“Pakistan’s Scenario in Pandemic Situation of COVID-19”

Emergence of Covid-19 in Pakistan is an element of continuing pandemic caused by (SARS-CoV-2) virus1.It was confirmed in our country on 26th February 20202. By 18th March 2020, cases were confirmed in 4 different provinces of Pakistan,3 and by 17th June, each district had recorded a minimum of one confirmed case of COVID-19.

Role of Early Brief Psychological Interventions in Substance Use Disorders

Objective: To assess the effects of early brief psychological interventions in patients of substance use disorders. Study Design and Setting: This descriptive prospective study was conducted at main reception centre filter clinic/ Emergency Department of PNS Shifa hospital from 1st July 2020 to 31st March 2021. Methodology: Total n=78 patients were identified after a simple screening question regarding substance abuse which was how many times the patient had used an illegal drug in the last one year. An answer of more than 1 was considered as a positive response and further screening was done with Drug and Alcohol screening test (DAST). Patients who showed low scores on DAST were recommended for brief interventions which were given as weekly sessions for 6 weeks and reassessment was done at 3rd month. The SPSS 20 package program was used for statistical analysis. The descriptive statistics were analyzed for all the variables evaluated in the study. Results: This study revealed that that after 3 months of brief psychological interventions, 43(55.1%) patients remained abstinent from drugs. 18(23%) patients did not report for follow up. 9(11.5%) had reduced their use while 8(10.2%) were still using drugs regularly. Conclusion: This study showed that brief psychological interventions at the level of filter clinics/Emergency departments can help patients of substance use seek early care who fear going to a psychiatric clinic.

Effect of Anti-Emetic Combination of Sevoflurane / Propofol Anesthesia Technique in Laparoscopic Cholecystectomy

Objective: To assess symptoms of nausea and vomiting in laparoscopic cholecystectomy post-operatively, administered anesthesia by sevoflurane or propofol and to assess the effect of dexamethasone and ondansetron anti-emetic combination. Study design & Setting: It was an experimental study design conducted from 08-Oct-2017 till 11-Jul-2018 at Rawal General & Dental Hospital. Methodology: Patients were recruited in interventional groups by lottery method as n=160, with 80 cases allocated in each group. The patients with gallstones planned for laparoscopic cholecystectomy after preoperative assessment were classified to American Society of Anesthesiologist (ASA) physical status class I-II. All the patients placed in a particular ASA physical status class were (exposed to both induction methods) either anesthetic induction by propofol 1-2 mg/kg (group-A) or by employing sevoflurane 4-8% (group-B) in combination with oxygen, while maintenance was done in both study groups with 2% sevoflurane and 50% nitrous oxide in oxygen. After procedure patients stayed in post-anesthesia care unit where intra-operative monitoring was evaluated. The primary end point of the study was to note the rate of nausea and vomiting in 24 hours interval after surgery. Results: Both sevoflurane and propofol are equally effective anesthetic induction agents. The same combination of dexamethasone and ondansetron was given to both groups and so the actual effect of both anesthesia drugs in terms of side effects were nullified. Conclusion: In laparoscopic cholecystectomy, both sevoflurane and propofol are good enough when administered with dexamethasone and ondansetron anti-emetic combination, for post-operative nausea and vomiting up to 24 hours observation time in study.

Comparison of Oral Stereognostic Proficiency Between New and Previous Complete Denture Wearers

Objective: To compare oral stereognostic proficiency scores between new and previous complete denture wearers. Study design and study settings: This cross-sectional study design was conducted at Armed Forces Institute of Dentistry, Rawalpindi. Methodology: Total 60 patients belonging to age group of 45–75 years were selected from the study setting. Oral stereognostic proficiency was recorded by using different oral stereognostic intra oral testing tools and scores were noted. Data analysis was done using SPSS (version 20) software. Independent sample t-test was used to compare the scores of new and old previous complete denture wearers. Effect modifier like gender was rectified by method of stratification. Post stratification independent sample t-test was applied and p value of 0.05 or less was considered to be significant. Results: The mean age of patients was 59.8+7.85 years. Previous complete denture wearers were found to have a higher value as compared to the new complete denture wearers. Significant difference between both groups according to age was found with older individuals having a lower stereognostic value than younger individuals. Conclusions: Oral stereognostic test is a dependable test to measure patients’ oral stereognostic perception which can help the dentist in better educating the patient in terms of his/her expectations regarding the prosthesis and in better understanding the limitations of the prosthesis

Perception of Dental Faculty on Face-to-Face and Virtual Programs of Faculty Development; A Cross-Sectional Study

Objective: To compare the perception of dental faculty regarding face-to-face and virtual faculty development programs (FDPs) in dental institutes of Karachi. Study design and Setting: A descriptive cross-sectional study was conducted at multiple dental colleges of Karachi.(January to April 2020). Methodology: The study was carried out among 161 faculty members teaching in private dental institutes, using a modified, validated questionnaire with convenient sampling. Data was analyzed on SPSS version 21. Results: The mean age of study participants was 32.31±8.09 years, and teaching experience was 5.01 ± 6.34 years. Majority of the participants had not received any faculty development training (p-value of 0.001). Most of the faculty reported no established faculty development program available either face-to-face or virtually in their respective institute. Majority (28.8 %) of participants perceived that the main barrier for FDPs was the lack of administrative support. However, the facultydesired to enhance their teaching skills, recommending that faculty development programs be made compulsory for all faculty members. The majority of participants (35.43 +ve mean rank) were in favour of face-to-face sessions (p=0.001) but were reluctant towards virtual sessions. Most (49.2 %) of the faculty perceived the foremost benefit of attending FDPs to be improvement in teaching skills and MCQs /EMQs writing. Conclusion: Dental faculty were more inclined towards face-to-face sessions than virtually conducted sessions however, their perception of the utility of FDPs were found to be limited . Moreover, it was that some of the barriers to attend FDPs was faculty determinants like deficient time and dearth of commitment

Learning Preferences among Medical and Physical Therapy Students: A Systematic Review

Learning style is known as affective, cognitive, physiological, or combined characteristics which indicate the ways through which students interact, respond and understand the learning environment. A systematic review was conducted with relevant literature from 2012 to 2021 by hand searching and from electronic databases (PubMed, MEDLINE, ProQuest, and Eric) with proper search strategy as Boolean operator. They were searched using the keywords ‘allied health students’ ‘learning style’, ‘medical students’, ‘MBBS students’ and ‘physical therapy students OR physiotherapists’. Out of 1027 studies, only 16 potentially relevant articles were included in this review. This study reflected undergraduate physical therapy and MBBS students from various countries and their most preferred learning style is kinaesthetic and activist which states learning is based on experiments, hands-on practice, audio-visual lectures, teaching sessions in a new environment allowing students to analyze and synthesize theories. However, students require adaptable, educative, and assessment strategies as they have different learning styles.

Association of Levels of Anxiety in Resident Doctors with Factors related to the Postgraduate Training in Teaching Hospitals

Objective: To assess level of anxiety, its associated factors and coping strategies in postgraduate trainees of public and private teaching hospitals of Karachi Study Design and Setting: It was a cross-sectional study. The data was collected from different major teaching hospitals February 2019 till April Methodology: A total of 230 postgraduate trainees were interviewed using a pre-tested structured questionnaire specifically designed for this study which included General Anxiety Disorder-7 Scale and Brief COPE Questionnaire. Data were analyzed on SPSS version 21. Chi-square test and multinomial logistic regression was performed and P-value <0.05 was considered as statistically significant Results: Total 39.6% of the participants had no anxiety, 34.3% had mild, 16.1% had moderate while 10.0% had severe anxiety. Being single, nuclear family system and low monthly household income had higher odds of having severe anxiety (Adjusted Odds Ratio (AOR); 5.50, 95% CI 1.38,22.14, AOR; 2.50, 95% CI 0.83,7.51 and AOR; 3.17, 95% CI 0.96,10.49 respectively). Severe anxiety was also highly associated with irregular sleep pattern (AOR; 2.06, 95% CI 0.70, 6.06), no daily exercise (AOR; 5.01, 95% CI 1.21, 2.69) and lack of job satisfaction (AOR; 2.64, 95% CI 0.90, 7.90). The most frequently adapted coping strategies by participants who were found to have anxiety were, planning (89.9%), acceptance (87%) and religion (85.6%). Conclusion: Postgraduate trainees should be provided with psychological counseling and support at workplace to keep them mentally healthy to enhance their everyday performance in dealing and treating patients

Ingestion of A Sharp Foreign Body by an Infant

A four-month-old infant, previously healthy and developmentally normal, presented to the emergency department (ER) of a tertiary care hospital with hematemesis and pallor for one day, as well as a three-week history of irritability and intermittent vomiting. The infant was taken to various hospitals in their town, where he was given symptomatic treatment for vomiting and the mother was advised to feed infant. Nothing out of the ordinary was reported by the parents. The infant's symptoms were managed in the ER, and baseline labs were performed to determine the cause of the blood-stained vomiting and pallor. Except for a low Hb level, the baseline labs were normal. An abdominal x-ray revealed a stainlesssteel blade in his stomach. The ingestion of a blade was unknown to the parents. The case was referred to pediatric gastroenterology for further treatment. The blade was removed through endoscopy, and recovery was uneventful. Conclusion: The importance of supervising infants and young children under all circumstances is emphasized

Unusal Presentation of Dengue Fever as Pyomyositis

Dengue is the most common and widespread arthropod-borne arboviral infection. Symptoms include fever, headache, muscle, and joint pains, and a characteristic skin rash. Although viral myositis is common, myositis caused by the dengue virus is not commonly reported. The case of serologically confirmed dengue fever complicated by pyomyositis associated with a tenfold increase in serum creatine phosphokinase is presented.

Medical Writing: Challenges in the Contemporary Era

Publication of a research article in medical journal is reflection of scholarly activity and academic credentials.1 History of medical writing dates back to very ancient times but in the contemporary era, medical writing has been changed a lot and also changing continuously with each passing day