COVID-19 PANDEMIC: HOW STRESSED THE STUDENTS AND FACULTY ARE?

Objective: To assess the perceived stress levels amongst faculty and students of medicine, dentistry and allied health sciences during COVID-19 pandemic. Methods: This multi-institutional descriptive study was conducted from April to June 2020. All the students and faculty from three institutes namely University College of Medicine, University College of Dentistry and Institute of Allied Health Sciences were invited to participate. Data were collected using a pre-validated Perceived Stress Scale (PSS -10). Descriptive and inferential statistics were calculated using SPSS v.21. Results: 1199 responses were obtained. Students from University College of Medicine reported higher score on the perceived stress scale (23.02+11.85) than those from University College of Dentistry (21.87+10.86) and Institute of Allied Health Sciences (21.95+11.32). The students and the faculty experienced stress ‘sometimes to fairly often’ during this pandemic. Females experienced more stress than males and there were no significant differences among students and faculty of various age groups. Conclusion: During COVID-19 pandemic, the students and the faculty from medicine, dentistry and allied health sciences institutes are moderately stressed. The medical students are more affected than the allied health students and the faculty in general. Institutions should promote resilience and mental well-being and provide for flexible work schedules.

ORAL HEALTH-RELATED QUALITY OF LIFE AND ITS ASSOCIATED FACTORS IN ELDERLY POPULATION

Objectives: The aim of this study was to evaluate oral health related quality of life and its associated factors in elderly. Material and Methods: A cross sectional study was done at medical OPD of KTH Peshawar by using Non-probability consecutive sampling method of 411 elderly patients. All the patients had oral examination, followed by an interview through a validated questionnaire having demographics and oral health related quality of life( OHRQoL) was measured using OHIP-14 having Likert, with higher scores indicating poor oral health (lower OHRQoL) and vice versa. Results: The mean OHIP-14 score (range 0-56) was 62.35± 10.94 which is much higher than the threshold for poor OHRQoL ‘poor OH’ ?11.0 (SD?±?6.9). OHRQoL was found good in the participants having good oral Hygiene (51.74) and who were more qualified. Females had relatively good OHRQoL (61.4).Mean OHIP score was higher in the participants belonging to rural areas (67.1) as compared to urban areas. Conclusion: This study found poor OHRQoL in elderly population in Peshawar. Participants who had good oral hygiene & who were qualified had good OHRQoL. OHRQoL was found poor in rural areas participants; it was relatively good in females as compared to males.

DETERMINATION OF FOOD PRESERVATIVES (BENZOIC AND SORBIC ACIDS) IN BAKERY PRODUCTS OF DISTRICT PESHAWAR, PAKISTAN

Objective: To determine the level of preservatives (Benzoic and Sorbic acid) in bakery products of Peshawar Material & methods: This cross-sectional study was performed in district Peshawar from August 2019 to December 2019 by visiting four bakery stores in each union council (total of ten union councils) by collecting three samples (of biscuits, cakes and bread) from each bakery store. Thus, a total of 120 samples were collected. Food additives in the form of Benzoic and Sorbic acid were checked in Forensic and toxicology laboratory of Khyber medical college Peshawar. Data was analyzed using SPSS 23, where frequencies and percentages were used for categorical variables and mean, standard deviation for numerical data. Results: In samples of cakes, concentration of benzoic acid (BA) ranged from 314 to 457 ppm (WHO permissible limit is up to 500ppm) while that of sorbic acid(SA) ranged from 597 to 859 ppm (WHO permissible limit is up to 1000ppm). Similarly, concentration of benzoic acid in biscuits samples ranged from 363 to 467 ppm and sorbic acid ranged from 649 to 895 ppm. In bread samples, BA ranged from 350 - 487 ppm and sorbic acid ranged from 619 to 944. Comparing the values with WHO standards for preservatives, the concentration of benzoic and sorbic acid is found to be within permissible limits with p value < 0.05 . Conclusion: Benzoic acid and Sorbic acid were found in permissible limits in 3 bakery products in the city of Peshawar, as set by World Health Organization.

Efficacy Of Robot-assisted Physiotherapy For Pain Management In Neurological Disorders-A Systematic Review

Efficacy Of Robot-assisted Physiotherapy For Pain Management In Neurological Disorders-A Systematic Review Abstract Background: Neurological disorders (ND) are ranked as the leading cause of death and disability around the globe and the escalating burden summons the advancements in the treatment strategies hence this systematic review aimed to fill the knowledge gap regarding the efficacy of robot-assisted physiotherapy (RAPT) for pain management in ND. Methodology: Scientific trials were sought by an extensive search via electronic databases mainly PubMed, PEDro, and Scopus. Randomized controlled trials published from the year 2014 to April 2021, evaluating the potential effects of RAPT for pain management in ND were included in the review. The quality appraisal of the RCTs was analyzed via Cochrane tool for assessing risk of bias. Results: The Majority of the trials reported the effectiveness of RAPT using PARO robot, Armeo spring, Gloreha robot, and robotic Lokomat gait training system in significantly improving pain of ND such as stroke, dementia, phantom syndrome, and spinal cord injuries. Conclusions: Large body of evidence suggested RAPT as a potential solution in improving pain of various ND however further rigorous trials are necessary to draw conclusive recommendations. Keywords: Neurological disorders, pain, physiotherapy management, rehabilitation, robot-assisted physiotherapy, robotics

OMPARATIVE ANTIFUNGAL ACTIVITY OF WILD AND CULTIVATED LEAVES OF FICUS CARICA LINN

Objective: To compare the antifungal activity of wild and cultivated Ficus carica Linn (common fig) leaves extract Materials and Methods: An experimental study was conducted in the department of Botany Islamia College Peshawar from June 2016 to December 2016 which was shaped in 2021 into a research study in the Department of Community Medicine, Khyber Medical College Peshawar. The agar tube dilution method was used for antifungal activity of the extracts. Results: Comparison of Zone of Inhibition (%) in both Aspergillus niger and Aspergillus fumigatus colonies revealed that cultivated species of Ficus carica Linn (common fig locally known as Anjeer ) had more antifungal property against both the fungal species (63% and higher compared that to wild species having maximum zone of inhibition of 54.54%) with the exception of wild plant extract in polar solvent such as chloroform which had high level of antifungal activity (61.53%) only against Aspegillus fumigatus. The experiment also revealed that extracts from both wild and cultivated Ficus carica Linn leaves in polar solvents such as methanol( also written and referred to methanolic in the article) and chloroform showed higher level of antifungal activity against both the fungal species compared to extract taken in non-polar solvents. Conclusion: Extract from cultivated species of Ficus carica Linn had higher level of activity against both the fungal species i.e. Aspergillus niger and Aspergillus fumigatus, especially extract taken in polar solvents. Key words: Ficus carica Linn, antifungal, tube dilution, zone of inhibition

THE RATE OF SUCCESS IN UTEROVAGINAL PACKING IN ATONIC UTERUS IN A TERTIARY CARE HOSPITAL IN LOW RESOURCE SETTING

Objective: To find out the success rate of uterovaginal packing of Atonic Uterus in a tertiary care hospital, in low resource setting.Methods: This was a interventional prospective trial conducted in Gynae department of Lady Reading Hospital from January 2019 to December 2019. Our study included those patients with PPH not responding to medical treatment in vaginal delivery. Patients in shock with PPH and PPH after Csection were excluded from the study. The study was approved by the ethical committee of hospital.Results: In our study 250 patients with Atonic Uterus with PPH with failed medical treatment were done uterovaginal packing, the success rate after 12 hours was 86.4%, in rest of the patients PPH was controlled by second line surgical intervention in 34 cases (13.6%), B Lynch was done in 18 (7.2%) cases, subtotal hysterectomies 13 (5.2%) cases and internal Iliac ligation in 3 cases (1.2%)Conclusion: Uterovaginal packing is an effective, easy, quick and life saving method in the control of PPH in low resource setting.

PERCEPTION OF POSTGRADUATE FAMILY MEDICINE TRAINEES ABOUT THE OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) ASSESSMENT METHOD

Background: Assessment drives learning and improving the quality of assessment has a remarkable impact on the quality of learning. Objective Structured Clinical Examination is termed more reliable and valid as compared to conventional practical examination. Objective: The objective of this study was to find the perception of postgraduate family medicine trainees about the OSCE assessment method and compare those having previous experience with those having no previous experience. Methodology: This was a cross-section study conducted at the end of exit examination of diploma in family medicine at the Family Medicine Department, Khyber Medical University Peshawar. Data were collected on an eleven items questionnaire on a five-point Likert Scale. Study participants were categorized based on their previous experience of the OSCE, and were grouped into two categories. Data were analyzed by using Fisher’s Exact test and a p-value of ? 0.05 was considered statistically significant. Results: 56 out of 60 candidates returned completed questionnaires. The response rate was 93.33% where the majority were males 52(92.9%). Participants with experience of the OSCE were 22 (39.3%) while 34 (60.7%) were having no experience of the assessment method. There was a significant difference (p= 0.001) in the perception about the OSCE with the simulated patient than real patient, fairness and reliability of the OSCE, stress and length of the OSCE and reduction of bias in the OSCE. The perception about weightage to be given to the OSCE in any examination was significantly different (p=0.004) between the two groups. Conclusion: Participants of both groups (experienced vs non-experienced) agreed on some aspects of the OSCE. Their opinion differed about the fairness, validity and stress related to the OSCE assessment method. This difference is probably explained by the inadequacy of an experience to form an opinion. Keywords: Conventional practical examination, Family medicine, OSCE.

EXPLORATION OF BARRIERS PERCEIVED BY ONCOLOGY NURSES RELATED TO CANCER PAIN MANAGEMENT

Objectives: To explore barriers perceived by oncology nurses in cancer pain management. Methods: A descriptive Cross sectional study was conducted in oncology department of four tertiary care hospitals of Punjab which include Mayo hospital Lahore, Jinnah hospital Lahore, Allied hospital Faisalabad and Nishtar hospital Multan. Sample of 72 nurses working in oncology departments of four tertiary care hospitals were selected by using purposive sampling. Self-administered questionnaire was used to collect data. The data analysis was performed using SPSS version 20 and micro soft excel. Results: The results identified that system related barriers were found more prevalent. From system related barriers inappropriate nurse –patient ratio was found most prevalent barriers as 95.9% (n=72) respondent were agree for this barrier Conclusion: nurses face lot of barriers in pain management that hinder their efficiency to control pain.

MICROBIOLOGICAL QUALITY ASSESSMENT OF RAW COWS MILK IN PESHAWAR DISTRICT

Objectives To study the microbial analysis of raw cow's milk collected from selling points of Peshawar. Materials and methods: A total of 80 aseptically raw milk samples were collected by multistage sampling technique from four towns of Peshawar in sterile glass bottles and stored in ice container for laboratory analysis at Agriculture University Peshawar. Microbial analysis was performed on plate count and samples were screened for staph aureus, E.coli spp, and salmonella spp. Microbiological load was tested and the data were analyzed by Statistical Package for Social Sciences (SPSS) version 20. Results: The microbial analysis of milk revealed contamination of milk and most prevalent bacteria was Escherichia coli (26.2%) and least prevalent was Salmonella spp (3.75%). Conclusion Although the presence of E.coli spp, staph spp and salmonella spp. indicate that the milk is contaminated but found that total bacterial count was within permissible limit. If not controlled in time will lead to public health issues. This highlights an urgent need to adopt good sanitary practices and monitoring of milk from production to distribution by the health authorities.

THE SAFETY OF VEROCELL COVID -19 (SINOPHARM) VACCINATION AMONG HEALTH CARE WORKERS IN KHYBER TEACHING HOSPITAL, PESHAWAR

Objectives: To determine the safety of Sinopharm Covid -19 vaccine among health care workers of Khyber Teaching Hospital (KTH, Peshawar). Material and Methods: This observational study was carried out to assess the side effects associated with the first dose of Sinopharm vaccine among health care workers in KTH Peshawar, Pakistan. Data was collected using a close ended questionnaire which was filled by the health care workers above 18 years of age. The participants were asked to monitor any side effects upto 1 week after the first dose of sinopharm vaccine administered to them. Data was analyzed using SPSS version 23 for macbook. Results: A total of 400 health workers were included in the study but only 155 partcipants responded by completing the questionnaire. It was observed that 63.9% of the participants who were vaccinated experienced at least one symptom after vaccination. The most common symptom was pain at injection site (36.8%) experienced during 15 – 30 minutes after vaccination. The occurrence of symptoms after vaccination was greater in age group 24-42 years which was 60.6% while in age group 43-60 years it was 39.4%. Our analysis shows that there is no association between co-morbidities and post vaccination symptoms (p>0.01). Conclusion: Our study concludes that sinopharm vaccine has no severe/ moderate side effects and therefore safe for public use. Key words: Safety, SARS Covid-19, Sinopharm vaccine