Journal of Shifa Tameer-e-Millat University

Oral/Dental health services for intellectually/physically challenged individuals in Pakistan

Amjad H Wyne — Mon, 08 Jan 2024 20:58:32 -0700

The societal moral compass hinges on two critical benchmarks: first, how the society looks after their elderly population and second, the care afforded to individuals with special healthcare needs. In Pakistan, a nation enriched with cultural and religious values, a commendable tradition of honoring and caring for the elderly exists. However, a significant gap persists, particularly within the healthcare sector, in addressing the needs of those individuals who are intellectually and/or physically challenged.

Cytopenia in dengue fever and their associations: A Cohort Study

Mon, 08 Jan 2024 21:07:55 -0700

Introduction: Dengue fever is endemic in countries like Pakistan and has multiple complications. Leukopenia and thrombocytopenia are common cytopenia that sometimes lead to complex outcomes. So, we considered it essential to find the associations of dengue-related cytopenia and planned this study.

Methodology: An observational, retrospective cohort study was conducted at Shifa International Hospital Islamabad. 125 patients from the inpatient department diagnosed with dengue fever based on clinical presentation and positive dengue non-structural protein 1 (NS1) were enrolled. Their vitamin B12 levels, minimum values of TLC (total leukocyte count), and platelet counts during admission were found in their records. All information was entered and analyzed using the SPSS 23 version. After descriptive statistics, Patients' age, gender, residence, and B12 levels were cross tabulated against the TLC and platelet count values using the chi-square test. The descriptive results were expressed in percentages, while chi-square was described as a p < 0.05, considered statistically significant.

Results: 125 patients with dengue fever were included in the study; 73 (58.4%) were male, and 52 (41.6%) were female. The mean age was 42.8, the mean B12 level was 94.3 pmol/L, the mean platelet count was 57,000/ µL, and the mean TLC was 5084.8/ µL. Age, gender, residence, and B12 levels did not affect leukopenia and thrombocytopenia in dengue patients (p > 0.05).

Conclusion: Dengue-related cytopenia is not correlated with the differences in age, gender, residence and B12 levels and mandates further research work.

Case-based learning with a twist: Testing the effectiveness of integrated case-based learning in an undergraduate dental curriculum

Taliya Sajjad, Ayesha Younas, Laila Shakeel Abbasi — Mon, 08 Jan 2024 21:15:21 -0700

Introduction: Integrated Case-based learning (i-CBL) is a variation of traditional case-based learning in which integrated cases are developed to emulate real-life scenarios that healthcare practitioners encounter in everyday practice. This study explores the effectiveness and relative success of i-CBL pedagogy in an undergraduate dental curriculum.

Objective: To assess the impact of the i-CBL as a pedagogical strategy in an undergraduate dental curriculum..

Methodology: i-CBL was introduced in three years of a Bachelor of Dental Surgery (BDS) program. Cases based on integrated modules in the curriculum were developed and vetted by trained faculty. Students were also introduced to the i-CBL concept, and their detailed online feedback was taken on completing each i-CBL session in their academic year. Descriptive and analytic statistics were used for the Likert response data, and thematic analysis was conducted for the free text items.

Results: Eighty-three feedback questionnaires were collected from students throughout the year (18.2% first year, 47.5% second Year and 34.3% third Year). There was a significant difference in the students' perceptions regarding the conduct of the i-CBL over the three BDS years (p=0.00). However, there was no significant difference in their delivery by the concerned tutors (p=0.468) and the scenario construct (p=0.55). Thematic analysis of free text comments also highlighted overall student satisfaction with the i-CBL pedagogy.

Conclusion: This study highlights the value of introducing i-CBL. More focus on faculty training and the development of appropriate cases will be helpful for effective student learning.

Qualities of good medical teacher as perceived by medical (MBBS) students of a private medical college in Lahore, Pakistan

Mon, 08 Jan 2024 21:24:40 -0700

Introduction: In human societies, teachers play a fundamental role; teacher is more than just an educator. The present research aims to analyze the perceptions of medical (MBBS) students towards the personality traits and qualities of an excellent teacher so that standards can be set for teaching philosophy.

Methodology: This observational cross-sectional study was conducted at Azra Naheed Medical College, Superior University Lahore. After informed consent, 200 medical (MBBS) students of both genders participated in the study. Each student filled out a questionnaire compromising the qualities of an excellent medical teacher.

Result: According to the student responses, the most commonly agreed factor for an excellent medical teacher was 'Medical Teacher uses simple language' reported by 113 (56.5%) students, followed by 'Medical Teacher uses technology' in 107 (53.5%), 'Medical Teacher has command on the subject' in 106 (53.0%), 'Medical Teacher is enthusiastic about the subject' 105 (52.5%), 'Medical Teacher summarizes topic at the end of the lecture' 105 (52.5%), 'Medical Teacher announces topic one week before lecture' 96 (48.0%), Textbooks are allowed by Medical Teacher during lectures' (94 (47.0%), 'Medical Teacher begins class by asking questions related to the topic' 86 (43%), students reported 'Handouts are given to students by medical teacher' 83 (41.5%) and 61 (30.5%) students said 'There are breaks for discussions and group activities for students during class'.

Conclusion: According to medical (MBBS) students, an excellent medical teacher uses simple language technology, has command of the subject, is enthusiastic and summarizes the topic at the end of the lecture.

Prevalence and awareness of polycystic ovarian syndrome among medical students of Karachi, Pakistan

Shazia Abdul Hamid Khalfe, Urooj Rafi, Batool Fatima — Mon, 08 Jan 2024 21:32:54 -0700

Introduction: PCOS is the most common condition experienced by females of reproductive age across all ethnicities and cultures worldwide. The term "polycystic" refers to several cysts or many cysts, each harboring an immature egg.

Objective: The objective of this study is to determine the prevalence and awareness among female medical students regarding polycystic ovarian symptoms in Karachi.

Methodology: A cross-sectional study was conducted with a sample of 377 medical students, and data was collected using a questionnaire-based survey.

Results: The results revealed that 77.2% of participants showed awareness of PCOS. 10.9% were diagnosed with PCOS, and all of them were taking medication for this syndrome. However, 63.9% had regular menstrual cycles.

Conclusion: Most of the sample population was aware of PCOS. 10.9% were diagnosed with PCOS.

Frequency and pattern of female genital tract malignancies in patients presenting with gynecological problems

Mon, 08 Jan 2024 21:53:10 -0700

Introduction: Significant morbidity and mortality is caused by cancers in women all over the world. Cancers of the female reproductive organs are called genital tract cancers. They include cervical cancer, ovarian cancer, endometrial cancer, vaginal carcinoma, cancer of the fallopian tubes and gestational trophoblastic tumor. After breast carcinomas, they account for the second most common carcinomas in females.

Methodology: This cross-sectional study was conducted from 1 June 2018 to 31 May 2022. After taking written informed consent, 256 patients presenting to Gynae A Unit, Ayub Teaching Hospital, Abbottabad, were included in the study. Patients with a history of menstrual irregularities, vaginal bleeding, abdominopelvic pain or mass were included, while those presenting with other gynecological problems were excluded. The confirmed diagnosis was made based on histopathology reports by the consultant pathologist of the laboratory in the hospital after the patient's surgery.

Results: Out of the 256 patients, 30 (11.71%) had female genital tract malignancies. The mean age was 48.79 years, and the standard deviation was 12.93 years. 17 patients (56.66%) had ovarian cancer, 5 (16.66%) had cervical cancer, 7 (23.33%) had endometrial cancer, and 1 (3.33%) had vaginal cancer. Ovarian cancer was the most common (56.66%), followed by endometrial cancer. Serous adenocarcinoma of the ovary was the most frequent type (26.66%).

Conclusion: The percentage of female genital tract malignancies in patients with gynecological problems is relatively high with serous adenocarcinoma of the ovary being the most common malignancy. Developing and implementing an effective policy regarding early cancer detection is necessary.

Frequency of Vitamin D deficiency in women with polycystic ovarian syndrome.

Islam Bano, Sofia Naz, Ayesha Ismail, Tahira Yasmeen, Munnaza Andaleeb — Mon, 08 Jan 2024 22:00:39 -0700

Introduction: Approximately 20% of women who are of reproductive age suffer from the common endocrine illness known as polycystic ovarian syndrome, or PCOS. Vitamin D insufficiency is common among PCOS-affected women. The symptoms of PCOS seem to be regulated by the vitamin D pathway. According to studies, women with PCOS had high frequencies of vitamin D insufficiency, ranging from 65.0% to 70.3%. Thus, we aimed to discover how common vitamin D deficiency was in women diagnosed with PCOS.

Methodology: This cross-sectional study was conducted at the Department of Obstetrics & Gynecology, CMH- Rawalpindi, from January to July 2022. A total of 90 women with polycystic ovarian syndrome diagnosed on Rotterdam criteria, 18 to 40 years of age, were included through a non-probability consecutive sampling technique. Pregnant female patients with chronic illnesses were excluded. After informed consent, data was collected from patients on a self-developed questionnaire. In all patients, a 3 ml blood sample was taken and sent to the institutional pathology laboratory to measure vitamin D levels.

Results: The patients' average age was 28.91 ± 4.85 years—ages 18 to 30 comprised most of the 48 patients (53.33%). The average time a person had PCOS was 3.64 ± 1.58 years. The average body mass index was 29.02 ± 2.43 kg/m². Forty-one (45.56%) of the PCOS patients had vitamin D insufficiency.

Conclusion: As the frequency of vitamin D deficiency in women with PCOS is relatively high, we recommend that early identification through screening of the affected patients should be done.

The influence of birth order on anxiety disorders in emerging adulthood: A longitudinal study.

Asima Mehaboob Khan, Rizwan Taj, Aamir Naveed, Kamran Mahmood, Abdul Wali — Mon, 08 Jan 2024 22:09:57 -0700

Introduction: The current longitudinal scholarly research analyses the impact of birth order on children's psychological and mental health status.

Objective: The birth order indicates the paramount effect on an individual's psychological, physiological and behavioural transformation.

Methodology: This research study enrolled 150 individuals aged 18 to 25 years to assess their anxiety status in association with birth order. The study applied a mixed-method approach involving structured questionnaires, semi-structured interviews and focal group discussions.

Results: The statistical analysis yields that birth order is statistically inversely related to the level of anxiety, having weak statistical evidence of significance. It predicts that the latterly born (younger) children experience fewer episodes and severity of anxiety as compared to the elder ones.

Conclusion: Family support is a critical factor in buffering anxiety among children. The study suggests the parental consideration of birth order to provide a balance of attention and care to overcome the psychological adverse outcomes among children. Further scholarly attention is required to study the association among these dynamics with multiple approaches for further analysis of associated aspects.

Unraveling the complexity: A comprehensive guide to subclavian steal syndrome.

Fatima Khurshid, Ayesha Khurshid — Mon, 08 Jan 2024 22:18:00 -0700

Subclavian steal syndrome is a diagnosis that is thought to be relatively uncommon even though its occurrence is not well understood. Some individuals may experience crippling symptoms of arm ischemia and vertebral-basilar insufficiency due to subclavian steal, which is more frequent than the accompanying illness. Patients with uneven arm blood pressure or unilaterally faint pulses should be evaluated for subclavian steal. Although it is not always necessary to check the blood pressure and pulse on both sides, they become significant when these measurements differ and are accompanied by vertebral-basilar or arm ischemia symptoms. Although subclavian steal does not significantly increase the risk of stroke, it is nevertheless essential to recognize and treat asymmetric blood pressure and weak pulses as these may be signs of subclavian steal syndrome. This page thoroughly analyses the aetiology of subclavian steal syndrome, signs, symptoms, diagnosis, and available treatments.

Nanoparticle's efficacy in the suppression of heavy metals that affect breast cancer progression.

Yasir Nawaz, Saba Munir, Fouzia Tanvir, Asma Umar, Muhammad Ali — Mon, 08 Jan 2024 22:27:16 -0700

The study aimed to assess the literature to explore the efficacy of different nanoparticles that play a role in suppressing various heavy metals that cause breast cancer. Breast cancer is a prevalent reason of death among females around the world. Heavy metals, including arsenic, beryllium, cadmium, nickel, hexavalent chromium, and much more, play a role in the expansion of various types of cancer, mainly breast cancer. Nanomedicine has unbelievable potential for developing cancer treatment and diagnosis by inventive biocompatible nanocomposites for treatment. Gold nanoparticle's role as an effective treatment is quickly increasing. Silver exhibited significant interactivity among various nanoparticles due to its distinctive characteristics, such as conductivity, stability, catalytic properties, and antibacterial attributes. These can also be used for antimicrobial activities for many microorganisms such as bacteria, fungi, protozoans, and, recently, viruses. The data from various studies was retrieved. The studies on heavy metals and nanoparticles and their role were retrieved and added to this study. This will help people understand the influential role of nanomedicine in suppressing breast cancer. It is concluded that extensive efforts have been devoted to addressing breast cancer by utilizing various nanoparticles, including gold and silver nanoparticles. Silver nanoparticles, gold nanoparticles, and Myr-AuNPs (Gold nanoparticles) demonstrate promise as potent anticancer agents for breast cancer. However, further research is needed to combat the current state of breast cancer effectively.

Tuberculosis and scavenger receptors: Exploring their relationship.

Ezza Binte Tariq, Urooj Subhan, Farah Deeba, Sidra Younis — Mon, 08 Jan 2024 22:35:21 -0700

Tuberculosis (TB) remains a significant global health concern, particularly in low- and middle-income countries. Several risk factors are associated with TB infection and its progression from infection to disease onset, including host factors, microbial factors, environmental factors, and socio-economic status. Host genetic factors play a significant role in determining susceptibility to acquiring infection, progression to active disease, and the severity of the disease. Innate immunity is essential in the initial defense, advancement, and long-term control of mycobacterial infection. Among various cell surface and intracellular receptors mediating mycobacteria uptake, scavenger receptors play a crucial role in innate immunity. Scavenger receptors are classified into 12 classes, with class B comprising SR-B1 (SCARB-1), SR-B2 (LIMP2), and SR-B3 (CD36). SR-B1 and CD36 are involved in the uptake and phagocytosis of Mycobacterium tuberculosis (Mtb). Scavenger receptors promote cytokine production and modulate cytokine production during antimycobacterial responses. The SR-B1 and CD36 genes contain various single nucleotide polymorphisms in their intronic and exonic regions. These polymorphisms may influence the expression of the genes, leading to changes in Mtb uptake and antimycobacterial response. In this current review, we have explored the importance of scavenger receptors in TB pathogenesis. Additionally, we have summarized SNPs in SR-B1 and CD36 genes and their effect on protein expression.

An afebrile neuroleptic malignant syndrome with hyponatremia: A case report.

Muhammad shoaib, Ainan Arshad, Midrar Ullah, Sehrish Sajjad — Mon, 08 Jan 2024 22:42:37 -0700

Neuroleptic malignant syndrome (NMS) is a rare, life-threatening situation in response to the adverse reaction of antipsychotic medications characterized by high-grade fever, altered Glasgow coma scale, autonomic dysfunction, and stiffness. We herein present a case with a typical presentation of stiffness and autonomic dysregulations along with the atypical symptoms of urinary incontinence and a history of falls. The patient was afebrile with hyponatremia, showing a similar presentation diagnosed as NMS and treated successfully according to the hospital protocol.