Assessing medical students' perception of cross-cultural competence at a private University in Karachi.

BACKGROUND: Cross-cultural competence is widely regarded to play an important role in being able to deliver appropriate and effective health care to patients with different backgrounds, race, gender orientation and cultural beliefs. This study aims to assess how medical students feel about their comfort, knowledge, and skill level in handling a diverse patient population using a validated questionnaire. METHODS: This study was carried out over a period of three weeks from July 5th to July 26th of 2021, in the Aga Khan University Hospital, Karachi, Pakistan. All medical students who fulfilled the eligibility criteria and gave informed consent were included in the study. A modified version of the Harvard cross-cultural care survey was used to assess the medical students' comfort, knowledge and skill level in a variety of circumstances related to patients with different backgrounds and cultures. Descriptive statistical analysis of the questionnaire items was carried out. We reported frequencies and percentages for gender and year of study. For the questionnaire items, we reported mean, assuming that our Likert scale had equivariant intervals. Furthermore, multivariate analysis between demographics and themes was carried out. A p-value of < 0.05 was taken as statistically significant. RESULTS: It was found that students of year 5 considered themselves more knowledgeable, comfortable and skilled in dealing with patients of different backgrounds, religions and beliefs compared to students of year 1 and had a higher average score in all of these categories which was statistically significant. Additionally, students who believed it is extremely important to practice medicine with a diverse patient population also had the highest averages in perceived knowledge, comfort and skills in dealing with patients of different sociocultural backgrounds compared to students who believed it wasn't important at all. CONCLUSION: This is a first of its kind study in a private medical university in Pakistan and highlights the students' self-assessment of their competence when caring for patients from different backgrounds. This study can be used as a reference study in the region to carry out further studies and to assess and improve the gaps in medical training being provided.

YAG capsulotomy rates between two types of trifocal intraocular lenses.

Objectives: To evaluate YAG capsulotomy rates following implantation of two types of trifocal intraocular lenses (IOLs). METHODS: In this retrospective cohort study consecutive patients who underwent cataract surgery with a trifocal IOL from 1st May 2017 to 30th October 2019 at Aga Khan University Hospital, Karachi were included. Eyes which either had an AT Lisa Tri or Alcon PanOptix IOL implant were included. The primary outcome measure was Nd: YAG laser. Univariate analysis of all predictor variables was performed followed by a multivariate regression analysis of those which were significant. A p-value of < 0.05 was taken as significant. RESULTS: A total of 328 eligible eyes were identified. Nine eyes were excluded. Out of the 319 eyes of 177 patients included in this study, 180 received AT Lisa Tri while 139 of them received Alcon PanOptix Trifocal IOLs. The mean (SD) age of the patients was 52.29 years (±11.04). Gender was equally distributed with 91(51.4%). male patients. Median (IQR) time to laser capsulotomy was 8 months (3-16). Clinically posterior capsular opacification (PCO) was present in 75(23.5%) eyes. A total of 39(12.2%) eyes underwent Nd: YAG laser capsulotomy. Among the AT Lisa Tri group 29 (16.1%) eyes underwent laser capsulotomy compared to 10 (7.2%) (n=10) in Alcon PanOptix group (p=0.016). In both univariate and multivariate analyses, gender and IOL type were statistically significant. CONCLUSIONS: Eyes implanted with AT Lisa Tri showed a significantly increased rate of YAG capsulotomy. A prospective randomized control trial is recommended to confirm these findings.