Journal of Gandhara Medical and Dental Science
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Repercussion of Academic Stress on Vital Parameters among Medical Students of Ayub Medical College Abbottabad
Get PDFOBJECTIVES:
An increased stress is a common cause of mental fatigue and physical consumption among medical students. Therefore, the purpose of this study was to assess the effect of stress on vital parameters during students’ examination and to highlight the importance of personal well being among medical students.
METHODOLOGY:
The major aim of this study was to assess the effect of academic stress on vital parameters in medical students. This study was carried out in Ayub Medical College, Abbottabad in September to October 2018. The subjects selected for the study were final year MBBS students. Data was collected before and during the examinations. After taking their due consent, physical parameters such as blood pressure (both systolic and diastolic), heart rate were measured and psychological parameters like perceived stress and total mood disturbance were evaluated. Data was analyzed by using SPSS-22.
RESULTS:
Parameters like blood pressure (both systolic and diastolic) and total mood disturbance score with a p-value of <.01 showed significant difference during examination. However other variables like age, height, weight, BMI, heart rate, and perceived stress score showed no significant difference.
CONCLUSION:
The study concludes that students during examinations were under pressure which resulted in anxiety and stress. Total Mood Disturbance is considered a more reliable and prominent factor in interpretation of a student's stressed and disturbed state. It is more closely related to the stress state of students than any other.
 
Pain Abdomen as a Presentation of Congenital Malrotation of Gut: A Case Series
Get PDFMalrotation of the gut can present at any age but the majority of patients present in neonatal period or early infancy. Most children present with a history of recurrent colicky abdominal pain, vomiting which can be bilious and failure to thrive. Delay in diagnosis leads to increase in mortality and morbidity. Here we present a series of three patients, one girl aged 6 years, one 10 months old boy and one 10 years old boy, who got admitted at our Pediatric Department in a one month period. Patients had a history of recurrent abdominal pain and occasional vomiting, seen and managed by multiple paediatricians and GP doctors with extensive diagnostic workup but never the accurate diagnosis was made. Thorough history was taken and examination done, planned work up done for diagnosis. High index of suspicion is needed in children presenting with recurrent pain in the abdomen. Targeted work-up should be done and patients be kept on follow-up for diagnosis of late presentation of congenital malrotation of the gut
Frequency of Hyperlipidemia in the Diagnosed Type 2 Diabetic Patients
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The primary event in the development of type-2 diabetes is directly associated with lipid metabolism derangement occurring due to insulin resistance. The aim of this study was to find out the prevalence of hyperlipidemia in the newly diagnosed type-2 DM.
METHODOLOGY:
This hospital based descriptive study was conducted in the year 2018 to 2019, on 100 newly diagnosed type-2 diabetic patients attending medical O.P.D or admitted in medial wards of Naseer Ullah Khan Babar Memorial Hospital Kohat Road Peshawar.
RESULTS:
The incidence of hyperlipidemia in newly diagnosed diabetic patients was 29%. About 71% patients were having normal lipid profile. Our study also revealed that the frequency of hyperlipidemia increases with age. Half of the patients having age more than 60 years developed hyperlipidemia. Among hyperlipidemic patients, hypercholesterolemia was present in 36% and hypertriglyceridemia in 64% patients
CONCLUSION:
The study suggests that hyperlipidemia is very common in newly diagnosed type-2 diabetic patients in this part of the world.
 
Aggression, Body Esteem and Self-Esteem among College Students: Exploring the Influence of Gender
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Finding out the role of gender in aggression, self-esteem, and body esteem was the purpose of this study.
METHODOLOGY:
A cross-sectional research design was used. Different universities in Peshawar were visited, and 300 students were selected as a sample (N=300), which consisted of both boys (N=150) and girls (N=150) from the age-group 17-22 years. Purposive sampling technique was used to collect the data, and the measuring tools used were Rosenberg Self-Esteem, Buss Perry Aggression Questionnaire, and Body-Esteem Questionnaire.
RESULTS:
Although the research didn’t prove any difference in gender roles regarding self-esteem, it was revealed that boys are more aggressive as compared to girls. Furthermore, a correlation between self-esteem, body-esteem, and aggression was reported.
CONCLUSION:
The study gave the conclusion that gender has a role in levels of aggression found in students; however, both boys and girls are equally affected regarding self-esteem and body-esteem.
 
Spinal Cord Injuries Among Genders; Psychological Well- Being
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The aim of this study was to analyse the psychological wellbeing among gender suffering from spinal cord injury (SCI).
METHODOLOGY:
This was a comparative study. It was conducted from January-March 2020 in Hayatabad Medical Complex (HMC), Peshawar. This study compares the psychological well being in terms of their stress, anxiety, and depression. A questionnaire DASS-42 was used to collect the data from both genders. The inclusion criteria comprise of patients who came for the treatment of their spinal cord injury to the orthopaedic department. Those patients having severe physical and comorbid psychiatric illness were excluded. The data was collected and analysed on SPSS 26.
RESULTS:
The total sample of 127 in which male were 83 and female were 44. The results were significant according to stress, anxiety, and depression. The level of stress was more in male patients,whereas anxiety results were insignificant among gender and depression were high in females respectively.
CONCLUSION:
Our results revealed, SCI patients have a high risk of anxiety or depression in among male and female. This information could help physicians understand the long-term risk of new-onset anxiety or depression in SCI patients .
 
POST-COVID-19HEALTHCARE:TRANSITIONTOANEW NORMAL
No full textThe COVID-19 pandemic has challenged the health care system to face extraordinary circumstances. These challenges bring forth a new era with a certain high point like the transition to the fusion of in person and digital health practice framework. Post COVID-19 there is a lot of sludge in health care, inthe form of administrative processes and requirements that slow down the core activities of providing care. COVID-19 crisis is used as an opportunity to reduce administrative burdens which most of the times made a primary care physician feel demoralized and burned out'. The focus of healthcare has shifted from hospitals to homes using telemedicine technologies which enabled virtual visits and remote care delivery. COVID-19 signified the telemedicine to be an essential component of healthcare delivery. It proved to an effective and safe way of treatment and avoiding nosocomial infections’. Previously, telemedicine was not considered to be a normal consultation method, nowadays it’s part of the normal lives of the patients as well as health care providers. The other big advantage of this great tool is that one can consult doctors even from very remote areas, which is impossible to consult physically. Different technological advancement like Artificial Intelligence-based diagnostics, cloud-based storage of medical records and integration of information in and outside hospitals were explored and adopted in the COVID-19 pandemic. Data is the key to advance research and refine health care process and outcomes for the COVID-19 patients. The digitalization of the health care system can provide significant benefit’. The phenomenon of digitalization of healthcare system is especially benefited for the developing world, because, in the resource-limited environment, a lot of cost and resources can be saved by opting paperless systems. When people were locked down, social media was pivotal in creating awareness and educating people in a short period*. There was a lot of stuff regarding COVID-19 pandemic on social media and most interestingly it was portrayedin a way that one could not be able to neglect the content. Consequently, intentionally or unintentionally many of the users opted some of the measures for prevention of the deadlyinfection. The pandemic has shown us that countries with the more robust public health system, primary care services and a healthier population perform well in the fight against the pandemic. Safeguard of voluntary and community organization is essential’. At the same time the countries with fewer resources and with limited measures for controlling massive disasters, in the form of this pandemic, got exposed. This is an alarming situation for global organizations like the World Health Organization and other health-related global leaders to work together for making sure that health resources be equally provided to all the countries across the globe. The COVID-19 pandemic educated the underdeveloped countries regarding infection control measures like Biosafety and Biosecurity. Health official shifted their resources in maintaining hygienic measures to patients, doctors and support staff. Overall, this led to great impact in revolutionizing patient care and improving quality standards. The deficiency of trained staff in Intensive Care Unit and Accident & Emergency is also highlighted in this pandemic. Hence the focus should be on enabling the existing resources to acquire skill in these specialties. The people started making the right food choice, adapting to healthy physical exercise and ensuring therapies to relieve stress and anxiety’. The pandemic brings changes to the healthcare system, whichis not entirely new, these were introduced by technologists earlier; the system is going back to normal that is stronger, smarter and healthier. Hospitals should ensure that their infrastructure is sufficiently ready to cope with the advent of digitalization
Is Artificial Intelligence Transforming Dentistry Today?
Get PDFSince the birth of science, the most fascinating structure of the human body is the human brain. Over the past centuries’ researchers have been developing the latest technologies to imitate and explore how the human brain functions. However, to develop a machine that thinks like a human brain is still a dream for researchers. Aristotle’s early efforts to devise logical thinking via his syllogisms (a three-part deductive reasoning) were a source of inspiration for modern computers and technologies1. In the1950, Alan Turing designed a machine to decode encrypted messages, which was a breakthrough of super computers in the days of yore. He designed the “Turing Test” which was coined to assess whether a computer could exhibit intelligence better known as “artificial intelligence” (AI) today2. AI is “a field of science and engineering concerned with the computational understanding of what is commonly called intelligent behavior, and with the creation of artifacts that exhibit such behaviour”3.
Since 1980, AI has come a long way, virtual reality is being used in dental education these days to create real life situations and promote clinical work on simulators to eliminate risk factors associated with training on live patients. Recently artificial intelligence has been integrated with tutoring systems like “Unified Medical Language System” (UMLS), which have resulted in a better quality of feedback, which the preclinical virtual patients provide to the students4,5. This interactive phase helps students to evaluate their clinical skills and compare their skills with the standard ones, thus creating an ideal and high-quality training environment. Studies have been carried out regarding the efficacy of AI systems, which have stipulated that preclinical students build higher competencies than with the use of traditional simulator units6-8.
Currently AI inbuilt virtual dental assistants are present in the market. They can execute various chair side tasks with greater accuracy and less manpower ensuring minimum error during the procedures. In the world of implantology and maxillofacial surgery AI helps plan and prepare surgeries with smallest details forgoing actual surgery. Some exceptional uses of AI include robotic surgeries in the field of maxillofacial surgery and bioprinting (where tissues and organs can be reconstructed in thin layers)9. The field of AI has flourished to great extent in the past decade; AI systems are an aid to the field of dentistry and dental education.
This narrative attempts to explain possible AI-based applications in the future, it can be used for dental diagnosis, planning out treatments, conducting image analysis, and record keeping. AI-based technologies streamline and reduce laborious workforce to routine tasks, it ensures dental procedures are possible at a lower cost and ultimately makes predictive, preventive, and participatory dentistry possible. The use of AI in dental procedures needs to be guaranteed; its application with human oversight and evidence-based dentistry shall be expected. Dental education needs to be introduced to clinical AI solutions by promoting digital literacy in the future dental liveware
CHALLENGES OF LEARNING DURING THE COVID-19 PANDEMIC
Get PDFAccording to United Nations Educational, Scientific and Cultural Organization (UNESCO)1, 850 million children and young adults are out of education or training because of the COVID-19 pandemic. In many countries, this has resulted in a shift from traditional in-person learning to online learning. However, online learning is not new in developed countries. Many universities had ventured since long into online education with some courses offered as a supplement to in-person teaching. Pakistan is one of the countries lacking both accessibility and infrastructure for this major transition2. Hence there is a need to examine the current challenges and the impact on our students.
There will be certainly an increase in educational inequalities and the setback will last for a long-time affecting employment and income especially for those coming from underdeveloped areas. As regards medical students, this pandemic presents the greatest practical and logistical challenge3. It has disrupted medical education, requiring intense and prompt attention from medical educators. These challenges have affected patient care due to focusing attention on COVID-19 patients, which has severely limited the availability of bedside teaching opportunities for medical students4. Resultantly they are unable to complete clerkships and lack direct patient care experience. To make online education more inclusive, institutions need to ensure that learners benefit from technologies and have access to the Internet. Smartphone use has increased manifold in our country, and it can be easily used for online learning, which is a good replacement for laptops. Surveys focusing on accessibility to the Internet, laptops/tablets/smartphones can provide a platform, involving stakeholders who can help students who have limited or no access5. The college IT department should be involved which should help students with issues that come up during e-learning. Although e-learning is not an alternative to hospital rotations, yet it can help continue medical education through access to clinical videos and other online resources focusing on clinical scenarios and examination techniques. We need to ensure teachers’ training for the unique demands that online teaching poses. Many strategies have been developed for improving the quality of online teaching and engaging students. These include interacting with students, encouraging student’s participation by giving more open-ended questions, sharing videos focusing on examination techniques and different clinical scenarios, providing clear directions at the start of the session, and providing students with emotional support in this time of crisis. We should not forget that students’ attitudes are influenced by the support they receive from families and teachers. As teachers, we play an important role in the development of positive attitudes and providing students with emotional support6. There is a need for specific guidelines for online medical education framed by Pakistan Medical Council for implementing e-learning. With this sudden shift, away from the classroom in many parts of the world, some are wondering whether the adoption of online learning will continue to persist post-pandemic. For teachers, it is an opportunity to implement this teaching and learning methodology in our medical schools and training institutions whereas for students it is an opportunity to make use of e-learning for deriving maximum benefit thus preparing us for an unforeseeable situation in the future
Evaluation of Thyroid Dysfunction in Adult Patients of Celiac Disease
Get PDFOBJECTIVES:
To assess free thyroxine (fT4), thyroid stimulating hormone (TSH), and anti thyroid peroxidase antibodies (anti TPO abs) in adult Celiac disease patients and non-celiac controls and to find out any statistically significant difference in their corresponding means between the two groups.
METHODOLOGY:
The study design was analytical cross sectional. Sixty adult patients of celiac disease (CD) and 30 apparently healthy non-celiac adults were included in the study. CD patients had earlier been diagnosed by elevated levels of serological evidence of elevated (greater than 15X ULN) anti tissue transglutaminase (TTG) (IgA class) antibodies. CD was ruled out in the control group by normal levels of the antibodies. TSH, fT4 and anti TPO abs were obtained from all individuals of CD patient and control groups.
RESULTS:
Mean age of Celiac disease in patients was 23.85±5.43 years. Mean age of individuals in the control group was 24.26±5.55 years. Statistically significant difference in mean TSH and anti-TPO abs levels between the CD patient group and control group (p values of 0.03 and 0.038, respectively) was present. No statistically significant difference was seen between mean fT4 of patients and control group (p=0.74). Subclinical and overt hypothyroidism was present in 10% and 5% of CD patients, while anti TPO abs was positive in 16.6% of CD patients.
CONCLUSION:
There is a considerably high prevalence of subclinical and overt hypothyroidism as well as serological evidence of thyroid dysfunction in adult patients of CD
Outcome of Laparoscopic Total Extra Peritoneal Versus Lichtenstein Repair For Treatment of Inguinal Hernia: A Randomized Control Trial
Get PDFOBJECTIVES:
To compare the outcome of laparoscopic total extra peritoneal (TEP) repair versus Lichtenstein repair (LR) of inguinal hernia in terms of post-operative pain, hematoma, seroma, wound infection and early recurrence.
METHODOLOGY:
This randomized control trial was conducted at Surgical Unit III, General Hospital Lahore, Pakistan during the period June 2017 to May 2018. Male patients aged up to 50 years diagnosed with unilateral, reducible primary inguinal hernia were randomized into two groups, Group A (TEP) and Group B (LR), with 38 patients each. Data was collected prospectively on structured proforma. Patients were regularly followed up for one year for early postoperative complications. Statistical analysis was done using SPSS version 26.
RESULTS:
Out of 76 patients, mean age for TEP was 36.72±4.50 years and LR was 34.42±6.8 years. No significant difference was found in both the groups in terms of short-term postoperative complications. LR group had comparatively high rate of postoperative complications; hematoma formation (n=3/38; 7.9%), wound infection (n=3/38; 7.9%) and seroma formation (n=1/38; 2.6%). Postoperative pain with Visual Analogue Score in TEP group on the 1st day, 3rd day, 7th day and 1 month follow up was less as compared to LR group.
CONCLUSION:
The present study concludes that TEP is better than LR in inguinal hernia in terms of less postoperative pain after 1 month. However, no statistical difference was found in seroma and hematoma formation and wound infection.