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> (Prof Dr. Muhammad Akram Malik) (Aroosa Noor) Wed, 23 Feb 2022 00:00:00 +0000 OJS 60 Contents editor Copyright (c) Tue, 22 Feb 2022 00:00:00 +0000 Time to rationalize the use of antibiotics Aisha Sajid Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 Global research trends in Coronavirus disease 2019 (COVID-19) and hepatitis: A bibliometric analysis Tauseef Ahmad, Saba Tariq, Sundus Tariq Copyright (c) 2022 Journal of University Medical & Dental College Sat, 26 Feb 2022 00:00:00 +0000 Missed dose error among nurses working at tertiary care hospitals, Karachi <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> Medication administration error (MAE) has been recognized as a serious health related issue that can lead to surge mortality and morbidity. In addition, it may rise hospitalization that, will increase the ratio of the patient. This study was accomplished to determine the missed dose error among nurses working at tertiary care hospitals in Karachi.</p> <p><strong>METHODOLOGY:</strong> This analytical cross-sectional study was accomplished at Dr. Ruth K.M. Pfau Civil Hospital and Dow University Hospital, Karachi, for the period of six months from February to July 2018. The calculated sample was 204 nurses of both genders. Nurses having one year of working experience and licensed with Pakistan Nursing Council had been invited for the study. The participants were approached by a non-probability convenient sampling method. The adopted and validated questionnaire was utilized to gather the data. The data was entered and analyzed by using SPSS version 21.0.</p> <p><strong>RESULTS:</strong> Out of 204 subjects, 106 (52%) were male. With respect to age, 168 (82.3%) of respondents had age below 35 years. The percentage of missed medication doses was reported to be 12.3%. In this study, nurses to patients ratio, and timing of medication administration were found statistically significant with missed dose errors p-value≤0.05.</p> <p><strong>CONCLUSION:</strong> The study finding showed a small frequency of missed dose errors among nurses working in tertiary care public sector hospitals, Karachi. The majority of missed doses were recorded in the morning shift, and nurses who had more patients ratio.</p> Raja, Badil, Pawan Kumar, Sana Rehman, Gulsher Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 Trend analysis of COVID-19 cases in Pakistan <p><strong>BACKGROUND &amp; OBJECTIVE</strong>: Statistical models play a significant role in understanding the trend, level and trajectory of infectious diseases and provide the foundation to formulate effective policies and timely intervention, so that the morbidity and mortality due to these diseases can be declined. This study aimed to uncover the trend and proposing a forecasting model for daily expected outbreaks due to COVID-19 of fourth spike in Pakistan.&nbsp;</p> <p><strong>METHODOLOGY: </strong>This study is primarily based on a secondary data of COVID-19 daily confirmed outbreaks. The two-month (1<sup>st</sup> June to 31<sup>st</sup> July 2021) time series data is recorded and available from COVID-19 health advisory platform by Ministry of National Health Services Regulation and Coordination official website. Descriptive and time series analysis (ARIMA, exponential smoothing models) were applied. The analysis was carried out using R programming language.</p> <p><strong>RESULTS:</strong> The highest (5026) and the lowest (663), COVID-19 confirm cases reported on 31 July 2021 and 21 June 2021 respective, whereas the average confirmed cases were 1830 [762-2898] per day. Four different time series models are executed namely ARIMA, Brown, Holt and Winter.&nbsp; Among competitive models, ARIMA (0, 2, 1) is found to be an optimum forecasting model, selected by using auto ARIMA function with least root mean square error. A day ahead forecast is obtained under the selected ARIMA model and yielded that COVID-19 confirmed outbreaks is expected to increase about 3.1% per day.</p> <p><strong>CONCLUSION: </strong>COVID-19 outbreaks are expected to rise in Pakistan and ARIMA (0, 2, 1) is an optimum forecasting model for daily COVID-19 outbreaks.</p> Sumera Shareef, Shumiala Akhtar, Naima Tufail , Fiaz Ahmad, Muhammad Imran shakoor Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 A comparative study of postoperative airway management between traditional nasal packing and modified nasal airway after nasal surgeries <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>One of the most common challenging complications after nasal surgeries is maintaining airways. The study aimed to use an alternative technique instead of nasal packing in the immediate postoperative period undergoing different nasal surgery under general anesthesia regarding airway management.</p> <p><strong>METHODOLOGY: </strong>An interventional study was conducted at Aziz Fatimah Trust Hospital, Faisalabad, from<strong>&nbsp;</strong> March 20, 2018, to January 31, 2019.&nbsp;A total of 100 participants were enrolled in the study divided into two groups (A &amp; B), 50 each. Group A patients were treated postoperatively with a modified nasal airway devised with a Nelton catheter and Group B patients with traditional nasal packing. The participants were assessed on different parameters which were statistically compared and analyzed.</p> <p><strong>RESULTS: </strong>Group Descriptive statistics revealed that the Mean±SD of the age of group A and group B patients was 24.28±9.72 and 26.68±11.09 respectively, which had no significant difference between them {p-value (0.008)}. The postoperative parameters such as patient's comfort and sleep, surgeon satisfaction, ease of suction through Nelton catheter, and oxygen saturation were evaluated as significant variables in the evaluation of the study. p-value ≤0.05 and ≤0.005 were considered as significant and highly significant respectively.</p> <p><strong>CONCLUSION: </strong>This modified nasal airway has proven to be easily replicable and reliable, and a cost-effective measure elucidated as a potential and exclusive outcome of the present study.</p> Muhammad Saleem, Baber Rafiq Khan, Sarwat Bibi, Humaira Ahmad, Muhammad Hamza Rana Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 COVID-19 pandemic and the use of tele-health by pediatricians and pediatric post graduate residents <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>During the COVID-19 pandemic, burden on healthcare facilities has increased worldwide; which has led to acceptance of the ‘telehealth services’ by the pediatricians. Objective of this study was to determine the impact on frequency of use of tele-health services by pediatricians during the COVID-19 pandemic; and to determine the factors promoting and preventing the use of tele-health services by pediatricians.</p> <p><strong>METHODOLOGY:</strong> This descriptive cross-sectional study was carried out from August 2020 to January 2021 among the pediatricians of Children Hospital Faisalabad and other affiliated hospitals of Faisalabad Medical University, Pakistan. An e-questionnaire was circulated among 357 pediatricians, which was filled and submitted by 114 pediatricians online. Demographic details and other data were collected and analyzed by SPSS v.20. P-value &lt;0.05 was taken as significant.</p> <p><strong>RESULTS: </strong>Out of 114 participants, 29(25.4%) paediatricians were already using Telehealth before the COVID-19 pandemic. Whereas, 101(88.6%) participants used Telehealth during the pandemic. There was an increase in frequency of telehealth use during the pandemic by 72(63.2%) paediatricians (p-value= 0.037). Most common factor promoting the use of telehealth during pandemic was ‘decreased chance of cross infection and maintenance of social distancing’. Most frequent factor preventing its use was ‘lack of confidence on virtual examination findings’.</p> <p><strong>CONCLUSION: </strong>Telehealth provided an effective means of practicing social distancing by the paediatricians without any breach in healthcare provision. However, there are a few factors contributing to hesitancy towards it. Therefore, more platforms must be provided and incentives to be given to paediatricians to promote the use of telehealth.</p> Tehreem Fatima, Zaib Nasir, AbdulAhad Jamshaid, Hina Ayesha Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 Understanding, oral hygiene practices, behaviors and myths to deal with Toothache in rural areas <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>In Pakistan, there is lack of awareness to maintain oral hygiene and cleaning of oral structures. The current study aims to unveil homemade remedies and self-care methods followed by a majority of the rural population to cure dental pain in Sindh, Pakistan.</p> <p>&nbsp;<strong>METHODOLOGY: </strong>This cross-sectional descriptive study was conducted at dental OPD of the Secondary Health Care Facility of Sindh, Pakistan, by following a random sample selection approach.&nbsp; Patients from both genders representing oro-dental problems of ages ≥ 5 year were included in the study. Patient’s clinical and demographic data was collected, and further descriptive data analysis was done by using Microsoft Excel 2016.</p> <p><strong>RESULTS: </strong>A total of 1627 patients fulfilled the inclusion criteria of the study. The highest number of cases (73.81%) were belonging to the age group 15-49 years, affirming that adults are at greater risk of developing toothache and dental pain. Surprisingly, about 78.97% patients had never visited any physician for seeking the clinical services. Similarly, 37.18 % of patients did not use any cleaning substance while 22.12 % patients preferred miswak for cleaning of their teeth. Only 2.95 % of patients visited dentists for proper care.</p> <p><strong>CONCLUSION: </strong>Current research report concludes that from all the confirmed toothache cases, 22.13 % of patients sought care from general physicians in parallel with 22.34 % patients were preferring religious spells to manage their dental pain, which further multiplied the disease rate. However, general physicians at primary healthcare settings have limited knowledge and training in managing dental pain.</p> Sarang Suresh Hotchandani, Priya Rani Harjani, Suneel Kumar Punjabi, Mowaffaq Abdullmomen Al Absi, Hafiz Mahmood Azam, Aswad Ahmed Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 Association between artificially sweetened beverages consumption and changes in body mass index among children <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Poor food quality and choices are a major concern in the modern life style and increased consumption of sweetened and artificially sweetened beverages have been implicated as contributing factors for obesity. The objective of this study is to determine the association between the consumption of artificially sweetened beverages and changes in body mass index among children.</p> <p><strong>METHODOLOGY: </strong>Data on the consumption of artificially sweetened beverages consumption and BMI for 13,287 children was analyzed for exposure and outcome from Millennium Cohort Study (MCS). The association between frequency of ASB consumption and BMI was quantified using demographics and linear regression analysis. The linear regression analysis was done adjusting demographic, socioeconomic variables and confounding factors of frequency of physical activity. Regression analysis was conducted using survey weights to account for the complex sampling design.</p> <p><strong>RESULTS: &nbsp;</strong>Adjusted linear regression for demographical and socioeconomic variables showed that more frequent consumption of ASB was associated with a significant increase in BMI. As the frequency of ASB increased, BMI significantly increased by 0.69-1.06 units in categories (p&lt;0.01). Regression analysis adjusted for frequency of physical activity also showed an increase of BMI by 0.36 units (p&lt;0.01) with the highest frequency of ASB consumption.</p> <p><strong>CONCLUSION: </strong>Higher consumption of artificially sweetened beverages causes an increase in BMI among UK children.</p> Muhammad Bilal Arshad, Muhammad Usman Sheikh, Muhammad Afzal, Aneela Amjad, Shahzeb Patoli, Muhammad Behzad Salahuddin Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 Effectiveness of muscle energy technique (met) in patients with acute low back pain: Qusai experimental Study <p><strong>BACKGROUND &amp; OBJECTIVE</strong>: Low back pain is a common problem in society. Acute low back pain can persist for up to six weeks and requires immediate attention for treatment. The muscle energy technique was mostly used in rehabilitation for strengthening and relaxation purposes. The objective of the study was to find out the effectiveness of the muscle energy technique in patients with acute low back pain.</p> <p><strong>METHODOLOGY: </strong>It was a quasi-experimental trial; with a sample size of 60 were collected from 05 June 2020 to 05 November 2020. A convenient sampling technique was used and patients were divided into two groups after inclusion and exclusion criteria. The tools were the Standardized visual analog scale (VAS) and Oswestry disability index (ODI). The setting was Ibn e Siena Hospital and Research Institute, Multan and Multi-care physiotherapy clinic Multan. An Independent t-test was applied to measure the significance of data. The experimental group was treated by muscle energy technique and the control group was treated through neuromuscular control exercises.</p> <p><strong>RESULTS: </strong>Total number of patients in the study was 60, equally divided into two groups. Pre and post control and experiment group ODI mean±SD 28.13±5.25, 12.66±3.78 and 26.13±4.12, 7.80±3.14, pre and post-VAS 8.70±0.79, 8.30± 1.17 and 2.00± 1.20, 0.76± 1.00 respectively. There was a significant difference (p&lt;0.000) between a pre and post intervention score of the Oswestry disability index (ODI) and the visual analog scale (VAS).</p> <p><strong>CONCLUSION: </strong>Muscle energy technique was more effective than neuromuscular control exercises in mechanical acute low back pain.</p> Muhammad Usman Khalid, Danish Hassan, Yasir kazmi , Muhammad Hassan, Haroon Mansha , Hayatullah khalid Copyright (c) 2022 Journal of University Medical & Dental College Sat, 26 Feb 2022 00:00:00 +0000 Efficacy of topical 0.5% bupivacaine in pain reduction in pediatric tonsillectomy patients <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Palatine tonsils are lymphoid organs in the oropharynx part of the waldeyer's ring and serve as host defence organs with maximum immunological activity from 3-10 years. Tonsillectomy is associated with considerable postoperative pain and requires significant consumption of analgesia. This study aimed to determine effect of topically suffused 0.5% bupivacaine on postoperative tonsillectomy pain.</p> <p><strong>RESULTS</strong> One hundred &amp; twenty (120) patients with 61 males and 60-patients in each group with age range of 5-15 years (Group-A=8.63±2.63 and Group-B=8.32±6.60 in). Mean BMI of Group-A and group-B was 15.18±1.60 and 14.96±1.34 respectively (p=0.417). Mean pain score in group-A and group-B was 2.63±0.938 and 6.07±0.800 respectively (p&lt;0.001).</p> <p><strong>CONCLUSION: </strong>nsillectomies performed using bupivacaine-soaked packs postoperatively are associated with lower postoperative pain compared with those packed with normal saline.</p> Sabih Nadeem Qamar, Zia us salam qazi, Sarfraz Latif, Sadia Maqsood Awan, Saulat Sarfraz, Riffat Saeed Copyright (c) 2022 Journal of University Medical & Dental College Wed, 02 Mar 2022 00:00:00 +0000 Coronary Artery disease prevalence in patients having essential hypertension with Or without diabetes Mellitus detected by Cardiac MIBI scan <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>The aim of this retrospective study was to find the prevalence of coronary artery disease (CAD) in hypertensive patients with or without diabetes mellitus.</p> <p><strong>METHODOLOGY: </strong>Data of patients having essential hypertension (n=931) referred to PINUM from April 2017 to December 2018 for stress/rest cardiac MIBI scan was analyzed. This data was divided into two groups. HD group contains data of patients having hypertension with diabetes mellitus (n=456, 48.98% of total population, M:F=245:211). While data of patients having hypertension without diabetes mellitus was placed in H group (n=475, 51.02% of total population, M: F=254:221).</p> <p><strong>RESULTS: </strong>Prevalence of CAD is higher in HD group than in H group (47.8% vs. 30.1%; p&lt;0.001). CAD is more prevalent in males than females in both groups (53.9 % vs. 40.8% in HD group, and 39.4% vs. 19.5% in H group). This difference in prevalence of CAD in HD and H groups is more marked in females (40.8% vs. 19.5%; p&lt;0.001) than males (53.9 % vs. 39.4%; p=0.001). Prevalence of CAD in patients with typical presentation is not statistically significant in HD and H groups (72.3% vs. 68.4%; p=0.645), while in subjects with atypical presentation prevalence is significantly higher in HD group than H group (40.8% vs. 26.8%; p&lt;0.001).</p> <p><strong>CONCLUSION: </strong>Prevalence of CAD is higher in the group of patients having essential hypertension with diabetes mellitus than the group of patients having essential hypertension without diabetes mellitus.</p> Owais Bin Qadeer Gill, Talal Abdul Rehman, Muhammed Shahzad Afzal, Hafiz Amjad Hussain Copyright (c) 2022 Journal of University Medical & Dental College Wed, 02 Mar 2022 00:00:00 +0000 Research trends in polio during the last 50 years: a bibliometric analysis <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> Many polio cases have been reported in recent years, which strongly affect the Global Polio Eradication Initiative campaign. This study aimed to determine the global trends in polio research during the last fifty years.</p> <p><strong>METHODOLOGY:</strong> An online search was conducted utilizing the Web of Science Core Collection database. The key term used was “Polio*" and the retrieved documents were assessed for several attributes. The required graphs were generated using OriginPro 2018. Furthermore, the data were plotted for co-authorship organizations, co-authorship countries, and co-occurrence author keywords network visualization mapping using VOSviewer software for windows.</p> <p><strong>RESULTS:</strong> A total of 2,345 publications were included, cited 22,872 times. The year 2017 was the most frequent year with 162 (6.91%) publications. The paper authored by Nomoto and colleagues published in 1977 was the leading paper with 237 citations. In total, Vaccine was the leading journal with 168 (7.16%) publications, followed by Journal of Infectious Diseases 106 (4.52%), and Lancet 77 (3.28%). The included publications were published from 132 countries, of which 44 countries contributed ≥10 publications. The United States of America was the leading country with the highest number of publications (n=740, 31.56%), followed by India (n=215, 9.17%), and England (n=180, 7.68%).</p> <p><strong>CONCLUSION: </strong>This study provide researchers and policy makers with a comprehensive list of the key bibliometric characteristics and major contribution in polio research. Majority of the studies were published in developed countries. The developing countries need to make strong research collaborations with developed countries.</p> Muhammad Khan, Tauseef Ahmad, Muhammad Mumtaz Khan, Manal Abdulaziz Murad, Mukhtiar Baig, Asmat Ali, Abdur Rehman Copyright (c) 2022 Journal of University Medical & Dental College Mon, 21 Feb 2022 00:00:00 +0000 Barriers in use of colostrum, Breast milk, and supplemental feed: assessing maternal Knowledge & practices <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Colostrum and breast milk are not only highly nutritious but also a source of maternal antibodies for infants. We explore maternal awareness and barriers in use of colostrum and breast milk.</p> <p><strong>METHODOLOGY</strong>: This cross-sectional study included mothers of children aged 3 years or less who visited primary care centers in urban and peri-urban areas of Lahore, Pakistan, between December 2020 to March 2021.</p> <p><strong>RESULTS<em>: </em></strong>A total of 384 mothers were included in the study, mean age was 28 years. 47% (n=179) had primary or secondary school education. Higher maternal education (p=0.05) and age were associated with better knowledge about the benefits of colostrum. Reasons for not giving colostrum among mothers without formal education (42%) were “it’s not clean milk”, while 38% of mothers with higher education give a reason they could not feed because find it difficult due to C-section. Use of supplemental feed was noted across all educational levels, 60% mothers with no educational background preferred bovine milk, whereas 79% of highly qualified ones preferred formula milk (p=0.00). The use of formula milk was more frequently observed in families with 100,000 PKR per month and above (p=0.00). 80% of mothers were unaware that bovine milk in infants can lead to anemia.</p> <p><strong>CONCLUSION<em>: </em></strong>There is inadequate knowledge, among mothers of all educational levels with reference to colostrum use and the relationship between consumption of bovine milk by infants and iron deficiency. Measures to improving maternal nutritional awareness and optimize infant feeding practices during antenatal visits are needed.</p> Hina Jawaid, Marriam Sheraz, Khudija Amna Arif, Zia Ul Hassan, Hina Akhter Copyright (c) 2022 Journal of University Medical & Dental College Tue, 22 Feb 2022 00:00:00 +0000 Listeriosis in pregnancy: a common yet underdiagnosed cause of febrile illness. <p>Food borne listeria infection is common in pregnancy compared to the general population because of the reduced immune defense mechanism in pregnancy. It may cause maternal morbidity and fetal mortality if not treated on time. Precooked meat and milk products are the main source of listeria.&nbsp; The diagnosis is confirmed by blood culture, and the infection is cured with ampicillin. This case report is of a patient presenting with febrile illness in the second trimester of pregnancy. She gets promptly investigated for possible differential diagnosis, bacterial, viral, and protozoal. Maternal complication increased till definitive management is offered.</p> <p>&nbsp;</p> Rubab Riaz, Rubina Shaheen Copyright (c) 2022 Journal of University Medical & Dental College Tue, 22 Feb 2022 00:00:00 +0000