Islamic International Medical College Research Articles

CERVICAL SMEAR

Objective: To review cervical smear results in women of reproductive age group. Study design: Descriptive study. Place andduration of study: This study was carried out at the pathology department, Railway hospital, Islamic International Medical College Trust.Rawalpindi, from Jan 2007-Dec 2010. Materials and methods: A total of four hundred and seventy seven cervical smears were included in thestudy. Inclusion criteria was females of reproductive age group. Smears from postmenopausal women and those who had hysterectomy wereexcluded from the study. The cervical smear was taken using modified Ayres wooden spatula, or plastic spatula, to collect endocervical sample.The slides prepared were immediately fixed in 95% ethyl alcohol, and were subsequently stained by the recommended procedure of Papstaining. After staining, the slides were mounted with Canada balsam and finally reported by the cytopathologist according to the BethesdaSystem. Results: Four hundred and seventy seven patients were included in the study. Most of the patients belonged to low socio economicstatus. The cytological examination of the smears showed inflammatory changes in 33% (n=159) cases, normal smears/ no positive finding in25% (n= 118) cases, while reactive changes were seen in 2% (n= 10). Dysplastic changes were seen in 2 %( n= 10), while unsatisfactory/Inadequate samples were reported in 38 %( n=182) cases.

Sleep habits of first year and final year female MBBS students

Introduction Medical education and training is taxing and may lead to different psychosocial stressors, behavioral problems, drug abuse and changes of lifestyles in medical students. Objectives: The present study was conducted in first year and final year female students to determine their sleep habits. Study Design: It was a cross- sectional study with one year (March 2010-March 2011) duration. Setting: Study was carried out in Islamic International Medical College Rawalpindi and IIMC-T Railway General Hospital Rawalpindi. Subjects and methods: A total number of 30 female MBBS students were randomly selected and were divided into two groups. Group ˝A˝ was comprised of 15 female students from first year and Group “B” was consisted of 15 female students from final year class. Their sleep habits were assessed by sleep questionnaire. Results: Most of the First year female students (93.33) reported normal duration of sleep as compared to final year female students but they experienced more sleep difficulties like increased number of awakenings at night (P≤0.002) as well as less dream remembering. Conclusions: This study indicates that the first year female medical students have decreased quality of sleep and have more sleep difficulties as compared to final year students.

PIOGLITAZONE VS GLIMEPIRIDE

Objectives: To compare the improvement in renal function tests (RFTs) of type 2 diabetic patients who were taking glimeperide alone and this drug in combination with piogliatzone and pioglitazone alone. Data source: Data was analyzed using ANOVA. P < 0.05 was taken as significant. Study Design: Randomized prospective study. Setting: This study was conducted in the diabetic clinic of Fauji Foundation hospital Rawalpindi and the tests were analyzed in the Biochemistry Lab of Islamic International Medical College Rawalpindi. Duration of study: 12 weeks. Materials & Methods: Blood glucose levels were determined by glucose oxidase method (globe marketing GD Italy), HbA1c by Microlab 200, urea/creatinine /uric acid by Selectra E & micro albumin by Spin colour. Results: No significant differences were observed for the variables of hemoglobin A1c, uric acid and urinary albumin P >0.05. Significant decreases were observed in the levels of fasting plasma glucose, urea and creatinine P< 0.05. Conclusions: In patients with type 2 diabetes pioglitazone and the combinations of glimepiride with pioglitazone produced significant improvements in measures of glycemic control and RFTs.

Classification of suprascapular notch according to anatomical measurements in human scapulae.

The objective of this study was to measure the maximum superior and inferior lengths of the suprascapular notch with the help of a Vernier caliper and to classify the notches accordingly into four types. This is an observational study, conducted from January to December 2009 at Islamic International Medical College, Rawalpindi. Two hundred and fifty dried human scapulae were procured and measured irrespective of age, gender, race, and sidedness. The maximum superior and inferior lengths were calculated with the help of Vernier caliper. The percentage of notches with greater maximum superior length as compared to inferior length was the highest i.e. 68% (type-III); percentage of notches with equal superior and inferior length was 14% (type-II) absence of notch was noted in 10% of scapulae (type-I) and notches with greater maximum superior length as compared to inferior length was 8% (type-IV). Suprascapular nerve entrapment may be associated with a specific type of suprascapular notch.

STRESS

Objectives: To assess different level of stress and reaction to those stressors among undergraduate medical students andalso observe an association between different academic years, if any exists. Design of the study: Cross-sectional study. Settings: IslamicInternational medical college- a private medical college in Rawalpindi. Period: From 2006 to 2007. Material & methods: Questionnaire usedwas a stress inventory called students life stress inventory. It was distributed to all registered MBBS students at IIMC in years 1- 5 whovoluntarily participated. 403 out of 500 students completed the questionnaire with response rate 81.6%. Results: Data was analyzed throughSPSS by applying different statistical tests, which were ANOVA, and t test. Results reveal that 21.53% students were mildly stressed, 39.12%students were moderately stressed and 12.64% students were severely stressed. Significant gender differences were found on almost all thesub-scales. The findings reveal that females face more stressors especially conflicts, emotional and behavioral (p < .01), stress was moresignificant between boarders as compare to non-boarders. One Way Analyses of variance (ANOVA) was computed to check the significanceof differences on mean scores. An analysis of variance on Student Life Stress Inventory is significant, F = (3.774), p <.01. Mean differenceindicates that prevalence of stress is higher in first year and final year MBBS students. Conclusion: This study presents pragmatic evidenceregarding the psychological health of students in our college. These findings suggest that high levels of stress exist in our students especiallysignificant during first and final years of their course. It is important for us to know the prevalence and causes of student stress, which not onlyaffects their health, but also their academic achievement. Information from this study can be used to develop appropriate intervention programsfor medical students, in order to decrease their stress leve

Outcome of tissue sparing surgical intervention in mine blast limb injuries.

To describe the pattern of mine blast limb injuries in civilian population of Kashmir, to evaluate the outcome of tissue sparing surgical intervention in these injuries and to determine the sensitivity of hand-held percutaneous Doppler for tissue viability. Descriptive study. Combined Military Hospital, Muzaffarabad and Islamic International Medical College Hospitals at Rawalpindi/Islamabad from November 1997 to May 2005. One hundred and three patients who sustained mine blast injuries to upper or lower limbs, along side the line of control between the Indian-held Kashmir and Azad Kashmir, regardless of age and gender, were included in this study. Patients who already had amputation after injury at some other place were excluded. All patients were initially managed in emergency and had more than one surgical intervention. Transcutaneous Doppler was used to evaluate the vascularity of the remaining tissue. All patients were operated under spinal or general anaesthesia and had repeated debridements followed by skin cover by split skin graft, full thickness skin graft or rotational flaps. Every patient received at least 5 days course of antibiotics and tetanus prophylaxis. Postoperative rehabilitation and follow-up was conducted for at least 6 months after discharge from the hospital. Mean age of victims in this study was 22 years. Out of 103 patients, 72 (69.9%) received initial wound care in the peripheral primary health care centre but were not amputated while 31 patients (30%) were just dressed and referred for further treatment at tertiary care hospitals. Eighty-five patients (82.5%), out of the total, had some sort of traumatic amputation at presentation due to the original injury. That included loss of limb below knee in 19 (18.45%) patients, at distal tibiofibular region in 13 (12.6%), mid tarsal amputations in 39(37.9%), and hemi foot amputation in 15 (14.6%) patients. Nine (8.7%) patients had losses of two or less than two toes, 1 (0.97%) patient had injury at mid palmer region, and 5 (4.9%) patients had 2 fingers traumatic amputation. Eighteen (17.5%) patients had soft tissue ( with or without bony injury) injury only without any actual traumatic amputation. Infection rate was 27% in patients who did not have wound care in the periphery. Those who had wound toilet in-the peripheral hospital had infection rate of 16%. Two patients developed fulminating multi-resistant progressive infection requiring below knee amputation. Conservative wound debridement and early skin coverage by different means and preserving maximum soft tissues and bone results in functionally and cosmetically better limb in victims of land mine.

Impact of Combined modular assessment on deep learning and personal development of medical students.

Objective:To determine the effect of transition of summative assessment from frequent modular to combined block assessment and its role on learning of medical students.Methods:A descriptive study was carried out at Islamic International Medical College. A questionnaire comprizing of 8 questions with Likert scale (1-5) was designed for 3rd year students. The questions were grouped in three categories which included learning acquired, personal development and efficacy of assessment tools used in combined block assessment and frequent modular exam separately. Results of end of year exams were analyzed for difference in performance of students in two exams. The received data was analyzed by using SPPS 21.Results:About 60% students agreed that they need to study regularly in frequent modular exams. Combined block assessment promoted more indepth studies and multiple revisions 51% and 55% students respectively. About 42% students, in comparison with 33%, agreed that CBA helped in their personal development while 42% students agreed to assessment tools used in CBA while only 28% students to those used in frequent modular exam. About 47% students agreed that assessment tools in CBA were useful for deep learning and 47% students agreed that time given in CBA was enough in exam preparation. Comparison of all results (x 2 tests) was statistically significant. The comparison of end of year performance showed improvement in the mean of total marks obtained and decrease in the number of failed students in combined block assessment.Conclusion:Transition from frequent to combined block assessment with regular formative assessment has positive effect on learning, personal grooming and performance in summative assessment.