Journal of Rawalpindi Medical College
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Frequency of DÉJÀ VU Experience and Its Relationship with Stress in Students of The Medical University of Islamabad
Full text linkObjective: This research aims to evaluate the frequency of déjà vu experience in medical students and its relationship with stress along with different prognostic factors that lead to déjà vu experience.
Methods: A descriptive cross-sectional study was conducted at Foundation University Islamabad over 4 months from May 2023 to August 2023. The sample size (239) was calculated using open Epi software with a previous prevalence of 67%. Stratified random sampling was used to select students. Data was collected through a questionnaire containing demographic variables from a validated déjà vu inventory and stress tool. Analysis was done on a validated déjà vu inventory and perceived stress scale 10. SPSS 26 was used to assess the relationship between stress and the frequency of déjà vu using the chi-square test, with statistical significance at p<0.05.
Results: 89.2% of the participants reported that they had experienced this sensation at least once in their life. The most popular ways this feeling happened were in a certain place or a certain situation. The association between stress and Déjà vu experiences was found to be significant(p-value 0.012)
Conclusion: 89.2% of the participants reported that they had experienced Déjà vu sensation at least once. There was a significant association between stress among medical university students and Déjà vu experience.
Keywords: Déjà vu, Stress, Familiarity, Sensation, Epilepsy, Dopamine
Comparative Analysis of Barriers and Challenges in Adoption of Electronic Health Record System in Government and Private Hospitals of Islamabad: Analysis of Barriers and challenges in Adoption of Electronic Health Record System
Full text linkObjective: The purpose of this study was to identify the barriers and challenges in adoption of the EHR system in hospitals of Islamabad and to compare the barriers and challenges faced in adopting and running of electronic health record system in government and private hospitals of Islamabad.
Materials and Methods: This multicentric cross-sectional study was carried out among 160 health providers of four government and four private hospitals in Islamabad from June 2022 to November 2022. A structured questionnaire was distributed to the management, health professionals and the staff using EHR system by simple random sampling. Data were analyzed using SPSS version 26. Independent sample t test was applied for comparative analysis of challenges and barriers in government and private hospitals.
Results: The response rate for the electronic health record system survey was 160 (76%). Of those responding, 85.75% and 72% reported use of EHR system regarding patient care from government and private hospitals respectively. Around 42.5% and 83.75% government and private hospitals have fully functional EHR system and 72% from government and 90% responses from private reported use of computers as a major mode of patients’ data entry. Significant difference was found between government and private hospitals regarding social and legal barrier and lack of knowledge of EHR system (p value <0.05). Implementation of single module and multi module was a big challenge for government and private hospital respectively (p value <0.05).
Conclusion: Government and private hospitals equally face the challenges and barriers tin implementation of EHR system with some barriers and challenges more prevalent in private hospitals and some in government hospitals
Frequency Of Functional Outcome In Management Of Post Burn Neck Contractures
Full text linkObjective: To determine the frequency of functional outcomes in managing post-burn neck contractures. Descriptive study. At the department of plastic surgery.
Methods: A total of 150 cases presenting from Liaquat University of Medical and Health Sciences with any degree of post-burn neck contracture admitted to the plastic surgery unit and fulfilling the inclusion criteria, were included in the study. A detailed clinical and radiological examination was carried out. Before the interventional procedure was instituted, the cause of burn injury and functional grade of neck contracture was documented. A follow-up of 6 months was done to evaluate the range of neck motion and postoperative improvement in neck extension to document patient satisfaction. All data was recorded on a predesigned proforma.
Results: The average age of the patient was 29.67±7.67 years. Out of 150, 96 (64%) patients showed satisfactory outcomes, 52 (34.67%) had good outcomes and 2 (1.33%) patients were poor outcomes.
Conclusion: After oral intubation and SSG resurfacing of the raw region, it can be stated that contracture release under tumescent anaesthesia is a successful treatment for individuals with post-burn contractures of the neck
Perception of Gender Issues among Surgical Residents and their Supervisors
Full text linkObjective: To discover attitudes and perceptions about gender related issues in surgical residents and supervisors in major teaching hospitals of twin cities.
Methods: This study was conducted in Rawalpindi and Islamabad during July and August 2020. Responses of 22 surgical training supervisors from five institutions and 49 surgery residents from three training institutions were collected via separate questionnaires. These were based on 5-point Likert scale. Responses were tabulated and analyzed on SPSS version 23.
Results: Among the 49 residents, 53.1% (n=26) were men and 46.9% (n=23) were women. Of these, only 19% (n=10) felt any gender discrimination at workplace. This perception was comparatively more in men (P=0.006). More males felt comfortable working at odd hours then women (P=0.005). Childcare service was not a requisite for 77% of residents. Those who required it were mostly women (P=0.050).
64% (n=14) of the supervisors were men. Only 36% (n=8) considered gender to be unimportant during selection of residents. There was a slight tilt towards preferring male residents during selection. More than half of all supervisors considered men to be more confident, better leaders and decision makers in the emergency setting.
Conclusion: Gender is not felt as a discriminatory factor by residents during training. Female residents suffer during training due to family obligations, pregnancy and parenthood. These challenges may be facilitated by changing surgical culture; However, supervisors disagree. Supervisors rate men higher on confidence, decision making and availability and tend to incline towards male residents while selecting. During training, supervisors do not discriminate amongst residents in imparting training and assigning tasks.
KEYWORDS: Surgery; Surgeons; Career choice; Education; Gender bias
Association of ABO Blood group phenotypes with FEV1/FVC values among students of Aziz Fatima Medical and Dental College
Full text linkObjective: To find the frequency of obstructive and restrictive lung disease in various blood groups in young students of Aziz Fatimah Medical and dental college.
Methods: This cross-sectional analytical study was conducted at Aziz Fatima Medical and Dental College, Faisalabad from 1st January to 31st March 2022. It included 80 participants of first-year MBBS comprising both genders between 18 to 22 years. Ethical approval was taken from the institutional ethical committee of the institute. After fulfilling inclusion and exclusion criteria blood grouping was done by conventional slide method and Spirometry was performed to access lung function parameters to determine obstructive and restrictive lung diseases. Data was analyzed by using SPSS version 26.
Results: The study population included 36 males (45%) and 44 females (55%). Mean±SD age of participants was 20 ± 1.07 years. The most frequent blood group was B followed by O, A and AB. Restrictive lung disease ( FEV1/FVC ratio ≥ 0.8) was found in 19(23.8%) participants while obstructive lung disease ( FEV1/FVC ratio <0.8) was found in 46(57.5%) participants. Obstructive lung diseases were more frequently found in subjects with blood group AB while restrictive lung diseases were more commonly noticed in subjects with blood group O. Mean±SD of FEV1/FVC% of subjects with obstructive and restrictive lung diseases were 45.15± 19.04 and 81.79±8.25 respectively.
Conclusion: Blood group AB is more prone to have Obstructive lung disease with decreased FEV1/FVC ratio. Restrictive lung disease was more commonly seen in blood group O.
To Compare Serum Procalcitonin And CRP As Markers Of Neonatal Sepsis
Full text linkObjective: This study compares serum Procalcitonin (PCT) levels with CRP as predictive markers for neonatal sepsis.
Method: It was a Quasi-experimental study performed in the neonatal intensive care unit (NICU) of Holy Family Hospital, Rawalpindi, for six months from July 2021 to January 2022 after the approval of the ethical board. The study included neonates admitted to the neonatal intensive care unit of Holy Family Hospital with a diagnosis of neonatal sepsis. Parents are permitted via written informed consent. A predesigned proforma was used to record clinical examinations, histories, and outcomes, which included hospital stay duration, complications, neonatal discharge, or mortality.
Results: Seventy neonates meeting the study's inclusion criteria were enrolled. The average age in the study was 6.44 ± 5.24 days, with 40 (57.1%) males and 30 (42.9%) females. The CRP test demonstrated a sensitivity of 85.42%, specificity of 81.82%, positive predictive value (PPV) of 91.11%, negative predictive value (NPV) of 72.00%, and diagnostic accuracy of 84.29% in predicting neonatal sepsis. The PCT test displayed sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 87.76%, 90.48%, 95.56%, 76.00%, and 88.57%, respectively.
Conclusion: This study underscores Procalcitonin as a superior and early predictor compared to CRP in forecasting neonatal sepsis. Procalcitonin emerges as a particular marker for bacterial infections when contrasted with other inflammation indicators such as CRP, white blood cells, or lactate. Notably, Procalcitonin levels remain unaffected in viral or atypical bacterial infections.
Keywords: Serum, Predictor, Neonatal, Sepsis
Functional Outcome Of Percutaneous K-Wires System In Elder Patients With Proximal Humeral Fractures
Full text linkObjective: To evaluate the functional outcome of the percutaneous K-wires system in elder patients with proximal humeral fractures.
Method: This one-year observational prospective study was conducted on 68 patients aged 50 to 70 years with proximal humeral fractures, treated at the Orthopaedic Department of Benazir Bhutto Hospital, Rawalpindi. Participants with NEER two-, three-, or four-part fractures, capable of participating in follow-up assessments, were included. Percutaneous K-wire fixation was performed, and standardized postoperative care was administered. Chi-Square test and Pearson’s Coefficient Correlation were used for the assessment of association.
Results: The mean age of the patients was 59.65 ± 6.47 years. Gender distribution revealed 29 (42.6%) male and 39 (57.4%) female patients. Assessing functional outcomes, 20.60% of patients exhibited an excellent outcome, 64.70% showed a good outcome, 11.80% displayed a fair outcome, and 2.90% experienced a poor outcome.
Conclusion: The use of K-wire fixation for humerus fractures produces exceedingly favourable outcomes in the post-operative context in elderly patients
The Frequency Of Hematological Abnormalities in Children (Age 1 Month To 12 Years) Presenting With Sars-Cov-2 Infection At Shifa International Hospital
Full text linkObjective: To determine the frequency of haematological abnormalities in pediatric patients presenting with COVID-19 infection.
Methods: A Cross-Sectional analytical study was conducted at the paediatric department of Shifa International Hospital Islamabad, over a period of six months from December 2021 to June 2022. A total of 325 pediatric patients of 1 month to 12 years of age who presented with symptoms of COVID-19 having positive reverse transcription polymerase chain reaction results were included in this study. Effect modifiers such as age and gender were controlled through stratification. Post-stratification Chi-square test was applied to determine the association of these effect modifiers with haematological abnormalities. A p-value equal to or less than 0.05 was considered significant. Data analysis was done using SPSS version 24.0.
Results: The mean age of patients included in this study was 5.62±2.70 years. The majority were males with a male to female were 187(57.54%) and 138 (42.46%) respectively. Low WBC count was found in 58 (17.8%), leukocytosis in 20 (6.2%), thrombocytopenia in 43(13.2%), thrombocytosis in 06(1.8%), neutropenia in 69 (21.2%), lymphopenia in 17 (5.2%), lymphocytosis in 59 (18.2%), monocytopenia in 10 (3.1%), deranged fibrinogen levels in 07 (2.2%), deranged D-Dimers in 154 (47.4%) and deranged INR in 166 (51.1%) patients.
Conclusion: Hematological abnormalities are common in children presenting with COVID-19 infection. Deranged INR, D-Dimers, low WBC count, thrombocytopenia and neutropenia were commonly found in haematological abnormalities in children with COVID-19 infection.
Keywords: COVID-19, Hematological abnormalities, Neutropenia, SARS-COV-2 infection
Evaluating the Safety Profile of Propofol Sedation in Patients Undergoing Endoscopic Variceal Band Ligation: A Comprehensive Analysis
Full text linkObjective: To find out the incidence of complications of Endoscopic Variceal Band Ligation, when done under Propofol sedation.
Methods: This was a retrospective observational study, which was conducted in the Gastroenterology department, PAF Hospital. From 1st Feb 2019 to 30th June 2023. Patients who underwent Endoscopic Variceal Band Ligation were included in the study. Anesthesia was provided using Propofol and Midazolam. Endoscopic variceal band ligation was carried out by a consultant gastroenterologist. Incidence of complications during the procedure and within 48 hours was noted.
Results: Out of 385 patients included in the study, re-bleeding was reported in 8 patients (2.1%), bacteremia in 8 patients (2.1%), hypotension in 77 patients (20%), and hypoxia in 56 patients (14.5%). The rest of the complications such as perforation, Mallory-Weis tear, cardiac arrhythmias, and myocardial infarction were not observed in any patient.
Conclusion: Propofol is a safe drug for deep sedation during Endoscopic Variceal Band Ligation associated with reduced complication risk
Evaluating The Effectiveness Of Near-Peer Teaching Modality In Undergraduate Dental Students Learning A Psychomotor Skill (Partial Denture Fabrication) Considering Social And Cognitive Congruence Factors
Full text linkObjective: To analyze the effectiveness of Near Peer Teaching (NPT) modality in the psychomotor skills development of dental students in fabricating removable partial dentures considering cognitive and social congruence factors
Methods: This sequential two-phase experimental study was carried out from September 2022- December 2022 at Watim Dental College Rawalpindi. 50 Students of second-year BDS and recently graduated dental interns who were doing House jobs participated in the study. 50 students were divided into 2 groups A and B respectively. Quantitative data was collected against a 5-point performance appraisal rating scale and feedback from students was taken using a course experience questionnaire. The quantitative data was analyzed using SPSS-23. Descriptive statistics and the Whitney U test were applied to make a comparison between tutoring techniques. P-value ≤ 0.05 was considered significant. The qualitative data gathered through three Focus Group Discussions (two tutee groups and one peer tutor group) was analyzed through thematic analysis.
Results: All the participants (50) of the survey were in the age group 20-24 years and female students outnumbered the males (7:1). The Mann-Whitney U test applied to make a comparison between experienced and near-peer tutoring modality showed greater student satisfaction with near-peer teaching. Focus group discussion also revealed various themes such as the benefits of experience as NPT, skills achieved and enhanced motivation thus supporting the “Involvement of NPT in dental education”.
Conclusion: It can be concluded that the near-peer teaching technique is advantageous and feasible for both tutees and tutors because of social and cognitive factors. Near-peer tutors have more cognitive congruence and are more socially active in helping their peers. Near peer tutors endorse this technique as it allows them to enhance their knowledge and improve their communication and professional skills