Comparison between bipolar diathermy and silk ligation technique during tonsillectomy

Objective: to compare the use of bipolar diathermy and silk ligation in tonsillectomy with respect to operative time and post op hemorrhage, in our setting. Study design: randomized controlled trail. Place and duration of study: nishtar hospital, multan from May 2016 to May 2018.  Methodology: After consent, 234 patients of chronic tonsillitis of 5 to 35 year of age were selected as per inclusion and exclusion criteria. They were randomly divided in to two groups by using lottery method. In group A, tonsillectomy was done and suture ligation was applied for hemostasis. In group B, tonsillectomy was done and bipolar diathermy was used for hemostasis. Data was entered and analyzed by using SPSS software. Results: In our study, mean age was 13.84 + 5.83 years. Majority of patients 55.13% were between 5-15 years of age. Out of 234 patients, 71.37% were male and 28.63% were females. The mean operative time in group A was 29.45 + 9.71 minutes and in group B was 16.37 + 4.38 minutes with p-value <0.0001. Secondary hemorrhage was seen in 2.56% patients in group A (suture ligation group) and 10.56% patients in group B (Bipolar diathermy group) with p-value of 0.016. Conclusion: bipolar diathermy method of hemostasis in tonsillectomy is fast but associated with statistically increase risk of secondary hemorrhage compared to silk ligation. Keywords: tonsillectomy, silk ligation, bipolar diathermy, operative interval, secondary hemorrhage

Using “Pub Quiz” to promote participation and active learning in prospective teachers

It has become an established fact that wheneverr students and teachers are involved equally for learning purpose, the use of effective and innovative teaching strategies serve the purpose at its optimal level. Both active learning and classroom participation have been found influential by increasing classroom performance of the students. Having knowledge about the use of multiple teaching strategies and knowing ways to modify applicable strategies in attaining teaching objectives are sensitive, yet crucial to apply in classrooms especially when it is subjected to prospective teachers. The current study was aimed to explore the effect of pub quiz activities on active learning, classroom participation and academic performance of prospective teachers that emphasized the idea of integrating activities in teacher training programs. Sample of the study comprised 22 prospective teachers enrolled in Science course of one year degree program at a public teacher training institute. It was an experimental study that allowed integrating the use of multiple activities during eight weeks of running semester. A five point Likert type scale followed by an open ended questionnaire was used to measure the level of participation and active learning of prospective teachers; whereas their academic performance was measured through taking a test. Data was analyzed by using descriptive statistics and thematic analysis. The results supported the assumption of the study that integration of planned and relevant activities into teaching are not only helpful in pursuit of positively affecting the active learning, classroom participation and academic performance of prospective teachers but also helpfull in breaking the monotony of conventional ways of teaching and learning. The study recommended that adopting flexible use of activities accelerates learning process by ensuring active participation and learning on the part of students

Institutional Performance and Progress at Rawalpindi Medical College & Its Allied Hospitals 2014-16- A SWOT Analysis

Background: A SWOT (strengths, weaknesses,opportunities and threats) analysis of institutionalperformance and progress at Rawalpindi MedicalCollege and its Allied Hospitals during period of2014-16 was conducted.Methods: This cross sectional study using mixedquantitative and qualitative approach was conductedat Rawalpindi in December 2016 at RawalpindiMedical College and Rawalpindi Medical College(RMC) and its three Allied Hospitals Data wascollected through observation of all availableadministrative records and also through 30 in depthinterviews and 4 Focus group discussions withsenior administrative staff members, senior facultystaff members, Post Graduate Trainees of variousspecialties, nurses and paramedics, inpatients andundergraduates of RMC were carried out.Results: The salient features of progress at RMC &Allied hospitals were provision of new advanceddiagnostic and therapeutic equipment, induction ofnew personnel, initiation of new specialties,commencement of various programs for faculty, postgraduate training and academic and extracurricularprograms for undergraduates of RMC. Renovation ofvarious buildings at RMC & Allied hospitals alsotook place while Research capacity was enhancedswiftly. Weaknesses in various areas were alsoidentified in addition to all potential opportunitiesand threats.Conclusion: The performance and progress atRMC and Allied hospital during period 2014-16remained significant with few weaknesses too, byovercoming which, it can further strive forunparalleled quality in medical education

Assessment of musculoskeletal disorders among cricketers playing in domestic clubs of Lahore

Objective: To assess musculoskeletal disorders among male cricketers in an urban centre. Method: The cross-sectional study was conducted from October to November 2020 in Lahore, Pakistan, and comprised male cricket players aged 10-25 years playing in four domestic clubs. Data was collected about musculoskeletal disorders experienced during the preceding 12 months using the Extended Nordic Musculoskeletal Questionnaire. Data was analysed using SPSS 22. Results: Of the 89 players with a mean age of 19.24+3.12 years, 35(39.3%) were bowlers, 26(29.2%) were batsmen, 17(19.1%) were all-rounders, and 11(12.4%) were wicketkeepers. The anatomical distribution of disorder was lower-back 68(76.4%), shoulder 40(44.9%), neck 39(43.8%), upper-back 37(41.6%), knees 31(34.8%), ankle/feet 29(32.6%), thighs 27(30.3%), wrist/hands 18(20.2%), and elbows 17(19.1%). There were 22(24.7%) players who had at any time seen a doctor or a physiotherapist, while 24(27%) players had a history of taking sick leave. Conclusion: The most affected anatomical segments were lower-back, shoulder, knee, ankle and upper-back. Key Words: Musculoskeletal disorders, MSDs, Occupational health, Nordic musculoskeletal questionnaire extended version, NMQ-E

Factors Responsible for Delay in Initiation of Insulin Treatment in Type-2 Diabetes Mellitus Patients with Secondary Failure of Oral Hypoglycemic Agents

Background: To assess patients’ and physicians’ perceptions regarding factors responsible for delay of Insulin initiation and compared.Methods: In this cross sectional study using mixed quantitative and qualitative approach, quantitative component included structured interviews of 400 Type 2 Diabetic patients with failure to oral hypoglycemic agents (equally stratified based on gender and public or private health care settings) who had not initiated Insulin despite physicians advice. For qualitative aspect, 4 Focus group discussions with 29 consultant physicians of diabetic patients and four including 31 diabetic patients with delay were conducted. The factors responsible for delay and mean duration of delays were assessed and also compared based on gender and health care type.Results: The mean duration of diabetes in 400 patients was 12.91±3.78 years while the duration of delay in months was 23.08±14.62 months with highly statistically significant increase in female patients. Patients identified fear of injection or needle phobia as the commonest factor (24.62%), followed by fear of side effects of Insulin (18.87%). Consultant physicians in addition to same above factors also mentioned the role of quacks and fear of loss of patients by doctors as important factors.Conclusion: Factors identified by patients and physicians responsible for delay of initiation of insulin included perceptions of fears, difficult and lifelong application, cost, storage issues, last resort of treatment, misdirection from quacks and patients reluctance tempting doctors to hold up insulin till inevitable