Factors Affecting Clinical Performance among Pakistani Dental Students: A Cross-Sectional Study

Objective: To identify the factors affecting clinical performance among dental students and to help addressing these problems. Material and Methods: A cross-sectional study in which students of third and final year of dentistry participated. Data was collected from June 2022 till September 2022. Data was collected from the third and final year dental students of both public and private dental colleges within the Pakistan using a purposive sampling technique. Results: A total of 372 dental students participated in this study. Thirty eight (31.9%) students belonged to third year while 81 (68.1%) were final year students from government college. For the private dental college, 121 (47.8%) were third year students while 132 (52.2%) were final year students. Majority of the participants were males from both the colleges. 42.9% of government dental students and 26.5% of private dental students agreed on well-preparedness of clinical instructors. 5.5% from private and 21.0% from government dental colleges agreed that adequate personal protective equipment were present in clinical departments. Conclusion: From this study, it is concluded that there should be focus more focus on the factors to enhance clinical skills, supervision of students in clinical practice to help addressing the problems faced during learning and performance in a clinical environment, to produce self-confident, motivated, knowledgeable, skillful and a professional dental graduates

Burnout among Dental Students of Private and Public Dental Colleges in Pakistan - A Cross-Sectional Study

Objective: To assess the prevalence of burnout among dental students of public and private institutions in Khyber Pakhtunkhwa and Punjab, Pakistan. Material and Methods: A cross-sectional descriptive survey was conducted at five public and private dental institutions from June 2021 to May 2022. A validated twelve-item closed-ended Burnout Clinical Subtype Questionnaire was distributed among the dental students of two private and two public institutes in Pakistan. The research questions focused on demographic information and students\u27 academic experiences. Data analysis is presented through tables and descriptive methods. Results: A total of 274 dental undergraduate students - second (42.3%), third (35.4%), and final (22.3%) academic year participated in this study. The mean age of the respondents was 21.9, with the range of 20-26 years. Most participants were females (74.1%) compared to the males (25.9%). The findings for burnout syndrome among dentistry students and students in the private and public sectors were not significant. Conclusion: In the current study, burnout levels among dental undergraduates, both private and public, were low

MINOCA - A Rarity Of It\u27s Own And The Importance Of Cardiac MRI

Myocardial infarction with non-obstructive coronary arteries (MINOCA) disease is a diagnostic dilemma with clinical evidence of acute myocardial infarction (AMI) with normal coronary arteries. MINOCA is a complex issue; the management of the patients needs to be focused on identifying the core problem. Cardiac magnetic resonance (CMR) imaging is a non-invasive diagnostic tool that can play an important role in enabling clinicians to build a differential diagnosis in patients with MINOCA and also identify other non-ischemic aetiologies of myocardial injury. We present a challenging case of a patient with MINOCA with MI in small proximal septal artery distribution revealed on cardiac magnetic resonance imaging

Cystic Fibrosis - An Ever Evolving Challenge

Cystic fibrosis (CF) is a genetic disease that results from mutations in a large single gene located on chromosome 7. More than 2000 different mutations in the gene have been identified to have caused the disease. Most of these mutations are exceedingly rare and therefore not a part of CF screening or all testing panels. This case discusses an adult female with a history of asthma, bronchiectasis, pseudomonas colonization, and respiratory failure on chronic oxygen who presented to the ED with sudden onset shortness of breath, fever, chills, body aches, nonproductive cough, and headache. The patient\u27s condition clinically improved with treatment and was discharged on day three. The patient had previously undergone a laboratory evaluation of bronchiectasis. Due to the patient\u27s history of bronchiectasis and pseudomonas colonization, there was a decision to reconsider the possibility of CF. The patient underwent a routine cystic fibrosis genetic testing panel which subsequently confirmed a CFTR mutation. The discussion highlights the importance of remaining vigilant for signs of CF, to remain open to the possibility of CF or CFTR related disorders, when patients have had evaluations for such that predate current testing standards or capabilities

Student Involvement in Curriculum Development Enhances Medical Education

Background: During the 2014 annual review of the curriculum for first year medical students at the Medical College of Georgia, the public health module was noted as an area that needed improvement. To address this concern, a Public Health Curriculum Workgroup was formed for the purpose of identifying specific areas to improve and developing a more robust and integrative curriculum. A small cohort of medical students with public health backgrounds were invited to be members of this workgroup and participate in the development and delivery of public health content to the next cohort of first year medical students. We hypothesized that having this type of student participation results in a more clinically relevant and engaging curriculum. Methods: The curriculum workgroup met weekly to establish learning objectives, prioritize topics, and design interactive activities. The student members contributed to both curricular planning and content delivery. First year medical students completed course evaluations following the public health curriculum. These evaluations included five Likert scale questions and three narrative feedback response questions. Evaluation data before and after student involvement in the curriculum was examined. Results: Student evaluations of the overall quality of the public health curriculum increased 38% from 2014-2016. The measure of how well the content contributed to development as a future physician increased 36%. There was a 33% increase in how well the instructional materials aided understanding of topics. Theming of narrative evaluation comments showed that student involvement in the curriculum was well received. In 2016, 28.4% of narrative comments cited student presentations as the most valuable aspect of their public health experience. Conclusions: Involving medical students with public health backgrounds in curriculum development and content delivery of a public health module for first year medical students led to improvements in overall quality, clinical relevance, and instructional materials

Cocaine as a Rare Cause of Cholecystitis

Cholecystitis, inflammation of the gallbladder, is diagnosed in approximately 200,000 people in the US each year. Cocaine is an illicit drug that is wildly abused in the US, GI complications such as acute pancreatitis, colitis, bowel perforation, mesenteric ischemia, and biliary tree obstruction have been reported in limited studies. To the best of our knowledge, there are no reported cases of cocaine-induced cholecystitis and no established treatment plans to date, however, we strongly believe that our patient’s cocaine use resulted in cholecystitis. Hence, we wanted to shed some light on the possible side effects of cocaine on the gall bladder

The Frequency of Asymptomatic Sacroiliitis in Jordanian Patients with Crohn’s Disease. Assessment by Magnetic Resonance Enterography

Background: our aim was to assess frequency of asymptomatic sacroiliitis (SI) in patients with Crohns disease referred for magnetic resonant enterography (MRE) as a part of small bowel evaluation. Methods: this was a retrospective study of all patients with Crohns disease who were referred for MRE between January of 2016 to October of 2017 to Jordan University Hospital. All MRE were reviewed by an experienced radiologist and SI was diagnosed and graded based on predefined MRI criteria. All patients were contacted and assessed for symptomatic SI based on Assessment of SpondyloArthritis international Society (ASAS) criteria of 2009 for axial spondyloarthropathy. All patients were included in the final analysis.Results: a total of 60 patients were included, overall 18 (30%) showed evidence of SI, two patients were symptomatic and another two were diagnosed with ankylosing spondylitis as assessed by ASAS criteria. Those were excluded. Fourteen (23%) patients were included in the final analysis, with an average age of 36.7 years, 71% males. The average disease duration was 7.25 years. The percentage of ASA used by patients was 50%, Azathioprine 71%, Biologic agents in 36% in combination and single drug was used in 36% of patients.Conclusion: The prevalence of asymptomatic SI based on predefined MRI criteria was 23%, the importance of this finding and future course progression needs further studies

Assessment of Knowledge and Attitude of First Aid Management of Epistaxis among the General Population in Najran Region: A Cross-Sectional Study

Background: Nasal bleeding, epistaxis, is a common emergency. Few Saudi studies exist on epistaxis awareness and first aid management. We aimed to assess knowledge and attitude of adults in Najran, Saudi Arabia towards epistaxis first aid management, as well as their association with sociodemographic factors.Methods: A cross-sectional web-based survey was carried out involving general adults of Najran, Saudi Arabia, using a snowball sampling method. A pretested questionnaire was utilized for data collection. Knowledge and attitude scores were categorized as good/positive or poor/negative.  Both descriptive and inferential statistics were carried out with odds ratio (OR), 95% confidence intervals (CIs), and logistic regression analysis to investigate factors associated with knowledge and attitude towards epistaxis first aid management using SPSS Software.Results: The study included 518 participants with 58.9% experienced nosebleeds. Common causes were hypertension (24.5%) and nose injuries (23.7%). Factors as nasal dryness, blood thinner use, and tumors/nasal polyps were also identified. Around 60.2% believed first aid was necessary and 59.5% had good knowledge about epistaxis first aid management. Participants with university/higher education, employed in health sector, and with previous experience with nosebleed were more knowledgeable, more likely to have positive attitudes, and showed significantly higher ORs for knowledge and attitude scores compared to others.Conclusion: The study showed fair knowledge and attitude of Najran adults towards epistaxis first aid management with sociodemographic variables showing varying associations. Educational initiatives are needed especially for those with lower education, non-health sectors, and not experienced nosebleeds, to improve public first aid knowledge and attitudes.Keywords: Epistaxis; Knowledge; Attitude; First aid management; Saudi Arabia