ABSTRACT
Background: There is paucity of research based information regarding the dermatology learning needs and their fulfilment in primary care physicians
Objective: To determine skin diseases burden in the community AND adequacy of preparedness of Primary Care Physicians to deal with skin diseases
Methodology: This was a cross sectional study conducted from 1[st] January 2015 to 31[st] December 2016 at Dermatology Outpatient Department of Sheikh Zayed Medical College/Hospital [SZMC/H], Rahim Yar Khan, for burden of skin diseases and feedback from Primary Care Physicians of both SZMC/H and Primary Health Care setups [BHUs and RHCs] of District Rahim Yar Khan regarding adequacy of their preparedness to deal with skin disease patients. Records from a tertiary care teaching hospital was sought from OPD to assess skin disease burden and Primary Care Physicians from tertiary care hospital and BHU and RHC of district were surveyed regarding content AND teaching adequacy of undergraduates through their dermatology curriculum. Data was entered and analyzed by using SPSS version 20
Results: A total of 356 doctors participated in this study. Of these 233 [65.4%] were males. It was found that 10% of patients attending OPD in Sheikh Zayed Hospital [A tertiary care teaching hospital] suffered from skin disease. Frequencies of "Common skin diseases" in the community were; eczema 12.9%, scabies 10.8%, fungal infection 9%, bacterial infection 8% and acne 7%. Of all participants, 274 [77%] reported that <10% of their patients suffered from skin disease and only 30 [8.4%] of them were fully confident while treating skin disease patients and only 36 [10.1%] reported that most of their patients were cured. It was noted that 145 [40.7%] participants could name only 1-3 of the common skin diseases in the community, 182 [51.1%] named 4-6 while only 12[3.4%] could name 7 or more and 17[4.8%] had no knowledge of even a single common skin disease in the community. Only 92[25.8%] participants rated that their undergraduate training was adequate while 264[74.2%] rated it to be inadequate
Conclusion: This study concluded that primary care physician were not adequately prepared for managing common skin diseases during their undergraduate training. Appropriate exposure and adequate teaching in dermatology throughout undergraduate medical curriculum is essential because skin presentations manifest throughout all aspects of medicine, and most often dermatological problems are dealt with exclusively by non-dermatologists
ABSTRACT
Muscular dystrophies [MD] traditionally refer to a group of genetically determined, progressive, degenerative disorders of the skeletal muscle. The most common disease manifestations being Duchenne Muscular Dystrophy [DMD] and Becker Muscular Dystrophy [BMD]. This descriptive study was carried out on 40 patients of muscular dystrophies, selected on clinical grounds and subjected to biochemical, morphological and immunohistochemical analysis. Muscle biopsies were taken from patients by an open method and formalin fixed paraffin embedded blocks were made. Haematoxylin and Eosin stain, PAS and Gomori's trichrome and immunohistochemical stains were conducted on the sections from these blocks. Dystrophin and beta - Spectrin antibodies were used for immunohistochemistry. Among the 40 cases of muscular dystrophy the above investigations were correlated with clinical findings to reach the final diagnosis in each case. In Pakistan the diagnosis of muscular dystrophies is still based on clinical grounds and CPK values only, however the present study has provided us an opportunity to combine clinical, biochemical, morphlogical and immunohistochemical evaluations of the patients with muscular dystrophies. It was concluded from this study that although muscular dystrophy can be diagnosed using clinical parameters and CPK levels, histochemistry and IHC can confirm and differentiate the various types of muscular dystrophy and make it possible to identify the female patients of DMD and BMD