Journal of University College of Medicine and Dentistry

The Power of Story Telling in Healthcare

Mariyah Hidayat — 2023-06-05

Today, digital storytelling has emerged as a popular tool in educating the public on health matters as it integrates digital technology with public health. It is predominantly defined as a story in multimedia form, presented as a video or animation for public viewing and used as educational material for healthcare professionals, patients and families. Patient education is becoming increasingly important with the rise in chronic illnesses, and this technique of educating and engaging patients leaves a lasting impression on their minds. The inspirational aspect of digital storytelling is that it works equally well for all viewers, educated oruneducated, as it engages listeners on a whole new level, arousing their emotions and energy. To motivate people to reach certain goals, we must engage their emotions, and the key to their hearts is a compelling story. By applying digital technology, we can better engage and motivate our trainees and transform them into lifelong learners, as storytelling is a catalyst for inspiring not only empathy but also behavioral change, both in education and health care.

Comparison between Vitamin-D and Urinary Angiotensin Converting Enzyme Levels in Type 2 Diabetic Hypertensive Patients with Non-Diabetic Hypertensive Patients

Mah e Jabeen Sear — 2023-06-06

Objective: To correlate urinary Angiotensin Converting Enzyme–2 (ACE-2) with serum Vitamin D levels in Type 2 Diabetic-Hypertensive and non-Diabetic-Hypertensive patients.
Methodology:The Department of Physiology at the University of Health Sciences in Lahore undertook this observational, correlational study from March 2018 to February 2019. The Services Institute of Medical Services (SIMS), Lahore's medical OPD and diabetic centers were used to select 95 hypertension patients between the ages of 30 and 60, divided into 2 groups. Anthropometric parameters, as well as Blood Sugar Random (BSR) and serum Vitamin D were recorded. Urine samples for evaluating angiotensin converting enzyme 2 were collected.
Results: Urinary ACE2 showed negative correlation with serum Vitamin D level (r=-0.336, p=0.034) in group A non-diabetic hypertensive patients, but not in group B diabetic hypertensive patients (r=0.07, p=0.677). Despite somewhat greater vitamin D levels in group B, this difference was not statistically significant.
Conclusion: There was no link between ACE2 and blood Vitamin D levels in the diabetic hypertensive patients, despite the fact that we hypothesised that vitamin D would be considered as a viable treatment alternative for treating these individuals.

Depression and Suicide Attempt during Dementia, and their Clinical Correlation in Elderly Indian Population from LASI Wave I (2017-2018)

Poonam Yadav — 2023-06-06

Objective: Adult people are more prone to developing physical organ-related or mental disorders due to deterioration of body functions. Dementia is one such condition that prevails among older patients. This survey collates the effects of various demographic characteristics on depression and suicidal tendencies among the adult population with dementia across India.

Methodology: This was a cross-sectional online survey that included 402 elderly patients (45 years and above) with dementia from different states of India conducted between June 2017 to June 2018. Depression and suicidal tendencies were dichotomized as No-“0” and Yes-“1’. Other explored variables in respect to depression and suicidal tendencies among patients with dementia were age, gender, area of living, wealth index, education, caste, religion, marital status, living arrangement, social security.

Results: Age, gender and place of living had a significant effect on developing depression among adults with dementia (P<0.05). Factors such as education, wealth index, caste, religion, marital status, living alone or not and the presence or absence of social security didn’t have a significant effect on depression amongst people with dementia (p>0.05). In case of emerging suicidal tendencies among patients with dementia all the mentioned categories didn’t show significant changes.

Conclusion: The patients with dementia had a greater inclination towards developing suicidal tendencies. Suicidal tendencies didn’t change significantly with age, gender, education, wealth, caste, social security, place of living, living arrangements, and marital status. Depression showed significant effect in terms of gender i.e. female and rural areas. Other socioeconomic characteristics didn’t establish significant effect on developing depressive symptoms and dementia.

Evaluation of the Impact of Audio-Visual Aids in Reducing Dental Patients' Fear in Pakistan

Ammara Chaudhry — 2023-06-06

Objective: To assess the use of employing visual information to alleviate dental anxiety in individuals undergoing tooth extraction under local Anesthesia.
Methodology: An experimental study was done in three dental institutes of Lahore, University Dental Hospital, Sharif Medical and Dental College and Azra Naheed Dental College. This included a sample size of 80 patients who were divided into two groups of 40 each. The first group was the control group which received verbal information before the extraction of teeth under local anesthesia. The second group was the study group and was shown a video clip containing information about the procedure and non-probability consecutive sampling was carried out. Statistical analyses were performed by using SPSS version 25.
Results: Pre-operative anxiety scores in both the groups undergoing extractions revealed the patients were relatively anxious before undergoing dental extraction. A pre-operative comparison drawn between the groups showed the data to be statistically insignificant (p-value=0.222). Verbal communication and the use
of audio-visual aid for Group 2 resulted in a decrease in anxiety scores. Group 1 showed a mean anxiety score of 5.4 whereas Group 2 showed 28% reduction in anxiety with a mean of 4.6. The data was found to be statistically significant (p-value<0.001). Similarly a postoperative comparison between the two groups revealed drastic decrease in dental distress and anxiety score for the patients in Group 2 with p<0.001 with the results being statistically significant. Pre-operative and post-operative paired sample statistics of these groups showed
55% reduction postoperatively in Group 2 as compared to Group 1 which showed only 27% reduction in anxiety levels.
Conclusion: By showing a tooth extraction video to patients before surgery, dentists can reduce the dental anxiety and panic associated with local anesthetic dental extractions.

The Intake of Junk Food as an Etiological Factor of Megaloblastic Anemia in Patients visiting Mayo Hospital, Lahore

Zunairah Mughal — 2023-06-06

Objective: The study was performed to determine role of junk food intake in the development of megaloblastic anemia.

Methodology: It was a clinical based cross-sectional study conducted at Mayo Hospital Lahore in collaboration with Pathology Department of King Edward Medical University from June 2017 to June 2021. All the patients of age 7 to 70 years including males and non-pregnant females attending the Out Patient Department or admitted in the hospital and having hemoglobin values<12 gm/l, MCV more than 95 fl and bone marrow examination suggestive of a megaloblastic change in the marrow (WHO criteria)were included in our study. The patients who had received blood transfusion or hematinic in less than 6 months before diagnosis and pregnant females were excluded from our study. A total 1333 patients were screened, out of which only 160 patients were diagnosed with megaloblastic anemia who had undergone bone marrow trephine biopsy. Their dietary history was taken in detail and history of depression was noted on validated questionnaires. The obtained data was analyzed on the basis of age groups (7-25 years, 26-50 years, 51-75 years) using SPSS descriptive analysis and results were formulated.

Results: The study revealed that 160 (12%) of total 1333 patients were diagnosed with megaloblastic anemia on bone marrow trephine biopsy with male to female ratio of 1:1.28. Total 58 (36%) patients belonged to 1-25 years age group 68 (43%) patients to 26-50 years age group and 34 (21%) patients belonged to 51-75 years age group. Junk food consumption was seen (60.3%) in 7-25 years age group as a prevalent etiological factor.

Conclusion: Junk food consumption is the major cause of megaloblastic anemia in young population and poor diet in middle age group, whereas comorbidities are the major etiological factor in older people.

The Efficacy of Therapeutic Needling with Narrow-Band UVB in Patients of Stable Vitiligo

Sameera Iqbal — 2023-06-06

Objective: To determine the efficacy of therapeutic needling with narrow-band UVB in patients of stable vitiligo with type IV skin, which is the most common depigmenting skin disorder, characterized by clearly demarcated discolored patches of various shapes and sizes.
Methodology: This descriptive case series was conducted on one hundred dermal skin patches of stable vitiligo in 20 patients presenting to the outdoor of Dermatology Department, Services Hospital Lahore from January- June 2019. They were subjected to therapeutic needling using 30 G disposable insulin syringe followed immediately by Narrow-Band UVB exposure thrice weekly for 6 months. The efficacy was determined by re-pigmentation of patches using "Five Grade Scale System." Patients were clinically assessed during and after completion of therapy. All the detailed information was collected through a specially designed proforma. Procedures and follow up of all the patients were conducted and SPSS version 23 was used to analyze the collected data. Descriptive and inferential statistics were used for present the results.
Results: Out of 100 dermal patches of stable vitiligo in 20 patients, 58% patches showed grade 4 response i.e 75% or more re-pigmentation, which is therapeutically the first major step of depigmentation in this process, followed by reduction of pigmentation with further therapies.
Conclusion: Therapeutic needling with Narrow-Band UVB is an effective therapy in the treatment of stable vitiligo in patients with type IV skin.

Impact of Maternal Education on Breast Feeding and Complementary Feeding Practices of Infants

Muhammad Bilal Safdar — 2023-06-06

Objectives: To determine the impact of maternal education on incidence of breast feeding, duration and infant complementary feeding practices.

Methodology: A Cross sectional study done in Department of Paediatric medicine, University of Lahore Teaching Hospital ,Lahore from October 2020 to March 2021. Non probability consecutive sampling technique, total 198 mothers having child 6 to 12 months were enrolled in study after approval of hospital ethical committee and informed consent from mother. Data was entered and analyzed using SPPS 22.

Results: Breast feeding was adopted by 62.8% mothers. Mean duration of breast feeding was 8.52±3.1 months. Regarding initiation of breast feeding 35.1% started immediately after delivery. Regarding introduction of solid feed 27.3% started before 6 months of age. Pre lacteal was given in 35.5% infants. There was no impact of maternal education on frequency of breast feeding, p-value 0.328 but duration of breast-feeding was longer in mother having graduation as compared to mothers having education less than matric i.e. 8.77±2.977 months vs 7.82±3.384 months.

Conclusion: Mothers with higher education have greater duration of breast-feeding ad compared to mother with less education.

Ethical Principles for Medical Student Recruitment in Education Research in Pakistan: A Systematic Review

Noori Kiran Naeem — 2023-06-06

Objective: With the increasing publication in medical education research in Pakistan, this systematic
review aims to identify both addressed and un-addressed ethical issues for student recruitment in
medical education research.
Methodology: After key search terms finalisation selection criteria were defined for the systematic review. The finalised keywords were put in data bases of Pub-Med, Pakmedinet, and ERIC, revealing a total of 12084 articles. Google Scholar was used as grey literature search leading to 2509 articles. 10056 out of 10087 were removed upon initial screening. A total of 31 met the eligibility criteria according to PRISMA guidelines, out of which 23 were excluded leaving a final count of 8 articles to be included in the study.
Results: The ethical issues identified in the selected studies were, Distributive Justice, Autonomy, Rights to withdraw, Coercion into Study, Confidentiality, Informed Consent, Equity in participant selection, Awareness of research participation. Four out of eight studies failed to openly declare the rights of the students to participate voluntarily, while five out of eight studies failed to declare students having rights to withdraw. Three out of eight studies lacked distributive justice of educational content among different groups whereas two studies lacked methodological rigor on participant selection.
Conclusion: During the recruitment of students for research, researchers need to be aware of ethical issues and devise a strategy to address them. These issues should be thoroughly addressed before Institutional Review Boards approve data collection. Institutes promoting such research can train and educate researchers by practicing ethical research protocols.