JOURNAL OF MEDICAL STUDENTS

2022-12-13T17:37:51+00:00

About the Journal

2022-12-13T17:41:51+00:00

Editorial Board

2022-12-13T17:46:30+00:00

ERADICATION OF POLIO IN KHYBER PAKHTUNKHWA VIA E- POLIO

2022-12-13T17:54:59+00:00

WASTES MANAGEMENT PRACTICES IN SELECTED PUBLIC AND PRIVATE HOSPITALS OF PESHAWAR, KHYBER PAKHTUNKHWA

2022-12-13T18:07:51+00:00

Introduction: Standard hospital wastes management practices are the main preventive measures for infection control, yet no study has been conducted to evaluate the wastes management at tertiary care hospitals in Peshawar, Khyber Pakhtunkhwa.

Materials & Methods: A cross-sectional facility survey was conducted from January to April 2015 on four tertiary care hospitals - Rehman Medical Institute (RMI) & North West General Hospital (NWGH), private sector; Lady Reading Hospital (LRH) & Hayatabad Medical Complex (HMC), public sector - of Peshawar. After taking permission from Medical Superintendents of hospitals, checklist-based observational assessment of the Housekeeping departments and relevant areas (Wards, Sanitation, Wastes Collection, Segregation, Disposal and Incineration) was done on multiple visits by the research team using modified World Health Organization (WHO) checklist and interviews, where required. Binary inputs (yes/No) were recorded for Noninfectious, Infectious, Pathological and Pharmacological wastes. Manual analysis was done for compilation and decision making; outputs were categorized into Segregation, Collection, Storage, and Handling.

Results: All hospitals fared poorly for Pharmacological wastes management with no segregation practices; hospitals were also poor in segregation for different types of wastes. For wastes collection, only NWGH performed adequately. The private hospitals did better than the public ones for wastes storage and handling. Overall the private sector hospitals followed the regulations of EPA and WHO compared to public sector hospitals.

Conclusions: Substandard practices were observed in public sector hospitals. The overall attitude of the staff towards wastes handling was different in both sectors due to different administrative monitoring.

Keywords: Wastes Management; Wastes Disposal Facilities; Sanitation; Healthcare Systems; Public Health.

RISK FACTORS AND AWARENESS LEVELS REGARDING ISCHEMIC HEART DISEASES AMONG MEDICAL STUDENTS OF A PRIVATE MEDICAL COLLEGE OF PESHAWAR, KHYBER PAKHTUNKHWA

2022-12-13T18:24:35+00:00

Introduction: Ischemic Heart Disease (IHD) is a major cause of illness and disability and a leading cause of death in the modern world and that is why is considered as great epidemic menace of mid-twentieth century. It is the “Black Death” of our time. This study was conducted to determine the awareness levels regarding risk factors of Ischemic Heart Disease among preclinical students of RMC and to determine risk factors currently present among the included students of RMC.
Materials & Methods: It was a cross-sectional study conducted from February to May 2012 on all 200 students from first and second year MBBS of Rehman Medical College. Data were collected using a Universal Sampling approach through an interview based questionnaire, which included questions related to awareness level of students and their risk factors regarding IHD. Descriptive statistics were obtained using SPSS 20.0. The Chi Square test was used to test for associations, keeping p<0.05 as significant.
Results: Mean age of the 143(71.5% response rate) student respondents was 19.8±1.004 years (range 18-23 years). Of these, 84(58.7%) students were male and 59(41.3%) were females. Vast majority of the students (90.2%) were well aware of the risk factors associated with IHD. Students were found to be vulnerable to various risk factors associated with IHD such as lack of exercise (43%), family history of IHD (27.3%), presence of stress (66.3%) and use of junk food per week (39.1%). No association was found between awareness levels of students with smoking habits, exercise, and stress, use of oil or ghee and consumption of junk food.
Conclusions: Despite the fact that over whelming majority of the students were well aware of the risk factors for IHD, a fairly large proportion were prone to common risk factors such as lack of exercise, use of junk food, family history of IHD and presence of stress. These factors may impose both short term as well as long term threats to the overall health of the medical students.
Keywords: Ischemic Heart Disease; Awareness; Risk Factors; Medical Students; Life Stress; Smoking.

INFLUENCE OF TYPE 2 DIABETES MELLITUS ON THE KILLIP CLASS IN ACUTE MYOCARDIAL INFARCTION PATIENTS VISITING HAYATABAD MEDICAL COMPLEX, PESHAWAR, KHYBER PAKHTUNKHWA

2022-12-13T18:39:25+00:00

Introduction: Diabetes mellitus (DM) is well known risk factor for myocardial infarction. Some studies report that DM also affects the Killip class of heart failure in post-Acute Myocardial Infarction (AMI) patients. This study was carried out to evaluate the influence of concomitant DM and AMI on Killip class of heart failure.

Materials & Methods: This was a case-control study in which data were collected from 196 patients, who presented with AMI to Department of Cardiology in Hayatabad Medical Complex (HMC) between September and December, 2015. Cases were those who had type 2 Diabetes Mellitus (T2DM) along with AMI, while controls were those AMI patients who were not having T2DM. Within each group, subgroups were made on the basis of Killip Classification. Assessment was done by expert cardiologists. Non-probability convenience sampling technique was used. Data were collected on Performa comprising of demographic data, clinical assessment and Killip scale assessment. Data were analyzed by SPSS version 16.

Results: A total of 196 subjects from both sexes who presented with first AMI were included in the study. Mean age was 59±7.58 years. Out of 196 subjects who had AMI, 17.86% were type 2 diabetics and 82.14% were non-diabetics (p<0.001). There was no significant difference in terms of gender (p=0.79), age (p=0.72), weight (p=0.53), height (p=1.00), body mass index (p=0.33), heart rate (p=0.85), systolic blood pressure (p=0.80) and diastolic blood pressure (p=0.83) between diabetics and non-diabetics. In AMI patients without diabetes mellitus (control group), 57.1% patients did not develop heart failure, 13.7% patients were in Killip Class II, 19.9% were in Killip Class III, and 9.3% were in Killip class IV. In contrast, , 57.1 % AMI patients with diabetes mellitus didn’t develop heart failure (OR = 1.00, 95% CI: 0.48 to 2.09, p=1.00), 22.9% patients were in Killip Class II (OR=1.67, 95% CI: 0.65 to 4.29, p=0.28), 11.4% were in Killip Class III (OR=0.57, 95% CI: 0.18 to 1.81, p=0.34), and 8.5% were in Killip Class IV (OR=0.92, 95% CI:

0.24 to 3.48 , p=0.92). There was insignificant difference between two groups (p>0.05).

Conclusion: Though Type 2 Diabetes Mellitus is one of the major risk factor for Acute Myocardial Infarction, however, concomitant Diabetes Mellitus and Acute Myocardial Infarction do not influence the Killip class outcome (heart failure).

PROFESSIONAL BURNOUT AMONG DOCTORS IN REHMAN MEDICAL INSTITUTE, PESHAWAR, KHYBER PAKHTUNKHWA

2022-12-13T18:51:49+00:00

Introduction: Burnout is a monster which ultimately saps an individual’s productivity and reduces one’s energy, leaving an individual feeling increasingly helpless, hopeless, and resentful. Burnout is a gradual process that takes years to build up. This study was done to determine the extent and types of professional burnout among the medical professionals of a tertiary care private hospital of Peshawar, Khyber Pakhtunkhwa.

Materials & Methods: It was a cross-sectional study, conducted in Rehman Medical Institute (RMI) Peshawar, from March to June 2015. All the doctors working in Rehman Medical Hospital were included; the sample size was 150 and universal sampling technique was used. The questionnaires had four parts related to Socio-demographic data, Professional data, Free time activities, and the Maslach Burnout Inventory (MBI). For analysis of data related to MBI, we added up each component (emotional exhaustion, depersonalization, and reduced personal accomplishment). The reference values of the Center of Advanced Studies on Burnout Syndrome (NEPASB) were used for comparing obtained values.

Results: The response rate out of 150 questionnaires was 62% (n=93 participants); among them 57(61%) were male and 36(39%) were female; it was found that 33% of doctors had severe professional burnout, 36% moderate burnout and 31% mild professional burnout. Regarding Emotional Exhaustion (EE), 48.4%, 26% and 26% have severe EE, moderate EE and mild EE respectively. Also 32.3%, 39.8% and 28% doctors have severe, moderate and mild depersonalization respectively. As far as personal accomplishment is concerned; 20.4% have mild, 41% moderate, and 39% have high personal accomplishment.

Conclusions: Majority of doctors had moderate level professional burnout, and males were having more professional burnout than females.

STATUS OF HEPATITIS B VACCINATION AMONG MEDICAL STUDENTS UNDERGOING CLINICAL ROUNDS IN PESHAWAR, KHYBER PAKHTUNKHWA

2022-12-13T18:59:43+00:00

Introduction: Two billion people worldwide are infected with hepatitis B virus (HBV) and 360 million with chronic hepatitis, out of which 600 thousand die every year. Since medical students are at increased risk of contracting the disease due to their greater exposure to the disease high degree of risk of developing the diseases due to exposure to it during clinical rounds.

Materials & Methods: This was a cross-sectional study conducted on medical students undergoing clinical rotations in the hospital. The medical students attending the hospital postings, mainly 4th and 5th year, were invited to complete a 17- item questionnaire.

Results: A total number of 500 medical students were approached for the study but only 459 of them responded, of which 44.7% were males and 55.3% were females. The maximum age was 25 years and minimum age 20 years, with a mean age of 22.5±1.08 years. Regarding awareness of HBV vaccination, 46.7% students were well aware, 40.6% were moderately aware while 12.7% were less aware. For vaccination status, 67.5% of the students were vaccinated against hepatitis B while 24.4% were not vaccinated, whereas 8.1% did not know whether they were vaccinated or not. Of the 67.5% vaccinated, 59.35% had completed all three doses while 36.7% were partially vaccinated with two or less than two doses while 3.87% did not know if they were partially vaccinated or fully vaccinated. Of the students vaccinated, 18.4% were vaccinated in the past 1 year, 23.7% were vaccinated between 1-5 years ago, and 11.6% were vaccinated between 6- 10 years ago while 26.5% were vaccinated more than 10 years ago.

Conclusion: A large number of students were not vaccinated despite the high awareness levels of the students and the availability of a cheap and easily accessible hepatitis B vaccine.

RISK FACTORS AND CO-MORBIDITIES IN TYPE 2 DIABETES MELLITUS PATIENTS VISITING HAYATABAD MEDICAL COMPLEX, PESHAWAR, KHYBER PAKHTUNKHWA

2022-12-13T19:07:54+00:00

Introduction: Various risk factors for type 2 diabetes mellitus (T2DM) and comorbid conditions have been identified in epidemiological and clinical studies. The present study was carried out to find out various risk factors and comorbidities in T2DM patients during their management.

Materials & Methods: This was a descriptive study, between conducted during September to December, 2015 on patients who presented with T2DM to Endocrinology Outpatient Department and Ward of Hayatabad Medical Complex (HMC), Peshawar, Khyber Pakhtunkhwa. Data were collected on objectively designed Performa based on convenience sampling. Assessment of risk factors and co-morbidities was done clinically by Endocrinologists and Performa filled under their supervision. BMI was calculated using formula kg/m2; Obesity was defined as BMI 30. Data were analyzed for descriptive statistics by using SPSS version 16.

Results: A total of 236 type 2 diabetic subjects from both sexes were included. Mean age of subjects was 55±7.58 years; 77(32.63%) were male and 159(67.37%) were female. The most common mode of treatment in subjects was oral hypoglycemic medication (42%). In terms of risk factors, 50(21.19%) were obese, 113(47.89%) had family history of DM, 96(40.68%) were either active smokers or had history of chronic smoking and 97(41.10%) were not active physically. Among co-morbidities, 177(75%) were hypertensive, 96(40.68%) were having osteoporosis, 74(31.35%) were suffering from different types of renal diseases and 70(29.66%) had eye related issues. Also, 64(27.11%) and 33(13.98%) patients had concomitant coronary artery disease and heart failure respectively; 17(7.2%) patients had positive history of previous stroke and only 21(8.9%) subjects had diabetic foot.

Conclusion: Despite following treatment protocols, the frequencies of risk factors, complications, and comorbidities are quite high in type 2 diabetics.