from both urban and rural
locations did not see menopause as an illness and had never thought to seek help from quacks or traditional healers when the
characteristics were compared to the race.

AN EXPLORATORY STUDY ON FOSTERING EARLY CAREER RESEARCHER GROWTH THROUGH AN INTERPROFESSIONAL UNDERGRADUATE MEDICAL CONFERENCE AT A PRIVATE SECTOR UNIVERSITY IN PUNJAB.

Kainat Javed1, Mahnoor Tariq2, Umair Bin Nasir3, Arooj Javed4 — Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUND: This study explores at how undergraduate research conferences influence students' perspectives and
promote career development. Through the use of the contextual learning concept, it explores how these conferences function
as experiential learning opportunities and aid in the development of critical graduate competencies.METHODOLOGY:
This investigation was qualitative design. 211 students who participated in Rashid Latif Medical College's Interprofessional
Undergraduate Student Conference were interviewed to gather data, and theme analysis was used to pinpoint and match their
skill improvement.RESULTS:The three main advantages of attending the conference, according to the students, were the
opportunity to engage with other professionals, present papers and posters and get feedback, and fully experience the
conference atmosphere. Many of the talents and qualities they reported were in line with the domains of the Five-Star and
Seven-Star Doctor frameworks. In order to compare the projected results with the actual skill growth, the study also looked
at student engagement. CONCLUSION: Conference planners can learn a lot from this study about how to create programs
that optimize interprofessional undergraduate students' skill development. Additionally, it gives learning creators advice on
how to help students get ready for these kinds of conferences. By emphasizing the importance of undergraduate research
conferences for networking, improving communication skills, and cultivating competencies pertinent to undergraduate
medical and allied health sciences students, the study closes a knowledge gap regarding how these events support skill
development in interprofessional contexts.

OUTCOMES OF MODIFIED RADICAL MASTECTOMY MRM VS BREAST CONSERVATION SURGERY BCS.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUND:Breast cancer is the most common malignancy in women and leads to substantial health issues globally.
Historically, Modified Radical Mastectomy MRM total removal of breast and tissue was a standard treatment of choice.
However, advances in surgical techniques as well as oncological care has led way for Breast Conservation Surgery BCS,
where the tumor is removed, while preserving the breast's appearance. While the intent of both approaches is to provide an
adequate oncological control, the perioperative outcomes, complication rates and the resulting patient quality of life have
been a matter of ongoing debate when discussing comparative efficacy and aesthetic outcome.OBJECTIVE: To compare
the outcome of two different surgical methods, Modified Radical Mastectomy MRM and Breast Conservation
Surgery BCS, in treatment of breast cancer.MATERIALS AND METHODS: This comparative observational
study was carried out at General Surgery Department Hayatabad Medical Complex Peshawar during the period
August 2020 to October 2021. A total of 120 female patients suffering from breast cancer were enrolled. A total
of 5747.5% patients underwent MRMGroup A whereas 6352.5% further received BCS for tumor excision while
maintaining breast appearance Group B.RESULTS:Axillary lymph node metastasis was present in 1933.3%
cases in group A and 2234.9% cases in group B. In group A there were 3459.6% cases of TNM stage-1 and
2340.4% cases had stage-II, while in group B stage-I was noted in 4165% cases and stage-II in 2235% cases
respectively. In group A invasive ductal carcinoma was observed in 4273.6% cases, invasive lobular carcinoma
in 1021.3% and other types were 58.8%, while on the other hand in group B these figures were 4673%, 1219%
and 57.9% respectively. There was no significant difference in age, menopause status and other general data,
suggesting that the two groups were comparable P>0.05. CONCLUSION: BCs provides better perioperative
outcomes, lesser postoperative complications and aesthetic superiority than MRM in breast cancer
patients.

EFFECT OF SITAGLIPTIN ON LIPID PROFILE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUND: Dyslipidemia has been identified as a major risk factor for the development of macrovascular disease;
hence, disturbed lipid metabolism and altered serum lipid levels exacerbate the chances of cardiovascular disease and stroke.
Sitagliptin, one of the emerging antidiabetic drugs was selected to investigate its effect on the lipid profile in type 2 diabetes.
METHODS: This prospective study was conducted on patients diagnosed with type 2 diabetes. The patients were recruited
according to the inclusion and exclusion criteria and were monitored for a period ranging from 18 to 36 weeks. Blood
samples were taken and analyzed for lipid and blood parameters using the standardized enzymatic method. A paired sample
t-test and chi-square test were applied to identify the mean difference in pre- and post-findings using SPSS version 15. The
level of significance was set at a p-value of ≤ 0.05. RESULTS: Out of 110 patients, only 100 were selected for the study.
Among these, males accounted for 54.50% and females for 45.50%, with a mean age of 50.35 years. The mean fasting blood
glucose level prior to therapy was 163.65±32.0 mg/dl, and post-therapy it was 106.20±17.74 mg/dl. At baseline, HbA1C was
9.08±0.97%, which reduced to 6.26±0.87% after therapy. After 36 weeks of treatment with sitagliptin, triglycerides were
reduced from 291.32±71.58 to 145.83±36.18 mg/dl. Initially, total cholesterol was found to be 250.30±57.71 mg/dl, which
decreased to 131.89±12.80 mg/dl. Upon further analysis, VLDL-C changed from 35.98±7.65 mg/dl to 24.70±7.71 mg/dl.
LDL-C levels showed a highly significant reduction from baseline 136.98±20.77 to 119.87±9.24 mg/dl, while HDL-C was
found to have increased to 43.63±7.21 mg/dl from 25.38±5.33 mg/dl. CONCLUSION: The results showed statistical
significant difference in lipid and blood profiles after treatment with sitagliptin for 36 weeks. It significantly reduced the
levels of triglycerides, cholesterol, LDL-C, and VLDL-C, while also improving HDL-C levels.

FREQUENCY OF SURGICAL SITE INFECTION AFTER APPENDICECTOMY.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUND:Acute appendicitis is one of the most common surgical emergencies worldwide, and appendectomy
remains the definitive treatment. Despite advancements in surgical techniques and perioperative care, surgical site infections
SSIs continue to be a frequent complication following appendectomy, particularly in cases of complicated or perforated
appendicitis. SSIs can significantly impact patient recovery, leading to prolonged hospital stays, increased healthcare costs,
and morbidity. OBJECTIVE:To determine the frequency of surgical site infection after appendectomy. Patients and
METHODS: This descriptive cross-sectional study was conducted on 50 patients who underwent appendectomy
Department of General Surgery, Hayatabad Medical Complex Peshawar, from January 24 to June 24. Inclusion criteria were
patients aged 18-65 years with a clinical diagnosis of acute appendicitis confirmed by histopathology. Exclusion criteria
included patients with immunocompromised status, prior abdominal surgeries, and those on preoperative antibiotics.
Surgical site infection SSI was defined according to CDC criteria and assessed postoperatively at 7, 14, and 30 days
RESULTS:Surgical site infections SSIs were observed in 19 patients 38%, with 11 22% having superficial incisional SSIs
and 8 16% having deep incisional SSIs. CONCLUSION:This study highlights the significant burden of surgical site
infections SSIs following appendectomy, particularly in cases of complicated appendicitis.

THE CORRELATION BETWEEN APRI SCORE AND CHRONIC LIVER DISEASE IN 300 SUBJECTS, ADMITTEDTO MEDICAL UNIT I, PMCH NAWABSHAH

Sun, 30 Jun 2024 00:00:00 +0200

BACKGROUND:Over the pastdecades, the number of people suffering from chronic liver disease CLD has reached epidemic levels with significant effects on the health and increase rates of morbidity and mortality. The Aspartate Aminotransferase to Platelet Ratio Index APRI scores areone of the cheap & non-invasive methods that can be used to assess liver fibrosis in chronic liver disease patients. The purpose of this study was to seek the relationship between degree of liver disease and APRI in patients admitted to Medical Unit I of Nawabshah PMCH. Methodology: This was a descriptive cross sectional study. The sample size contained 300 individuals who were admitted to Nawabsha Medical Unit I of PMCH with the diagnosis of CLD. The site of the study was the medical department of PMCH Nawabshah hospital. Data Collection and Analysis: Data was collected by using a self-administered and validated questionnaire. SPSS version 25 was applied to analyze the data and T-tests for independents were used. The results, of the 300 cases surveyed, revealed that out of the 300 cases, 169 56.33% were males and 131 43.77% were females. The age range of patients with CLD was 20 to 70 years.Tanul 52.88 anos de idad DE ± 12.67. Los promedios de los plaquetas fueron 81.5x103/ dμL SDE dimensiones 11.5x103/μL. La media del APRI fue 1.24 DE ± 0.67 y la media de la actividad de la enzima aminotransferasa aspartato ALT en suero fue 76.0 IU S

LONG-TERM OUTCOMES OF COMMON BILE DUCT INJURY: A COMPARISON BETWEEN OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY.

Mon, 30 Sep 2024 00:00:00 +0200

BACKGROUND:Common bile duct CBD injury is a significant complication of cholecystectomy, occurring more
frequently in laparoscopic procedures than in open surgeries. The purpose of this study is to compare the postoperative long
term outcomes of CBD injury treated by both surgical procedures.OBJECTIVE: In order to compare the incidence of CBD
injuries and postoperative complications, reintervention rates, and quality of life outcome between patients undergoing open
and laparoscopic cholecystectomy. MATERIAL AND METHODS:This prospective study included 132 patients 66 open
cholecystectomies, 66 laparoscopic cholecystectomy at Surgical Department within Surgical Units I, II, and III of Peoples
Medical College Hospital Nawabshah from 1st February 2024 to 31st July 2024. Data were collected on demographic
information, ethnicity, injury characteristics, follow up outcomes and quality of life in terms of the SF 36 questionnaire with
ethical approval, after which data were processed. All statistical analyses were performed using SPSS version 21.0 and the
appropriate tests were performed for comparison. RESULTS:There were no significant differences in the incidence of CBD
injuries, postoperative complications including cholangitis and biliary stricture, or reintervention rates at 24 months. The
median hospital stay was longer for open cholecystectomy 8 days than for laparoscopic cholecystectomy 5 days; p=0.001.
Scores of quality of life were similar, without significant statistical differences in any of the domains. CONCLUSION:
Despite the shorter duration of hospital stay in laparoscopic procedures, the long-term complication rates, the rates of
reintervention, and the quality of life scores were similar for the two approaches.

ROLE OF SURGICAL EXPERIENCE IN REDUCING THE INCIDENCE OF COMMON BILE DUCT INJURY DURING LAPAROSCOPIC CHOLECYSTECTOMY.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUND:Common bile duct injury CBDI is a significant complication during laparoscopic cholecystectomy LC,
often associated with high morbidity. Previous studies have highlighted the importance of surgical experience in reducing
the incidence of CBDI. However, the relationship between surgeon experience and CBDI rates remains to be fully explored.
Objective: To evaluate the role of surgical experience in reducing the incidence of CBDI during LC.MATERIALS AND
METHODS:This prospective observational study was conducted at Surgical Department within Surgical Units I, II, and III
of Peoples Medical College Hospital Nawabshah from 1st March 2024 to 31st August 2024, including 132 patients
undergoing elective LC. Patients were classified into three groups based on surgeon experience: Group A 0-20 cases, Group
B 21-50 cases, and Group C >50 cases. The incidence of CBDI was recorded, and injuries were classified as minor or major.
Data were analyzed in SPSS version 21.0.RESULTS:The overall incidence of CBDI was 8.3%. Group A exhibited the
highest rate of CBDI 13.6%, followed by Group B 9.1%, and Group C 2.3%, showing a statistically significant reduction in
injury rates with increasing experience p=0.025. Major injuries were only observed in Groups A 4.5% and B 2.3%, while no
Long-term outcomes of common bile duct injury: a comparison between open and laparoscopic
cholecystectomymajor injuries occurred in Group C p=0.041. Between Groups A and C, there was a statistically
significant difference p=0.003, underscoring the protective effect of surgical experience. Conclusion: Surgical experience
plays a critical role in reducing the incidence and severity of CBDI during LC. Surgeons with more experience demonstrated
a significantly lower rate of complications, reinforcing the importance of expertise and continuous skill development in
improving surgical outcomes.

THE IMPACT OF OBESITY ON COVID-19 SEVERITY: A CROSS-SECTIONAL STUDY AT SUB POPULATION OF KARACHI.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT:
BACKGROUND:The introduction of SARS-CoV-2 has caused considerable hurdles to healthcare systems globally,
particularly for people with pre-existing health disorders. Due to viral reservoirs in adipose tissue and dysregulated
inflammatory reactions, obesity has become a distinct risk factor for severe SARS and MERS infections. To understand the
impact of obesity as a risk factor for many health disorders, particularly COVID-19, more research is
required.METHODOLOGY:The current cross-sectional study was carried out at Ziauddin University to look into the
connection between obesity and the severity of COVID-19. Between 2021 and 2022, PCR-positive patients who sought
medical attention at the hospital's OPDs or received inpatient services were included. Data were gathered from medical
records while adhering to ethical standards. The data were analyzed using descriptive statistics and Chi-Square testing, with
a significance level of p 0.05. RESULTS:In this study, the majority of patients were male and older than 50, and there was a
strong correlation between age and illness severity. Common signs of disease severity included fever, coughing, and
dyspnea. Several inflammatory markers, including CRP 0.001, TLC 0.001, ferritin 0.001, and LDH 0.001, were found to be
strongly related to COVID-19 severity. Age and gender had no discernible influence on the outcome; however, fever was
discovered to be connected to it. Additionally, the study classified patients' Body Mass Index BMI into several ranges,
finding no link between gender and disease severity as determined by BMI. CONCLUSION:The current study
demonstrates that age, symptoms, and specific inflammatory markers significantly contribute to the severity of COVID-19,
while gender and BMI do not exhibit significant associations.

ASSOCIATION BETWEEN DIABETES AND SKIN COMPLICATIONS A STUDY ON DIABETIC DERMOPATHY IN TERTIARY CARE PATIENTS.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUND: Diabetic dermopathy DD is a common cutaneous manifestation of diabetes, often associated with poor
glycemic control and microvascular complications. This study aimed to assess the prevalence, characteristics, and related
biochemical parameters of DD in diabetic patients. METHODS: A cross-sectional study was conducted at LUMHS,
Jamshoro, and LUH, Hyderabad, from January 2024 to September 2024, involving 338 diabetic patients. Clinical
examinations were performed to document skin lesions' characteristics, including size, distribution, and severity.
Biochemical analysis included fasting blood glucose, HbA1c, lipid profile, microalbumin, and serum insulin levels.
Histopathological examination was performed on biopsies from severe cases to confirm diagnosis. Statistical analysis
involved descriptive statistics, t-tests for group comparisons, and Fisher’s exact test for small sample sizes to explore the
association between DD severity and biochemical parameters. RESULTS: The prevalence of DD was 33%, with lesions
primarily characterized as round, atrophic, brownish-red patches on the shins. Patients with DD had significantly higher
HbA1c levels mean ± SD: 9.0 ± 1.0% compared to those without 7.5 ± 1.0%, p < 0.001. Biopsy findings in severe cases
showed epidermal thinning and microangiopathy. A significant association was noted between poor glycemic control HbA1c
> 8.5% and the presence of DD. CONCLUSION: This study reinforces the association between diabetic dermopathy and
poor glycemic control, highlighting the need for regular monitoring and optimal diabetes management. The findings
emphasize the importance of recognizing DD as a marker for underlying microvascular complications. Future research
should investigate the role of ethnic and genetic factors in the variability of DD presentations.

A CROSS-SECTIONAL STUDY ON PREVALENCE OF DIFFERENT BREAST LESIONS AND ASSOCIATED FACTORS AMONG WOMEN OF NAWABSHAH CHARACTERIZED ON MAMMOGRAPHY.

Mon, 30 Sep 2024 00:00:00 +0200

ABSTRACT
BACKGROUND: Breast cancer stands as a formidable group health challenge and its impact is particularly profound in
Pakistan. As the second leading cause of cancer related deaths among women worldwide, it demands urgent and
comprehensive action. Pakistan faces a particularly heavy burden of breast cancer with a disproportionately high incidence
rate compared to to other South Asian countries. The alarming trend underscores the urgent need for a multifaceted approach
to combat thus growing health crisis. This disparity highlights the critical need for improved access to early detection
methods such as mammography. Mammography as a cornerstone of breast cancer screening, plays a pivotal role in early
detection and improved prognosis. This practice approach is particularly crucial for high risk individuals, such as those with
family history of breast cancer. Despite proven efficacy of mammography in reducing breast cancer mortality, awareness
and access to this vital tool remain limited in Pakistan. OBJECTIVE: This research study was aimed to measure the
prevalence of the different breast lesions and associated factors among women characterized on Mammography at NORIN
Hospital, Nawabshah. DESIGN OF STUDY: Descriptive Cross-Sectional study. PLACE AND DURATION: NORIN
Hospital Nawabshah from April,2024 to September,2024. METHOD: This retrospective cross-sectional study was
conducted at NORIN Hospital Nawabshah. The study included 286 female patients who underwent mammography.
Mammography reports and patient records were reviewed, patients with incomplete data were excluded. Mammography
findings were categorized using BIRADS SYSTEM. Data analysis involved Descriptive statistics and inferential statistics
were applied using Statistical Package for Social Sciences SPSS software. Chi-square tests and logistic regression analysis
were performed to examine associations between variables. The study was approved by Ethics Committee/Institutional
Review Board. Patient confidentiality and anonymity were maintained. The study variables included: •Mammography
findings dependent variable •Age, marital status, number of children, symptoms, and consanguinity independent variables
RESULT: A total of 286 females participated in this study at Norin Hospital, out of which 80% were diagnostic and 20%
were screening cases. Amongst which 36.71% Benign cases and 3.1% of the Malignant cases. From mammography findings
BIRAD 3 is more prevalent. CONCLUSION: Due to lack of knowledge, women were ignorant about mammography
screening and breast cancer, women who were infertile or were in a consanguinity were more susceptible.

IMPACT OF ACUTE KIDNEY INJURY ON CARDIAC FUNCTION: AN ANALYSIS OF MORTALITY RISK IN CRITICAL CARE PATIENTS.

Mon, 30 Sep 2024 00:00:00 +0200

BACKGROUND:Acute Kidney Injury usually aggravates cardiac vascular complications, therefore aggravating mortality in critically ill patients. Co-morbid conditions such as diabetes mellitus, hypertension, IHD, CCF, CKD, obesity, and old age in the presence of AKI significantly influence cardiac outcomes. OBJECTIVE:To evaluate the impact of AKI on cardiac function and predict risk for death by applying specific cardiovascular risk factors. METHODS:There were 386 patients diagnosed with AKI, grouped into as 20–40 years, 40–60 years, >60 years and gender male, 58%; female, 42%. The mortality by demographics and co-morbidities has been studied for their associations with cardiac outcomes. RESULTS:The mean ages were 43.22 years with SD± 12.61 years, mean creatinine levels were 3.59 mg/dl with SD± 0.61 mg/dl. Mortality was at a peak among the aged people >60 being at 43%, followed by those in middle age groups that were 25% and in young age being 12% but was marked with the occurrence of obesity which was significant. The rates among men were found to be higher at 35% compared to women at 28%. CONCLUSION:The study unravels the fact that AKI carries a compounded mortality risk for cardiac function, but a great emphasis was given to the necessity of developing targeted management strategies to address high-risk conditions, especially in older, male, and co morbid AKI patients. Proper monitoring would enable early intervention, thus improving survival in this population.

PREVALENCE OF ANAEMIA IN MBBS MEDICAL STUDENTS AT PUMHSW UNIVERSITY NAWABSHAH. A CROSS SECTIONAL STUDY.

Mon, 30 Sep 2024 00:00:00 +0200

BACK GROUND: Anemia is the global health problem most frequently encountered in women, particularly young adults,
and is caused by various physiological as well as lifestyle causes. OBJECTIVE: To evaluate the burden and severity of
anemia among female MBBS students at People's University of Medical and Health Sciences for Women PUMHSW
Nawabshah, Pakistan. METHODS: A cross-sectional study was conducted that recruited a sample of 19 to 25-year-old
female medical students. RESULTS: The mean age of subjects was 21.50 years with SD 1.65± years, the mean
haemoglobin levels in non anaemic individuals was 12.58 g/dl and SD± 0.22 g/dl, in anaemic patients mean haemoglobin
levels were 10.56 g/dl with SD± 1.11 g/dl. The results found a high prevalence rate of anemia among the students, with 43%
of the respondents falling under the class of anemia. Most of these were mild anemia at 56%, followed by moderate 41%,
and severe 3%. Contributing factors were likely poor intakes of food, irregular meal patterns, and hectic academic lives
possibly influencing their nutritional status. CONCLUSION:Combating anemia among such populations would be
important in the context of generating improvements in outcomes but also getting these children to perform better at school
because symptoms such as fatigue and poor concentration by anemia could impact academic performance.

FACTORS INFLUENCING CONVERSION FROM LAPAROSCOPIC TO OPEN CHOLECYSTECTOMY DUE TO RISK OF BILE DUCT INJURY: AN ANALYTICAL STUDY

Mon, 30 Sep 2024 00:00:00 +0200

BACKGROUND:Cholecystectomy is now one of the most commonly performed surgical procedures because theincidence of gallbladder disease has risen dramatically. The latter that is, LC is preferred than OC since it is less invasive, causes less pain and has shorter hospital stay. However, LC has been attributes to pose a threat to the BDI and as a result requires conversion to OC and which in the process prolongs the operating time, hospital stay and consequently adds more morbidity. OBJECTIVE: This study aims to identify and analyze factors influencing the conversion from laparoscopic cholecystectomy to open cholecystectomy due to the risk of bile duct injury.MATERIALS AND METHODS:This was a six months prospective observational study conducted on surgical units I, II, III of Peoples Medical College Hospital, Nawabshah. We included CHC in a total of 132 patients undergoing elective or emergency cholecystectomy who had no previous upper abdominal surgery, liver or bile duct disease not attributable to gallbladder disease, and impaired consent. Data collection included baseline demographic data, clinical presentation, imaging data, intraoperative type of procedure, complications, conversion reasons, and a postoperative complications, recovery outcome data. We performed statistical analysis usingSPSSversion25, andlogisticregressiontodetermine the significant predictors ofconversion.RESULTS: Of the 132 patients mean age 45.6 ± 12.3 years, 56.1% were female. Comorbidities included hypertension 24.2% and diabetes 20.5%.Abdominal pain was the most common preoperative symptom 72%. Conversion from LC to OC occurred in 22 outof 112 LCs 19.6%, primarilydueto difficult anatomy45.5%, risk of BDI31.8%, severe inflammation/adhesions 18.2%,and intraoperative bleeding 4.5%. Logistic regression analysis revealed that age, comorbidities especially hypertension, difficult anatomy, and abnormal preoperative imaging were significant predictors of conversion p<0.05, while gender was not. CONCLUSION: This study has shown that challenging anatomic features and patient-specific factors like age and comorbidities are valuable predictive factors for conversion from LC to OC because of BDI concerns. This study suggests that enhanced preoperative evaluation of the patients and isolation ofthe presumably risky ones will help decrease the rates of the conversion and the possible adverse consequences.

THE ROLE OF ARTIFICIAL INTELLIGENCE IN DIAGNOSTICS: CURRENT APPLICATIONS AND FUTURE PROSPECTS.

Mon, 30 Sep 2024 00:00:00 +0200

Artificial Intelligence AI refers to the
simulation of human intelligence processes by
machines,especiallycomputersystems.Such
processesincludelearning,reasoning,problem
solving, perception, and language
understanding.

THE ROLE OF MEDICAL EDUCATION IN COMBATING HEALTH DISPARITIES IN PAKISTAN

Safdar Ali Pervez Tunio — Mon, 30 Sep 2024 00:00:00 +0200

Dear Editor,
I write to bring attention to the critical role that
medical education could play in the eradication of
health disparities in Pakistan. Health disparities
affect populations from vulnerable and rural
regions, driven by various factors such as
socioeconomic inequities, lack of access to
healthcare services, inadequate public health
infrastructure, and educational gaps. Educators and
healthcare professionals, as educators of the future
physicians, have a role in empowering them with
knowledge and skills to improve these disparities
and offer healthy services without inequality.