Pakistan Journal of Medical Sciences最新文献

Objective: To determine the prevalence of compassion fatigue, compassion satisfaction and burnout and identify the socio-demographic and work-related factors associated with compassion fatigue among FCPS Part-II trainees in Pakistan.

Method: A cross-sectional study of FCPS-II trainees was conducted using stratified sampling at multiple centers over six months. Data was collected through an online, self-administered survey, which consisted of the 30-item ProQOL-V and a socio-demographic and work-related characteristics questionnaire. Informed consent was obtained from all participants. Data was analysed using SPSS 26 for descriptive stats, one-sample t-test, Pearson correlation, and multivariate linear regression at a 95% significance level.

Results: Out of 460, only 392 trainees completely filled the online survey (completion rate: 90.74%). The study found that 78.80% of postgraduate trainees experienced moderate levels of compassion fatigue (CF) (Mean = 27.6, SD = 6.3), with moderate burnout (BO) (75.50%, Mean = 26.6, SD = 5.9), while moderately high Compassion satisfaction (CS) (90.60%, Mean = 33.3, SD = 5.5). Compared to normative data, compassion fatigue levels were significantly elevated among post-graduate trainees (p < 0.001). Significant correlations were observed between CF and BO (r =0.59), CF and CS (r = -0.20), and BO and CS (r = -0.63). Factors associated with higher CF included family dependents (p = 0.029), longer working hours (p < 0.001), and inadequate sleep (p < 0.001). Trainees in "Poor" work environments reported higher CF levels than those in "Excellent" environments (p < 0.001). Additionally, engaging in self-care activities such as exercise, prayer, and socialising were associated with lower CF levels (p < 0.05).

Conclusion: The study revealed that many postgraduate trainees experience moderate compassion fatigue and burnout, with a strong positive correlation between CF and BO. Compassion satisfaction inversely related to both CF and BO, highlighting the need to boost CS. Factors like longer work hours, poor sleep, family dependents and unfavorable work conditions were linked to higher Compassion Fatigue. Conversely, engaging in self-care practices like prayer, meditation, exercise, and socialising is associated with decreased compassion fatigue levels. These results stress the importance of tailored interventions to enhance trainees' well-being and ultimately improve patient care quality.

Objective: To assess the presence of Streptococcus Mutans (S.mutans) and Lactobacillus species (LB) of newborn-mother pairs using the real time polymerase chain reaction (qRT-PCR).

Method: Subjects were selected from the patients followed in the Neonatology Clinic of Akdeniz University's Faculty of Medicine between the years 2017-2018. First samples collected within 48 hours after birth, and second samples were at six months. The samples were analyzed for the presence of S.mutans and LB using qRT-PCR. Mothers' smoking habits, education level, occupation, oral hygiene habits, DMFT scores and dietary history; Babies' delivery type, birth weight, feeding type, oral hygiene practices, feeding habits, bottle usage, pacifier usage, consumption of sugary foods, were also recorded. The effect of factors related to both mothers and infants was examined comparatively.

Results: S.mutans DNA was detectable in 87% and LB DNA was detected in 37% mothers, while it was undetected in 63% mothers at the first sampling. S.mutans was detected in 37% and, while LB was detected in 5% of the newborns in the first 48 hours of their life. At the second sampling, the S.mutans and LB levels in infants have increased, while there has been no significant change in mothers. A significant relationship was found only between the increase in S.mutans in infants and the presence of erupted teeth.

Conclusion: S.mutans and LB were able to colonize on the oral mucosal surfaces of edentulous newborns, with the counts of both bacteria increasing significantly with tooth eruption.

Electronic health records (EHRs) play a critical role in the management of patient information and timely decision making in health facilities. In resource-limited settings, especially low- and middle-income countries (LMICs), nurse informaticists play a pivotal role in the implementation of EHRs. This article underscores their multifaceted responsibilities, emphasising critical contributions in vendor selection, system evaluation, workflow analysis, content development, end-user device assessment, training, and post-implementation stability support. By providing nurse informaticists in lower middle-income countries with a clear understanding of their responsibilities and tailored strategies, this article aims to enhance EHR implementation success in these unique contexts.

Objective: This laboratory study aimed to evaluate the effect of different mouthwash solutions on the surface and mechanical properties of NiTi arch wire.

Methods: This experimental study was conducted at the Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Saudi Arabia from September 2023 to November 2023. A 30 mm NiTi wires in length with 0.017 × 0.022" in dimensions were selected and equally divided into four groups: Control (G₀) group wires were immersed in distilled water (DW); G₁ wires were immersed in antiseptic mouthwash; G₂ wires were immersed in fluoridated mouthwash; and G₃ wires were immersed in therapeutic mouthwash. Surface morphology, nanohardness, and flexural modulus were evaluated at 24-hours, four weeks, and eight weeks' time points. Data were statistically analyzed using a two-way analysis of variance (P<0.05).

Results: The arch wires immersed in DW showed insignificant effects on surface roughness, nanohardness, and flexural modulus at different time points. However, all the experimental groups showed a significant effect of time and immersion solutions on the said properties (P<0.05). At the end of eight weeks, G₃ showed the highest surface roughness (0.346 ± 0.032 µm) and the lowest nanohardness (1.350 ± 0.412 GPa) and flexural modulus (3.960 ± 0.140 MPa) compared to other study groups.

Conclusions: The efficiency of tooth realignment could be influenced by the detrimental influence of fluoride and hydrogen peroxide mouthwash solutions on superelastic NiTi arch wires.

Objective: To analyze the psychological status of patients with acute cerebral infarction (ACI), and to evaluate the effect of positive psychological intervention on the treatment and prognosis of ACI.

Methods: This was retrospective study. Eighty patients with ACI admitted to Institute of Psychology, Chinese Academy of Sciences from January 2021 to September 2022 were included and randomly divided into observation group (n=40) and control group(n=40). Patients in the control group received conventional treatment and routine care, while those in the observation group received positive psychological intervention based on the control group. Adverse psychological scores, treatment and prognosis, and quality of life as well as nursing satisfaction etc. were analyzed and compared between the two groups.

Results: Both groups showed a significant decrease in SDS and SAS scores at three months after the intervention compared with the pre-intervention period, with a statistically significant difference(P<0.05). After the intervention, the NIHSS score of both groups decreased, with a statistically significant difference(P<0.05). The FMAS and MBI scores increased in both groups compared with those before the intervention, with a statistically significant difference(P<0.05). The SS-QOL scores of both groups were significantly improved compared with before the intervention, with a statistically significant difference(P<0.05). The hospital satisfaction rate in the observation group was significantly higher than that in the control group, with a statistically significant difference (t=12.325, P=0.000).

Conclusion: Positive psychological intervention offers a variety of benefits in the treatment of patients with ACI, such as may alleviate anxiety and depression, reduce neurological deficits, improving quality of life and motor function, and ameliorate the prognosis of patients.

Objectives: To evaluate the changes in oral health-related quality of life [OHRQoL] before and three months after complete denture oral rehabilitation using the Geriatric oral health assessment index [GOHAI] in Pakistani elderly edentulous patients.

Methods: In this descriptive case series study a total of 80 edentulous patients were recruited from Islamic International Dental Hospital, Islamabad, Pakistan from November 2021 to April 2022. The OHRQoL was evaluated twice by using the GOHAI- Urdu version. First, before getting the complete denture, and subsequently after three months of using a prosthesis. The data were analysed using SPSS-23. Pre and post-comparison were done by t-test. Moreover, the ANOVA test was utilized to assess the socio-demographic variables-GOHAI score and association.

Results: The mean GOHAI scores increased significantly from 22.9 (SD = 3.01) at baseline to 28.1 (SD = 5.59) after three months (P = 0.001), reflecting an overall increase of 5.2 points. At baseline, the ability of the patient to swallow comfortably was found to have the highest mean GOHAI score of 3.02 (SD= 1.24) and after three months of complete denture insertion, the same questionnaire item further improved with the highest mean GOHAI score of 3.43 (SD=1.05). The socio-demographic characteristics-based comparison of mean pre and post-insertion GOHAI scores suggested a statistically significant difference (p=0.001).

Conclusion: The OHRQoL in elderly edentulous patients improved after complete denture delivery, and a significant improvement was noted in most GOHAI domains.

Objective: To assess anxiety levels among 1^st and 2^nd year MBBS and 1^st year BDS students in oral examinations of anatomy and physiology and to compare the anxiety scores among students of 1^st and 2^nd year MBBS and 1^st year BDS.

Methods: This cross-sectional study was conducted on 231 undergraduate (MBBS and BDS) students of University from Karachi durning December 2022 to May 2023. Westside anxiety scale was used to assess anxiety levels in students and the scores were compared with oral examination scores using One-way analysis of variance.

Results: Extremely high levels of anxiety was noted in relation to oral examination of Anatomy with a mean score of 25±3.801 while a mean of 30.00±5.170 was noted in Physiology in BDS students. However, significant results were observed on comparing Anatomy and Physiology oral examination scores among 1^st and 2^nd year students.

Conclusion: In summary higher levels of test anxiety, especially for oral examinations was observed in MBBS students as compared to BDS students. It was also observed that anxiety levels were much higher for Anatomy oral examinations as compared to those for Physiology.

Objective: To assess the effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of non-palpable undescended testis (NPUT) and to compare DW-MRI results with surgical findings.

Methods: This descriptive, cross-sectional study was carried out at Dow Institute of Radiology, Dow University of Health Sciences. Karachi on a cohort of patients who underwent DW-MRI for suspected NPUT between 15^th September, 2022 to 16^th March, 2023. The study included 175 boys below the age of 16 years with history of clinically non-palpable testes. MRI scans were acquired using additional DWI sequence. Two radiology faculty of more than five years of experience independently evaluated the DW-MRI images for the presence or absence of testes in its normal anatomical position, abnormal location, side and size of testes.

Results: Out of the 175 patients, DW-MRI successfully detected 128 (73.1%) non-palpable undescended testes. Statistical analysis in clinically detected cases of showed sensitivity of NPTU 0.8%, specificity of 92.5%, diagnostic accuracy 94.29%, positive predictive value 97.7%, and negative predictive value 84.1% for localizing undescended testes with Diffusion Weighted DW-MRI taking surgical findings as gold standard.

Conclusion: DWI sequences complement the conventional MRI, increasing its sensitivity and diagnostic accuracy. By facilitating early and accurate diagnosis, DW-MRI has the potential to streamline patient management, reduce unnecessary surgical exploration, and ultimately improve the long-term reproductive health and quality of life for individuals with undescended testes.

Objective: This study explores the application and feasibility of problem based learning (PBL), integrating case based learning (CBL), and the mini clinical evaluation exercise (Mini-CEX) into the standardized training of residents in nephrology department, in order to assess their clinical skills in a comprehensive manner.

Methods: This prospective study enrolled 60, three years residents majoring in clinical medicine, from June 2022 to December 2023 in Nephrology Department of Baoding No.1 Central Hospital. These participants were randomly allocated into either the combined PBL-CBL and Mini-CEX teaching group (experimental group) or the traditional lecture-based teaching group (control group). Two groups were evaluated with Mini-CEX assessments and test scores upon exit the department, followed by a questionnaire survey to measure satisfaction levels for the teachers.

Results: There was no statistically significant difference in age, sex, year of graduate school, specialty and student source between the two groups of residents upon the entering the department (P>0.05). Upon the completion, the experimental group, which received PBL-CBL and Mini-CEX teaching methods, demonstrated significantly higher scores in all aspects compared to the control group, with a statistically significant difference (P<0.01). Furthermore, compared the control group, most residents in the experimental group agreed that the PBL-CBL and Mini-CEX teaching methods improve curiosity and enthusiasm for learning (73.3%), communication and expression abilities (73.3%), self-learning abilities (80%), understanding of diseases (76.7%), and like this teaching method (86.7%).

Conclusions: PBL-CBL and Mini-CEX may be an effective method for improving medical residents' performance and enhancing their clinical skills, which is worthy of promotion in the standardized training of the residents.

Background & objective: Type-2 Diabetes Mellitus (T2DM) is one of the most common chronic non-communicable diseases and a serious health issue worldwide because of its rising prevalence amongst the young adults. Dietary diversity, rapid economic development and sedentary lifestyle are amongst the common factors contributing for the rapid rise of diabetes. Our objective was to assess the average carbohydrate (CHO) and caloric consumption and its association with obesity and disease status in patients with Type-2 diabetic patients in an outpatient setting.

Methods: This study was performed at an outpatient department (OPD), of Hayatabad Medical Complex, Peshawar. Patients with T2DM were interviewed who completed dietary assessment using 24 hours dietary recall method.

Results: A total of 150 patients with Type-2 diabetes were interviewed. The mean carbohydrate intake was 400.3±106 mg/day, out of which 43.3 % participant's had carbohydrate intake above recommendations. The mean energy intake for all participants was 2504.5±587.4 Kcal/day. Majority of the participants were overweight and obese with mean BMI of 28kg/m² ± 4.4. There was no significant difference in energy and carbohydrate intake between male and female participants.

Conclusions: Majority of Pakistani patients with Type-2 diabetes consume foods rich in carbohydrate as well as have high caloric value. These finding were more in patients with no formal education compared to those who were well educated with a degree.