Journal of University Medical & Dental College

Health literacy to address health disparities: Innovative & integrated strategies

Sumera Shahzad — 2023-11-27

Bridge to Trust: EPAs and the Cultural Odyssey in Pakistan's Medical Training

Komal Atta — 2023-11-27

Psychological well-being of patients with arthritis: impact of psychological distress on quality of life, and patient satisfaction

Sameera Shafiq — 2023-10-18

BACKGROUND & OBJECTIVE: Arthritis is an autoimmune disease in which individual’s immune system attack healthy cells in one’s body and giving rise to inflammation. Recently, it has been found to be manifested in individuals with stress-related diagnosis. This study investigates how psychological distress, quality of life, patient satisfaction, and the role of pharmacists affect the psychological well-being of patients who have received medical diagnoses of different forms of arthritis.

METHODOLOGY: This cross-sectional study was conducted at the Department of Psychology University of Gujrat during 1^st January to 30^th August, 2022. A sample of 380 patients already diagnosed with arthritis by the physicians was taken by Purposive sampling technique, from various orthopedic hospitals. A demographic sheet, and Urdu versions of Depression, Anxiety, Stress Scale DASS-21, WHO QOL-BREF, Patient Satisfaction with Pharmacist Services Questionnaire and Flourishing Scale were used to assess psychological distress, quality of life, doctor patient satisfaction and psychological well-being in arthritis patients.

RESULTS: The study results showed that there is a significant negative correlation between quality of life and psychological distress (r= -.11, p<0.01). Well-being and quality of life are positively correlated (r=.68, p<0.01). 57% variance in wellbeing of the patients with arthritis is explainable due to the presence of psychological distress, and perceived quality of life.

CONCLUSION: The well-being of individuals diagnosed with arthritis can be strongly predicted by their levels of psychological distress and their perceived quality of life. This study delves into the implications of these findings.

Diabetes-specific quality of life scale (DSQOL): Translation and validation of Urdu short version

Laraib Javaid — 2023-10-05

BACKGROUND & OBJECTIVE: Quality of life has been affected by numerous psychosocial factors. Thus, for diabetic patients, it was necessary to identify the underlying factors keeping in view the cultural norms.The objective of the current study was to validate the cultural norms of DSQOL (Diabetes-Specific Quality of Life Scale)through translationinto“Urdu” language.

METHODOLOGY: A correlational research design was used in the study. Initially, forward and backward translation method was followed to translate DSQOL. Afterward, the final Urdu translated version (20-items)wastested on a representative sample of 200 diabetic patients to establish its psychometric properties.

RESULTS: Internal consistency and correlational matrix of original, Urdu, and English scales were yielded reliable results. In the main study, 200 male and female diabetic patients with an age range of 30-70 years and an average of (M±SD;45±8.25) participated. The reliability analysis showed significant alpha coefficient for five subscales; “Social relations (α= .80), Physical complaints (α=.90), Worries about the future (α= .88), Daily hassles (α= .88), and Emotional worries (α=.87)”. The item analysis of Urdu version confirmed the item total correlation of all subscales except three items. Further, CFA confirmed the factor structure of newly translated Urdu version of DSQOL through AMOS(Analysis of Moment Structure), and the model yielded acceptable model fit indices (CFI=.90; NFI= .90). Final Urdu version of DSQOL had 20 items.

CONCLUSION: The Urdu version of DSQOL is a valid and reliable measure for assessing the diabetics-specific quality of life. This translated tool overcame the cultural barrier with respect to language, and norms.

Understanding and application of restoring endodontically treated teeth among dentists of Islamabad and Rawalpindi - a twin city survey

Rabia Qamar — 2023-10-18

BACKGROUND & OBJECTIVE: Endodontically treated teeth undergo loss of tooth structure resulting in increased fracture susceptibility as compared to unrestored vital teeth. The final restoration following the root canal treatment is of paramount importance. This study aimed to determine current concepts, opinions, and techniques used for restoration of Endodontically Treated Teeth among dentists of Islamabad and Rawalpindi and compare their knowledge with their clinical practice in order to determine the gap between their understanding and application.

METHODOLOGY: A cross-sectional study, conducted in Rawal Institute of Health Sciences, Islamabad from February-June 2022 after ethical approval. Convenience sampling technique was used. About 235 dentists including house officers, general dentists, postgraduate trainees and consultants of Endodontics of Islamabad/Rawalpindi participated. Data was collected by structured questionnaire widely accepted with Cronbach’s alpha of 0.75, through electronic media. Its first part included demographics while second part included questions regarding understanding and practice of endodontically treated teeth restoration. Statistical analysis was done by using SPSS 2, chi-square test and fisher’s exact test were applied.

RESULTS: Mean age of study participants was 29.0±4.54 years. Out of 235 participants, 76(32.3%) were males and 159(67.75%) were females. The responses regarding technical management of endodontically treated teeth showed significant difference with p-value≤0.001 in the understanding and applications of general dental practitioners and endodontists.

CONCLUSION: Significant difference was found among dentists regarding their understanding and practice of restoring endodontically treated teeth.

To compare the efficiencies of shock waves extracorporeal lithotripsies (ESWL) versus ureterorenoscopy (URS) to remove proximate ureteric stones

Muhammad Adnan Sarwar — 2023-10-19

Introduction: - Urolithiasis is a widespread health problem. The objective of this research was to contrast the use of shock waves extracorporeals lithotripsies’ (ESWL) versus ureterorenoscopy (URS) for the proximal ureteric stones treatment. Ureteric stone is a common disease of urinary system in Pakistan. Despite ongoing success in endourological stone treatment, question about optimal management of proximal ureteric stone still remains debatable amongst urologist; therefore this study is being performed to find an appropriate and effective tool to treat ureteric stones.

Objective: - For patients with large proximal ureteric gallstones, our goal was to compare the advantages of ureterorenoscopy with shock wave extracorporeal lithotripsy (ESWL) (10–15 mm).

Settings: The Karachi-based Sindh Hospital of Urology & Transplantation's Urology Department.

Duration: 6 months from 28-01-2022 to 28-07-2022

Design: Randomized control trial

Subject and Methods: Sixty people were enrolled in the trial, all of whom had a single, radio-opaque stone in the proximal ureter detected by IVU. Thirty patients received ESWL and thirty received URS, both at random. After 3 weeks, x-ray KUB was used to monitor patients in both groups. A computerized pre-structured proforma was used for all data collection.

Result: - The victims were 27.58 6.20 years old on aggregate.There were 38(63.3%) male and 22(36.7%) female. Efficacy of URS treatment was significantly high as compare to ESWL [93.33% vs. 60%; p 0.002].

Conclusion: - This research shows that the results support the hypothesis that URS is more effective for proximal ureteric stone clearance than ESWL.

Phenotypic identification of Candida species and relative expression of candida drug resistance (CDR1) gene in fluconazole resistant and sensitive Candida albicans

Muneeza Anwar — 2023-11-25

ABSTRACT:

Background and objective:

Candida albicans belongs to the genus Candida. It is a commensal yeast in healthy individuals and can cause wide variety of infections in immune-compromised patients. The aim of the present study was to observe the frequency of Candida species, resistant profile of C. albicans against fluconazole and over-expression of CDR1 gene in both fluconazole resistant and sensitive C. albicans.

Methodology:

A total number of 206 Candida species were collected on Sabouraud Dextrose agar from Jinnah hospital Lahore. The isolates were re-confirmed by using various microbiological techniques like wet preparation, Gram stain and Germ tube test. Identification upto the species level was done by APIC 20AUX. Antifungal susceptibility profile of C. albicans against fluconazole was determined by broth microdilutiom method. Real Time PCR was performed on both the sensitive and resistant C. albicans to observe the role of CDR1 gene against fluconazole resistance.
Results:

tropicals was the most common species with the frequency of 66 (32.0%) followed by C. albicans 41(19.9), C. glabrata 24 (11.7%), C. lusitaniae 14 (6.8%) and other less common species. The majority of infected patients were females (59.2%) than males (41%). Antifungal susceptibility testing showed that 80% C. albicans were sensitive to fluconazole. Results of gene expression showed that CDR1 gene play a major role towards fluconazole resistance in C.albicans.
Conclusion: Fluconazole was found to be effective in treating infections caused by C. albicans.

Keywords: Candida albicans, Candida Drug Resistant Gene 1, Polymerase Chain Reaction, Candida Tropicalis, Candida glabrata, and Candida lusitaniae

Knowledge, attitude, and practice toward COVID-19 among nurses

Ghulam Murtaza — 2023-11-27

ABSTRACT

BACKGROUND & OBJECTIVE: COVID-19 is caused by the SARS-CoV-2 virus. It can lead to mild to severe respiratory illness, as well as death. Nurses are frontline health workers to care the COVID-19 patients effectively. The objective of the study was to determine the knowledge, attitude, and practice regarding COVID-19 among nurses working at tertiary care public sector hospitals in Karachi.

METHODOLOGY: Analytical cross-sectional study was conducted at Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, for three months from October to December 2020.

The calculated sample size was 239 nurses of both genders. Non-probability convenient sampling technique was used to access the participants. A validated and open accessed tool was used for data collection. A Chi-square test was used to assess the association of Knowledge, attitude, and practice toward COVID-19 with demographic variables. The level of significance was considered with a p-value ≤0.05.

RESULTS: Out of the total, 145 (59.4%) were female, and a majority of 158 (66.1%) of the study subject's ages ranged from 25-30 years old. Mostly 156 (65.3%) of the study participants had a diploma in nursing. Approximately half of 130 (54.4%) of the participants worked the morning shift. The majority of 209 (87.4%) participants' experiences were two years and above. The gender and work experience of the participants were found statistically significant (p-value<0.05). This also found that more experienced nurses were somewhat better to mean Knowledge (7.87) than less experienced nurses (7.13).

CONCLUSION: It is concluded that most of the study participants had sound Knowledge, a positive attitude towards its remedy, and appropriate practice towards COVID-19.

KEYWORDS: COVID-19, Nurses, Knowledge, Attitude, Practice

Frequency of bullying behavior, sources and coping strategies among student nurses in karachi, Pakistan

Muhmooda Abdul Razzaque — 2023-11-27

Background and objective: Bullying is being increasing day by day among health care professionals and specially nursing students (NS) are victimized due to their novelty in nursing profession. The objectives of this study were to find out frequencies of bullying behavior and its association with sources (perpetrators), and coping strategies among NS in Karachi, Pakistan.

Methodology: This cross-sectional survey was conducted among NS and study setting was Dow (institute of Nursing and Midwifery) University of Health Sciences Karachi, Pakistan. Study duration was three months. Inclusion Criteria: NS who were bullied at least in the last 03 months. Exclusion criteria: unwilling participants and those who were absent at the time of data collection. Data was collected through an adapted questionnaire. The data was analyzed and entered into the SPSS version 26. Mean, standard deviations and percentages were used to analyze different forms, frequencies of bully behavior. A chi-square test was used to find the association of forms of bully behavior with sources(perpetrators), and coping strategies of bully.

Result: Out of 300 NS, 64% of the NS were bullied repetitively at clinical duties and 45% were occasionally bullied at the nursing institute. Most frequent source of bully was seniors (57.0%) and a largely NS (51.7%) using coping strategy by overlooking bully which is significantly (p-value <0.05 ) associated with types of bully behavior.

Conclusion: Present study highlighted that NS were experienced various forms of bully and mainly were bullied by seniors at clinicals and mostly they have overlooked bully incidence.

The association of temporomandibular Joint dysfunction with the cervical spine pain

Muhammad Waqas Ghauri — 2023-11-27

ABSTRACT

Background

Temporo-mandibular dysfunction” is a terminology that is used to refer a broad/wide range of interconnected conditions which affecting the temporo-mandibular joint, muscles involve in the process of chewing, and clogging up of the joint. Cervical spine dysfunction is related with the temporomandibular joint dysfunction.

Objective

To find out the association of temporomandibular joint dysfunction with the cervical spine pain.

Methodology

The study, conducted at Gardezi Lab and Clinic, involved 145 participants aged 18-30, with 145 samples in 3 months ranges February 09 to May 09, 2023 after the approval of research study from Ethical research committee. Numeric Pain Rating Scale and Questionnaire form for TMD were used. Results were analyzed using SPSS version 22, and interpreted using frequency and tables.

Results

The test statistics of the cervical spine pain and chewing difficulty, uncomfortable bite, temple pain, and noises from the dysfunctional jaw (a = 10.898, a = 35.446, a = 18.813, and a = 14.345 respectively) have a p value of 0.000, which was less than the normal and standard p value of 0.05. So there is association present between neck pain and chewing difficulty, uncomfortable bite, temple pain and noises from the dysfunctional jaw.

Conclusion

This study concluded that there is positive association between the pain in the cervical-region and resistance in chewing, uncomfortable feelings during bite, pain in the temple region, and noises from the jaw. But there is negative association present between the neck pain and locking sensation of the jaw.

Key Words

Cervical Spine, Temporo-mandibular Dysfunction

Effect of knee strengthening exercises with and without hip Strengthening exercises in women with knee osteoarthritis: randomized controlled trials

Mariam Umer Hayat — 2023-11-25

Background and Objective: Hip strengthening exercises in patients with knee osteoarthritis is very beneficial the aim of study to determine combine effects of hip strengthening exercises with knee strengthening exercises on knee pain, function and activities of daily livings and quality of life in women with knee osteoarthritis.

Methodology: In total, seventy women aged 40-70 year with knee OA, II–III grades on the Kellgren-Lawrence scale were included and randomized to experimental group (EG) and control group (CG) 35 in each group. The participants were going for 6-week supervised session, 4 times per week. The strengthening program consisted knee with hip strengthening exercises for EG, and only knee strengthening exercise for CG. Elastic Thera-Bands were used for resistance. KOOS was used for assessment and perform at baseline, 2nd week, 4th week and 6th week.

Results: Finally 61 subjects were completed the study 31 in EG and 30 in CG. Results show that there were statistically and clinical significant improvements in the KOOS score in both groups from baseline to at 6^th week. There was significant difference were observed in experimental group with mean pain 36.94±8.718 to 82.19±7.472 (p=0.051) in EG, & 22.97±4.165 to 72.53±5.237 (p=0.004) CG. The mean function 29.71±9.389 to 81.19±6.036 (p=0.000) EG & 24.14±4.927 to 67.94±3.984 (p=0.003) in CG and the mean Quality Of Life 27.06 ±7.806 to 60.61±10.148 (p=0.005) in EG & 24.30± 6.271 to 67.27± 7.821(p=0.000) in CG respectively.

Conclusion(s): The combined knee strengthening exercise with hip strengthening exercises provide more significant enhancement in the clinical outcomes that are pain, function of daily living and quality of life in the women with osteoarthritis of the knee.

Perceived relevance of oral biology: a comparative study among dental interns and faculty

Sadia Shakeel — 2023-11-27

Background & Objective: This study aims to compare and examine the distinctive perspectives of dental trainees and distinguished faculty members toward the significance of oral biology subject for dentistry, clinical training, and dental education.

Methodology: A prevalidated questionnaire consisting of two sections was distributed through Google Forms and handouts to dental interns and faculty members of basic and clinical departments of different dental institutes and hospitals oh Punjab. The data was collected and statistically analyzed using IBM-SPSS version 25. The chi-square test was applied to check the significance of questions regarding perception of oral biology. A p-value of less than 0.05 was considered as the threshold for statistical significance.

Results: Both groups perceived high relevance of oral biology towards dentistry with slightly more relevance reported by dental interns regarding the importance of oral biology for dental education and clinical training. Regarding the data collected from clinical dental departments Oral surgery department showed the highest relevance of oral biology with dentistry whereas the Orthodontic department considered oral biology most relevant for future clinical training and practice.

Conclusions: Dental faculty and interns emphasized the importance of oral biology as a discipline for dentistry, but interns reported substantial application for relevance related to future clinical training and practice.

Examining the tapestry of mental health crises in low- & middle-income countries: an intercontinental analysis of the contributing factors and instructive approaches"

Naeem Mubarak — 2023-11-27

In recent decades, the intricate landscape of mental health challenges has become a focal point of global concern, with particular urgency in Low- and Middle-Income Countries (LMICs). This manuscript delves into the multidimensional tapestry of mental health issues prevalent in these regions, offering an intercontinental analysis that seeks to unravel the contributing factors and proposes strategies for improvement. Through a meticulous examination of diverse sociocultural, economic, and healthcare-related variables, this study aims to provide a comprehensive understanding of the complex dynamics shaping mental health crises in LMICs. Through an intercontinental lens, our analysis aims to transcend geographical boundaries, examining the commonalities and distinctions inherent in the mental health landscapes of LMICs. This inquiry is driven by a dual commitment: to comprehensively understand the determinants of mental health challenges and to identify instructive approaches that can serve as foundations for targeted interventions. In navigating this intellectual terrain, our study not only strives to contribute to the academic discourse on global mental health but also aspires to inform policy and practice, fostering a nuanced understanding of mental health dynamics and cultivating evidence-based strategies to ameliorate the burden faced by individuals in LMICs. By synthesizing current research, empirical data, and theoretical frameworks, our exploration not only illuminates the challenges but also endeavors to identify instructive approaches for mitigating the impact of mental health issues in resource-constrained settings. The confluence of factors influencing mental health in LMICs demands an interdisciplinary lens, and this manuscript endeavors to navigate this intricate terrain with rigor and precision. This article exposes the significant gap in mental health services, attributing this disparity to limited public funding, insufficient allocation for children and adolescents, and an inadequate distribution of funds in mental health infrastructure. The scarcity of mental health workers, particularly in primary healthcare settings, further exacerbates the problem. The contributing factors to mental health crises in LMICs include ineffective legislation, leadership, and national health policies, as well as cultural beliefs and stereotypes. The lack of a mental health information system further hampers meaningful progress in these regions. There is a need for a comprehensive mental health system that considers cultural, social, and economic factors unique to LMICs. To address the challenges faced by LMICs, the article suggests strategies, including legislative reforms, policy development, public education to reduce stigma, and promotion of evidence-based interventions. By drawing on existing principles and considerations, the authors provide a specific system of mental health services grounded in community-based care and "mental health-in-all-policies" approach which advocates for rational investment allocations, considering social determinants, prevalence data, and the humane treatment of individuals with mental health issues in these regions.