King Edward Medical University Research Articles

Reliability of Duo Chrome Test in Different Age Groups Considering Patient Satisfaction as Gold Standard

Purpose: To check the reliability of the duo-chrome test in different age groups after best correction.
 Study Design: Descriptive, Cross Sectional Study.
 Place and Duration of Study: College of Ophthalmology and Allied Vision Sciences. King Edward Medical University, Lahore from September 2019 – December 2019.
 Methods: Forty two cooperative patients of both genders more than 15 years of age were included but patients with poor fixation, any opacity or any other ocular pathology were excluded. Equipment used was Trial box Trial frame Auto-refractor and Snellen Chart. Group 1 composed of 17 patients (15 – 35 years of age). Group 2 (36 – 60 years) had 15 patients and group 3 (age 61-80 years) comprised of 10 patients. Data was collected on self-designed Performa. Duo Chrome was dependent variable and gender was independent variable. Data was analyzed by using statistical package for social science (SPSS22.00) and chi square test was applied.
 Results: Out 42, 21 patients reported red, 12 reported green and 9 patients reported equally clear in the right eye. P value=0.156 showed that duo chrome test was equally reliable in every age group in the right eye. Similar results with p = 0.755 showed that duo chrome test was equally reliable in every age group in the left eye. Test when performed bilaterally, showed similar results. Out of 42 patients, 32 were satisfied and 10 were not satisfied with the test.
 Conclusion: Red Green duo-chrome test is equally reliable in all age groups to confirm refraction.
 Key Words: Duo chrome test, Refraction, Myopia, Hypermetropia.

Factors Associated with Seroconversion of Hepatitis C Virus in End Stage Renal Disease Patients.

To determine patient and dialysis services-related factors associated with seroconversion of hepatitis C virus (HCV) in hemodialysis (HD) patients. Cross-sectional study. Department of Nephrology, Mayo Hospital, King Edward Medical University (KEMU), Lahore, from January to December, 2018. All patients on regular HD for more than three months were enrolled. All patients who seroconverted from HCV-negative to positive status three months after starting HD, were included. Patient-related factors (age, gender, blood transfusion, duration and frequency of dialysis, history of dental treatment and surgical intervention) and dialysis services-related parameters (dedicated staff, isolated room, hemodialysis machine, reverse osmosis plant, compliance of universal infection control measure) were noted. Out of 990 patients, 492 (49.7%) were reported as seroconverted for HCV during HD. Factors determined statistically significant for seroconversion were surgical intervention (p<0.001), history of dental procedure (p <0.001), blood transfusions (p <0.001), multiple sexual partner (p <0.001), age (p=0.035) and duration of hemodialysis (p <0.001). Factors not affecting seroconversion included frequency of dialysis (p=0.062), history of renal transplant (p =0.097) and family history of hepatitis (p=0.941). A significant negative correlation was observed between the rate of seroconversion of HCV and the score of universal infection control measures (r=-0.665, p=0.018). There was a high rate of seroconversion of HCV in HD patients. Factors responsible for seroconversion were history of surgical intervention, dental treatment, blood transfusion, multiple sexual partners, age and duration of dialysis. The dialysis centres non-compliant with universal infection control measures were having high rate of seroconversion. Key Words: Hemodialysis, Seroconversion, HCV, Blood transfusion, Dental treatment, Surgical intervention, Infection, Isolation.

Efficacy of Whole-Blood Del Nido Cardioplegia Compared with Diluted Del Nido Cardioplegia in Coronary Artery Bypass Grafting: A Retrospective Monocentric Analysis of Pakistan.

Background and Objectives: Cardioplegia is one of the most significant components used to protect the myocardium during cardiac surgery. There is a paucity of evidence regarding the utilization of whole-blood Del Nido cardioplegia (WB-DNC) on clinical outcomes in coronary artery bypass grafting (CABG). The purpose of this retrospective cross-sectional study is to compare the effectiveness of diluted (blood to crystalloid; 1:4) Del Nido cardioplegia (DNC) with WB-DNC in patients who underwent elective CABG in a tertiary care hospital in Lahore-Pakistan. Materials and Methods: This was a retrospective descriptive study conducted at the Department of Cardiovascular Surgery, King Edward Medical University, Lahore. The medical database of all consecutive patients admitted from January 2018 to March 2020 and who fulfilled the inclusion criteria were reviewed. Results: Out of 471 patients admitted during the study period, 450 underwent various elective cardiac surgeries. Out of 450, 321 patients (71.33%) were operated on for CABG. Only 234/321 (72.89%) CABG patients fulfilled our inclusion criteria; 120 (51.28%) patients received WB-DNC, while 114 (48.71%) patients were administered with DNC. The former group presented with better clinical outcomes compared with the latter in terms of lesser requirements of inotropic support, low degree of hemodilution, shorter in-hospital stay, improved renal function, and cost-effectiveness. Peak values of serum Troponin-T (Trop-T), creatine kinase-myocardial band (CK-MB) release, and activated clotting time (ACT) were also lower in the WB-DNC group compared with the DNC group. Conclusions: The WB-DNC conferred better myocardial protection, improved early clinical outcomes, and also proved to be economical for patients undergoing elective CABG compared with classical crystalloid cardioplegia solution.

Effect of Green Tea and Black Tea Aqueous Extract on Histomorphology of Precentral Gyrus of Cerebral Cortex of Albino Rats

Aim: To compare the histomorphological changes in the precentral gyrus of cerebral cortex of albino rats by taking green tea and black tea aqueous extract. Study design: Experimental Study Duration of study: 30 days study conducted in Animal Experimental Research Laboratory of PGMI and Department of Anatomy, King Edward Medical University, Lahore. Methodology: 90 albino rats were divided into three groups of 30 animals each. Rats in the group I were given distilled water, while group II and group III received green tea and black tea aqueous extract respectively. At the end of 30 days of experiment, brains were removed and studied for histological changes. Results: When comparison among all the three groups was made at 30 days time, p-value was significant for gliosis i.e. p&lt;0.01. However, experimental group III revealed more gliosis among all the three groups. Necrosis was absent in all the groups and was not statistically analyzed. Conclusion: Gliosis caused by black tea is highly significant as compared to green tea. Key words: Cerebral Cortex, Green tea, Black tea, Gliosis, Necrosis.

Gross Anatomical Variations of Cystic Duct: A Cadaveric Study

Aim: To determine the frequency of anatomical variations of cystic duct. Study design: Descriptive Case Study Place and duration of study: Anatomy Department of King Edward Medical University Lahore and duration of study was from August 2018 to December 2019. Methodology: The dissection of 43 cadavers was done and extra hepatic biliary tract was explored. The length of cystic duct and site of insertion of cystic duct in common hepatic duct was noted. The length of cystic duct &lt;1 cm was taken as short cystic duct and &gt;4cm as long cystic duct. The insertion of cystic duct near porta hepatis is high insertion and near duodenum is low insertion. Results: The mean length of cystic duct was 2.67±0.71 cm. Out of 43 cadavers 2(4.7%) of cadavers had short cystic duct. 41(95.3%) of cadavers had normal length of cystic duct. There was no cadaver observed with long cystic duct. Out of 43 cadavers 39(90.7%) of cadavers had mid insertion of cystic duct, 4(9.3%) of cadavers with high insertion of cystic duct and no cadaver with low insertion. Conclusion: The most common anatomical variation of cystic duct is high insertion of cystic duct 9.3%. Keywords: Anatomical variations, cystic duct, cholecystectomy.

Effects of McConnell Taping on Function and Dynamic Postural Control in Athletes with Patellofemoral Pain Syndrome

Abstract&#x0D; &#x0D; Background: Patellofemoral pain syndrome represented by anterior knee pain is the most common condition experienced by individuals suffering from knee pathology. Pain behind the kneecap or around the kneecap is the main characteristic, can occur due to the stress on joint structures, commonly affecting athletes and females. It mostly occurs during ascending and descending stairs and remains in a sitting position for a prolonged duration. Objective: To determine the effects of McConnell taping on function and dynamic postural control in athletes with patellofemoral pain syndrome. Methods: This quasi-experimental study consisted of 38 participants with ages ranging from 18 to 40 years presenting with anterior knee pain. Data was collected from the Spine Physiotherapy clinic, Sahiwal. About 28 patients were treated with McConnell taping along with conventional physical therapy. Star excursion balance test and lower extremity functional test scale were used to assess functional and dynamic postural control before treatment and after 24 hours of treatment. Results: The outcomes revealed that there was a statistically significant difference within the group. The p-value was found significant (p&lt;0.001) for both variables. Conclusion: This study concluded that McConnell taping was effective for treating patients with patellofemoral pain syndrome for functional and dynamic postural control.&#x0D; *Corresponding Author: Naeem Aslam, King Edward Medical University, Lahore, Pakistan; Email: naeemaslam693@gmail.com&#x0D; Citation: Aslam N., A. Razzaq, S. Iftikhar. 2021. Effects of McConnell taping on function and dynamic postural control in athletes with patellofemoral pain syndrome. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 1(1):9-14. &#x0D; Keywords: anterior knee pain; McConnell taping; patellofemoral pain syndrome

Antibacterial Susceptibility Pattern of Gram Negative Bacteria Isolated from Patients with Urinary Tract Infection

In clinical setting, urinary tract infections (UTIs) rank second among infectious presentations. Each year, around 150 million people receive a UTI diagnosis worldwide. Objectives: To determine the antibacterial sensitivity of meropenem, imipenem and ciprofloxacin against bacteria isolated from patients presented with Urinary Tract Infection. Methods: This Descriptive type Cross-sectional study was carried out at Clinical Microbiology Laboratory, Pathology Department of King Edward Medical University. A total of 100 patients were included that had Urinary Tract Infections. Urine culture was done using standardized Cysteine lactose electrolyte deficient (CLED) agar. Gram reaction, morphology, and biochemical properties were used to identify bacterial pathogens. Antibiotic sensitivity of the selected Gram negative bacteria was observed by using the Kirby Bauer method for antibiotic susceptibility. Results: The bacteria isolated were E. coli (62%), Klebsiella spp. (11%), Candida spp. (8%), Pseudomonas aeruginosa (7%), Proteus spp. (4%), Staphylococcus spp. (3%), Staphylococcus saprophyticus (3%) and Enterobacter spp. (2%). Sensitivity pattern for Ciprofloxacin was 20 (23.3%) sensitive and 66 (76.7%) resistant. Similarly 87.2% were sensitive to Meropenem and 12.8% were resistant. While for Imipenem 95.3% were sensitive and 4.7% were resistant. Conclusions: It was concluded that UTI most commonly caused by E. coli which is a gram negative bacteria followed by Klebsiella, Pseudomonas, Proteus and Enterobacter. Other microorganisms such as Staphylococcus spp., Staphylococcus saprophyticus and Candida spp. were also isolated in least amount. Antimicrobial susceptibility showed that Gram negative isolates of uropathogens were highly resistant against Ciprofloxacin and showed sensitivity against Imipenem and Meropenem

FACULTY PERSPECTIVE ABOUT DIFFICULTIES IN IMPLEMENTATION OF NEWLY INTRODUCED INTEGRATED CURRICULUM FOR BASIC SCIENCES IN KING EDWARD MEDICAL UNIVERSITY

Objective: To explore the perceptions of basic sciences faculty about the integrated curriculum.&#x0D; Study Design: Sequential mixed method study.&#x0D; Place and Duration of Study: King Edward Medical University Lahore, from Oct to Dec 2017.&#x0D; Methodology: A 15-item survey was utilized as quantitative information collection device that gave the numerical depiction of the patterns, views or conclusions of the participants. In-depth interviews were done after survey as a tool of qualitative data collection to investigate beliefs and explore the attitudes.&#x0D; Results: All ninety three faculty members of basic sciences in medical college were contacted and survey response rate was 96.77% (90/93). 97% of faculty members had awareness about curricular integration; but majority (56%) had concerns about its appropriate implementation. Majority agreed that integration was beneficial for students‟ learning. They were satisfied with its design and relevance. Major considerations were correct implementation and lack of coaching in adopting new teaching methods and educational approaches.&#x0D; Conclusion: Curriculum integration is useful and essential in student‟s learning but training is necessary in its planning and execution. Current negative perceptions need to be addressed through further research.

Psychological Impact of Cadaveric Dissection on First-Year Medical Students

Background This cross-sectional study was carried out to ascertain if first-time cadaver dissections can cause acute stress disorder (ASD) in medical students, and if death anxiety and gender play a role in the development of these symptoms. Methods A total of 135 first-year medical students at the Services Institute of Medical Sciences and King Edward Medical University, Lahore, Pakistan, who had recently conducted their first ever cadaver dissection filled out three scales: the Impact of Event Scale-Revised (IES-R), the Appraisal of Life Scale (Revised) (ALS-R) and Death Anxiety Inventory. The results were then calculated via SPSS v.23. Any students with a history of psychiatric treatment or disorder were not included in the study. Results Scores on the IES-R showed that the sample suffered from symptoms of ASD (mean = 36.15, standard deviation = 15.99). Multilinear regression showed that death anxiety did not predict any variance on the scores for IES-R, whereas higher scores on the ALS-R threat domain scale predicted higher scores on the IES-R. Death anxiety had little to no impact on the scores for IES-R. Conclusion Results showed that students who perceived the dissection situation as threatening and anxiety inducing were more likely to test positively for ASD symptoms. A major limitation of the study was that it did not measure whether these symptoms reduced with repeated exposure to cadaver dissection or how symptoms changed over time.

Auricular Cartilage Interposition Arthroplasty in Recurrent Temporomandibular Joint Ankylosis in Pediatric Patients

Background: Temporomandibular joint (TMJ) ankylosis in early childhood can lead to disturbances in growth, facial asymmetry and difficulties in eating as well as in breathing. The objective of the study was to evaluate the effectiveness of auricular cartilage as an interpositional material after gap arthroplasty in pediatric patients with temporomandibular joint ankylosis in maintaining the achieved postoperative mouth opening.&#x0D; Material and Methods: This prospective study was conducted at the Oral and Maxillofacial Surgery Department of King Edward Medical University, Lahore, from 1st January 2019 to 30th November 2019. Thirty patients, aged 5 to 15 years with clinical and radiological diagnosis of TMJ ankylosis were included in the study. TMJ ankylotic mass was removed, the gap was created and interposition of auricular cartilage graft was done in these patients. Mouth opening was measured as a distance between the incisal edges of mandibular central incisors to maxillary central incisors using the scale. Preoperative and postoperative mouth opening was noted and compared using the paired t-test.&#x0D; Results: Among the thirty patients, 19 were male and 11 were female. The mean (±SD) age of patients was 9.23±3.23 years (age range 5 to 15 years). The mean preoperative mouth opening (T1) was 7.3±3.1 mm, while the mean postoperative mouth opening (T2) was 29.2±3.3 mm. The mean interincisal distance was 29.0 mm (range 21 mm to 35 mm). The mean difference in pre- and postoperative mouth opening (T2-T1) was 21.6 ± 5 mm.&#x0D; Conclusions: Autogenous auricular cartilage graft is an efficient and reliable interpositional material for achieving early postoperative mouth opening in TMJ ankylosis patients.

Effect of Red Bull on Histology of Renal Mesangium

Objective: To determine the consequences of energy drink (Red bull) on renal mesangium of albino rats.Materials and Methods: This study was carried out at the Anatomy Department of King Edward Medical University, Lahore, from August 2018 to December 2019. It was an experimental randomized controlled trial. Total 90 adult albino male rats, 8-12 weeks old, weighing 130 to 160 grams were taken. Healthy animals were included. Rats were divided into three groups Group A and B experimental groups received 1.5ml/kg and 2.2ml/kg body weight of red bull energy drink, respectively. Group C received 1ml/kg body weight of distilled water.Results: The mean initial and final weight of animals was around 150g and 170g, respectively. The mean paired kidney weight and relative tissue weight index for all three groups were found insignificant. Microscopic examination showed mesangial hypercellularity and vascular congestion in renal cortex of groups A and B, none in group C. These were significant among two experimental groups with a p-value less than 0.001.Conclusion: It was found that the use of energy drinks induces histopathological changes in the renal mesangium.

Recent Antimicrobial Susceptibility Patterns of Salmonella Isolates in A Tertiay Care Hospital Lahore

Objective: To determine the recent antimicrobial susceptibility patterns of salmonella isolates (typhi and paratyphi) in a tertiary care hospital of Lahore. Methods: It is cross sectional retrospective study conducted out in King Edward Medical University(Pathology deptt)/Mayo Hospital Lahore.The study period is six months from May 2019 to October 2019(Peak months of Typhoid fever).During this six months study period, total of 4284 samples for blood culture were received that were inoculated on the macConkey and blood agar plates.The growths obtained were then processed through biochemical profiling and analytical profile index(API).The Kirby Bauer technique was used for antibiotic susceptibility testing and reporting was done on the basis of clinical laboratory standard institute(CLSI). Results: During these six months, total 4284 blood samples were inoculated, out of which 433 growths were obtained. There were 84 strains of salmonella typhi isolated. Sensitivity pattern of different antibiotics showed that Azithromycin was sensitive to 70 (83.3%) isolates, imipenem in 72 (85.7%), ciprofloxacin to 56 (66.7%), gentamycin to 48 (57.1%), ceftriaxone to 45 (53.6%), cefepime to 20 (23.8%), chloramphenicol to 12 (14.3%) while ampicillin was least sensitive i.e. 8 (9.5%) isolates. There were 24 MDR(multidrug resistant) and 12 were XDR(extensive drug resistant) strains. We also found out that resistance to azithromycin drug is also emerging as 70 out of 84 strains were sensitive while remaining 14 were resistant. Conclusion: According to recent antibiotic susceptibility against salmonella typhi, the most sensitive drugs are Carbapenems (imipenem or meropenem) these days. Second sensitive antibiotic is azithromycin. Key Words: Antimicrobial susceptibility, Salmonella isolates, Carbapenems, Azithromycin. How to cite: Bukhari H., Komal T., Akhtar R., Mumtaz U.S., Waheed I., Recent Antimicrobial Susceptibility Patterns of Salmonella Isolates in A Tertiay Care Hospital of Lahore. Esculapio 2021;17(01):45-48

Association of Lifestyle Factors with Sub-optimal Health Status Among Undergraduate Medical Students: A Cross Sectional Study

Sub-optimal health status is a gray state of health interceding between health and disease, causing reduction in vitality and adaptability in absence of any diagnosed illness. It is considered as a precursor to disease state whose prevention will decrease burden on healthcare system. Objectives: To assess the burden of suboptimal health status and analyze its association with lifestyle factors among undergraduate medical students. Methods: A cross sectional study conducted at King Edward Medical University, Lahore, Pakistan. Questionnaires based upon “Sub-Health Measurement Scale V1.0 (SHMS V1.0)'' and “Health Promoting Lifestyle Profile-II (HPLP-II)'' were distributed among medical students of different years and 379 responses were completed. The data was entered in SPSS version 23 using quantitative variables. Chi-square test was employed to determine association of dependent with independent variables. Results: Frequency of the Sub-optimal health status and Health among individuals of study population was found to be 78.1% (296) and 21.9% (83) respectively. A significant positive association of lifestyle factors with Sub optimal Health Status was found (p &lt; 0.005). There was a slightly high frequency of SHS among females than males and day scholars than hostellers. The respondents having SHS had lower mean values for each HPLP-II dimension relative to those who were reported as healthy. Conclusion: There is a high frequency of SHS among medical students. Poor lifestyle is a risk factor as a significant correlation exists. It can be prevented by adopting a healthy lifestyle. Key Words: Sub optimal, SHS, Health, Lifestyle, Dimensions. How to cite: Rashid Z., Tariq S., Naeem Y., Jabeen Z., Tariq M., Kamran H.A.S. Association of lifestyle factors wih sub- optimal health status among undergraduate medical students: a cross sectinal study. Esculapio 2021;17(01):20-25

Perception of patient safety among Final year MBBS students at King Edward Medical University Lahore

Introduction: Patient safety is a vital part of healthcare. It is vital for the medical students that the concepts of the “Do no harm” theory must be understood. Those that do not understand this ultimately perform poorly in healthcare practice. Therefore, it is very important that medical students must be tutored for the concept of good medical practice.Objective: To assess the patient safety perception among medical students in a public sector Medical College.Methods: A sample size of 179 medical students (n=179) from the final year were selected. A questionnaire tool was used to calculate the understanding of medical students. Participants' responses were recorded and computed into SPSS 19 for descriptive analysis.Results: About 55% of participants indicated a lack of knowledge regarding patient safety.25% of the medical students could not understand the type and nature of the iatrogenic error in providing good healthcare and exercising good medical practice. Also, 57% and 48 % of medical students were unable to understand that how to explain the iatrogenic error to patients, their attendants,s and their superiors respectively and 59% did not know that patient safety can be improved by targeted medical practice.Conclusion: The majority of the medical students in final year MBBS were unaware of patient safety and how to improve it. However, they showed keen interest in understanding it and applying the concept of good medical practice to ensure patient safety.&#x0D; KEYWORDS: Patient safety, undergraduates, knowledge, attitude

EFFECTIVENESS OF ONLINE VS. TRADITIONAL CLASSROOM TEACHING FOR UNDERGRADUATE MEDICAL STUDENTS: A STUDENT’S PERSPECTIVE

Abstract:&#x0D; &#x0D; Objective:&#x0D; To find effectiveness between online and traditional classroom teaching methods among final year class of MBBS.&#x0D; Methods:&#x0D; An observational study conducted at King Edward Medical University Lahore in April 2020 among the final year class of MBBS. Two Likert-scale questionnaires generated on Google Docs after taking approval from the university’s ethical committee. Informed consent was taken and all students of the final year class of MBBS, of both genders, were included. Univariate analysis was done taking preference of teaching method as a primary objective. P-value ≤0.05 considered significant. Data was analyzed using SPSS v20.&#x0D; Results:&#x0D; Three hundred and three (n=303) students responded to the traditional model and three hundred and ten (n=310) responded to online. Overall, the mean value of student preference for the traditional mode of teaching was higher than online (3.62 vs. 3.09). Univariate analysis showed, in the traditional mode of teaching students felt more concentrated during lectures (p&lt;.001) and had more interclass interaction (p&lt;.001). The student felt the online mode of teaching more effective (p=0.02) and found it more feasible to respond to class tests (p=0.01). However, both methods were significant regarding increasing productivity of students (p&lt;.001, p&lt;.001), non-complex (p=0.01, p=0.01) and enjoyable (p&lt;.001, p=0.01)

An audit of death due to poisoning: a retrospective study

Background: Poisoning is being more frequently encountered nowadays, both globally and locally. Knowing what poisons are involved more commonly and what kind of victims present with this condition, helps the clinicians to manage and treat the patients in a better manner and lessens the mortality rates.&#x0D; Objectives: To determine the age group and gender most vulnerable to fatal poisoning. To identify the agent used for poisoning.&#x0D; Material &amp; Methods: The descriptive retrospective study was carried out King Edward Medical University, Lahore and reviewed the autopsy records of victims of fatal poisoning from January 2018 to December 2019. The data was analyzed using the SPSS software.&#x0D; Results: In the total 67 cases of poisoning that were studied, majority of the victims were males (85.07%).Most of the cases fell in the 21-30 years age group (53.73%), followed by the 31-40 years age group (23.88%).The overall mean age of the victims was calculated to be 32.597 years. Morphine was found to be the toxic agent in most cases (32 cases; 47.76%), followed by Dextromethorphan (26 cases; 38.80%) and codeine (19 cases; 28.35%).&#x0D; Conclusions: Poisoning is a serious issue that is more frequently encountered in our young adult and male population. Since narcotics were found in major share of the cases, measures should be taken for more strict control.&#x0D; Keywords: poisoning, autopsy, mortality, drug toxicity

Effect of ablution on Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonisation in healthcare workers.

Healthcare workers (HCWs) with MRSA nasal colonisation pose a serious threat of passing on the infection to patients. A cross sectional study was designed to investigate the effect of ablution on MRSA nasal colonisation and was conducted at the Department of Pathology, King Edward Medical University. A total of 220 nasal swab samples, 110 from ablution performing HCWs and 110 from non-ablution performing HCWs were processed for the identification of Staphylococcus aureus and sensitivity testing for Cefoxitin. In the ablution performing group, 11(10%) HCW were harbouring Staphylococcus aureus in their nose, while in non-ablution performing group 32 (29%) HCWs had colonisation of Staphylococcus aureus. Frequency of MRSA colonised HCWs was 9/11 (82%) in ablution performing group, while in the non-ablution group 16/32 (55%) had MRSA in their nose. Logistic regression analysis demonstrated that the duration of working experience and non-performance of ablution are the potential risk factors.

Student satisfaction level among allied health sciences students at King Edward Medical University

The purpose of this study was to evaluate student satisfaction with their program, academic environment and administrative services in terms of its effectiveness on their professional attitudes, lives and career. A total of 261 students of allied health sciences program at King Edward Medical University, were examined in terms of personal satisfaction by means of a specifically designed student satisfaction survey. A qualitative analysis approach was used to interpret the data generated by a three‐part survey form circulated to the four proceeding sessions of allied health sciences program and satisfaction of students in 12 major disciplines was evaluated. The data was entered in statistical product and service solutions (SPSS) version 22 using quantitative variables and descriptive statistics including frequency distribution tables and diagrams. The study revealed a student satisfaction of only 22.1% with their program with different levels of recommendation in different sub-disciplines. A total of 20.9% students agreed to the library facilities, 53.9% with computer lab, 35% with administrative support, 29.6% with sports facilities and 49% with teaching methodologies. The present study concludes that most of the students had little satisfaction concerning their field of study. So, it is necessary to make an attempt for continuous development of quality services.

Evaluation of Training Course on “Integrated Management of Neonatal &amp; Childhood Illness” (IMNCI) Using Kirkpatrick Model at Level-2

Introduction: Integrated Management of Childhood Illness (IMNCI), taught by a 6-day training course, is an important initiative to decrease childhood mortality. Level 2 of the Kirkpatrick model entails the assessment of the learning achieved by training activity.Objective: To assess improvement in the knowledge of IMNCI content among the participants of the 6-day IMNCI training program.Methods: After taking approval from IRB, this one-group pre-test-post-test study was carried out in the Paediatrics Medicine Department, King Edward Medical University / Mayo Hospital Lahore over 3 months. By non-probability consecutive sampling, all 77 participants of three 6-day courses (with no previous formal training of IMNCI) were included in the study. To assess any improvement in the knowledge (Kirkpatrick Model Level 2), each participant filled a pre-test and a similar post-test after the training.Data was analyzed by SPSS software. As the data was not normally distributed, the Wilcoxon test was applied to compare the overall median scores of pre-test and post-test. Kruskal-Wallis Test was applied for the comparison of the median scores of pre-test and post-test scores of each professional group. While Mann-Whitney U-test was applied for pairwise comparison of the pre-test and post-test scores between different pairs of professional groups.Results: Of the 77 participants, there were 35 doctors, 20 nurses, 20 Lady Health Visitors, and 2 midwives. The overall median score was 3 (IQR 3) of the pre-test and 8 (IQR 2) for the post-test (p-value &lt; 0.001). Except for the midwives, there was a statistically significant improvement in the median score of each group. Item-analysis of the questions showed that compared to the pre-test, the proportion of correct answers in the post-test showed statistically significant improvement for all the 10 questions. Pairwise comparison of the median pre-test and post-test scores between different professional groups did not show statistical significance except for the doctor-nurse pair.Conclusion: IMNCI training program significantly increased the knowledge of health care providers with no statistical difference between the post-test scores of doctors, LHVs, and midwives.&#x0D; KEYWORDS: IMNCI, Training program, Kirkpatrick Model, Childhood mortality, Knowledge evaluation&#x0D;

PREDICAMENTS OF PROSTHETISTS &amp; ORTHOTISTS IN PAKISTAN

Objective: To find out the level of anxiety, depression and stress and its association with quality of life ofProsthetists and Orthotists.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Rehabilitation departments and institutes including Pakistan Institute of Prosthetic and Orthotic Sciences, Peshawar; King Edward Medical University, Lahore; Dow Medical University, Karachi; Rawalpindi Medical College, Rawalpindi; and Prosthetists and Orthotists working in public and private sectors, over a period of 6 months from Jun 2018 to Nov 2018.&#x0D; Methodology: A sample of 250 Prosthetists and Orthotists of both genders, aged 20 to 60 years, were recruitedusing non probability purposive sampling. Those working in administrative posts and those who graduated after 2017 were excluded. Demographic sheet; Depression, Anxiety and Stress Scale-21; and 36-Item Short Form Health Survey-36 were administered through e-mail for data collection. Statistical analysis was done using SPSS Version21. Pearson correlation test was used to analyze any association.&#x0D; Results: Results revealed prevalence of 139 (55.6%) for depression with predominance of moderate depression63 (45.32%), followed by mild 37 (26.62%), severe 24 (17.37%) and very severe depression 15 (10.79%); 154 (61.6%) for anxiety with predominance of severe level of anxiety 59 (38.31%), followed by moderate 48 (31.17%), mild 26 (16.88%), &amp; severe anxiety 21 (13,64%); and 115 (46%) for stress with predominance of moderate stress 55 (47.82%), followed by mild 30 (26.10%), severe 20 (17.39%) and very severe stress 10 (8.69%). For quality of life SF-36 revealed a total mean score of 62.54 ± 16.72 and statistically..........