Medical Education Institutions Research Articles

Analyzing the Drivers of Clinical Teaching Doctors Performance and Quality of Medical Graduates

This study uses descriptive verificative approach to determine, analyze, and examine the influence of competence, organizational commitment, and motivation on clinical teaching doctor performance and its implication for quality of medical graduates at the Faculty of Medicine of Association of Indonesian Medical Education Institutions (AIPKI) Region III. This study is carried out using causal explanatory survey to examine the causal relationship between independent, intervening, and dependent variables using path analysis. The research sample is 185 clinical teaching doctors, which is chosen using proportional random sampling. The data obtained is first analyzed for validity and reliability, and is then tested for the hypothesis using path analysis. The findings indicate that competence, organizational commitment, and motivation partially has a positive and significant influence on clinical teachning doctor performance. Furthermore, it is also found that competence, organizational commitment, and motivation simultaneously have positive and significant influence on clinical teaching doctor performance. This implies that when the competence, organizational commitment, and motivation of clinical teaching doctor increase, this will lead to higher performance. In addition, this study found that clinical teaching doctor performance has a positive and significant influence on quality of graduates.

Association of Tension Headache with Anxiety among Medical Students of Lahore, A Cross-Sectional Study

Background: The prevalence of anxiety and tension-type headaches among medical students has become a topic of growing concern, given the rigorous demands of medical education. Anxiety, characterized by feelings of worry, nervousness, or unease, has been closely linked with the occurrence of tension-type headaches, a common condition manifesting as bilateral, pressing pain in the head. The intersection of these conditions within the medical student population necessitates a deeper investigation to elucidate potential associations and contributing factors. Objective: This study aimed to explore the association between chronic tension-type headaches and anxiety among medical students in Lahore, focusing on the prevalence of these conditions and identifying any significant correlations between them. Methods: A descriptive, cross-sectional study was conducted among 370 medical students in Lahore using convenient sampling. Data collection spanned from May 2020 to October 2020. Participants' anxiety levels were assessed using the Hamilton Anxiety Rating Scale, and tension-type headaches were evaluated based on criteria from the International Classification of Headache Disorders-3. Statistical analysis was performed using SPSS version 25, with a significance level set at p < 0.05. Results: The mean age of participants was 20.98 ± 1.8911 years, with 54.05% being female. The prevalence of chronic tension-type headaches was 72.97%, while anxiety levels were classified as mild (30.27%), moderate (32.97%), and severe (36.76%). A significant positive correlation (r = .348, p < .000) was observed between chronic tension-type headaches and anxiety levels among the medical students. Conclusion: The findings indicate a high prevalence of both chronic tension-type headaches and anxiety among medical students, with a significant association between these conditions. This underscores the need for medical educational institutions to implement comprehensive mental health and wellness programs to address these issues effectively.

NEW CHALLENGES OF DISTANCE TEACHING AT THE INTERNATIONAL MEDICAL FACULTY DURING THE WAR AND CORONAVIRUS PANDEMIC IN UKRAINE

The aim of this work is to address specific challenges related to the organization and future prospects of distance teaching in medical higher education institutions, especially pertinent amidst the current military situation in Ukraine. Materials and methods. In our analysis, we reviewed relevant experiences and documentation, considering the participation of medical students in higher education. The data analysis on student’s performance and engagement in online courses to assess the effectiveness of current distance teaching methods was performed. Results and discussion. The education of medical professionals at international faculties holds significant national importance, contributing to addressing various societal challenges and enhancing Ukraine's educational reputation. However, recent events such as the COVID-19 pandemic and martial law have posed new challenges for distance teaching practices in pedagogy. Ii is crucial for educators who work with international medical students to possess high levels of professionalism and moral integrity. Across the globe, simulation technologies are increasingly employed in medical training, offering innovative methods for preparing highly skilled medical personnel. One such technology is the "virtual patient," which allows learners to engage in realistic clinical scenarios, make diagnostic and treatment decisions, and understand the consequences of their actions without compromising patient safety. The development of communication and language skills among future medical professionals remains a pressing concern within higher education institutions. Utilizing technological storytelling methods to illustrate the journeys of successful specialists can provide valuable insights and inspiration for students. In the context of distance learning, maintaining prompt feedback channels between students and departmental teachers is essential for effective learning outcomes. Conclusion. Practical application of innovative methodological approaches provide with opportunity for teachers of medical higher education institutions to implement and improve the novel methods of work, to increase the effectiveness of the educational process and the level of knowledge of students of the international faculty. Innovative distance learning technologies stimulate the teacher's work, increase his/her professional level, since the organization of the educational process requires preparation for each class, constant pedagogical research, development and use of additional new materials, study of innovative technologies.

Determining the cost of acute stroke care for a single stay at a tertiary care centre in Pakistan.

To assess the economic burden of acute stroke, and to determine the average cost of acute stroke care for a single hospital stay in a public tertiary care hospital. The cross-sectional study was conducted at the Medical Teaching Institute, Bacha Khan Medical Complex, Swabi, Pakistan, from May 16 to September 19, 2022, and comprised patients of either gender who were hospitalised with an acute stroke for the first time. All costs incurred during the care of the patients were measured using the micro-costing methodology, and the association of the cost with other variables was evaluated. Data was analysed using SPSS 24. Of the 34 patients, 24(70.6%) were males and 10(29.4%) were females. The overall mean age was 66+/-13.00 years. The mean length of hospital stay was 4+/-3.00 days. The mean total cost was 18,156+/-9,068 Pakistani rupees, which was the equivalent of 76.89+/-38.4 United States dollars. The cost of the first day of admission was the highest, declining per day as the stay progressed, and imaging/laboratory investigations formed the highest component of the overall cost (p<0.001). The cost of acute stroke care was found to be high even in a public hospital. The length of hospital stay was the most important determinant of the overall cost.

Transpedicular Fixation for the Alleviation of Neurogenic Claudication and Backache in the Management of Spondylolisthesis

ABSTRACT Objective: To evaluate the surgical outcome of transpedicular fixation for degenerative spondylolisthesis in terms of alleviation of neurogenic claudication and backache Materials &amp; Methods: This prospective observational study was carried out at the department of Neurosurgery, Medical Teaching Institute, Bacha Khan Medical Complex, Swabi over a period of two years i.e. from 1st July, 2021 to 30th June, 2023. Patients presenting with backache and neurogenic claudication and having spondylolisthesis on radiological investigations were subjected to transpedicular fixation and evaluated for improvement in symptoms and fusion rate at 6 months follow up. Results: 60 patients participated in the study. Mean age was 41.42±7.29 years and 63.3% were females. L5-S1 was the most common level involved in 40% of the patients and 50% of the patients had Grade 2 spondylolisthesis. There was significant reduction in mean back-pain score on NRS post-operatively (Pre-op was 6.73±1.94 Vs. post-op was 1.57±1.34, P value = 0.00). The neurogenic claudication reduced from 88.3% Vs. 10% (P value = 0.00). The fusion rate was 90% at 6 month follow up. Conclusion: Transpedicular fixation for degenerative spondylolisthesis is the most effective procedure in terms of relief of neurogenic claudication and backache.

The process of formation of medical education in the Voronezh province and its impact on the stuff problem in the region in the second half of the XIX – early XX century

The object of the study is the medical education system of the Voronezh province in the second half of the XIX – early XX century. The subject of the study is medical educational institutions and their impact on the personnel problem in the healthcare sector of the region. The regional aspect of the study, involving a set of sources from the local archive of the Voronezh region, allows for a deeper study of the history of the development of certain types of professional educational institutions of the Russian Empire and the problems to which their quantitative deficiency in a particular region has introduced. Based on the materials of archival documents of the State Archive of the Voronezh Region, the most important medical educational institutions for the Voronezh province in the second half of the XIX – early XX century were identified: the Zemsky paramedic school and the obstetric school, which tried to solve the problem of shortage of qualified medical personnel in the region. The methodological basis of this work includes the principles of historicism, consistency and objectivity. The analysis of a wide range of sources allowed us to build a logical chain of interrelations between the development of professional medical education and the state of healthcare in the Voronezh province. The formation of medical education led to an increase in human resources in this area – already in the 1880s, the educational institutions of the province trained from 70 to 100 specialists in the field of medicine. By the beginning of the 20th century, there was an increase in the average standard of living of the population, both in the region and throughout the country. The author concludes that the improvement of the health care in the region became possible due to an increase in the number of medical personnel trained in professional educational institutions of the Voronezh province, as well as educational and explanatory work on sanitary and hygienic issues, which was carried out by prominent public figures, doctors, teachers among the entire population. The novelty of the research lies in the introduction of new archival materials into scientific circulation and a more detailed study of the issue of the relationship between vocational education and personnel policy in the region.

Mean Value of Probing Depth and Tooth Mobility of Abutment Teeth in Patients using Removable Partial Denture

Removable partial dentures (RPDs) are a typical treatment for supplanting missing teeth. Notwithstanding, concerns exist in regards to their effect on the health of the abutment teeth supporting the dental replacement. Objective: To assess the impact of RPDs on the periodontal health of abutment teeth. Methods: This cross-sectional study included patients from the Prosthodontics department, Bacha Khan Medical College (Medical Teaching Institute, Mardan) between January 6th, 2020, to June 6th, 2020. Examining profundity (pocket depth among gum and tooth) and tooth versatility were assessed in patients utilizing RPDs. The probing depth was estimated at six focuses around every tooth, and a profundity of 1-3 mm was viewed as typical. Results: The study found no massive contrasts in testing profundity or tooth versatility in view old enough, sort of tooth (front or back), or orientation. Notwithstanding, a genuinely critical affiliation was seen between probing depth and tooth mobility, proposing a possible connection between these two proportions of periodontal wellbeing. Conclusions: This study recommends that while RPD plan itself could not straightforwardly impact explicit periodontal boundaries like probing depth and tooth mobility, keeping up with great oral cleanliness and guaranteeing fitting RPD configuration are pivotal for forestalling expected periodontal issues.

Peculiarities of the Formation of Basic Knowledge on the Emergency Pre-medical Assistance Providing by Persons without Special Medical Education

Starting from February 2022, with the beginning of the russian federation’s unprovoked aggression against Ukraine, the time requirements for the direction of the trainings and the contingent for which they are intended have changed significantly. In addition, the issue of rapid spread of knowledge and skills in providing first aid to the injured persons has become very acute. The active help of the international community of higher medical education institutions contributed to the quick and effective training of our teachers as trainers for Basic Life Support (BLS), Stop Bleeding and PHTF courses. The use of innovative digital technologies, modeling of clinical situations, in particular, with the help of distance learning tools, the possibilities of modern simulation technologies and simulators allowed applicants to acquire the necessary theoretical knowledge and master practical skills quickly and at the best level. The objective: to perform a comparative assessment of the quality of conducting simulation trainings on providing pre-medical care to persons without basic medical education using various teaching techniques. Materials and methods. The trainings were conducted in two formats - traditional offline study with the participation of an instructor and using the HybridLab method (introduced by the Lithuanian University of Medical Sciences, Kaunas, Republic of Lithuania) for 112 schoolchildren and 27 teachers. 58 students and 14 teachers were trained according to the usual method in groups of 5-6 persons, according to the HybridLab method – 54 schoolchildren and 13 teachers in groups of 3-4 individuals. The duration of the trainings was 42 hours. Efficiency was evaluated according to two criteria: the average score of the final test and the indicator of acquiring new knowledge. Results. A unique combination of methods of organizing the educational process, such as HybridLab, trainings on pre-medical care, which were developed on the basis of the trainings “First on the scene”, “Stop the bleeding” and BLS, and modern tools that allow to evaluate the effectiveness of training, contributed to the achievement a high level of mastery of all the necessary skills by as many people as possible in the shortest time, which is the leading goal of today. Conclusions. We consider the experience of implementing these knowledge/skills and training methods, as well as the further evaluation of their effectiveness, to be the second task of all medical education institutions and training centers operating in Ukraine, after teaching training on tactical medical training of combatants and emergency tactical medical assistance for medical specialists.

Analysis of the Risk of COVID-19 in the Post-Vaccination Period Based on the Results of a Multicenter Study — a Survey of Medical Workers

Background. One of the vulnerable categories of the population during the COVID-19 pandemic has become employees of medical and educational institutions. Timely and properly organized prevention, based on anti-epidemic measures based on vaccination, is necessary not only to reduce the incidence of the disease, but primarily to reduce the severity in case of its occurrence, reduce the risk of hospitalization. Understanding the effectiveness of preventing SARS-CoV-2 infections among healthcare workers is a critical component of occupational health and safety policy and strategy.&#x0D; Aim — analysis of the incidence of COVID-19 after vaccination among medical staff and teaching staff of medical higher educational institutions.&#x0D; Methods. In the period from January to March 2022, a cross-sectional retrospective single-stage online study was conducted (anonymous questionnaires posted on the Anketologist platform). The survey was completed by 6032 respondents (82% efficiency). According to the criteria, 2114 respondents were excluded from the study. The analysis was carried out according to the questionnaires of 3918 respondents, including an assessment of the incidence after vaccination (n = 3668 respondents).&#x0D; Results. Fell ill after a double vaccination for 5 months — 663 (16.9%). Unvaccinated respondents reported that within 5 months. prior to the survey, 116 (46.4%) had a laboratory-confirmed new coronavirus infection. Lack of vaccination increased the risk of SARS-CoV-2 (OR 1.78 ± 0.14; 95% CI: 1.34–2.36). Efficiency within 5 months post-vaccination period was 55.5% (95% CI: 42.2–57.7%) for Sputnik V; 71.9% (95% CI: 68.1–85.4%) — Sputnik Light. It was found that gender and age were not a risk factor for the onset of the disease in the post-vaccination period. The presence of a history of previous COVID-19 increased the risk of disease in the post-vaccination period in individuals under 35 years of age (OR 2.323 ± 0.102; 95% CI: 1.903–2.836), aged 36–64 years (OR 2.547 ± 0.086; 95% CI: 2.150–3.016), older than 65 years (OR 1.323 ± 0.280; 95% CI: 0.764–2.290). Respondents with a history of a combination of chronic cardiovascular pathology and past COVID-19 had a higher risk of getting sick in the post-vaccination period (OR 1.338 ± 0.160; 95% CI: 0.977–1.832).&#x0D; Conclusion. According to the questionnaire, an important factor affecting the risk of COVID-19 in the post-vaccination period is the presence of SARS-CoV-2 before vaccination, which can increase the chance of developing the disease in the presence of other risk factors (chronic pathology, age, smoking, alcohol consumption).

Medical education and the epidemics: How educational technology responded.

The global disruption created by the Coronavirus Disease 2019 (COVID-19) pandemic in medical education and healthcare institutions is unparalleled. Consequently, it is essential to evaluate the usability of forms of educational technology and to identify their viability and suitability for medical education. The objective of the investigation was to present an assessment of the state of medical education during the COVID-19 epidemic and to identify the obstacles faced by educators while introducing online learning systems for medical students. Two cross-sectional surveys were conducted with 200 medical students and 75 staff members from Saudi Arabia's University of Health. A descriptive method was used to focus on the mechanisms of analysis, foresight, and comprehension of reality. The most significant findings were the obstacles posed by instructors' most urgent requirements for educational technology training and its applications in order to activate distance education in medical education. In addition to a detailed description of the academic and technological concerns and obstacles encountered by students and faculty of health colleges during the pandemic, this report includes a discussion of the pandemic itself. Several prospective recommendations for the use of online and blended learning in health colleges post-pandemic were also made. Additionally, the requirement to activate learning via virtual professional learning groups.

Bridging the Gaps: The Transformative Effect of Coronavirus Disease 2019 (COVID-19) on Preventive Measures Among Medical and Health Sciences College Students in Madinah, Saudi Arabia.

Background The global impact of coronavirus disease 2019 (COVID-19) has disrupted the activities of medical and health profession education institutions. This study aimed to determine the impact of COVID-19 on medical and health profession education students' knowledge, attitudes, and practices toward preventive measures and their commitment to precautionary measures before, during, and after the pandemic. Materials and methods A cross-sectional study was carried out from January to March 2023 using an online, structured, validated questionnaire survey to gather information from medical and health sciences students from three universities, encompassing five colleges in Madinah, Saudi Arabia. The minimum required sample size was estimated using the Epi Info software as 380. The data was analyzed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States). Statistical tests including Student's t-test, chi-squared test, and analysis of variance (ANOVA) test were applied. Results The findings revealed that personal experiences with COVID-19 infection had a significant impact on students' attitudes and commitment to preventive measures (p<0.05). Among the participants, 172 students (45%) reported having contracted COVID-19. Students with clinical exposure showed a higher level of understanding and adherence to preventive measures (248 students, 68%), compared to pre-clinical students (198 students, 52%) (p<0.05). Positive attitudes were observed toward practices such as sneezing etiquette (289 students, 76%) and flu vaccination (314 students, 83%) (p<0.05). However, negative attitudes were observed toward mask-wearing (155 students, 41%) and social distancing (144 students, 38%), particularly among male students (p<0.05). Conclusion The study provided valuable insights into the impact of the COVID-19 pandemic on medical and health sciences students' knowledge, attitudes, and practices toward preventive measures and the importance of introducing COVID-19 prevention measures in the pre-clinical phase as well as mental health support to promote positive attitudes and enhance adherence to preventive measures.

TEACHERS’ PROFESSIONAL COMPETENCE DEVELOPMENT AS AN INTEGRAL PART OF HIGHER MEDICAL EDUCATION IN THE UNITED STATES AND UKRAINE

Abstract. The article is dedicated to the research and comparative analysis of the processes involved in the development of professional competence among teachers in higher medical educational institutions in the United States and Ukraine. Contemporary approaches to the training of teachers are examined, while common and distinctive characteristics of this process in the two countries are analyzed. The primary focus is on the importance of developing pedagogical skills, medical knowledge, and effective teaching methods to enhance the quality of medical education. By conducting a comparative analysis of the educational systems and approaches to preparing medical professionals in these countries, the article examines the principal strategies and initiatives aimed at enhancing the qualifications of teachers in the medical field. It delves into an analysis of current teaching principles at medical universities and colleges in the United States, highlighting the use of advanced pedagogical methods, innovative technologies, active engagement in scientific research, and practical skills in the educational process. The article also addresses the necessity of improving educational programs, implementing modern teaching approaches, and the importance of stimulating the scientific and pedagogical activities of teachers in medical institutions in Ukraine. Through this comparative analysis, the aim is to identify best practices and provide recommendations for further refining the training of teachers in these countries.

FACTORS ASSOCIATED WITH DEVELOPING CHRONIC DAILY HEADACHE IN MIGRAINE PATIENTS

To examine the factors associated with developing chronic daily headache in migraine patients. Two hundred patients with migraine were selected for this descriptive study conducted from 01-Sept-2023 to 30-Nov-2023 at the Department of Medicine, Lady Reading Hospital, Medical Teaching Institution, Peshawar. Factors associated with developing chronic daily headache were assessed. SPSS 23 was employed for analyzing the data. The mean age was 38.09±12.03 years. The frequency of chronic daily headache in our study was 31 (15.5%). Female gender (p = 0.02), smoking (p = 0.0001), high caffeine intake (p = 0.0001), painkiller overuse (p = 0.0001) and obesity (p = 0.0001) were factors significantly identified for developing chronic daily headache. We conclude that the factors for developing chronic daily headache in migraine patients were female gender, smoking, high intake of pain relieving medicines, high intake of caffeinated drinks and obesity.

Assessment of Knowledge, Attitude and Practice regarding Patient’s Perioperative Pressure Injury Prevention among the Operating Room Personnel of Medical Teaching Institutions, Peshawar

Background: Pressure injuries (PIs), particularly perioperative pressure injuries (ORPIs), pose significant challenges in patient care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Despite established guidelines, the incidence of ORPIs remains a concern, underlining the need for improved prevention strategies within the operating room setting. Objective: This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding perioperative pressure injury prevention among operating room personnel in medical teaching institutions in Peshawar, Pakistan, to identify knowledge gaps and areas for intervention. Methods: A cross-sectional descriptive study was conducted over four months, from June to October 2023, involving 264 operating room personnel from three major medical teaching institutions in Peshawar. Participants included nurses, surgeons, and surgical technicians/technologists. Data were collected using structured questionnaires and the KoboCollect mobile application, covering sociodemographic information, and KAP related to perioperative pressure injury prevention. The study employed descriptive statistics, chi-square tests, and Pearson correlation coefficients for data analysis, utilizing IBM-SPSS version 27 and Microsoft Excel 365. Results: The study revealed a mean knowledge score of 66.02% (SD = 18.99), with 44.3% of participants displaying low knowledge levels (&lt;69%). Attitudes towards pressure injury prevention were predominantly positive, with an average score of 78.17% (SD = 10.38). Practice levels were moderate, with an average score of 79.43% (SD = 10.59), and 54.9% of respondents engaging in high-level practices (≥80%). Significant associations were found between knowledge levels and education (p=&lt;0.001), and between practice levels and both age (p=0.01) and professional role (p=0.006). Conclusion: The study highlights a critical gap in knowledge regarding perioperative pressure injury prevention among operating room personnel, despite positive attitudes and moderately high practice levels. Addressing this gap through tailored educational programs and policy interventions is crucial for enhancing patient care and preventing ORPIs.

Outcome of Olecranon Fracture Treated with Tension Band Wiring Versus Anatomical Locking Plate Fixation

Aim: Up to 10% of all upper limb fractures involve the olecranon, and this type of fracture is the most common osseous injury of the elbow joint. These show a bimodal distribution occurring in younger patients due to high-energy trauma and in elderly cohorts with low bone quality after low-energy falls. Objective: To compare functional outcome of tension band wiring versus anatomical locking plate fixation for reduction of olecranon fracture Materials and Methods: This randomized controlled trial study was conducted in the Department of Orthopedic, Lady Reading Hospital, Medical Teaching Institute Peshawar from December 2022 to June 2023. Non-probability consecutive sampling technique was used in this study. Sample size was calculated using WHO calculator keeping 95% confidence interval 80 % power of study, 10% absolute precision, mean Mayo elbow score was 84.0±9.3 in the TBW group and 88.3±9.1 in the locking plate fixation group (4). Expected sample size is 32 patients in each group, total 72 patients. Patients of both genders have age range from 20 to 70 year with Mayo type 2A olecranon fractures, more than 2 mm of joint displacement determined on X-ray elbow, and elbow extension loss determined on physical examination presented within 7 days of the injury were included in the study while Patients with open fracture and revision surgery were excluded from the study. Results: In this study age distribution among 72 patients was analyzed as n= 20-30 Years 17(27.4%) 31-40 Years 14(22.6%) 41-50.Years 11(17.7%) 51-70 Years 20(32.3%). Mean age was 47.1 Years with SD ± 2.87. Gender wise Distribution among 72 Patients was analyzed as Male were 31(50.0%) and female were 31(50.0%). Distribution of duration of disease among 72 patients were analysed as n= 1-2 weeks were 47(75.8%) and 3-4 weeks were 15(24.2%) Practical Implication: There are no established guidelines for the treatment of olecranon fracture in our institution. Most olecranon fractures are treated according to surgeon preferences and surgical experience of the surgeon. Previous studies showed variables results with no consensus. We will provide rationale basis for universal use of standard treatment of olecranon fracture. Conclusion: Although there were no statistically significant differences in clinical outcomes between the two groups, the ALP group had a higher proportion of any complication than the RP group. Keywords: Anatomical locking plate; complications; eyelet wire; olecranon fracture; tension band wiring.

An Immersive Virtual Reality Simulator for Echocardiography Examination

Echocardiography is a medical examination that uses ultrasound to assess and diagnose the structure and function of the cardiac. Through the use of ultrasound waves, this examination allows medical professionals to create visualizations of the cardiac muscle, enabling them to diagnose and monitor conditions such as cardiac diseases, abnormalities, and functional disorders. An echocardiogram plays a crucial role in the early detection and diagnosis of various cardiac issues such as hypertension, myocardial infarction, valvular cardiac disease, and myocardial hypertrophy. It significantly contributes to determining treatment and management strategies. To achieve accurate disease diagnosis and develop appropriate treatment plans through echocardiography, it is essential to have a thorough understanding of proper probe usage, the precise acquisition of echocardiographic images, and the ability to interpret various echocardiographic examinations such as two-dimensional, M-mode, Doppler, etc. To enhance the skills required for echocardiography, medical educational institutions conduct theoretical classes, practical sessions using patient models, and clinical practice sessions with actual patients. However, issues such as inadequate practical adaptation due to theory-centric education, limitations in practical opportunities due to insufficient practice equipment, ethical or safety concerns arising during clinical practice, and a lack of educators leading to insufficient feedback, are currently being encountered. Hence, there is a need for new educational methods that can address the existing challenges in echocardiography education. In this paper, as part of these efforts, we propose a virtual reality-based immersive simulator for practical echocardiography training. The proposed echocardiography simulator allows users to explore a virtual echocardiography examination space by wearing a head-mounted display (HMD). This simulator consists of 3D virtual space models, interactive models manipulated by interaction devices, and 3D patient models containing normal or abnormal anatomical cardiac models. Using interactive devices such as HMD controllers and haptic devices, users can manipulate 3D models related to echocardiography within the simulator and interact with 3D patient models containing normal or abnormal anatomical cardiac models, allowing for the practice of echocardiography examinations. Ultimately, a performance evaluation of the developed immersive virtual reality simulator and usability validation targeting medical university students were conducted. The evaluation and validation results confirmed the potential efficacy of the proposed echocardiography VR simulator.

The Rate of Success of CPR in Patients Suffering from Cardiac Arrest in Patients Admitted in CCU in Cardiology Department Ayub Medical Teaching Institute

Cardiopulmonary resuscitation (CPR) is an essential procedure used to treat patients who are in cardiac arrest, particularly in the Critical Care Unit (CCU). Objective: To assess the success rate of CPR admitted to the CCU, revealing insight on the effectiveness of current resuscitation techniques. Methods: This retrospective study was conducted at Department of Cardiology Ayub Medical Teaching Institute, Abbottabad, between 13th April 2023 to 30th November 2023, 110 patients had cardiac arrest while in the intensive care unit. Data were gathered and examined on patient demographics, pre-existing comorbidities, time to start CPR, duration of CPR, and results. CPR success was defined as a sustained restoration of spontaneous circulation (ROSC) for at least 20 minutes. Results: This study included 110 cardiac patients. Most patients (68.18%) were male. Hypertension was the most common comorbidity at 72.7%. CPR started on average 4.8 minutes late, with a 1.2-minute standard deviation. The average CPR time was 18.2 minutes, with a 5.6-minute SD. After cardiac arrest, 60 (54.5%) patients began CPR within 5 minutes. Another subgroup found 96.0% CPR success in 25 (22.7%) ventricular fibrillation patients. Then occurred ventricular tachycardia (80.0%), pulseless electrical activity (76.0%), and asystole (68.9%). These data suggest that CPR works better in ventricular fibrillation patients. Conclusions: This research sheds light on cardiac arrest CCU patients' demographics, care, and outcomes. The data show that early CPR and ventricular fibrillation detection and treatment improve outcomes for these individuals.

Acetabular Fracture; its Management and Early Functional Outcome

Aim: To evaluate the functional results of open reduction and rigid internal fixation with Reconstruction plates and screws in acetabular fractures Methods: This prospective case series study was carried out on 47 consecutive patients, of either gender and age ranging from 18 to 60 years, who presented with an acetabular fracture within a month of injury at the Orthopedic and Trauma Department of the Medical Teaching Institute Lady Reading Hospital (LRH) in Peshawar, Pakistan, from January 2018 to September 2023. Excluded from the research were patients receiving traction therapy with a trochanteric pin for an open fracture. A non-probabilistic sequential sampling method was applied. Clinical grading followed D'aubigne and Postel's guidelines, with Matta's modifications. We measured range of motion, pain, and gait. Results: There were 47 patients in total, ages ranging from 20 to 60, with an average age of 37.52. there were 31 males (66.0%) and 16 females (33%). In 19(40.4%) patients, 5(10.6%) patients have physical violence and 23(48.9%) of the patients, the cause of injury was a road traffic collision. Our study shows that of the patients, 29(61.7%) were involved on the right side and 18(38.3%) on the left. In five (10.6%) of the instances, there was plate loosing. It is shown that 24(51.1%) cases, excellent outcomes were attained, in 15(31.9%) case good, 5(10.6%) cases fair, 3(6.4%) cases poor outcome were attained. Conclusion: According to Matta Grading, all acetabular fractures, including those involving osteoporotic bone, respond excellently to rather well to open reduction and internal fixation using a 3.5-millimeter reconstruction plate and screws. Keywords: Acetabulam, Fracture, Internal fixation, Open Reduction, Rigid Fixation.

Prevalence of substance use and substance use disorder in medically ill patients: A cross-sectional, hospital-based study from India.

Background Untreated co-occurring substance use and substance use disorders (SUDs) in patients with medical conditions may be associated with unfavourable medical outcomes. Understanding the prevalence of substance use and SUDs among patients admitted to hospital for medical illness may help in developing appropriate strategies to manage SUDs in this population and improve the outcomes of medical illness. We assessed the prevalence of substance use and SUDs among patients admitted for medical illnesses and the association between substance use and medical illness. Methods This cross-sectional study was done in an in-patient setting in a multidisciplinary teaching medical institution in India. Using systematic sampling, adult patients admitted in various departments for at least 24 hours were interviewed using standard instruments by psychiatrists trained in the study methodology. Results Two hundred and ninety patients participated. Their mean (SD) age was 42.2 (15.6) years. One hundred and nine participants (37.6%) reported lifetime use of any psychoactive substance, with tobacco being the most common substance used (91, 31.4%), followed by alcohol (69, 23.8%) and cannabis (12, 4.1%). Lifetime alcohol use was significantly associated with diseases of the circulatory system. Lifetime use of any substance or of alcohol, and current use of any substance or tobacco were significantly associated with injuries, poisoning and other consequences of external causes. Conclusions A large proportion of patients hospitalized for medical illness reported the use of psychoactive substances or had SUDs. The use of some of these substances was also associated with injuries as well as diseases of the circulatory system.

A cross-sectional study of breastfeeding device use and its determinants in mothers attending immunization outpatient department of an urban health training centre attached to a teaching medical institute

Background: Breastfeeding as a practice was recommended by World Health Organization. Breastfeeding devices are used to feed the expressed breastmilk to infants, it is one determinant which is linked with both favourable and unfavourable outcomes in exclusive breastfeeding practices among term and pre-term infants. Methods: This was a cross sectional, observational study carried at an urban health training centre. The study subjects were mother and their infants residing in the urban slum. Objectives of the research were to determine the proportion of exclusive breastfeeding, to find various breastfeeding devices used by mothers and the factors associated with it. A total of 230 mother-infant dyads were included in the study. Results: Majority of mothers belonged to 21-30-year age group, housewives (93%) and Hindu by religion (68%). Majority received education till secondary school (57%) and 3.5% were illiterate. Majority had their first child before they turned 30 and most of the infants were female (55%). Over 3/4th of the infants were being exclusively breastfed, initiated on breastfeeding within first hour of birth (41%) and 1/5th received pre-lacteal feed, Breastfeeding device use was noted in 15 participants (6.5%), in which majority were using spoon followed by bottle. Mothers using breastfeeding devices showed higher proportion of exclusive breastfeeding. Conclusions: Use of breastfeeding device showed association with mother’s occupation, lower age of mother at the time of marriage and first delivery while religion and parity of mothers were not significantly associated with it.