Medical Education Institutions Research Articles

PROJECT-BASED LEARNING AS A MEANS OF DEVELOPING SPEAKING SKILLS OF MEDICAL STUDENTS

This article explores the effectiveness of project-based learning (PBL) as a pedagogical approach to enhance speaking skills of medical students, emphasizing the practical application of language within professional field. In the context of evolving medical education, the need for proficient English language skills among healthcare professionals has become increasingly topical. By integrating constructivist, experiential, communicative, and task-based learning theories, PBL fosters critical thinking, collaboration, and creativity. Through active engagement in projects such as clinical simulations, case studies, and health campaigns, students not only acquire linguistic competence but also bridge knowledge across disciplines such as biology, pharmacology, ethics, etc. This study aims to analyze the methodologies, impacts, and potential obstacles of PBL in medical English education. The findings are intended to inform English language instructors in medical educational establishments, ultimately enhancing the quality of training for future healthcare professionals in a globalized surroundings. By promoting effective communication skills, PBL serves as a vital tool in preparing a new generation of adaptable and skilled practitioners.

DEVELOPMENT OF HIGHER MEDICAL EDUCATION ABROAD IN THE STUDIES OF UKRAINIAN COMPARATIVISTS

The article presents a synthesized historiographical analysis of Ukrainian pedagogical comparativistsʼ works on the development of higher medical education in foreign countries, identifying trends, achievements, bottlenecks, and prospects for studying this problem. The presented sample of dissertations, monographs, and textbooks demonstrated their narrow country-specific vector and similarity in formulating the subject of research. Historiographical and comparative analysis revealed similar approaches of scientists to determining trends in the development and functioning of national systems of professional training for doctors. These concern the preservation and expansion of decentralization in higher medical education management; strengthening the interaction of its various links; shifting emphasis in determining the prerequisites for the development of national higher medical education systems from “traditional” factors (political, socio-economic, cultural situation of the country, etc.) to clarifying the influences of international medical organizations and documents in the field of healthcare that substantiate general strategies for training doctors in higher medical education institutions, etc. Scientists also propose original approaches to studying the functioning of national systems of higher medical education. These are manifested in the development of authors periodizations and classifications of the specified process; thorough characteristics of university environments for training future doctors in different countries; comprehensive understanding of the determinants of their formation and development, which, in addition to social, economic, and cultural factors of the country's development, relate to the level of education of the population, its multiculturalism, the specifics of educational systems, etc. In these perspectives, the analyzed studies mark two main country-specific vectors of research in higher medical education: “overseas” (USA and Canada) and “European” (mainly Great Britain, Poland, and German-speaking countries).

Pediatric Allergy Management at ULSNE: Insights into Public Health Implications

Abstract Introduction Pediatric allergies present a complex challenge to public health systems, affecting both policy-making and clinical management. This study explores the management trends and challenges of pediatric allergies at the Unidade Local de Saúde do Nordeste (ULSNE) in Portugal, emphasizing its implications for refining healthcare practices over a seven-year period. Methods A retrospective review of medical records was performed, from children aged 0 to 18 who presented with allergic reactions at ULSNE’s emergency services between 2017 and 2023. The analysis concentrated on demographics, allergen types, reaction severity, and the management strategies deployed. Results The analysis revealed a wide range of allergens, from food to insect stings, with medication being the most prevalent triggers. Significant findings include observing severe allergic reactions across all age groups, highlighting the need for acute emergency interventions. The data underscores a critical demand for early diagnosis and tailored-made management plans to efficiently handle the diverse severity of allergic reactions observed. Conclusions This study demonstrates the complexity of managing pediatric allergies within ULSNE’s public health framework. Standardized, evidence-based management methods should be adopted to strengthen emergency response capabilities, as shown by the frequency of severe responses and the prevalence of various allergens. As an outcome, our results support a comprehensive, interdisciplinary strategy that includes medical personnel, educational institutions, and family involvement to create a supportive community that is supportive of both immediate care and long-term preventive measures. Subsequent efforts should give precedence to educational programs designed to increase consciousness and encourage preventive measures in community environments. Key messages • A rapid response is essential for healthcare systems to have fast, effective strategies ready for children’s severe allergic reactions. • Emphasizes a collective approach involving healthcare workers, schools, and families to prevent and manage children’s allergies, enhancing safety and awareness.

Comparing readiness for self directed learning in undergraduates of private and public medical colleges

Objective: To measure the readiness for self-directed learning among medical undergraduates of private and public medical colleges, and to evaluate their performance and strategies. Method: The cross-sectional study was conducted in Lahore, Pakistan from February to July 2023, and comprised medical undergraduate students of either gender from 1 private and 1 public academic institution. Data was collected using a pre-validated structured questionnaire having self-management, desire for learning, and self-control domains to explore self-directed learning readiness. Data was analysed using SPSS 26. Results: Of the 330 subjects, 166(50.3%) were females and 164(49.7%) males, while 166(50.3%) were from the private institution and 164(49.7%) were from the public institution. There were 183(55.4%) students in the 3rd year, 89(27.0%) in the 4th year and 58(17.6%) in the final year of their coursework. Self-directed learning readiness was significantly higher in students from the private institution (p<0.05). Conclusion: There was a significant correlation between self-directed learning readiness in private and public medical education institutions, with readiness being higher in the private sector. Key Words: Self-directed learning, Self-control, Experiential learning, Problem-based learning, Active learning.

Profiles, tissue and microbial integrity of cadavers used in medical faculties in South-western Uganda: implication in anatomical education.

Cadaveric dissection has remained an integral part of anatomical education globally; hence, the profiles of cadavers, their gross tissue and microbial integrity has great implication in anatomical education. This study determined the profiles, gross tissue and microbial integrity of cadavers used in South-western Uganda (SWU) medical schools. A cross-sectional study was carried out for three months in anatomy and microbiology laboratories of SWU medical teaching institutions. Ethical approval was obtained, cadavers were proportionately selected and examined grossly, and surface swabs taken for microbial analysis. Data collected was entered into Microsoft Excel, cleaned, and exported to Stata version 17 for analysis. Majority of cadavers were male (68%), adult (96%), blacks (100%), unknown cause of death (96%), obtained as unclaimed bodies (100%) and with no cadaver record tag (96%). Nearly a half (48%) cadavers had disrupted dentition, 68% had poor muscle integrity and 80% with abnormal fat. About 27% cadavers had poor surface microbial integrity among which 62.5% had a mixture of both bacteria and fungi, 25.0% had only fungi while 12.5% had only bacteria. A high number of cadavers had micro-organisms on their surfaces with majority having a mixture of bacteria and fungi. Majority of cadavers had poor gross tissue integrity. Better cadaver preservation methods should be adopted. To advocate for the establishment of cadaver donation policy and programs through which good quality cadavers can be obtained.

THE POTENTIAL OF DIGITAL TECHNOLOGIES IN IMPROVING THE PROCESS OF TRAINING AND RETRAINING OF MILITARY DOCTORS

The issue of improving the process of training and retraining of military doctors is determined by changes in the security environment of the state today, and the need to develop the military medical sector in the conditions of long-term resistance to russian aggression. This article highlights the potential of using digital technologies to improve the process of training and retraining of military doctors. The results of a survey of trainees at the Ukrainian Military Medical Academy (a higher military medical educational institution that provides training, retraining and advanced training of specialists in almost all specialties for the Armed Forces of Ukraine and other military establishment of Ukraine) are presented. It is shown that for the implementation of changes in the system of training and retraining of military doctors the Academy provides for a number of measures: introducing innovative changes in the content and methodology of education; introduction of flexible technology for planning and organizing the educational process, focused on personalization of learning; development of international scientific and scientific-medical collaborations. Based on the conducted research, it was determined that in the conditions of active hostilities in Ukraine, it is digital technologies that make it possible to quickly introduce changes in the process of training and retraining of military doctors by improving the educational and informational environment. It was established that improving the readiness of military doctors to use digital technologies in their professional activities requires their end-to-end use in the entire training system. The article provides examples of the use of digital technologies in the process of training and retraining of military doctors.

A-204 Commitment to Sustainability From Laboratory Medicine

Abstract Background According to McGill University, sustainability means “meeting our needs without compromising the ability of future generations to meet their own needs”. Sustainable environmental practices improve water and air quality, reduce landfills, and increase renewable energy sources in the long term. In response to the growing urgency of global sustainability challenges, the healthcare industry is taking a step forward to reduce its environmental impact. University of Malaya Medical Centre (UMMC) is a government-funded teaching hospital and medical institution, which processes about 3.95 million chemistry and 371,000 immunoassay tests per year. This study aims to evaluate the sustainability aspects of Atellica Solution, focusing on water usage, power consumption, carbon dioxide emissions and plastic waste generations. Methods Power and water consumption for the analysers Advia Chemistry 2400 & XPT and Advia Centaur XPT were obtained from Atellica Solution using the year 2022 test volumes and compared with those of Siemens legacy system for the year 2019 test volumes. In addition, the reduction of plastic usage was also assessed for the year 2019 and 2022. Results With innovative Atellica Solution replacing Siemens legacy system, the data showed reduction in water and energy consumption by 36.44% and 47.74% respectively, whereas the annual throughput increased by 13.7%. By using Atellica INTELIQ QC management, fewer aliquot tubes were used and thus plastic waste was reduced by 168 kg. These reductions combined to lower CO2 emissions by about 16 tons. Conclusions Atellica Solution is designed for high throughput and sustainability, reducing water and energy consumption while also significantly reducing CO2 emissions. Furthermore, it enables faster, streamlined quality control management with Atellica INTELIQ QC management system. UMMC is strongly committed to minimizing laboratories’ environmental footprint and provide better access to care eventually contributing to the well-being of patients.

THE CLINICO-CLASSIFICATION OF IMMUNOLOGIC ASPECTS OF JUVENILE RHEUMATOID DISEASES IN TEACHING STUDENTS CLINICAL SCIENCES IN MEDICAL EDUCATION

The article deals with the clinic and classification of immunological aspects of juvenile rheumatoid arthritis in students while teaching clinical sciences in medical education, acute rheumatic diseases, etiopathogenesis, classification, clinical signs, diagnostic criteria, comparative diagnosis, treatment methods, prevention and dissemination. Rheumatism, immunological aspects and its classification considered related to treatment methods, etiology and pathogenesis of the disease, infectious factors. Causes of rheumatism, solution of therapeutic and methodical tasks necessary in medical educational institutions, in classes, based on medico-didactic approach outlined.

Evaluating the Diagnostic Accuracy of Rapid Malaria Tests in Pediatric Patients: A Retrospective Cohort Study.

Background Malaria remains one of the most significant public health challenges, particularly in pediatric populations in developing countries. Rapid diagnostic tests (RDTs) have been widely adopted due to their ease of use and quick results, but their diagnostic accuracy, compared to microscopy, the gold standard, remains a topic of interest. Early and accurate detection of malaria is crucial in reducing complications and mortality in children, who are especially vulnerable to delayed or inaccurate diagnoses. Objective This study aims to evaluate the diagnostic accuracy of RDTs for diagnosing Plasmodium falciparum malaria in children, using microscopy as the gold standard for comparison. Methods A retrospective cohort study was conducted in the Pediatric Department of Lady Reading Hospital Medical Teaching Institution (MTI), Peshawar, from January 1, 2023, to December 31, 2023. A total of 140 pediatric patients (aged 12 years or below) who were clinically suspected of malaria were included. Patients were excluded if they had a prior confirmed diagnosis of malaria before admission, were already receiving anti-malarial treatment, or if their guardians did not provide consent for participation. Blood samples were collected from each patient and subjected to both RDT and microscopic examination. Statistical analyses, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy, were calculated using SPSS version 24.0. Multivariate logistic regression was conducted to adjust for potential confounders such as age, gender, and parasitic load. Results Out of 140 children, 83 (58.57%) tested positive for malaria by RDT, while microscopy confirmed 80 (57.14%) positive cases. The sensitivity of RDT was 96.25% (95% CI: 89.43%-99.22%), and the specificity was 90.00% (95% CI: 79.49%-96.24%). The PPV was 92.77%, and the NPV was 94.74%, with a diagnostic accuracy of 93.57%. Multivariate logistic regression analysis indicated that parasitic load was a significant predictor of RDT accuracy, while age and gender were not. Conclusion RDT is a highly accurate diagnostic tool for detecting Plasmodium falciparum malaria in children, demonstrating high sensitivity and specificity compared to microscopy. RDTs can be effectively used in resource-limited settings, but attention should be given to parasitemia levels to ensure accurate diagnosis.

Prevalence of Non-ST-Segment Elevation Myocardial Infarction in Acute Coronary Syndrome With Unremarkable Electrocardiogram: A Cross-Sectional Study From Lady Reading Hospital, Medical Teaching Institute, Peshawar.

Introduction Patients admitted to the cardiac care unit with non-ST-segment elevation myocardial infarction frequently have inconclusive electrocardiogram results. In individuals presenting with sudden central chest discomfort, non-ST-segment elevation myocardial infarction should be suspected until confirmed or ruled out by a cardiac biomarker analysis. This study aims to determine the prevalence of non-ST-elevation myocardial infarction among acute coronary syndrome patients who present with normal electrocardiogram findings. Materials and methods This study was conducted from October 24, 2022, to April 24, 2023, and involved 120 patients who came to the cardiac emergency department at Lady Reading Hospital, Peshawar. These patients experienced chest pain and symptoms of acute coronary syndrome, all within 24 hours of the onset of their symptoms. Demographic data and clinical histories were recorded for each patient. Electrocardiograms were performed, and non-ST-segment elevation was observed. The diagnosis of non-ST-segment elevation myocardial infarction was confirmed by measuring cardiac troponin T levels. A threshold value greater than 0.5 ng/mL was considered diagnostic. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics for Windows, Version 23, Armonk, NY), and grammar was checked using the Grammarly software (Grammarly, Inc., San Francisco, CA). Results The study participants had an average age of 53.96 years, with a standard deviation of 8.57. Most participants were male, comprising 65.83% of the total population, while 34.17% were female. Among the participants, 26.66% were diagnosed with non-ST-segment elevation myocardial infarction, affecting 32 individuals. The results showed a significant correlation between the occurrence of non-ST-segment elevation myocardial infarction and male gender, as well as with individuals who had pre-existing comorbidities. The p-values for these associations were 0.032 and 0.043, respectively, indicating statistically significant relationships. Conclusion In conclusion, a significant proportion of patients who presented to the emergency department with acute coronary syndrome symptoms and a normal electrocardiogram were diagnosed with non-ST-segment elevation myocardial infarction. This highlights the need for special attention to male patients and those with comorbidities.

Investigating the Impact of Admission Requirements on Academic Performance in Khyber Pakhtunkhwa's Medical Teaching Institutions

Investigating the Impact of Admission Requirements on Academic Performance in Khyber Pakhtunkhwa's Medical Teaching Institutions

Utilizing Un-enhanced Chest Computed Tomography Screening for Blunt Trauma Surgery Decisions.

Background Blunt chest trauma is a common and potentially life-threatening condition that requires prompt assessment for potential surgical intervention. Computed tomography (CT) of the chest has emerged as a valuable tool due to its heightened sensitivity and specificity in detecting thoracic injuries compared to conventional chest radiography. Objective This study aims to assess the impact of non-contrast CT chest findings on surgical decision-making and compare these findings with those from chest radiographs. Methods The study was conducted at the Accident and Emergency Department of Medical Teaching Institute, Lady Reading Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan. Patients of all ages and genders who presented with blunt chest trauma were included. Non-contrast CT chest scans were used as an initial screening tool and compared with traditional chest radiographs. Data collected included patient demographics, mechanism of injury, diagnostic findings, and treatment decisions. Imaging was performed using a GE Optima 16-slice scanner (Medsystems Sp. z o.o., Lublin, Poland). Results The study included 246 patients, of whom 210 (85.4%) were males. The most common age group was 50 years or older, comprising 71 (28.9%) of the sample. The predominant mechanism of trauma was road traffic accidents, reported by 188 (76.4%) patients. Hemopneumothorax was detected in 121 (49.2%) patients on CT scans compared to 34 (13.8%) patients on chest radiographs. On chest radiograph, the pneumothorax component was missed in 43 (17.5%) patients, and the hemothorax component was not detected in 21 (8.5%) patients. Patient management included conservative management in 30 (12.2%) cases and surgical intervention in the form of unilateral tube thoracostomy in 173 (70.3%) patients or bilateral tube thoracostomy in 43 (17.5%) patients. Conclusion Our study supports the use of non-contrast CT scans as a reliable diagnostic tool for blunt chest trauma, consistent with current literature. This approach facilitates prompt management decisions, particularly for initiating tube thoracostomy based on findings of pneumothorax and hemothorax. The rarity of mediastinal great vessel trauma further justifies minimizing routine contrast use, thereby enhancing the efficiency of trauma evaluations.

Perceived outcomes of medical teaching institute reforms: insights from management, faculty, and administration in Pakistani tertiary health care

ObjectiveThe study aims to explore the perceived outcomes of Medical Teaching Institution (MTI) reforms on autonomy and overall performance within tertiary healthcare institutions in Khyber Pakhtunkhwa (KP) province, Pakistan.MethodologyA cross-sectional study was carried out from September 2023 to March 2024, involving interviews with frontline staff, administrative personnel, and senior management within MTI-affiliated institutions. The methodology employed, using both qualitative and quantitative data analysis techniques.ResultsThe study showed that institutional staff members’ knowledge and understanding of the MTI changes differed. Some observed very minor adjustments, while others saw advances in hospital operations and service delivery. Administrative complexity, political meddling, and resource allocation problems were noted as challenges. Positive results were also observed, though, and they included improved infrastructure, possibilities for staff training, and decision-making procedures.ConclusionDespite significant improved, there are still challenges, such as inconsistent staff comprehension, mixed impacts on service delivery, resource allocation issues, and political meddling. Addressing these issues necessitates improved communication, continuous evaluation, and coordinated efforts to improve administrative systems and obtain consistent funding.

Probiotics vs. Placebo: Preventing Necrotizing Enterocolitis in a Premature Infant.

Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition primarily affecting preterm newborns, leading to significant morbidity and mortality. This prospective cohort study aimed to evaluate the effectiveness of probiotics in preventing NEC in premature infants. Secondary objectives included assessing the impact on mortality, late-onset sepsis, duration of hospital stay, and weight gain. The study was conducted at Lady Reading Hospital Medical Teaching Institute, Peshawar, from April 1, 2023, to March 31, 2024, involving 102 preterm infants. Participants were randomly assigned to receive daily oral probiotics (Lactobacillus and Bifidobacterium species) or a placebo. The incidence of NEC was significantly lower in the probiotic group (7.8%) compared to the placebo group (21.6%; p = 0.04). The probiotic group also showed significant reductions in late-onset sepsis (13.7% vs. 29.4%; p = 0.03), shorter hospital stays (42.5 vs. 48.1 days; p = 0.02), and greater weight gain (15.3 vs. 13.4 grams/day; p = 0.01). These findings support the integration of probiotics into neonatal care, particularly in resource-limited settings.

Post-COVID cognitive impairment, level of depression and anxiety in university students

Recently, a significant amount of research has focused on the impact of COVID-19 on mental health. One of the increasingly common long-term consequences of COVID-19 is its effect on cognitive function, even in patients with an initially mild course of the acute illness. The article presents the results of a study of cognitive impairment and anxiety and depression levels among students of a higher medical educational institution. The study consisted of a continuous screening survey of students who had and had not experienced COVID-19 using an original questionnaire, as well as psychometric scales: Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). Based on the screening results, two groups were formed (those who had COVID-19 and those who did not), and a comparative analysis was carried out. It was found that a third (32.4%) of young people who had COVID-19 developed cognitive impairment. In students who were not ill, cognitive impairment was detected half as often – 16.8%. It was revealed that regardless of the fact of having suffered an infectious disease, a quarter of students experienced increased anxiety and decreased mood. Affective experiences, in turn, negatively affected cognitive functioning and caused young people to be more attentive to their health, including mental health, which was accompanied by a large number of positive responses when using the PHQ-9 and GAD-7 screening questionnaires.

EDUCATIONAL AND METHODOLOGICAL FUNDAMENTALS OF TEACHING THE TOPIC "ANATOMY OF THE SUPPORTING APPARATUS OF THE EYE"

The article is devoted to the analysis of the peculiarities of teaching the topic "Supporting apparatus of the eye" in domestic medical higher education institutions. Given the importance of studying the anatomy of the connective tissue structures of the eye socket for understanding the spread of infectious processes, we believe that in modern curricula on normal human anatomy, methodologists pay insufficient attention to their study. As a rule, these questions are only a small part of the wide variations of the topic "Accessory structures of the eye". At the same time, the peculiarities of the structure of the periosteum of the eye socket, the orbital septum, the socket of the eyeball, Whitnall's and Lockwood's ligaments, the tendinous funnel, the fascia of the rectus and oblique muscles have an extremely complex structure. Thorough knowledge of these features is a necessary condition for the development of the clinical thinking of the future doctor. The development of modern technologies for the surgical treatment of many eye diseases requires scientists and teachers to improve their knowledge of the structure of certain connective tissue structures of the eye. For example, the features of the structure and attachment of Tenon's capsule in the limbus area are the formation of an area where the approach to the fibrous membrane of the eye during surgical interventions can be carried out without damaging it. Nowadays, aesthetic surgery of the eye area is gaining particular popularity. Blepharoplasty is one of the surgical interventions most often performed in plastic surgery. Without a perfect knowledge of the structure of the orbital septum, safe performance of blepharoplasty is impossible. The surgeon needs to be oriented in the peculiarities of the structure of the orbital septum and the differences in its structure in the areas of the upper and lower eyelids. It is important to note that in the lower part of the eye socket, the space behind the orbital septum is much larger than in the upper part, it sinks into the depth of the eye socket, behind the back pole of the eye and is filled with fatty tissue, the growth of which is often an indication for surgical intervention. The structure of the upper part of the space behind the orbital septum is somewhat more complex, because it contains many vessels, nerves and connective tissue structures.

Clinical Audit in the Elderly by Assessing Hydration and Renal Functions Before and After Contrast CT Scans at District Headquarters Hospital, Dera Ismail Khan, Pakistan.

Introduction Contrast-induced nephropathy (CIN) is a serious risk involved in computed tomography (CT) scans, particularly for older people. The main idea of this clinical audit was to assess current practices regarding renal function tests (RFTs) and hydration status before and after contrast CT scans in older patients at District Headquarters Hospital (DHQ), Dera Ismail Khan, Pakistan, and to implement recommendations for improvement. CIN is a form of acute kidney injury that occurs after the administration of contrast dye used in imaging procedures and is characterized by a sudden deterioration in renal functions. Methods This clinical audit checked adherence to renal protection protocols in elderly patients undergoing contrast CT scans. Conducted over three cycles from July 5 to August 15, 2022, this clinical audit included 30 patients aged 75 and above. Each cycle had 10patients, divided equally between males and females, and further categorized into age groups of 75-85 years and 86-95 years. Data collection involved reviewing patient files, medication charts, and CT scan reports. Compliance with RFT documentation and hydration before and after the CT scan was assessed against the standards set by Basildon and Thurrock University Hospitals NHS Foundation Trust. Data were analyzed using Microsoft Excel 2023 (Microsoft® Corp., Redmond, WA), and graphs were created using Microsoft Word 2023 (Microsoft® Corp., Redmond, WA). Results The mean age ± standard deviation (SD) for males was 81.8 ± 5.01 in the first cycle, 83.4 ± 6.46 in the second cycle, and 82.4 ± 4.72 in the third cycle. For females, the mean age ± SD was 83.2 ± 5.80 in the first cycle, 85.2 ± 6.41 in the second cycle, and 83.0 ± 6.12 in the third cycle. The first audit cycle revealed that, while all patients (100%) had their RFTs documented before the CT scan, only 20% were adequately hydrated pre-scan, and none (0%) had RFTs performed post scan. Post-scan hydration was also low at 20%. These findings highlighted gaps in adherence to renal protection protocols. The second cycle showed improvements, with pre-scan hydration adherence increasing to 80%, post-scan RFTs to 60%, and post-scan hydration to 70%. By the third cycle, full compliance (100%) was achieved across all standards, including pre- and post-scan renal functions test and hydration. Conclusion The clinical audit at District Headquarters Hospital, Dera Ismail Khan, addressed gaps in renal protection protocols for elderly patients undergoing contrast CT scans. The audit improved adherence over three cycles through targeted interventions, including staff training, implementation of checklists, patient education, modifying the reporting format, and providing instructions in the local language. It also highlighted the importance of continuous education and regular monitoring. The clinical audit would be expanded to another hospital within the medical teaching institute, Dera Ismail Khan. This measure will maintain and enhance patient care, prevent CIN, and improve the renal health of elderly patients.

Epidemiology of Penetrating Chest Injuries Presenting at a Tertiary Care Center in Peshawar: A Retrospective Study.

Trauma is the leading cause of mortality globally.Penetrating chest trauma is a type ofinjury that occurs when an object pierces the skin and enters the chest wall. The incidence of penetrating chest trauma is high in the Khyber Pakhtunkhwa Province of Pakistan, with firearm injuries being the most common cause. The objective of this study is to determine the epidemiology and outcome of non-cardiac penetrating chest injuries presented at a tertiary care center in Peshawar. This retrospective cohort study was conducted from January 2022 to January 2023 at Medical Teaching Institute, Lady Reading Hospital, Peshawar, KPK, Pakistan. Two hundred and three patients who suffered penetrating chest trauma in the Khyber Province of Pakistan between January 2022 and January 2023 were included in this retrospective cohort study. The epidemiology and outcomes were analyzed using IBMSPSSStatistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). The mean age of the patients was 30.25 ± 16.674 years. Males comprised 183 (90.1%) of the study sample whereas females comprised only one-tenth 20 (9.9%). Gunshot injuries were the predominant mode of penetrating thoracic trauma comprising 128 (63.05%) of all injuries. Injuries inflicted by knife constituted approximately one-fifth of the presentations 44 (21.67%). The remaining injuries labeled 'Others' comprised modes such as road traffic accidents and fall injuries where the predominant mechanism was penetrating injury. The latter comprised 31 (15.27%) of the injuries. Penetrating chest trauma is common in the Khyber Pakhtunkhwa Province of Pakistan. Gunshot injury is the most common mode. Males are predominantly affected. Most non-cardiac penetrating chest trauma can be managed conservatively.

Epidemiological study of health profile and quality of life of postmenopausal women in the urban field practice area of a teaching medical institute in a metropolitan city.

Menopause is one of the most significant phases in the life of a woman which brings about various physiological changes called postmenopausal syndrome. A health programme catering to the needs of postmenopausal women is lacking in our health system. A cross-sectional study was conducted in an urban health and training centre. Sample size of 171 was taken by simple random sampling. Women of age more than or equal to 45 and having 12 months of amenorrhea were enrolled in the study after obtaining their consent. The mean age of menopause was found to be 45.31 years. In the vasomotor domain, the most common postmenopausal symptom was hot flushes (47.95%) followed by sweating (25.73%) while in the psychological domain it was seen that the most common symptom was feeling depressed down or blue (37.43%) followed by being dissatisfied with personal life, feeling anxious or nervous (36.26%) and being impatient with other people and feelings of wanting to be alone (34.50%). In physical domain, the most common symptom was ache in muscles and joints (92.98%) followed by low backache (86.55%), feeling tired or worn out (84.80%), decrease in physical strength (83.63%) and aches in the back of neck or head (81.87%). The other domain was the sexual domain in which the most common symptom was a change in sexual desire (93.57%) followed by avoiding intimacy (92.98%). It was found that the domain, most severely affecting quality of life was sexual followed by physical and psychological domain. Awareness should be created regarding the psychosocial, physical, nutritional and sexual needs of postmenopausal women.

The Experience of Teaching Students of Medical Educational Institutions to Quickly Assess the General Condition of a Patient in an Urgent Situation

The Experience of Teaching Students of Medical Educational Institutions to Quickly Assess the General Condition of a Patient in an Urgent Situation