Student Journal of Supplement of Rawalpindi Medical College

Annual Undergraduate Research Conference (RECON 21) Event Report

Mohammad Ebad, Anoosha Tariq — Thu, 29 Sep 2022 00:00:00 +0000

Since its establishment in 2014, Rawalian Students' Research Society has strived to promote undergraduate research at Rawalpindi Medical University. Under the supervision of Patron-in-Chief Vice Chancellor Professor Dr. Muhammad Umar (S.I.), Patron-in-Charge Professor Dr. Arshad Sabir and Chief Coordinator Dr. Afifa Kulsoom, RSRS conducts the Annual Undergraduate Research Conference (RECON), providing medical students from all over Pakistan a platform to present their research work in front of a wide audience.

The Annual Undergraduate Research Conference - RECON'21 was conducted on November 20, 2021 in New Teaching Block, Rawalpindi Medical University. The call for abstracts was opened from November 5 to November 14; more than a hundred abstracts were submitted by medical students of 15+ institutes. The received abstracts were reviewed by subject specialists of Medicine and Allied, Surgery and Allied, Public Health and Psychiatry. Thirty-nine abstracts were selected for oral presentation and 57 abstracts were selected for poster presentation. All presentations were judged by an esteemed panel of senior research faculty on the basis of research knowledge, quality of research and presenting style. In the hopes of encouraging the brilliant undergraduate researchers to continue to strive for excellence, the worthy Vice Chancellor Professor Dr. Muhammad Umar (S.I.) and Rawalian Students' Research Society awarded shields, certificates and cash prizes to the two highest scoring oral and poster presenters in each specialty.

In addition, all winners were invited to present their research work as oral presentations in the 5th International Scientific Conference, held at Rawalpindi Medical University on December 23, 2021, to an audience comprising of delegates from APPNA, APPNE, APNE, RMCAANA and RMU alumni from United Kingdom, Australia and New Zealand.

Comparison of Communication Skills of Third Year and Final Year MBBS Undergraduate Students Using Kalamazoo Scale

Tue, 13 Sep 2022 00:00:00 +0000

Abstract

Background: Efficient communication is the mainstay of a productive patient–physician relationship. Efficient use of proficient communication skills is essential for patient’s care, therapeutic and diagnostic purposes as well in establishing satisfactory doctor-patient relationship.

Objective : To compare the communication skills in third year and final year MBBS students of Rawalpindi Medical University and to assess the gap in communication skills for third year and final year MBBS students of the University.

Materials and Methods: This descriptive cross-sectional survey was conducted in March-December 2021 after institutional review board approval at Rawalpindi Medical University, Pakistan. Of 242 participants, 121 students each from third and final year were asked to fill the questionnaire according to Kalamazoo scale ^[]. Data were analyzed using SPSS 25. The mean, standard deviation and P-value was calculated to assess the communication skills on variables of interest. (P-value< 0.05 was considered significant).

Results: The number of students with average communication skills from third year were 21.5%, and with good communication skills 78.5%. In final year, average communication skills were found in 15.7% and 84.3% had good communication skills. In our study gathering information from patients showed significant P-value (p=0.002).

Conclusions: Results suggested that final year students had stronger grip on communication skills, specifically in gathering information from patients, as compared to third year. Both third year and final year students had a major communication skill gap in reaching agreement and understanding patient problem. These results propose that comprehensive communication training, workshops and feedback may be needed to increase student's perception of various aspects of communication.

Keywords: Communication skills, undergraduates.

Knowledge, Key Motivation and Obstacles to Become COVID-19 Convalescent Plasma Donor among Medical Students of Rawalpindi Medical University, Pakistan: A Cross-Sectional Study

Tue, 13 Sep 2022 00:00:00 +0000

Background: Gaining convalescent plasma from individuals recuperated from COVID-19 with adequate immune response titers is a possible choice for the treatment and anticipation of COVID-19.

Objective: To determine the knowledge, key motivations of donating and causes of not donating convalescent plasma by qualified donors.

Materials and Methods: It is an analytical cross-sectional study. A sample of 347 was collected using the convenience sampling technique. Respondents were asked to fill out questionnaires about their understanding of convalescent plasma, their motives, and hurdles to donation. MBBS students of Rawalpindi medical university were included while students with any chronic disease, COVID-19 infection, immunosuppression, blood-borne diseases, leukemic, thalassemic, and smokers were excluded. Comparative analysis was done using independent T-test and linear regression was applied.

Results: Participants were predominantly females 222 in number (61%) and 57% of respondents were aged between 20-22 years. Knowledge of convalescent plasma donation (CPD) was satisfactory among participants. Knowledge showed positive correlation with the key motivations (r=0.0414, p= 0.000) and negative correlation with the barriers (r=-0.128, p=0.015).

Conclusion: This study indicated that the knowledge of participants regarding convalescent plasma donation (CPD) was satisfactory. Knowledge had a positive impact on motivation for CPD. Barriers to convalescent plasma donation were more common among female participants. Barriers showed a negative correlation with key motivation and knowledge.

Keywords: Barriers, Plasma, Donation.

Vaccine Hesitancy: A New Challenge in Fight against COVID-19

Tue, 13 Sep 2022 00:00:00 +0000

Abstract

Introduction:Vaccination is an important public health intervention for the control of infectious diseases. To tackle the humongous upsurge of COVID-19, vaccines were introduced globally. Prevention can only be achieved if there is a high acceptance rate of the vaccine. On the other hand, vaccine hesitancy is the main challenge faced by the world's health system. It is seen among people mostly because of misconceptions, lack of awareness, and low education levels.

Objective: To investigate the etiological factors of vaccine hesitancy against COVID-19 among general population of Rawalpindi and Islamabad.

Materials and methods: A cross-sectional study was conducted in Rawalpindi and Islamabad, Pakistan.. Data were collected using a self-designed questionnaire that included questions regarding demographic details, the attitude of people towards getting vaccinated, accessibility and availability of the vaccine, the major reason for reluctance, knowledge regarding pros and cons of getting vaccinated, and prior vaccination history.

Results: Total number of participants were 403. Our results indicate that majority of the population did not believe in myths circulating regarding vaccines (81.1 % , n=327); however, 206 people (51.1%) believe that vaccines can affect the newborn and 247 participants (61.2%) believe that people might get COVID after vaccination. Vaccines were easily available to 88.2% (n=355) of the study population, yet 78.7% (n=317) were doubtful about the adverse effects of vaccines. The highest incidence of hesitancy was found in males (Odds Ratio OR 1.12), married candidates (OR 2.27), housewives (OR 2.5), and individuals belonging to rural areas (OR 2.47).

Conclusion : Our results indicate that majority of the population did not believe in myths circulating regarding vaccine side effects. However, in those who were hesitant, the major factors contributing to vaccine hesitancy were lack of sufficient information about vaccine.

Keywords:Vaccine hesitancy, vaccine, COVID-19, pandemic

Knowledge, Attitude and Practices towards Exclusive Breastfeeding among Lactating Mothers Presenting to Immunization Center, Holy Family Hospital, Rawalpindi, Pakistan

Tue, 13 Sep 2022 00:00:00 +0000

Abstract

Background: Suitable nourishment at the stage of infancy and during the early years of a child is essential to ensure children's growth to their full potential. The World Health Organization (WHO) recommends exclusive breastfeeding for infants during the first six months after their birth, followed by breastfeeding in addition to complementary foods for up to two years of age or even after this period.

Objectives: To determine the knowledge, attitude, and practices of mothers related to exclusive breastfeeding.

Methods: This cross-sectional descriptive study was conducted at the immunization center, Holy Family Hospital, Rawalpindi. Women who were in the lactating phase in the past two years or already had children above two years of age were interviewed using a validated interviewer-administered questionnaire. Data were entered into SPSS version 23, and descriptive analysis was run.

Results: The majority of the respondents belonged to 26-30 years (52.8%) and were housewives (83.0%). 96.6% of participants had heard of exclusive breastfeeding, and 44.9% had heard about it from health institutions. 88.0% believed that a child should get exclusive breastfeeding for at least six months. The majority thought that exclusive breastfeeding is better than artificial milk (93.1%), it is enough for six months (89.2%), and children fed under exclusive breastfeeding are relatively healthier (95.5%). 81.8% preferred exclusive breastfeeding in the first six months, but only 67.6% mothers practiced it.

Conclusion: Our study found that most of the population had adequate knowledge and a positive attitude towards exclusive breastfeeding. Furthermore, a much greater proportion of people were practicing exclusive breast feeding as compared to previous years.

Keywords: Exclusive breastfeeding, lactating mothers, knowledge, attitude, practices, breastfeeding, infants

Psychological Impact of β-Thalassemia Major in Young Patients

Tue, 13 Sep 2022 00:00:00 +0000

Abstract

Background: ß-Thalassemia is an inherited blood disorder that shows a marked psychological burden in affected individuals.

Objective: To explore the psychological implications of ß-Thalassemia major in young patients living in Rawalpindi and Islamabad.

Materials and Methods: A study was conducted between March to November 2021 at the Thalassemia center of Holy Family Hospital, Rawalpindi. 306 voluntary patients suffering from ß-Thalassemia major on regular blood transfusion between the age of 10-30 years were included in the study through consecutive sampling. DASS-42 questionnaire was used. Semi-structured in-depth interviews were taken by the researchers to know the perception of patients about Thalassemia. Data were analyzed using SPSS version 21. Age, gender, and the effects of depression, anxiety and stress on routine activities, school performance and personalities were recorded.

Results: Among the study participants 62% of β-Thalassemia patients were suffering from anxiety, 40% from depression and 41% individuals were facing having moderate stress as per DASS score. Mean scores SD of participants were 9.25(6.77) for depression, 9.32(4.02) for anxiety and 18.46(8.90) for stress. Mean depression, anxiety and stress scores were higher among 10-20 years old males; however, the difference was not statistically significant.

Conclusion: β-Thalassemia has major psychological impacts on life of patients causing stress, anxiety and depression affecting them physically, mentally, and socially.

Keywords: Quality of Life, depression, anxiety, Thalassemia major.

Emotional Impact of Delay in Entrance Examination on Intermediate Students – Another Hard Strike of COVID-19

Tue, 13 Sep 2022 00:00:00 +0000

Background: COVID-19 pandemic quickly became a major health issue globally. In order to contain it, there was a lockdown and consequently shutdown of many educational institutions and delays in examinations. It particularly influenced students’ psychological health which we studied in our research.

Objective: To assess the emotional impact of delay of entrance examination on intermediate students of Federal Capital and Punjab and to find its association with demographic variables.

Materials and Methods: Students who had registered themselves, whether they appeared in the entrance examination or not, were selected by non-probability convenience sampling in this cross-sectional descriptive study. Our online Google form included an explanation of study objectives, consent of the student and a section on the demographic variables of the students. Anxiety was assessed by using GAD-7 and PHQ-9 was utilized to assess depression. Maslach Burnout Inventory was used to asses burnout .Insomnia Severity Index was used to asses insomnia. Descriptive statistics were applied by SPSS v.25.Chisquare was applied to compare variables of emotional impact with socio-demographic variables. p≤0.05 was taken as significant.

Results: Among the total of 196 participants, 64 (32.1 %) were male and 132 (67.1 %) were female with a mean age of 18.9 ± 0.93 years. Anxiety, depression, burnout, and insomnia (mild to severe) were present among 136 (69.4 %),173 (88.3%), 185 (94.4%), and115 (58.6%) of the participants correspondingly. A noteworthy association was established between the students who joined online classes for entrance examination preparation and those at risk of developing burnout (p=0.039). The frequency of sub-threshold and moderately severe insomnia in female students of intermediate was higher.

Conclusion: Due to the long-lasting pandemic situation and measures such as lockdown and repeated delays in exams, many students were suffering from emotional issues such as anxiety, depression, insomnia, and burnout.

Keywords: Anxiety, Depression, Insomnia, Burnout.

Assessment of Burnout and Professional Fulfillment in Practicing Doctors and their Association with Self-Reported Medical Errors: A Hospital-Based Cross-sectional study

Tue, 13 Sep 2022 00:00:00 +0000

Background: The well-being of health care workers is essential for providing good patient care. Burnout is an epidemic plaguing the healthcare system worldwide and its undesirable effects on healthcare workers as well as patients have been reported time and again.

Objectives: To measure the levels of burnout and professional fulfillment among practicing doctors and to determine any association of burnout and professional fulfillment with self-reported medical errors.

Materials and Methods: It is a descriptive cross-sectional study. Practicing doctors in Allied hospitals of Rawalpindi Medical University were included, while those in administration and Heads of Departments were excluded. The sample size was calculated by using the WHO calculator with a confidence interval of 95%. Convenience sampling was used. A self-structured, close-ended questionnaire validated by senior professors was used. The Maslach Burnout Inventory and Professional Fulfilment Index (PFI) were added to the questionnaire. Medical errors were assessed using a self-made scale. Data were analyzed using SPSS version 23. The significance level was set at P-Value <0.05.

Results: Most of the participants belonged to the age group of 25-35 years. Males made up 46.5% of the population while females were 53.5%. Most of the participants (69.7%) had a good level of professional fulfillment. A significant proportion of the participants (82.5%) experienced only a mild degree of burnout. Most of the participants (79.4%) rarely reported medical errors. Results showed a significant negative correlation between the professional fulfillment and burnout scores and a significant positive correlation between burnout scores and medical error reporting scores.

Conclusion: The majority of the participants had a good level of professional fulfillment and a mild degree of burnout. There was a significant positive correlation between medical errors and burnout among doctors of allied hospitals of RMU.

Keywords: Burn out, Medical Errors, Physicians, Self-Report

Impact of Social Media Misinformation on its Users Regarding Vaccination, Prevention, and Treatment of COVID-19

Tue, 13 Sep 2022 00:00:00 +0000

Abstract

Background: COVID-19 is a mild to severe respiratory illness caused by a coronavirus characterized mainly by fever, cough and shortness of breath and may progress to pneumonia and respiratory failure. It has been observed that social media users were influenced by the misinformation spread through it.

Objective: To determine the effect of misinformation on social media regarding vaccination, prevention, and treatment of COVID-19, among inhabitants of Rawalpindi and Islamabad.

Materials and Methods: A descriptive cross-sectional study was carried out among 406 participants who were active social media users for at least 6 months prior to the start of the study i.e., November 2020 to April 2021. They were included in the study by convenience sampling. The study was conducted by students of Rawalpindi Medical University at specific areas of Rawalpindi and Islamabad. A structured questionnaire was filled by the participants in which they were asked about age, marital status, education, views on the utility of information found on social media about COVID-19 and whether they crosschecked information collected through social media about COVID-19. Information was also collected regarding the use of masks, social distancing and vaccination status. Data were entered and analyzed through SPSS version 25.

Results: Out of 406 people, 350 (86.2%) were active social media users and 56 (13.8%) were using social media occasionally. 322 (79.3%) were vaccinated against COVID-19 and 84 (20.7%) were not vaccinated. 317 (78.1%) heard false news on social media regarding COVID-19 and 296 (72.9%) obtained misinformation regarding the SARS-Cov-2 virus. About 199 participants (49%) cross-checked the information that they received from social media. The number of people who practiced social distancing, wore a mask and, read tweets about COVID-19 on social media was 164 (40.4%), 312 (76.8%), and 282 (69.5%) respectively.

Conclusion: The majority of people got vaccinated against COVID-19. The study population was more aware, and most of them could differentiate between actual and false news on social media by verifying it. The reach of misinformation about COVID-19 was found to be extensive among social media users.

Key words: Social media findings, COVID-19, misinformation.

Food Fortification: The Level of Awareness among Pakistani Consumers

Tue, 13 Sep 2022 00:00:00 +0000

Abstract

Background: A lack of essential vitamins and minerals required in small amounts by the human body for proper growth and development is termed as micronutrient deficiency. Such deficiencies are widespread among Pakistani consumers and they include anemia, deficiencies of iron, vitamin A, zinc, vitamin D etc.

Objective: The objectives of this study are to assess awareness levels of Pakistani consumers regarding food fortification and to determine factors affecting purchase of fortified food.

Materials and Methods: A descriptive cross-sectional study was carried out among the inhabitants of selected areas of Rawalpindi and Islamabad over a period of one year. Sample size was 398 as calculated by WHO sample size calculator. Non-probability consecutive sampling technique was used. Residents of Rawalpindi and Islamabad aged 18 and above were included while people involved in food industry (owners and employees) were excluded. Data were collected through self-structured questionnaire and analyzed on SPSS version 22. Descriptive statistics were calculated.

Results: 53.3% of our respondents were found to be aware of the term ‘food fortification’, and 67.5% people believed that the government should make food fortification mandatory.

Conclusion: The majority of the population was aware of the benefits of fortification of milk with vitamin D and preferred fortified milk for their children. The most important factors governing purchase of fortified food were price, availability and nutritive value.

Keywords: food fortification, awareness, vitamin D, nutritive value.

Importance of communication skills in increasing patient satisfaction, improving treatment adherence, and providing a quality medical care to patients.

Faizan Fazal — Tue, 13 Sep 2022 00:00:00 +0000

Communication skills are a very basic and at the same time very important part of any dealing that involves any two or more than two humans. Communication is the way in which one expresses himself in an overt or in a covert sort of manner. Communication is a means of advocacy that provides the avenue to which a positive impact can be made.1 Communication is just like any other skill which can be mastered by proper technique and practice.
The role of communication skills in medical practice is of utmost significance. Correct and efficient use of communication skills has the potential to significantly increase the level of patient satisfaction. It has been shown that doctors with good attentive listening skills identify patients' problems more accurately and their patients adjust better psychologically and are more satisfied with their care.2 Research has shown that doctor, who undergoes training to acquire good communication skills, can better satisfy their patients.3 It is the patient dis-satisfaction that then leads to malpractice claims against the doctors.
Communication problems have also been cited as the most common factor in the initiation of malpractice suits.4 Thus, improving communication skills is for the benefit of both doctor and the patient, culminating in a win-win situation. Moreover, patients adhere to their treatment plans more effectively when they feel satisfied after their consultation with a doctor.
Non-adherence to treatment is a major problem in getting the desired results in any health care system around the world. Not adhering to the treatment plan given and negotiated during the doctor-patient consultation results in poor health outcomes and an increased decrease burden. Despite proper treatment, doctors sometimes have to face legal consequences if they have not communicated their plan of action properly with their patients. In a meta-analysis on physician communication and patient adherence to treatment, it was concluded that physician communication is significantly positively correlated with patient adherence to treatment. There is a 19% higher risk of non-adherence among patients whose physician communicates poorly than among patients whose physician communicates well.5 Specifically speaking about pediatric illnesses, parental illness perceptions and medication beliefs should be identified during the doctor-patient consultation because they are strong drivers of treatment non-adherence.6
In short, appropriate and efficient use of communication skills by health care medical staff has a great role to play when it comes to providing quality health care. Doctors, nurses, and paramedical staff should properly be trained in appropriate communication skills during their interaction with patients. Communication skills training for nurses is very important and has shown to cause a profound elevation in the quality of nursing care.7
Proper courses on communication skills should be arranged and made mandatory for medical students, doctors, nurses, and paramedical staff. Doctors have shown improvement in skills over the course of the residency program with a multistep evaluative process in the hospitals where the communication skills curriculum has been designed and implemented.8 Thus, it is the need of the hour that we focus our attention and resources on designing and implementing a proper curriculum on communication skills for the medical staff.

Pros and cons of Increasing Gadgets’ Usage in Medical Students of Pakistan

Tehseen haider — Tue, 13 Sep 2022 00:00:00 +0000

The use of technological gadgets is growing at an unprecedented pace all over the world for the past few decades. In present times, dependency on these devices and the services provided by them has greatly increased in all age groups and work professions. According to the recent statistics for the year 2021, in a population of 223 million, 77.7% of people owned mobile connections; 64 million people had internet access and 46 million used social media platforms.1 Almost 10 million smartphone users have been added to the list in a single year.2
As our topic suggests, we will mainly focus on gadget overuse especially mobile phones among medical students in Pakistan. According to the literature, almost 96% of medical students in Islamabad and 100% of medical students in Lahore were using their smartphones.3,4
These above-mentioned statistics and percentages clearly define the importance of these devices in our lives. They have become part and parcel of our day-to-day routine in the true sense. Here are a few reasons enlisted:
 There is a great revolution in teaching methods over the past few decades. We have transcended from the traditional methods of teaching to a whole new digitalised and internet-driven world of gaining knowledge. Previously used methods though were cheaper but provided limited access to information at a given time while the modern techniques not only have grabbed the interests of medical students but also have issued them with a better understanding and vast amount of knowledge via internet access, videos, online lectures, and books. It has put an end to all the limitations and boundaries in attaining knowledge. Hence it’s not wrong to say that every type of information is just one click away.
 Along with the teaching modalities, there is a complete shift in spending leisure time. Previously students used to spend their free time engaged in some sort of healthy out-door activity or hobbies like painting, gardening or board games but now the only thing that makes students satisfied and satiated is the use of mobile phones, playing videos games and spending their time over different social media platforms like Facebook, Twitter, Instagram, TikTok and many more to name.
 Moreover, these electronic devices are also being used as methods of coping with stress and anxiety which is widely prevalent among medical students.
So, technology has not just become the best source of entertainment but also a great escape for medical students in their stressful lives. In addition to this, the devotion of their working and studying hours to these devices has greatly escalated the time spent in front of the screen. This increased screen time is negatively correlated to physical activity and the physical and mental health of students.
The greater the sitting hours in front of screen-based devices, the lower the physical activity of an individual. Thus promoting a greater prevalence of different physical and mental problems which are mentioned below
 Physical problems: Excessive use of these gadgets can cause backache, headache, neck pain, sleep disturbances, stomach upset, eye strain, increased incidence of glasses wearers, obesity, and cancers.
 Mental problems: Increased screen time significantly influences the mental health of the individual. Reduced concentrating ability, stress, and depression are particularly reported after long hours of gadget usage. It is positively associated with psychiatric comorbidity.
 Social isolation: This is probably the worst effect of it. A person gets secluded from the things and people around that then positively contributes to mental and physical health deterioration.
Although technology has silently crept into the intricacies of our life and has adversely affected the overall well-being of an individual but we have to admit it is providing great service to us by breaking geographical barriers and making information accessible. Any webinar, seminar, or session whether conducted within the premises of Pakistan or arranged in any foreign country can be attended while sitting in our bedrooms. Research activities have been made a doodle because of the easy availability of articles via different research engines. The Internet serves as an important learning tool in medical education by providing access to the latest evidence anytime and anywhere. It allows the learners to study at their own pace with convenience without the hassle of attending physical classes. It is especially useful for students of developing countries to keep abreast of ever-expanding knowledge bridging the gap resulting from a scarcity of resources.
In short, science and technology came as a boon for us but it is our use that made them a curse. Undeniably these gadgets have become a necessity in our lives and cannot be pulled away; neither it is recommended to stop their use completely in order to keep pace with the ever-growing world but they definitely should be used appropriately and judiciously. Using electronic devices in a controlled way can limit the negative effects they are posing in our everyday lives and thus they can yield maximum benefit.