Journal of Islamabad Medical & Dental College
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The Impact of Certificate-Based Simulation Training on Faculty Development: A Study on Self-Efficacy in Clinical Education
Full text linkObjective: To evaluate the effectiveness of a certificate course in simulation-based clinical education on faculty self-efficacy in key teaching domains.Methodology: In this study, 50 faculty members (60% physicians, 30% nurses, 10% allied health professionals) participated in a structured one-week certificate course in March 2023. Self-efficacy in three domains including scenario design, facilitation, and debriefing was assessed using a 5-point Likert scale, both before and after the course. Paired t-tests was used to analyze pre- and post-training changes keeping 95% confidence intervalResults: Participants showed statistically significant (p < 0.001) improvements in self-efficacy across all domains—Scenario Design, Facilitation, and Debriefing—with mean increases ranging from 1.05 to 1.10 points on a 5-point scale. Debriefing showed the highest gain, supporting the course’s effectiveness in enhancing simulation teaching confidence.Conclusions: The certificate course significantly enhanced faculty self-efficacy in simulation-based teaching tasks. These findings support the inclusion of structured simulation curricula in faculty development programs to strengthen clinical teaching competencies in medical education.Keywords: Debriefing, Faculty development, Scenario design, Self-efficacy, Simulation-based education
Clinical Outcomes of Male Gynecomastia Surgery: A cohort Study Conducted at Med City Hospital, Islamabad
Full text linkObjective: To assess both the physical and psychological outcomes of gynecomastia surgery in a Pakistani cohort.Methodology: The study was conducted at Med City Hospital, Islamabad in a 2-year period from January 2021 to December 2023. This study comprised of 150 male patients who underwent gynecomastia surgery. The sample size was estimated based on an anticipated proportion of 89.0% with satisfaction after gynecomastia surgery, a confidence level of 95% and an alpha of 5%. All the male patients were referred to the radiologist to rule out any malignancy. All the 150 patients didn’t have any abnormal findings on sonographic or Mammography study. Demographic information, type of surgery, type of anaesthesia given, post operative complication, and satisfaction were noted. Outcomes were assessed by comparison after short-term (1-3 months) and long-term follow-up (6-12 months) periods. Statistical analysis included descriptive statistics as frequency, mean and standard deviation. For comparisons, chi-square tests, and t-tests were applied. .Results: The mean age of patients was 30.5 ± 5.8 ranging from 20-40 years. Most frequent operation was liposuction 85 (56.7%), followed by gland excision and combined operation applied in 40 (26.6%) and 25 (16.7%) cases, respectively. At first follow-up the mean satisfaction score was 8.7 ± 1.1, which improved to 9.2 ± 0.8 on second, the long-term follow-up (p-value, 0.001). Pain/discomfort scores were low (2.3 ± 1.5 on a 10-point visual analogue scale), and 90.6% reported psychological gain after surgery. Complications were low, with 15 (10.0%) experiencing minor complications like hematoma and seroma.Conclusions: Gynecomastia surgery is very effective in improving both physical and psychological well-being with minimal complications. Careful patient assessment and customized surgical planning are essential to optimizing results.Key words: Emotional distress, Gynaecomastia, Psychological satisfaction, Self-esteem, Social anxiety
Clinico-Anatomical Variations of Hepatobiliary Vasculature and Gallbladder Encountered during Laparoscopic Cholecystectomy
Full text linkObjective: To identify and document the clinico-anatomical variations of hepatobiliary vascular structures and gallbladder observed during laparoscopic cholecystectomy.Methodology: This descriptive cross-sectional study was conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan, from January 2024 to June 2025. A total of 350 patients who underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis were included. Intraoperative findings were carefully recorded to identify variations in the cystic artery, cystic duct, hepatic arteries, and gallbladder morphology.Results: Out of the 350 patients who underwent laparoscopic cholecystectomy, 221 (63.1%) were female and 129 (36.9%) were male, with a mean age of 42.6±11.3 years. Clinico-anatomical variations were observed in 112 patients (32%). Cystic artery variations were noted in 84 patients (24%). The most common variation was a short cystic artery arising from the right hepatic artery (n=47; 13.4%), followed by a double cystic artery (n=21; 6%). In 16 cases (4.6%), the cystic artery originated from the aberrant right hepatic artery. Cystic duct anomalies were observed in 28 patients (8%), including low insertion (n=12; 3.4%), medial insertion (n=9; 2.6%), and short cystic duct (n=7; 2%). Anomalies in gallbladder position or shape were observed in 18 patients (5.1%). These included intrahepatic gallbladder (n=7), Phrygian cap deformity (n=6), and left-sided gallbladder (n=5).Conclusion: Clinico-anatomical variations in hepatobiliary vasculature and gallbladder are frequently encountered during laparoscopic cholecystectomy. A thorough understanding of these variants is crucial for minimizing surgical risks and improving patient outcomes.Keywords: Anatomic Variation, Bile Ducts, Cholecystectomy, Extrahepatic, Gallbladder, Hepatic Artery, Laparoscopic, Vascular System Abnormalities
Assessment Of Denture Hygiene Knowledge and Practices Among Complete Denture Wearers Reporting to a Tertiary Care Dental Hospital
Full text linkObjective: To assess the denture hygiene knowledge and practices among complete denture wearers.Methods: The study was conducted in Prosthodontics department, Foundation University College of Dentistry from August 2024 to January 2025. A total of 160 complete denture wearers were selected fulfilling the criteria using non-probability consecutive sampling technique. A self-administered questionnaire comprising of questions related to demographics, denture characteristics, and denture hygiene habits was distributed among complete denture wearers. Each question was scored and categorized to calculate the overall denture hygiene knowledge score of each patient. Data was entered and analysed in SPSS 21.Results: A total of 160 patients were selected with a mean age of 64.68 ± 5.6 years. Out of these, 79 (49.38%) were males and 81 (50.63%) were females. The score obtained by the study participants ranged from 9 to 27 with the mean denture hygiene knowledge and practices score of 17.08 ± 5.5. A significant association was found between level of education, denture duration and socioeconomic status with that of hygiene score (p value <0.001).Conclusion: A large proportion of denture wearers were found to have poor hygiene practices and little knowledge regarding proper denture cleansing. A strong association among low socioeconomic status, rural setting, and deficient denture oral hygiene reinforces systematic obstacles to denture care like limited dental provision and financial insecurity.Keywords: Complete Denture, Denture Hygiene, Edentulous, Knowledge, Practice
Outcome of Operative vs. Non-Operative Management of Weber B Ankle Fractures
Full text linkObjectives; Ankle fractures are very common injury presented to trauma surgeons all over the world. Various treatments options are available and several classification exist to aid in the decision making process. We aim to to look at the outcome of Weber B fracture treatment and how various trauma surgeons have been treating them and final outcome with various treatment protocols.
Methods; Data was collected from medical records after approval of Ethical committee. All ankle fracture presented at two hospitals in Lahore during 2020 to 2023 were evaluated for treatment offered and final outcome was recorded from clinical review and x-rays performed at final visit.
Results; We looked at a total number of 90 Weber B ankle fractures treated at our two institutions during the three years’ time period and conservative vs. operative treatment was offered to the patients as per on call trauma team’s preferred method of treatment. Out of 90 patients, 47 (52%) patients were treated non-operative and 43(48%) patients were operated. 5 patients from non-operative group needed to be operated within first two weeks. All patients went on to achieve full union at the end of one year follow-up.
Conclusion; Our study showed that for non-displaced Weber B ankle fracture, conservative treatment is a suitable alternative to operative management. Risk of treatment failure is very low and patient satisfaction is comparable to operative group
Effect of Early Mobilization and Bed Positioning on Mobility among Patients with Traumatic Brain Injury
Full text linkBackground: Traumatic brain injury is defined as the disturbance in the function of the brain , or indication of pathology of brain, by the application of an exterior bodily force. Early mobilization exercises are explained as physiotherapy exercises of altering degree that are clinically safe and accurate developmentally started within 2 to 3 days of admission in neurological ICU. This early mobilization exercises helps in improving TBI patients recovery.
Objective: The purpose of this study is to validate and evaluate the effect of early mobilization and bed positioning on mobility among patients with traumatic brain injury.
Methods: This quasi-experimental study included 28 TBI patients. This study was conducted at general hospital, Lahore, and Jinnah hospital Lahore. Early mobilization and bed positioning therapies protocol were performed for 6 weeks. There were three sessions per week. Each session was 30 minutes. Mobilization scale and Norton scale were used as evaluation parameters before and after 6 weeks.
Results: The data’s regularity was assessed by the Shapiro-Wilks test. Following statistical analysis, the regimen for early mobilization and bed positioning therapy’s efficacy for all examined variables was confirmed. The scores on early mobilization and Norton scales differ significantly.
Conclusion: The results suggested that early mobilization and bed positioning therapies has improved mobility in TBI patients. This therapy protocol has also improved the TBI patients’ quality of life.
Keywords: Bed positioning, Mobility and Traumatic brain injury
Psychological Impact of the COVID-19 Pandemic on the Pakistani Population and Health Care Providers
Full text linkThe psychological crisis during COVID-19 was complex and badly affected the general population and healthcare providers in Pakistan. Due to illiteracy and a lack of trust in public health care providers, people were heavily influenced by quaks, clerics and conspiracy theories. Unemployment led to financial constraints and the chances of domestic violence in lower socioeconomic classes. The people's general attitude towards coronatine and related preventive measures also faced backlash, as people frequently violated the suggested isolation or even did not bother to attack law enforcement agencies. Similarly, obtaining psychological services did not get enough attention as people were more convinced of easy remedies from different sources (quakes, clerics and self-proclaimed scholars) who claimed to have a miracle treatment for COVID-19 infection. The psychologically challenging situation was even dreadful for healthcare providers who were providing services upfront. The health professionals endured crises at personal and professional levels as firstly they faced the moral dilemma of not being able to save the lives of critical patients—secondly, the potential to be carriers of infection for their relatives and close ones. Thirdly, facing unseen fear for their safety and multiple deaths of health professionals reported in media and other sources. These above crises were further ignited by patients' neglected behaviours because patients used to be involved in neglected behaviours that often put their personal and health care provider health safety at risk. Consequently, a large number of health care providers restricted their services and many of them opted to quit their jobs.