Journal of University Medical & Dental College <p>Journal of University Medical &amp; Dental College, JUMDC, is the official peer reviewed Journal of University Medical &amp; Dental College, constituent college of The University of Faisalabad. JUMDC is open access journal being published quarterly.<br><br>ISSN, 2221-7827<br>ISSN, 2310-5542</p> <p>Original research articles, review articles, practical updates, case reports, letter to editor of medical and allied health sciences are being evaluated by editorial board and peer reviewers before publication in the journal.</p> en-US <p><a href="" rel="license"><img src="" alt="Creative Commons License" border="0"></a><br>This work is licensed under a&nbsp;<a href="" rel="license">Creative Commons Attribution 4.0 International License</a>.</p> (Editor,) (Dr. Muhammad Akram Malik) Wed, 26 May 2021 00:00:00 +0000 OJS 60 DIGITAL TECHNOLOGY, ARTIFICIAL INTELLIGENCE AND FUTURE OF MEDICAL EDUCATION Alam Sher Malik Copyright (c) 2021 Journal of University Medical & Dental College Tue, 25 May 2021 08:57:45 +0000 THE PERILS OF VACCINE HESITANCY BASED ON CONSPIRACY THEORIES AND MISINFORMATION: IMPLICATIONS AND WAY FORWARD FOR PAKISTAN Naeem Mubarak, Asad Majeed Khan, Sundus Tariq, Sabba Kanwal, Saba Tariq Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 STRATEGY FOR RESUMING ELECTIVE SURGICAL PROCEDURES DURING & AFTER COVID-19 PANDEMIC <p><strong>ABSTRACT</strong></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; COVID-19 pandemic has afflicted the individuals, national economies, and healthcare system worldwide. It has badly struck the ongoing and planned surgical procedures in nearly all healthcare centers which has led the surgical procedures to come to a grinding halt. This serious issue invites comments from surgical experts throughout the world.</p> <p>&nbsp;</p> Shabir Ahmed Lehri, Muhammad Iqbal Khan, Riffat Arbab Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 COVID-19: PSYCHOLOGICAL TIPS FOR ALL <p><strong>BACKGROUND &amp; </strong><strong>OBJECTIVE:</strong> <strong>&nbsp;</strong>The world is facing a COVID-19 pandemic. The cure for the disease is yet to be established. This situation has created a severe stress-producing challenge for humankind. &nbsp;It has been reported in few studies that human health and adaptability are dependent on and are related to hope level. How this connection could help humanity to face the COVID-19 challenge was the main focus of the present work.</p> <p><strong>METHODOLOGY: </strong>A library research was conducted to explore the individual potential to increase 'hope’ and to evolve specialized instructions (tips) that could help to improve pandemic stress coping: It was convincing that increase in level of hope with due watchfulness is possible, that could contribute towards improving coping in the prevailing challenging, stressful situation.</p> <p><strong>RESULTS:&nbsp;</strong>To exercise ‘tips’ to improve hope was found psychologically possible. It was also convincing that ‘tips’ by improving the ‘hope’ level would add to the surviving spirit and subsequent coping.</p> <p><strong>CONCLUSION:</strong> Exercising ‘tips’ would improve pandemic stress coping.</p> Naveed Shibli, Tariq Rashid, Ali Sher Copyright (c) 2021 Journal of University Medical & Dental College Fri, 28 May 2021 00:00:00 +0000 PALLIDOTOMY IN PARKINSONIAN DISEASE: THE RENAISSANCE <p><strong>ABSTRACT:</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> To assess the results of pallidotomy in Parkinson’s disease, and its effect on improving the lifestyle of the patients and cost-effectiveness.</p> <p><strong>METHODOLOGY: </strong>A descriptive study was conducted at Neuro-Spinal &amp; Cancer Care Institute, Karachi from June 2014 to January 2020. Patients who were known case of Parkinson’s disease refractory to medication and developed side effects to medication were included in the study and patients with previous brain surgery, associated brain disorders like Alzheimer’s disease, basal ganglia lesion, brain trauma were excluded. All patients were treated by pallidotomy on the contralateral side. The significance of the difference between groups to compare between the pre-op or post-op treatments was calculated through non-parametric assessment Kruskal-Wallis tests.&nbsp;</p> <p><strong>&nbsp;RESULTS: </strong>The mean age of the patients was around 57 years. There were 34(81%) male and 8(19%) female patients’ Maximum number of patients who were more than 45 years, were having a left-sided proportion. More male patients were having a left-sided proportion as compared to female patients.&nbsp; The majority of patients (57.5%) were having dyskinesia as q primary symptom. A significant difference (p-value &lt;0.001) existed in pre &amp; post-operative UPDRS-III scores. A significant difference (p-value &lt;0.001) also existed between on &amp; off medications UPDRS- III (pre-op/post-op) scores.</p> <p><strong>CONCLUSION: </strong>The result of pallidotomy is promising especially for unilateral pallidotomy to minimize the risk of cognition and speech disorder and long-term follow-up is needed to prove the statement further. Currently, pallidotomy is associated with minimal complications, more effective, and improving the quality of life of Parkinsonian patients.</p> Aurangzeb Kalhoro, Abdul Basit Sattar, Abdul Sattar M. Hashim , Abid Saleem Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 COMPARISON OF THE PARENTERAL AND ORAL VITAMIN D SUPPLEMENTATION IN THE TREATMENT OF NUTRITIONAL RICKETS IN TERMS OF MEAN CHANGE IN SERUM CALCIUM, PHOSPHORUS, AND ALKALINE PHOSPHATASE <p><strong>ABSTRACT:</strong>&nbsp;</p> <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Rickets is a common presentation on the pediatric floor, with nutritional rickets being the cause of leading significant morbidity, disability, especially in the developing countries of the world. The objective is to compare the efficacy of parenteral and oral vitamin D supplementation in the treatment of nutritional rickets</p> <p>&nbsp;<strong>METHODOLOGY: </strong>This comparative interventional, prospective analysis was conducted at Aziz Fatimah Hospital Faisalabad (1-1-2017 to 30-6-2017) outdoor patients divided into parenteral and oral groups. All of the outcome variables were measured at baseline and one month after treatment.</p> <p><strong>RESULTS:</strong> In this study, mean age was calculated as 2.12 <u>+</u> 0.76 years and 2.15<u>+</u>0.77 in parental and oral groups respectively. 49.29% (n=69) and 45%(n=63) were male and 50.71%(n=71) and 55% (n=77) were female respectively in both groups.&nbsp; At baseline, serum calcium was 8.68 <u>+</u> 0.35 and 8.71 <u>+</u> 0.37 (p=0.62) serum phosphorus was 3.92 <u>+</u> 9.22 and 3.84 <u>+</u> 0.20 (p=0.03), and serum alkaline phosphatase was 230.01 <u>+</u> 13.09 and 228.89 <u>+</u> 13.80 (p=0.48) in parenteral and oral groups respectively. After treatment the mean change seen in serum calcium was 1.14 <u>+</u> 0.26 and 0.72 <u>+</u> 0.19 (p=0.001), serum phosphorus was 1.42 <u>+</u> 0.33 and 0.71 <u>+</u> 0.26 (p=0.001), serum Alkaline phosphatase was 79.48 <u>+</u> 14.84 and 23.65 <u>+</u> 12.21 (p=0.001) in parenteral and oral groups respectively.</p> <p><strong>CONCLUSION:</strong>&nbsp; We concluded that the parenteral route for vitamin. D supplementation is significantly better than the oral route in treating nutritional rickets in terms of mean change in serum calcium, serum phosphorus, and serum alkaline phosphatase.</p> Sumaira Tehseen, Tahir Mehmood, Nisar Khan Sajid, Tanveer Ahmed , Ramsha Abbas, Saeed Ahmed Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 PREVALENCE OF CROSSBITE IN SCHOOL CHILDREN OF SUNDAR INDUSTRIAL STATE AND RAIWIND, LAHORE: AN EPIDEMIOLOGICAL STUDY <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Crossbite is a commonly occurring malocclusion. It may be anterior or posterior, and it may occur either unilaterally or bilaterally. This study determined the prevalence of crossbite in children of different schools of Sundar industrial state and Raiwind.</p> <p><strong>METHODOLOGY:</strong> Nine hundred (428 male and 472 female) children of various schools of Raiwind and Sundar Industrial State, Lahore, were examined. Information regarding age, sex, and crossbite were noted. The recorded data were analyzed by using SPSS version 20. Frequency distribution was used for the descriptive analysis. Statistical level of significance using student’s t-test was p&lt; 0.05.</p> <p><strong>RESULTS: </strong>Out of 900 children, 117(13%) were noted to have at least one tooth in crossbite, which was more frequent in permanent (13.2%) than in mixed dentition (12.3%). The prevalence of crossbite was slightly greater in female subjects (16.1%) than in male subjects (9.1%). &nbsp;Crossbite was seen more frequently in the posterior (6.3%) than the anterior region (5.9%). Combined anterior and posterior crossbite was found in 7(0.8%) children. Unilateral crossbite on the left side was found to be more frequent (6.6%) than on the right side (4.6%), and the bilateral crossbite was found to be in 1.9% of children. Buccal crossbite was more prevalent (6.8%) than lingual crossbite (5.8%). Combined lingual and buccal crossbite was found to be in 0.4% of children.</p> <p><strong>CONCLUSION:</strong> Crossbite is a frequently occurring malocclusion in school children of Sundar industrial state and Raiwind, Lahore. Posterior crossbite is more prevalent than anterior crossbite.</p> Rabia Tabassum, Nazish Amjad, Faiza Malik, Munazza Saleem Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 COMPARISON OF SAFETY AND EFFICACY OF PNEUMATIC VERSUS LASER LITHOTRIPSY IN URETERIC STONES <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> Treatments for ureteral calculi evolve, over the past decades from open ureterolithotomy to minimally invasive procedures. Objective of this study is to compare the efficacy of pneumatic versus laser lithotripsy in ureteric stones.</p> <p><strong>METHODOLGY: </strong>A randomized controlled trial was conducted in Department of Urology Sir Ganga Ram Hospital, Lahore from 1st March 2018 to 31st August&nbsp; 2018. Patients were divided into two groups. In group A, 2 Fr pneumatic probe was used for pneumatic lithotripsy, while in group B, 550 μm fiber probe was used for laser lithotripsy.</p> <p><strong>RESULTS:</strong> Efficacy of Group A (pneumatic lithotripsy) was seen in 57 (77.63%) patients while in Group B (laser lithotripsy) was seen in 71 (93.42%) patients with p-value of 0.006</p> <p><strong>CONCLUSION:</strong> Laser lithotripsy in ureteric stones is better as compared to pneumatic lithotripsy.</p> <p>&nbsp;</p> Muhammad Saddiq Haris, Syed Atif Hussain, Rana Ata ur Rehman, Khizar Hayat Gondal, Ali Shandar Durrani, Muhammad Raheem Sajjad Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 STUDENTS PERSPECTIVE ON ONLINE MEDICAL EDUCATION DURING LOCKDOWN AS A RESULT OF COVID-19 PANDEMIC <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>The COVID-19 pandemic has badly affected medical education. We explored the perspective of undergraduate medical students regarding e-learning across Pakistan.</p> <p><strong>METHODOLOGY: </strong>A questionnaire was developed and disseminated via what’s app to MBBS students of medical institutes in Pakistan. The Google form data was retrieved in Microsoft Excel sheets and for further analysis. Ten medical colleges were selected based on a higher response rate. Out of 500 students, 492 students’ replied with valid data. SPPS-version 22 was used for data analysis.</p> <p><strong>RESULTS:</strong> The mean age of respondents was 22± 2.1. 64.4% of respondents were female, and 43.6% were male. Only 5 % of total students were of the opinion that online teaching was a good substitute for learning than face-to-face sessions. Majority of the students responded that online classes were not effective. There was no statistical difference between the support offered to students by faculty and college administration before and during COVID-19. About 43% of students responded that ZOOM software was a major platform for e-learning during the lockdown. Internet connectivity (33%) was the major hurdle in e-learning, followed by distractions at home (25%). Generally, health issues (35%) and financial crises (25%) in families were major stress factors.</p> <p><strong>CONCLUSION:</strong> The perspective of medical students regarding online teaching was not promising in our study. Most of the indicators were negative.</p> Muhammad Sajid Mehmood , Wajahat Sultan Baig, Sadia Azam Khan , Fauzia Khan , Shakil Ahmad Awan, Ayesha Babar Copyright (c) 2021 Journal of University Medical & Dental College Fri, 28 May 2021 00:00:00 +0000 EFFECTS OF POSITIVE EMOTIONS, ACADEMIC SELF EFFICACY AND SELF REGULATED LEARNING ON SATISFACTION WITH LIFE IN MEDICAL STUDENTS <p><strong>ABSTRACT</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>The previous studies had found a significant relationship among positive emotions, academic self-efficacy (ASE), self-regulated learning (SRL), and satisfaction with life (SWL). The present study was conducted to predict SWL from positive emotions and SRL in medical students.</p> <p><strong>METHODOLOGY:</strong> The study involved a cross-sectional survey research design. Three hundred medical students from the three medical colleges in Bahawalpur, Lodhran, and Sahiwal were randomly recruited to participate in the study from October 2019 to January 2020. Research Ethics Committee duly approved the study at The Islamia University of Bahawalpur vide No. REC/B-31/2019-F. All the participants filled the necessary informed consent form. Four Likert type scales (a) Dispositional Positive Emotions Scale, (b) Academic Self Efficacy Scale, (c) Efficacy for Self Regulated Learning Scale, and (d) Satisfaction with Life Scale were appended to a single questionnaire to collect the data. The Statistical Package for the Social Sciences, version 25, was used for statistical analysis. The correlation analysis, multiple regression analysis, and analysis of variance were used to compute results.</p> <p><strong>RESULTS:</strong> The study found a statistically significant positive correlation among positive emotions, ASE, SRL, and SWL in medical students. The positive emotions and SRL significantly predicted SWL while ASE did not significantly predict SWL in medical students. The 4<sup>th</sup> and 5<sup>th</sup>-year students showed more positive emotions, and students of 1<sup>st</sup> and 4<sup>th</sup> years showed more SRL than students of other years.&nbsp;</p> <p><strong>CONCLUSION:</strong> The study concluded that both positive emotions and SRL significantly predicted SWL in medical students. There were found significant year-wise differences in both positive emotions and SRL.</p> Ahmad Bilal, Muhammad Umair , Muhammad Ateeb , Alina Saif Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 BREASTFEEDING TEMPORAL DISTRIBUTION TRENDS AMONG NEONATES IN TERTIARY CARE HOSPITAL IN LAHORE <p><strong>ABSTRACT</strong></p> <p><strong>&nbsp;</strong><strong>BACKGROUND &amp; OBJECTIVE: </strong>Breastfeeding provides immunity against bacterial, viral, and other infectious diseases. More than four million new neonates die due to vaccine-related diseases in the first 28 days of their lives. It is therefore emphasized that breastfeeding in the first hours after delivery may save the neonate. The objective of this study was to determine the factors affecting the pattern of breastfeeding among the neonates and assess the frequency of early breastfeeding among neonates at Gulab Devi Hospital, Lahore.</p> <p><strong>METHODOLOGY: </strong>It was a cross-sectional descriptive study. One hundred mothers were selected through convenient purposes sampling. Chi-square test applied for an association between mode of delivery and initiation of breastfeeding.</p> <p><strong>RESULTS: </strong>The result of the study showed variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery.Pre-lacteal was given to 59 mothers, while 41 were not given with any pre-lacteal. A significant association was found between mode of delivery and initiation of breastfeeding with a p&lt;0.001.</p> <p><strong>CONCLUSION: </strong>The result of the study showed that variability in the time of breastfeeding by the mothers from one hour to 24 hours after delivery provided a significant difference in the production of the neonate in the first 28 days.</p> Hamid Mehmood, Zarmast Khan, Abdul Rauf, Ammara Waqar Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 EVALUATION OF CHONDROPROTECTIVE EFFICACY OF TRIAMCINOLONE IN OSTEOARTHRITIS INDUCED RAT MODEL <p><strong>BACKGROUND &amp; OBJECTIVE: </strong></p> <p style="text-align: justify;">Osteoarthritis (OA) is one of the most common joint diseases afflicting human, characterized by progressive degeneration of articular cartilage in which chondrocytes fails to repair adequately. The objective of this study is to evaluate the chondroprotection treated by triamcinolone in osteoarthritis induced rat model.</p> <p style="text-align: justify;"><strong>METHODOLOGY: </strong>This laboratory-based experimental study was conducted inthe Department of Pharmacology, Army Medical College, Rawalpindi, in collaboration with the National Institute of Health, Islamabad, from May-July2019.Osteoarthritis was induced by surgical removal of the medial meniscus and anterior cruciate ligament resection in the right knee joint of Sixteen (16) anesthetized rats of Sprague Dawley breed. They were divided into two (02) groups, with eight (08) rats in each group. Group-I was disease control in which 0.2 ml Intraarticular saline was administered for three weeks. While in group-II, a treatment group was treated with 70 µl intraarticular triamcinolone once weekly for three weeks. After that gait pattern of rats was scored. Animals were euthanized with overdosage of inhaled chloroform and a sample of proximal tibia was taken for histopathological analysis.</p> <p style="text-align: justify;"><strong>RESULTS: </strong>The mean gait score of the control group and treatment group was 3.25±.707 and 2.25±.463 with a p-value of 0.006 that is statistically significant. While mean histopathological modified Mankin score of the control and treatment group was 11.5±1.195 and 8.5±1.195, respectively, with a significant p&lt;0.001.</p> <p><strong>CONCLUSION:</strong> Intraarticular administration of triamcinolone in osteoarthritis-induced rats resulted in improvement in gait pattern and histopathology.</p> Noaman Ishaq, Quratulain Mehdi, Novera Sohail Bajwa, Shabana Ali, Bushra Shaheen, Muhammad Waqar Aslam Khan Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000 OUTCOME OF SCLEROTHERAPY IN THETREATMENT OF NON-HEALING VARICOSE ULCERS UNDER ULTRASOUND CONTROL <p><strong>BACKGROUND &amp; OBJECTIVE:&nbsp; </strong>Varicose veins are the commonest vascular problem both in men and women worldwide. Lack of timely management, inadequate treatment, and maltreatment of varicose veins can lead to the development of nonhealing ulcers and affects the quality of life in terms of health. Surgery, heat therapy, chemical therapy, and endoscopic treatment are the options of treatment. Foam sclerotherapy is relatively a new technique being practiced all over the world and has promising results.The objective was to determine the outcomes of foam sclerotherapy in the treatment of non-healing varicose ulcers.</p> <p><strong>METHODOLOGY:</strong>In this descriptive study, 240 patients with chronic leg ulcers with varicose veins had been managed with foam sclerotherapy under ultrasound and compression bandage. All patients were reviewed at 7 days, 1month, 3 months, 6 months, 1 year, and 18 months both clinically and radiologically with a doppler ultrasound to assess the ulcer healing rates.</p> <p><strong>RESULTS:</strong>The overall healing after 04 weeks of foam sclerotherapy was 83%. Two hundred and twenty-nine patients (95.4%) with ulcers healed within 02 months of the start of ultrasound-guided foam sclerotherapy. Delayed healing occurred after four months in11 cases. All those cases had either previous varicose veins surgery or deep vein thrombosis,or extensive perforator disease. During 18 months of follow-up, seven patients showed recurrence with a mean symptom-free period of 07 months.</p> <p><strong>CONCLUSION:</strong>Chronic venous ulcers treated with foam sclerotherapyunder ultrasound guidance are associated with a high healing rate and low recurrence rate.</p> Muhammad Jamil, Rashid Usman, Aaiza Aman, Kishwar Ali, Rai Ahmad Khan Kharl Copyright (c) 2021 Journal of University Medical & Dental College Fri, 28 May 2021 00:00:00 +0000 OUTCOME OF PRIMARY REPAIR OF VESICOVAGINAL FISTULA (VVF) <p><strong>BACKGROUND &amp; OBJECTIVE: &nbsp;</strong>Vesicovaginal fistula is one of the common gynecological problems faced by ladies in developing countries on account of certain significant lacunas in the healthcare delivery system and lack of awareness. The purpose of this study is to highlight our experience of primary vesicovaginal fistula repair.</p> <p><strong>METHODOLOGY: </strong>It is a cross-sectional experimental study from February 2019 to February 2020. Nineteen consecutive patients having vesicovaginal fistulas up to 3 cm in size, single in number were included in the study while those having fistulas more than 3 cm, involving urethra, bladder neck, and ureteric orifice were excluded. After a detailed history, physical examination, laboratory workup, and cystoscopic examination under anesthesia, the fistulas were repaired. All information was noted on the pre-planned questionnaire for this purpose.</p> <p><strong>RESULTS: </strong>There are around 63% of patients having fistula infratrigonal and the rest percentage on the supratrigonal area of the urinary bladder. The risk factor found hysterectomy in 32% of patients, unsupervised home delivery in 16% of patients, C-Section in 12% of patients, delivery by an untrained person in 26% of patients, induced miscarriages in 5% of patients, and other risk factors found in 12% patients. The 68% of patients managed through transabdominal and the rest 32% patients operated through the transvaginal approach. The surgery, either transabdominal or transvaginal, was successfully done in 84% of patients and failed in the rest of 16% of patients.</p> <p><strong>CONCLUSION</strong>: Fistulas due to obstetric trauma were mostly preventable. The success of surgical repair was due to health professionals' expertise, the suitable decision about approach, method of repair, proper preoperative evaluation, and careful postoperative management.</p> Muhammed khalid, Muhammad Hammad Hassan, Muhammad Asif , Qadeer Ahmad Tariq Copyright (c) 2021 Journal of University Medical & Dental College Wed, 26 May 2021 00:00:00 +0000