Pub Date : 2023-09-30DOI: 10.35845/kmuj.2023.23435
Abbasi Kamran, Ali Parveen, Barbour Virginia, Bibbins-Domingo Kirsten, Olde Rikker Marcel Gm, Gong Peng, Haines Andy, Helfand Ira, Horton Richard, Mash Robert, Mitra Arun, Monteiro Carlos, Naumova Elena N, Rubin Eric J, Ruff Tilman, Sahni Peush, Tumwine James, Yonga Paul, Zielinski Chris
{"title":"Reducing the risks of nuclear war—the role of health professionals","authors":"Abbasi Kamran, Ali Parveen, Barbour Virginia, Bibbins-Domingo Kirsten, Olde Rikker Marcel Gm, Gong Peng, Haines Andy, Helfand Ira, Horton Richard, Mash Robert, Mitra Arun, Monteiro Carlos, Naumova Elena N, Rubin Eric J, Ruff Tilman, Sahni Peush, Tumwine James, Yonga Paul, Zielinski Chris","doi":"10.35845/kmuj.2023.23435","DOIUrl":"https://doi.org/10.35845/kmuj.2023.23435","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135083992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.35845/kmuj.2023.22983
{"title":"Impact of socio-economic status on Diabetes Mellitus knowledge and hemoglobin A1c control","authors":"","doi":"10.35845/kmuj.2023.22983","DOIUrl":"https://doi.org/10.35845/kmuj.2023.22983","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135127491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.35845/kmuj.2023.22823
{"title":"Serum E-Cadherin level in various clinical variants of oral potentially pre-malignant disorders","authors":"","doi":"10.35845/kmuj.2023.22823","DOIUrl":"https://doi.org/10.35845/kmuj.2023.22823","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135127504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.35845/kmuj.2023.23427
When implementing governance reforms, it is essential to understand the political economy, especially in the healthcare sector, where shifts in political power often have a significant impact.1 Like in several other countries, changes in political power influence the policies and priorities of previous governments, particularly affecting healthcare, which relies heavily on government funding and support. The medical teaching institution (MTI) reforms were designed to strengthen the provision of high-quality healthcare services and urgently improve medical teaching institutions across the country. These institutions serve as custodians for developing competent healthcare professionals, conducting innovative studies, and providing good-quality patient care. However, they faced challenges, including a shortage of faculty, outdated facilities, and tight budgets. MTI reforms were promulgated, and the institutions were provided with the necessary resources.2 The objective of the reforms was to grant MTIs autonomy, giving them more control over fund allocation, faculty hiring, and facility development. The goal was to create a healthcare system that is both more effective and efficient, meeting the demands of the general population.3 Despite the admirable concept, implementing reforms posed a significant challenge. The transition of power and changes in political leadership hindered reform efforts. Challenges arising from meeting competing demands from various stakeholders and the influence of political economy on the decision-making process might be attributed to the delay in implementing these reforms. The lack of continuity and consistency in the reform implementation process has presented challenges for MTIs, their employees, students, and the healthcare sector as a whole. MTIs require strong governance frameworks and a defined set of rules to operate effectively. The autonomy granted by the MTI Act fosters timely decision-making, flexibility in responding to changing needs, and effective resource management. However, when reforms are put on hold, administrative procedures become cumbersome and delayed, making it difficult to reach decisions and efficiently administer the institution. This disruption upsets institutions and academia, and as a result, students are confused navigating two very different systems with distinct requirements and expectations. Such disruption could have a profound impact on educational standards. To ensure the identification and rectification of potential inadequacies in the implementation and to suggest improvements, it is crucial to conduct continuous evaluations throughout the extended duration of the process. Political support is also vital for the success of reform initiatives.1 The backing of political figures and parties provides the essential energy and resources for effective execution. Understanding how political developments could impact reform efforts is important. Political or ideological concerns may cause re
{"title":"Unpredictable future of medical teaching institution reforms amid political transitions in Pakistan","authors":"","doi":"10.35845/kmuj.2023.23427","DOIUrl":"https://doi.org/10.35845/kmuj.2023.23427","url":null,"abstract":"When implementing governance reforms, it is essential to understand the political economy, especially in the healthcare sector, where shifts in political power often have a significant impact.1 Like in several other countries, changes in political power influence the policies and priorities of previous governments, particularly affecting healthcare, which relies heavily on government funding and support. The medical teaching institution (MTI) reforms were designed to strengthen the provision of high-quality healthcare services and urgently improve medical teaching institutions across the country. These institutions serve as custodians for developing competent healthcare professionals, conducting innovative studies, and providing good-quality patient care. However, they faced challenges, including a shortage of faculty, outdated facilities, and tight budgets. MTI reforms were promulgated, and the institutions were provided with the necessary resources.2 The objective of the reforms was to grant MTIs autonomy, giving them more control over fund allocation, faculty hiring, and facility development. The goal was to create a healthcare system that is both more effective and efficient, meeting the demands of the general population.3 Despite the admirable concept, implementing reforms posed a significant challenge. The transition of power and changes in political leadership hindered reform efforts. Challenges arising from meeting competing demands from various stakeholders and the influence of political economy on the decision-making process might be attributed to the delay in implementing these reforms. The lack of continuity and consistency in the reform implementation process has presented challenges for MTIs, their employees, students, and the healthcare sector as a whole. MTIs require strong governance frameworks and a defined set of rules to operate effectively. The autonomy granted by the MTI Act fosters timely decision-making, flexibility in responding to changing needs, and effective resource management. However, when reforms are put on hold, administrative procedures become cumbersome and delayed, making it difficult to reach decisions and efficiently administer the institution. This disruption upsets institutions and academia, and as a result, students are confused navigating two very different systems with distinct requirements and expectations. Such disruption could have a profound impact on educational standards. To ensure the identification and rectification of potential inadequacies in the implementation and to suggest improvements, it is crucial to conduct continuous evaluations throughout the extended duration of the process. Political support is also vital for the success of reform initiatives.1 The backing of political figures and parties provides the essential energy and resources for effective execution. Understanding how political developments could impact reform efforts is important. Political or ideological concerns may cause re","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135084624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.35845/kmuj.2023.23247
{"title":"Association of asthenopia with refractive errors in madrassa students","authors":"","doi":"10.35845/kmuj.2023.23247","DOIUrl":"https://doi.org/10.35845/kmuj.2023.23247","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46624220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.35845/kmuj.2023.23381
{"title":"Combatting the escalating threat of antimicrobial resistance in Pakistan: urgent call for prioritization and commitment in decision-making","authors":"","doi":"10.35845/kmuj.2023.23381","DOIUrl":"https://doi.org/10.35845/kmuj.2023.23381","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44494592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.35845/kmuj.2023.22843
{"title":"Addictive social media usage during covid-19 pandemic: a case study of southern Punjab, Pakistan","authors":"","doi":"10.35845/kmuj.2023.22843","DOIUrl":"https://doi.org/10.35845/kmuj.2023.22843","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70050358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.35845/kmuj.2023.22928
{"title":"Restoration of subtotal bilateral maxillectomy defect following mucormycosis with zygomatic implant-retained obturator: a case report","authors":"","doi":"10.35845/kmuj.2023.22928","DOIUrl":"https://doi.org/10.35845/kmuj.2023.22928","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42694408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.35845/kmuj.2023.22728
Syed Shahid, Habib Thamir, Abdulrahman Al-khlaiwi, Alhowikan Zohair, Al Aseri, Syed Mohammad, Huthayfah Habib, Ahmad Al-khliwi, Omair
OBJECTIVE: To evaluate gender difference in non-traditional cardiovascular risk factors among Saudi patients with angiographically defined coronary artery disease (CAD). METHODS: We recruited 144 (male=105, female=39) patients with CAD who underwent coronary angiography. Laboratory analysis of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), lipoprotein(a) [Lp(a)], and high sensitivity C-reactive protein (hs-CRP) were performed along with echocardiographic evaluation. RESULTS: Systolic blood pressure (SBP) was significantly higher in females (138.65±18.67 vs 129.59±21.03 mmHg; p=0.0363). Although no significant difference was observed in TC (4.30±1.36 vs 4.67±1.07 mmol/L), however significantly higher levels of both HDL and LDL were seen in females (0.86±0.17 vs 0.70±0.23 mmol/L; p=0.0592 and 3.50±0.67 vs 2.72±1.13; p=0.0466 respectively). There were no significant differences in TG, Lp(a) and hs-CRP, however females had comparatively higher Lp(a) (30.43±28.89 vs 24.02±23.42 mg/dl) and hs-CRP (1.14±1.46 vs 0.95±1.25 mg/L). On angiography, greater extent of stenosis was observed in left anterior descending and right coronary arteries among males, while the left circumflex artery was affected more in the female patients without statistical significance (p=0.0797; 0.3890 and 0.5032 respectively). Gensini Score in males & females was 60.46±46.17 and 74.39±39.52 respectively (p=0.3013). Significantly narrower aortic root diameter (ARD) was observed among females (27.30±6.66 vs 29.73±3.40 mm; p=0.0293). CONCLUSION: Female patients have greater risk of cardiovascular diseases due to higher SBP and LDL levels which could lead to a greater Gensini score when compared to male patients. In addition, narrow ARD among females could also be a contributing factor to CAD.
目的:评价沙特冠心病(CAD)患者非传统心血管危险因素的性别差异。方法:我们招募了144例(男105例，女39例)行冠状动脉造影的冠心病患者。实验室分析总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、脂蛋白(a) [Lp(a)]和高敏c反应蛋白(hs-CRP)并进行超声心动图评价。结果:女性患者收缩压(SBP)明显高于男性(138.65±18.67 vs 129.59±21.03 mmHg);p = 0.0363)。尽管在TC(4.30±1.36 vs 4.67±1.07 mmol/L)方面没有观察到显著差异，但在女性中高密度脂蛋白和低密度脂蛋白水平明显较高(0.86±0.17 vs 0.70±0.23 mmol/L);P =0.0592和3.50±0.67 vs 2.72±1.13;p = 0.0466)。男女TG、Lp(a)和hs-CRP无显著差异，但女性Lp(a)(30.43±28.89 vs 24.02±23.42 mg/dl)和hs-CRP(1.14±1.46 vs 0.95±1.25 mg/L)较高。血管造影显示，男性患者左前降支和右冠状动脉狭窄程度较大，女性患者左旋支狭窄程度较大，差异无统计学意义(p=0.0797;0.3890和0.5032)。男性和女性Gensini评分分别为60.46±46.17和74.39±39.52 (p=0.3013)。女性主动脉根部直径(ARD)明显变窄(27.30±6.66 vs 29.73±3.40 mm);p = 0.0293)。结论:与男性患者相比，女性患者由于较高的收缩压和低密度脂蛋白水平而有更大的心血管疾病风险，这可能导致更高的Gensini评分。此外，女性狭窄的ARD也可能是CAD的一个促成因素。
{"title":"Gender differences in plasma levels of cardiovascular risk markers and severity indices in Saudi patients with angiographic evidence of coronary artery disease","authors":"Syed Shahid, Habib Thamir, Abdulrahman Al-khlaiwi, Alhowikan Zohair, Al Aseri, Syed Mohammad, Huthayfah Habib, Ahmad Al-khliwi, Omair","doi":"10.35845/kmuj.2023.22728","DOIUrl":"https://doi.org/10.35845/kmuj.2023.22728","url":null,"abstract":"OBJECTIVE: To evaluate gender difference in non-traditional cardiovascular risk factors among Saudi patients with angiographically defined coronary artery disease (CAD). METHODS: We recruited 144 (male=105, female=39) patients with CAD who underwent coronary angiography. Laboratory analysis of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), lipoprotein(a) [Lp(a)], and high sensitivity C-reactive protein (hs-CRP) were performed along with echocardiographic evaluation. RESULTS: Systolic blood pressure (SBP) was significantly higher in females (138.65±18.67 vs 129.59±21.03 mmHg; p=0.0363). Although no significant difference was observed in TC (4.30±1.36 vs 4.67±1.07 mmol/L), however significantly higher levels of both HDL and LDL were seen in females (0.86±0.17 vs 0.70±0.23 mmol/L; p=0.0592 and 3.50±0.67 vs 2.72±1.13; p=0.0466 respectively). There were no significant differences in TG, Lp(a) and hs-CRP, however females had comparatively higher Lp(a) (30.43±28.89 vs 24.02±23.42 mg/dl) and hs-CRP (1.14±1.46 vs 0.95±1.25 mg/L). On angiography, greater extent of stenosis was observed in left anterior descending and right coronary arteries among males, while the left circumflex artery was affected more in the female patients without statistical significance (p=0.0797; 0.3890 and 0.5032 respectively). Gensini Score in males & females was 60.46±46.17 and 74.39±39.52 respectively (p=0.3013). Significantly narrower aortic root diameter (ARD) was observed among females (27.30±6.66 vs 29.73±3.40 mm; p=0.0293). CONCLUSION: Female patients have greater risk of cardiovascular diseases due to higher SBP and LDL levels which could lead to a greater Gensini score when compared to male patients. In addition, narrow ARD among females could also be a contributing factor to CAD.","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43160922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.35845/kmuj.2023.22750
{"title":"Clinical profile and association of Celiac Disease in children with type-1 Diabetes Mellitus","authors":"","doi":"10.35845/kmuj.2023.22750","DOIUrl":"https://doi.org/10.35845/kmuj.2023.22750","url":null,"abstract":"","PeriodicalId":42581,"journal":{"name":"Khyber Medical University Journal-KMUJ","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49392665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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