bluuebunny/crossref_metadata_2025 huggingface dataset:
Online versus Conventional Paper Based Formative Assessment: Do They Predict Summative Scores?
Authors: Azam Fahad , Irshad Khurram , Shaheen Abida , Moin Hira , Javed Nismat , Ahmer Hania
Published: July 2024

Background: Different mechanisms and methods to conduct formative assessments may influence the learning environment and the learning outcomes. Present study aims to compare the effect of online formative assessments with conventional paper-based formative assessments on summative scores of medical students. Methods: This prospective-observational study was conducted from Oct to Dec 2018 at Shifa College of Medicine, Islamabad. A total of 93 undergraduate students were included. Students were assigned two online formative assessments before the summative assessment of one module and two paper-based formative assessments before the summative assessment of another module. ClassMarkerþ software was used for online assessments. Data were analysed on SPSS-21. Comparison of quantitative data was done using paired t-test and student’s t-test. Association between performance in online and paper-based formative assessment to their respective summative scores was performed by Pearson’s correlation coefficient and regression analysis, and p?0.05 were considered significant. Results: Mean summative score (75.17±9.18) of the module with online formative assessments was significantly higher in comparison to the mean summative score (63.66±10.12) of the module with paper-based formative assessments. Students who performed better in online formative assessments had significantly higher scores in the summative assessment in comparison to the other students. There was a significant (p<0.001) and positive (r=0.45) correlation between scores of online formative tests and summative tests. Conclusion: Online formative assessments have a positive effect on the summative scores of medical students in comparison to the conventional paper-based formative assessments.
Pak J Physiol 2021;17(1):46?50
Prognostic categorization of primary myelofibrosis patients of Khyber Pakhtunkhwa
Authors: Humayun Sidra , Farooq Ghulam , Ali Mohsin , Mehwish Alina , Anwar Ghulam Rabbani , Shereen Muhammad Irfan
Published: July 2024

Background: Primary myelofibrosis (PMF) is a least common type of myeloproliferative neoplasm (MPN) and is clonally derived stem cell disorder classified as Philadelphia chromosome negative MPN. The Dynamic International Prognostic Scoring System (DIPSS) utilizes five variables including age, haemoglobin level, white blood cells count, peripheral blood blasts and other symptoms for characterization of myelofibrosis patients. The objective of this study was to categorize primary myelofibrosis patients of Khyber Pakhtunkhwa. Methods: This cross-sectional analysis was carried out from June 2018 till May 2019. Blood samples and other information were collected from 50 PMF patients enrolled at the assigned health care facilities of Peshawar. Non-probability convenience sampling technique was used, and an informed and written consent was obtained from the participants. DIPSS was utilized for the prognostic categorization of PMF patients. Results: Majority (26, 52%) of the patients were in the age group II (41–60 years) and most (34, 68%) of them were male. Participants were categorized into four risk groups (low, intermediate-1, intermediate-2, and high) by applying DIPSS scoring system. Among the 50 patients, 3 (6%) were in low-risk group, whereas only one was in the high-risk group. Thirteen (26%) patients fell in intermediate-1 risk category and 33 (66%) were placed in the intermediate-2 risk group. Conclusion: Most of the myelofibrosis patients in Peshawar fall in intermediate-risk group while small percentage was included in high-risk group.
Pak J Physiol 2021;17(1):8–11
Early postoperative complications of cataract surgery in diabetic patients
Authors: Islam Sanam Munawar Ul , Pahuja Mukesh , Mirza Azfar , Mahesar Mona Liza , Maree Ghazi Khan , Bhatti Urooj
Published: July 2024

Background: Progressions in technology and expertise has made cataract surgery a common and safe procedure now but this might be associated with early postoperative complications in diabetics. The objective of this study was to determine the occurrence of early postoperative complications after cataract surgery among diagnosed cases of diabetes mellitus. Methods: This clinical observational analytical study was carried at Department of Ophthalmology, Liaquat University Eye Hospital, Jamshoro from May to Oct 2018. Diagnosed diabetic patients who underwent cataract surgery, were enrolled for this study. The patients with early senile cataract and diagnosed cases of diabetes mellitus with normal arterial pressure and better macular function were included. Patients were enquired for early postoperative findings after cataract surgery. Data was analysed using SPSS-22. Mean±SD for quantitative variables and frequency (%) for qualitative were calculated. Results: Total 91 diabetic patients were included in the study. Early postoperative complications of cataract surgery in diabetic patients were compared according to duration of diabetes mellitus. Visual acuity of most patients remained between 6/6 and 6/24. Diabetics for >5 years were more prone to early postoperative complications as compared to those with <5 years. Statistically significant differences between early postoperative complications in the two groups were observed (p=0.01). Conclusion: Though frequency of complications after cataract surgery has decreased due to advances in surgical techniques, better preoperative assessment, and understanding of diabetes control, still early postoperative complications are common in individuals with longer duration of diabetes.
Pak J Physiol 2021;17(1):12–4
PERCEIVED STIGMA, FAMILY SUPPORT AND QUALITY OF LIFE AMONG CAREGIVERS OF FEMALE PATIENTS WITH SCHIZOPHRENIA DISORDER
Authors: Iqbal Rehmina , Majeed Sana
Published: July 2024

Background: Family caregivers of persons with schizophrenia experience high level of poor quality of life be causes, Schizophrenia is severe mental illness which leads long term decline in person overall functional competence, alters communication patterns in the family, leads to occupational difficulties, and puts a load on the family caregivers. This study was done to examine how stigma and quality of life correlate with each other, and to determine impact of family support on quality of life of schizophrenia patients. Methods: Purposive sampling technique served sample recruitment of 200 caregivers of female patients with schizophrenia and correlational research design was used to analyse data. Devaluation of Consumer Family Scale, Perceived Social Support from the Family Scale, and WHO Quality of Life Scale were used as tools for data collection. Descriptive statistics, Pearson product moment co-relational analysis and hierarchal regression analysis were practiced for data analysis. Results: Significant negative relationship was found between perceive stigma and quality of life sub scales (Physical, Psychological and Environmental). Significant positive correlation between familial support and Quality of Life sub scales (Physical, Psychological and Environmental) was found among caregivers of women with schizophrenia. No significant differences were found between males and females with reference of quality of life. Conclusion: Stigma and quality of life are negatively associated while family support is positively associated with quality of life. Perceived stigma and family support were significant predictors of Quality of Life.
Pak J Physiol 2021;17(2):42–5
COMBINED EFFECTS OF AGING AND OBESITY ON SERUM TESTOSTERONE LEVELS OF OTHERWISE HEALTHY MALES OF SOUTH PUNJAB
Authors: Hassan Hamid , Abdullah Muhammad , Ahmad Muhammad , Muzammil Muhammad , Humayun Zunairah , Khan Mariyam , Zaidi Mehreen , Khan Saadat Ali
Published: July 2024

Background: Aging men experience gradual decline in serum testosterone levels (andropause) which is accentuated if aging is coupled with obesity. This study aimed to note the age and obesity related testosterone decline in men. Methods: It was a cross-sectional study comprising of 80 healthy male subjects categorized into younger (20–40 years) and elder (41–60 years) groups which were equally divided into non-obese and obese subgroups. Serum testosterone levels were measured using ELISA. Results: Serum testosterone levels (ng/dl) of young non-obese subjects (Group A) were significantly higher [680 (575.0–778.5)] as compared to their elder (Group B) [286.0 (263.5–370.0)] counterparts (p=0.000), and so was true for comparison between (Group C) younger [412.5 (338.0–542.5)] and (Group D) elder obese subjects [258.0 (220.0–287.5)] (p=0.000). Serum testosterone levels of obese elder subjects (group D), though lower than their age and ethnicity matched non-obese (Group B) counterparts, were not statistically significant (p=0.114). Moreover, serum testosterone levels of non-obese (Group A+B) subjects were negatively correlated to Waist Circumference (WC) and Waist Hip Ratio (WHR) [(rho= -0.374, p=0.018) and (rho= -0.355, p=0.025) respectively] while within obese subjects (Group C+D) serum testosterone levels were negatively correlated to waist circumference only [(rho= -0.643, p=0.000)]. Conclusion: Circumferential obesity coupled with aging results in a steeper decline in serum testosterone levels which can puts obese aging men at high risk of systemic disorders.
RELATIONSHIP OF BODY MASS INDEX AND WAIST HIP RATIO WITH SCORES OF DEPRESSION, ANXIETY AND ACADEMIC PERFORMANCE IN FEMALES
Authors: Hassan Hamid , Abdullah Muhammad , Naseer Hafsa , Mahmood Amna , Siddiqui Maria , Ayub Naveera
Published: July 2024

Background: Enhanced adipose tissue is likely to affect an individual’s mental health. This study aimed to link its indices (BMI/WHR) with indices of depression/anxiety in female medical students. Methods: One hundred and six female medical students were equally divided into non-obese (BMI?24.9+WHR<0.8) and obese (BMI>24.9+WHR?0.8) groups. Depression/anxiety scores were calculated using Aga Khan University Anxiety Depression Scale (AKUADS), Beck’s Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) while last exam percentage was considered as an indicator of academic performance. Results: AKUADS and BDI scores of obese subjects were higher than those of non-obese subjects (p=0.018 and p=0.030 respectively) while academic score of obese subjects was lesser than that of non-obese subjects (p<0.0001). Within non-obese and obese subjects, and within total study population AKUADS scores were positively correlated to BMI and WHR (rho=0.39, p=0.00), (rho=0.38, p=0.00), (rho=0.36, p=0.00), (rho=0.38, p=0.00) and (rho=0.35, p=0.00), (rho=0.35, p=0.00) respectively. BDI scores within non-obese group, obese group, and in total population were positively correlated to BMI and WHR too (rho=0.40, p=0.00), (rho=0.40, p=0.00), (rho=0.32, p=0.01), (rho=0.34, p=0.01), and (rho=0.30, p=0.00), (rho=0.31, p=0.00) respectively. AKUADS and BDI scores had a negative correlation with academic score in both non-obese and obese subjects (rho= -0.29, p=0.03), (rho= -0.30, p=0.02), and (rho= -0.44, p=0.00), (rho= -0.35, p=0.00) respectively. Conclusion: Within obese female medical students enhanced degree of depression/ anxiety affects academic performance considerably; this calls for shrewder monitoring of their mental wellbeing.
ENDOSCOPIC SPECTRUM OF OESOPHAGEAL FINDINGS PRESENTING WITH DYSPHAGIA
Authors: Naveed Shabnam , Nageen Ayesha , Rani Priyanka , Ahmed Syed Masroor , Ali Zeeshan
Published: July 2024

Background: The causes of dysphagia may represent chronic benign disorders to life threatening oesophageal neoplasia. The first line investigation in evaluation of dysphagia is upper gastrointestinal endoscopy.  The objective of the study was to observe the oesophageal endoscopic findings in patients presenting with dysphagia and their correlation with age and gender. Methods: This cross-sectional study was conducted in Jinnah Postgraduate Medical Centre, Karachi, from 2017 to 2019. Adult patients who had their chief complaint as dysphagia underwent endoscopy and their findings were noted on a pre-designed proforma. The findings were analysed on SPSS-22. Results: Out of 242, patients, males were 102 (42%) and females were 140 (58%). Among them 19 (8%) were in the age group of 18–20 years, 103 (42.5%) between the ages of 21–40 years, 81 (33.5%) in the ages of 41–60 years and 39 (16%) in the age group of 61 years and above. Pharyngeal growth was seen in 27 (11%) patients. The commonest pathology in oesophagus was oesophageal growth (58, 24%). With respect to age group, oesophagitis was more common between the ages 18–20 years while oesophageal growth was more prevalent in all age groups above 18 years. With respect to gender, oesophageal web/stricture was twice more in females while the oesophageal growth frequency was nearly equal in both genders. Conclusion: There is high frequency of oesophageal growth among all age groups and is alarming. In patients with dysphagia, endoscopic evaluation for early detection is crucial.
AMELIORATING EFFECT OF ZINC ON PROTEIN SUPPLEMENT INDUCED DNA AND SPERM DAMAGE IN MALE SPRAGUE DAWLEY RATS
Authors: Safdar Saira , Ali Shazia , Fayyaz Hummaira , Munir Hina , Majeed Sana , Atif Fozia , Jabeen Sidra
Published: July 2024

Background: Oxidative stress induced DNA damage and impairment in testicular tissue histology are indicative of male infertility. The aim of this study was to evaluate the protective role of Zinc on Protein supplement induced damage to the DNA and testicular tissue histology. Methods: The study comprised a total 30 male Sprague Dawley rats divided into Group 1 (n=10) fed on standard laboratory food, Group 2 (n=10) fed on standard laboratory food and dietary supplement powder and Group 3 (n=10) fed on standard laboratory food, dietary supplement powder and Zinc. Serum levels of 8-hydroxy-2?-deoxyguanosine were estimated with ELISA. Testicular Tissue histology was examined for Spermatogenic cells, size of seminiferous tubules and lumen of seminiferous tubules. Results: Mean±SEM of serum 8-hydroxy-2?-deoxyguanosine (8-OHdG) levels in Group-2 rats was significantly increased (p<0.05) as compared to Group 1 rats. While Mean±SEM of serum 8-hydroxy-2?-deoxyguanosine (8-OHdG) levels of Group 3 rats was significantly decreased (p<0.05) as compared to Group 2 rats. There was no significant difference in Mean±SEM of serum 8-hydroxy-2?-deoxyguanosine (8-OHdG) levels between Group-1 and Group-3. Evident pathological changes were seen in the testicular tissue of the Group-2 rats, characterized by atrophic seminiferous tubules with reduced number of spermatogenetic cells and widening of lumen. Rats of Group 3 received Zinc supplement and showed normal seminiferous tubules with increased number of mature spermatozoa in their lumen. Conclusion: Soy protein and silicon dioxide induce DNA damage and destroys testicular tissue. Zinc has potential to restore the DNA damage and testicular tissue structure.
Pak J Physiol 2021;17(3):22?6
FREQUENCY OF HEPATITIS B AND C VIRUS IN SURGICAL PATIENTS IN A TERTIARY CARE HOSPITAL OF MUZAFFARABAD
Authors: Gilani Irum , Kayani Ziyad Afzal , Awan Sarmud Lateef , Sabir Farzana , Akhter Naheed , Naqvi Syed Zakir
Published: July 2024

Background: Hepatitis B and C, parenterally transmitted diseases are major health problems all over the world especially in the developing countries. Patients presenting in different hospitals are not routinely screened for hepatitis B and C if they are not symptomatic. Since majority of carriers are asymptomatic, they create a real threat to health staff through self pricks, and other patients who share the same surgical instruments. Objective of this study was to assess the extent of hepatitis B and C in hospitalized surgical patients. Methods: This study, a cross-sectional survey, was carried out in Department of Surgery, Abbas Institute of Medical Sciences Muzaffarabad, from June to December 2018. Sample size was calculated using WHO sample size calculator for cross-sectional surveys. Non-probability convenient sampling technique was used. Results: Out of the total 100 patients included in this study, there were 54 (54%) males and 46 (46%) females, with ages ranging from 20 to 70 years. Three percent (3%) patients were hepatitis B positive while 12% were hepatitis C positive. Highest frequency of hepatitis C was seen in the age group 61–70 years, while hepatitis B patients were one each in age group of 20–30 years, 41–50 years, and 51–60 years. Conclusion: The frequency of hepatitis B surface antigen and hepatitis C virus in patients undergoing surgery is increasing which is a public health concern. There is an urgent need to implement infection control practices and preventive measures.
HAEMATOLOGICAL AND BIOCHEMICAL EFFECTS OF TRANSFUSION OF STORED BLOOD IN TRANSFUSION-DEPENDENT THALASSEMIA PATIENTS
Authors: Humayun Sidra , Farooq Ghulam , Farid Nayab , Asmat Sara , Mehwish Alina , Ali Mohsin
Published: July 2024

Background: Thalassemia is a genetic disease in which there is an imbalance in the synthesis of globin polypeptide chains. The current study aimed to determine the haematological and biochemical effects of transfusion of seven days stored blood in transfusion-dependent thalassemia patients. Methods: A quasi-experimental study was conducted between January and July 2021 at Muhammad College of Medicine, Peshawar. A total of 20 transfusion-dependent thalassemia patients were selected. The impact of transfusion of 7-days old blood on haemoglobin levels, serum LDH, serum electrolytes, serum-free haemoglobin, serum bilirubin, serum-free iron, serum ferritin, and C-reactive protein were measured. Variations in pre-transfusion and post-transfusion samples were determined using paired-samples t-test, and p<0.05 was considered significant. Results: There was a non-significant difference in increase of haemoglobin levels (p=0.543) after transfusion of fresh and stored blood. Similarly, RBC counts, MCV, MCH, MCHC showed a slightly lower increase as compared to fresh blood. No differences were seen in platelet count between the two groups. However, the rise in white cells was significantly higher after transfusion of 7-days stored blood as compared to fresh blood (p=0.002). A non-significant increase in post-transfusion LDH (p=0.13), direct bilirubin (p=0.76) and indirect bilirubin (p=0.45) was seen. No differences in creatinine, glucose, and uric acid variations were found. Levels of C-reactive protein showed a significantly higher raise when 7-days stored blood was transfused in comparison with fresh blood (p=0.012). Conclusion: At least seven days stored blood can be safely transfused to transfusion-dependent thalassemia patients.
ROLE-PLAY: A SIMULATED TEACHING TECHNIQUE IN PHYSIOLOGY
Authors: Khan Huma Saeed , Sheikh Naveen Siddique
Published: July 2024

Background: Simulation is an artificial representation of a situation to facilitate learning without the risks inherent in a similar real-life experience. Role-play is one type of simulation that focuses attention on the interaction of students in scripted scenarios. In the process, students learn about that patient or given situation. This study was conducted with an aim to record the response of undergraduates to role-play of clinical scenarios and to have their feedback. Methods: Two clinical topics were selected from second-year MBBS Physiology syllabus and assigned to two groups of students, having 7 students each. Case scenarios were formulated; scripted and roles were divided among students. Role-play of each scenario was followed by a presentation on the pathophysiology. Student feedback was recorded and analysed. Results: Out of the 137, 56 (40.88%) were male and 81 (59.12%) were female students who participated in the study, 50.4% considered role-play alone as a useful learning tool whereas 94.9% agreed that if role-play is combined with a multimedia tool then it is useful for learning (?2=110.43, p<0.001). 95.9% said that role-play is enjoyable (?2= 114.07, p<0.001) and 97.1% said that it is a good technique to improve communication skills (?2= 121.46, p<0.001). Regarding future interest in more role-play scenarios, 56.9% of the study participants said they will be very interested. Conclusion: Hence, concluded that with careful planning and utilization of resources, role-play has the potential to be incorporated in the teaching of clinical scenarios to undergraduates to promote learning.
Pak J Physiol 2021;17(4):46–50
CLINICAL SPECTRUM AND OUTCOME OF CHILDREN PRESENTING WITH POISONING TO TERTIARY CARE HOSPITAL
Authors: Shah Sajid Hussain , Alia Bibi , Muhammad Khyal , Raza Muhammad Ali , Najeeb Shahzad
Published: July 2024

Background: Accidental poisoning is one of the important emergencies in children. The objective of this study was to enlighten the clinical spectrum and outcome of poisoning in children presenting to a tertiary care hospital. Methods: This retrospective study was done in one of tertiary care hospitals, from Jan 2018 to Dec 2019. Retrieved from data, children of either sex aged from one month to 13 years admitted with diagnosis of accidental poisoning were included. Patients’ age, sex, poisoning product, presenting symptoms to hospital and outcome from hospital as discharge, expired, transfer out, or left against medical advice were documented. Analysis of data was done using SPSS-20 and p<0.05 was taken as significant. Results: There were 51 patients, 33 (64.7%) males and 18 (35.3%) females. Patients’ mean age was 4.24±3.6 years (Range: 1 month to 13 years). Children up to two years of age accounted for 45.1% of patients. The majority (41.2%) of poisoning was due to organophosphorus compounds. Opioids were major type of poisoning in younger children. Most common clinical presenting feature was vomiting and diarrhoea in 45.1% patients followed by the other presenting feature of respiratory difficulty which was present in 21.6% patients. Antidote was given in 68.6% patients. Out of 51 patients, 45 (88.2%) got discharged, 4 (7.8%) expired while 2 (3.9%) were transferred to other hospitals. Conclusion: Young male children are more at risk of poisoning. Organophosphorus compounds are leading cause of poisoning and the most common presentation is with vomiting and diarrhoea.
Pak J Physiol 2021;17(4):15?8
COMPARISON BETWEEN TRADITIONAL, RECORDED, AND ZOOM ONLINE PHYSIOLOGY TEACHING IN UNDERGRADUATE MEDICAL STUDENTS DURING THE COVID-19 PANDEMIC
Authors: Fatima Sadaf , Fatima Sulail , Rafique Sara , Kanwal Sassi , Rizwan Rabeea , Zehra Kiran
Published: July 2024

Background: Due to COVID-19 educational institutions remained closed for traditional teaching, and online teaching methods were implemented. The recorded physiology lectures were forwarded to students, and teaching was conducted online. The objective of this study was to compare online, recorded, and face-to-face physiology teaching in undergraduate medical students during COVID-19 pandemic. Methods: This cross-sectional study was conducted from April to June 2021 at Jinnah Medical and Dental College, Karachi, Pakistan. The study participants included 84 undergraduate 2nd year medical students. The questionnaire included 21 items regarding zoom online, recorded, and traditional teaching. The students selected the preferred teaching method. The data were presented in terms of percentage for individual items, preference in theory, tutorial, and overall preferred teaching method. Results: The medical students believed that presence of teacher (86.9%), asking queries to teacher (87%), giving feedback to teacher (81.2%), and interest in learning (83.8%) were more important elements to consider for traditional teaching. Regarding the recorded lectures, understanding the lecture (51.4%), and studying at own pace (52.7%) were found to have high percentage. In relation to preference of teaching method for theory (73.5%), tutorial (76.9%) overall preferred teaching method (78.2%), majority of the students selected traditional teaching method. Conclusion: The majority of undergraduate medical students had a preference for traditional teaching methods in Physiology. Among online teaching during COVID-19 pandemic, the students preferred recorded sessions over zoom online classes.
Pak J Physiol 2021;17(4):51–4
MICROBIOLOGICAL SPECTRUM OF UROPATHOGENS CAUSING URINARY TRACT INFECTIONS IN DIABETICS
Authors: Bashir Shabana , Khan Mumtaz Ahmad , Khawaja Samia Wazir , Mumtaz Sehrish , Mumtaz Asim
Published: July 2024

Background: Patients with diabetes mellitus (DM) are at increased risk of infections most commonly urinary tract infections. The objective of this study was to determine the spectrum of bacterial pathogens causing UTI in diabetic patients. Methods: A descriptive, cross-sectional study was carried out in the Department of Pathology, Abbas Institute of Medical Sciences, Muzaffarabad, from Jan to Dec 2019. A total of 292 patients with DM were enrolled in the study after informed consent regardless of the presence or absence of UTI symptoms. Patients with underlying renal pathology or chronic renal disease, pregnancy and antimicrobial therapy were excluded. Urine samples were taken and isolates were identified on the basis of colony morphology, gram staining, and biochemical reactions like catalase, coagulase, DNAse, oxidase test and Analytical Profile Index 20E strips (BioMerieux) as required. Results: A total of 292 patients were included. Mean age of the patients was 40.95±8.95 years. Out of these, 120 (58.90%) were male and 172 (41.10%) were females. The frequency of bacterial pathogens causing UTI was 37 (12.67%) for E. coli, 13 (4.45%) for Klebsiella spp, 5 (1.71%) for Proteus spp, 7 (2.40%) for Pseudomonas spp, 9 (3.08%) for Staphylococcus aureus, 7 (2.40%) for Enterococci, and in 214 (73.29%) patients there was no growth of any organism. Conclusion: E. coli is the most common bacterial pathogens causing UTI in diabetic patients.
Pak J Physiol 2021;17(4):31?4
CATHETER ASSOCIATED URINARY TRACT INFECTION DUE TO PROLONGED CATHETERIZATION AND ITS CAUSATIVE UROPATHOGENS
Authors: Khawaja Samia Wazir , Khan Mumtaz Ahmad , Bashir Shabana , Jalal-ud-din Mir , Mumtaz Sehrish , Mumtaz Asim
Published: July 2024

Background: The presence of a urinary catheter is the most important risk factor for bacteriuria and Catheter-associated urinary tract infection (CA-UTI). The objective of this study was to determine the frequency of catheter associated urinary tract infections and most common causative uropathogens due to prolonged catheterization. Methods: This descriptive, cross-sectional study was carried out in the Department of Microbiology, Abbas Institute of Medical Sciences, Muzaffarabad from January to December 2019. Total 270 patients of critical patient care areas and wards with age range 18–70 years were selected. Patients suffering from UTI prior to catheterization, suffering from complicated UTI, and already catheterized at the time of admission were excluded. Urine samples were collected from the distal end of urinary catheters under strict aseptic techniques. Samples were cultured and growing microbes identified on the basis of gram stain, colony morphology, and biochemical reactions. Results: Catheter associated urinary tract infections due to prolonged catheterization of patients for more than 48 hours were found in 143 (52.96%) patients. The frequency of common causative uropathogens was: E. coli in 67 (47.18%), Kleibsella spp in 15 (10.56%), Proteus spp in 10 (7.04%), Pseudomonas spp in 8 (5.63%), Staphylococci in 14 (9.86%), Enterococci in 13 (9.15%) and other organisms in 15 (10.56%) patients. Conclusion: The frequency of catheter associated urinary tract infections with E. coli as the bacterial pathogen causing UTI due to prolonged catheterization is quite high.
Pak J Physiol 2021;17(4):19?22
IMPACT OF PRIMING WITH THE HELP OF VIDEOS ON THE STUDENTS’ LEARNING EXPERIENCES IN UNDERGRADUATE MEDICAL EDUCATION
Authors: Majeed Sadaf , Zaidi Nilofar Nasir , Moin Hira , Shafi Riffat
Published: July 2024

Background: Priming is an active learning approach which helps prepare a learner for an educational task. This study aims to introduce priming with the help of videos in undergraduate medical curriculum and to assess the perceptions of students regarding the impact of priming on their learning experiences. Methods: It was a questionnaire based cross-sectional study conducted for 3 months in 2020. Videos were introduced to 2nd year medical students in the Special Senses Module conducted online. Videos retrieved from authentic websites were posted, with due permission, and shared before the didactic session on a particular topic. At the end of module, perceptions of students were gathered via an online questionnaire, after consent. Results: Majority of students ‘agreed’ or ‘strongly agreed’ that priming is an effective way of learning (86%) and they would like to be provided with resources for priming in the future (90.7%). Sum 89.2% of the participants ‘agreed’ or ‘strongly agreed’ that they prefer priming with in class discussion over traditional teaching. Majority of the students ‘agreed’ or ‘strongly agreed’ that the video resources used for priming were conducive to their learning (92.2%), helped in better comprehension of the respective topics (93.8%), and would make it easier for them to revise for assessments (67.2%). Conclusion: This research supports the benefits of priming with the help of videos in undergraduate medical education. Using videos as a tool for priming helps in better comprehension of the and makes it easier for students to revise for assessment.
Pak J Physiol 2021;17(4):42–5
COMPARATIVE EFFECT OF ALPHA TOCOPHEROL AND ASCORBIC ACID ON BODY WEIGHT OF RATS EXPOSED TO CHRONIC RESTRAINT STRESS
Authors: Moazzam Sadia , Majeed Farzana , Sattar Rabia , Irfan Asma , Mughal Irfan Afzal
Published: July 2024

Background: The stress is defined as the constellation of events, which begins with a stimulus, and subsequently results in the activation of certain physiologic systems. This study was planned to determine the comparative effect of ascorbic acid and alpha tocopherol on body weight of Sprague Dawley rats exposed to chronic restraint stress. Methods: This comparative experimental study was done in National Institute of Health (NIH), Islamabad. One-hundred-and-twenty male Sprague Dawley rats (mean weight 250±50 grams) were used and divided into 4 equal groups. Group I was taken as control. Group II was exposed to chronic stress, Group III was given only ascorbic acid prior to restraint stress, and Group IV was given only alpha tocopherol prior to restraint stress. Group III & IV were given prior supplementation of ascorbic acid, alpha tocopherol for 1 month. Results: There was a significant decrease in weight gain of rats exposed to the chronic stress as compared to control group. Individual supplementation with ascorbic acid and alpha tocopherol resulted in significant improvement of their eating habits with rats supplemented with ascorbic acid. Conclusion: Chronic stress has a detrimental effect on weight. This effect can be minimised by the intake of sufficient amount of antioxidants.
Pak J Physiol 2021;17(4):8?10
ASSESSMENT OF STRESS, ANXIETY & DEPRESSION LEVELS AMONG MEDICAL FACULTY DUE TO ONLINE TEACHING IN COVID-19
Authors: Majeed Farzana , Ghafoor Seemeen , Afridi Fatima , Saeed Hamza Bin , Janjua Jamila Riaz , Muazam Shazia
Published: July 2024

Background: COVID-19 pandemic brought with it new challenges for teaching activities of the faculty, including need to master the basic use of technology to teach online in changed working environment while dealing with the additional health, family, and work-related challenges. This study aims to evaluate the occurrence of psychological parameters of stress, anxiety, and depression among the participants and the factors for coping with the said psychological parameters. Methods: This cross-sectional, questionnaire-based study was conducted in Jan–Jul 2021. Faculty teaching online classes in different medical colleges of Pakistan were invited through social media platforms to participate in the study. The DASS-21 scale was used to evaluate depression, anxiety and stress. Results: The factors that had significant contribution to stress, anxiety and depression in the faculty of medical colleges teaching include abrupt transition from face to face to online teaching, job insecurity, and personal and family financial situation. Lack of prior training in proper use of technology was associated with depression, while the uncertainty for duration of the lockdown and personal health issues were associated with anxiety. Coping factor that showed significant association with stress, anxiety and depression was increased intake of drugs. Conclusion: There are substantial changes in faculty’s mental state concerning exhaustion, stress, depression, and anxiety after switching to online teaching as a result of COVID-19 quarantine. Appropriate measures need to be taken for training of the faculty with IT support, and to ensure peace of mind for the faculty for maximum output.
Pak J Physiol 2021;17(4):55–8
LEARNING ENVIRONMENTS FOR UNDERGRADUATE MEDICAL STUDENTS
Authors: Iqbal Tehseen
Published: July 2024

Learning Environment for Medical Students is defined as everything that happens within the classroom, department, university, Teaching Hospital, or outside, that is essential in determining the success of undergraduate medical students. Learning environment for undergraduate medical students has two major areas: Medical College, and Teaching Hospital. Each one of them has many components. Each component has its own learning style, dynamics and rules to follow. Each learning environment provides students an opportunity to interact with peers and teachers, to have frequent feedback, to apply their learning in other situations, and to experience diversity. Classroom/Lecture Hall, Laboratory, Museums, Tutorial Room, College Auditorium, College Library, Play Grounds, Patient Bedside, Outpatient Department, Operation Theatre, Demonstration Room, Community Health Centre, MCH Centre, Vaccination Centre, and even the Examination Hall are all parts of learning environment of an undergraduate medical student.
Pak J Physiol 2021;17(4):1?2
FREQUENCY AND ANTIBIOTIC SENSITIVITY OF MOST COMMON ORGANISMS CAUSING URINARY TRACT INFECTIONS IN CHILDREN
Authors: Khalily Muhammad Athar , Anwar Hamayun , Bashir Bushra , Farhat Aneela , Shafiq Maria , Tariq Sidra
Published: July 2024

Background: Urinary tract infections (UTIs) are common and significant clinical condition in children. This study was conducted to determine the frequency of most common organisms causing urinary tract infections (UTI) and their sensitivity to various antibiotics in children admitted in a tertiary care health facility. Methods: In this retrospective study, 225 patients of both genders, aged 1–15 years and diagnosed as a case of UTI of any duration were included. Relevant data was collected from hospital electronic patients’ record section. The data was analysed using SPSS-16. Results: There were 38% male and 62% female patients in the study. Mean age of the patients was 6±1.26 years. Mean duration of symptoms was 3±2.21 days. Escherichia coli was found in 45%, Klebsiella pneumoniae in 20%, Staphylococcus aureus in 18%, Pseudomonas aeruginosa in 11%, Proteus mirabilis in 3%, and Enterococcus in 3% of patients. All organisms were sensitive to most of the commonly used antimicrobial agents. Conclusion: The most common organism causing UTIs in our setup was Escherichia coli, followed by Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and Proteus mirabilis, and these pathogens were sensitive to Ceftriaxone, Amikacin, Tetracycline, Ciprofloxacin, Augmentin, Ceftazidime and Nitrofurantoin. Resistance to these antibioticd was low in our setup.
Pak J Physiol 2022;18(1):29?31
COMPARISON OF D-DIMER LEVELS IN PREECLAMPSIA AND NORMAL PREGNANCY
Authors: Shams Nosheen , Taimoor Alruba , Nazir Aamir , Zaman Uzma , Shams Huma , Javed Sumaira
Published: July 2024

Background: Preeclampsia is associated with deposition of fibrin in microvasculature and maternal organ dysfunction. D-dimer is used as a marker of degradation and production of fibrin in the body. The objective of this study was to determine the mean plasma D-dimer levels among pregnant women and to compare mean plasma D-dimer levels between preeclamptic patients and women without preeclampsia. Methods: A cross sectional study was designed and conducted in the Obs/Gyn Department, Hayatabad Medical Complex, Peshawar. A total of 154 pregnant women fulfilling inclusion criteria were included. Non-probability consecutive sampling was used for collection of samples. Mean±SD was calculated for quantitative variables while qualitative variables were presented in the form of frequency and percentage. Independent sample t-test was used to compare mean plasma D-dimer levels between preeclampsia and normal patients. Stratification was done on the basis of age, gestational age, BMI, and booking status. Post-stratification t-test was applied and p?0.05 was considered significant. Results: The mean age of patients was 27.73±2.68 years (Range: 18–34 years). The mean gestational age was 37.43±1.15 weeks (Range: 35–40 weeks). Preeclamptics were 58 (37.7%) while 96 (62.3%) were normotensive. The mean plasma D-dimer levels in total cases was 0.50±0.41 ng/ml (Range: 0.115–1.156). The mean plasma D-dimer level in preeclamptics and normal cases was 1.02±0.07 and 0.18±0.04 (ng/ml) respectively (p<0.00). Conclusion: Mean plasma D-dimer level was higher in preeclamptic patients as compared to normotensive pregnant women showing a significant correlation between preeclampsia and plasma D-dimer level in third trimester of pregnancy.
Pak J Physiol 2022;18(1):20?2
RISK FACTORS AND PARENTS’ ATTITUDE FOR CHILDREN PRESENTING WITH ASTHMA AT A TERTIARY CARE HOSPITAL
Authors: Shah Sajid Hussain , Najeeb Shahzad , Aalia Bibi , Raza Mohammad Ali , Muhammad Khyal , Abbasi Munir Ahmad
Published: July 2024

Background: Asthma is commonly prevalent disease in children. There has been increasing prevalence and incidence of asthma in children in last few decades. Risk factors and parent’s attitude towards therapy matters in management. The objective was to assess the risk factors and parents’ attitude for children presenting with asthma. Methods: This cross sectional study was done at Ayub Teaching Hospital, Abbottabad. History was taken about risk factors and associated myths. Duration of asthma, visits per year to clinic/hospital, tobacco smoke exposure, pets, fur toys, wood/coal burning, carpets in rooms, perfumes/powder use was documented. Parents’ attitude towards use of spacer and inhaler was documented with specific questionnaire. Data was analysed using SPSS-20 and p<0.05 was taken as significant. Results: There were 136 patients, 93 (68.4%) males and 43 (31.6%) females. Mean age was 7.3±3.13 years. Most (80.1%) patients were <10 years old. Patient visits per year ranged from 2 to 15 visits with mean of 5.97±3.02 visits per year. Intermittent asthma was seen in 8.8% and persistent asthma was seen in 66.9% patients. The most common risk factor was use of perfume in 48.5% and family history in 65.4% patients. Parents’ misconception towards inhaler use was noted in 38.2% patients. Younger children are at more risk of having asthma symptoms with exposure to wood/coal smoke and perfume powder exposure (p=0.04). Conclusion: Family history of asthma with perfume/powder exposure and wood/coal smoke exposure are major risk factors in children. Parents’ misconception is a hurdle to timely management. 
Pak J Physiol 2022;18(2):54–7
ROLE OF ASCORBIC ACID ON ALTERED LEVELS OF TESTOSTERONE DURING CHEMOTHERAPY
Authors: Haq Aisha Abdul , Khan Maria , Rehman Dur-e-Shewar , Rehan Rabia , Khalid Shumaila , Kamran Durr-e-Sameen
Published: July 2024

Background: Improvement in quality of life of cancer survivors has become a significant healthcare dilemma. Despite having important part in the support of spermatogenesis, few studies are conducted on Leydig cells secretion, i.e., testosterone which has an important role in fertility The objective of this study was to demonstrate altered serum testosterone levels by anthracycline on mice and to study changes observed in serum level in DOX affected mice with co-administration of antioxidant ascorbic acid. Methodology: Male mice aged five weeks were used. The animals were divided into 3 groups of 10 mice each. Animals in Group A were given normal saline intraperitoneally (IP). Group B mice were given DOX IP alone. In Group C, DOX and ascorbic acid were given orally. Blood samples were taken through cardiac puncture. Sera from centrifuged blood were tested for testosterone using ELISA kit. Results: Serum testosterone levels were 1.61±1.77, 6.22±4.78, and 1.98±0.45 ng /ml in Group A, B and C respectively. The administration of DOX induced significant increase (p<0.001) in the serum testosterone level. However co-administration of Ascorbic acid with DOX significantly reduced (p<0.001) the serum testosterone level. Conclusion: Ascorbic acid has a role against DOX induced altered hormonal levels.
Pak J Physiol 2022;18(2):3?5
COMPARISON OF DIET INDUCED METABOLIC SYNDROME WITH ARTIFICIALLY INDUCED METABOLIC SYNDROME IN A RAT MODEL
Authors: Ilyas Jawaria , Zahra Noor , Siddique Amer Hassan , Iqbal Komal , Yousaf Rana Muhammad , Saeed Muniza
Published: July 2024

Background: Metabolic syndrome is an emerging health problem. The diets rich in fats and refined carbohydrates and monosodium glutamate are considered major risk factors for this emerging epidemic. The aim of this study was to determine whether high fat high carbohydrate (HFHC) diet, Monosodium glutamate (MSG) diet or their combination is faster/more potent inducer of MS. Methods: Twenty male Sprague Dawley rats were randomly divided into four groups. Group 1 was given normal rat chow, group 2 was given HFHC diet, group 3 was given MSG in diet and group 4 was given both HFHC and MSG in their diet for 20 weeks. Body weight, blood pressure, lipid profile and glycaemic indices were determined at the end of study. Results: After 20 weeks of study, HFHC and MSG groups showed full blown Metabolic syndrome (MS) with development of obesity, hypertension, hyperglycaemia and dyslipidemia. However, group 4 which was given combination diet did not develop features of MS. Conclusion: Both HFHC and MSG containing diets when given alone are potent inducers of MS in rat model rather than their combination.
Pak J Physiol 2022;18(2):6?9
EFFECT OF RAMADAN FASTING ON POST-EXERCISE HEART RATE RECOVERY AT TWO MINUTES AND BODY COMPOSITION IN HEALTHY MALE ADULTS
Authors: Shaheen Abida , Azam Fahad , Liaquat Afrose , Irshad Khurram , Ahmer Hania , Naveed Hania
Published: July 2024

Background: The effects of Ramadan fasting on weight loss are well-known but its effects on heart rate recovery after 2 minutes (HRR2) have not been investigated. The present study aims to observe the effects of Ramadan fasting on body composition variables and post-exercise heart rate recovery after two minutes of rest. Methods: A prospective, observational study was conducted from April 2019 to July 2020. Sixty-four healthy male participants aged 26 to 53 years were enrolled on the first day of fasting in Islamic month of Ramadan and were followed up for two weeks. Baseline anthropometric measurements and body composition measurements were recorded on day 1 of Ramadan in a fasting state. Peak heart rate and heart rate recovery were recorded immediately after exercise and after two minutes of rest. Blood pressure was also recorded after cessation of exercise. After fourteen days of fasting, anthropometric measurements and aforementioned readings with repeat exercise protocol were recorded. Results: Mean BMI, waist circumference and body fat ratio of the study participants reduced significantly after fourteen days of Ramadan fasting. The resting heart rate of the study participants was significantly reduced from 74.5±9.7 to 68.4±10.7 bpm (p<0.001). HRR2 of rest significantly increased from 22.9±11.7 to 30.3±13.7 bpm (p=0.001). None of the smokers showed an improvement in heart rate recovery after two minutes of rest. Conclusion:  Ramadan fasting resulted in significant improvement in body fat ratio,  BMI, waist circumference and heart rate recovery after two minutes of rest in healthy adult males.
Pak J Physiol 2022;18(2):10?4
EFFECT OF ANGER EXPRESSION ON MENTAL WELLBEING AND EMOTIONAL EXPRESSIVITY OF ORPHANS AND NON-ORPHANS
Authors: Alvi Sajid Mahmood , Khan Ayla , Bhatti Mazhar Iqbal , Younis Kainat
Published: July 2024

Background: Orphan-hood is a stage that includes numerous mental and emotional problems. Lack of control on emotions puts orphans at risk of uneasiness. The aim of this study was to see the relationship between anger expressions on mental wellbeing and emotional expressions of orphans and non-orphans. Methods: This was a cross-sectional survey conducted from April to June 2021. Data were collected from the orphan and non-orphan adolescent students aged 13–19 years, studying in different institutes of Haripur, Pakistan. After informed consent, State Trait Anger Expression Inventory (STAXI), Short Warwick Edinburg Well-being Scale (SWEMWBS), and Emotional expressivity questionnaires were self-administered by authors and analysed on SPSS-20. Result: Sample size was 200 orphan and non-orphan adolescent students, with equal proportion of males and females. Anger expression was positively linked with emotional expressivity (r=0.29, p<0.001), and anger expression was negatively linked with mental wellbeing (r= -0.45, p<0.001). Orphan students scored high on anger expression (27.62±5.4) and emotional expressivity (55.28±5.79) as compare to non-orphans (23.59±5.79 and 53.31±5.99 respectively). Conclusion: Anger expression is positively linked with emotional expressivity and negatively linked with mental wellbeing. Girls are shyer to express their feelings compared to boys. Boys are more engaged in verbal and physical aggression than girls. Orphan boys show more aggression because they face a lot of adjustment and many other difficulties in institutions.
Pak J Physiol 2022;18(2):62–5
EFFECTS OF CLINICAL INTERVENTIONS ON NURSING CARE PRACTICES REGARDING INCIDENCE OF PRIMARY POST-PARTUM HAEMORRHAGE
Authors: Khadim Iram , Yaqoob Adnan , Parveen Kousar , Khan Sadia
Published: July 2024

Background: Postpartum haemorrhage (PPH) is a common obstetric haemorrhage. That is one of the leading causes for maternal mortality. This study aims to assess the effect of clinical interventions on nursing care practices regarding primary postpartum haemorrhage. Methods: This quasi-experimental study was conducted in Gynaecology Department of Allied Hospital, Faisalabad. Eighty-five license holder nurses who work in morning, and evening shifts, aged 25?50 were included. Nurses who had PPH training and/or teach obstetrics, gynaecology and midwifery students, were excluded. Purposive sampling technique was used. A 16-items adopted validated checklist was used to assess the practices of nurses pre- and post-educational training about primary PPH. Results: Demographic and skill related variables were checked for frequency and percentages. All of nurses (n=85) had poor practices before clinical interventions. In post-intervention assessment, results revealed that 11 (12.9%) nurses had good and 74 (87.3%) showed excellent practices, and no one had poor practices. Conclusion: Educational trainings had prominent effect in improving skill performances and practices of maternity nurses regarding the management of labour to prevent primary post-partum haemorrhage.
Pak J Physiol 2022;18(2):51–3