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

THE BENEFITS AND HARMS OF MODULAR SYSTEM IN MEDICAL UNIVERSITIES.

Safdar Ali Pervaiz Tunio — Fri, 31 Mar 2023 00:00:00 +0200

The modular system of education is
becoming increasingly popular in many
universities around the world, including in
medical universities. This system involves
breaking down the curriculum into smaller,
more focused modules, each of which
covers a specific topic or area of study. In
this essay, we will explore both the benefits
and harms of a modular system in medical
universities.

EVALUATION OF HEMATOLOGICAL PARAMETERS IN CONFIRMED NON- STRUCTURAL-1 ANTIGEN (NS1AG) DENGUE INFECTED PATIENTS.

Fri, 31 Mar 2023 00:00:00 +0200

Abstract
Introduction: The most prevalent virus spread by mosquitoes in Pakistan is dengue virus. The high ratio
of illness to mortality caused by dengue virus infection may include clinical features ranging from mild
dengue fever to dengue shock syndrome, which may even be lethal. Objective: This study aimed to
investigate the haematological parameters in patients with confirmed Non-Structural 1 Antigen (Ns1Ag)
dengue infection. Study Design: Descriptive cross-sectional study. Place of Study: Govt. Naseerullah
Khan Babar Memorial Hospital, Peshawar. Duration of study: From September to December 2022 (Four
Months). Methods: Participants were enrolled in the current study regardless of gender after being
recruited and clinically examined by medical professionals. Immunochromatography was used to identify
Non-Structural 1 Antigen (NS1Ag) of dengue virus in all cases. Blood was drawn and processed to get a
complete blood count to study haematological parameters. The obtained data was analyzed via the
statistical programme for social sciences version 22. Results: In this study, 102 dengue-infected
individuals were recruited, with 61.8% males and 38.2% females. Haemoglobin levels were normal in
90.2% of dengue patients and decreased in 9.8%. The majority of female patients had low haemoglobin
levels. White blood cell counts were low in 26.5% of patients. Neutrophil levels were high in 67.6% of
the patients. Male patients (n=47) had more abnormal neutrophils than female patients (n=22). Low
lymphocyte levels were reported in 51% of patients, whereas high lymphocyte levels were found in
13.7% of dengue-infected patients. Low platelet levels were identified in 30.4% of individuals, with
males suffering from thrombocytopenia more than female infected with dengue virus. Conclusion: Based
on the results obtained in the current study the dengue-infected individuals had higher levels of
neutrophils, lower levels of lymphocytes, and lower levels of platelets. Also, males were seen to have
suffered more than femals. It is critical to developing diagnostic criteria based on clinical signs and
symptoms for more accurate and prompt diagnosis.

ASSESSMENT OF ANTICOAGULATION USING ACTIVATED CLOTTING TIME (ACT) IN PATIENTS RECEIVING ENOXAPARIN AND HEPARIN DURING PERCUTANEOUS CORONARY INTERVENTION (PCI).

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: The standard of therapy for some patients with coronary artery disease,

particularly those who arrive with acute coronary syndrome, is percutaneous coronary

intervention (PCI) (ACS). To avoid thrombotic problems during PCI, the American College of

Cardiology (ACC) and the European Society of Cardiology (ESC) advise using anticoagulation

in addition to dual antiplatelet treatment (DAPT). Objective: to assess how enoxaparin affects

the active clotting time (ACT) and how UFH reacts to enoxaparin. Material and methods: The

intervention cardiology department at Hayatabad Hospital Complex in Peshawar did this crosssectional descriptive research from June 1 to April 30, 2022. By using a non-probability

sequential sampling strategy, patients were included. After a thorough history, examination, and

informed permission, all patients 18 years old having PCI were included in the research.

Individuals with known blood dyscrasias or thrombophilia, as well as those who had received

anticoagulation within the previous 12 hours or just prior, were excluded from the trial. Results:

Among the patients who received heparin, ACT increased from 104.76±27.31 seconds to

448.34±169.11 (t-statistic=13.750, 95% CI: 293.9540 to 393.2060, p: <0.01) whereas among

patients who received enoxaparin, this number increased from 99.58±27.68 seconds to

334.37±166.45 seconds (t statistic=6.817, 95% CI: 165.4597 to 304.1203, p:<0.01). The postanticoagulation ACT was significantly higher in the heparin group compared to enoxaparin

group i.e. 448.34±169.11 and 334.37±166.45 seconds respectively (t statistic=2.700, 95% CI:

29.7639 to 198.1661, p:<0.01). Conclusion: After taking i.v. enoxaparin and heparin, the ACT is

extended in patients for around 15 minutes, and this prolongation may help track the

anticoagulant action of the medication. Moreover, in this situation, ACT levels and ENOX

clotting times are correlated. A bigger experiment will be necessary to determine the association

between ACT level and clinical effectiveness utilising intravenous enoxaparin.

COMPLICATIONS OF UNSKILLED HOME BIRTH: A CROSS SECTIONAL ANALYSIS OF THIRD STAGE OF LABOR.

Falak Sehar Sahito1*, Samia Shuja2 — Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT:

Introduction: Child birth at home is easily approachable but associated with certain complications which

if not dealt timely can lead to severe morbidity and even mortality of mother and child. Objective: To

evaluate the complications encountered during home birth, in women who presented to a tertiary care

hospital for further management. Methodology: A descriptive cross-sectional study was conducted at

Jinnah Postgraduate Medical Centre (JPMC) Karachi, after approval from research evaluation unit. Total

206 women, who delivered at home by traditional birth attendant/ Dai and then were referred to the

hospital obstetrical emergency unit for further management of a complicated third stage of labor, were

enrolled in the study after fulfillment of selection criteria and informed consent. Nonprobability purposive

sampling was done. Demographic and other required data was collected on predesigned proforma.

Results: Patients presented with multiple complications. Majority of patients presented with postpartum

hemorrhage due to uterine atony (56.3%), followed by retained product of conception (54.4%), retained

placenta (26.7%) and traumatic lesion (21.8%). Few (8.7%) presented with puerperal sepsis also. Most

patients presented within 24 hrs. of delivery. P-value < 0.05 was taken as significant. Conclusion: This

study concluded that home birth is associated with increased maternal morbidity, where postpartum

hemorrhage due to uterine atony is the most common presentation. Patient often present with multiple

complications, which necessitate skilled training of traditional birth attendants/Dai, in terms of prevention

of postpartum hemorrhage (including active management of third stage of labor) and infection control

measures.

RELATIONSHIP BETWEEN THE ABSENTEEISM AND DYSMENORRHEA OTHER ASSOCIATED SYMPTOMS IN ADOLESCENT FEMALES ATTENDING THE PUBLIC UNIVERSITY.

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: These menstruation episodes amongst young women might be viewed as a

pertinent issue since they cause absenteeism and may have a detrimental impact on academic

performance. Awareness-building on the socioeconomic effects of absence is crucial. Aims and

objectives: Since dysmenorrhea affects women of reproductive age, it is a cause for concern for

the public. The focus of this research was to determine if menstrual periods or unpleasant

complaints such dysmenorrhea were present amongst normal undergraduates at Sindh Public

University and also how they affected absenteeism. Sample size and Material methods: A total

of 339 teenage students enrolled in the first year of study at the public university of Sindh from

September 2019 to December 2019 engaged in this cross-sectional investigation. Statistics on

socio-demographics, gynaecology, and noteworthy menstrual events were gathered by a

questionaire; the much more common of these was dysmenorrhea, which afflicted 95.3% of

students. Significant pain-related dysmenorrhea was detected in 25.7% of cases, followed by

medium and milder cases in 46% and 23.6% of cases. Absenteeism among students with period

pain was observed in 65% of cases, with moderate cases affecting 53% of students and having a

significant P value of 0.007. Nonetheless, it was shown that students with significant

dysmenorrhea and stomach pain that reached their legs were much more probable to miss class

(36%). Conclusion: These menstruation episodes amongst young women might be viewed as a

pertinent issue since they cause absenteeism and have a detrimental impact on their school

performance. It is crucial to create new menstrual experience-improving techniques and make

people aware of economical effects of absence.

OUTCOMES OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION WITH AND WITHOUT POST DILATATION IN PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: It is debatable how SPD (stent post-dilatation) work during PPCI (primary percutaneous

intervention). It is up to the operator to decide when to execute stent after dilatation because there are

currently no definitive rules or general agreement on the subject. Objective: To assess the results of PPCI

(primary percutaneous coronary intervention) in participants having ST segment elevation myocardial

infarction with as well as without post-dilatation. Methodology: This retrospective analysis research was

performed in Hayatabad medical complex, Peshawar, Pakistan after the approval from the institutional

and ethical review board. The study included 180 patients, both sexes, ages 18 to 70 years, who received

primary percutaneous coronary intervention due to STEMI. The patients' various characteristics, such as

DM, HTN (hypertension), CKD (chronic kidney disease), BMI, smoking history, the location of the MI,

blood pressure, the type of artery, and the TIMI flow before and after the procedure, were recorded in an

excel sheet. Results: Regarding the culprit artery, there wasn't a scientifically significant distinction between

the two categories; group 1's left anterior descending artery (LAD) was observed in 50 (55.5%) cases & in

group 2 in 49(54.4%) cases. Right coronary artery (RCA) in group 1 in 31(34.4%) and 27(30%) in group

2. Left circumflex artery (LCX) in group 1 was noted in 17(18.9%) and 19(21.1%) in group 2. The use of

thrombus aspiration catheters was greater in group 2 than in group 1, with 24 (26.7%) compared to 15

(16.7%). GP IIb/IIIa inhibitors were given to 20 (22.2%) individuals in group 2 compared to 18 (20%)

patients in group 1. Patients in groups 1 and 2 had substantially larger pre-stenting balloon dilatation, 44

(48.9%) and 11 (12.2%), respectively. In both groups, every patient got DES (drug-eluting stents).

Conclusion: In patients with STEMI, selective postdilation enhanced some angiographic and clinical

outcomes, and it could not be discouraged from being used in the primary percutaneous coronary

intervention

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.

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: Musculoskeletal health defines to the act of the locomotor system, consists intact

muscles, bones, joints and face-to-face connective tissues. The most common issue among nurses is Low

Back Pain, compared to other health care providers such as dcotors, consultant and parmamedics. The

overall health of nurses including physical, mental, and social health can be affected due to occupational

or job or work stress. Moreover, the increasing demands at work and higher work stress among nurses

may predispose them to back ache. The higher occurrence of pain in lowerback among nursing staff is

responsible for reduced productivity of workers and increased medical expenditures of both individual,

their family and ultimately nurses could not able to contribute in developing nation economy. This

research was intended to conclude the frequency of work-stress and their association with Low Back Pain

among working nureses of Karachi. Objective: This research study was aimed to define prevalance of

job-stress and factors assoiated with back ache or pain in lower back among nurses working in a tertinary

care hospitals in Karachi. Design of study: Descriptive Cross-sectional. Place & Duration: Dow

University hospital and Civil Hospital Karachi, from May 2019 to August 2019. Materials and

Methods: This cross-sectional study was implementated during May-August 2019 on total sample of

target population that is 324, working at tertiary care hospitals in Karachi, with minimum qualification of

3 years diploma in nursing, and had minimum 1 year of working experience. The data collection

instrument consisted of a section on demographic information and Nursing Stress Scale. The analysis of

data was done through SPSS 21.0, Data scrutiny involved in the use of descriptive statistics. Moreover

chi-square test was used for comparative and qualitiative analysis. Results: In this study, 59%

participants were male and 75% having bachelor degree. Overall, 91 (28.1%) nurses reported that they did

not have work stress while presence of high stress was found in only 4 (1.7%) nurses. low to moderate

level of stress was observed in 229 (70.6%) nurses. Although low back pain was positively associated

with work stress. The findings were not statistically significant (p>0.05) to draw reasonable conclusions.

The findings were similar for all the work stress subscales except that 12-month Low Back Pain

frequency was negative correlated with conflict with physicians (r=-.222, p=.008). Conclusion: The

frequency of low to moderate work stress was found high among health care professional (nurses)

employed in two hospitals of Karachi, while there is also association found between low back pain and

job-stress. However, it was not clear whether there is a connection or not between work stress and low

back pain.

BARRIERS IN RESEARCH AMONGST UNDERGRADUATE MEDICAL STUDENTS IN PAKISTAN.

Kainat Javed1, Absar Nazir2, Zeeshan Malik3, Umair Bin Nasir4. — Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: Medical research has an impact on disease prevention, diagnosis, and newer

treatments. It has resulted in policy changes for health-care programmes. Because

undergraduates were underrepresented in research, this study was designed to identify the factors

and their opinions towards them. Objective: The study's goal was to evaluate the knowledge,

attitude, experience, and research hurdles of medical undergraduates. palce and duration of the

study: In May 2022, this study was carried out at the University Faculty of Medicine and

Dentistry in Lahore. Methods: A cross-sectional questionnaire-based study was carried out with

institutional ethics committee approval and written informed consent from the students. A

verified pre-designed questionnaire with 34 questions was used in this study. From UCMD, we

received completed questionnaires from first to Final year medical students of MBBS

programmes. Descriptive statistics were used to analyse the data. Results: Data was collected

from 674 students out of 785 students and the response rate was 86%, out of which 595 were

females. 67% students totally agreed that research should be part of undergraduate curriculum.

60% students thought that it would improve clinical practice and better understanding of subject.

Almost 69% believed that research was not a waste of time and did not interfere with studying.

Funding (49%), Lack of awareness (53%), time (63%), follow up (77%), interest (54%) were the

main barriers to research. 62% of students were dissatisfied with the faculty's lack of

encouragement. Conclusion: The majority of students were knowledgeable about research and

indicated a good attitude toward participating in research activities. Some barriers, which

undergraduates faced, were lack of awareness, time and funding.

TACROLIMUS OINTMENT AS MONOTHERAPY IN MANAGEMENT OF MODERATE TO SEVEREREFRACTORY VERNAL KERATOCONJUNCTIVITIS.

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: In the modern era of industrialization and global seasonal change, human health has been

adversely affected. One of its sequels is ocular allergy. Objective: To evaluate the efficacy and

safety of (0.03%) tacrolimus skin ointment in patients with moderate to severe refractory vernal

keratoconjunctivitis (VKC). Study Design: Prospective interventional study. Setting & Duration:

Ophthalmology outpatient department (OPD) Peoples University of Medical and Health Sciences from 16

February 2019 to 16 August 2021. Material &Methods: 200 patients suffering from moderate to severe

VKC were selected, based on TSSS (Total subjective scoring system) and TOSS total objective scoring

system). The study participants were separated into 2 groups (100 each) withtreatment group

receiving0.03% Tacrolimus ointment while the other receiving conventional therapy. To determine the

effectiveness (measured by the change mostly in clinical condition), a randomised clinical investigation

was carried out and safety (safe treatment from development of any complications or side effects) of

Tacrolimus ointment in comparison with conventional therapy. Result: It was observed that 73% patients

had tarsal form of VKC, 24% had limbal and 3% had mixed (both) types of disease. Every one of the

patients had complete subjective symptom severity ratings (TSSS) and total objective ocular severity

scores (TOSS) which ranged among 2 & 3. Treatment with either 0.03% Tacrolimus or conventional

group was found to be effective in eradicating the symptoms of VKC measured by TSSS scores.

Conclusion: Among the medical therapies used in this study it is found that, Tacrolimus ointment 0.03%

was more nontoxic & actual in eradicating the severity of signs and symptoms of the vernal

keratoconjunctivitis evident by the TSSS and TOSS scores. (ASM allergic systemic

manifestations)rhinitis, asthma and eczema)

EFFECTS OF MANIPULATION AND CASTING OF PONSETI METHOD OUTCOME IN CHILDREN WITH IDIOPATHIC CLUBFOOT.

Sundas Mastoi1 , Muhammad Usman2 , Sana3 . — Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: One of the most prevalent paediatric foot deformity is clubfoot. Idiopathic

clubfoot is a condition for which there is no known cause. The Ponseti Technique became the

best choice for treating clubfoot all around the world. The Ponseti method of treating idiopathic

clubfoot includes weekly serial manipulations and castings until the foot can be abducted to 60

degrees. The patient is subsequently placed in a foot abduction orthosis to maintain the

correction made and prevent the deformity from relapsing after Achilles tendon tenotomy and

casting. Objective: To determine the effects of manipulation and casting of Ponseti method

outcomes in children with idiopathic clubfoot. Methodology: This descriptive cross sectional

study was conducted in orthopaedic department of PMCH Hospital Nawabshah from August

2022 to February 2023. 100 children of both genders with idiopathic clubfoot were included.

After enrolment complete history and physical examination of all children were carried out.

Informed written consent was taken from parents or guardians of the children. Data were entered

in excel sheet and analyzed in SPSS version 21. Qualitative variables were presented in

percentage and frequencies while quantitative variables were presented in mean and standard

deviation. Paired sample t test was applied. Results: According to our results, 100 children with

clubfoot were included in this study. 50 children were male and 50 children were female. The

mean ages of children were 4.02 months. Bilateral clubfeet were 53% and unilateral clubfoot was

47%. The right club foot was 32% and 20% was left side. The average no: of cast were 5.45.

41% of children need tenotomy. The initial Pirani score was 3.140. The final Pirani score mean

was 0.60. Post stratification data analysis revealed statically significant between initial and final

Pirani score with P-value (0.001). Conclusion: Clubfoot can be effectively treated with the

Ponseti method of casting and manipulation.. It is the simplest approach. Therefore, we advise

using this method as the first line of treatment for infants with idiopathic club feet.

PREVALENCE, OUTCOME AND RISK FACTORS ASSOCIATED WITH CONGENITAL MALFORMATIONS IN NEONATES AT A TERTIARY CARE HOSPITAL -A RETROSPECTIVE STUDY

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

INTRODUCTION: There is a high burden of congenital anomalies worldwide and more so in

the developing countries. These birth defects contribute significantly to the neonatal mortality

rate in our country, which is one of the highest globally. Addressing and identifying the risk

factors for these conditions is imperative for their prevention .OBJECTIVE: this study was

done to determine the prevalence of congenital malformations and the risk factors associated

with them. METHODOLOGY: this cross-sectional retrospective study was carried out at the

Pediatric unit of Ziauddin Hospital from 1st January 2020 till 1st January 2023.Data was extracted

from the electronic health records and entered on a pre-designed proforma. Information

regarding maternal risk factors , antenatal visits ,neonatal characteristics and type of congenital

anomalies was noted .Data was analyzed using SPSS version 20 and expressed as frequencies

and percentages and chi square test was applied with P-value of <0.05 considered statistically

significant. RESULTS :The prevalence of congenital malformations was 4.5%.Anomalies

related to the central nervous system were the highest ,followed by cardiac birth defects .A

smaller percentage undertook regular antenatal visits and folic acid supplementation. Family

history of birth defects is a significant risk factor. CONCLUSION: Congenital malformations

are a frequent occurrence in our set up .Effective antenatal care and screening are the cornerstone

of preventing these disorders.

ASSESSMENT OF RISK FACTORS IN CHILDREN WITH CHRONIC DIARRHEA AND WEIGHT LOSS AT A TERTIARY CARE HOSPITAL.

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: Diarrhoea is still the second leading reason for death among kids underneath the

five years of age. Neither preventive measures nor therapeutic options are available. Objective:

To assess the risk factors associated with chronic diarrhea & weight loss in the children of

Pakistan. Methods: A purposive randomized controlled trial was conducted among the 110

children of District SBA / Jamshoro sindh, Pakistan with ages between 6 and 36 months and

mean age 24 months having more than 4 episodes of acute watery diarrhea for more than 48

hours. Results: There were total 110 children’s out of them 75(68.18%) were male and

35(31.82%) females. There were <12 months 40 (36.36%) of the children were below 01 year of

age, 12-24 months 32 (29.09%) belonged to 12-24 months and 38 (34.54%) were between 24-

36 months. Only 40 (36.36%) were undergoing breastfeeding or exclusively breastfed. 60

(54.55%) had an updated vaccinated status. 70 (63.64%)were low for birth weight. 80

(72.72%)families were consuming the municipal water supplies drinking and cooking. 75

(68.18%)were living in a joint family system. 30 (27.28%) of the mothers were literate with a

minimum of primary education and above. 75 (68.18%)of the children had an early weaning

history below 6 months of age. Conclusion: It was observed that children who had a history of

low birth weight below 2.5 kg, under 12 months of age, not or under breastfed during their

infancy, nursed on formula milk, unvaccinated status, those consuming un boiled water

(municipal water) and those who had a history of early weaning below 6 months of age suffered

more episodes of watery diarrhea.

FREQUENCY AND RISK FACTORS OF IRON DEFICIENCYANEMIA IN CHILDREN BELOW 10 YEARS OF AGE AT A TERTIARY CARE HOSPITAL PAKISTAN.

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: In South Asia, anaemia affects more than 50% of preschool-aged kids due to its

diverse aetiology. To successfully solve this issue, it is necessary to clarify the situationally

reasons of anaemia. Anemia is a common medical finding among children. Anemia due to iron

deficiency affects 40–70percent of the overall of kids less than the age of 10 in Pakistan. Anemia

not only alters normal physical development but also impairs cognition and endurance in kids.

Under this analysis, the frequency and risk markers of iron deficiency anaemia in kids below the

age of 10 who visit PMCH Pakistan are evaluated. Materials And Methods: A total of 385

children were enrolled through a purposive random sampling presenting to the Pediatrics ward of

PMCH, Pakistan fulfilling the operational definition and admission criteria during JANUARY

2021 to DECEMBER 2022. Hb level below 11gm/dlwas termed as anemia and anemia is further

classified into microcytic, normocytic or macrocytic on peripheral blood film. Further testing for

serum ferritin, hemoglobin electrophoresis, serum C-reactive protein and stool microscopy was

advised to establish the definitive diagnosis. Risk factors were looked for in cases of iron

deficiency anemia. Results: Out of 385 patients there were total 210(54.54%) male and

175(45.46%) females. Mean age 5.2466, minimum 2 years and maximum 10 years. Out of 385

patients There were 152 with normocytic anemia, 216 microcytic anemia and 17 with macrocytic

anemia. Out of 210 male patients There were 57 males with normocytic anemia, 146 microcytic

anemia and 7 with macrocytic anemia. Out of 175 female patients There were 95 females with

normocytic anemia, 70 microcytic anemia and 10 with macrocytic anemia.p value =0.05

Conclusion: Around children under 10 years of age were found to be anemic, among them

around half of them were suffering from iron deficiency anemia. The findings of this study

stresses upon the significance of evaluating the risk factors of anemia in children. Prompt

awareness campaigns and revamping health education programs focusing mother and child health

can serve as a valuable tool to manage this health problem in countries like Pakistan.

COMPARISON OF OUTCOME OF 0.5% HYPERBARIC BUPIVACAINE WITH 0.5% HYPERBARIC ROPIVACAINE IN SPINAL ANAESTHESIA FOR PERIANAL SURGERIES.

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: The field of anaesthesiology has undergone significant advancements in recent

years, resulting in improved patient outcomes and reduced hospitalization durations. This is

primarily due to the availability of anaesthetic agents that block sensations locally or regionally

for shorter durations. Objective: To compare the outcome of 0.5% hyperbaric Ropivacaine with

0.5% hyperbaric Bupivacaine in spinal anaesthesia for perianal surgeries. Design: Randomized

controlled trial. Setting: Anaesthesiology Department, Surgical Intensive Care Unit And Pain

Management, Jinnah Post graduate Medical Centre (JPMC), Karachi. Duration: Six months

(From 7 April 2016 to 7 October 2016). Methods: 126 Perianal surgery patients were

approached for consent for study. Two groups viz; A & B were made, and group allocation of

consecutive patients were made through using opaque envelopes containing strip of either group.

Group A patients received three mililiter of Ropivacaine (5 mg/ml) with glucose 83 mg/ml.

Whereas, Group B received three mililiter of hyperbaric Bupivacaine (5 mg/ml) with glucose 80

mg/ml. Moreover, Oral temazepam 10–20 mg was administered to patients before to surgery to

reduce anxiety. Results: The duration of sensory block was statistically less in the Ropivacaine

group (153.8±9.3min) as compared to Bupivacaine group (190.2±8.3min) with P-value 0.0001.

In addition, the ropivacaine group's mean time in motor block was less than that of the

bupivacaine group (120.89±12.122 min vs 189.33±11.947min; P = 0.0001). Conclusion:

According to the results of the current investigation, bupivacaine applied intrathecally causes

sensory block to begin more quickly and last longer than ropivacaine.

PREVALENCE OF ANAEMIA AMONG THE STUDENTS AT SHAH ABDUL LATIF UNIVERSITY, KHAIRPUR.

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: Iron deficiency, which leads to nutritional anaemia, is a serious health problem in

economically developing nations like Pakistan. Objective: To determine the incidence of anemia

in male and female students at Shah Abdul Latif University, Khairpur. Methodology: In this

study, a total of 179 students were evaluated, with 63 (35.1%) being male and 116 (64.8%) being

female. The participants were selected from various departments of Shah Abdul Latif University

using a convenience sampling method, with informed consent obtained from each individual.

The study participants underwent interviews and screening for anemia. Demographic

information, such as age and gender, was gathered using a pre-designed questionnaire. Blood

samples were collected in EDTA vacutainers and analyzed using a Hematology Analyzer Huma

Reader Plus. The data was then analyzed using the SPSS software version 26.0. Results: The

average age of the participants was 19.4 ± 1.1 years. 47.5% (n=85) of the 179 students studied

were found to have anemia. The prevalence was higher in female students at 55.8% (n = 64)

compared to 33.3% (n=21) in male students. The mean levels of haemoglobin and red blood cells

were found to be significantly different between male and female students (P < 0.05). No

significant differences were observed in other hematological parameters between the two

groups.Conclusion: The female students had a higher prevalence of anaemia than male students,

more study with a bigger sample of healthy college students is needed to corroborate these

findings and safeguard the well-being of potential moms

KNOWLEDGE OF UNDERGRADUATE NURSING STUDENTS REGARDING NURSING INFORMATICS IN KHYBER MEDICAL UNIVERSITY PESHAWAR.

Amir Sultan1 , Najma Naz2 , Afrooz bibi3 , Haseen Jamal4 , Sanaullah5 — Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction Nursing informatics is a specialty that "integrates nursing science with multiple

information and analytical sciences to identify, define, manage and communicate data,

information, knowledge, and wisdom in nursing practice". Nursing students entering different

programs of nursing have different backgrounds; therefore their informatics competencies and

preparation are different from each other. Objective: the study was conducted to assess the

knowledge of nursing students regarding basic computer skills and nursing informatics. Design

and Methodology: A Cross-sectional descriptive study was conducted in a two months period

from 10 November 2021 to 10 January 2022 from 129 participants at institute of nursing

sciences Khyber medical university after approval from director of nursing institutes. Results:

Participants in this study were mostly female which was (51%) n=66, while the Male students

were (49%) n=63, The study showed that the excellent category regarding knowledge of 4 years

BSN students were high 25.67%, than the knowledge of 2 years Post-Rn students 12.81%, and

the mean score of the Excellent category regarding knowledge of 4 years BSN students were 19,

more than the knowledge of 2 years Post-Rn students 6.6. Furthermore the knowledge regarding

nursing informatics of Excellent category of 4 years BSN students were 16.04%, more than the

knowledge of 2 years Post-Rn students 13.52%, and the mean score of nursing informatics in the

Excellent category regarding knowledge of 4 years BSN students were 11.87, more than the

knowledge of 2 years Post-Rn students 5.18. Conclusion: In this study the results provide input

to educators that the students of 4 years BSN perform significantly well than 2 years Post-RN

BSN students, therefore it should now be the responsibility of higher authorities to work hard

with every nursing students to promote patient safety, and evidence based practice.

ROLE OF MAGNESIUM SULFATE FOR FETAL NEUROPROTECTION IN WOMEN AT RISK OF PRETERM BIRTH.

Madiha Iqbal1 , Zia Muhammad2 , Sana Iqbal3 . — Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: With a decrease in gestational age, the chance of cerebral palsy increases

significantly and is primarily ascribed to preterm birth. Currently, infants delivered prior to 34

weeks of gestation account for 25% of all new instances of cerebral palsy. Objective: To evaluate

the impact of MgSO4 administered to pregnant women at risk for premature delivery for fetal

neuroprotection. Materials and Methods: From January 2020 to December 2022, this

prospective observational research was carried out at obstetrics & gynecology department

hayatabad medical complex peshawar. Total 519 preterm pregnant women between 28-36 weeks

gestational age were enrolled. Out of 519, 199 premature laboring women received MgSO4 and

were placed in group A, while the remaining 320 were placed in group B because they did not

receive MgSO4. Women in group A got a 4g bolus dose of MgSO4 over 20–30 minutes, then

1g/hour. All pregnant women, whether carrying a single or multiple pregnencies, who were

between 28-36 weeks gestational age. Results: Neonatal outcomes of groups include the

following: Mechanical ventilation in group A was 45(22.6%) & 85(26.5%) in group B,

Respiratory distress 83(41.7%) vs 191(59.7%), neonatal enterocolitis 11(5.5%) vs 9(2.8%),

intensive resuscitation 6(3%) vs 12(3.7%), neonatal seizures 7(3.5%) vs 11(3.4%), NICU

admission required in group A was 85(42.7%) vs 183(57.1%) in group B, mortality in both

groups was 2(1%) vs 4(1.2%). Conclusion: The development of cerebral palsy in preterm

infants may be prevented by administering MgSO4 with a wide margin of safety. Even

though MgSO4 has only moderate benefits, it is a secure, affordable drug, so the risk-benefit

ratio favors using it.

PREVALENCE OF THYROID DYSFUNCTION IN DIFFERENT AGE AND GENDER GROUPS.

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: Thyroid disorders are increasing day-by-day throughout the world, especially in

sub-continent of Asia. There seem to be 20 million individuals in Pakistan who live in iodinedeficient regions. At a minimum, 1 million individuals have psychological illnesses, whereas 8

million people have had some type of iodine deficiency. This study was designed to determine

thyroxine (T4) and Thyroid Stimulating Hormones (TSH) level in suspected patients of different

age groups and gender. Methodology: This cross-sectional survey lasted three (03) months, from

September to December 2020. The work was authorised by the ethics committee of Abdul Wali

Khan University's Department of Biotechnology in Mardan. The research included a total of 177

suspected patients. All individuals referred by medical doctors after recognizing signs and

symptoms of thyroid dysfunction, regardless of age or gender, were recruited. A statistical

programme for social version (SPSS) 22 was utilized to analyze data. Results: overall 177

potential candidates got examined. An average age of the individuals that were enlisted were

33.8 17.3, including a minimum seven years as well as a maximum age of 80. Among total, 26%

male and 74% were female patients. Majority patients were found in age group 30-70 years.

Total thyroid dysfunction in females was 43.8% and 6.4% in male patients. Sub clinical

hypothyroidism in females were found very high (16.0%), followed by hypothyroidism and

hyperthyroidism (9.2%) and euthyroid sick syndrome (4.6%). In males only hypothyroidism

were observed in 6.4% patients. Conclusion: Thyroid dysfunction is common among patients,

especially among females and the elderly. Iodine-rich foods should be consumed. People's

awareness in Pakistan, particularly in KPK, is nil. People's health awareness should be raised,

and basic health care facilities should be made available.

EVALUATING THE USEFULNESS OF SELF-SCORING AFTER DISCUSSING ANSWERS WITH 3RD YEAR MBBS PHARMACOLOGY STUDENTS.

Kashif Rasheed Shaikh1 , M. Atif Ata2 , Umair Ali Soomro3 . — Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: Students may only utilise the idea of self-evaluate when they are able to choose the

standards that will be applied and make assessments about the extent to which their work satisfies those

standards. Methods: The present study was conducted at Suleman Roshan Medical College Tando Adam,

after the approval from institutional ethics review committee, from January 2022 to December 2022.

During the course of an entire year, Eleven separate tests, comprising 2 midterms, have already been

given. Following the final test, the pupils were provided with a Likert question asking them to contrast the

new assessment format with old one in terms of its academic potential & ability to assess their

competence. As well, the pupils were tasked with assessing the test's difficulty level, relevancy, &

duration. Results: A total of n=82 participants had submitted the responses on evaluating the usefulness

of self-scoring after discussing answers with 3rd year MBBS Pharmacology students. The responses were

obtained by likert Scale. Analysis of the findings had revealed that majority of the participants had either

strongly agree and agree with the questions regarding evaluating the usefulness of self-scoring after

discussion thus suggesting the fact 3rd year MBBS students were favouring the concept of self-scoring.

Results were analysed using P-value of ≤ 0.05(95% CI) as significant. Conclusion: It has always been

discovered that learners view this type of exam as a far more useful educational instrument than the

traditional one. The students are given real - time feedback, were made aware of one‘s wrong responses &

gaps in knowledge, & given the chance to think about them.

ASSESSMENT OF THE ACCEPTANCE AND EFFECTIVENESS OF PAL SESSION IN BIOCHEMISTRY 2ND YEAR MBBS STUDENTS.

M. Atif Ata1 , Kashif Rasheed Shaikh2 , Umair Ali Soomro3 — Fri, 31 Mar 2023 00:00:00 +0200

Abstract:

Introduction: In early 90’s in UK a system is generated for the student support was PAL and its variant

Objectives: To assess the effectiveness and acceptance of PAL session in Biochemistry 2nd year MBBS

students. Methods: The present study was conducted in Suleman Roshan Medical college tandoadam

from March 2022 to September 2022, was conducted in first year MBBS student for Biochemistry

subject. Students were divided into 10 groups and each group has to present PAL session, remaining

students were allowed to ask questions after completion of session and finally comments on session by

teachers as well as from students. After completion of academic year a LIKERT scale feedback was given

to students for giving answer on them. Result: There were 60 participants who were filled the feedback

form among 88 students, 83.33% participants were of the opinion that The PAL session was appropriately

placed in weekly time table, whereas the 66.67% had considered the topic discuss in the PAL session

were appropriately selected, results were considered significant when P value was <0.05. Conclusion:

PAL Sessions had good impact on students for enhances their knowledge and academic results.

FACE BOOK POSITIVE AND NEGETIVE IMPACTS ON MEDICAL STUDENTS.

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: Facebook use is on the rising amongst Pakistani medical graduates; however it's

questionable whether this has direct effect on their mental health or educational achievement.

The intent of this research is to look at the advantages and disadvantages of Facebook use among

Pakistani medical graduates. Location of Study, Sample Details, Size, and Duration: 385

medical students participated in the study at the KMC / Peoples University of Medical and

Health Sciences for Women (PUMHSW) in Nawabshah, Pakistan. The information was

collected for the study over the course of a full calendar year, from January 2022 to December

2022, using a cross-sectional methodology. A self-administered questionnaire that evaluated the

research participants' usage of Facebook, mental health, and academic performance was also

filled by them. Results: A number of 385 pupils from various classrooms were chosen, & 90%

of the questionnaires were accurately completed. The average age of the respondents, was ranged

in age from 18 to 22 years, was 19.5 years. All students were females. There were 15.85%

students from 1st year MBBS, 18.18, 16.88, 12.98 and 36.36% 2nd, 3rd, 4th and final year

respectively. majority of students 33.76% were using face book up to 01 hour, while others

25.98%, 18.18%, 15.58% and 6.49% for 02, 03, 04, and 05 hours respectively. In accordance

with the research, Pakistani med professionals' use of social media had both favourable and

unfavourable effects on their emotional well-being & educational success. Conclusion: The

study concludes that while Facebook can be a valuable tool for learning and networking, its

excessive use can lead to negative impacts on mental health and academic performance.

Awareness, guidance, and self-regulation can help medical students use Facebook effectively

and minimize its negative impacts. The study provides useful insights for medical students and

institutions to use Facebook in a balanced and controlled way to optimize its positive impacts

and minimize its negative impacts.

A MINI REVIEW: ADVANTAGES AND DISADVANTAGES OF SEMESTER SYSTEM AND ANNUAL SYSTEM

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

A modular system is a system that is made up of different independent modules or components

that can be combined or interchanged to create a variety of configurations. Every element is

created to carry out a certain task, and as necessary, these may be extended, withdrawn, or

altered to adapt the platform to a specific input. Modular systems are commonly used in fields

such as manufacturing, electronics, and construction. An annual system, on the other hand, is a

system that is based on a yearly cycle or period. This system is commonly used for financial

purposes, where transactions or calculations are recorded on an annual basis. Universities use

different educational systems to teach students, including the Semester System & the Annual

System. In the Annual System, students take tests consecutively throughout the academic year,

while in the Semester System, examinations are held five or six months after the start of the

academic year. There are several differences between the two systems, and this paper aims to

explore their advantages and disadvantages. This study aims to differentiate between the Annual

and Semester Systems, focusing on their objectives and intrinsic values. It aims to compare the

benefits of both systems, taking into account the perspectives of both students and teachers. The

purpose of this study is to help individuals identify which system is more effective and efficient

for their educational needs.

CHALLENGES FACED BY STUDENTS AND FACULTY DURING ONLINE CLASSES AND EXAMINATIONS – FINDING A WAY FORWARD

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: The traditional concept of classroom learning has been gradually replaced by

online teaching since the year 2020 when the world witnessed COVID-19 pandemic which

caused closing down of all teaching institutions across the globe, making more than one billion

children sit at home. Aim: To highlight the merits and demerits of online learning and

examination methods and to give recommendations for its improvement. Methodology: The

study population included 421 students and 220 faculty members of Fazaia Medical College

along with and other private schools and colleges of Rawalpindi and Islamabad. An online

survey was conducted using simple random sampling. Data was collected using separate online

Google forms for students and teachers. Results: 71.3% of students preferred on campus classes

and 23% of students did not take online classes seriously. During online exams, more than 50%

students had problems with internet connection and accessing the exam content. 46% of study

participants said that there were no institutional protocols and they felt stressed due to this. More

than 50% teachers preferred taking an online class from home and 25% of them thought that they

were not competent enough to take online classes. Conclusion: The main challenges for students

were lack of institutional protocols, non- availability of electronic gadgets, slow internet

connection during exams and poor accessibility to online exam content. For teachers; their lack

of proper training for conduction of online classes and examinations and non-serious attitude of

students were the main issues

PREVALENCE OF SCREEN EXPOSURE AND MUSCULOSKELETAL RELATED SYMPTOMS AMONG TEENAGERS.

Fri, 31 Mar 2023 00:00:00 +0200

Abstract

Introduction: This article discusses the association between high screen time and

musculoskeletal symptoms in adolescents. The prevalence of musculoskeletal symptoms among

adolescents is high, and the symptoms can cause physical discomfort and functional limitations,

affecting the overall quality of life. The aim of the study was to determine the prevalence of

screen exposure and musculoskeletal related symptoms among teenagers Methods: The cross

sectional survey based study was conducted in Hyderabad, Pakistan, with a sample of 200

participants aged between 13 to 19 years, engaged in screen-based activities for at least 2 hours

per day. Duration of study was 4month from Sept 2023 to January 2023. The musculoskeletal

symptoms were assessed using a standardized questionnaire, the Nordic Musculoskeletal

Questionnaire (NMQ). Data was analyzed through SPSS ver 23. Results: The study finds that

the majority of participants spend between 6 to 9 hours per day engaged in screen-based

activities. Specifically, 30.5% of participants spend 8 hours per day on electronic devices, while

28% spend 9 hours per day. The highest screen exposure reported is 9 hours per day, with 56

participants (28%) exceeding this threshold. The prevalence of musculoskeletal symptoms is

found to be high in the neck (42%), followed by the lower back (29%), and wrist (14.5%).

Conclusion: The study concludes that high screen time is associated with musculoskeletal

symptoms in adolescents, highlighting the importance of reducing screen time and promoting

physical activity.

COMPARISON OF RADIAL VS FEMORAL APPROACH IN ELDERLY PATIENTS UNDERGOING PERCUTENEOUS CORONARY INTERVENTION

Neelam Akhund1 Imad Uddin2 Javeria Akhund3 Itizaz Hakim4 — Fri, 31 Mar 2023 00:00:00 +0200

Introduction The radial access might have less complications than the femoral access.

Objective: In older individuals with changed vascular anatomy, it might potentially be more

challenging. In contrast to the femoral method, we evaluated the success rates, technical

details and complication rates of radial angiography in elderly patients. Material &

Methods: This study was conducted at the Cardiology Department Saidu Group of

Teaching hospitals between January 2019 and January 2020. In this study, we enrolled all

patients referred to our center for in-patient invasive angiography who were 65 years of age or

older and had a history of probable coronary artery disease or suspected progression of known

coronary disease. Two groups of patients were equally divided. Each group consists of 500

patients. The femoral artery was accessed by group 2 patients, while the radial artery was

accessed by group 1.Results: Major adverse cardiovascular events (MACE) observed in

group1 in 2(0.4%) cases, and in group 2 in 17(3.4%) cases, all of which were complications at

the arterial access site. Minor adverse events occurred in group2 was 29(5.8%) as opposed to

9(1.8%) in group 1.Overall duration was significantly longer in group 1 as compare to group 2

(31.1 min. vs. 23.5 min) Those in group 1 had a lower mean GRACE score (110±32 versus

128±41), improved renal function according to cretanine level (0.8±0.4 versus 1.0±0.8) and a

reduced prevalence of indications of left ventricular failure (9% versus 23%) when compared to

patients in group 2. Time of admission for the type of ACS heart rate (69±15 Vs 75±16), systolic

arterial pressure (141±30 Vs 150±32), positive troponin 59(79.7%) Vs 51(68.9%),

electrocardiographic ischemia 190(38%) Vs 179(35.8%). Conclusion: In elder patients over

the age of 65, radial coronary angiography have a greater technological success rate and

fewer complications than femoral approach.

TO ASSESS KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARDS HEPATITIS B VIRUS INFECTION IN PATIENTS COMING TO GASTROENTEROLOGY OPD AT RAWAL INSTITUTE OF HEALTH SCIENCES, ISLAMABAD

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Objective: The objective behind this study was to assess knowledge, attitude, and

practice towards hepatitis b virus infection in patients coming to gastroenterology OPD

at Rawal Institute of Health Sciences, Islamabad. Methods: This population & hospitalbased descriptive study was conducted through a convenience sampling technique from

st March, 2022 to 31st August, 2022 in the department of general medicine, Rawal

Institute of Health Sciences, Rawalpindi. The study implemented 24- close ended

questions consisted of three sections through which knowledge, attitude, and practice

were assessed regarding HBV infection. All baseline and clinical data were taken using a

structured questionnaire and then entered & analysed using SPSS v. 22. Results: A total

of 243 patients who responded to the questions were included in this study for final

analysis. Overall mean age and SD was 36.27±17.81 years. The age range between 18

years to 85 years and majority belongs to young age group, ≥18 – 40 years (40.74%, n

=99). Study participants had overall good knowledge (79.21%) while average practice

regarding HBV was (57.83%) regarding HBV infection. Conclusions: Most of our study

participants were males and belong to younger age group. Overall response rate of

knowledge regarding HBV infection was good and most of the participants will seek

medical attention if they get infected. Unluckily, only a small percentage of participants

(11.11%) participated in health education regarding HBV infection

PREVALENCE OF HEPATIS B AND C AMONG BETA THALASSEMIA MAJOR PATIENTS AT A TERTIARY CARE HOSPITAL

Fri, 31 Mar 2023 00:00:00 +0200

ABSTRACT

Introduction: The beta-thalassemia are among the most prevalent hereditary diseases, and they

influence the lives of millions of children all over the world. Because appropriate viral screening

of donated blood has never been carried out, the infection risk in -thalassemia individuals serve

as a signal for the hazard of transfusion-transmitted illnesses, specifically hepatitis B and C as

well as other viral infections. Objective: To determine the prevalence of hepatitis B and C

among beta-thalassemia major patients at a tertiary care Hospital.Material and methods: This

descriptive cross-sectional study was done at the pediatric department at SKBZ/AK, CMH

Hospital Muzaffarabad, during a period of six months from October 2019 to March 2020. All the

beta thalassemia major patients, aged up to 15 years, and both genders, were included. Following

informed consent, a 3-5 mL blood sample was collected from each case and immediately sent to

the hospital diagnostic laboratory to screen for HCV and HVB infections using the Elisa method.

All the informatiosn was collected via a study proforma, and SPSS version 26 was used for data

analysis.Results: A total of 87 patients with beta thalassemia major were studied; their mean age

was 10.0+3.68 years. Males were 55.8% and females were 44.8%. Out of all 35.6% patients were

infected by HCV, while only one patient found with HCV and HBV co-infection. As per the

stratification, HCV infection was significantly linked to age more than 10 years (p-0.001), while

statistically insignificant according to gender (p-0.344). Conclusion: As per the study

conclusion, HCV infection was observed to be highly prevalent among patients with betathalassemia major. It was positively related to the blood transfusions. Unfortunately, due to the

high incidence of these viruses in individuals with beta thalassemia, it would appear that the

precautions used in blood preparation and testing to prevent infections that are transferred by

blood transfusion are still insufficient.