Awareness and knowledge regarding rotavirus disease and vaccine among healthcare providers in tertiary care settings.

A descriptive, cross-sectional study was conducted from July 2018 to September 2018 to assess the level of awareness among healthcare workers regarding rotavirus infection and its vaccination in Rawalpindi and Islamabad. The study site was conducted at tertiary care hospitals of Rawalpindi and Islamabad. Ethical approval was obtained from the Institutional Review Board of Army Medical College, Rawalpindi. Closed and open ended questionnaires were distributed via non-probability convenient sampling. The sample size was 257. Among the study participants, 247 (96.1%) of the participants had good level of awareness regarding rotavirus, whereas 212 (82.5%) had awareness regarding the vaccine. The mean awareness score was 16.16 ± 4.097 out of a maximum score of 22. Both male and female participants had almost equal awareness regarding the rotavirus infection (Males = 96, 93.2%, Females = 151, 98%) and vaccination (Males = 87, 84%, Females = 125, 81.1%). The mean awareness was directly related with the level of education of the participants, i.e. MBBS/FCPS/MCPS = 221(85.9%), MBBS = 209(81.5%), B.Sc. Nursing = 206(80%), and Basic Education = 220(85.7%) knew about the vaccine.

Physician Gender Preference Amongst Females Attending Obstetrics/Gynecology Clinics.

INTRODUCTION: The objective of our study was to explore the views and perceptions of female patients attending the obstetrics and gynecology (OB/GYN) outpatient department towards the gender of their healthcare provider, to look for any preference that might exist in this regard, and to highlight any discrimination towards male obstetricians/gynecologists. MATERIAL AND METHODS: A cross-sectional study was conducted from November 2020 to March 2021 at Combined Military Hospital, Lahore. A total of 280 female patients were included in the study and interviewed consecutively. A self-designed questionnaire was administered. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY). Chi-square test was used to determine for any statistical significance and p≤0.05 was considered significant. Numerical data were represented as percentages. RESULTS: Over 280 female patients participated in our study, out of which 132 were married and 148 were single. Thirteen of these patients were uneducated, 40 had completed high school and 227 patients had obtained a bachelor's level of education; 120 patients were aged 15-25 years, 95 patients were aged 26-35 years, 30 patients were aged 36-45 years, and 35 patients were aged >46. Women with less education preferred to be seen by a female obstetrician/gynecologist, whereas those with higher education were less biased (p=0.0001). Married patients preferred to be seen by female obstetrician/gynecologists as compared to single patients (p=0.0004). A significant proportion of females were impartial in terms of physician competence but those who did have a preference preferred female obstetrician/gynecologist based on three significant variables: competence, rapport building and empathy, and personal comfort. CONCLUSION: A female gender preference exists in obstetrics and gynecology clinic attendees. This is significant in those who are married and those with no formal education. Overall, a significant proportion of women feel a higher comfort level with female doctors and find it easier to discuss their medical issues and develop rapport.

Takayasu's Arteritis in a 33-Year-Old Male.

Takayasu's arteritis (TA), commonly referred to as "pulseless" disease, is a large-vessel inflammatory vasculitis most commonly affecting the aorta and its major branches. Due to its irregular nature, it has the propensity to involve any organ system thus leading to a wide spectrum of clinical features. Most patients affected by TA are females in their second or third decades of lives. Our case is of a 33-year-old male who presented with sudden onset of hypertension for which he was prescribed antihypertensives. Over the next few weeks, he had multiple visits to the emergency department for a variety of different symptoms including fever, myalgias, left arm numbness, and persistence of hypertension. His CT aortogram showed multi-vessel narrowing including that of the celiac axis, superior mesenteric, renal, and internal iliac arteries with right atrophic kidney. At this time, a diagnosis of TA was made and he was started on oral corticosteroid and immunosuppressant therapy and continued to be treated as an outpatient. Nearly five years after his initial symptoms, he presented to the Emergency for acute abdomen, severe vomiting, and constipation, at which time an emergency laparotomy was done and peritonitis was found. A CT angiogram of the abdomen done after this procedure showed tight stenosis of the inferior mesenteric artery (IMA) and proximal stenosis of the left renal artery. He is currently planned for left renal artery and IMA stenting. Our case highlights the important characteristics of TA in male patients and how they differ from females. It also focuses on the importance of early initial workup and diagnosis and the need for a multi-disciplinary team when handling any patient with TA.

Assessment of risk factor profile in young patients undergoing elective coronary artery bypass grafting surgery in Armed Forces Institute of Cardiology/National Institute of Heart Disease, a tertiary care cardiac facility.

OBJECTIVE: To identify modifiable and non-modifiable risk factors among young patients undergoing elective coronary artery bypass graft surgery. METHODS: The descriptive cross-sectional study was conducted at the Department of Adult Cardiac Surgery of the Armed Forces Institute of Cardiology and National Institute of Heart Disease, Rawalpindi, Pakistan, from January 1, 2015, to April 24, 2018, and comprised patients who underwent elective coronary artery bypass grafting. Data was collected using a predesigned questionnaire, and the risk factors studied were hypertension, diabetes, smoking, serum cholesterol, family history and body mass index. Data was analysed using SPSS 23. RESULTS: Of the 1270 patients, 838(66.1%) were males and 432(33.9%) were females. The overall mean age was 39.29±8.64 years (range: 18-49 years). Of the total, 319(25.2%) patients were hypertensive; 170(13.3%) were diabetics; 303(23.9%) had history of smoking; 566(44.6%) were obese. CONCLUSIONS: There was a high prevalence of obesity, hypertension and smoking in the patients undergoing coronary artery bypass graft surgery at age <50 years.

Do Patients With Osteoarthritis get Weight Loss Counseling?

INTRODUCTION: Osteoarthritis (OA) is a degenerative disease of joints which if untreated can lead to a permanent disability of joints. Obesity plays an important role in the morbidity of OA. Since there is no curative treatment for OA, several researches focusing on nonpharmacological intervention for OA have come forth. Triad of education, exercise, and weight loss has been gaining popularity as a first-line nonpharmacological treatment for OA. This article measures the number of OA patients, irrespective of age and gender, who have received weight-loss counseling from their physicians and it also studies patients' willingness to lose weight after being counseled. METHODOLOGY: A cross-sectional study was conducted from 10th June 2020 to 10th July 2020. Diagnosed cases of OA were included and their consent was taken. A self-administered questionnaire was used which included questions asking if they have ever received weight-loss counseling and if they will try to lose weight on being advised by their physician. Data were collected from the participants using google forms and analyzed using SPSS-22. RESULTS: Out of 199 OA patients included in our study, only 28 (14%) participants received weight loss and exercise counseling from their physicians. A positive response was observed in 175 (87.9%) participants out of 199 who reported that they would exercise and practice a healthy lifestyle to lose weight if they were advised properly. CONCLUSION: Results of our study showed that the total number of OA patients receiving advice from their treating physician regarding weight loss is less. However, the majority of the patients were willing to exercise and control their weight if advised properly by their physician.

Association between migraine and Body Mass Index in patients reporting at a military hospital, Rawalpindi.

The objective of this study was to determine the association between Body Mass Index (BMI) and migraine. This prospective study took place from 5th February, 2017 to 5th August, 2017 at a Military Hospital in Rawalpindi. Migraine in subjects was diagnosed according to the ICHD-III criteria by clinicians after taking an informed, written consent from 78 patients and the data was analysed using SPSS 22. Of the 78 patients, 35(44.9%) were males and 43(55.1%) were females. Out of the 78 subjects, 9(11.5%) were underweight, 33(41.0%) were of normal weight, 9(14.10%) were overweight, 19(24.4%) were obese and 7(9.0%) were morbidly obese. The p-value calculated was 0.892 which indicates no significant evidence of any association between BMI and migraine in the survey population reporting at the Rawalpindi Military Hospital. A follow-up study at a national level with much larger sample size will be able to better predict the changing results in our country, because as of now the association between BMI and migraine is debatable.

Awareness Among Healthcare Professionals Regarding Contaminated Stethoscopes as a Source of Nosocomial Infections.

Objectives The objective of this study was to determine the awareness among healthcare professionals regarding stethoscopes as a source of nosocomial infections, their cleaning practices in this regard before or after examination, and to find out about the existence of any guidelines and accountability criteria issued by the hospitals in this regard. Methodology A descriptive cross-sectional study of 243 healthcare professionals using non-probability convenience sampling was done to include consultants, residents, final-year medical students, and nursing staff and excluding medical students from pre-clinical years as well as doctors of those departments with infrequent use of a stethoscope. The study was conducted for a period of nine months at tertiary health care facilities of Rawalpindi and Islamabad. A self-administered structured questionnaire was used for data collection. Results Participants from both genders included 54 participants (22.2%) from the final year, 48 (19.8%) house officers, 106 (43.6%) postgraduate trainees, nine (3.7%) specialists, and 26 (10.7%) nurses. A total of 210 (86.4%) were aware of stethoscopes as a source of nosocomial infections. Among participants, 23 (9.5%) cleaned their stethoscope per patient, 50 (20.6%) did it daily, 48 (19.8%) did it weekly, 41 (16.9%) did it monthly, 12 (4.9%) participants cleaned it six-monthly while 69 (28.4%) respondents had never cleaned their stethoscope. Almost 127 participants (52.3%) used alcohol wipes to clean their stethoscopes, 11 (4.5%) used a wet cloth, six (2.5%) used tissue paper. Sixty-one (24.9%) agreed that the hospital issued protocols for the decontamination of stethoscopes while 189 (77.8%) did not. A total of 241 (99.2%) believed that there were no accountability criteria set for the assessment of the cleanliness of stethoscopes in their hospitals. Conclusion A majority of the participants were aware of stethoscopes being a source of nosocomial infections and believed in cleaning stethoscopes regularly. However, a majority of the participants believed that their hospital did not issue any protocols for the decontamination of stethoscopes. Further research can expand our recommendations.

Speciality preference with respect to gender among medical students of Pakistan.

This research was conducted to determine the impact of gender and other factors in choosing a medical speciality. This cross-sectional study was conducted from 5th February 2017 to 5th July 2017 at different Medical Colleges and Teaching Hospitals. Students from fourth, final year and House Officers were enrolled using a self made questionnaire. Data was analyzed using SPSS 22. Of the 314 participants, 171(54.5%) were males and 143(45.5%) were females. Majority chose Surgery 90(28.7%), and Internal Medicine 58(18.5%). Only 1(0.3%) participant chose Public Health as a career speciality. The main reason for choice for both genders was "Interest in Content" and "Good Salary". Research shows a shift in trend of women towards Surgery and Internal Medicine rather than Gynaecology and Paediatrics, which indicates more competition in Surgery in near future. Main influencing factors for choice were personal interest and good salary. Students should be counselled regarding career in Public Health and Psychiatry.

A Prediction Model for Membrane Proteins Using Moments Based Features.

The most expedient unit of the human body is its cell. Encapsulated within the cell are many infinitesimal entities and molecules which are protected by a cell membrane. The proteins that are associated with this lipid based bilayer cell membrane are known as membrane proteins and are considered to play a significant role. These membrane proteins exhibit their effect in cellular activities inside and outside of the cell. According to the scientists in pharmaceutical organizations, these membrane proteins perform key task in drug interactions. In this study, a technique is presented that is based on various computationally intelligent methods used for the prediction of membrane protein without the experimental use of mass spectrometry. Statistical moments were used to extract features and furthermore a Multilayer Neural Network was trained using backpropagation for the prediction of membrane proteins. Results show that the proposed technique performs better than existing methodologies.