The Transition towards Virtual Teaching Learning Environment during COVID Pandemic : Medical Educator’s Perspective

Introduction : We are moving towards a technically advanced Medical Education. However, effectiveness of online Teaching, Learning (T/L) remained unknown until COVID-19 pandemic.Aim : This study was planned to assess the perception of e-educators towards online T/L, the challenges and possible solutions during pandemic. Methodology : A mixed method cross-sectional study was conducted among 126 medical educators through online google survey from July to September, 2020 in a Tertiary Heath Care Institute & 2 neighbouring medical college. Result : Non response rate was 32%, 72.2% were males, 63.9% were between 31 to 50 years of age, 58% were having 10 or more years teaching experience. 36.2% were from basic sciences, 69.5% were holding higher academic post. 61% preferred combination of face to face and e-learning Although online classes were helpful in terms of 63.8% convenience, (54%) flexibility, 77.5% felt difficulties teaching and assessing skills domain. The major challenges encountered were technical glitches, no active participation and suggested solutions were technical assistance, formative assessments and use of new T/L, assessment tools. Conclusion : Although the change was negatively perceived, it’s inevitable. Training of faculties, sensitization of students and conducive environment is needed to combat the challenges, to improve the e-education system in health profession.

Disease staging according to international scoring system in newly diagnosed patients with multiple myeloma

Objective: To determine the frequency of disease staging according to international scoring system in patients who are newly diagnosed with Multiple Myeloma [MM] at a tertiary care hospital at Karachi

Methods: This single center, non probability consecutive, cross sectional study was conducted from Nov 11, 2015 to May 11, 2016. After taking informed written consent, detailed history was taken and serum beta2 microglobulin and albumin levels were checked to assess the study outcome variable i.e. stage of MM. All the collected information was entered in the prescribed performa

Results: Eighty newly diagnosed patients with multiple myeloma as per inclusion criteria were included. Sixty seven [83.75%] were male and 13[16.25] were females, with mean age of 58.35+10.077 years. Twenty seven patients [33.75%] were found to have stage-I disease, in 23 [28.75%] stage-II and stage-III in 30 [37.5%]

Conclusion: Multiple myeloma is relatively common in 5th decade, with male predominance. International Staging System have great potential for characterizing and stratifying multiple myeloma and revealed a predominance of advanced stage III disease in our setting

Emergency contraception: awareness, attitudes and barriers of Saudi Arabian Women

Objectives: To assess knowledge, attitude, and barriers about emergency contraception [EC] among married women of child bearing age

Methods: A quantitative cross-sectional study was conducted over a 6-month period, commencing in March 2013 at Family Practice Clinics of King Khalid University Hospital [KKUH], Riyadh, Saudi Arabia. Data was collected using a structured pretested questionnaire and analyzed using SPSS version 21.0 statistical software

Result: A total of 242 women were enrolled in the study. Only 6.2% [15/242] had some knowledge of EC and of these only two had ever used it. Health care professionals were the least reported source of EC information [6.6%, n=1]. Majority [73.3%] had negative attitude toward EC being available over-the-counter without a prescription. The most common barriers to using EC were concerns about possible health effects. Only two women [13.3%] considered religious belief as a major hindrance to its use

Conclusion: Awareness of emergency contraception is very low among women of Saudi Arabia. Health care professionals were the least reported source of information, which is a cause for concern. Our findings reveal an urgent need to educate women about EC, keeping in view the social norms and the Islamic values

Views of family medicine trainees of a teaching hospital in Riyadh regarding their hospital rotations: a qualitative study

To explore Family Medicine Trainees views regarding the hospital component of their Family Medicine [FM] training program. This is a qualitative focus group discussion based study. Thirteen trainees, eight from final year of FM training program and five from third year of the same program participated in the study. The structure for discussion included a previously distributed and completed questionnaire that included three sections. The first section was evaluation of the satisfaction of trainees with the different hospital specialties rotations. The second section related to reasons for rating the different rotations as excellent and very good. The third section related to deficiencies in training for those rotations which received a score of 3-5. The items in the questionnaire were utilized in the focus group discussion. Two facilitators who were investigators facilitated the discussion. The data was qualitatively analyzed to identify emergent themes and subthemes that described the trainees' views. The trainees highlighted the following views: Teaching in the hospital component is not relevant to the needs of Family Medicine trainees. Duration of the hospital posts should be reviewed. Emphasis should be on out-patient clinics rather than in-patient. More emphasis must be given to procedural skills, minor surgery and teaching in clinical contexts. Hospital training component of the Family Medicine training program should be reviewed, as the structure and its implementation doesn't reflect the views of trainees regarding its relevance to their day to day practice

Correlation of inflammatory markers with type 2 diabetes mellitus in Pakistani patients

To study the levels of inflammatory markers in Type 2 Diabetes Mellitus Pakistani patients and determine their correlation with the disease. This cross sectional study was conducted at Military Hospital, Rawalpindi, and Centre for Research in Experimental and Applied Medicine [CREAM], Army Medical College, Rawalpindi, Pakistan from June 2011-June 2012. We determined the levels of Erythrocyte Sedimentation Rate [ESR], Total Leukocyte Count [TLC], Interleukin 6 [IL-6] and Tumor Necrosis Factor- alpha [TNF- alpha] in 72 patients with Type 2 Diabetes Mellitus [T2DM] and 40 healthy controls. The levels were correlated with age, duration of the disease, Body Mass Index [BMI], lipid profile and insulin resistance. ESR, TLC, IL-6 and TNF- alpha were found to be significantly higher in T2DM patients. There was also statistically significant difference in BMI, fasting blood sugar, insulin resistance and dyslipidemia [except LDL] between diabetic and control group. All inflammatory markers except TNF- alpha were positively correlated with insulin resistance. Only TNF- alpha was found to be correlated to duration of the disease. Both TLC and Serum insulin were positively correlated to BMI. Inflammatory markers were not correlated to dyslipidemia. This is the first study reporting levels of cytokines in Pakistani diabetic patients and healthy controls. There is augmented inflammation in T2DM in Pakistani patients which plays role in higher insulin resistance in these patients. TNF- alpha levels increases with longer duration of the disease. Levels of inflammatory markers are not correlated to BMI, dyslipidemia or increasing age

Psychological problems and family functioning as risk factors in addiction

Family provides a rich mixture of stimuli to the offspring that often affects both physical and psychological development. Instilling in children the beliefs, values, and suitable behavior of their society remains a fundamental function of the family. The manner in which the family interaction goes about this process contributes to a range of developmental outcomes. The purpose of the present research was to determine the role of family functioning and psychological problems of drug addicts and non addicts by assessing the difference between the two groups. A cluster sampling method was used. Sample of present research consisted of 240 adolescents divided into two groups of 120 addicts and 120 non addicts each from different socioeconomic status. Cohort study. General scale of Family Assessment Measure, Version III [FAM-III] was administered in order to measure the level of communication, value and norms whereas dyadic Relationship Scale was used to measure affective expression and control among the family members of addicts and non addicts. Renold Adolescent Adjustment Screening Inventory was administered in order to assess anger control problems, emotional distress and positive self in addicts and non addicts. Student's t-test was calculated in order to determine the difference in the level of communication, value and norms, affective expression and control among families of addicts and non addicts. Difference in anger control problems, emotional distress and positive self between the addicts and non addicts was also determined by calculating t-test. Results showed significant differences in the variables among the family members and there is also a significant difference between addicts and non addicts. The family occupies an important place among other groups that socially influence addicts. The problem of relation between the family and addicts should be taken into consideration while designing effective programs for the prevention of addiction. Psychological problems in young persons are playing an equal role in the development of addiction

Communication skills of family physicians in a doctor-patient consultation

Communication skills survey points out the areas where deficiencies exist and also creates awareness among the practitioners to improve their communication skills. Effective communication skills are necessary for medical practice and improves patient's satisfaction and compliance with treatment. We have found it useful to conduct a communication skills survey at our Family Practice Center, and recommend its practice by all medical practitioners. This is a short communication

Clinical experience of motor neurone disease

Motor Neurone Disease [MND] is an adult onset idiopathic, progressive and ultimately fatal degenerative neurological disorder, involving both upper and lower motor neurons in the cerebral cortex, brain stem and spinal cord. Recent studies revealed additional degeneration of some other areas of brain. No definite cause or treatment is known. Clinically it has been shown to have different onset forms, which frequently evolve into a common clinical entity known as A.l.S. This study, describes clinical pattern of MND in a portion of Pakistani population who presented at Neurology Department of Civil Hospital Karachi during the period 1992 - 1998. Total of 29 cases fulfilled the diagnostic criteria; all the cases were sporadic, except an elderly male patient with pure lower motor neuron illness. Twentyeight cases presented with combination of upper and lower motor neuron signs. Of these, 8 had bulbar onset and later spinal features. Twenty had spinal onset, out of them 7 developed additional bulbar symptoms and 13 retained the features of onset at the time of presentation. Overall mean age of onset was 43 +/- 9 years, about a decade younger than European population and nearer to South Asian studies. Spinal onset form affected mostly young males [male: female ratio 19:1] and bulbar onset form affected elderly patients with equal sex ratio. However male to female ratio, considering all cases, was 4.8:1. Females were observed to be relatively spared during the reproductive age period. Rate of progression was slow to moderately rapid. Only two patients had fulminant course

Sensorineural deafness in insulin dependent diabetes mellitus

32 patients suffering form Insulin Dependent Diabetes Mellitus [IDDM], who did not complain of any overt hearing problem, underwent Pure Tone Audiometry. Appreciable bilateral sensorineural deafness was found in seven patients. The loss was more at higher frequencies in males. IDDM patients having longstanding disease were significantly deafer than those with recent onset of diabetes. No correlation between the degree of deafness and poorly controlled diabetes or insulin dosage was noted. We conclude that IDDM does predispose to sensorineural deafness, the impairment being directly proportional to the duration of the disease