Risk Factors of Intracerebral Hemorrhage – A Cross Sectional Study

ABSTRACT Background and Objective: Stroke is the major cause of disability and one of the top causes of death in the globe. Though the rate is decreasing in the West, it is most likely growing in Asia. In Pakistan, the burden of stroke risk factors is substantial. Although data on the incidence and prevalence of stroke in Pakistan is limited, there are several published case studies demonstrating major disparities in stroke epidemiology, risk factors, kinds, and patterns. This study aims to identify risk factors of intracerebral hemorrhage among patients presenting to a teaching hospital. Methods: From August 2019 to February 2020, 103 patients from DHQ Teaching Hospital Abbottabad\u27s medical units participated in this prospective cross-sectional research. A CT scan of the brain was performed in all patients to identify intra cerebral hemorrhage and was used to diagnose cerebrovascular events. In patients with intracerebral hemorrhage, detailed histories and medical records were thoroughly examined in order to identify risk factors such as uncontrolled hypertension. To detect poorly managed diabetes and hyperlipidemia, fasting blood glucose, fasting serum cholesterol, and fasting triglycerides were measured. SPSS 20 was used to evaluate the data obtained on a standardized proforma. Results: The majority of the patients (n=41) were over 70 years old, with 71 (68.93%) males and 32 (31.07%) females. Intracerebral hemorrhage was reported in 8.74 percent (n=9) of patients with acute cerebrovascular accidents, with 66.67 percent (n=6) having uncontrolled hypertension, 44.44 percent (n=4) having diabetes, and 33.33 percent (n=3) having hyperlipidemia. Conclusion: Intracerebral hemorrhage is prevalent in individuals who have had a cerebrovascular accident, and hypertension is the most common risk factor for this consequenc

Albuminuria in diabetic patients with stroke.

Diabetes is a major health burden worldwide. There is a close association between albuminuria and development of stroke in diabetics. This study was conducted to determine the frequency of albuminuria among diabetic patients presenting with strok

Blending Old and New Teaching Methods and Tools in Medical Education

OBJECTIVES To identify a preference for current teaching methods and use new teaching aids through feedback by medical students and teachers of first and second-year MBBS. METHODOLOGY This cross-sectional study was conducted on 91 MBBS students and teachers of Nowshera Medical College (NMC), Nowshera. Both male and female students and teachers of NMC of class first and second-year MBBS participated in the study. A feedback proforma-based questionnaire was filled out by all the participants online using Google forms. Participants were given the option to select more than one option in the case of the mode of teaching and tool of teaching. The data was collected, analyzed and presented in tabular and graphical forms using SPSS version 23. RESULTS Out of the 91 participants who responded to our research, 45 (49.5%) were males, and 46(50.5%) were female. The majority, 74 (81.3%), were MBBS students, while 17(18.7%) were MBBS teachers. Most of the participants selected more than one option. Most 48(52.7%) of the participants preferred lectures as the mode of delivery while 35(38.4%) opted for SGD, for demonstrations 14(15.3%), PBL 33(36.2%), assignments 13(14.2%0 and notes opted by 4(4.39%). 60.4% (55) were selected to use whiteboards and markers. Only 15.3% (14) were in favour of Powerpoint use, dissection 25(27.4%), models 29(31.86%), and figures 11(12%). CONCLUSION Lectures remain the most preferred teaching method in basic medical sciences among teachers and students, along with other teaching methods. Multiple teaching tools must be used during the class instead of solely depending on Powerpoint presentations

Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence of type 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan

Objectives: We conducted a Pakistan-wide community-based survey on the prevalence of type 2 diabetes using glycated haemoglobin (HbA1c) as the screening test. The aim was to estimate diabetes prevalence across different demographic groups as well as all regions of Pakistan. Design, settings and participants: Multistaged stratified cluster sampling was used for the representative selection of people aged ≥20 years, residing in 378 sampled clusters of 16 randomly selected districts, in this cross-sectional study. Eligible participants had blood drawn for HbA1c analyses at field clinics near to their homes. The oral glucose tolerance test (OGTT) was conducted on a subsample of the participants. Overall and stratified prevalence of type 2 diabetes and its association with risk factors were estimated using logistic regression models. Main outcome measures: Prevalence of prediabetes and type 2 diabetes. Results: Of 18 856 eligible participants the prevalence of prediabetes was 10.91% (95% CI 10.46 to 11.36, n=2057) and type 2 diabetes was 16.98% (95% CI 16.44 to 17.51, n=3201). Overall, the mean HbA1c level was 5.62% (SD 1.96), and among newly diagnosed was 8.56% (SD 2.08). The prevalence was highest in age 51–60 years (26.03%, p\u3c0.001), no formal education (17.66%, p\u3c0.001), class III obese (35.09%, p\u3c0.001), family history (31.29%, p\u3c0.001) and female (17.80%, p=0.009). On multivariate analysis, there was a significant association between type 2 diabetes and older age, increase in body mass index and central obesity, positive family history, and having hypertension and an inverse relation with education as a categorical variable. On a subsample (n=1027), summary statistics for diagnosis of diabetes on HbA1c showed a sensitivity of 84.7%, specificity of 87.2% and area under the receiver operating characteristic curve 0.86, compared with OGTT. Conclusions: The prevalence of type 2 diabetes and prediabetes is much higher than previously thought in Pakistan. Comprehensive strategies need to be developed to incorporate screening, prevention and treatment of type 2 diabetes at a community level

Depression, Anxiety and Stress using Depression, Anxiety, and Stress Scoring System (DASS-21) Among the Students of Women Medical and Dental College Abbottabad, Pakistan

Objective: To determine the frequency of stress, anxiety, and depression among medical students using DASS21 scoring system. Study Design: Cross sectional survey. Place and Duration of Study: Women Medical and Dental College Abbottabad from 1 February 2023 to 31 July 2023. Materials and Methods: A sample, containing 140 students, was included in the study after receiving ethical approval from the medical college. Twenty-eight medical students each from the first year to the fifth year were contacted by using simple random sampling technique and were each given a Depression, Anxiety and Stress Scale (DASS-21). The questionnaire used in this study had two parts: a sociodemographic one that asked students about their age, year of study, relationship with family, health status, time they spent on social media, personalities, socioeconomic class, academic performance, and DASS scale, the second part of the questionnaire.The data was analyzed using the IBM SPSS (version 26.0, Armonk, NY, USA). Results: Anxiety was found in 85% of students (17% mild, 31% moderate, 15% severe, and 22% extremely severe). A total of 52% of students reported having depression (15% mild, 19% moderate, 11% severe, and 7% extremely severe). Forty-two percent of the medical students were stressed (15% mild, 12% moderate, 13% severe, and 2% extremely severe). Conclusion: A high occurrence of anxiety, followed by depression and stress, was found among medical students, affecting their academic performance and social well-being

Evaluation of internet access and utilization by medical students in Lahore, Pakistan

<p>Abstract</p> <p>Background</p> <p>The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become an important tool for healthcare professionals training but the data on its use by medical students in developing countries is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the pattern of internet access and utilization by medical students in Pakistan.</p> <p>Methods</p> <p>A structured pre-tested questionnaire was administered to a group of 750 medical students in clinical years studying at various public and private medical colleges in Lahore. The questions were related to patterns of internet access, purpose of use and self reported confidence in performing various internet related tasks, use of health related websites to supplement learning and the problems faced by students in using internet at the institution.</p> <p>Results</p> <p>A total of 532 medical students (70.9%) returned the questionnaire. The mean age of study participants was 21.04 years (SD 1.96 years). Majority of the respondents (84.0%) reported experience with internet use. About half of the students (42.1%) were using internet occasionally with 23.1%, 20.9% and 13.9% doing so frequently, regularly and rarely respectively. About two third of the students (61.0%) stated that they use internet for both academic and professional activities. Most of the participants preferred to use internet at home (70.5%). Self reported ability to search for required article from PubMed and PakMedinet was reported by only 34.0% of the entire sample. Students were moderately confident in performing various internet related tasks including downloading medical books from internet, searching internet for classification of diseases and downloading full text article. Health related websites were being accessed by 55.1% students to supplement their learning process. Lack of time, inadequate number of available computers and lack of support from staff were cited as the most common problems faced by students while accessing internet in the institution premises. There were significant differences among male and female students with respect to the place of internet use (p = 0.001) and the ability to search online databases for required articles (p = 0.014).</p> <p>Conclusions</p> <p>Majority of the medical students in this study had access to internet and were using it for both academic and personal reasons. Nevertheless, it was seen that there is under utilization of the potential of internet resources to augment learning. Increase in awareness, availability of requisite facilities and training in computing skills are required to enable better utilization of digital resources of digital resources by medical students.</p

Prevalence of Trachoma in Pakistan: Results of 42 Population-Based Prevalence Surveys from the Global Trachoma Mapping Project.

Purpose: Previous phases of trachoma mapping in Pakistan completed baseline surveys in 38 districts. To help guide national trachoma elimination planning, we set out to estimate trachoma prevalence in 43 suspected-endemic evaluation units (EUs) of 15 further districts.Methods: We planned a population-based trachoma prevalence survey in each EU. Two-stage cluster sampling was employed, using the systems and approaches of the Global Trachoma Mapping Project. In each EU, residents aged ≥1 year living in 30 households in each of 26 villages were invited to be examined by trained, certified trachoma graders. Questionnaires and direct observation were used to evaluate household-level access to water and sanitation.Results: One EU was not completed due to insecurity. Of the remaining 42, three EUs had trichiasis prevalence estimates in ≥15-year-olds ≥0.2%, and six (different) EUs had prevalence estimates of trachomatous inflammation-follicular (TF) in 1-9-year-olds ≥5%; each EU requires trichiasis and TF prevalence estimates below these thresholds to achieve elimination of trachoma as a public health problem. All six EUs with TF prevalences ≥5% were in Khyber Pakhtunkhwa Province. Household-level access to improved sanitation ranged by EU from 6% to 100%. Household-level access to an improved source of water for face and hand washing ranged by EU from 37% to 100%.Conclusion: Trachoma was a public health problem in 21% (9/42) of the EUs. Because the current outbreak of extremely drug-resistant typhoid in Pakistan limits domestic use of azithromycin mass drug administration, other interventions against active trachoma should be considered here

Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence of type 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan

Objectives: We conducted a Pakistan-wide community-based survey on the prevalence of type 2 diabetes using glycated haemoglobin (HbA1c) as the screening test. The aim was to estimate diabetes prevalence across different demographic groups as well as all regions of Pakistan. Design, settings and participants: Multistaged stratified cluster sampling was used for the representative selection of people aged ≥20 years, residing in 378 sampled clusters of 16 randomly selected districts, in this cross-sectional study. Eligible participants had blood drawn for HbA1c analyses at field clinics near to their homes. The oral glucose tolerance test (OGTT) was conducted on a subsample of the participants. Overall and stratified prevalence of type 2 diabetes and its association with risk factors were estimated using logistic regression models. Main outcome measures: Prevalence of prediabetes and type 2 diabetes. Results: Of 18 856 eligible participants the prevalence of prediabetes was 10.91% (95% CI 10.46 to 11.36, n=2057) and type 2 diabetes was 16.98% (95% CI 16.44 to 17.51, n=3201). Overall, the mean HbA1c level was 5.62% (SD 1.96), and among newly diagnosed was 8.56% (SD 2.08). The prevalence was highest in age 51–60 years (26.03%, p&lt;0.001), no formal education (17.66%, p&lt;0.001), class III obese (35.09%, p&lt;0.001), family history (31.29%, p&lt;0.001) and female (17.80%, p=0.009). On multivariate analysis, there was a significant association between type 2 diabetes and older age, increase in body mass index and central obesity, positive family history, and having hypertension and an inverse relation with education as a categorical variable. On a subsample (n=1027), summary statistics for diagnosis of diabetes on HbA1c showed a sensitivity of 84.7%, specificity of 87.2% and area under the receiver operating characteristic curve 0.86, compared with OGTT. Conclusions: The prevalence of type 2 diabetes and prediabetes is much higher than previously thought in Pakistan. Comprehensive strategies need to be developed to incorporate screening, prevention and treatment of type 2 diabetes at a community level

Rapid Assessment of Avoidable Blindness Dataset: Pakistan, Khyber Pakhtunkhwa, Mansehra (2016)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde

Rapid Assessment of Avoidable Blindness Dataset: Pakistan, Khyber Pakhtunkhwa, Swabi (2016)

Anonymous participant level dataset including variables for visual acuity, spectacle use, lens status, cause of vision impairment, cataract surgical history, barriers to cataract surgery and population count data for five-year age-gender groups for males and females 50 years and olde