Impact of Refractive Errors on the Academic Performance of High School Children of Lahore.

Introduction: The process of learning begins in childhood and accurate vision can greatly affects a child's learning capacity. It is documented that visual impairment in children can have a significant impact on their performance at school as well as their social interaction and development. Objective: This research aimed to study the impact of refractive corrections on the academic performance of high school children in Lahore. Methodology: A total of 2,000 students with equal distribution of gender, public, private school, and locality were included in the study. All students were screened for defective vision. The academic performance before and after corrections was recorded on the prescribed proforma. Results: The prevalence of refractive error was high among the public high schools 244 (59.2%) as compared to the private schools 168 (40.8%). The area-based prevalence was higher among the students in urban settings 255 (62%) while in rural it was 157 (38%). It was found that in the public sector, the average score of academic results before the intervention was 56.39 ± 13.24 which was increased to 60.27 ± 14.94 after the intervention while in the private sector, before the intervention, the average score was 63.53 ± 17.50 which was improved to 67.12 ± 18.48. It was found to be statistically significant at p-value < 0.05. Conclusion: A significant impact was observed in the average academic scores of the results after refractive corrections.

Delineating Novel and Known Pathogenic Variants in TYR, OCA2 and HPS-1 Genes in Eight Oculocutaneous Albinism (OCA) Pakistani Families.

Oculocutaneous albinism (OCA) is associated with a wide range of clinical presentations and has been categorized with syndromic and non-syndromic features. The most common causative genes in non-syndromic OCA are TYR and OCA2 and HSP1 is in the syndromic albinism. The objective of this study was to identify pathogenic variants in congenital OCA families from Pakistan. Eight consanguineous families were recruited, and clinical and ophthalmological examination was carried out to diagnose the disease. Whole blood was collected from the participating individuals, and genomic DNA was extracted for sequencing analysis. TruSight one-panel sequencing was carried out on one affected individual of each family, and termination Sanger sequencing was carried out to establish the co-segregation of the causative gene or genes. In silico analysis was conducted to predict the causative pathogenic variants. Two families were found to have novel genetic pathogenic variants, and six families harbored previously reported variants. One novel compound heterozygous pathogenic variant in the TYR gene, c.1002delA; p.Ala335LeufsTer20, a novel frameshift deletion pathogenic variant and c.832C>T; and p.Arg278Ter (a known pathogenic variant) were found in one family, whereas HPS1; c.437G>A; and p.Trp146Ter were detected in another family. The identification of new and previous pathogenic variants in TYR, OCA2, and HPS1 genes are causative of congenital OCA, and these findings are expanding the heterogeneity of OCA.

Comparison of effectiveness of WhatsApp and Facebook as learning tool for the students of a medical college.

OBJECTIVE: To compare the effectiveness of Facebook and WhatsApp as learning tools for undergraduate medical students in ophthalmology. METHODS: The quantitative, quasi-experimental study was conducted at Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan from October 2017 to March 2018, and comprised 4th year medical students. A pre-test of ophthalmology topics was taken and participants were divided into Facebook and WhatsApp groups by gender-based stratified randomisation. Four topics were taught through Facebook and WhatsApp to the relevant groups and post-test was taken using multiple choice questions. Data was analysed using SPSS 20. RESULTS: Of the 100 students, 35(35%) were males and 65(65%) were females. The overall mean age was 21.76±0.85 years (range: 20-24 years of. The two groups had 50(50%) subjects each. A significant difference was found between pre- and post-test results of both the groups (p<0.001). There was no significant difference between the groups (p>0.05) neither the baseline nor post-intervention. There was significant difference along gender lines (p>0.05). CONCLUSION: Facebook and WhatsApp as learning tools had no significant difference in terms of impact on the learning process.

Use of Smart Phones and Social Media in Medical Education: Trends, Advantages, Challenges and Barriers.

INTRODUCTION: The technological advancements have transformed the society into a global forum influencing the educational processes and learning environments. Medical education is no exemption with an increasing trend to use the social media and smart phones for teaching and learning. Facebook, WhatsApp, Instagram, YouTube and Edmodo are the platforms promoting collaborative learning, improved communication and knowledge sharing. AIM: This study aims to review the use of smart phones and social media in the context of medical education. It reviews the usage of smart phone and social medical applications including Facebook, WhatsApp and Edmodo for teaching and learning in medical education. RESULTS: The use of personal smartphones for teaching and learning among medical community is highly prevalent and increasing day by day. Medical students use the mobile application for online textbooks (70%), medical podcasts (60%), medical calculator (75%), online lecture (50%) and notes taking (45%). Relevant studies conclude that the majority of students use smart phones for education (62.7%), communication (81.7%) and recreation (82.5%). Social media has a great potential in educational setting and provide students a chance to involve, share and express knowledge and information with each other. Facebook, WhatsApp and Edmodo are the commonly used applications having multiple benefits like collaboration, feedback and engagement but negative aspects including addiction, distraction and maintenance of privacy have also been found. CONCLUSION: The review article concludes that social media is a powerful instrument for social interactions and is also used as a tool for teaching and learning. The integration of social media with traditional class teaching in medical education has clear advantages but there is a debate about the probable disadvantages as well.

Association of seeking ophthalmic assessment in children with parental history of refractive errors.

OBJECTIVE: To find out the association of seeking ophthalmic assessment in children with parental history of refractive errors. METHODS: After the approval of ethical review board, an analytical cross-sectional study was conducted in eight high schools of public and private sector at Lahore during the period of seven months from August 2017 to March 2018. Multistage random sampling technique was opted and 2000 study subjects were recruited including 50% boys and 50% girls. Informed consent was obtained and data was collected on a structured questionnaire. The data was organized, entered in version 23 of IBM SPSS and analyzed by the use of statistical tools. RESULTS: Age of the respondents ranged between nine to 18 years with a mean of 13.40 ± 1.82 SD.Parental history of wearing spectacles was present in 21.3% of the fathers and 28.6% of the mothers. Moreover, 72.4% of the participants never visited eye care professional. Among private schools, an association was found between the visit of boys to eye care professional and maternal positive history of wearing spectacles (p-value 0.019). A significant association was found between the positive paternal history of wearing spectacles and visit of the female strudy subjects to an eye care professional (p-value 0.001). In public schools, there was an association between visit of children to eye care services and positive history of mothers about the use of spectacles (p-value 0.018). CONCLUSIONS: This study concludes that positive maternal history of wearing spectacles is associated with the ophthalmic examination of children in both public and private school.

Prevalence of refractive errors; an evidence from the public high schools of Lahore, Pakistan.

OBJECTIVE: To assess the magnitude of refractive errors among high school children. METHODS: The cross-sectional, descriptive study was conducted from April to August 2017 in four public-sector high schools in Lahore, Pakistan. Using multistage simple random sampling, all public sector high schools of the city were initially included. Screening of refractive errors was managed on the school premises. Data was collected on a pre-tested, structured questionnaire. SPSS 23 was used for data analysis. RESULTS: There were 1000 subjects with an overall mean age of 13.78±1.72 years (range: 10-18 years). Refractive errors were present in 244(24.4%) and myopia 127(52%) was the major type of refractive error followed by astigmatism 93(38.1%) and hypermetropia 24(9.8%). Differece in the prevalence of refractive errors in urban and rural settings was significant (p=0.00002). CONCLUSIONS: Uncorrected refractive errors were present in a considerable segment of public-sector high school students of Lahore.

Self-Medication Phenomenon; A Population Based Study from Lahore.

OBJECTIVE: To study the reasons of self-medication in rural and urban population.. METHODS: The cross-sectional descriptive study was conducted in Lahore, Pakistan, from March to August 2017, and comprised inhabitants of rural and urban areas of the city regardless of gender and aged 18-50 years. The subjects were enrolled using non probability convenience sampling technique. Data was collected using a semi-structured questionnaire, which was validated through content validity index. Data was analysed using SPSS 21. RESULTS: Of the 786 participants, 551(70%) were from the urban areas and 235(30%) were from the rural areas. The mean age of the sample was 30.54±8.50. Overall, 746(95%) were taking medicines without a prescription. Among them, 528(96%) were urban and 218(93%) were rural inhabitants (p<0.07). Besides, 352(47.2%) were males and 394(52.8%) were females (p>0.05). The most frequent reason cited for self-medication was quick relief by 478(64.1%) subjects. CONCLUSIONS: Self-medication prevalence was very high in both urban and rural populations.

Reforming Medical Education in Pakistan through strengthening Departments of Medical Education.

OBJECTIVE: To review the current status of departments of medical education in all public and private medical colleges located in the city of Lahore, Pakistan. METHODS: This was a quantitative, cross sectional descriptive study; conducted from March to October 2015 in Pakistan Medical & Dental Council (PM&DC) recognized medical colleges located in Lahore, Pakistan. Respondents were the heads of departments of medical education or any other well-informed faculty member. A questionnaire was prepared to obtain information about the current status of the departments of medical education (DMEs). The investigator personally visited all medical colleges for data collection. Both verbal and written consents were obtained and the questionnaire was administered to the resource persons. The data was organized and entered in SPSS for descriptive analysis. RESULTS: Out of the 18 medical colleges in Lahore, six (33.3%) belonged to public sector and 12 (66.7%) were from private sector. All medical colleges reported to have a functional DME. However, eight had established DMEs during the past five years. Only one (5.6%) head of DME was working on full-time basis. Eleven (61.1%) heads of DMEs did not have any formal qualification in medical education. Eight (44.4%) colleges claimed to have adequate human resources for DME. Thirteen (72.2%) colleges mentioned that adequate financial resources were available for running DMEs. It is encouraging to see that DMEs in private sector medical colleges are playing increasingly significant role in managing educational activities. Similarly, the senior management of private sector seems to be relatively more eager to promote educational activities. CONCLUSION: There is an increasing recognition towards establishing DMEs in the medical colleges, but their infrastructure, proper functioning and availability of human and financial resources are serious impediments requiring immediate attention.

Prevalence of hepatitis B and C in internally displaced persons of war against terrorism in Swat, Pakistan.

BACKGROUND: Hepatitis B and C are the most common blood-borne liver infections worldwide. According to the recent estimates, 270-300 million people worldwide are infected with hepatitis C virus (HCV) and more than 2 billion people have been infected with the hepatitis B virus (HBV). Transmission of these viruses is carried out by exposure to infectious blood or body fluids containing blood. METHODS: Five-hundred and ninety (290 males and 300 females, 5-65 years) internally displaced persons (IDPs) from Swat area of northern Pakistan were screened for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using immune-chromatography kits. The subjects, positive for virus-related antibody, were further confirmed for viral RNA (for HCV) and DNA (for HBV) in the blood by polymerase chain reaction (PCR) amplification. The virus of PCR-confirmed HCV-individuals was further genotyped and the prevalence of HCV infection was determined with respect to age, sex, history of exposure to blood or surgical operation and different types of liver diseases. RESULTS: The HCV infection was found to be the predominant liver infection in the population which was 91% of the positive cases, as against 9% of HBV. Among the HCV-positive subjects (68% females, 32% males) 56% were asymptomatic. No co-incidence of HBV and HCV was found in any subject. Genotype 3a was the dominant strain of HCV followed by 2a > 3b > 1b > 1a, 2b. CONCLUSION: The viral hepatitis among the apparently healthy population of a relatively natural and pollution free environment refers to an alarming condition about liver infections, particularly of HCV, in Pakistan.