Association of Trace Metals in Patients with Schizophrenia.

OBJECTIVE: To compare the serum concentrations of copper, iron and zinc in schizophrenic patients with healthy individuals. STUDY DESIGN: Cross-sectional comparison study. PLACE AND DURATION OF STUDY: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan. The study was conducted from July to December 2020. METHODOLOGY: Among 115 participants in the study, schizophrenic patients and healthy subjects were 35 and 80, respectively. Copper and zinc were measured by using atomic absorption spectrophotometry. Serum Iron measurement was done on ADVIA 1800 chemistry auto analyser. Comparison of these trace metals among patients with schizophrenia and healthy subjects, by using Mann-Whitney U-test and correlation with the duration of disease, was analysed by the application of Spearman's correlation. RESULTS: Males accounted for 25 (71.4%) and females were 10 (28.6%) in diseased group; while in healthy subjects, males accounted for 54 (67.5%) and females 26 (32.5%). Copper, iron and zinc levels were noted to be significantly reduced in schizophrenic patients, when compared with healthy subjects (p <0.001). CONCLUSION: This study could offer an additional clue in the diagnosis and possible role of trace metals in pathophysiology and progression of many psychiatric illnesses, particularly schizophrenia. Key Words: Psychiatric illness, Schizophrenia, Trace metals.

Pakistani Student Nurses' perceptions of their hospital's health professionals' attitudes and suggested ways to improve patient care - An untainted view.

BACKGROUND & OBJECTIVES: Feedback brings a fresh perspective and improvement in any organization. Health professionals (HPs) lose insight of the gaps in medical care. The views of student nurses can help improve systems. The objective of this study was to assess the views of our student nurses and how they perceive the way the doctors and HPs work in our hospital and comment on training, attitudes, care pathways, teamwork, and what needed to be improved. METHODS: A proforma based qualitative study was carried out at the Nurses' Training Centre of PAF Hospital and Fazaia Medical College, Islamabad, from January to March 2020. After approval, a semi-structured proforma with open and closed ended questions was administered, in English and Urdu. The results were analyzed by comparative numbers and percentages for each question and descriptive responses were grouped in recurring themes and analyzed for content and their constructive value. RESULTS: Out of 85 nursing cadets, the proforma could be administered to 61(M=38(62.3%) and F=23(37.7%). Most were FSc with 26% graduates. Majority of the female students' main reason for joining was to serve humanity, unlike most males. According to gender many responses were interestingly different. Majority of females thought male doctors were better (86%). Only 36% said the doctors were sincere in care of patients. Most thought that we needed to improve patient counseling. Most thought the seniors treated them unfairly, but bullying was negligible. They wanted the senior HPs to improve their attitudes and ensure adequate equipment in the wards. They were worried about personal security from patients and relatives. Dedicated mental health services to deal with stress of witnessing every day misery and death was suggested. CONCLUSIONS: Doctors need to improve their counseling skills and should talk more to the patients and their relatives. They should acknowledge the nursing students and improve teamwork. Belittling them in front of others harms their self-efficacy. Simple corrections like punctuality, ownership of their patients and improvement of equipment and systems can improve patient care.

The influence of operation theatre environment on patients' perceptions during awake procedures: a cross-sectional study.

OBJECTIVE: To determine the perceptions of patients regarding operation theatre conversation and environment during an awake procedure. METHODS: The descriptive, cross-sectional study was conducted from February to August 2017 in postoperative wards of Military Hospital, Rawalpindi, Pakistan, and comprised women undergoing gynaecological or obstetric procedures under regional anaesthesia. Closedended questionnaires were distributed via nonprobability convenient sampling. Operation theatre data was collected from the anaesthesia notes, and data was analysed using SPSS 22. RESULTS: There were 93 female subjects with a mean age of 28.23}5.42 years (range: 19-48 years). Overall, 90(96.8%) subjects regarded the conduct of operation theatre staff as cooperative and friendly with 64(68.8%) viewing the conversation among the staff as helpful in relieving anxiety. The thought of anaesthesia waning caused anxiety in 40(43%) subjects, but there was no difference in perceived anxiety between those counselled 61(65%) and not counselled by the anaesthetist. With regards to the environment, 41(44%) subjects said more measures were required to prevent patients from seeing the operating field. Besides, 30(32.2%) and 20(21%)subjects had reservations regarding the presence of male staff and medical students respectively. The opinion regarding medical professionals did not change for 60(64%) subjects after the procedure, and 37(39.8%) recommended that communication skills of medical professional needed improvement. CONCLUSIONS: The environment in the theatre can have an influence on the patient's anxiety levels. Counselling by surgeons, casual conversations in the theatre can help alleviate apprehensions of the patients.

Grooming and etiquette as part of nurse's professionalism: An essential curricular competency.

OBJECTIVE: The B.Sc. Nursing has limited hours dedicated to grooming and personal development. A smartly turned out, trained empathetic and efficient nurse helps in alleviating the miseries of the patients. The objective of this study was to see the acceptability and perceived usefulness of a course on grooming and etiquette. METHODS: A proforma based qualitative study was carried out at College of Nursing, AFPGMI & National University of Medical Sciences (NUMS), Rawalpindi, from Jan to Dec, 2017. An eight week course, with weekly lectures was conducted for first to fourth year classes. At the end a semi-structured proforma with simple open ended questions was administered. The questions were both in English and Urdu. The results were analyzed by finding percentages of positive and negative responses. The descriptive responses were grouped in recurring themes and analyzed for content and their constructive value. RESULTS: There were 186 nursing cadets who completed the course and filled the proforma (55, 52, 45 and 34 from first year to fourth year, respectively). Out of 186, 98.9% (184) thought that this was a useful course. All topics were considered useful. Most liked were communication skills, teaching visits to wards, hostels and balancing home and work. About 7% disagreed about the strict dress codes, but agreed with the proper demeanor. Many suggested that senior nurses also have a dire need of these grooming lectures as many used derogatory language. Also pointed out was absence of a mechanism to report a lapse in ethical conduct seen in a colleague or a senior. CONCLUSION: Nursing is a demanding profession. It is important that our training includes sensitization to the non-technical attributes. They have to be groomed to become role models for young talented girls to join this noble profession. Even a short course may help to sensitize these young ladies to a very important aspect of their lives and profession.