Journal of Peoples University of Medical & Health Sciences Nawabshah. (JPUMHS) <table> <tbody> <tr> <td width="716"> <p><strong>About the Journal</strong></p> <p><strong>JPUMHS </strong>is an official journal of Peoples University of medical and Health Sciences, Pakistan. JPUMHS came into existence in 2011. It is a quarterly published, multi- disciplinary, peer reviewed journal. We have a team of highly qualified editorial board members who are dedicated to meet and improve the standards of Journal as per the laid International guidelines. In addition, we are in process of maintaining a multidisciplinary reviewer’s bank, which comprises of dedicated national and international researchers and subject specialists, who strive their best to evaluate the manuscript in the shortest possible time the journal has its own dedicated website, where all previous, current issues are available with an <strong><u>open </u></strong><strong><u>access</u></strong> permitted to everyone.</p> <p>The journal is devoted to provide updates and advancements to health care providers in the field of basic as well as applied medical sciences. It is committed to rapidly publish the high quality research work in the form of original research articles, review articles, meta-analysis reviews, letter to the editor, case reports, case series report and short communication.</p> <p>We are striving to promote the quality research papers along with its free online availability to the readers all over the world for reference and awareness purpose. It is a forum for communicating the health related issues around the Globe. Moreover the <strong><u>ethical considerations</u></strong> and <strong><u>conflicts of interest</u></strong> amongst the co-authors are observed strictly to maintain the research protocols.</p> <p>Regardless of the employment status, journal accepts the quality research and updated authentic / evidence based information from any source. From patient's perspectives, this evidence based research will ultimately be a step forward to improve the health care facilities at National and International levels.</p> <p><strong>Checklist for authors</strong></p> <p>All corresponding and co-authors must ensure a complete protocol of submission processing order to avoid delay in publishing process of their papers. Incomplete submission will not be considered for the publications.</p> <p>Please complete the following requirements with following</p> <p>♦ <strong>Covering letter</strong> duly signed by all authors.</p> <p>♦ <strong>Undertaking/Certificate</strong> duly signed by all authors.</p> <p>♦ Copy of <strong>ethical permission</strong> letter issued to be signed by the Chairman/Head of Institutional Review Board/Ethical Committee, where research has been conducted.</p> <p>♦ Complete article with tables, figures and references.</p> <p>♦ Identification of <strong>corresponding author</strong> with full name, degree, affiliated institute, institutional title, e-mail address, corresponding address and phone numbers.</p> </td> </tr> </tbody> </table> <ul> <li>Details of <strong>ALL AUTHORS</strong> including full names, degrees, affiliated institute, institutional title, e- mail address, corresponding address and phone</li> <li>The journal will only correspond with the assigned corresponding</li> <li>Contributions of all authors in accordance with <strong>ICMJE guidelines</strong>.</li> <li>Declaration of <strong><u>Conflict of interest</u></strong> and funding information</li> </ul> <p>Before proceeding for submission of this manuscript, please follow the link:</p> <p>Complete the checklist and make sure that the manuscript is prepared according to the checklist. After completing the checklist, email the duly signed checklist by corresponding author, to editor thru email:</p> <p><a href=""></a></p> <p><strong>Important note: </strong>Delay in compliance and incomplete documentation may lead to delay in the processing of your manuscript.</p> <p><strong>Review Process</strong></p> <p>JPUMHS has a uniform and structured, <strong>blind peer-review</strong> process during which all manuscripts go through certain steps before a manuscript is accepted for publication. A manuscript goes through following steps during JPUMHS review process.</p> <ol> <li>After receiving a manuscript will be sent for initial <strong>Editorial review</strong>, to assess whether the submitted manuscript is written according to <strong><u>ICMJE authors guidelines</u></strong> and format and suitable for review or If manuscript is found suitable for further processing the correspondence author is informed within <strong><u>02 weeks</u></strong> regarding acceptance for further processing otherwise the author is asked to re-submit his manuscript after making necessary amendments as per <strong><u>ICMJE</u></strong> guidelines and format.</li> <li>After acceptance for processing a unique Ref will be allotted to the manuscript which will be used for future correspondence.</li> <li>After Editorial Review, the manuscript will checked thru <strong><u>TURNITIN Plagiarism Checker</u></strong> and sent to the Plagiarism Committee for judging Similarity Index (SI). The Technical assistant will submit its report within 02 weeks regarding Similarity If the report has similarity index &lt;=17%, then benefit of doubt may be given to the author but, in case, any single source has similarity index</li> </ol> <p>&gt;=5% without citation then it needs to be revised and will be sent back to the author for revision to bring similarity index down to permissible limit.</p> <ol start="4"> <li>In next step, the manuscript will be sent to reviewers of concerned specialty who will review the manuscript meticulously keeping in view all technical The reviewers will submit their review report within <strong><u>six weeks</u></strong>.</li> <li>After receiving the reviewers comments, the correspondence author will be informed immediately about the reviewers comments and asked to make necessary amendments in manuscript in the light of reviewers comments or give their comments where he don't agree with the reviewers comments within two</li> <li>After receiving the amended version from author, the manuscript will be evaluated by the Editorial Committee to see whether necessary amendments advised by reviewers were incorporated in the manuscript properly or not and whether the manuscript needs further review or This process will take <strong><u>two weeks </u></strong>to complete.</li> </ol> en-US (Dr Anwar Ali Jamali) (Muhammad Ali Daud Poto) Fri, 31 Mar 2023 17:04:17 +0200 OJS 60 THE BENEFITS AND HARMS OF MODULAR SYSTEM IN MEDICAL UNIVERSITIES. <p>The modular system of education is<br>becoming increasingly popular in many<br>universities around the world, including in<br>medical universities. This system involves<br>breaking down the curriculum into smaller,<br>more focused modules, each of which<br>covers a specific topic or area of study. In<br>this essay, we will explore both the benefits<br>and harms of a modular system in medical<br>universities.</p> Safdar Ali Pervaiz Tunio Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 EVALUATION OF HEMATOLOGICAL PARAMETERS IN CONFIRMED NON- STRUCTURAL-1 ANTIGEN (NS1AG) DENGUE INFECTED PATIENTS. <p>Abstract<br>Introduction: The most prevalent virus spread by mosquitoes in Pakistan is dengue virus. The high ratio<br>of illness to mortality caused by dengue virus infection may include clinical features ranging from mild<br>dengue fever to dengue shock syndrome, which may even be lethal. Objective: This study aimed to<br>investigate the haematological parameters in patients with confirmed Non-Structural 1 Antigen (Ns1Ag)<br>dengue infection. Study Design: Descriptive cross-sectional study. Place of Study: Govt. Naseerullah<br>Khan Babar Memorial Hospital, Peshawar. Duration of study: From September to December 2022 (Four<br>Months). Methods: Participants were enrolled in the current study regardless of gender after being<br>recruited and clinically examined by medical professionals. Immunochromatography was used to identify<br>Non-Structural 1 Antigen (NS1Ag) of dengue virus in all cases. Blood was drawn and processed to get a<br>complete blood count to study haematological parameters. The obtained data was analyzed via the<br>statistical programme for social sciences version 22. Results: In this study, 102 dengue-infected<br>individuals were recruited, with 61.8% males and 38.2% females. Haemoglobin levels were normal in<br>90.2% of dengue patients and decreased in 9.8%. The majority of female patients had low haemoglobin<br>levels. White blood cell counts were low in 26.5% of patients. Neutrophil levels were high in 67.6% of<br>the patients. Male patients (n=47) had more abnormal neutrophils than female patients (n=22). Low<br>lymphocyte levels were reported in 51% of patients, whereas high lymphocyte levels were found in<br>13.7% of dengue-infected patients. Low platelet levels were identified in 30.4% of individuals, with<br>males suffering from thrombocytopenia more than female infected with dengue virus. Conclusion: Based<br>on the results obtained in the current study the dengue-infected individuals had higher levels of<br>neutrophils, lower levels of lymphocytes, and lower levels of platelets. Also, males were seen to have<br>suffered more than femals. It is critical to developing diagnostic criteria based on clinical signs and<br>symptoms for more accurate and prompt diagnosis.</p> Ansa Khan 1 , Nazish Babar 2 , Zainab Syed 3 , Hajira Ameer 4 , Muhammad Bilal 5 , Ammar Bin Saad 6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 ASSESSMENT OF ANTICOAGULATION USING ACTIVATED CLOTTING TIME (ACT) IN PATIENTS RECEIVING ENOXAPARIN AND HEPARIN DURING PERCUTANEOUS CORONARY INTERVENTION (PCI). <p>ABSTRACT</p> <p>Introduction: The standard of therapy for some patients with coronary artery disease,</p> <p>particularly those who arrive with acute coronary syndrome, is percutaneous coronary</p> <p>intervention (PCI) (ACS). To avoid thrombotic problems during PCI, the American College of</p> <p>Cardiology (ACC) and the European Society of Cardiology (ESC) advise using anticoagulation</p> <p>in addition to dual antiplatelet treatment (DAPT). Objective: to assess how enoxaparin affects</p> <p>the active clotting time (ACT) and how UFH reacts to enoxaparin. Material and methods: The</p> <p>intervention cardiology department at Hayatabad Hospital Complex in Peshawar did this cross￾sectional descriptive research from June 1 to April 30, 2022. By using a non-probability</p> <p>sequential sampling strategy, patients were included. After a thorough history, examination, and</p> <p>informed permission, all patients 18 years old having PCI were included in the research.</p> <p>Individuals with known blood dyscrasias or thrombophilia, as well as those who had received</p> <p>anticoagulation within the previous 12 hours or just prior, were excluded from the trial. Results:</p> <p>Among the patients who received heparin, ACT increased from 104.76±27.31 seconds to</p> <p>448.34±169.11 (t-statistic=13.750, 95% CI: 293.9540 to 393.2060, p: &lt;0.01) whereas among</p> <p>patients who received enoxaparin, this number increased from 99.58±27.68 seconds to</p> <p>334.37±166.45 seconds (t statistic=6.817, 95% CI: 165.4597 to 304.1203, p:&lt;0.01). The post￾anticoagulation ACT was significantly higher in the heparin group compared to enoxaparin</p> <p>group i.e. 448.34±169.11 and 334.37±166.45 seconds respectively (t statistic=2.700, 95% CI:</p> <p>29.7639 to 198.1661, p:&lt;0.01). Conclusion: After taking i.v. enoxaparin and heparin, the ACT is</p> <p>extended in patients for around 15 minutes, and this prolongation may help track the</p> <p>anticoagulant action of the medication. Moreover, in this situation, ACT levels and ENOX</p> <p>clotting times are correlated. A bigger experiment will be necessary to determine the association</p> <p>between ACT level and clinical effectiveness utilising intravenous enoxaparin.</p> Yasir Hayat1 , Mohammad Ishaq2 , Najeeb Ullah3 , Hafsa Nasir4 , Inam Ullah5 , Ijaz Khan6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 COMPLICATIONS OF UNSKILLED HOME BIRTH: A CROSS SECTIONAL ANALYSIS OF THIRD STAGE OF LABOR. <p>ABSTRACT:</p> <p>Introduction: Child birth at home is easily approachable but associated with certain complications which</p> <p>if not dealt timely can lead to severe morbidity and even mortality of mother and child. Objective: To</p> <p>evaluate the complications encountered during home birth, in women who presented to a tertiary care</p> <p>hospital for further management. Methodology: A descriptive cross-sectional study was conducted at</p> <p>Jinnah Postgraduate Medical Centre (JPMC) Karachi, after approval from research evaluation unit. Total</p> <p>206 women, who delivered at home by traditional birth attendant/ Dai and then were referred to the</p> <p>hospital obstetrical emergency unit for further management of a complicated third stage of labor, were</p> <p>enrolled in the study after fulfillment of selection criteria and informed consent. Nonprobability purposive</p> <p>sampling was done. Demographic and other required data was collected on predesigned proforma.</p> <p>Results: Patients presented with multiple complications. Majority of patients presented with postpartum</p> <p>hemorrhage due to uterine atony (56.3%), followed by retained product of conception (54.4%), retained</p> <p>placenta (26.7%) and traumatic lesion (21.8%). Few (8.7%) presented with puerperal sepsis also. Most</p> <p>patients presented within 24 hrs. of delivery. P-value &lt; 0.05 was taken as significant. Conclusion: This</p> <p>study concluded that home birth is associated with increased maternal morbidity, where postpartum</p> <p>hemorrhage due to uterine atony is the most common presentation. Patient often present with multiple</p> <p>complications, which necessitate skilled training of traditional birth attendants/Dai, in terms of prevention</p> <p>of postpartum hemorrhage (including active management of third stage of labor) and infection control</p> <p>measures.</p> Falak Sehar Sahito1*, Samia Shuja2 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 RELATIONSHIP BETWEEN THE ABSENTEEISM AND DYSMENORRHEA OTHER ASSOCIATED SYMPTOMS IN ADOLESCENT FEMALES ATTENDING THE PUBLIC UNIVERSITY. <p>ABSTRACT</p> <p>Introduction: These menstruation episodes amongst young women might be viewed as a</p> <p>pertinent issue since they cause absenteeism and may have a detrimental impact on academic</p> <p>performance. Awareness-building on the socioeconomic effects of absence is crucial. Aims and</p> <p>objectives: Since dysmenorrhea affects women of reproductive age, it is a cause for concern for</p> <p>the public. The focus of this research was to determine if menstrual periods or unpleasant</p> <p>complaints such dysmenorrhea were present amongst normal undergraduates at Sindh Public</p> <p>University and also how they affected absenteeism. Sample size and Material methods: A total</p> <p>of 339 teenage students enrolled in the first year of study at the public university of Sindh from</p> <p>September 2019 to December 2019 engaged in this cross-sectional investigation. Statistics on</p> <p>socio-demographics, gynaecology, and noteworthy menstrual events were gathered by a</p> <p>questionaire; the much more common of these was dysmenorrhea, which afflicted 95.3% of</p> <p>students. Significant pain-related dysmenorrhea was detected in 25.7% of cases, followed by</p> <p>medium and milder cases in 46% and 23.6% of cases. Absenteeism among students with period</p> <p>pain was observed in 65% of cases, with moderate cases affecting 53% of students and having a</p> <p>significant P value of 0.007. Nonetheless, it was shown that students with significant</p> <p>dysmenorrhea and stomach pain that reached their legs were much more probable to miss class</p> <p>(36%). Conclusion: These menstruation episodes amongst young women might be viewed as a</p> <p>pertinent issue since they cause absenteeism and have a detrimental impact on their school</p> <p>performance. It is crucial to create new menstrual experience-improving techniques and make</p> <p>people aware of economical effects of absence.</p> Roomi1, Abroo Fatima2, Farzana Rahim Memon3, Rushba4, Ayaz Samoo5, Zulfiqar Ali Laghari6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 OUTCOMES OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION WITH AND WITHOUT POST DILATATION IN PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION <p>ABSTRACT</p> <p>Introduction: It is debatable how SPD (stent post-dilatation) work during PPCI (primary percutaneous</p> <p>intervention). It is up to the operator to decide when to execute stent after dilatation because there are</p> <p>currently no definitive rules or general agreement on the subject. Objective: To assess the results of PPCI</p> <p>(primary percutaneous coronary intervention) in participants having ST segment elevation myocardial</p> <p>infarction with as well as without post-dilatation. Methodology: This retrospective analysis research was</p> <p>performed in Hayatabad medical complex, Peshawar, Pakistan after the approval from the institutional</p> <p>and ethical review board. The study included 180 patients, both sexes, ages 18 to 70 years, who received</p> <p>primary percutaneous coronary intervention due to STEMI. The patients' various characteristics, such as</p> <p>DM, HTN (hypertension), CKD (chronic kidney disease), BMI, smoking history, the location of the MI,</p> <p>blood pressure, the type of artery, and the TIMI flow before and after the procedure, were recorded in an</p> <p>excel sheet. Results: Regarding the culprit artery, there wasn't a scientifically significant distinction between</p> <p>the two categories; group 1's left anterior descending artery (LAD) was observed in 50 (55.5%) cases &amp; in</p> <p>group 2 in 49(54.4%) cases. Right coronary artery (RCA) in group 1 in 31(34.4%) and 27(30%) in group</p> <p>2. Left circumflex artery (LCX) in group 1 was noted in 17(18.9%) and 19(21.1%) in group 2. The use of</p> <p>thrombus aspiration catheters was greater in group 2 than in group 1, with 24 (26.7%) compared to 15</p> <p>(16.7%). GP IIb/IIIa inhibitors were given to 20 (22.2%) individuals in group 2 compared to 18 (20%)</p> <p>patients in group 1. Patients in groups 1 and 2 had substantially larger pre-stenting balloon dilatation, 44</p> <p>(48.9%) and 11 (12.2%), respectively. In both groups, every patient got DES (drug-eluting stents).</p> <p>Conclusion: In patients with STEMI, selective postdilation enhanced some angiographic and clinical</p> <p>outcomes, and it could not be discouraged from being used in the primary percutaneous coronary</p> <p>intervention</p> Mohammad Ishaq1, Yasir Hayyat2, Muzdalfa Parvez3, Najeeb, Umer4, M. Tayyab5, Iqtidar Ud Din6. Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 A PREVALENCE STUDY ON WORK-RELATED STRESS AND RELATIONSHIP WITH LOW BACK PAIN (LBP) AMONG NURSING STAFF IN A TERTIARY CARE HOSPITALS OF KARACHI, SINDH. <p>ABSTRACT</p> <p>Introduction: Musculoskeletal health defines to the act of the locomotor system, consists intact</p> <p>muscles, bones, joints and face-to-face connective tissues. The most common issue among nurses is Low</p> <p>Back Pain, compared to other health care providers such as dcotors, consultant and parmamedics. The</p> <p>overall health of nurses including physical, mental, and social health can be affected due to occupational</p> <p>or job or work stress. Moreover, the increasing demands at work and higher work stress among nurses</p> <p>may predispose them to back ache. The higher occurrence of pain in lowerback among nursing staff is</p> <p>responsible for reduced productivity of workers and increased medical expenditures of both individual,</p> <p>their family and ultimately nurses could not able to contribute in developing nation economy. This</p> <p>research was intended to conclude the frequency of work-stress and their association with Low Back Pain</p> <p>among working nureses of Karachi. Objective: This research study was aimed to define prevalance of</p> <p>job-stress and factors assoiated with back ache or pain in lower back among nurses working in a tertinary</p> <p>care hospitals in Karachi. Design of study: Descriptive Cross-sectional. Place &amp; Duration: Dow</p> <p>University hospital and Civil Hospital Karachi, from May 2019 to August 2019. Materials and</p> <p>Methods: This cross-sectional study was implementated during May-August 2019 on total sample of</p> <p>target population that is 324, working at tertiary care hospitals in Karachi, with minimum qualification of</p> <p>3 years diploma in nursing, and had minimum 1 year of working experience. The data collection</p> <p>instrument consisted of a section on demographic information and Nursing Stress Scale. The analysis of</p> <p>data was done through SPSS 21.0, Data scrutiny involved in the use of descriptive statistics. Moreover</p> <p>chi-square test was used for comparative and qualitiative analysis. Results: In this study, 59%</p> <p>participants were male and 75% having bachelor degree. Overall, 91 (28.1%) nurses reported that they did</p> <p>not have work stress while presence of high stress was found in only 4 (1.7%) nurses. low to moderate</p> <p>level of stress was observed in 229 (70.6%) nurses. Although low back pain was positively associated</p> <p>with work stress. The findings were not statistically significant (p&gt;0.05) to draw reasonable conclusions.</p> <p>The findings were similar for all the work stress subscales except that 12-month Low Back Pain</p> <p>frequency was negative correlated with conflict with physicians (r=-.222, p=.008). Conclusion: The</p> <p>frequency of low to moderate work stress was found high among health care professional (nurses)</p> <p>employed in two hospitals of Karachi, while there is also association found between low back pain and</p> <p>job-stress. However, it was not clear whether there is a connection or not between work stress and low</p> <p>back pain.</p> Rashid Hussain1, Tanseer Ahmed2, Bahadur Ali3, Greesh Kumar Maheshwari4, Imran Ahmed5, Attiq-ur-Rehman6 , Gotam Kumar7. Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 BARRIERS IN RESEARCH AMONGST UNDERGRADUATE MEDICAL STUDENTS IN PAKISTAN. <p>Abstract</p> <p>Introduction: Medical research has an impact on disease prevention, diagnosis, and newer</p> <p>treatments. It has resulted in policy changes for health-care programmes. Because</p> <p>undergraduates were underrepresented in research, this study was designed to identify the factors</p> <p>and their opinions towards them. Objective: The study's goal was to evaluate the knowledge,</p> <p>attitude, experience, and research hurdles of medical undergraduates. palce and duration of the</p> <p>study: In May 2022, this study was carried out at the University Faculty of Medicine and</p> <p>Dentistry in Lahore. Methods: A cross-sectional questionnaire-based study was carried out with</p> <p>institutional ethics committee approval and written informed consent from the students. A</p> <p>verified pre-designed questionnaire with 34 questions was used in this study. From UCMD, we</p> <p>received completed questionnaires from first to Final year medical students of MBBS</p> <p>programmes. Descriptive statistics were used to analyse the data. Results: Data was collected</p> <p>from 674 students out of 785 students and the response rate was 86%, out of which 595 were</p> <p>females. 67% students totally agreed that research should be part of undergraduate curriculum.</p> <p>60% students thought that it would improve clinical practice and better understanding of subject.</p> <p>Almost 69% believed that research was not a waste of time and did not interfere with studying.</p> <p>Funding (49%), Lack of awareness (53%), time (63%), follow up (77%), interest (54%) were the</p> <p>main barriers to research. 62% of students were dissatisfied with the faculty's lack of</p> <p>encouragement. Conclusion: The majority of students were knowledgeable about research and</p> <p>indicated a good attitude toward participating in research activities. Some barriers, which</p> <p>undergraduates faced, were lack of awareness, time and funding.</p> Kainat Javed1, Absar Nazir2, Zeeshan Malik3, Umair Bin Nasir4. Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 TACROLIMUS OINTMENT AS MONOTHERAPY IN MANAGEMENT OF MODERATE TO SEVEREREFRACTORY VERNAL KERATOCONJUNCTIVITIS. <p>ABSTRACT</p> <p>Introduction: In the modern era of industrialization and global seasonal change, human health has been</p> <p>adversely affected. One of its sequels is ocular allergy. Objective: To evaluate the efficacy and</p> <p>safety of (0.03%) tacrolimus skin ointment in patients with moderate to severe refractory vernal</p> <p>keratoconjunctivitis (VKC). Study Design: Prospective interventional study. Setting &amp; Duration:</p> <p>Ophthalmology outpatient department (OPD) Peoples University of Medical and Health Sciences from 16</p> <p>February 2019 to 16 August 2021. Material &amp;Methods: 200 patients suffering from moderate to severe</p> <p>VKC were selected, based on TSSS (Total subjective scoring system) and TOSS total objective scoring</p> <p>system). The study participants were separated into 2 groups (100 each) withtreatment group</p> <p>receiving0.03% Tacrolimus ointment while the other receiving conventional therapy. To determine the</p> <p>effectiveness (measured by the change mostly in clinical condition), a randomised clinical investigation</p> <p>was carried out and safety (safe treatment from development of any complications or side effects) of</p> <p>Tacrolimus ointment in comparison with conventional therapy. Result: It was observed that 73% patients</p> <p>had tarsal form of VKC, 24% had limbal and 3% had mixed (both) types of disease. Every one of the</p> <p>patients had complete subjective symptom severity ratings (TSSS) and total objective ocular severity</p> <p>scores (TOSS) which ranged among 2 &amp; 3. Treatment with either 0.03% Tacrolimus or conventional</p> <p>group was found to be effective in eradicating the symptoms of VKC measured by TSSS scores.</p> <p>Conclusion: Among the medical therapies used in this study it is found that, Tacrolimus ointment 0.03%</p> <p>was more nontoxic &amp; actual in eradicating the severity of signs and symptoms of the vernal</p> <p>keratoconjunctivitis evident by the TSSS and TOSS scores. (ASM allergic systemic</p> <p>manifestations)rhinitis, asthma and eczema)</p> Neelam Manzoor1 , Parus Saleem 2 , Khan Muhammad Nangrejo3 , Amjad Sahito4 , Ayesha khan5 , Sikandar Mirza6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 EFFECTS OF MANIPULATION AND CASTING OF PONSETI METHOD OUTCOME IN CHILDREN WITH IDIOPATHIC CLUBFOOT. <p>Abstract</p> <p>Introduction: One of the most prevalent paediatric foot deformity is clubfoot. Idiopathic</p> <p>clubfoot is a condition for which there is no known cause. The Ponseti Technique became the</p> <p>best choice for treating clubfoot all around the world. The Ponseti method of treating idiopathic</p> <p>clubfoot includes weekly serial manipulations and castings until the foot can be abducted to 60</p> <p>degrees. The patient is subsequently placed in a foot abduction orthosis to maintain the</p> <p>correction made and prevent the deformity from relapsing after Achilles tendon tenotomy and</p> <p>casting. Objective: To determine the effects of manipulation and casting of Ponseti method</p> <p>outcomes in children with idiopathic clubfoot. Methodology: This descriptive cross sectional</p> <p>study was conducted in orthopaedic department of PMCH Hospital Nawabshah from August</p> <p>2022 to February 2023. 100 children of both genders with idiopathic clubfoot were included.</p> <p>After enrolment complete history and physical examination of all children were carried out.</p> <p>Informed written consent was taken from parents or guardians of the children. Data were entered</p> <p>in excel sheet and analyzed in SPSS version 21. Qualitative variables were presented in</p> <p>percentage and frequencies while quantitative variables were presented in mean and standard</p> <p>deviation. Paired sample t test was applied. Results: According to our results, 100 children with</p> <p>clubfoot were included in this study. 50 children were male and 50 children were female. The</p> <p>mean ages of children were 4.02 months. Bilateral clubfeet were 53% and unilateral clubfoot was</p> <p>47%. The right club foot was 32% and 20% was left side. The average no: of cast were 5.45.</p> <p>41% of children need tenotomy. The initial Pirani score was 3.140. The final Pirani score mean</p> <p>was 0.60. Post stratification data analysis revealed statically significant between initial and final</p> <p>Pirani score with P-value (0.001). Conclusion: Clubfoot can be effectively treated with the</p> <p>Ponseti method of casting and manipulation.. It is the simplest approach. Therefore, we advise</p> <p>using this method as the first line of treatment for infants with idiopathic club feet.</p> Sundas Mastoi1 , Muhammad Usman2 , Sana3 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 PREVALENCE, OUTCOME AND RISK FACTORS ASSOCIATED WITH CONGENITAL MALFORMATIONS IN NEONATES AT A TERTIARY CARE HOSPITAL -A RETROSPECTIVE STUDY <p>ABSTRACT</p> <p>INTRODUCTION: There is a high burden of congenital anomalies worldwide and more so in</p> <p>the developing countries. These birth defects contribute significantly to the neonatal mortality</p> <p>rate in our country, which is one of the highest globally. Addressing and identifying the risk</p> <p>factors for these conditions is imperative for their prevention .OBJECTIVE: this study was</p> <p>done to determine the prevalence of congenital malformations and the risk factors associated</p> <p>with them. METHODOLOGY: this cross-sectional retrospective study was carried out at the</p> <p>Pediatric unit of Ziauddin Hospital from 1st January 2020 till 1st January 2023.Data was extracted</p> <p>from the electronic health records and entered on a pre-designed proforma. Information</p> <p>regarding maternal risk factors , antenatal visits ,neonatal characteristics and type of congenital</p> <p>anomalies was noted .Data was analyzed using SPSS version 20 and expressed as frequencies</p> <p>and percentages and chi square test was applied with P-value of &lt;0.05 considered statistically</p> <p>significant. RESULTS :The prevalence of congenital malformations was 4.5%.Anomalies</p> <p>related to the central nervous system were the highest ,followed by cardiac birth defects .A</p> <p>smaller percentage undertook regular antenatal visits and folic acid supplementation. Family</p> <p>history of birth defects is a significant risk factor. CONCLUSION: Congenital malformations</p> <p>are a frequent occurrence in our set up .Effective antenatal care and screening are the cornerstone</p> <p>of preventing these disorders.</p> Shaista Ehsan1 , Nadia Shahid2 , Mahreen Ahsan3 , Asif Nadeem Jamali4 , Habibullah Siyal5 , Aliza Aman6 , Sundas Parveen7 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 ASSESSMENT OF RISK FACTORS IN CHILDREN WITH CHRONIC DIARRHEA AND WEIGHT LOSS AT A TERTIARY CARE HOSPITAL. <p>ABSTRACT</p> <p>Introduction: Diarrhoea is still the second leading reason for death among kids underneath the</p> <p>five years of age. Neither preventive measures nor therapeutic options are available. Objective:</p> <p>To assess the risk factors associated with chronic diarrhea &amp; weight loss in the children of</p> <p>Pakistan. Methods: A purposive randomized controlled trial was conducted among the 110</p> <p>children of District SBA / Jamshoro sindh, Pakistan with ages between 6 and 36 months and</p> <p>mean age 24 months having more than 4 episodes of acute watery diarrhea for more than 48</p> <p>hours. Results: There were total 110 children’s out of them 75(68.18%) were male and</p> <p>35(31.82%) females. There were &lt;12 months 40 (36.36%) of the children were below 01 year of</p> <p>age, 12-24 months 32 (29.09%) belonged to 12-24 months and 38 (34.54%) were between 24-</p> <p>36 months. Only 40 (36.36%) were undergoing breastfeeding or exclusively breastfed. 60</p> <p>(54.55%) had an updated vaccinated status. 70 (63.64%)were low for birth weight. 80</p> <p>(72.72%)families were consuming the municipal water supplies drinking and cooking. 75</p> <p>(68.18%)were living in a joint family system. 30 (27.28%) of the mothers were literate with a</p> <p>minimum of primary education and above. 75 (68.18%)of the children had an early weaning</p> <p>history below 6 months of age. Conclusion: It was observed that children who had a history of</p> <p>low birth weight below 2.5 kg, under 12 months of age, not or under breastfed during their</p> <p>infancy, nursed on formula milk, unvaccinated status, those consuming un boiled water</p> <p>(municipal water) and those who had a history of early weaning below 6 months of age suffered</p> <p>more episodes of watery diarrhea.</p> Zameer Ahmed Qambrani1 , Shaista Ehsan2 , Asif Nadeem Jamali3 , Habibullah Siyal4 , Sundas Parveen5 , Fariha Maqbool6 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 FREQUENCY AND RISK FACTORS OF IRON DEFICIENCYANEMIA IN CHILDREN BELOW 10 YEARS OF AGE AT A TERTIARY CARE HOSPITAL PAKISTAN. <p>Abstract</p> <p>Introduction: In South Asia, anaemia affects more than 50% of preschool-aged kids due to its</p> <p>diverse aetiology. To successfully solve this issue, it is necessary to clarify the situationally</p> <p>reasons of anaemia. Anemia is a common medical finding among children. Anemia due to iron</p> <p>deficiency affects 40–70percent of the overall of kids less than the age of 10 in Pakistan. Anemia</p> <p>not only alters normal physical development but also impairs cognition and endurance in kids.</p> <p>Under this analysis, the frequency and risk markers of iron deficiency anaemia in kids below the</p> <p>age of 10 who visit PMCH Pakistan are evaluated. Materials And Methods: A total of 385</p> <p>children were enrolled through a purposive random sampling presenting to the Pediatrics ward of</p> <p>PMCH, Pakistan fulfilling the operational definition and admission criteria during JANUARY</p> <p>2021 to DECEMBER 2022. Hb level below 11gm/dlwas termed as anemia and anemia is further</p> <p>classified into microcytic, normocytic or macrocytic on peripheral blood film. Further testing for</p> <p>serum ferritin, hemoglobin electrophoresis, serum C-reactive protein and stool microscopy was</p> <p>advised to establish the definitive diagnosis. Risk factors were looked for in cases of iron</p> <p>deficiency anemia. Results: Out of 385 patients there were total 210(54.54%) male and</p> <p>175(45.46%) females. Mean age 5.2466, minimum 2 years and maximum 10 years. Out of 385</p> <p>patients There were 152 with normocytic anemia, 216 microcytic anemia and 17 with macrocytic</p> <p>anemia. Out of 210 male patients There were 57 males with normocytic anemia, 146 microcytic</p> <p>anemia and 7 with macrocytic anemia. Out of 175 female patients There were 95 females with</p> <p>normocytic anemia, 70 microcytic anemia and 10 with macrocytic anemia.p value =0.05</p> <p>Conclusion: Around children under 10 years of age were found to be anemic, among them</p> <p>around half of them were suffering from iron deficiency anemia. The findings of this study</p> <p>stresses upon the significance of evaluating the risk factors of anemia in children. Prompt</p> <p>awareness campaigns and revamping health education programs focusing mother and child health</p> <p>can serve as a valuable tool to manage this health problem in countries like Pakistan.</p> Asif Nadeem Jamali1 , Shaista Ehsan2 , Zameer ahmed qambrani3 , Habibullah Siyal4 , Sundas Parveen5 , Areeza Shaikh6 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 COMPARISON OF OUTCOME OF 0.5% HYPERBARIC BUPIVACAINE WITH 0.5% HYPERBARIC ROPIVACAINE IN SPINAL ANAESTHESIA FOR PERIANAL SURGERIES. <p>Abstract</p> <p>Introduction: The field of anaesthesiology has undergone significant advancements in recent</p> <p>years, resulting in improved patient outcomes and reduced hospitalization durations. This is</p> <p>primarily due to the availability of anaesthetic agents that block sensations locally or regionally</p> <p>for shorter durations. Objective: To compare the outcome of 0.5% hyperbaric Ropivacaine with</p> <p>0.5% hyperbaric Bupivacaine in spinal anaesthesia for perianal surgeries. Design: Randomized</p> <p>controlled trial. Setting: Anaesthesiology Department, Surgical Intensive Care Unit And Pain</p> <p>Management, Jinnah Post graduate Medical Centre (JPMC), Karachi. Duration: Six months</p> <p>(From 7 April 2016 to 7 October 2016). Methods: 126 Perianal surgery patients were</p> <p>approached for consent for study. Two groups viz; A &amp; B were made, and group allocation of</p> <p>consecutive patients were made through using opaque envelopes containing strip of either group.</p> <p>Group A patients received three mililiter of Ropivacaine (5 mg/ml) with glucose 83 mg/ml.</p> <p>Whereas, Group B received three mililiter of hyperbaric Bupivacaine (5 mg/ml) with glucose 80</p> <p>mg/ml. Moreover, Oral temazepam 10–20 mg was administered to patients before to surgery to</p> <p>reduce anxiety. Results: The duration of sensory block was statistically less in the Ropivacaine</p> <p>group (153.8±9.3min) as compared to Bupivacaine group (190.2±8.3min) with P-value 0.0001.</p> <p>In addition, the ropivacaine group's mean time in motor block was less than that of the</p> <p>bupivacaine group (120.89±12.122 min vs 189.33±11.947min; P = 0.0001). Conclusion:</p> <p>According to the results of the current investigation, bupivacaine applied intrathecally causes</p> <p>sensory block to begin more quickly and last longer than ropivacaine.</p> Hira Shujaat1 , Mehreen Khan2 , Ravi Kumar3 , Muhammad Waseem Abdul Razzak4 , Vijai Kumar5 , Zamir Ahmad6 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 PREVALENCE OF ANAEMIA AMONG THE STUDENTS AT SHAH ABDUL LATIF UNIVERSITY, KHAIRPUR. <p>Abstract</p> <p>Introduction: Iron deficiency, which leads to nutritional anaemia, is a serious health problem in</p> <p>economically developing nations like Pakistan. Objective: To determine the incidence of anemia</p> <p>in male and female students at Shah Abdul Latif University, Khairpur. Methodology: In this</p> <p>study, a total of 179 students were evaluated, with 63 (35.1%) being male and 116 (64.8%) being</p> <p>female. The participants were selected from various departments of Shah Abdul Latif University</p> <p>using a convenience sampling method, with informed consent obtained from each individual.</p> <p>The study participants underwent interviews and screening for anemia. Demographic</p> <p>information, such as age and gender, was gathered using a pre-designed questionnaire. Blood</p> <p>samples were collected in EDTA vacutainers and analyzed using a Hematology Analyzer Huma</p> <p>Reader Plus. The data was then analyzed using the SPSS software version 26.0. Results: The</p> <p>average age of the participants was 19.4 ± 1.1 years. 47.5% (n=85) of the 179 students studied</p> <p>were found to have anemia. The prevalence was higher in female students at 55.8% (n = 64)</p> <p>compared to 33.3% (n=21) in male students. The mean levels of haemoglobin and red blood cells</p> <p>were found to be significantly different between male and female students (P &lt; 0.05). No</p> <p>significant differences were observed in other hematological parameters between the two</p> <p>groups.Conclusion: The female students had a higher prevalence of anaemia than male students,</p> <p>more study with a bigger sample of healthy college students is needed to corroborate these</p> <p>findings and safeguard the well-being of potential moms</p> Yasir Akbar Jamali1, Jawad Ahmad Khan2, Mushtaq Hussain3, Ali Bux Khuhro4, Sagheer Ahmed5, Irfanullah Unar6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 KNOWLEDGE OF UNDERGRADUATE NURSING STUDENTS REGARDING NURSING INFORMATICS IN KHYBER MEDICAL UNIVERSITY PESHAWAR. <p>Abstract</p> <p>Introduction Nursing informatics is a specialty that "integrates nursing science with multiple</p> <p>information and analytical sciences to identify, define, manage and communicate data,</p> <p>information, knowledge, and wisdom in nursing practice". Nursing students entering different</p> <p>programs of nursing have different backgrounds; therefore their informatics competencies and</p> <p>preparation are different from each other. Objective: the study was conducted to assess the</p> <p>knowledge of nursing students regarding basic computer skills and nursing informatics. Design</p> <p>and Methodology: A Cross-sectional descriptive study was conducted in a two months period</p> <p>from 10 November 2021 to 10 January 2022 from 129 participants at institute of nursing</p> <p>sciences Khyber medical university after approval from director of nursing institutes. Results:</p> <p>Participants in this study were mostly female which was (51%) n=66, while the Male students</p> <p>were (49%) n=63, The study showed that the excellent category regarding knowledge of 4 years</p> <p>BSN students were high 25.67%, than the knowledge of 2 years Post-Rn students 12.81%, and</p> <p>the mean score of the Excellent category regarding knowledge of 4 years BSN students were 19,</p> <p>more than the knowledge of 2 years Post-Rn students 6.6. Furthermore the knowledge regarding</p> <p>nursing informatics of Excellent category of 4 years BSN students were 16.04%, more than the</p> <p>knowledge of 2 years Post-Rn students 13.52%, and the mean score of nursing informatics in the</p> <p>Excellent category regarding knowledge of 4 years BSN students were 11.87, more than the</p> <p>knowledge of 2 years Post-Rn students 5.18. Conclusion: In this study the results provide input</p> <p>to educators that the students of 4 years BSN perform significantly well than 2 years Post-RN</p> <p>BSN students, therefore it should now be the responsibility of higher authorities to work hard</p> <p>with every nursing students to promote patient safety, and evidence based practice.</p> Amir Sultan1 , Najma Naz2 , Afrooz bibi3 , Haseen Jamal4 , Sanaullah5 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 ROLE OF MAGNESIUM SULFATE FOR FETAL NEUROPROTECTION IN WOMEN AT RISK OF PRETERM BIRTH. <p>ABSTRACT</p> <p>Introduction: With a decrease in gestational age, the chance of cerebral palsy increases</p> <p>significantly and is primarily ascribed to preterm birth. Currently, infants delivered prior to 34</p> <p>weeks of gestation account for 25% of all new instances of cerebral palsy. Objective: To evaluate</p> <p>the impact of MgSO4 administered to pregnant women at risk for premature delivery for fetal</p> <p>neuroprotection. Materials and Methods: From January 2020 to December 2022, this</p> <p>prospective observational research was carried out at obstetrics &amp; gynecology department</p> <p>hayatabad medical complex peshawar. Total 519 preterm pregnant women between 28-36 weeks</p> <p>gestational age were enrolled. Out of 519, 199 premature laboring women received MgSO4 and</p> <p>were placed in group A, while the remaining 320 were placed in group B because they did not</p> <p>receive MgSO4. Women in group A got a 4g bolus dose of MgSO4 over 20–30 minutes, then</p> <p>1g/hour. All pregnant women, whether carrying a single or multiple pregnencies, who were</p> <p>between 28-36 weeks gestational age. Results: Neonatal outcomes of groups include the</p> <p>following: Mechanical ventilation in group A was 45(22.6%) &amp; 85(26.5%) in group B,</p> <p>Respiratory distress 83(41.7%) vs 191(59.7%), neonatal enterocolitis 11(5.5%) vs 9(2.8%),</p> <p>intensive resuscitation 6(3%) vs 12(3.7%), neonatal seizures 7(3.5%) vs 11(3.4%), NICU</p> <p>admission required in group A was 85(42.7%) vs 183(57.1%) in group B, mortality in both</p> <p>groups was 2(1%) vs 4(1.2%). Conclusion: The development of cerebral palsy in preterm</p> <p>infants may be prevented by administering MgSO4 with a wide margin of safety. Even</p> <p>though MgSO4 has only moderate benefits, it is a secure, affordable drug, so the risk-benefit</p> <p>ratio favors using it.</p> Madiha Iqbal1 , Zia Muhammad2 , Sana Iqbal3 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 PREVALENCE OF THYROID DYSFUNCTION IN DIFFERENT AGE AND GENDER GROUPS. <p>Abstract</p> <p>Introduction: Thyroid disorders are increasing day-by-day throughout the world, especially in</p> <p>sub-continent of Asia. There seem to be 20 million individuals in Pakistan who live in iodine￾deficient regions. At a minimum, 1 million individuals have psychological illnesses, whereas 8</p> <p>million people have had some type of iodine deficiency. This study was designed to determine</p> <p>thyroxine (T4) and Thyroid Stimulating Hormones (TSH) level in suspected patients of different</p> <p>age groups and gender. Methodology: This cross-sectional survey lasted three (03) months, from</p> <p>September to December 2020. The work was authorised by the ethics committee of Abdul Wali</p> <p>Khan University's Department of Biotechnology in Mardan. The research included a total of 177</p> <p>suspected patients. All individuals referred by medical doctors after recognizing signs and</p> <p>symptoms of thyroid dysfunction, regardless of age or gender, were recruited. A statistical</p> <p>programme for social version (SPSS) 22 was utilized to analyze data. Results: overall 177</p> <p>potential candidates got examined. An average age of the individuals that were enlisted were</p> <p>33.8 17.3, including a minimum seven years as well as a maximum age of 80. Among total, 26%</p> <p>male and 74% were female patients. Majority patients were found in age group 30-70 years.</p> <p>Total thyroid dysfunction in females was 43.8% and 6.4% in male patients. Sub clinical</p> <p>hypothyroidism in females were found very high (16.0%), followed by hypothyroidism and</p> <p>hyperthyroidism (9.2%) and euthyroid sick syndrome (4.6%). In males only hypothyroidism</p> <p>were observed in 6.4% patients. Conclusion: Thyroid dysfunction is common among patients,</p> <p>especially among females and the elderly. Iodine-rich foods should be consumed. People's</p> <p>awareness in Pakistan, particularly in KPK, is nil. People's health awareness should be raised,</p> <p>and basic health care facilities should be made available.</p> Sajid Ali1 , Mehnaz Bilal2 , Fayaz Ahmad Khan3 , Atiq Ahmad4 , Sumbal Hussain5 , Nourin Mahmood6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 EVALUATING THE USEFULNESS OF SELF-SCORING AFTER DISCUSSING ANSWERS WITH 3RD YEAR MBBS PHARMACOLOGY STUDENTS. <p>Abstract</p> <p>Introduction: Students may only utilise the idea of self-evaluate when they are able to choose the</p> <p>standards that will be applied and make assessments about the extent to which their work satisfies those</p> <p>standards. Methods: The present study was conducted at Suleman Roshan Medical College Tando Adam,</p> <p>after the approval from institutional ethics review committee, from January 2022 to December 2022.</p> <p>During the course of an entire year, Eleven separate tests, comprising 2 midterms, have already been</p> <p>given. Following the final test, the pupils were provided with a Likert question asking them to contrast the</p> <p>new assessment format with old one in terms of its academic potential &amp; ability to assess their</p> <p>competence. As well, the pupils were tasked with assessing the test's difficulty level, relevancy, &amp;</p> <p>duration. Results: A total of n=82 participants had submitted the responses on evaluating the usefulness</p> <p>of self-scoring after discussing answers with 3rd year MBBS Pharmacology students. The responses were</p> <p>obtained by likert Scale. Analysis of the findings had revealed that majority of the participants had either</p> <p>strongly agree and agree with the questions regarding evaluating the usefulness of self-scoring after</p> <p>discussion thus suggesting the fact 3rd year MBBS students were favouring the concept of self-scoring.</p> <p>Results were analysed using P-value of ≤ 0.05(95% CI) as significant. Conclusion: It has always been</p> <p>discovered that learners view this type of exam as a far more useful educational instrument than the</p> <p>traditional one. The students are given real - time feedback, were made aware of one‘s wrong responses &amp;</p> <p>gaps in knowledge, &amp; given the chance to think about them.</p> Kashif Rasheed Shaikh1 , M. Atif Ata2 , Umair Ali Soomro3 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 ASSESSMENT OF THE ACCEPTANCE AND EFFECTIVENESS OF PAL SESSION IN BIOCHEMISTRY 2ND YEAR MBBS STUDENTS. <p>Abstract:</p> <p>Introduction: In early 90’s in UK a system is generated for the student support was PAL and its variant</p> <p>Objectives: To assess the effectiveness and acceptance of PAL session in Biochemistry 2nd year MBBS</p> <p>students. Methods: The present study was conducted in Suleman Roshan Medical college tandoadam</p> <p>from March 2022 to September 2022, was conducted in first year MBBS student for Biochemistry</p> <p>subject. Students were divided into 10 groups and each group has to present PAL session, remaining</p> <p>students were allowed to ask questions after completion of session and finally comments on session by</p> <p>teachers as well as from students. After completion of academic year a LIKERT scale feedback was given</p> <p>to students for giving answer on them. Result: There were 60 participants who were filled the feedback</p> <p>form among 88 students, 83.33% participants were of the opinion that The PAL session was appropriately</p> <p>placed in weekly time table, whereas the 66.67% had considered the topic discuss in the PAL session</p> <p>were appropriately selected, results were considered significant when P value was &lt;0.05. Conclusion:</p> <p>PAL Sessions had good impact on students for enhances their knowledge and academic results.</p> M. Atif Ata1 , Kashif Rasheed Shaikh2 , Umair Ali Soomro3 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 FACE BOOK POSITIVE AND NEGETIVE IMPACTS ON MEDICAL STUDENTS. <p>Abstract</p> <p>Introduction: Facebook use is on the rising amongst Pakistani medical graduates; however it's</p> <p>questionable whether this has direct effect on their mental health or educational achievement.</p> <p>The intent of this research is to look at the advantages and disadvantages of Facebook use among</p> <p>Pakistani medical graduates. Location of Study, Sample Details, Size, and Duration: 385</p> <p>medical students participated in the study at the KMC / Peoples University of Medical and</p> <p>Health Sciences for Women (PUMHSW) in Nawabshah, Pakistan. The information was</p> <p>collected for the study over the course of a full calendar year, from January 2022 to December</p> <p>2022, using a cross-sectional methodology. A self-administered questionnaire that evaluated the</p> <p>research participants' usage of Facebook, mental health, and academic performance was also</p> <p>filled by them. Results: A number of 385 pupils from various classrooms were chosen, &amp; 90%</p> <p>of the questionnaires were accurately completed. The average age of the respondents, was ranged</p> <p>in age from 18 to 22 years, was 19.5 years. All students were females. There were 15.85%</p> <p>students from 1st year MBBS, 18.18, 16.88, 12.98 and 36.36% 2nd, 3rd, 4th and final year</p> <p>respectively. majority of students 33.76% were using face book up to 01 hour, while others</p> <p>25.98%, 18.18%, 15.58% and 6.49% for 02, 03, 04, and 05 hours respectively. In accordance</p> <p>with the research, Pakistani med professionals' use of social media had both favourable and</p> <p>unfavourable effects on their emotional well-being &amp; educational success. Conclusion: The</p> <p>study concludes that while Facebook can be a valuable tool for learning and networking, its</p> <p>excessive use can lead to negative impacts on mental health and academic performance.</p> <p>Awareness, guidance, and self-regulation can help medical students use Facebook effectively</p> <p>and minimize its negative impacts. The study provides useful insights for medical students and</p> <p>institutions to use Facebook in a balanced and controlled way to optimize its positive impacts</p> <p>and minimize its negative impacts.</p> Haresh Kumar1 , Guljan Bukhari2 , Farheen Arshad3 , Fariha Awan4 , Janat Memon5 , Afreen Nisar6 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 A MINI REVIEW: ADVANTAGES AND DISADVANTAGES OF SEMESTER SYSTEM AND ANNUAL SYSTEM <p>Abstract</p> <p>A modular system is a system that is made up of different independent modules or components</p> <p>that can be combined or interchanged to create a variety of configurations. Every element is</p> <p>created to carry out a certain task, and as necessary, these may be extended, withdrawn, or</p> <p>altered to adapt the platform to a specific input. Modular systems are commonly used in fields</p> <p>such as manufacturing, electronics, and construction. An annual system, on the other hand, is a</p> <p>system that is based on a yearly cycle or period. This system is commonly used for financial</p> <p>purposes, where transactions or calculations are recorded on an annual basis. Universities use</p> <p>different educational systems to teach students, including the Semester System &amp; the Annual</p> <p>System. In the Annual System, students take tests consecutively throughout the academic year,</p> <p>while in the Semester System, examinations are held five or six months after the start of the</p> <p>academic year. There are several differences between the two systems, and this paper aims to</p> <p>explore their advantages and disadvantages. This study aims to differentiate between the Annual</p> <p>and Semester Systems, focusing on their objectives and intrinsic values. It aims to compare the</p> <p>benefits of both systems, taking into account the perspectives of both students and teachers. The</p> <p>purpose of this study is to help individuals identify which system is more effective and efficient</p> <p>for their educational needs.</p> Farzana Mallah1 , Aisha Laghari2 . Aqsa Memon3 . Aisha M. Aslam4 . Uyaina Zulfiqar Ali5 , Hafsa Lashari 6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 CHALLENGES FACED BY STUDENTS AND FACULTY DURING ONLINE CLASSES AND EXAMINATIONS – FINDING A WAY FORWARD <p>Abstract</p> <p>Introduction: The traditional concept of classroom learning has been gradually replaced by</p> <p>online teaching since the year 2020 when the world witnessed COVID-19 pandemic which</p> <p>caused closing down of all teaching institutions across the globe, making more than one billion</p> <p>children sit at home. Aim: To highlight the merits and demerits of online learning and</p> <p>examination methods and to give recommendations for its improvement. Methodology: The</p> <p>study population included 421 students and 220 faculty members of Fazaia Medical College</p> <p>along with and other private schools and colleges of Rawalpindi and Islamabad. An online</p> <p>survey was conducted using simple random sampling. Data was collected using separate online</p> <p>Google forms for students and teachers. Results: 71.3% of students preferred on campus classes</p> <p>and 23% of students did not take online classes seriously. During online exams, more than 50%</p> <p>students had problems with internet connection and accessing the exam content. 46% of study</p> <p>participants said that there were no institutional protocols and they felt stressed due to this. More</p> <p>than 50% teachers preferred taking an online class from home and 25% of them thought that they</p> <p>were not competent enough to take online classes. Conclusion: The main challenges for students</p> <p>were lack of institutional protocols, non- availability of electronic gadgets, slow internet</p> <p>connection during exams and poor accessibility to online exam content. For teachers; their lack</p> <p>of proper training for conduction of online classes and examinations and non-serious attitude of</p> <p>students were the main issues</p> Zille Huma Mustehsan1 , Arshia Bilal2 , Asifa Afzal3 , Nida Khaliq4 , Inzamam Khalil5 , Syeda Amna Waseem6 . Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 PREVALENCE OF SCREEN EXPOSURE AND MUSCULOSKELETAL RELATED SYMPTOMS AMONG TEENAGERS. <p>Abstract</p> <p>Introduction: This article discusses the association between high screen time and</p> <p>musculoskeletal symptoms in adolescents. The prevalence of musculoskeletal symptoms among</p> <p>adolescents is high, and the symptoms can cause physical discomfort and functional limitations,</p> <p>affecting the overall quality of life. The aim of the study was to determine the prevalence of</p> <p>screen exposure and musculoskeletal related symptoms among teenagers Methods: The cross</p> <p>sectional survey based study was conducted in Hyderabad, Pakistan, with a sample of 200</p> <p>participants aged between 13 to 19 years, engaged in screen-based activities for at least 2 hours</p> <p>per day. Duration of study was 4month from Sept 2023 to January 2023. The musculoskeletal</p> <p>symptoms were assessed using a standardized questionnaire, the Nordic Musculoskeletal</p> <p>Questionnaire (NMQ). Data was analyzed through SPSS ver 23. Results: The study finds that</p> <p>the majority of participants spend between 6 to 9 hours per day engaged in screen-based</p> <p>activities. Specifically, 30.5% of participants spend 8 hours per day on electronic devices, while</p> <p>28% spend 9 hours per day. The highest screen exposure reported is 9 hours per day, with 56</p> <p>participants (28%) exceeding this threshold. The prevalence of musculoskeletal symptoms is</p> <p>found to be high in the neck (42%), followed by the lower back (29%), and wrist (14.5%).</p> <p>Conclusion: The study concludes that high screen time is associated with musculoskeletal</p> <p>symptoms in adolescents, highlighting the importance of reducing screen time and promoting</p> <p>physical activity.</p> Hina Rathi1 , Tehreem Anis PT2 , Falak Abdul Latif3 , Bisma Sheikh4 Aamir Gul Memon5 , Saleh Shah6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 COMPARISON OF RADIAL VS FEMORAL APPROACH IN ELDERLY PATIENTS UNDERGOING PERCUTENEOUS CORONARY INTERVENTION <p>Introduction The radial access might have less complications than the femoral access.</p> <p>Objective: In older individuals with changed vascular anatomy, it might potentially be more</p> <p>challenging. In contrast to the femoral method, we evaluated the success rates, technical</p> <p>details and complication rates of radial angiography in elderly patients. Material &amp;</p> <p>Methods: This study was conducted at the Cardiology Department Saidu Group of</p> <p>Teaching hospitals between January 2019 and January 2020. In this study, we enrolled all</p> <p>patients referred to our center for in-patient invasive angiography who were 65 years of age or</p> <p>older and had a history of probable coronary artery disease or suspected progression of known</p> <p>coronary disease. Two groups of patients were equally divided. Each group consists of 500</p> <p>patients. The femoral artery was accessed by group 2 patients, while the radial artery was</p> <p>accessed by group 1.Results: Major adverse cardiovascular events (MACE) observed in</p> <p>group1 in 2(0.4%) cases, and in group 2 in 17(3.4%) cases, all of which were complications at</p> <p>the arterial access site. Minor adverse events occurred in group2 was 29(5.8%) as opposed to</p> <p>9(1.8%) in group 1.Overall duration was significantly longer in group 1 as compare to group 2</p> <p>(31.1 min. vs. 23.5 min) Those in group 1 had a lower mean GRACE score (110±32 versus</p> <p>128±41), improved renal function according to cretanine level (0.8±0.4 versus 1.0±0.8) and a</p> <p>reduced prevalence of indications of left ventricular failure (9% versus 23%) when compared to</p> <p>patients in group 2. Time of admission for the type of ACS heart rate (69±15 Vs 75±16), systolic</p> <p>arterial pressure (141±30 Vs 150±32), positive troponin 59(79.7%) Vs 51(68.9%),</p> <p>electrocardiographic ischemia 190(38%) Vs 179(35.8%). Conclusion: In elder patients over</p> <p>the age of 65, radial coronary angiography have a greater technological success rate and</p> <p>fewer complications than femoral approach.</p> Neelam Akhund1 Imad Uddin2 Javeria Akhund3 Itizaz Hakim4 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 TO ASSESS KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARDS HEPATITIS B VIRUS INFECTION IN PATIENTS COMING TO GASTROENTEROLOGY OPD AT RAWAL INSTITUTE OF HEALTH SCIENCES, ISLAMABAD <p>ABSTRACT</p> <p>Objective: The objective behind this study was to assess knowledge, attitude, and</p> <p>practice towards hepatitis b virus infection in patients coming to gastroenterology OPD</p> <p>at Rawal Institute of Health Sciences, Islamabad. Methods: This population &amp; hospital￾based descriptive study was conducted through a convenience sampling technique from</p> <p>1</p> <p>st March, 2022 to 31st August, 2022 in the department of general medicine, Rawal</p> <p>Institute of Health Sciences, Rawalpindi. The study implemented 24- close ended</p> <p>questions consisted of three sections through which knowledge, attitude, and practice</p> <p>were assessed regarding HBV infection. All baseline and clinical data were taken using a</p> <p>structured questionnaire and then entered &amp; analysed using SPSS v. 22. Results: A total</p> <p>of 243 patients who responded to the questions were included in this study for final</p> <p>analysis. Overall mean age and SD was 36.27±17.81 years. The age range between 18</p> <p>years to 85 years and majority belongs to young age group, ≥18 – 40 years (40.74%, n</p> <p>=99). Study participants had overall good knowledge (79.21%) while average practice</p> <p>regarding HBV was (57.83%) regarding HBV infection. Conclusions: Most of our study</p> <p>participants were males and belong to younger age group. Overall response rate of</p> <p>knowledge regarding HBV infection was good and most of the participants will seek</p> <p>medical attention if they get infected. Unluckily, only a small percentage of participants</p> <p>(11.11%) participated in health education regarding HBV infection</p> Anwar Hussain Abbasi1 , Aasia Zameer2 , Taqdees Abrar3 , Hina Andaleeb4 , Khawaja Ishfaq Ahmed5 , Nadeem Yousuf6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200 PREVALENCE OF HEPATIS B AND C AMONG BETA THALASSEMIA MAJOR PATIENTS AT A TERTIARY CARE HOSPITAL <p>ABSTRACT</p> <p>Introduction: The beta-thalassemia are among the most prevalent hereditary diseases, and they</p> <p>influence the lives of millions of children all over the world. Because appropriate viral screening</p> <p>of donated blood has never been carried out, the infection risk in -thalassemia individuals serve</p> <p>as a signal for the hazard of transfusion-transmitted illnesses, specifically hepatitis B and C as</p> <p>well as other viral infections. Objective: To determine the prevalence of hepatitis B and C</p> <p>among beta-thalassemia major patients at a tertiary care Hospital.Material and methods: This</p> <p>descriptive cross-sectional study was done at the pediatric department at SKBZ/AK, CMH</p> <p>Hospital Muzaffarabad, during a period of six months from October 2019 to March 2020. All the</p> <p>beta thalassemia major patients, aged up to 15 years, and both genders, were included. Following</p> <p>informed consent, a 3-5 mL blood sample was collected from each case and immediately sent to</p> <p>the hospital diagnostic laboratory to screen for HCV and HVB infections using the Elisa method.</p> <p>All the informatiosn was collected via a study proforma, and SPSS version 26 was used for data</p> <p>analysis.Results: A total of 87 patients with beta thalassemia major were studied; their mean age</p> <p>was 10.0+3.68 years. Males were 55.8% and females were 44.8%. Out of all 35.6% patients were</p> <p>infected by HCV, while only one patient found with HCV and HBV co-infection. As per the</p> <p>stratification, HCV infection was significantly linked to age more than 10 years (p-0.001), while</p> <p>statistically insignificant according to gender (p-0.344). Conclusion: As per the study</p> <p>conclusion, HCV infection was observed to be highly prevalent among patients with beta￾thalassemia major. It was positively related to the blood transfusions. Unfortunately, due to the</p> <p>high incidence of these viruses in individuals with beta thalassemia, it would appear that the</p> <p>precautions used in blood preparation and testing to prevent infections that are transferred by</p> <p>blood transfusion are still insufficient.</p> Mubashara Murtaza1 , Kiran Ashfaq Ahmed2 , Maryam Abbasi3 , Aalya Farooq4 , Momina Shafique5 , Naheem Ahmed6 Copyright (c) 2023 Fri, 31 Mar 2023 00:00:00 +0200