Nishtar Medical Research Articles

Effectiveness of Cognitive Behavioral Techniques for Diabetes Distress in Patients Presenting With Diabetes Related Distress at a Tertiary Care Hospital

Diabetes-related distress is a common psychological issue among diabetic patients, often affecting their ability to manage the condition effectively. Objective: To determine the effectiveness of cognitive behavioral techniques for diabetes distress in patients presenting with diabetes related distress at a tertiary care hospital. Methods: This study was conducted in the General Medicine Department at Nishtar Medical University and Hospital, Multan, a tertiary care hospital, over a period of 12 months. It was a Quasi Experimental Study. Sample size was 64 patients with diabetes related distress, (32 in each group) calculated by using sample size formula for comparing two proportions. Sampling technique was non probability consecutive sampling. Results: The mean age of patients experiencing diabetes-related distress was 51.45 ± 8.34 years, with an age range of 37 to 65 years. Among the 64 participants, only 20 (31.3%) had controlled diabetes, while 41 (64.1%) had uncontrolled diabetes. Efficacy was observed in 23 (35.9%) of the study cases. Specifically, 17 (53.1%) participants in group an exhibited efficacy, compared to 6 (18.8%) in group B (P=0.004). Conclusions: The findings of the study supported cognitive behavioral techniques for the management of diabetes related distress as these techniques were found effective and reliable in the management of diabetes related distress. Effectiveness of therapy was significantly higher among experimental group as compared with control group.

Endometrial Hyperplasia on Rising Trends among Peri-Menopausal Women

Endometrial hyperplasia demonstrates a uterine pathology characterized by a range of endometrial morphological remodeling. The clinical importance of endometrial hyperplasia lies in its progression to endometrial carcinoma. Objectives: To analyze histopathological findings of endometrial biopsy in perimenopausal women having abnormal uterine bleeding and to observe the correlation of various risk factors with endometrial hyperplasia. Methods: The cross-sectional study was conducted at the Department of Gynaecology, Nishtar Medical University, Pakistan. Two hundred and fifty-five perimenopausal women having abnormal uterine bleeding of 3-12 months’ duration were included. The participants were subjected to histopathological analysis of endometrial biopsy obtained by dilatation and curettage. All the information and the histopathology report were entered on a specific proforma. Data analysis was performed using SPSS software version 26.0. Results: Out of a total of 255 patients, the mean age was 48+/-6 years. A vast majority was grand multiparous (n=163, 64%). Out of a total of 255 endometrial samples, the majority (n=88, 34.5%) turned out to be proliferative endometrium, indicating hormonal imbalance like unopposed estrogen stimulation. In total, 66 (25.9%) samples fulfilled the criteria of endometrial hyperplasia. 54 (21.7%) had endometrial hyperplasia without atypia, while 12 (4.2%) had atypical endometrial hyperplasia. Regarding atypical uterine bleeding, the commonest symptom was heavy regular cycle (n=74, 29%) followed by irregular vaginal bleeding (n=70, 27.5%). Conclusions: It was concluded that atypical uterine bleeding in the peri-menopausal life period is alarming. All such women should undergo endometrial histopathological examination to detect endometrial hyperplasia to prevent its progression to endometrial carcinoma.

RELATIONSHIP OF EARPHONE USAGE WITH THE EMERGENCE OF HEARING LOSS AND HEALTH PROBLEMS IN MEDICAL STUDENTS OF SOUTH PUNJAB

Noise induced hearing loss (NIHL) is a rising concern, particularly in the young adult population who frequently use personal listening devices (PLDs) such as earphones. Medical students are at risk of having hearing related problems due to the high usage of PLDs for both academic and recreational purposes. This study aimed to assess the prevalence of hearing loss, symptoms associated with earphone use, and the relationship between earphone usage patterns and hearing thresholds among medical students in South Punjab, Pakistan. Objective: To evaluate the prevalence of hearing loss and associated symptoms (headache, tinnitus, otalgia, fatigue) about earphone usage habits, including daily duration, volume, and frequency of use, among undergraduate medical students. Methods: This cross sectional study was conducted at Nishtar Medical University and CMH Institute of Medical Sciences (CIMS), Multan from October 2023 to August 2024. A total of 267 medical students aged 18 26 years participated in this study. Participants were categorized into two groups: mild users (≤1 hour/day) and Intense users (>1 hour/day) of PLDs. Data were collected using a self administered questionnaire on demographics, earphone usage patterns, and associated symptoms. Audiometric testing was performed using Pure Tone Audiometry (PTA) to assess hearing thresholds at 250 Hz to 8000 Hz. Descriptive statistics, t tests, chi square tests, and Pearson correlation were used to analyze the data. Results: The majority of participants (55.4%) were aged 21 23 years, with a balanced gender distribution (52.4% male, 47.6% female). Intense users (53.2%) had significantly higher hearing thresholds at all frequencies compared to mild users, particularly at higher frequencies (4000 Hz and 8000 Hz). In the right ear, the prevalence of hearing loss is 3.2% for mild users and 13.3% for intense users whereas in the left ear, it is 4.8% and 12.7% for mild and intense users respectively. The most common form of hearing loss was mild sensorineural hearing loss at 4000Hz. Intense users reported higher rates of symptoms, including headache (35.9% vs. 16%), fatigue (47.2% vs. 17.6%), otalgia (46.5% vs. 22.4%), and tinnitus (34.5% vs. 17.6%), with statistically significant associations between symptom prevalence and usage duration and volume. Conclusion: Prolonged earphone usage is significantly associated with the emergence of hearing loss and increased prevalence of auditory symptoms among medical students. Despite being aware of the risks, many students do not follow safe listening practices, underscoring the need for educational initiatives. Promoting the "Rule of 60" and encouraging regular breaks during usage are essential steps to mitigate the risk of NIHL.

PREVALENCE OF ERECTILE DYSFUNCTION AFTER PELVIC RADIOTHERAPY

Erectile dysfunction (ED) is a common complication among male cancer survivors undergoing pelvic radiotherapy, significantly impacting their quality of life. Despite its high prevalence globally, data on ED among Pakistani cancer survivors remain limited. Objective: To determine the prevalence, severity, and associated risk factors of ED among male patients undergoing pelvic radiotherapy at Nishtar Medical University and Hospital, Multan. Methods: This prospective observational study included 50 male patients aged 50–85 years undergoing pelvic radiotherapy for malignancies. Baseline and six-month follow-up assessments of erectile function were conducted using the International Index of Erectile Function (IIEF-5) questionnaire. Factors associated with ED, including age, comorbidities, and treatment parameters, were analyzed using SPSS version 26.Results: The prevalence of ED six months post-radiotherapy was 61%. Advanced age (≥65 years) and diabetes were significant risk factors, with 71.4% and 88.9% of patients, respectively, developing ED. Moderate and severe ED accounted for 42.9% and 35.7% of cases, respectively. Cultural stigma and limited healthcare resources were additional barriers to managing ED in the Pakistani context. Conclusion: ED is highly prevalent among male patients undergoing pelvic radiotherapy, with advanced age and diabetes being significant contributors. These findings underscore the need for routine ED screening, culturally sensitive counseling, and targeted interventions to improve the quality of life for cancer survivors in Pakistan.

IMPACT OF FLIPPED CLASSROOM IN GENERIC STUDENTS IN COLLEGE OF NURSING, NISHTAR MEDICAL UNIVERSITY MULTAN

Traditional teaching methods in nursing education often fail to engage students in active learning, limiting their ability to develop critical thinking and problem-solving skills. The flipped classroom model, which integrates pre-class independent learning with in-class active engagement, has shown promise in improving learning outcomes. Objective: To evaluate the impact of the flipped classroom model on academic performance, engagement, and perceptions among nursing students at the College of Nursing, Nishtar Medical University, Multan. Methods: A quasi-experimental pre-test and post-test design was used. A total of 130 BSN students were randomly assigned to experimental (flipped classroom) and control (traditional lecture) groups. Pre-class materials were provided to the experimental group, while the control group followed traditional lectures. Data were collected using a validated questionnaire and analyzed using IBM SPSS version 26. Results: The flipped classroom model significantly improved post-test scores, critical thinking, and engagement levels compared to traditional methods. Most students (85%) reported that the flipped classroom approach fostered lifelong learning skills, and 90% agreed it effectively integrated theory and practice. Key challenges included limited resources and infrequent use of flipped learning by educators. Conclusion: The flipped classroom model is an effective strategy for enhancing academic performance and engagement in nursing education. Addressing barriers such as faculty training and resource limitations is essential for its successful implementation in resource-constrained settings like Pakistan.

Burn Injuries in Epileptic Patients: Prevalence, Causes, and Outcomes - A Cross Sectional Study at Pak Italian Burn Center Nishter Hospital Multan

Objective: To evaluate the patterns of burn injuries, identifying the prevalence, causative factors and outcomes of burn injuries among patients of epilepsy admitted to the Pak-Italian Burn Center, Nishtar Hospital Multan. Methodology: A descriptive cross-sectional study was conducted at the Pak-Italian Modern Burn Center, Nishtar Medical University and Hospital, Multan from January 2018 to June 2023. Patients with epilepsy and burn injuries caused directly by seizures, covering all age groups and both genders were included. Patients were received in the emergency department where the fluid resuscitation was done and every effort was made to eliminate shock and were admitted to the burn unit. On the stable condition all the patients or their care taker were interviewed to assess the causes of burn injuries. A structured proforma was used to collect data including demographic characteristics, causes of injuries and outcomes. Data was analyzed using SPSS version 26. Results: Out of 3482 patients with burn injuries, 264 (7.5%) were epileptic. Average age of patients was 30.10±11.23 years. About 52.7% burn accidents occurred at homes, 28.4% at workplace and 18.9% at some outdoor locations. Based on causes flame burn was the most common with 48.5% followed by scald, electric burns and other miscellaneous causes with 42.4%, 4.9% and 4.2% incidence rate respectively. Post-burn contracture was the most common complications in 37.9% patients, followed by wound infections 19.3% cases, while 12.1% patients experienced loss of body parts. Overall mortality rate was 11.4%. Conclusion: Burn injuries among epileptic patients were observed 7.5%, with the most common causes being flame burns, scalds, and electrical burns and overall mortality rate of 11.4%.

Evaluating Risk Factors and the Burden of Silent Myocardial Ischemia Among Diabetic Patients.

Silent myocardial ischemia (SMI) is a significant concern for diabetic patients, often remaining undetected until severe complications arise. Prolonged hyperglycemia, poor glycemic control, and lifestyle factors contribute to its risk, with older adults and those with long-standing diabetes particularly vulnerable. To assess the prevalence and predictors of SMI in adults with diabetes, emphasizing long-term management and monitoring. A longitudinal observational study was conducted at Nishtar Medical University, Multan, from October 2020 to September 2022, involving 388 adults with diabetes for at least five years. Patients with significant cardiovascular diseases or recent medication-affecting biomarkers were excluded. Data collection included demographics, medical history, and clinical assessments such as HbA1c levels, 12-lead resting ECGs, and treadmill exercise stress tests, with myocardial perfusion imaging (MPI) for those unable to perform stress tests. Statistical analyses using IBM SPSS (version 22) incorporated univariate and multivariate logistic regression to identify predictors of SMI, adjusting for confounders such as age, sex, smoking, and blood pressure. Thresholds included microalbuminuria at 30-300 mg/24 hours and HbA1c ≥7%, with missing data addressed through multiple imputations. Among the participants, the prevalence of SMI was 48%, increasing to 58% in those with microalbuminuria. Significant predictors included the duration of diabetes (OR 1.28, 95% CI: 1.08-1.52, p=0.001), HbA1c levels (OR 1.75, 95% CI: 1.42-2.16, p<0.001), age (OR 1.05, 95% CI: 1.01-1.09, p=0.035), and smoking status (OR 1.42, 95% CI: 1.05-1.92, p=0.025). Smoking status was based on self-report. Notably, microalbuminuria showed a strong association with SMI (OR 2.89, 95% CI: 2.10-3.98, p<0.001). The distribution of participants was balanced in terms of age and gender, with a mean age of 58 years (SD 9.4), and 52% were male. No unexpected findings were observed, and the results aligned with the anticipated relationships between the variables. This study highlights a concerning prevalence of SMI among diabetic patients, emphasizing the importance of monitoring diabetes duration and glycemic control, particularly in individuals with microalbuminuria. Regular follow-up care, including routine ECGs, stress tests, and biomarker assessments, is crucial for improving cardiovascular outcomes in this high-risk population. Limitations such as the observational design and potential self-report bias in smoking status may affect the generalizability of the findings. Future research should focus on large-scale, multicenter studies to validate these findings and explore interventions that could reduce the burden of SMI in diabetic patients.

Understanding childhood obesity in Pakistan: exploring the knowledge, attitudes, practices of mothers, and influential factors. A cross-sectional study.

Childhood obesity is a significant public health issue with far-reaching implications. The World Health Organization reported that in 2020, around 38 million children under five were overweight or obese globally, and in 2016, 340 million children and adolescents aged 5-19 were affected. In Pakistan, the situation is alarming; 66.9% of school-going children in Punjab were overweight, and 5.8% were obese in 2022. This study explores mothers' knowledge, attitudes, and practices regarding childhood obesity in Pakistan and identifies factors contributing to this epidemic. Maternal perspectives are crucial as they significantly influence children's dietary habits, physical activity, and attitudes toward food and body image. A cross-sectional study was conducted from November 2023 to January 2024 at four medical centers: Fazaia Ruth Pfau Medical College Hospitals Karachi, Baqai Medical University Karachi, and Nishtar Medical University Multan. The study included 191 mothers with children aged 5 to 15 years. Data were collected using a structured questionnaire on sociodemographic characteristics, knowledge, attitudes, practices, and perceptions of childhood obesity. IBM-SPSS version 26.0 was used for data analysis, employing statistical tests like Kruskal-Wallis, Mann-Whitney U, Spearman, or Kendall Tau correlation to examine associations. Among the 191 mothers, 48.7% had education beyond intermediate, and 86.9% were housewives. The children's BMI distribution showed that 27.7% were obese and 21.5% overweight. Mothers had moderate knowledge (60.5%) about childhood obesity; 75.4% recognized its long-term health risks, and 62.8% associated it with diabetes. Attitudes were generally positive, with a 78.5% average score. Most mothers (73.8%) believed obesity could be controlled and had healthy practices (70.1% average score). However, 96.9% reported witnessing stigmatization of obese children, and 79.6% felt pressured by relatives about their child's weight. The findings indicate that while Pakistani mothers have moderate knowledge and positive attitudes toward childhood obesity, their practices are influenced by educational and socioeconomic factors. Addressing these disparities, enhancing public health initiatives, and mitigating stigmatization could improve childhood obesity management in Pakistan.

COMPARATIVE STUDY ON OUTCOME OF OPEN FISTULECTOMY VERSUS LIFT PROCEDURE FOR UNCOMPLICATED PERIANAL FISTULAS

Perianal fistulas, particularly trans sphincteric types, pose a significant challenge in terms of management, often requiring surgical intervention. Traditional open fistulotomy has been a common procedure, but newer techniques like the ligation of the intersphincteric fistula tract (LIFT) procedure are being explored for improved outcomes, particularly in terms of preserving continence. This study aims to compare the outcomes of open fistulotomy versus the LIFT procedure in patients with trans sphincteric perianal fistulas. Objective: To compare the clinical outcomes, healing times, recurrence rates, and continence status between patients undergoing open fistulotomy and those treated with the LIFT procedure for trans sphincteric perianal fistulas. Methods: A prospective comparative study was conducted in the General Surgery Department of Nishtar Medical Hospital, Multan, from May 2024 to August 2024. A total of 150 adult patients with trans sphincteric perianal fistulas were enrolled using consecutive sampling. The patients were randomly divided into two groups: Group A (n = 75) underwent the LIFT procedure, and Group B (n = 75) underwent fistulectomy. Postoperative follow-up was conducted weekly until wound healing and at three months after healing to assess pain scores, recurrence rates, healing time, and continence status. Statistical analysis was conducted using SPSS Version 25, with a significance level set at p &lt; 0.05. Results: Among the participants, 6 patients (8%) in Group A and 8 patients (10.7%) in Group B experienced recurrent fistulas, showing no significant difference between the groups. Postoperative pain scores were similar between both groups. However, the healing time was significantly shorter in Group A (27.2 days) compared to Group B (48.1 days) (p &lt; 0.05). Recurrence rates were higher in Group A (16%) compared to Group B (2.7%) (p &lt; 0.05). Incontinence was observed in 10.7% of patients in Group B, while no incontinence was reported in Group A (p &lt; 0.05). Conclusion: The LIFT procedure offers better outcomes in terms of continence preservation and shorter healing time compared to open fistulotomy in the management of trans sphincteric perianal fistulas. However, open fistulotomy showed lower recurrence rates. These findings suggest that the LIFT procedure may be preferable in patients for whom preserving continence is a priority, while open fistulotomy may be a better option in cases where recurrence prevention is the main concern.

EFFICACY OF NOVEL ANTIMICROBIAL AGENTS AGAINST MULTI-DRUG RESISTANT BACTERIA

Background: The rise of multi-drug resistant (MDR) bacteria poses a significant threat to public health worldwide, undermining the efficacy of conventional antibiotics and escalating the severity of infections. Addressing this challenge requires the development of innovative antimicrobial agents that can effectively combat these resistant strains. Objective: To evaluate the efficacy of novel antimicrobial agents against isolated MDR bacteria from clinical samples, assessing their potential as viable therapeutic options. Methods: This experimental study was conducted at Nishtar Medical University Multan, with ethical approval from the hospital’s ethical board. Bacterial strains were isolated from various clinical samples and identified as MDR pathogens. The antimicrobial efficacy of three novel agents was assessed using minimum inhibitory concentration (MIC) tests and bactericidal assays, quantifying the agents' ability to inhibit and eradicate bacterial growth. Results: The novel agents demonstrated varying efficacy against the bacteria. Agent A showed a significant reduction in Klebsiella pneumoniae with 99.0% bactericidal activity. Agent B reduced Pseudomonas aeruginosa by 82.4%, while Agent C was particularly effective against Acinetobacter baumannii, with an MIC of 0.66 µg/ml. These results indicate the agents' potent antimicrobial properties across different MDR bacterial strains. Conclusion: The study highlights the promising potential of novel antimicrobial agents in treating infections caused by MDR bacteria. The significant bactericidal effects observed suggest these agents could be crucial in developing new therapeutic strategies against resistant pathogens.

Significance of Modified Hodge Test in Carbapenemase Detection: A Brief Insight

Neonatal sepsis is one of the leading causes of neonatal deaths. A. baumannii-calcoaceticus is the most notorious bacterial agent. Carbapenems are the most important antibiotics and modified Hodge Test is considered as important phenotypic method for observing Carbapenemase production. Objective: To evaluate the efficacy rate of Modified Hodge Test, for detection of Carbapenem resistance. Methods: A cross sectional study was conducted at department of pathology, Nishtar Medical University, Multan from August 2023 to September 2023. The blood samples of suspected cases of sepsis were collected and after isolation of Acinetobacter baumannii sensitivity of multiple antibiotics were checked by disc diffusion method. Carbapenem resistance was re-evaluated by Modified Hodge Test using Meropenem disc (10 µg). All data were entered and analyzed by SPSS version 23.0. Results: Total samples of neonatal sepsis were 182. 83 (45.6%) were culture positive for bacterial growth. Among the positive samples 26 (31.3%) were isolated as Acinetobacter baumannii. Kirby-Bauer disc diffusion method was used to check sensitivity of multiple antibiotics including Carbapenems. Out of 26 Acinetobacter isolated samples, 16 were found to be Carbapenem resistant by this method. Modified Hodge test was used to re-confirm Carbapenem resistance. Out of 16 Meropenem resistant cases this phenotypic test only detected 5 cases (31.25%). Conclusions: Staphylococcus aureus followed by Acinetobacter baumannii were isolated predominantly and Carbapenem resistance has markedly increased. In contrast to a study conducted in 2010 in Pakistan on MHT effectiveness where effectiveness of MHT for Carbapenemase detection was satisfactory, our results reveled that some other techniques should be introduced for Carbapenemase detection as Modified Hodge test did not give satisfactory results

Descriptive Analysis Regarding Optic Canal Variations: A Study In South Punjab Region Of Pakistan

Objective: This study aimed to conduct a comprehensive investigation into optic canal variations within the South Punjab region of Pakistan. The primary objectives were to analyze the size, shape, and anomalies of the optic canal, providing valuable insights for healthcare professionals and researchers involved in ophthalmology, neurosurgery, and radiology. Methods: A meticulous examination of 221 dried cadaveric human skulls from Nishtar Medical University's Anatomy Department was undertaken. The sample was carefully selected to ensure diverse representation across age groups and genders, contributing to a robust dataset for analysis. Optic canal dimensions were measured using precision callipers and digital devices, encompassing length, width, and height. Qualitative analyses involved scrutinizing variations in shape, such as curvature, tapering, and irregularities. Specific anomalies, including optic canal duplication, were identified and documented. Ethical guidelines were strictly followed with approval from the institutional review board (IRB). Statistical analyses, conducted using SPSS 22.0, included measures like mean, median, and standard deviation, providing a rigorous framework for discerning patterns and variations within the optic canal. Results: The study revealed significant anatomical variations within the optic canal. Quantitative analysis of size variations demonstrated mean lengths, widths, and heights, offering insights into the normative anatomy of the optic canal in the South Punjab population. Diverse shapes were observed, with the majority displaying a gently curved configuration. Anomalies, including optic canal duplication and the keyhole anomaly, were identified, contributing to our understanding of rare anatomical peculiarities. Slight but noteworthy differences between the right and left optic canals were observed, with the right side generally displaying larger dimensions and specific anomalies. Conclusion: The findings contribute valuable insights into optic canal morphology, emphasizing its complexity and diversity within the South Punjab population. These results hold practical implications for clinicians, informing diagnostic imaging, surgical planning, and interventions involving the optic canal. The study underscores the importance of individualized patient care, considering the variations in optic canal anatomy. As our understanding advances, these findings pave the way for enhanced clinical assessments and nuanced approaches to cranial anatomical considerations, ultimately improving patient outcomes and guiding future research in this field.

Empathy Levels in Medical Students as they Advance through their Years of Education

Background: At Nishtar Medical University, medical students' empathy levels across different years of medical education were compared to identify and present any differences in empathy levels between the medical students of other years. Methods: Using cross-sectional analysis stratified random sampling technique, this study compared empathy among Nishtar Medical University medical students in the first, third, final, and internship years. MBBS 2nd and 4th-year students in Nishtar Medical University, Multan, are excluded from the study. A Google Form questionnaire was shared with the students to compare their empathy levels in various years of medical education. The sample size is 288. Results: Empathy scores decreased over time, with first-year students scoring the highest (84.09 ± 3.68) and third-year students scoring 75.06 ± 3.71. The 5th year had a somewhat lower empathy score of 74.63 ± 3.82, followed by a considerable reduction in average scores to 64.15 ± 0.84 during the internship year. Conclusion: A definitive cross-sectional study at Nishtar Medical University has conclusively addressed the inquiry of comparing empathy levels across the different years of medical education. The results unequivocally show a decline in empathy during undergraduate medical training.

Exploring Sleep Hygiene Practices and Their Relation to Sleep Quality among Medical Students at Nishtar Medical University Multan

Abstract: Background: Sleep quality is particularly important for medical students who often face demanding schedules, high stress levels and an atypical sleep pattern. Objective: To evaluate subjective sleep quality among medical students and its association with sleep hygiene practices. Methods: This descriptive cross-sectional study design was carried out on 385 undergraduate medical students enrolled through simple random sampling. The questionnaire had three sections. The first part covered demographic information; the second part evaluated subjective sleep quality by using the Pittsburgh Sleep Quality Index; and the third part was related to a 13-item sleep hygiene questionnaire. Data was entered and analyzed using SPSS version 26. Pearson chi-square test was employed to identify the factors linked to deprived sleep quality. A p-value of ≤ 0.05 was considered statistically significant. Results: This study revealed that 55.3% of medical students experienced poor sleep quality with a mean PSQI score of 5.17+3.71, which was mostly influenced by subjective sleep quality. 45.19% of the study participants reported poor sleep hygiene practices. The analysis revealed that students with habits of watching television, a lack of exercise and taking daytime naps slept worse. A significant association was observed between poor sleep quality and deficient sleep hygiene practices (p&lt;0.01). Conclusion: Insufficient sleep hygiene practices are prevalent among students with poor sleep quality. Sleep hygiene education programs must be given due consideration because these will ultimately improve future doctors’ health and enhance their performance in the long term

EVALUATION OF NURSE-PATIENT COMMUNICATION AND ITS IMPACT ON PATIENT SATISFACTION

Effective nurse-patient communication is critical to patient satisfaction, particularly in specialized care units like burn units. Poor communication can lead to adverse patient outcomes and dissatisfaction, highlighting the need for focused studies to evaluate and improve communication practices in healthcare settings. Objective: To assess nurse-patient communication and its impact on patient satisfaction in the burn unit of Nishtar Medical Hospital, Multan. Methods: A descriptive, cross-sectional study was conducted in the Burn Unit of Nishtar Medical Hospital, Multan, from May 2023 to May 2024. Three hundred patients admitted to the burn unit were selected using convenience sampling at discharge. Data were collected using two modified questionnaires: the La Monica Oberst Patient Satisfaction Scale (LOPSS) and the Nurse Quality of Communication with Patient Questionnaire (NQCPQ), both translated into English and Urdu. Patients were presented with the questionnaires before discharge and were given adequate time to complete them. Statistical analysis was performed to evaluate the results. Results: The mean score of LOPSS was 150.47 ± 9.09, indicating patient dissatisfaction in several areas, including the nurses' reluctance to consider patients' choices, inadequate assessments, and insufficient explanation of treatment plans, leading to patients feeling like mere cases. The mean score of NQCPQ was 89.29 ± 6.10, with the highest communication scores noted in the patient's active involvement in maintaining personal hygiene and the nurses' assistance with mobility, diet, and hygiene. Gender showed a direct statistical association with satisfaction scores and communication quality. Conclusion: Weak nurse-patient communication led to poor patient satisfaction scores. Enhancing professional communication among healthcare staff is imperative to improving the quality of care and patient satisfaction in burn units.

EVALUATION OF MIGRAINE AWARENESS AND ITS IMPACT ON STUDENTS OF NISHTAR MEDICAL UNIVERSITY

The cross-sectional study was conducted in Nishtar Medical Hospital from January 2022 to January 2023 to assess the prevalence, impact, and triggers of migraine in medical students. The study included both male and female students from all the years. The data was collected using a questionnaire containing questions regarding demographics, knowledge about migraine, character of pain, triggers, and accompanying factors. The questionnaire was standardised according to Migraine Disability Assessment Score (MIDAS) and International Headache Society (IHS) criteria. A total of 500 students were invited, of whom 470 (94%) completed the survey. The prevalence of migraine was 25.9% (122/470), and 50% (61/122) had more than five episodes in the last three months. Over one-third, 36% (44/122) of participants experienced severe pain. Moreover, 41% (50/122) sought medical advice, and 19.6% (24/122) were hospitalised. The most common symptoms experienced during an episode were unilateral headache (81.9%), pulsating headache (65.5%), photophobia (60%), and phonophobia (55.7%). The most common triggers were sleep deprivation (73.7%), stress (57.3%), loud sounds (55.7%), hunger (53.2%), and fatigue (51.6%). Of 122, 77 (63.1%) participants reported moderate to severe disability due to migraine attacks. It is concluded that migraine is prevalent among medical students and hurt the well-being and productivity of the students.

AWARENESS AND KNOWLEDGE OF VIRAL HEPATITIS PREVENTION AND TRANSMISSION IN HEALTHCARE WORKERS

The objective of this study was to evaluate the knowledge and awareness of healthcare workers about the prevention and transmission of hepatitis B virus. The study was conducted in Nishtar Medical Hospital, Multan, from January 2023 to September 2023 and included 300 healthcare workers, such as doctors and nurses. The participants were asked to fill out a 50-question questionnaire designed to test their knowledge about hepatitis B. The questionnaire was in English, but assistance was provided if needed. The questions were related to the virus, behaviors, and medical practices when treating infected patients, and it took an average of 30 minutes to complete. The results showed that 74% of the healthcare workers knew the consequences and possible complications of acquiring HBV infection. Between 69% and 80% of the respondents answered correctly about the transmission routes. However, only 24% of the HCWs knew the age distribution of the infections and that neonates were at the highest risk of developing it through mother-to-child transmission. Respondents answered wrongly about transmission through food and cutlery with the infected (69%), through sneezing and coughing (81%), prevention of infection by thorough cleaning (50%), and not sharing food and cutlery with the infected (55%). Only half of the workers knew about disposing of needles and syringes correctly. The average knowledge score was 24 ± 5 with a median score of 24 (10-33). Respondents performed the worst when answering questions about CHB monitoring and treatment. In conclusion, this study found that the awareness and knowledge about hepatitis B prevention and transmission among healthcare workers in Pakistan is poor. Therefore, it is recommended to make training programs mandatory for professionals to improve disease management.

VISUAL ACUITY ASSESSMENT WITH ATROPINE PENALIZATION VS PARTIAL OCCLUSION THERAPY IN AMBLYOPIA PATIENTS IN SOUTH PUNJAB

A retrospective study was conducted in the Ophthalmology Department of Nishtar Medical Hospital from September 2022 to September 2023 to compare the effectiveness of atropine penalization and occlusion therapy in treating amblyopia in children. The study included 50 children aged 2-9 years with no prior treatment history of amblyopia. The children were divided into two groups: Group A received atropine penalization, while Group B received occlusion therapy. Both groups had a mean age of 5.5 years, and all patients passed the visual acuity tests. Strabismus was high in both groups, with 96% in Group A and 92% in Group B. The treatment duration in Group A was 7.5 months on average, while it was 4.5 months in Group B. Treatment compliance was higher in Group A (96%) compared to Group B (68%). After the treatment, the atropine group had a visual acuity range of 6/6 to 6/60, with a mean visual acuity of 6/10. On the other hand, the occlusion group had a visual acuity range of 6/6 to 6/120, with a mean visual acuity of 6/20. The study concluded that atropine penalization had better patient outcomes and compliance in treating amblyopia in pediatric patients. The study concluded that atropine penalization had better patient outcomes and compliance in treating amblyopia in pediatric patients.

Comparing the outcomes between silver sulfadiazine (SSD) versus sustained-release silver foam in treatment of partial thickness burn patients

Objective: To compare the outcomes between silver sulfadiazine (SSD) versus sustained-release silver foam in treatment of partial thickness burn patients.&#x0D; Study design: Randomized controlled trial.&#x0D; Place and Duration: Department of Burn/Plastic surgery, Nishtar Medical University/Hospital, Multan in Six months from 27-11-2021 to 27-05-2022.&#x0D; Methodology; All patients of second degree partial thickness burns (n=164) were divided in equally in two groups through draw method, 82 patients in each, group (A) treated with silver sulfadiazine and group (B) with sustained-release silver foam dressing. Baseline data and outcome i.e., pain, wound healing and hospital stay were recorded on predesigned proforma&#x0D; Results: In Group I, there were 15.0% patients who had wound healed and 25.0% patients had wound healed in Group II. The mean VAS score at 5, 10, 15 and 20 day of Group II was less than the Group II (p&lt;0.001). whereas, the wound healing in both the groups were almost equal at 5, 10, 15 and 20 day, and the differences were statistically insignificant, (p&gt;0.050).&#x0D; Conclusion; utilization of sustained-release silver dressing exhibits notable advantages in the wound healing process, including accelerated recovery rates, reduced pain levels, and consequently, earlier hospital discharge, when compared to silver sulfadiazine (SSD) dressings in treatment of partial thickness burn patients.

Effectiveness of Intralesional Cautery in Treatment of Vascular Malformations

Objective: to evaluate effectiveness of intralesional cautery in treatment of vascular malformations&#x0D; Methodology: Descriptive case series study was conducted at Pak Italian Modern Burn Center /plastic surgery department, Nishtar Medical University Multan during a period from January 2020 to December 2020. A total of 20 patients were enrolled with vascular malformation involving head and neck region.The average follow-up period was 06 months after completion of a multisession treatment. Advanced diagnostic technology, mostly noninvasive, was used on all 20 patients with vascularmalformation.&#x0D; Results: Majority of our study cases i.e. 18 (90%) reported with the venous vascular malformation followed by Arteriovenous malformation 02 (10%). Overall regression was better in venous malformations shown in six weeks and it was observed in 18 (90%) of the study cases.Arteriovenous malformations showed less regression with procedure and took three to four sessions (as compared to VM which took two sessions). Color matching was comparable to that of normal site in 18 (90%) of our study cases mostly seen in slow flow venous malformation, while Arteriovenous malformation showed less improvement 02 (10%) of our study cases. Normal healing was noted in 19 (95%) of our study cases while one (05%) oral vascular malformation case got burn wound near oral commissure.&#x0D; Conclusion: Intralesional cautery technique for vascular malformation particularly venous one is a reliable, safe and versatile technique. It provides a good aesthetic outcome in terms of color matching, regression and scarring. It results in restoration of normal form and function in critically challenging areas like head and neck and pinna.