Jinnah Sindh Medical University Research Articles

YouTube as a learning modality for clinical procedures among medical and dental students: A study in public sector teaching institutes.

To evaluate the effectiveness and analyse the influence of YouTube as a learning modality for clinical procedures among medical and dental students in a public-sector setting. The cross-sectional study was conducted at the medical and dental constituent institutes of Jinnah Sindh Medical University and Jinnah Postgraduate Medical Centre between August and October 2023, and comprised undergraduate, graduate, and postgraduate students of either gender aged 18-40 years. Data was collected using a self-administered, structured, closed-ended 16-item questionnaire, which was developed in the English language and explored the usage of YouTube as a source of information about medical and dental clinical procedures. Data was coded and analysed using SPSS 26. Of the 314 participants, 153(48.7%) were medical students and 161(51.3%) were from the dental stream, 175(55.7%) were females, and 139(44.3%) were males. YouTube was a helpful tool for 143(45.5%) students who used it when needed, 172(54.8%) used it occasionally before attempting procedures, while majority of the dental students 140(44.6%) used it to study for prosthodontics. There were 154(49%) students who supported the idea that faculty should recommend watching relevant videos on YouTube, while 256(81.5%) preferred other websites. YouTube was mostly used for learning clinical procedures by the students.

Impact of Intraoperative Hypothermia on Incidence of Infection in Implant-Based Breast Reconstruction in Pakistan

Background: Intraoperative hypothermia, an unintentional drop in core body temperature during surgery, poses a significant risk in implant-based breast reconstruction. This condition can weaken immune function, slow blood flow, and increase the risk of postoperative infections. Objective: To evaluate the impact of intraoperative hypothermia on the incidence of infections in patients undergoing implant-based breast reconstruction in Pakistan. Methods: This retrospective cohort study was conducted at Jinnah Sindh Medical University from January 2023 to November 2023. The study included 195 female breast cancer patients aged 18 and above who underwent implant-based breast reconstruction. Patients with pre-existing infections, concurrent chemotherapy or radiotherapy during the perioperative period, and incomplete medical records were excluded. Detailed patient demographics, surgical specifics, and intraoperative temperature control measures were recorded. Patients were categorized into normothermic (core body temperature ≥ 36°C) and hypothermic (core body temperature <36°C) groups. Infection data post-surgery were collected through clinical assessments, blood tests, and imaging techniques. Data were analyzed using SPSS version 25, with descriptive statistics, chi-square tests for categorical variables, and independent t-tests for continuous variables. A p-value of less than 0.05 was considered statistically significant. Ethical approval was obtained, and informed consent was secured from all participants. Results: The mean age of patients was 45.23±3.45 years in the normothermic group and 46.01±2.89 years in the hypothermic group. The hypothermic group had a slightly higher average BMI (25.1 kg/m²) compared to the normothermic group (24.5 kg/m²). Total infections were observed in 26.3% of the hypothermic group versus 10% in the normothermic group. Superficial infections were reported in 12.6% of hypothermic patients compared to 6% of normothermic patients. Deep infections were more prevalent in the hypothermic group at 13.7%, compared to 4% in the normothermic group. The univariate odds ratio (OR) for intraoperative hypothermia was 3.2 (95% CI: 1.5-6.8) and the multivariate OR was 3.0 (95% CI: 1.3-6.5), both with a p-value of less than 0.01. Conclusion: Intraoperative hypothermia significantly increases the risk of postoperative infections in patients undergoing implant-based breast reconstruction. Effective temperature management strategies, such as preoperative warming and the use of intraoperative warming devices, are crucial to reducing infection rates and improving surgical outcomes

The Consonance Between Medical Practitioners and Pharmacists Regarding Antimicrobial Stewardship Practices - An Observational Study.

To determine the consonance between medical practitioners and clinical pharmacists about antimicrobial resistance and stewardship in their practices. Descriptive cross-sectional study. Place and Duration of the Study: Department of Pathology and Department of Pharmacology, Jinnah Sindh Medical University, Karachi, Pakistan, from September 2023 to January 2024. Medicinal and Clinical Pharmacy professionals were included in the study through purposive sampling technique. The study employed a methodological approach using a predesigned questionnaire administered through Google Forms, based on a 4-step scale strategy. Through an extensive literature review, item development, expert validation, and pilot testing, the questionnaire aimed to assess medical practitioners' and pharmacists' knowledge and perceptions regarding antibiotic practices and antimicrobial stewardship (AMS). Following a pilot test involving 30 participants and a Cronbach's alpha analysis yielding a value of 0.7 for internal consistency, minor modifications were implemented before dissemination to the participants. The responses were analysed using descriptive statistics, Chi-square test, and Kappa index. Out of the total 200 participants, 130 responded within the stipulated timeframe, resulting in an overall response rate of 65%. Among the respondents, medical practitioners constituted 60% (n = 78), while clinical pharmacists comprised 42% (n = 52) of the total. The general agreement level between medical practitioners and clinical pharmacists was determined to be 0.39, indicating a fair level of concordance between the two cohorts. The present investigation emphasised the agreement level between medical practitioners and pharmacists, the two key components of the AMS programme. Nevertheless, a consistent deficiency in knowledge was observed across both cohorts, underscoring the necessity for a heightened level of consensus among the study participants. Antimicrobial stewardship, Antimicrobial resistance, Anti-bacterial agents, Pharmacists.

Characteristics and motivational factors of candidates applying to the Master in Health Professions Education (MHPE) program

ObjectiveTo determine characteristics and motivational factors of applicants applying for MHPE program at a Public-sector University, Karachi. MethodsThis cross-sectional descriptive study, conducted from September till October 2022, included all 60 applicants of MHPE program at Jinnah Sindh Medical University. The survey questionnaire was administered (google form) and comprised questions seeking demographic information, few questions with options to select and 34 statements to be responded on 5-point scale. One open-ended question asking motivational factor/s. Data was analyzed using SPSS and independent sample t-test was used to determine the differences between groups of applicants based on demographic factors. Results48 participants responded, mean age was 35.8 ± 7.3 years, with predominantly males (81.3%), graduates of medical and dental programs (n = 29), and employed in medical education departments (n = 36). Most of the applicants wanted to join the program to improve their teaching skills, especially psychomotor skills teaching (96%) and educational research [90%]. Majority (64.6%) learned about the program through peers, whereas 29.9% independently chose to pursue the program. Their primary motivation stemmed from their inability to secure admission elsewhere and the belief that minimal effort was needed to acquire the degree (mean score 4.58 ± 0.87 and 4.42 ± 0.94), respectively. For medical and dental graduates, comparable responses emerged, displaying a statistically significant correlation (p < 0.05). However, there was mutual disagreement regarding the program's structure and faculty as motivating factors. ConclusionPrimary motivations to earn an MHPE degree were to improve teaching skills. Motivations to apply to this particular program was the failure to be accepted elsewhere and the perception that minimal efforts were needed to complete this program. The program goals and purpose need to be better propagated along with changes in the admission processes in order to encourage those individuals to apply who are motivated to pursue medical education as a career.

EXPLORING POTENTIAL CAREER CHALLENGES AND ASSOCIATED FACTORS INFLUENCING DENTAL STUDENTS, HOUSE OFFICERS AND RESIDENTS IN A PUBLIC SECTOR UNIVERSITY, KARACHI PAKISTAN - A CROSS-SECTIONAL STUDY

Objectives: To find out dental students' opinions about their future career challenges in the dental profession, and to recognize factors associated with career challenges faced by dental students, house officers, and residents in a public sector university, Karachi. Materials and Methods: A cross-sectional study was conducted at Sindh Institute of Oral Health Sciences on dental undergraduate, graduate, and postgraduate students currently enrolled at Jinnah Sindh Medical University in November and December 2023. Participants were asked to complete a closed-ended questionnaire on a 5-point Likert scale specifically designed to record relevant items about their career challenges. The data was then analyzed through SPSS version 24. Results: A total of 163 people participated in the study with the majority being females (63.8%, n=104), the majority from second-year BDS (23.9%, n=39) with most scoring below 80% academically. Both parents had a university education (52.5%, n=171) and a monthly income of more than 80,000/=PKR (58%,n=94). The majority reported facing difficulty in securing a job in the government sector (74.2%), local postgraduate course (77.9%), postgraduate courses abroad difficult and expensive (68.1%) and quackery may affect their job prospects negatively(69.3%). The factors that showed positive association included “facing competition for government sector jobs” and “the difficulty of obtaining a job as a lecturer” at p-value=0.05. Conclusion: Young dentists perceive finding jobs in the public sector and getting admission to postgraduate courses as difficult in comparison to getting hired at a private clinic. All these hindrances can be avoided by arranging job fairs and career counseling sessions for students and graduates. KEYWORDS: Career Choice, Motivation, Goals, Specialization, Workforce

Exploring the gaps between training and expected job skills of public health graduates to identify: A way forward.

To explore the non-alignment between what is taught in academic programmes for public health and what is actually needed or expected in the field. The qualitative phenomenological study was conducted from October 2020 to April 2021 in Karachi after approval from the institutional ethics review board of Jinnah Sindh Medical University, Karachi. The sample comprised major stakeholders including representatives of public health institutions and organisations involved in the implementation of public health programmes. Data was collected through in-depth interviews and focus group discussions using a guide after content validation by an expert. Data was analysed using both inductive and deductive approaches. A total of 13 in-depth interviews and 5 focus group discussions were conducted. Regarding gaps in the process of curriculum development, 2 major concerns emerged; lack of comprehensive involvement of experts in different fields of public health in designing the curriculum, and the lack of incorporation of the feedback provided by students in revising the curriculum. Regarding the content of curriculum, three main themes emerged; theoretical nature of courses, lack of uniformity in all programmes, and poor local contextualisation. The casual approach of students and barriers faced by them in joining public health programmes also affected the quality of such programmes. Three broad areas of improvement were identified, which included improvement in curriculum, methods of learning, and improving students' approach.

Relationship between academic procrastination and self-efficacy amongst dental undergraduate students at a public university in Karachi, Pakistan.

To compare the procrastination and self-efficacy scores among students with respect to the academic year of dental undergraduate programme, and to assess the relationship between self-efficacy and academic procrastination among the students. The descriptive study was conducted at Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, from January to March 2023, and comprised medical students of either gender from all the 4 academic years. Data was collected using a structured questionnaire whose validity was assessed using a pilot study. Data was analysed using SPSS 18. Of the 136 students, 84(61.8%) were females and 52(38.2%) were males. There were 34(25%) students from the 1st year, 32(23.5%) from 2nd year, 38(28%) from the 3rd year, and 32(23.5%) from the final year. The highest mean score for procrastination was from 3rd year students 67.7±12.8, while the highest mean score for self-efficacy was from 1st year students 30.2±4. There was no significant difference in terms of gender (p>0.05). Procrastination scores had a significant association with the academic year (p=0.016). Procrastination scores were high among the dental students with the highest score from 3rd year students. The academic environment should provide support help the students devise strategies to optimally utilise the available time.

Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study.

Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study aimed to evaluate the prevalence of anemia and associated factors in women of reproductive age visiting a tertiary care hospital in Karachi, Pakistan. The primary objective was to determine the prevalence of anemia in women of reproductive age, while the secondary objective was to investigate potential causes of anemia within this demographic group. A prospective cross-sectional approach was employed, adhering to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A questionnaire-based method was used to assess anemia, and data were collected from women aged 14 to 40 years. The study was conducted at the Jinnah Postgraduate Medical Center from January to May 2023. The study was approved by the Institutional Review Board of Jinnah Sindh Medical University (Institutional Review Board reference number JSMU/IRB/2023/699). A sample of 397 women was included, and various demographic and lifestyle factors were assessed. In this study of 397 participants, 71.5% were found to have anemia, primarily microcytic anemia (48.2%). Anemia prevalence was highest among the 14-18 years age group (80.7%) and those from lower socioeconomic backgrounds (73.6%). Factors such as frequent tea consumption, irregular mealtimes, and pica consumption were associated with higher anemia rates. Pregnant women and those with more children were at a heightened risk of anemia. The study reveals a notable prevalence of anemia among women of reproductive age with a surprising emphasis on younger individuals and lower socioeconomic groups. Dietary habits, lifestyle choices, and pregnancy status play significant roles in anemia development. Targeted interventions are essential, particularly for younger women, those from disadvantaged backgrounds, and pregnant individuals, to combat anemia effectively in this region.

Ripple effects of COVID-19 lockdown pertaining to clinical skills among undergraduate medical students of Karachi.

To determine the outcomes of coronavirus disease-2019 lockdown pertaining to clinical skills among undergraduate medical students. The cross-sectional questionnaire-based study was conducted after approval from the Jinnah Sindh Medical University, Karachi, at 6 public and private medical education institutions in Karachi from July 3 to August 3, 2021, and comprised undergraduate students from the 3rd, 4th and final academic years. Data was collected using a pre-designed questionnaire. Data was analysed using SPSS 20. Of the 383 subjects, 260(67.9%) were females and 123(32.1%) were males. The overall age range was 20-25 years. There were 145(37.9%) students from the 3rd year, 154(40.2%) from 4th and 84(21.9%) from the final year. Among them, 251(84.2%) accepted having decreased efficiency in clinical skills because they were not being able to train in person, 157(41%) claimed that certain topics related to clinical study were given in exams even though they were not taught, and 164(72.6%) faced difficulty in exams related to clinical skills. Coronavirus disease-2019 caused disruption in routine life, and medical education was not an exception. E-learning modality was found to be insufficient, and patient exposure elevates confidence, eliminates hesitation, and improves clinical skills.

Understanding ethics of reporting health related events in media: A qualitative phenomenological study in Karachi and Peshawar.

The specific objectives of this study were to identify the ethical issues in reporting of health-related events in media and suggest ways to improve it. This was a qualitative phenomenological study conducted by APPNA Institute of Public Health, Jinnah Sindh Medical University in collaboration with Institute of Public Health, Khyber Medical University from January to April 2022. A total of 38 focus group discussions and in-depth interviews were conducted either face to face at place of convenience of interviewees or online. The participants were health reporters, healthcare workers (HCWs), and representatives of law enforcement agencies in two cities i.e., Karachi and Peshawar. Data were analyzed by using the deductive and inductive approaches, by four independent experts including the Principal Investigator (PI) and three research fellows. Ethical issues related to health reporting in the field included interference of the reporters in rescue efforts during an emergency and interference in emergency medical care of the victims. In reporting, careless disregard for patient confidentiality and privacy; using unreliable sources of information; using wrong terminology; sensationalizing the news and jumping to conclusions in cases of malpractice were reported as main problems. Negative influences on health reporting included poor training of the reporters on health reporting ethics, organizational pressures, and lack of cooperation by relevant health authorities. The quality of health reporting can be improved by building the capacity of health reporters in understanding the ethical issues and their social responsibilities toward health.

PREVALENCE OF ANEMIA ASSOCIATED WITH MENSTRUAL DISORDERS AMONG NURSING STUDENTS IN A PRIVATE NURSING COLLEGE AT KARACHI

This study aimed to investigate the prevalence of anemia among nursing students at a private college in Karachi and its association with menstrual problems. The institution approved the study and conducted it with the participation of 144 nursing students who provided informed consent. A pretested questionnaire was used to collect data to estimate the risk factors for anemia in nursing students, and hematological examinations were conducted on their blood samples at Jinnah Sindh Medical University Hospital. The data was analyzed using SPSS version 20.0. The results showed that 52.7% of nursing students suffered from anemia. Interviews with the students revealed that 70.1% had a monthly menstrual flow of 5-7 days, 9.5% had a flow of 3-5 days, and 22.9% had a flow of less than three days. The study found that a menstrual flow length of 3-5 days was associated with a higher incidence of anemia (P=&lt;0.001 chi-square 14.3). However, the number of sanitary pads used per day was not significant in relation to the prevalence of anemia (p=0.5 1.2). In conclusion, menstrual issues were found to be the leading cause of anemia among nursing students. Therefore, raising awareness about this health condition and implementing necessary measures can significantly enhance students' quality of life in educational institutions.

Use of a Novel Deep Learning Open-Source Model for Quantification of Ki-67 in Breast Cancer Patients in Pakistan: A Comparative Study between the Manual and Automated Methods.

Introduction: Breast cancer is the most common cancer in women; its early detection plays a crucial role in improving patient outcomes. Ki-67 is a biomarker commonly used for evaluating the proliferation of cancer cells in breast cancer patients. The quantification of Ki-67 has traditionally been performed by pathologists through a manual examination of tissue samples, which can be time-consuming and subject to inter- and intra-observer variability. In this study, we used a novel deep learning model to quantify Ki-67 in breast cancer in digital images prepared by a microscope-attached camera. Objective: To compare the automated detection of Ki-67 with the manual eyeball/hotspot method. Place and duration of study: This descriptive, cross-sectional study was conducted at the Jinnah Sindh Medical University. Glass slides of diagnosed cases of breast cancer were obtained from the Aga Khan University Hospital after receiving ethical approval. The duration of the study was one month. Methodology: We prepared 140 digital images stained with the Ki-67 antibody using a microscope-attached camera at 10×. An expert pathologist (P1) evaluated the Ki-67 index of the hotspot fields using the eyeball method. The images were uploaded to the DeepLiif software to detect the exact percentage of Ki-67 positive cells. SPSS version 24 was used for data analysis. Diagnostic accuracy was also calculated by other pathologists (P2, P3) and by AI using a Ki-67 cut-off score of 20 and taking P1 as the gold standard. Results: The manual and automated scoring methods showed a strong positive correlation as the kappa coefficient was significant. The p value was <0.001. The highest diagnostic accuracy, i.e., 95%, taking P1 as gold standard, was found for AI, compared to pathologists P2 and P3. Conclusions: Use of quantification-based deep learning models can make the work of pathologists easier and more reproducible. Our study is one of the earliest studies in this field. More studies with larger sample sizes are needed in future to develop a cohort.

Feasibility of nonoperative treatment of acute appendicitis in children: a prospective cohort study.

The management of acute appendicitis is a matter of debate even in contemporary era. Non-operative management is proposed as a valid treatment option for acute appendicitis in children. A prospective cohort study was conducted from April 2020 to September 2021 at the National Institute of Child Health, Jinnah Sindh Medical University, Karachi, Pakistan, in children aged ≤ 12 years who were suspected of having acute appendicitis. Children with diffuse peritonitis and complex mass on ultrasonography were excluded. All children were kept nil per oral and started on intravenous fluid hydration and antibiotics. Statistical analyses were performed using IBM SPSS version 20. Chi-square test and Fisher's exact test were applied to determine the statistical significance. A total of 190 patients were admitted with a diagnosis of acute appendicitis. Thirty-two children with advanced disease underwent surgery. The remaining 158 patients were managed with nonoperative treatment. In 138 (87.3%) patients, resolution of symptoms occurred. Twenty (12.7%) patients underwent operation during the same admission (non-responders). Thirteen (9.4%) patients had recurrence of symptoms and underwent appendectomy. A total of 33 (20.9%) patients had appendectomy either at the primary admission or after discharge. Non-operative treatment was more likely to be successful in patients with symptoms of ≤ 24 h duration (P = 0.02), total leucocyte count of <12 × 109 cells/L (P = 0.005) and smaller size of the appendix on ultrasound (P = 0.001). Among children with uncomplicated acute appendicitis, a non-operative approach resulted in resolution of symptoms in 87.3% of patients at the initial admission. Failure of non-operative treatment and recurrence of disease after discharge from the hospital occurred in 9.4% of patients after successful initial treatment. Thus, the overall success rate at a mean follow-up of 3 months was about 78%.

Investigating English Language Skills among the Medical Students at Jinnah Sindh Medical University Karachi

The present study aimed to investigate the English language skills of medical students who are currently pursuing their graduate degrees from Jinnah Sindh Medical University Karachi. Researchers used a quantitative approach using a five-point Likert scale survey method. A total of 60 students from the third and final year were selected by applying a purposive sampling technique. The questionnaire was adapted as a tool for the present study. The collected data was analyzed via SPSS version 25. Descriptive statistics was used to draw the results of frequency distribution, percentage and t-test. Overall findings concluded that medical students observed reading and writing as the most essential skills compared to listening and speaking. In addition, students also found their English language proficiency relatively high in some areas apart from some variation in their self-judgment. This can be suggested that more research studies are needed to be conducted on this topic so that a clear picture can be seen in the context of medical English education.

Adopted Coping Strategies among Professionals in Stress Management- A Questionnaire Based Survey

Background: Stress may affects professionals’ health and their professional performance. In present era of globalization where competition, novelty and change is a contributing factor in stress development and stimuli for tension, anxiety anger and behavioral changes ultimately lead to health problems. Coping strategies are then adopted to manage these stresses. Aim: To uncover the level of stress, the major responses in regards to the imposed stress and ultimately to inquire the adopted strategies to cope with stressful situation in professionalism. Methods: Thismulticenter crossestional survey was conducted among 257 participants of different level professions of different institute and departments of Grand Asian University (formerly Islam medical &amp; dental college) from June – August 2021 and at Jinnah Sindh medical University (JSMU) from Feb – April 2022. Stress causes and major responses were accessed by well-structured preexisting validated questionnaires (consent taken by mail). Sociodemograpic variables were taken using self-generated questionnaire comprising question about age, sex, education level, financial status, job level and marital status. Aim: To access the adopted coping strategies by the professional in stress management in their professional tasks Results:Major respondents of study (58.2%) were female followed by male (41.8%) , 82% with age group 20 -35 years old, 38.7% were married, 47.7% from joint family system, 52.3% were graduated, 83.2% with less than 100,000 PKR income per month. The major cause of stress was No recreational activity (32%), Frequent travelling (36.3%), Working on holidays (14.5%), Complications from children (22.7%) and for disorganization or misfiring of system (23.8%).Major responses to stress including unable to recall things (34.4%), Unable to express their feeling with their social circle (30.1%), unable to focus on their job related tasks (24.2%). abdominal pain (23.8%), usually feel stressed (23.8%) and get disappointed (19.5%). Practical implication: Although the findings of coping strategies in this study is emotional based coping which is considered the weak one and these findings reveals that stress among professionals is not much addressed which potentially placed hindrances in outcomes thus the organizational policy makers are suggested to make these consideration for better outcome and potential benefits of the professionals and organization to excel outcome and reduce health hazards. Conclusion: This research revealed that professionals were actively involved in emotional focused coping strategies and typically indicates adoptive coping mechanisms. Keywords: Stress, coping, strategies, job level, social support, health problems

Parents’ Willingness to Educate Child Sexual Abuse to their Children age 5-15 Years in Karachi, Pakistan

Child sexual abuse (CSA) is a foremost public health crisis and is now constantly reported in Pakistan Objective: This study gazes into perception of parents about the Child Sexual Abuse (CSA) as well as their willingness to educate their children about CSA. Methodology: The current study employed analytical cross-sectional study design. A sample of 123 parents of school age children (5-15 years) were selected via non-probability convenience sampling technique. Self-developed questionnaire was used. Ethical approval was taken from Institutional Review Board of Jinnah Sindh Medical University and written consent from individual parents. Data was collected and analyzed by using SPSS version 20. Result: A total of 123 parents with 03 refusals, with a response rate of 97.6%. Out of 123 parents, 88.62% showed willingness to provide education. 62.6% parents perceived close relatives as being the most common abusers. 42.3% of parents highlighted common methods as kissing, hugging and touching private parts. 43.9% perceived a loss of trust on people as a major consequence of victimization, with 71.5% fearing Post traumatic stress disorder and depression as a potential outcome. 64.2% perceived stigmatization as the primary cause for hesitation among those who are unwilling to report such cases. Conclusion: The study concludes parents are willing to educate their child on CSA, though their perceptions relating to common abusers, methods used, results as well as consequences of abuse vary. In this context, knowledge of effective parent-child communication should be strengthened to promote CSA prevention. Keywords: Child Sexual Abuse, Parents’ Willingness, Education, Awareness

Ki-67 Quantification in Breast Cancer by Digital Imaging AI Software and its Concordance with Manual Method.

To validate the concordance of automated detection of Ki67 in digital images of breast cancer with the manual eyeball / hotspot method. Descriptive study. Place and Duration of the Study: Jinnah Sindh Medical University, Karachi, from 1st January to 15th February 2022. Glass slides of cases diagnosed as invasive ductal carcinoma (IDC) were obtained from the Agha Khan Medical University Hospital, selected retrospectively and randomly from 60 patients. They were stained with the Ki67 antibody. An expert pathologist evaluated the Ki67 index in the hotspot fields using eyeball method. Digital images were taken from the hotspots using a camera attached to the microscope. The images were uploaded in the Mindpeak software to detect the exact percentage of Ki67-positive cells. The results obtained through automated detection were compared with the results reported by expert pathologists to see the differential outcome. The manual and automated scoring methods showed strong positive concordance (p <0.001). Automated scoring of Ki-67 staining has tremendous potential as the issues of lack of consistency, reproducibility, and accuracy can be eliminated. In the era of personalised medicine, pathologists can efficiently give a precise clinical diagnosis with the support of AI. Artificial intelligence, Algorithms, Breast cancer, Deep learning, Image detection, Ki-67.

Frequency of Oral Lesions in Diabetic Patients on Oral Hypoglycemic Drugs and Insulin

Background: Lichen planus is a pre-cancerous condition which is immune mediated. It is often linked with other autoimmune diseases such as Diabetes Mellitus. It is linked with both Type 1 and Type 2 DM. Methods: A retrospective cross-sectional study that was conducted at Jinnah Sindh Medical University on data of patients coming to Oral Medicine OPD from January 2020- December 2022. Diabetic patient`s data was extracted, and secondary analysis was done on it to find out the frequency of the lesions in both types. Results: Data of 211 patients were analyzed through SPSS ver. 20. Total of 30 patient with oral lesions presented with diabetes mellitus with 8 having hepatitis c. Data was excluded of those with co-morbid. The predominant age group was 41-50 years, all males, presenting with type 2 DM. Gingivitis(N=10) was the commonest followed by Oral Lichen Planus(N=7), Periodontitis(N=3), and Infections(N=2).The lesions were predominant in patients on Glucophage and insulin. Conclusion: Diabetes Mellitus predisposes patients to a variety of oral problems. Early diagnosis of these lesions and changes in medication as per requirement to treat these lesions may benefit the quality of life of these patients. Keywords: Oral Lichen Planus, Diabetes Mellitus, Autoimmune disorder

Effects of high impact exercises on physical activity, bone mineral density, body mass index and body fat percentage among osteopenic young females

IntroductionWhile osteopenia was once considered an older disease, it is now commonly seen in young individuals. The low bone density in the young population is alarming, leading to demands to improve physical activity. The study aims to determine the effectiveness of high impact exercise among young females with osteopenia.MethodsA quasi-experimental study was conducted in the out-patient department of Jinnah Sindh medical university among forty-five females aged 18 to 30 years, with osteopenia. The participants were enrolled through convenience and a purposive sampling technique. A training program involving high impact exercise was given for 4 weeks following an initial screening using a DEXA scan. The outcome was measured with the pre- and post-intervention of an exercise program on bone mass density (BMD), body mass index (BMI) and body fat percentage (BFP).ResultsAt the end of the four weeks, BMI, BMD and BFP showed significant improvements (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The BMD was improved from –1.95 to –1.89. It was found that BMD was significantly associated with age (0.04).ConclusionsOur study confirmed that the bone health of young females needs special attention to avoid osteoporosis in the future. The high impact exercises did show significant improvements through training, but additional studies are required on a larger scale.

THE ORAL HEALTH RELATED HABITS, KNOWLEDGE, AND FREQUENCY OF USE OF DENTAL FLOSS AMONG UNDERGRADUATE DENTAL STUDENTS OF A PUBLIC HEALTH SECTOR UNIVERSITY IN KARACHI, PAKISTAN

Objectives: To assess the gap between knowledge of interdental cleaning aids and the usage of dental floss among dental students. Materials and Methods: A cross-sectional study was undertaken at the Jinnah Sindh Medical University, Sindh Institute of Oral Health Sciences, Karachi, Pakistan, between March to May 2022. Using select statistics electronic software, a sample size of 172 was estimated, however, we included 200 participants in the study considering an expected drop-out rate of 15%. A structured questionnaire was designed to collect data from undergraduate dental students. All data were entered and analyzed using SPSS version 26. Percentages and frequencies were calculated to assess the knowledge and implementation of that knowledge among undergraduate dental students. In Association between the year of study and the use of dental floss, a chi-square test was used. A p-value of &lt; 0.05 was set as the cut-off for statistical significance. Results: A total of 200 participants were included with 24.5%males and 75.5%females. There was a significant association of interdental cleaning aid awareness with gender (p=0.007). Only a small percentage of females knew that waterjets and rubber tips were interdental cleaning aids while the majority of the respondents irrespective of gender knew that dental floss is interdental cleaning aid. Dental floss usage was significantly higher in the female population than in males (18.37% vs. 50.33%; p=0.019). Conclusion: Our study concluded that while the majority of dental students had knowledge that dental floss should be a routine habit, they themselves were not practicing it. Moreover, about 30% of the study population claimed that they only brushed once a day only. The use of dental floss was significantly more frequent in female dental students. Keywords: interdental cleaning, dental floss, oral health hygiene, dental plaque