Teaching paediatric critical care medicine to paediatric residents

Critical care training during paediatric residency provides an ideal opportunity to learn and refine the skills needed in the early recognition and prompt treatment of the acutely ill paediatric patients. Paediatric critical care medicine is a relatively young sub-specialty in Pakistan. The aim of this study is to describe our experience of teaching paediatric residents in paediatric critical care medicine during paediatric intensive care unit rotation. Our paediatric critical care teaching curriculum for residents is based on the spectrum of our common critical care problems along with basic principal of critical care. The clinical rotation in our paediatric intensive care unit is very dynamic, thrilling, enjoyable and provides a lot of learning opportunities. During the rotation, the residents were exposed to all major critical care illnesses in infants and children. We use four traditional models of learning in our Paediatric Intensive Care Unit (PICU): bedside rounds, direct patient care, didactic learning and self-study. Our curriculum enhances the resident\u27s educational and clinical experience of paediatric intensive care medicine

Investigation of Educational Language Policy of Pakistan: An Evaluative Study

Language policy and planning (LPP) is a mechanism of policy makers’ decisions and its implementation through documentational or non-documentational practices. This study has established stance around the term ‘Language Policy and Evaluation (LPE)’, which includes documents related to the language policy. The chief purpose of this study is to evaluate the policy planning with regards to evaluation of policy document ‘National Education Policy (NEP) 2017’, by applying proposed checklist on the basis of Haddad and Demsky’s (1995) framework for policy making and planning at macro-level Therefore, the current study has critically investigated: how educational Language Policy in Pakistan is designed. For the analysis purpose, the policy document was collected through online source. The findings of this study revealed that policy has mostly discussed the elements said by the modal at macro-level. The conclusion and educational implications of this study suggest stakeholders and researches for ELP assessment and evaluation for further development of policies and the field of study

An Insight into Different Strategies for Control and Prophylaxis of Fasciolosis: A Review

Fasciolosis is one of the important diseases of livestock and has zoonotic importance. Fasciolosis can cause huge economic losses due to decrease in milk and meat production, decreased feed conversion ratio, and cost of treatment. Treatment and prophylaxis strategies for Fasciola infection are formed based on epidemiological data. The control of Fasciola infection can be attained by treating the animals with active anthelmintics. The use of different combinations of anthelmintics with a possible rotation is more effective against immature as well as adult flukes. Control of the intermediate host (snail) is vital for the reduction of fasciolosis. Due to the rapid growth of snails, the eradication is quite difficult in waterlogged and marshy areas. The use of different grazing methods and treatment of grazing areas can also help to control fasciolosis. A variety of antigens generated by Fasciola spp. have been shown to protect against liver fluke infection. The crude antigens, excretory/secretory, and refined antigens and their combination can be used as prophylactic treatment for the control of fasciolosis. The use of any of the single or combination of these methods can be very effective for the control of fasciolosis

Fear of getting Covid-19: A challenge to elective surgical practice and ways to overcome

Background: Covid-19, a global pandemic has a huge impact on surgical practice. There is transmission risk of Covid-19 during the elective surgery and nowadays it is a part of informed consent process. This has an impact on patient decision making as it creates anxiety and fear. Objective: To evaluate patient experience (fear of getting Covid-19) from elective surgery and challenges of elective surgical practice and ways to overcome during this pandemic era. Methods: This study was an observational cross-sectional survey and it has been conducted in General Surgery Department of Dr Akbar Niazi Teaching Hospital, Islamabad, from May to August 2021 after approval of Institutional Review Board (IRB). Participants for elective surgery and their negative report of Covid-19 infection by polymerase chain reaction (PCR) were included in the study. Fear of Covid-19 infection was measured through “fear of Covid-19 scale” by Ahorsu et al and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 26 and analyzed. Effect modifier chi square was used to find out the patient’s dropout due to getting Covid-19 infection from surgery. Results: Total 200 patients were included; 62% patients were male and 38% were females. The mean age of the patients was 38.64±12.08 years. The statistical analysis showed that there was a very significant association between FCV-19 scale and getting Covid-19 infection from elective surgeries (p ≤ 0.05). When stratified FCV-19 scale with education status of all patients there was a very significant association between them (p=0.001). The patient’s observations regarding FCV-19 questionnaire, most of the patients were disagreed (46.3%) to getting Covid-19 infection from their elective surgeries or any fear of Covid-19 infection. The actual dropout of patients from elective surgery due to fear of getting Covid-19 infection during surgery or staying in hospital was 7.5%. Conclusion: Fear of getting Covid-19 is still present in some of the patients who visit hospitals for elective surgeries. Discussing the various steps taken by the institute to improve patient safety and minimize risk of Covid-19, greatly enhanced their confidence in elective surgery and improved satisfaction level. Key words: Covid-19; Fear; Fear of Covid-19 Scale; Elective Surgical Procedures

Epidemiology and Control of Congo Fever in Sacrificial Animals of Pakistan

The cases and deaths due to Crimean-Congo haemorrhagic fever (CCHF) [49] virus commonly known as Congo virus (fatality rate 15%) have been reported throughout Pakistan from the last five years especially during religious occasion, Eid-ul-Azha. The annual increase in death rates due to CCHF demonstrate the importance of awareness of Congo fever at academia as well as public level. The symptoms of Congo fever which appear one to nine days after tick bite, include sudden high fever, muscle aches, abdominal pain, headache, dizziness, sore eyes, jaundice, mood swings, confusion, aggression, and sensitivity to light. The other signs include sore throat, joint pain, vomiting, diarrhea, hemorrhages, and bleeding from skin and large intestine. The Infection has been reported in many species of wild as well as domestic animals including hares, cattle, sheep, goats, dogs, mice and hedgehogs. At least 31 species of Hyalomma, Boophilus, Rhipicephalus, Dermacentor (Ixodidae: hard ticks) act as vector of CCHF in which transovarial, transstadial and venereal transmission occurs. The virus attacks the immune system of the host and influences the immune cells. The Congo fever virus can be isolated from blood, plasma and many body tissues (kidneys, liver, spleen, lungs, brain and bone marrow). Mice inoculation, enzyme-linked immunosorbent assay (ELISA), reverse transcription polymerase chain reaction (RT-PCR) can be used for detection of the infection. Furthermore, IgM and IgG antibodies against CCHFV can also be detected and quantified. Education of general public, tick control with acaricides, use of anti-CCHFV immunoglobulin, usage of approved repellents to prevent tick bites, wearing neutral-coloured garments, application of a permethrin spray to the clothing, avoiding tall grasses and shrubs, applying sunscreen, avoiding direct contact with the blood or tissues of animals are the factors for successful prevention of the infection

Fear of getting Covid-19: A challenge to elective surgical practice and ways to overcome

Background: Covid-19, a global pandemic has a huge impact on surgical practice. There is transmission risk of Covid-19 during the elective surgery and nowadays it is a part of informed consent process. This has an impact on patient decision making as it creates anxiety and fear. Objective: To evaluate patient experience (fear of getting Covid-19) from elective surgery and challenges of elective surgical practice and ways to overcome during this pandemic era. Methods: This study was an observational cross-sectional survey and it has been conducted in General Surgery Department of Dr Akbar Niazi Teaching Hospital, Islamabad, from May to August 2021 after approval of Institutional Review Board (IRB). Participants for elective surgery and their negative report of Covid-19 infection by polymerase chain reaction (PCR) were included in the study. Fear of Covid-19 infection was measured through “fear of Covid-19 scale” by Ahorsu et al and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 26 and analyzed. Effect modifier chi square was used to find out the patient’s dropout due to getting Covid-19 infection from surgery. Results: Total 200 patients were included; 62% patients were male and 38% were females. The mean age of the patients was 38.64±12.08 years. The statistical analysis showed that there was a very significant association between FCV-19 scale and getting Covid-19 infection from elective surgeries (p ≤ 0.05). When stratified FCV-19 scale with education status of all patients there was a very significant association between them (p=0.001). The patient’s observations regarding FCV-19 questionnaire, most of the patients were disagreed (46.3%) to getting Covid-19 infection from their elective surgeries or any fear of Covid-19 infection. The actual dropout of patients from elective surgery due to fear of getting Covid-19 infection during surgery or staying in hospital was 7.5%. Conclusion: Fear of getting Covid-19 is still present in some of the patients who visit hospitals for elective surgeries. Discussing the various steps taken by the institute to improve patient safety and minimize risk of Covid-19, greatly enhanced their confidence in elective surgery and improved satisfaction level. Key words: Covid-19; Fear; Fear of Covid-19 Scale; Elective Surgical Procedures

Association of 25 Hydroxy Vitamin D Levels with Age in Community Acquired Pneumonia

Background : To determine association of 25 hydroxy vitamin D deficiency with age in patients with community acquired pneumonia (CAP). Methods: In this descriptive study 150 diagnosed patients of community-acquired pneumonia based on the CURB-65 scoring criteria were enrolled. The 25 hydroxy vitamin D levels were recorded in all patients. Patients were divided into three groups according to their age. Effect modifiers like gender were controlled by stratification. Post stratification chi square test was applied. A p value of 0.05 was considered significant. Results: Mean age of the patients was 40.05 ± 14.33 years (mean ± SD). Out of 150 patients 54.7% (n=82) were males while the 45.3% (n=68) were females. The mean level of vitamin D was 18.43 ± 5.005 (mean ± SD) ng/ml. When the cut off value for deficiency was applied i.e. 20 ng/ml, the 60% (n=90) patients were found deficient while 40% (n=60) patients had normal values. The p value was significant only for the age group to 35 to 50 years. Independent sample t test showed that the difference is statistically significant (p=0.003) in age groups between 35 to 50 years. Conclusions: Lower concentrations of vitamin D might be associated with CAP particularly in age group between 35 to 50 years