A Syringe in an Emergency Saves Time: An Audit on the Utility of Syringe Provision in Eye Emergency.

Background Patient satisfaction is the top priority of health care facilities in addition to the quality of health care delivery services. The convenience of health care receivers, be it temporal or monetary, fall in this domain. Hospitals should be equipped with dealing with all kinds of emergencies no matter how trivial or catastrophic. Aim To improve the provision of emergency care equipment (1 c.c. syringes) in the examination room of our ophthalmology department by 50% in two months' time. Materials and methods This quality improvement project (QIP) was conducted in the ophthalmology department of a teaching hospital in Khyber Pakhtunkhwa. This QIP was conducted over a period of two months in the form of three cycles. All cooperative patients with embedded and superficial corneal foreign bodies who presented to the eye emergency were included in the project. The provision of 1 c.c. syringes in the emergency eye care trolley of the eye examination room was ensured at all times after the first cycle survey. A record was maintained of the percentage of patients receiving syringes from the department as well as the percentage of patients purchasing them from the pharmacy. The progress was measured every 20 days, following the approval of this QI project. Results A total of 49 patients were included in this QIP. This QIP shows that the provision of syringes was improved to 92.8% and 88.2% in cycles 2 and 3 from the previous statistics of 16.6% in the first cycle. Conclusions It is concluded that this QIP achieved its target. The provision of emergency equipment, such as a 1 cc syringe costing less than 1/20th of a dollar, is a simple act that saves resources and improves patient satisfaction.

Sex-Linked Differences in Pulmonary Functions of COVID-19 Patients After a Six-Minute Walk Test.

Coronavirus disease 2019 (COVID-19) predominantly impacts the respiratory system. Historically, numerous lung diseases have shown sex-related differences throughout their progression. This study aimed to identify sex-linked disparities in pulmonary function tests (PFTs) among individuals who have recovered from COVID-19 when subjected to a six-minute walk test (6MWT). In this observational cross-sectional study, we analyzed 61 participants, consisting of 39 (64%) males and 22 (36%) females, all of whom previously contracted COVID-19 three months or more prior. We measured vitals such as blood pressure, pulse, oxygen saturation, and PFT values before and after the 6MWT. The post-6MWT evaluation revealed notable mean differences between males and females in parameters systolic blood pressure (SBP) (p = 0.003), diastolic blood pressure (DBP) (p = 0.026), forced expiratory volume in the first second (FEV1) (p = 0.038), forced vital capacity (FVC) (p = 0.041), and maximum voluntary ventilation (MVV) index (p = 0.011). PFT outcomes indicated sex-based variations among post-COVID-19 subjects. Specifically, post-stress values for FEV1, FVC, MVV index, SBP, and DBP were more elevated in males than in females. However, females presented with higher oxygen saturation levels post-COVID-19 compared to males. Using multiple linear regression modeling, sex was not found to be a strong predictor of PFT results. However, individual regression analyses for FEV1, FVC, and MVV index consistently showcased higher values in males. In conclusion, significant PFT differences exist between males and females after recovery from COVID-19 when exposed to stress induction via the 6MWT.

The menace of self citation: An audit of two years from journals of Khyber Pakhtunkhwa.

Objective: To assess the author and journal self-citation amongst journals of Khyber Pakhtunkhwa. Methods: This is a cross-sectional study conducted from January 2021 to July 2021. In total, manuscript published in 10 journals of Khyber Pakhtunkhwa, either recognized by the Higher Education Commission or Pakistan Medical Commission, in the years 2018 and 2019 were included in the present research. All types of manuscripts were analyzed using a pre-designed data extraction table. Results were extracted, analyzed and appropriate statistics were applied. Results: About 1235 manuscripts published in 68 issues over a period of two years' time were analyzed. The majority of manuscripts were 1039 (84.1%) original articles followed by case reports 90 (7.3%). Author self-citation came out to be 11.26% and journal self-citation was 6.5%. The same institute's author affiliation came out to be 40.6%. Conclusion: The trend of author self-citation was found to be high while that of journal self-citation was low when compared with already prevalent literature.

Link between COVID-19 vaccines and myocardial infarction.

BACKGROUND: Vaccines for coronavirus disease 2019 (COVID-19) include ChAdOx1-SARS-COV-2 (AstraZeneca), Ad26.COV2.S (Janssen), mRNA-1273 (Moderna), BNT162b2 (Pfizer), BBIBP-CorV (Sinopharm), CoronaVac (Sinovac), and Bharat Biotech BBV152 (Covaxin). AIM: To find the association between COVID-19 vaccines and myocardial infarction (MI). METHODS: This is a systematic review that involved searching databases such as MEDLINE, EMBASE, and PakMediNet after making a search strategy using MeSH and Emtree terms. Eligibility criteria were set, and studies having no mention of MI as a complication of COVID-19 vaccination, protocols, genetic studies, and animal studies were excluded. Data was extracted using a predesigned extraction table, and 29 studies were selected after screening and applying the eligibility criteria. RESULTS: The majority of studies mentioned AstraZeneca (18 studies) followed by Pfizer (14 studies) and Moderna (9 studies) in subjects reporting MI after vaccination. Out of all the studies, 69% reported MI cases after the first COVID-19 vaccination dose and 14% after the second, 44% reported ST-segment elevation MI, and 26% reported non-ST-segment elevation MI. The mortality rate was 29% after MI. CONCLUSION: In conclusion, many studies linked MI to COVID-19 vaccinations, but no definitive association could be found.

Let's Play Games: A Comparison of Case-Based Learning Approach With Gamification Technique.

Case-based learning (CBL) has been in practice throughout the world for several decades now. Our institute adopted it some four years back when we shifted toward a modular system of teaching. It is the main technique being used for conducting small group discussions. We decided to introduce a new technique called the gamification technique for conducting small group discussions. There was a need to determine the effectiveness of this new method, as well as to assess factors for its preference so that it could be modified to increase its efficacy. The aim of this research was to quantitatively and qualitatively assess the effectiveness of said gamification teaching technique by comparison with the traditional CBL technique. This was a mixed-method, randomized controlled trial. It was conducted at Khyber Medical College on first-year medical students from June to October 2021. Group-based teaching involving both CBL and the gamification approach was used in this study in a crossover manner. Addressing the ethical concerns, and after informed consent pre-testing and post-testing were done to quantify the performance, an open-ended survey was disseminated after the sessions to check the perceptions of the students. The study recorded (quantitatively) that the post-testing mean score of the gamification teaching technique was 3.41 ± 0.982. For CBL, the mean was 3.55 ± 1.055. This showed a recording of an insignificant difference with a p-value of 0.608. In qualitative analysis, about 12 (80%) students preferred the gamification technique. Their perception was that it instilled competitiveness and increased the involvement of students in class. Gamification also raised their motivation level. This research further revealed that the CBL approach had the advantage of quick learning via the facilitator presentation. Due to the handouts, it was easy to follow. One of the negative points of CBL was that the participants found it a boring and monotonous way of learning. The chief drawback of gamification was that the students were unsure about the accuracy of the information they initially prepared, as it was not being directed by the facilitator. The study concluded an insignificant quantitative difference between the two techniques. On the qualitative end, however, the students preferred gamification.

Oxyhemoglobin concentrations do not support hemoglobinopathy in COVID-19.

Based on computerized modeling studies, it has been postulated that the severe hypoxemia in COVID-19 may result from impaired oxygen carrying capacity on hemoglobin. Standard pulse oximetry may not detect hypoxemia resulting from hemoglobinopathy, therefore hemoglobin co-oximetry is needed to evaluate this divergence. In a clinical data analysis of a multicenter cohort of hospitalized patients with COVID-19, we found a minimal effect, less than 1%, on the correlation between oxyhemoglobin concentration and predicted oxygen saturation in the presence of COVID-19 infection. This effect is unlikely to explain the clinically significant hypoxia in COVID-19 patients.