Journal of University Medical & Dental College

JUMDC — 2024-09-14

Telehealth: A bridge divided? Bridging the digital divide for equitable healthcare access.

Sundus Tariq — 2024-08-23

Response of the intravenous versus oral antibiotic regimen in brucellosis bacteremia.

Imran Nazir — 2024-08-24

BACKGROUND AND OBJECTIVE: More than 500,000 new cases are reported globally annually. The World Health Organization recommends doxycycline with rifampicin or an aminoglycoside for brucellosis bacteremia. Some experts prefer to use doxycycline and rifampicin. We aimed to observe the response rate of intravenous versus oral anti-brucella therapy regimens in brucellosis bacteremia patients and compare the frequency of side effects and complications in both groups.

METHODOLOGY: This observational study included adult brucellosis bacteremia patients treated in a hospital in Makkah, KSA for four years. According to the method of treatment (oral versus IV antibiotics), patients were grouped into two categories. Following the treatment, all these patients’ records were evaluated. The negative blood culture was the primary endpoint whereas complications and all-cause mortality were secondary endpoints. The chi-square test, Fisher's exact test, and Mann-Whitney U test were applied accordingly to analyze the two groups’ characteristics.

RESULTS: A total of 93 cases were enrolled, the majority were males i.e., 64 (68.8%); with a mean age group (44.33 ±19.22 years). In total, 37 (39.8%) of patients were given IV regimens and the remaining 56 (60.2%) of patients were given oral regimens. Follow-up negative blood culture after 4 weeks was 90.3% (n = 84). The recovery rate was 93.5% (n = 87). No death was reported over this period. No difference was observed (P-value 0.309) between the oral and IV treatment regimens regarding the blood culture negativity.

CONCLUSION: Oral doxycycline-rifampicin (DR) and IV gentamicin-doxycycline-rifampicin (GDR) regimens have similar response rates in bacteremia brucellosis.

Assessing students’ perception of the surgical theatre educational environment of a private medical college in Pakistan

Tayyaba Sarfraz — 2024-08-24

ABSTRACT

BACKGROUND & OBJECTIVE: The learning environment is a crucial part of any educational institute. It should be ensured that the learning environment is facilitating the learning process. This study aims to assess undergraduate medical students' perception of the learning environment of surgical theater.

METHODOLOGY: This was a cross-sectional study done at Liaquat College of Medicine and Dentistry (LCMD) a private medical college in Karachi. Data was collected from final-year students, who attended surgical rotation using a pre-validated questionnaire “Surgical Theatre Educational Environment Measure (STEEM)” and analyzed using SPSS version 23.0.

RESULTS: Eighty-eight (n=88) out of a hundred participants have completed the given questionnaire. Most of the students (64.26%) were overall satisfied with the learning environment in the surgical theatre of the institute (p-value=0.083). Male students were found more satisfied with the learning environment as compared to their female counterparts. The overall Cronbach alpha of STEEM was found 0.75.

CONCLUSION: The outcomes of this study revealed that most of the students of LCMD had positive perceptions of instruction and training in surgical theatre.

To study the outcomes of scrotal exploration for acute scrotal pain in relation to monthly and daily temperature variations: A large contemporary series from a Teaching Hospital

Adeel Anwar — 2024-08-24

ABSTRACT:

BACKGROUND & OBJECTIVE:

Acute testicular pain requires emergency exploration for suspected testicular torsion (TT). It has been suggested that temperature variation is associated with TT. However, it was not possible to conclude whether the higher occurrence of TT was related to TT itself or the effect of the overall higher presentation of acute scrotum. We studied the impact of seasonal and daily temperature variations on acute testicular pain and outcomes.

METHODOLOGY: Retrospective data collection on patients required testicular exploration between January 2006 and December 2017 for TT. The Kruskal Wallis test & chi-square tests were used to assess the group difference between continuous and categorical variables, respectively.

RESULTS: In total, 502 patients required testicular exploration. The median age and duration of symptoms were 16.4 yrs. (1.3 – 77) and 4 hrs. (1 – 336). Respectively, TT was found in 231 (46%), torsion of the testicular appendix (TTA) in 126 (25%), epididymal inflammation (EI) in 46 (9.2%), and no identifiable cause (NIC) was found in 99 (19.7%). Scrotal explorations were more common in groups with mean daily temperature >6.2⁰C, 60.2% Vs 39.8% while there was no difference in TT 46% Vs 46% in these groups.

CONCLUSION: There was no seasonal variation for testicular torsion or operative findings. Cold weather and average low daily temperatures were not related to testicular torsion.

Efficacy and safety of triple diode laser in hair growth reduction

Tayyaba Iqbal — 2024-08-24

ABSTRACT

Background & Objective: Laser treatment for hair removal is a very common procedure in dermatology. Ruby, diode, alexandrite, Nd yag, and intense pulse light are frequently used for hair reduction. For more effective results a combination of wavelengths is used. The purpose of this study is to determine the efficacy and safety of triple diode lasers in hair growth reduction.

Methodology: This interventional longitudinal study comprises of total 82 patients using a non-probability convenience sampling technique, the mean age of the patients was 28.73, the age range was between 17 to 56 years, and all patients in this study were female of skin phenotype between III to V. Each session was done one month apart for four months, and hair growth reduction was assessed by using GAIS (Global Aesthetic Improvement Scale Assessment) score

by two independent dermatologists in 4^th session.

Results: Hair growth reduction was observed in all the enrolled patients from the first session. Out of 82 patients, 63.4% of patients are of skin phenotype IV, 23.2% patients are of skin phenotype III whereas 13.4% are skin phenotype V. After four sessions 41 patients (50%) showed excellent results, and 41 patients (50%) showed good results. None of these patients experienced any long-term side effects.

Conclusion: Triple diode laser is a safe and effective modality in hair growth reduction at all body sites in skin phenotype III- V with minimal side effects.

Prevalence of metabolic syndrome and its components among the teaching faculty of Allama Iqbal Medical College and Jinnah Hospital Lahore

Mudassar Ali Roomi — 2024-08-24

BACKGROUND & OBJECTIVES: Metabolic syndrome and its components are established risk factors for type-2 diabetes mellitus and cardiovascular diseases. The Objectives of the current study were to assess the mean values of cardiometabolic risk factors and anthropometric parameters among the teaching faculty of Allama Iqbal Medical College and Jinnah Hospital Lahore (AIMC/JHL). To investigate the prevalence of metabolic syndrome and its components.

METHODOLOGY: This cross-sectional study was conducted from December 2022 to July 2023 at AIMC/JHL. Faculty members (n=115), aged 30-60, were recruited by convenience sampling from basic and clinical departments. Metabolic syndrome was defined by ATP-III criteria. Means of quantitative variables were compared by student t-test. Chi-square was used to determine associations between nominal variables.

RESULTS: Mean values of arterial blood pressure were significantly higher in males than females. Fasting hyperglycemia was present in 38.3% of participants. Decreased HDL, hypertriglyceridemia, hypertension, and central obesity were found in 65.2%, 24.3%, 34.8%, and 74.8% of participants, respectively. The prevalence of low HDL and central obesity was significantly higher among females; however, hypertriglyceridemia and hypertension were more prevalent among males. A significant correlation (r=0.241) was observed (p=0.009) between age and waist circumference. Pre-metabolic syndrome and metabolic syndrome were present in 38.3% and 43.5% of participants, respectively.

CONCLUSION: An alarmingly high prevalence of metabolic syndrome and its components was observed among healthcare professionals who endeavor to treat similar diseases. This irony underscores the need for increased awareness and routine screening of metabolic syndrome among healthcare professionals

Determination of Knowledge of Patients Regarding Psoriasis

Maria Khalid — 2024-08-24

ABSTRACT

BACKGROUND & OBJECTIVE:

Psoriasis, a chronic, non-communicable skin condition, significantly impacts patients' quality of life. This study aimed to assess the knowledge levels among psoriasis patients, categorized into adequate, moderately adequate, and inadequate, to identify educational needs and opportunities for improved patient education.

METHODOLOGY:

This cross-sectional study was conducted at the Department of Dermatology, Imran Idrees Hospital, affiliated with Sialkot Medical College, from October 2023 to February 2024. It involved 218 patients aged 16-60 years, diagnosed with psoriasis for over a year. Knowledge levels were assessed using a self-administered questionnaire, with scores ≥7 out of 10 considered adequate knowledge.

RESULTS:

Out of the participants, 57.8% had inadequate knowledge about psoriasis, 32.6% had moderately adequate knowledge, and only 9.6% had adequate knowledge. The analysis showed no significant differences in knowledge levels across age, gender, duration of disease, education, and economic status (p-value > 0.05).

CONCLUSION:

The study revealed a significant gap in the knowledge about psoriasis among patients, emphasizing the obligation for routine patient education and counseling. This approach could improve treatment adherence and outcomes, reducing misconceptions and treatment discontinuation.

Institutional Barriers to Continuous Professional Development (CPD) Programs

Maaz Ahmad — 2024-08-24

Abstract

BACKGROUND AND OBJECTIVE: Continuous Professional Development (CPD) Programs aim to support the career progression of faculty members by leveraging their professional experiences, theoretical knowledge, research, and professionalism with colleagues. These programs enhance skills, knowledge, and competencies throughout a faculty career. However, institutional barriers such as heavy workloads and limited resources can hinder the effectiveness of CPD programs. Faculty training enables them to address concerns, be aware of their teaching assumptions, and foster a positive educational environment. It requires reflection, openness to new ideas, and intellectual work for professional growth. This study’s objective was to determine the frequencies of Institutional Barriers faced by faculty to Continuous Professional Development (CPD) Programs.

METHODOLOGY:

In this research, we used an observational study design. Purposive sampling was employed to collect the responses. A total of 229 participants responded. Data were entered and analyzed using IBM SPSS version 26 software. A pilot study was conducted to measure reliability. Frequencies were measured, and associations between categorical variables were determined using the Pearson Chi-Square Test.

RESULTS:

Significant associations of almost all the identified institutional barriers were observed with academic positions whereas the majority of the barriers demonstrated no association with gender and specialty.

CONCLUSION:

Academic position is the most important factor identified in our study, showing strong associations with almost all the institutional barriers studied. By creating a supportive environment and promoting continuous learning, institutions can empower faculty members to engage in CPD activities and enhance their professional development.

Role of SGLT2 inhibitors in improving cardiac functions (on Echocardiography) in patients having Diabetes Mellitus and ischemic heart disease

Muhammd Owais — 2024-08-24

BACKGROUND & OBJECTIVE: Sodium-glucose cotransporter-2 inhibitors (SGLT2i or SGLT2 inhibitors) have a distinctive mechanism of action unrelated to insulin secretion or action. By causing glucosuria, they reduce plasma glucose by inhibiting SGLT2 in the proximal tubules of the kidneys. This mechanism of action corrects several metabolic abnormalities, which are, in fact, CVD risks in addition to normoglycemia. This study was conducted to assess the average change in ejection fraction resulting from the use of SGLT2 inhibitors in enhancing cardiac function in patients with Diabetes Mellitus and ischemic heart disease.

METHODOLOGY: This is a descriptive case series conducted from 10^th December 2022 to 9^th May 2023 in the Department of Medicine, Faisalabad Medical University; 435 type II diabetes mellitus patients were selected, according to inclusion and exclusion criteria. All received a daily dose of 20 mg of SGLT2 for three months. Echocardiography was done before and after the treatment period left ventricular ejection fraction (EF) was evaluated, and improvement in cardiac function was noted.

RESULTS: In this study, the mean age of participants was 46.54±8.52 years. 314 (72.18%), or the majority, were between 30 and 50. The male-to-female ratio was 1.1:1, with 228 (52.41%) men and 207 (47.59%) women. The mean ejection fraction at baseline was 53.45 ± 4.12. The mean change in ejection fraction of SGLT2 inhibitors in improving cardiac functions among patients having Diabetes Mellitus and ischemic heart disease was 50.79 ± 3.76.( p-value ≤0.001).

CONCLUSION: SGLT2 inhibitors effectively improve cardiac functions among patients with Diabetes Mellitus type II and ischemic heart insult

Evaluation of correlation between compliance of a patient towards orthodontic treatment and plaque accumulation in lower anterior region with fixed orthodontic appliances. A cross-sectional study

Hafsa Riaz — 2024-08-24

BACKGROUND &OBJECTIVE: Using orthodontic appliances can offer new spots for the oral microbiota and dental plaque to attach. Poor oral hygiene can lead to gingivitis and tooth decay resulting in the removal of braces to repair damage and delay treatment. Orthodontic patients who are mindful of their oral health often show greater compliance with their treatment. They tend to miss fewer appointments and avoid losing brackets, demonstrating a strong commitment to their orthodontic care. This study aims to find a correlation between plaque accumulation and patients’ compliance with their orthodontic treatment.

METHODOLOGY:50 orthodontic patients (20 males and 30 females, aged 11 to 25 years) were assessed at their 3rd, 4th, or 5th appointments. The plaque index for each patient was calculated on these appointments. Patient compliance like appointment follow-ups and bracket failures was recorded. A correlation was found between the plaque index and compliance of the patient.

RESULTS: A statistical analysis revealed a significant, strong negative correlation between the rate of following appointment follow-ups and the plaque scoring index (r = -0.832, P value < 0.001), and a significant, strongly positive correlation between bracket failure rate and plaque scoring index (r = 0.795, P < 0.001). Patients who had good attendance at follow-up appointments and low bracket failure had lower mean plaque score indices.

CONCLUSION: Patients with good compliance in terms of low bracket failure rate and attending follow-up appointments regularly tend to have lower plaque scores.

A cross-sectional study of gender variations in dental anxiety among Pakistani undergraduate students

Syeda Lalarukh Saba Shah — 2024-08-24

ABSTRACT

BACKGROUND & OBJECTIVE: This study investigates gender differences in dental anxiety among Pakistani undergraduate students to enhance their oral health awareness and help reduce the avoidance of necessary dental care. To study the gender variations in dental anxiety among Pakistani undergraduate students.

METHODOLOGY: Data was collected from 350 students by using cross-sectional study design and the age of the students was 18-24 years. A non-probability convenience sampling technique was utilized. After getting institutional ethical permission, the study was carried out. Every participant provided their consent, and confidentiality was maintained. The significance level was set at 0.05, and a 95% confidence level was determined.

RESULTS: 350 students responded to the survey. Dental anxiety was more prevalent in females than males and found to be associated with other risk factors like visits to the dentist (<0.001), fear of dental pain (0.021), dental treatment (0.030), fear of white coat (0.006) and concerns (0.002). The findings emphasized the need for stress-reduction techniques and exercises done by the doctor before starting the dental treatments. Furthermore, it is crucial to minimize, if not completely avoid, the causes of dental anxiety through effective counseling and communication.

CONCLUSION: Dental fear is more common among female students, which is a barrier to receiving dental treatments. Therefore, decreasing dental anxiety could be accomplished by offering frequent dental education and public awareness regarding oral health.

Journal of University Medical & Dental College

Contents

Telehealth: A bridge divided? Bridging the digital divide for equitable healthcare access.

Response of the intravenous versus oral antibiotic regimen in brucellosis bacteremia.

Assessing students’ perception of the surgical theatre educational environment of a private medical college in Pakistan

To study the outcomes of scrotal exploration for acute scrotal pain in relation to monthly and daily temperature variations: A large contemporary series from a Teaching Hospital

Efficacy and safety of triple diode laser in hair growth reduction

Prevalence of metabolic syndrome and its components among the teaching faculty of Allama Iqbal Medical College and Jinnah Hospital Lahore

Determination of Knowledge of Patients Regarding Psoriasis

Institutional Barriers to Continuous Professional Development (CPD) Programs

Role of SGLT2 inhibitors in improving cardiac functions (on Echocardiography) in patients having Diabetes Mellitus and ischemic heart disease

Evaluation of correlation between compliance of a patient towards orthodontic treatment and plaque accumulation in lower anterior region with fixed orthodontic appliances. A cross-sectional study

A cross-sectional study of gender variations in dental anxiety among Pakistani undergraduate students