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) Thu, 01 Oct 2020 00:00:00 +0000 OJS 60 Contents <p>Content List</p> Editor Copyright (c) CORONAVIRUS DISEASE 2019 (COVID-19) <p><strong>Editorial</strong></p> <p><strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;CORONAVIRUS DISEASE 2019 (COVID-19)</strong></p> <p>The epidemic of 2019 novel coronavirus (2019-nCoV) has been emerged from a major city named Wuhan in the Hubei Province of China. It appears to have the potential to cause a major health problem globally. Earlier it is called 2019-nCoV but now this virus is taxonomically termed SARS-CoV-2. World Health Organization has named it as “coronavirus disease 2019” and abbreviated “COVID-19”<sup> [1]</sup>.</p> <p>A large family of viruses named coronavirus which are classified into 4 types of genera (α, β, γ, δ). These are present in various animal species which includes bats, camels, masked palm civets, cattle, mice, dogs, cats and even in humans. The animal coronaviruses may infect and then spread among people. Similar to other two pathogenic coronaviruses, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV), the COVID-19 virus is a beta-coronavirus. They cause respiratory disease (viral pneumonia) which even results in death. All such coronaviruses have their origins in the bats. Viral genomic sequences of infected subjects in U.S. are similar to Chinese patients which suggest expected single, recent emergence of this virus from an animal reservoir<sup>[2,3]</sup>.</p> <p>Many affected patients of COVID-19 outbreak in Wuhan, showed indication with the large live animal market or wet market. It indicated animal to person spread. Later reports did not mention exposure to wet markets which indicated persontoperson spread. Other countries including United States have also been reported person to person spread.COVID-19 transmission possibly happens through means of large droplets and contact. It is also transmitted by means of aerosols and fomites <sup>[4]</sup>. Zhu et al. have been sequenced the viral genome of novel coronavirus. Their results were in conjunction with other reports which showed 75 to 80% identical sequence with the SARS-CoV. Such findings also confirmed more close relation with numerous bat coronaviruses. It is also noted that SARS-CoV-2 grows better in primary human airway epithelial cells <sup>[5]</sup>.</p> <p>The prominent aspect of COVID-19 epidemic is fear. This feature is playing a devastating role in daily life, social and economics. Development is still going on for preparing specific anticoronaviral therapies. There is no vaccine for COVID-19 yet. We have better understanding now for how to control such infections in the community. This understanding must alleviate some of the novel virus fear. Regarding the people health measures, it includes isolation of the affected patients in the community. In time diagnosis and stringent observance to the universal precautions are important in preventing and controlling of COVID-19. To create awareness for prevention is the best strategy to protect ourselves in an outbreak. It includes the importance of hand washing, avoid touching face, cough or sneeze into a tissue or cloth, stay away from infected people and places. Wear a face mask if you are sick and stay at home. It is hoped that such precautions must be supportive in reducing transmission of the novel human coronavirus.</p> <p><strong>&nbsp;</strong><strong>REFERENCES:</strong></p> <ol> <li>WHO. Clinical management of severe acute respiratory infectionwhen novel coronavirus (nCoV) infection is suspected. [Internet] 2020, [cited on 19 Jan 2020]. Available from:</li> <li>Perlman S. Another decade, another coronavirus. New&nbsp;Englandjournal of medicine. 2020; 382:760-762. DOI: 10.1056/NEJMe2001126.</li> <li>Chu DK, Pan Y, Cheng SM, Hui KP, Krishnan P, Liu Y, et al. Molecular diagnosis of a novel coronavirus (2019-nCoV) causing an outbreak of pneumonia. Clinical chemistry. 2020;66(4):549-55. DOI: 10.1093/clinchem/hvaa029.</li> <li>Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020;395(10223):497-506.DOI:<a href="">10.1016/S0140-6736(20)30183-5</a></li> <li>Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020;382:727-733. DOI: 10.1056/NEJMoa2001017.</li> </ol> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> Copyright (c) 2020 Journal of University Medical & Dental College Fri, 25 Sep 2020 07:19:36 +0000 ASSESSMENT OF MEDICAL STUDENTS’ METACOGNITIVE AWARENESS OF READING STRATEGIES AND ITS RELATION WITH ACADEMIC PERFORMANCE: A CROSS SECTIONAL STUDY AT AZIZ FATIMA MEDICAL AND DENTAL COLLEGE, FAISALABAD <p><strong>ABSTRACT</strong></p> <p><strong>&nbsp;</strong><strong>BACKGROUND &amp; OBJECTIVE</strong>: Students reading strategies strongly influence their academic performance. Our study aimed to determine medical students' metacognitive awareness during reading strategies and its relation with their academic scores.</p> <p><strong>&nbsp;</strong><strong>METHODOLOGY: </strong>&nbsp;Study was done among third year MBBS students of Aziz Fatima Medical College Faisalabad. Students previous years academic achievement information was collected and they also filled questionnaire on metacognition regulation by the Metacognitive Awareness Reading Strategies Inventory. Convenient sampling was used for this study. The data were analyzed in SPSS 20. In our study the independent variable was metacognitive score while previous professional examination marks were taken as the dependent variable.Standard deviation and mean were used for the descriptive data. For categorical data, percentage and frequencies were used.</p> <p><strong>&nbsp;</strong><strong>RESULTS:</strong></p> <p>Different reading strategies employed by medical students in relation to metacognition were our main focus in the study. Metacognition was taken as score measured by a 30 item MARSI scale and their academic performance measured in terms of total marks obtained in the last professional examination held by the University. Total 101 out of 110 students from 3rd year MBBS class were enrolled in the study and the response rate was 92%. Forty one (41) respondents were females and sixty (60) respondents were male the mean± SD age of students was 21.05±0.74.</p> <p><strong>&nbsp;</strong><strong>CONCLUSION</strong>: All dimensions of metacognition are positive and strongly correlated with each other’s. Higher the score in one dimension will cause positive change in other dimension score and vice versa.</p> Subhan Ullah, Sami ullah, Khalid Parvez, Ghulam Abbas Sheikh Copyright (c) 2020 Journal of University Medical & Dental College Thu, 01 Oct 2020 15:06:48 +0000 ASSOCIATION OF GASTROESOPHAGEAL REFLUX SYMPTOMS (FREQUENCY AND SEVERITY) WITH BODY MASS INDEX IN FEMALES WITH GASTROESOPHAGEAL REFLUX DISEASE <p><strong>ABSTRACT</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Overweight individuals have a greater tendency to develop gastroesophageal reflux disease (GERD). This study aims at comparing gastroesophageal reflux symptoms (frequency and severity) in females with different body mass index (BMI) categories.</p> <p><strong>METHODOLOGY: </strong>This cross-sectional comparative research study was conducted over duration of 8 months. Both indoor and outdoor patients of medical unit – II Benazir Bhutto Hospital, Rawalpindi, fulfilling the inclusion criteria i.e. females 30-55 years of age with confirmed diagnosis of GERD and informed consent were included. Subjects with history of cigarette smoking, diabetes, use of postmenopausal hormone replacement therapy (HRT), anti-hypertensive or asthma medication were all excluded. Data were collected via proforma and analyzed on SPSS version 17.</p> <p><strong>RESULTS: </strong>Among 360 enrolled women, 08 (2.2%) subjects were underweight, 109 (30.3%) had normal BMI, 151 (41.9%) were overweight, 88 (24.4%) subjects were obese and 04 (1.1%) belonged to morbidly obese group. Among 109 subjects with normal BMI, 53 (48.6%) had mild, 40 (36.69%) moderate, 13 (11.9%) severe and 03 (2.75%) very severe GERD. Among 151 overweight subjects, 37 (24.50%) were with mild severity, 64 (42.38%) with moderate, 35 (23.17%) severe and 15 (9.93%) had very severe GERD. Among 04 morbidly obese subjects, 02 (50%) had severe while remaining 02 (50%) had very severe GERD (p=0.000).</p> <p><strong>CONCLUSION: </strong>Association of GERD symptoms and BMI were found in both normal and overweight women. Reflux symptoms may be exacerbated or even caused by moderate weight gain in people with normal weight.</p> Arshad Rabbani, Benish Adil, Ramsha Ghazal Arshad Copyright (c) 2020 Journal of University Medical & Dental College Thu, 01 Oct 2020 15:10:50 +0000 COMPARISON OF SELF-EVALUATED AND STUDENTS-REPORTED TEACHING EFFECTIVENESS OF MEDICAL TEACHERS: A CROSS SECTIONAL STUDY <p><strong>ABSTRACT</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Opinions regarding student’s evaluation of faculty performance and use of formal feedback from students and/or lack of self-evaluation to improve their performance ranges widely. Keeping this under consideration, the present study was conducted to compare self-evaluated and students-reported teaching effectiveness of medical teachers.</p> <p><strong>METHODOLOGY: </strong>A cross sectional study was conducted in Islamic international Medical college Rawalpindi, of three months duration (10<sup>th</sup> September to 10<sup>th</sup> December, 2018), on a sample of one hundred medical students and twenty medical teachers. Teaching effectiveness was assessed using “Self-assessment Instrument for Teacher Evaluation (SITE)” and students rated “Evaluation of teaching performance (CEID)” questionnaires.</p> <p><strong>RESULTS: </strong>Teachers rated their teaching more effective with a mean score (M=111) than students (M= 109). The result was significant statistically.</p> <p><strong>CONCLUSION: </strong>Self-evaluated teaching effectiveness was rated higher than students reported teaching effectiveness.</p> Gul Shaikh, Seema Gul, Manya Tahir Copyright (c) 2020 Journal of University Medical & Dental College Thu, 01 Oct 2020 16:26:06 +0000 COMPARISON OF LOCAL ADMINISTRATION OF AMINOPHYLLINE VERSUS NORMAL SALINE ON TRANSURETERAL LITHOTRIPSY IN PATIENTS PRESENTING WITH ACUTE RENAL COLIC <p><strong>&nbsp;</strong><strong>ABSTRACT</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Acute renal colic is most common disease presented with agonizing pain worldwide. Our study aims to compare outcomes (mean operative time and frequency of complete stone removal) between local administrations of aminophylline versus saline on Transureteral lithotripsy (TUL) in patients presented with acute renal colic.</p> <p><strong>METHODOLOGY: </strong>Our study design was randomized clinical trial, conducted at department of Urology &amp; Kidney in Pakistan Institute of Medical Sciences, Islamabad. Study duration was 6 months (February 2017-July 2017). Ethical approval and consent forms were taken in our study. A sample size of 90 cases was calculated (1:1 randomization that is 45 patients in each group) using WHO calculator. Acute renal colic patients were selected through consecutive (non-probability) sampling. A random division of patients is done in two groups; Group-A underwent local administration of aminophylline and group-B patients were given placebo. SPSS version 24 was used for analysis purpose. Post stratification chi-square and t-test was utilized in analysis for comparisons. In our study, p-value≤0.05 was found significant.</p> <p><strong>RESULTS: </strong>Total 90 cases were included in study. Mean age of patients was 47.56±18.1SD.Mean operative time was found to be significantly lower in Group-A (aminophylline group) as compared to group-B (placebo group) p=0.000. Group-A patients showed significantly high stone removal frequency as compared to group-B (44.4% vs 35.6%, p=0.03).</p> <p><strong>CONCLUSION: </strong>Aminophylline is an effective and safe drug in terms of lower operative time and complete stone removal among acute renal colic patients undergoing transureteral lithotripsy.</p> Hasham Khan, Ghulam Mustafa, Saqib Butt, Noor-Un Nisa, Ehsan-Ul- Haque Copyright (c) 2020 Journal of University Medical & Dental College Thu, 01 Oct 2020 16:29:13 +0000 IMPACT OF PSYCHOLOGICAL HEALTH ON ACADEMIC PERFORMANCE OF MEDICAL STUDENTS. WHERE DO WE STAND? <p><strong>&nbsp;</strong><strong>ABSTRACT</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>The objective of our study is to evaluate the prevalence of anxiety, stress and depression in undergraduate MBBS students to correlate it with self-efficacy, life satisfaction and to evaluate its effect on academic performance. We have also considered the relation between academic year and last year score.</p> <p><strong>METHODOLOGY: </strong>A total of 800 self-administered questionnaires were filled by 1<sup>st</sup> year to final year undergraduate students using non-probability, purposive sampling. The 10-minute questionnaire comprised of four sections: (1) demographics (2) Depression, Stress and Anxiety Scale (DASS ) 21 scoring system (3) Satisfaction with Life Scale (4) General Self-Efficacy Scale. The demographic questions included participants’ age, gender, and year of study, residence and last year professional examination score percentage. A percentage below 50% was named as low achievers. A percentage from 50% to 70% was considered as moderate achievers and above 70% as high achievers.</p> <p><strong>&nbsp;</strong><strong>RESULTS: </strong>In this sample of 505 students 180 (35.6%) were male undergraduates consisting of 18.6% from 1<sup>st</sup> year, 26.5% from 2<sup>nd</sup> year and 20.8%, 18% and 16% from 3<sup>rd</sup> year, 4<sup>th</sup> year and final year respectively. The depression, anxiety and stress rate were 69.5%, 78.6% and 63.4% respectively. Generally, depression, anxiety and stress were found more in females as compared to males. Anxiety was more common as compared to stress and depression. Students of 4<sup>th</sup> year were experiencing least psychological stress.</p> <p><strong>CONCLUSION: </strong>Moderate level of depression, stress and anxiety is necessary for good grades but excess of these psychological problems leads to emotional exhaustion and has a negative effect on learning and academic score. These psychological problems also lower the general self-efficacy of a student and are associated with low satisfaction with life.</p> Hamna Khan, Ain ul Momina, Muhammad Zeeshan Sarwar Copyright (c) 2020 Journal of University Medical & Dental College Thu, 01 Oct 2020 16:23:48 +0000 FREQUENCY OF OBESE PEOPLE AT HIGH RISK FOR DEVELOPING OBSTRUCTIVE SLEEP APNEA; A CROSS-SECTIONAL SURVEY <p><strong>ABSTRACT</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Obstructive sleep apnea (OSA) leads to multiple complications which may be life-threatening. In this study we determined the frequency of obese individuals at high risk for developing (OSA).</p> <p><strong>METHODOLOGY: </strong>It was a cross-sectional survey. The study was conducted in the Medicine department of Services hospital, Lahore from February 6, 2016 to August 5, 2016. A sample size of 300 healthy obese individuals (BMI ≥ 30kg/m<sup>2</sup>) aged between 18-60 years who were accompanying a patient or visiting someone admitted, were enrolled in our study. Informed Verbal consent was obtained before administering a structured, validated questionnaire to the significant obese population; Survey was translated into Urdu for ease. The data were stratified for age, gender and BMI of the patients to control the effect modifiers. Post-stratification Chi-square test was used. A p-value ≤ 0.05 was taken as significant.</p> <p><strong>RESULTS: </strong>A total of 300 subjects were enrolled. Mean age was calculated as 41.81±11.98 years, while 161(53.7%) individuals were females and 139(46.3%) were males. The frequency of risk of OSA was low in 241(80.3%) and high in 59(19.7%) of the population. The relationships of OSA with age groups and BMI were insignificant with p-value being 0.867 and 0.790 respectively.</p> <p><strong>CONCLUSION: </strong>In this study, a significant population of male obese individuals was found to be at high risk for obstructive sleep apnea.</p> Komal Atta, Raza Ahmad , Ayesha Nawaz , Iqra Ishtiaq, Muhammad Farooq Copyright (c) 2020 Journal of University Medical & Dental College Thu, 01 Oct 2020 16:20:42 +0000 FREQUENCY OF SUBCLINICAL HYPOTHYROIDISM AMONG DIAGNOSED CASES OF CHOLELITHIASIS <p><strong>Abstract</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE:&nbsp; </strong>Thyroid hormones act as foundation for the normal functioning of all the body hormones and body metabolism. The abnormality of thyroid hormones may lead to deranged lipid metabolism with abnormal relaxation of sphincter of oddi. This will cause stasis of bile in gallbladder and biliary channels leading to stone formation. The objective of the study is to determine the frequency of subclinical hypothyroidism among diagnosed cases of Cholelithiasis.</p> <p><strong>METHODOLOGY: </strong>This study was conducted in Surgical Department, Sandman Provincial Hospital Quetta, from January to December 2018. The study has been approved by the ethical review committee of Post Graduate Medical Institute Quetta. It is a cross-sectional study. A total of 193 patients with Cholelithiasis were included in the study. After informed written consent, blood was sent to laboratory for testing the levels of serum TSH, T3 and T4. Samples having TSH values more than 6.0mU/L and serum thyroxin within the normal range 9.0-19.0pmole/L, &nbsp;were labeled as subclinical hypothyroidism.</p> <p><strong>RESULTS: </strong>The data of all the patients between 35 to 62 years of age with Cholelithiasis during the study period was taken and analysis was performed. The inclusion and exclusion criteria were strictly considered. Mean ± SD of age was 47.03±5.401 with C.I (46.26-47.80) years. Out of 193 patients 25 (13%) were male and 168(87%) were female. Subclinical hypothyroidism was found to be in 16 (8.16%) patients and remaining 177(91.70%) patients were found normal.</p> <p><strong>CONCLUSION:</strong> It was concluded that the incidence of subclinical hypothyroidism in Cholelithiasis patients is low.</p> Riffat Arbab, Muhammad iqbal Khan, Abdullah Khan, Maria Mehmood, Aisha Arshad, Hafsa Qazi Copyright (c) 2020 Journal of University Medical & Dental College Thu, 01 Oct 2020 15:09:01 +0000