Students' Supplement of Journal of Rawalpindi Medical College

Inclusion of Bioethics in Curricula of Rawalpindi medical university: Perception of Teachers and Students about Teaching and Learning Process A cross sectional study

2024-09-08T17:45:05+00:00

Background: The change in trend of medicine has made it important that bioethics should be included curricula. The paternalistic approach of doctors can be changed via teaching bioethics. Many Countries are recognizing bioethics as an important part of their curricula, which has already been included in the curricula of Rawalpindi Medical University, Pakistan.

Objectives: The objectives of this study are to assess the perception of students about inclusion of bioethics and hurdles encountered by teachers as educators and to identify the effective mode of teaching.

Material and Methods: A Cross-Sectional Study was conducted in Rawalpindi Medical University Pakistan in a time period of 6 months.400 MBBS students of all academic years, while 23 faculty members from clinical and basic sciences took part in study. Perception about bioethics was assessed using a self-structured questionnaire, comprised of two parts; a student questionnaire and a teachers’ section, containing both close and open-ended questions The student questionnaire was validated and its Cronbach’s alpha value is 0.677. Descriptive Analysis was performed using SPSS version 23.

Results: The perception of students about inclusion of bioethics show that 56.5% (N=226) of participants agree that teaching bioethics will help them develop skills to solve ethical dilemmas. 23.5% (N=94) of participants strongly agree that formal teaching of bioethics should be emphasized and strengthened. 54.3% (N=217) of participants agree that assessment of bioethics should be made necessary. On the other hand, Teacher analyses showed that 91.3% (N=21) of the teachers agree upon the necessity of assessment of Bioethics. The only specific challenge for teachers was lack of special training.45.3% (N=181) of students think Role-play as the preferred method of teaching Bioethics.

Conclusion: It is concluded in the study that bioethics should be included in the curricula and students and teachers alike consider it important to assess. With the modernization and setting of different trends in the medical practice, the inclusion of bioethics is the need of the time. The different perception of students and the effective method of teaching of bioethics have been discussed.

Keywords: Bioethics, Challenges, and Perception

Sociodemographic Predictors of Knowledge and Attitude of Married Males About Antenatal and Post-Natal Needs of Women in the General Population of Rawalpindi; A Cross-Sectional Study

2024-10-16T08:38:18+00:00

Introduction:

Socioeconomic, cultural, religious, and ethnic disparities hinder women's health decisions. Male involvement in antenatal and post-natal health programs can improve outcomes.

Objective:

The objective is to assess the level of knowledge and attitudes among married males regarding the antenatal and postnatal needs of women in Rawalpindi.

Material and methods:

A cross-sectional study involving 323 married males for 06 months, was conducted using a self-structured validated questionnaire. Data was analyzed using IBM SPSS version 26.0.

Results:

49.2% of male participants had adequate knowledge, 26.9% had poor knowledge, and 23.5% had excellent knowledge. Attitude assessment showed that 35.6% had poor attitudes, 37.5% had adequate attitudes, and 26.9% had excellent attitudes. Significant association of knowledge was found with education, residence, monthly income and number of children.

Conclusion:

Good education, better income, and number of children positively influenced knowledge of antenatal and postnatal care, but similar trends were not observed for attitudes. Increased awareness and community education are needed.

Keywords: Antenatal care, Postnatal care, Maternal health

Estimation of Mean Hemoglobin, Anemia Prevalence, and Associated Risk Factors Among Medical Students

2024-09-26T20:25:53+00:00

Abstract

Background: Anemia is one of the most common types of blood disorders affecting twice as many as females as males. Anemia reduction is one of six World Health Assembly Global Nutrition Targets within the Comprehensive Implementation Plan on maternal, infant, and young child nutrition. Anemia caused by iron deficiency in women of reproductive age of 15-24 years increases the risk of maternal mortality and impaired fetal growth. It is important to promote dietary intake of iron rich food to compensate for menstrual iron losses. Therefore, this study aims at raising awareness, highlighting risk factors, to assess the mean hemoglobin levels of the students and the prevalence of anemia among students at Rawalpindi Medical University.

Materials and Methods: This is an observational cross-sectional study conducted among 110 undergraduate students of age 18 to 25 years at Rawalpindi Medical University by using a convenient sampling technique. Hemoglobin levels assessed using an automated CP analyzer were included. Data was collected by verified self-grading anemia questionnaire on Google Forms and analyzed using IBM SPSS software version 26. Anemia and nutritional indicators correlation was determined by Chi-square.

Results: In a total of 110 students, the frequency of non-anemic students was 1.75 times more than anemic students of 92.5% anemic students were female and 7.5% were males which suggesting that anemia is more prevalent in females than males. Among female 42% and that of male 14% were anemic. Our study demonstrates that the estimated value of mean hemoglobin in the studied population is 11.87mg/dl. Hemoglobin levels were significantly lower in females with heavy menstrual flow than those with normal flow. Among those who took iron a few times in their diet, 77.5% were anemic. However, BMI, socioeconomic status, and hostelite/ non-hostelite status did not have a significant relation.

Conclusion: The research conclusively demonstrates a higher prevalence of anemia among female medical students (92.5%) compared to their male counterparts (7.5%). The female population is particularly vulnerable to anemia due to heavy menstruation and insufficient iron intake. Our findings on the prevalence of anemia among RMU students indicate a pressing need for awareness programs focused on anemia and its preventive measures.

Assessment of Lifestyle Behaviour and its Association in Different Professions of Twin Cities Using Short Multidimensional Inventory Lifestyle Evaluation - Confinement (SMILE-C) Questionnaire; A Cross-sectional Survey

2024-09-01T11:49:08+00:00

Introduction: A multidimensional scale (SMILE-C) had been used during the COVID-19. This tool was developed from the original SMILE which is a self-assessed 43-item questionnaire comprising seven lifestyle domains. SMILE-C is a modified version of original SMILE consisting of 27 items and was developed to carry out a multidimensional and comprehensive assessment of lifestyle during the previous 30 days. It has been used in the western world during the COVID-19 pandemic but hasn’t been utilized in the general population of Pakistan. This study aimed at evaluating the lifestyle behavior in different professions by using SMILE-C questionnaire.

Objective: The study aims to analyze lifestyle behavior among individuals belonging to different professions in Pakistan.

Materials and methods: A survey was conducted among the general population of Pakistan living in Rawalpindi and Islamabad belonging to 5 occupations: doctor, teacher, IT specialist, banker, laborer. The survey comprised of demographic details and questions regarding lifestyle assessed through Short Multidimensional Inventory Lifestyle Evaluation- Confinement (SMILE-C) Questionnaire. The participants voluntarily filled the consent form and self-reported changes in 7 lifestyle domains. Data was analyzed using IBM® SPSS® 27. Kruskal-Wallis test and Mann-Whitney U test were used to test significance among variables

Results: The total sample size was 400, 80 from each of the five professions. Mean SMILE-C score was 82.24 in the total sample. Mean scores among professions were 81.82 ± 8.02 (doctor), 86.70 ± 8.53 (teacher), 81.06 ± 8.11 (IT specialist), 78.79 ± 11.57 (banker), 82.77 ± 12.47 (laborer), indicating that teachers had the highest score (better lifestyle). Differences in seven lifestyle domains among professions was statistically significant (p<0.001). Pairwise comparisons among them also showed significant differences in various domains.

Conclusion: Our study showed meaningful changes in lifestyle among different occupations in seven lifestyle domains, suggesting that occupation impacts lifestyle behavior in various ways. The findings highlight the importance of incorporating healthy lifestyle practices and the need for targeted lifestyle interventions to promote health in a community.

Keywords: Lifestyle, inventory, evaluation

Maternal And Fetal Outcomes Of Unbooked Cases Presenting In Obstetrical Emergency Of Public Sector Tertiary Hospitals Of Rawalpindi.

2024-10-03T15:33:45+00:00

INRODUCTION: Obstetric emergencies significantly affect both the mother and fetus, leading to considerable maternal and perinatal morbidity and mortality. Reducing maternal and newborn mortality and morbidity is a top priority for the global healthcare system.OBJECTIVES: The objectives of this study is to assess the maternal and fetal outcomes of un-booked patients presenting in emergency of Tertiary Care Hospital. METHODOLOGY: The self-administered questionnaire was used to obtain data and was cleaned and analyzed using excel and SPSS version 27. Descriptive statistics were found for demographic variables and maternal and fetal outcomes. RESULTS: Out of 200 participants ,maternal outcomes were uneventful in 144(72%) , anemia 25(12.5%), fever 14 (7.0%) and post-partum hemorrhage in 15(7.5%) being the most common pathological outcomes. Only a few had cerebrovascular accidents 4 (2%), wound sepsis 3(1.5%), maternal genital injuries 2 (1%) and acute renal failure 1(0.5%). No incidence of coma or death was found. Fetal outcomes were: 152(76%) of the fetus were live at birth.35(17.5%) were NICU admissions. CONCLUSIONS: The study's findings emphasize the outcomes linked to un-booked patients in obstetrical emergencies. These insights can influence health policies aimed at enhancing maternal and fetal outcomes. By identifying gaps, targeted interventions, improved emergency preparedness, and awareness campaigns can be initiated to reduce morbidity and mortality rates, ultimately promoting better health for mothers and newborns in tertiary care settings.
KEYWORDS: Obstetrical Emergencies, Un-booked patients, Maternal Outcomes, Fetal Outcomes

Father's Fear of Childbirth during Antenatal Period in Allied Hospitals of RMU, A Cross-Sectional Study

2024-09-06T13:21:58+00:00

Introduction The term "fathers' fear of childbirth" refers to the unpleasant and apprehensive feelings that arise during the prenatal period and are mostly felt during labor. An estimated 13% of expecting men experience pathological dread during their pregnancy. Fathers' anxiety about childbirth may be attributed to several factors such as having their first child, having their pregnant woman delivered via cesarean section, experiencing problems during labor, having a restricted income, and so on. The purpose of this study is to shed light on the men in our community who are afraid of giving birth. To foster better family dynamics, the ultimate objective is to de-stigmatize conversations on fathers' emotional health and give priority to their mental health. Objectives This study aims to measure the fear of childbirth that dads have throughout the prenatal period at RMU's affiliated hospitals and assess the relationship between fathers' fear of childbearing in relation to lifestyle choices. Materials and Methods 190 dads participated in an observational cross-sectional study employing the dads' Fear of Childbirth Scale (FFSC). The data was gathered using a self-administered questionnaire and consecutive sampling. The dread of childbirth among dads was analyzed statistically using Chi-square and Fisher Exact tests, as well as other tests, to find correlations with different demographic variables. Results According to the survey, 51.6% of fathers and 6.8% of fathers, respectively, report having moderate dread, while 41.6% report having mild fear. Fear and age (p=0.023), years of marriage (p=0.015), employment (p=0.022), and history of miscarriage (p=0.024) were shown to be significantly correlated. Conclusion In our research sample, moderate fear predominated, followed by mild and severe dread. "As the time of childbirth approaches, my worries increase" was the item with the highest mean and standard deviation among all FFCS items. The study finds a strong correlation between certain demographic characteristics (age, employment, history of miscarriage, and years of marriage) and fathers' anxiety of delivery. Keywords Fathers’ fear, childbirth, antenatal.

Navigating the Digital Age: Unveiling the Health Repercussions of Gadget Use in Adolescents, a cross-sectional study.

2024-10-16T11:55:10+00:00

Introduction:

The 21st century has come forth with massive developments in science and technology, the milestone of which is electronic gadgets and smartphones. Customary among all age groups, the most sensitive of them i.e. the adolescents are the prime users. By concentrating on this age group, this study aims to provide valuable insights into the effects of electronic gadget use on adolescent health as they are a focal point of interest for researchers worldwide.

Objectives:

The objectives of this study were to determine the frequency of electronic gadget usage among adolescents, to evaluate the perceived health effects associated with its usage, and to establish the correlation between electronic gadget usage and associated health effects.

Material and Methods:

Data of 258 adolescents was collected by using a semi-structured questionnaire. Data collection used two sources i.e. online forms and by visiting different schools/colleges in the Rawalpindi district. Data analysis was done using SPSS v26. The chi-square test was used to measure the association between study variables.

Results:

Out of the 258 participants, the majority were females (70.9%) while only (29.1%) males. The most used electronic device was mobile phones (87.9%). Majority of the participants (62%) used electronic devices for recreational purposes or for educational purposes (56.1%). Screen time reported by most of the participants (32.9%) was 2-4 hours/day. The study showed a significant relationship between screen time (measured hours per day) and eye irritation (p=0.039). Participants with 4 to 6 hours/day use of electronic devices reported the greatest percentage of eye irritation (63.9%).

Conclusion:

The use of electronic gadgets among adolescents significantly affects their ocular and musculoskeletal health. Therefore, electronic gadget use and screen time should be moderated among adolescents and better healthy alternatives e.g. outdoor activities should be promoted.

Keywords:

Adolescents, teenagers, youth, electronic gadgets, health effects.

The Effect of Ramadan Fasting on Cognition in Young Adults

2024-09-24T18:41:01+00:00

Introduction:

Fasting has been practiced for centuries, often for religious or spiritual reasons, and has gained popularity in recent years for its potential health benefits. During Ramadan, Muslims fast from sunrise to sunset for several days, which may impact various bodily functions, including cognition. Previous research has explored the effects of fasting on cognition, with some studies suggesting no significant cognitive impact. However, these studies often overlooked mild cognitive dysfunctions that may not be immediately apparent but could influence daily functioning, and such a change demands facilitation and acknowledgement by society.

Objectives:

This study aimed to investigate the impact of Ramadan fasting on cognitive function in young adults, specifically evaluating changes in cognition before and during fasting.

Materials and Methods:

A quasi-experimental design was utilized with 24 students from Rawalpindi Medical University. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) both before and during Ramadan fasting. Data were analyzed using paired-sample t-tests and Wilcoxon-Signed Rank tests.

Results:

Significant reductions in cognitive scores were observed during fasting (24.3 ± 2.2) compared to non-fasting (28.4 ± 0.9), with a p-value of 0.009. Short-term memory scores decreased significantly during fasting (11.4 ± 2.9) versus non-fasting (14.9 ± 0.4, p = 0.009). Word production also declined significantly (fasting: 10.3 ± 3.7; non-fasting: 13.4 ± 2.8, p = 0.002). Effect sizes were large for overall cognition and short-term memory and medium for word production. These results suggest a potential mild cognitive decline during Ramadan fasting.

Conclusion:

Ramadan fasting is associated with significant reductions in cognitive performance among young adults, particularly affecting short-term memory and word production. These findings highlight the potential cognitive challenges faced during fasting, which could impact academic and professional performance.

Key Words:

Cognition, fasting, memory, mental status and dementia tests, mental recall

Assessment of Mental Well-being in the Medical & Non-medical Students in the Twin Cities of Pakistan: A Cross-sectional Study

2024-09-26T19:26:54+00:00

Introduction: Worldwide, especially in Pakistan, concerns are growing concerning the prevalence of mental health issues among university students. This study examines the frequency of stress, anxiety, and depression to assess the mental health of students at the medical and non-medical universities in Rawalpindi and Islamabad.

Objectives: This research aims to look at mental health in a variety of academic domains, find out how common mental health issues are among students in Pakistan's twin cities, and look at possible connections between sociodemographic factors and depression, stress, and anxiety.

Methods: A cross-sectional survey of 352 undergraduate students from eight medical and eight non-medical universities was carried out using the Depression Anxiety Stress Scales (DASS-21). An online questionnaire was utilized to gather data using convenience sampling. To find correlations between different demographic characteristics and mental health outcomes, statistical analyses were conducted using Chi-square testing, Mann-Whitney U tests, and logistic regression.

Results: The study found that 70.7% of students experienced depression, 74.1% experienced anxiety, and 21% experienced stress above normal levels. Non-medical students reported higher levels of depression (76.7%) and anxiety (68.66%) compared to medical students (62.7% and 37.3%, respectively). Stress levels were comparable between the two groups. Significant associations were found between depression, anxiety, and the field of study (p<0.05). Gender was significantly associated with stress (p=0.017) and anxiety (p=0.035), with a higher prevalence among female students.

Conclusion: The results show that anxiety and depression are common among Pakistani university students, with non-medical students being more susceptible. The study emphasizes how important it is for institutions to have targeted mental health interventions and support services to successfully deal with these problems.

Keywords: Students, Mental Health, Stress, Anxiety, Depression.

Maternal care gaps; a study on ANC visit patterns and the reported challenges to prenatal care access in public sector hospitals of Rawalpindi District.

2024-09-05T16:38:45+00:00

Background:

Maternal and Child Health (MCH) is a critical area of focus globally due to its profound impact on the well-being of both mother and child. Owing to lack of proper MCH services, Maternal Mortality remains alarmingly high with many pregnant women succumbing to complications during and after pregnancy. Antenatal care (ANC), as a crucial component of maternal and child health (MCH), is one of the four pillars of safe motherhood recommended by the WHO. Pregnant mothers face various barriers that significantly hinder their ANC visits including social, cultural, economic, and geographical challenges. Given the lack of detailed regional data on ANC in Pakistan, particularly in Rawalpindi district, this study aims to assess the frequency of ANC visits and identify the barriers women face in accessing antenatal healthcare in the city.

Objectives:

To determine the frequency of ANC visits and to assess the reported barriers to ANC, as well as to establish the association between ANC visits and the reported barriers among pregnant women.

Materials and Methods:

A descriptive quantitative cross-sectional study was conductedin the Obstetrics and Gynecological Department of Tertiary Care Hospitals of Rawalpindi district with 348 pregnant women following their delivery either through SVD or C-section. For data collection a self-structured questionnaire was designed, consisting of socio-demographic profile, previous obstetric history, ANC visit patterns and reported barriers to ANC access.Data collection technique was one-on-one interview. Written informed consent was taken and confidentiality of the study participants was maintained. Data was entered and analyzed on SPSS version 26. Descriptive and inferential statistics were applied; p value of less than 0.05 was set as significant

Results:

The mean age of study participants was 28.26. ANC coverage was 97.7% out of which 79.9% received minimum 4 ANC visits while only 25% received recommended 8 ANC visits .Of the total participants, 84.8% delivered through C-section whereas the 15.2% via SVD. Among the barriers, lack of money for cost associated with transportation (p=0.015), education level of husband (p=0.042), employment status of the husband(p=0.032), language barrier with healthcare provider(p=0.010) and residence in urban areas(p=0.017) significantly influenced women’s ability to access ANC visits. Additionally lack of awareness among pregnant women appeared to be statistically significant in affecting ANC visits (with a p-value of 0.00).

Conclusions:

This study indicates that a considerable number of study participants received a minimum number of 4 ANC visits in Rawalpindi District. However, there is a need to address some major factors hindering the standard ANC visitations including limited awareness and geographic difficulties. Maternal health outcomes can be improved by addressing these issues and enhancing ANC services at the grass root level of Basic Health Units and Rural Health Centers to spare the population from the struggles of visiting tertiary care hospitals from distant areas.

MESH keywords:

Antenatal Care, Frequency, Barriers.

Determinants of Modern Contraceptive Discontinuation among Inclined Users: A Cross- Sectional Study in Rawalpindi City

2024-09-06T16:34:03+00:00

Introduction

Contraception is the intentional prevention of conception through various devices, sexual practices, chemicals, or surgical procedures. Discontinuing contraceptives without wanting to conceive can lead to adverse health outcomes for the mother. Modern methods include oral contraceptives, barrier methods, IUDs, injectables, patches, and implants, chosen based on comfort, protection, and cost. Stopping contraceptives poses challenges to public health efforts in family planning and reproductive health. Understanding the factors behind this issue is vital for creating effective interventions and improving adherence to contraceptive methods. Research in Pakistan indicates that women often avoid birth control due to cultural or religious beliefs, family or partner opposition, health concerns, or fear of side effects.

Objectives

To identify determinants associated with discontinuation of contraceptives in inclined users in Rawalpindi city

Materials and Methods

This three-month Cross-sectional study in Rawalpindi was specifically focused on married women. 324 participants who agreed to participate fulfilled the inclusion criteria using a interview based questionnaire form.

Results
Of the 324 women in Rawalpindi who responded, 32.19% had discontinued Oral Contraceptive pills, 30.31% had discontinued Barrier Method, 25% had discontinued Intra Uterine Contraceptive Device, 8.44% had discontinued Injectable Contraceptives, and 4.06% had discontinued Transdermal Patches after using each method for at least 6 months. Menstrual Abnormalities was the chief reason for discontinuation for Oral Contraceptive Pills. The chief reasons for Barrier method was slippage and breakage, for Intra Uterine Contraceptive Devices (IUCD) was Pelvic pain, for Injectables was site reactions and for Transdermal patches was skin discoloration.

Conclusions

The results of this study show that the most common contraceptive method to be discontinued is oral contraceptive pills and the chief reason for discontinuation is menstrual abnormalities. Tailored counseling is vital to address these concerns effectively, and comprehensive reproductive health programs are recommended to promote equitable contraceptive use.

Competency-Based Medical Education (CBME): Revolutionizing How Doctors Are Trained

2025-06-13T15:12:31+00:00

N/A

Classic Galactosemia: A Rare Cause of Neonatal Jaundice in Infants

2025-06-13T16:24:48+00:00

Classic galactosemia is a rare inborn error of galactose metabolism which is caused by a deficiency of an enzyme known as galactose-1-phosphate uridyl transferase (GALT). A 4-month-old male infant presented with yellowish discolouration of the skin and eyes (jaundice) and clay-coloured stools. On examination, the baby has normal development and no signs of chronic liver disease. Blood tests and ultrasound show raised bilirubin and liver enzymes, but no structural abnormality or biliary atresia. However, urine sugar chromatography detected galactose and lactose, and a direct enzyme assay confirmed a deficiency of galactose-1-phosphate uridyl transferase. The patient was treated with a galactosemia-based diet, non-lactose milk, and vitamin supplements and showed improvement. The patient is currently on follow-up for monitoring

Keywords: Classic galactosemia, neonatal jaundice, GALT deficiency, dietary modification, inborn errors of metabolism

Efficacy of PARP Inhibitors, Bevacizumab and Platinum Based Chemotherapy in Treatment Regimen of Patients with BRCA1/2-mutated Ovarian Cancer

2025-06-13T16:29:15+00:00

N/A