MedERA - Journal of CMH LMC and IOD https://jcmhlmc.com/index.php/medera <p>MedERA-Journal of CMH Lahore Medical College and Institute of Dentistry(JCMHLMC) [<strong>ISSN(p): 2521-0106</strong> ,<strong> ISSN(l): 2789-3081</strong>] is a <strong>Pakistan Medical &amp; Dental Council</strong> <strong>(PMDC)</strong> and <strong>Higher Education Commission (HEC) indexed</strong> , open-access peer-reviewed biomedical journal that publishes current research related to all the aspects of medical sciences. The acronym <strong>MedERA</strong> stands for <em>Medical and Experimental Research Articles</em>.</p> <p><a title="Read More" href="https://www.jcmhlmc.com/index.php/medera/about" target="_blank" rel="noopener">Read More</a></p> en-US editorinchief@jcmhlmc.com (Editor-in-Chief) editorialassistant@jcmhlmc.com (Editorial Assistant) Mon, 22 Jan 2024 06:54:45 +0000 OJS 3.3.0.3 http://blogs.law.harvard.edu/tech/rss 60 Skeletal Traction Followed by Plaster of Paris vs Open Reduction and Internal Fixation – Comparison of the Functional and Radiological Outcome of the Two Treatment Modalities in Schatzker Type V and VI Tibial Fractures https://jcmhlmc.com/index.php/medera/article/view/111 <p><strong>Objective:</strong> To compare the functional and radiological outcomes of Schatzker type V and VI tibial<br />fractures for the two currently employed treatment modalities.<br /><strong>Methodology:</strong> It was a quasi-experimental study conducted at Orthopedics department. Patients<br />were admitted through ER and OPD of Mayo hospital Lahore over a period of 1 year. Total 84 patients<br />were included in the study. Patients were divided into two groups. Patients in Group A were<br />managed with skeletal traction for 2 weeks followed by plaster of Paris back splint applied for next 2<br />weeks followed by plaster of Paris casting for stabilization of the fracture for another next 4 weeks.<br />Patients in Group B were managed with ORIF by wires, screws or plates. Functional and<br />Radiographic evaluations were performed to assess pain, range of motion weight bearing and<br />fracture union in each follow-up visit<br /><strong>Results:</strong> In this study functional outcome of patients was significantly better and higher in patients<br />who were treated with ORIF technique<br /><strong>Conclusion:</strong> ORIF is more effective for treating Schatzker type V and VI tibial fracture in terms of<br />functional and radiological outcome as that skeletal traction followed by plaster of Paris casting.<br /><strong>Keywords:</strong> Skeletal Traction; ORIF; Schatzker type V; Schatzker type VI; Tibial Fracture</p> Ayesha Javed, Nilesh Kumar Mishra, Usman Khalid Kazi, Hassan Mehmood, Syed Haider Abbas Kazmi, Muhammad Farhan Zafar Copyright (c) 2024 Ayesha Javed, Nilesh Kumar Mishra, Usman Khalid Kazi, Hassan Mehmood, Syed Haider Abbas Kazmi, Muhammad Farhan Zafar https://creativecommons.org/licenses/by/4.0 https://jcmhlmc.com/index.php/medera/article/view/111 Wed, 17 Jan 2024 00:00:00 +0000 Screening for Renal Function Impairment in Patients with Chronic Type II Diabetes Mellitus in a Tertiary Care Hospital of Pakistan https://jcmhlmc.com/index.php/medera/article/view/112 <p><strong>Objective:</strong> The objective of the present study was to detect early biochemical changes, in type II<br />diabetics, indicating renal function impairment leading to Chronic Kidney Disease (CKD).<br /><strong>Methodology:</strong> This study was conducted in the Department of Biochemistry at Shaikh Zayed FPGMI,<br />Lahore during September 2016 to April 2017. It was a cross-sectional analytical study and was done<br />through nonprobability convenient sampling The study comprised of 50 diagnosed patients of type<br />II diabetes mellitus (for the last 10 years) and 50 healthy subjects. Both male and female participants<br />in equal number between the age of 35-75 were included in the study. Blood glucose level (random),<br />blood urea, serum creatinine, urinary albumin and urinary creatinine were estimated and albumin to<br />creatinine ratio (ACR) in mg/g was calculated. eGFR was also calculated using S/creatinine. The lab<br />values of the study parameters were recorded on the designed proforma after getting proper written<br />consent from the participants. SPSS 20.0 was used for data entry and analysis.<br /><strong>Results:</strong> Mean values of random plasma glucose level, blood urea, serum creatinine, urine albumin,<br />urine creatinine, ACR and eGFR of patients when compared with those of healthy group showed<br />significant p-values (≤0.05).<br /><strong>Conclusion:</strong> There was a significant difference in renal laboratory parameters between diabetic<br />patients and healthy controls indicating the presence of CKD. In a developing country like Pakistan<br />type II diabetes mellitus is an incidental finding due to lack of regular health monitoring and it is very<br />difficult to determine the exact duration of the disease. Patients of type II DM develop CKD (Chronic<br />Kidney Disease) due to persistent high plasma glucose levels. Therefore good control of DM and<br />regular monitoring of renal parameters will be helpful in preventing the development of CKD.<br /><strong>Key Words:</strong> Diabetes Mellitus, Nephropathy, Chronic Kidney Disease, Urinary Albumin to<br />Creatinine ratio.</p> Rafiq Ahmad Siddiqui, Shamim Akram, Zoolfishan Imran, Emaan Fatima, Muhammad Mustansar, Saadia Liaqat Copyright (c) 2024 Rafiq Ahmad Siddiqui, Shamim Akram, Zoolfishan Imran, Emaan Fatima, Muhammad Mustansar, Saadia Liaqat https://creativecommons.org/licenses/by/4.0 https://jcmhlmc.com/index.php/medera/article/view/112 Wed, 17 Jan 2024 00:00:00 +0000 Characteristics of Critically ill Obstetric Patients Admitted to the ICU at a Tertiary Care Centre https://jcmhlmc.com/index.php/medera/article/view/114 <p><strong>Objective:</strong> To ascertain the characteristics, admission indications, interventions, and outcomes of <br />obstetric patients admitted to ICU.<br /><strong>Methodology:</strong> A retrospective, descriptive study was conducted at Lady Reading Hospital's ICU in <br />Peshawar, Pakistan (January 1 to December 31, 2022). During this time, a total of 1560 patients were <br />received in the ICU, out of which 132 full filled our inclusion and exclusion criteria. Characteristics of <br />patients, reasons for admission, interventions, demographic information, obstetric history, length of <br />stay, and outcomes were collected through a retrospective review of medical records. Statistical <br />analysis was performed using SPSS software version 21.0.<br /><strong>Results:</strong> Among the 1,560 admissions in ICU, 132 were obstetric cases (8.5% of all ICU admissions). <br />Majority of these patients had a mean age of 27.05 ± 6.23 years, with mean ICU stay duration of 6.55 ± <br />7.05 days. Among these, hypertensive disorders of pregnancy were identified in 47 patients (35.6%). <br />Obstetric hemorrhagic disorders accounted for admission in 40 patients (30.3%). Out of the 132 <br />patients, 26 (19.6%) did not survive. Highest mortality rates were of those admitted with fulminant <br />hepatic failure (2 patients, 66.7%). Among patients admitted for direct obstetric reasons, post-natal <br />septicemia caused the highest mortality (3 patients, 37.5%). Ventilatory support was required by 113 <br />patients (85.6%) and vasopressor support was administered to 87 patients (65.9%) of the patients. <br /><strong>Conclusions:</strong> To decrease maternal mortality and improve healthcare for pregnant individuals, it is <br />crucial to focus on hypertensive disorders of pregnancy and obstetric hemorrhage. Addressing these <br />issues, along with providing effective post-natal sepsis treatment, can contribute to a reduction in <br />mortality rates.<br /><strong>Keywords:</strong> Obstetric hemorrhage, Pre-Eclampsia, Post-natal septicemia, Mortality</p> Umair Khalil, Muhammad Luqman Saeed, Muhammad Tariq Khan, Kamran Munawar Copyright (c) 2024 Umair Khalil, Muhammad Luqman Saeed, Muhammad Tariq Khan, Kamran Munawar https://creativecommons.org/licenses/by/4.0 https://jcmhlmc.com/index.php/medera/article/view/114 Wed, 17 Jan 2024 00:00:00 +0000 Beyond Anxiety: Unveiling the Power of Self-Efficacy in Shaping Academic Performance among Medical Students https://jcmhlmc.com/index.php/medera/article/view/115 <p><strong>Objective: </strong>The study aimed to explore the relationship between anxiety and academic performance and discuss a key boundary condition i.e., self-efficacy as a strategy to manage anxiety in the academic setting.</p> <p><strong>Methodology: </strong>A quantitative survey design was used employing a cross-sectional time frame<strong>.</strong> Public sector medical colleges of Lahore affiliated with the University of Health Sciences (UHS) were selected such as Allama Iqbal Medical College, Ameer-ud-Din (PGMI) Medical College, Services Institute of Medical Sciences, and Shaikh Khalifa Bin Zayed Al-Nahyan Medical &amp; Dental College. The duration of the study was from June 2021 to January 2022. A convenience sampling technique was used to collect data from 259 medical students through self-administered questionnaires. The inclusion criteria applied were that the medical institution needs to be recognized by UHS and should be located in Lahore. Medical students included belonged to second to final year MBBS. First-year students were omitted as they had not taken their professional examinations.</p> <p><strong>Results: </strong>Hayes PROCESS Macro analysis in SPSS version 22 showed that social media overload and academic performance were significantly related (B=-0.198, p&lt;0.05). Moreover, a significant moderating role of self-efficacy in the relationship between anxiety and academic performance was found.</p> <p><strong>Conclusion: </strong>Results suggested that when medical students faced anxiety their academic performance was decreased however this did not apply to medical students with high self-efficacy. Medical students with low self-efficacy who see themselves as incompetent, lose motivation easily when they try to attempt tough tasks and focus too much on potential failure.</p> <p><strong>Key Words:</strong> Anxiety, academic performance, self-efficacy.</p> Muhammad Ali Ather, Hina Shahid, Sumaira Qambar Bokhari Copyright (c) 2024 Muhammad Ali Ather Ather, Hina Shahid, Sumaira Qambar Bokhari https://creativecommons.org/licenses/by/4.0 https://jcmhlmc.com/index.php/medera/article/view/115 Wed, 17 Jan 2024 00:00:00 +0000 Frequency of Musculoskeletal Discomforts and its Association with Various Breastfeeding Positions among Nursing Mothers https://jcmhlmc.com/index.php/medera/article/view/116 <p><strong>Objective:</strong> To determine the association between musculoskeletal discomforts and breastfeeding <br />positions among nursing mothers.<br /><strong>Methodology:</strong> It was an analytical cross-sectional conducted from January 2023 to June 2023 at Imran <br />Idrees Teaching Hospital and Idrees Hospital, Cantt Sialkot. The participants were selected using a <br />convenient sampling technique. All 232 participants were recruited after the informed consent who <br />met the inclusion criteria for the study. A musculoskeletal discomfort form developed from the <br />Nordic Musculoskeletal Questionnaire was used as an outcome measuring tool. The data were <br />analyzed using SPSS version 22. Descriptive statistics and chi-square tests were used to analyze the <br />data. <br /><strong>Results:</strong> The mean age of participants is 28.91±4.10 years. The majority of the participants had 1 <br />breastfeeding child N=181 (78.0%), postpartum duration 1-3 months N=86 (37.1%), with the <br />frequency of breastfeeding 1-3 sessions/day N= 87(37.5%) respectively. Most nursing mothers had a <br />caesarian section as their mode of delivery N=120 (51.7%) and cross-cradle hold was the most <br />common breastfeeding position N=83 (35.8%) causing musculoskeletal discomfort among N=213 <br />(91.8%) of participants. Chi-square showed a significant association for ache/pain and discomfort in <br />the regions of shoulders, elbows, wrist/hands as (p=0.00); upper back (p=0.01) and neck (p=0.02) at <br />significance level 0.05. For prevention scale regions of the neck (p=0.00), wrist/hand, low back (p=0.01)<br />and trouble scale regions of the upper back (p=0.01), shoulder, wrist/hand (p=0.02) respectively. <br /><strong>Conclusion:</strong> The Musculoskeletal discomforts were more pronounced in regions of the neck, <br />shoulders, elbows, and wrists, upper/lower back with the breastfeeding positions among nursing <br />mothers.<br /><strong>Key Words:</strong> Breastfeeding positions, musculoskeletal pain, nursing mothers, posture</p> Amina Irfan, Umara Iftikhar Rana, Iqra Tul Hussain, Usman Saeed, Hammad Tahir, Muhammad Talha Ahmad Copyright (c) 2024 Amina Irfan, Umara Iftikhar Rana, Iqra Tul Hussain, Usman Saeed, Hammad Tahir, Muhammad Talha Ahmad https://creativecommons.org/licenses/by/4.0 https://jcmhlmc.com/index.php/medera/article/view/116 Wed, 17 Jan 2024 00:00:00 +0000 A Comparison of Ureterorenoscopy and Extra-Corporeal Shock Wave Lithotripsy for the Treatment Of Upper Ureteric Stone Measuring Less than 1cm. https://jcmhlmc.com/index.php/medera/article/view/129 <p><strong>Objective:</strong> To compare the efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureterorenoscopy (URS) in the management of upper ureteric stone measuring &lt;1cm.<br /><strong>Methodology</strong>: Randomized clinical trial (RCT) was conducted by targeting the patient admitted in <br />urology ward, Jinnah Hospital Lahorethrough a period of one year. A sample size of 132 patients <br />fulfilling inclusion criteria were selected by employing Non-probability consecutive sampling <br />technique was employed to select 132 (sample size) patients fulfilling inclusion criteria. Patients were <br />randomly allocated into two groups (66 in each group A&amp;B) using lottery method. In group-A, stones <br />were treated using ESWL, while in group-B, URS was performed, and stones were broken with <br />pneumatic energy. Data were analyzed using SPSS version 27, and a Chi-square test was conducted <br />to compare the proportions of qualitative variables, while an independent sample t-test was applied <br />to assess mean differences between two groups of quantitative variables. Asignificance level of ≤0.05 <br />was adopted for determining statistical significance.<br /><strong>Results:</strong> The sociodemographic profile of the two groups was comparable. It was seen that stone free <br />rate nextto first session was higher in URS (81.8%) as compared to ESWL (63.6%) which later <br />increased to 87.7% after completion of three session. The complaint of pain in ESWL was more as <br />compared to URS (22.7% vs 12.1% p= 0.05)while the differences betweenthe rate of complications like <br />fever, UTI, mucosal abrasion, hematuria or perforation were not statistically significant in both <br />group. (p&gt; 0.05)<br /><strong>Conclusion:</strong> ESWL outperforms URS for the treatment of upper ureteric stones measuring &lt;1cm in <br />terms of efficacy and safety.Although not statistically significant, ourfindings suggest that URS achieves <br />stone-free rates earlier than ESWL. However, according to our findings, ESWL is recommended as <br />the treatment of choice for the majority of patients due to better compliance.<br /><strong>Keywords:</strong> Extra-corporeal Shock Wave Lithotripsy, Nephrolithiasis, Ureterorenoscopy</p> Shabbir Hussain Chaudhry, Salman Arshad , Shah Jahan Ur Rehman, Arooj Ahmad, Syed Umar Farooq, M.Asad Saeed Copyright (c) 2024 shabbir Chaudhry, 2. Dr.Salman Arshad , 3. Dr.Shah Jahan Ur Rehman, 4. Dr.Arooj Ahmad, 5. Dr.Syed Umar Farooq, 6. Dr.M.Asad Saeed https://creativecommons.org/licenses/by/4.0 https://jcmhlmc.com/index.php/medera/article/view/129 Wed, 17 Jan 2024 00:00:00 +0000 Integration of Artificial Intelligence Technology in Medical Education https://jcmhlmc.com/index.php/medera/article/view/138 <p>Artificial Intelligence <strong>(</strong>AI) originating in the mid-twentieth century, replicates human thought processes using computer systems, integrating elements from various disciplines. Since 1955, AI applications have expanded rapidly, addressing educational challenges in the past decade, notably in medical education. A Web of Science search indicates a growing interest, reflected in increasing publications and citations over the last two decades. The surge highlights a recent uptick in AI utilization for research and development in medical education, including virtual inquiry systems, medical distance learning, and teaching video creation in medical schools.<sup>1</sup>Top of Form</p> <p>Medical education is a continuous learning process, spanning from undergraduate to postgraduate and specialty training, applicable to various healthcare professionals.<sup>2,3</sup> Recognizing the need to build on existing knowledge amid rapidly advancing technology, AI in medical education becomes crucial. AI holds potential in enhancing the non-analytical, humanistic aspects of medicine, aiding healthcare professionals in processing vast amounts of information and improving diagnostic capabilities.<sup>3</sup></p> Farhat Ijaz Copyright (c) 2024 Farhat Ijaz https://creativecommons.org/licenses/by/4.0 https://jcmhlmc.com/index.php/medera/article/view/138 Mon, 22 Jan 2024 00:00:00 +0000