Journal of Shalamar Medical & Dental College - JSHMDC

Leg Edema Unveiled: The Uncommon Culprit of Follicular Lymphoma

Sat, 30 Dec 2023 00:00:00 +0000

Follicular Lymphoma is a type of Non-Hodgkin's Lymphoma. It is defined as a lymphoma of germinal center B cells and a complex disease involving genetic and epigenetic mutations of Follicular B cell. Some of the commonly known alterations are cell in BCL-2 oncogene and somatically mutated genes. Follicular Lymphoma is the second most prevalent malignancy in the west accounting for about 10-20% of all lymphomas although an alarming rise has been seen in Pakistan as well. A lot of diagnostic challenges are being faced as this disease is indolent and presents atypical features. An effective treatment regime for follicular lymphoma fluctuates depending on the extent of disease and the medical history of the patient. Various methods are available for the risk assessment of the disease. Radiotherapy, rituximab monotherapy or combination therapy are the first line of treatment for restricted spread for follicular lymphoma. For aggressive stage of disease is managed with disease surveillance with imaging and rituximab is given in low grade tumors while chemotherapy and along with immunotherapy is the choice of treatment in high grade tumors. We report a patient here who presented with gross and progressing edema of the right lower limb that started in the foot and progressed proximally up to the thigh. Literature shows that unilateral lymphoedema could be an initial symptom of malignancy and is more common in woman than in males so must be sought as a potential diagnosis.

Nurses in Politics: An Emergent Need

Tariq Ali, Kashif Khan — Sat, 30 Dec 2023 00:00:00 +0000

Nurses are recognized for their vigorous role in healthcare, own untapped potential in politics. Their advocacy skills, honed through patient care, could be harnessed to make policies for improved healthcare access and health equity. The representation of nurses in politics is unreasonably low, in U.S., only 10 out of 535 Congress members are nurses, despite being the largest group of healthcare professionals. Similarly, there is absence of nursing representation in Pakistan's parliament. To tie this gap, nurses should be inspired to enter politics, provided with mentorship, policy training, and financial support.

Academic Procrastination and its Association with Academic Achievement among Undergraduate Health Sciences’ Students

Khalid Hussain, Zafar Iqbal, Muhammad Fayyaz, Ubedullah Rahimoon, Tanseer Ahmed — Sat, 30 Dec 2023 00:00:00 +0000

Background: Academic procrastination is the postponement of educational activities. Most university students try to keep themselves away from academic activities which might lead to procrastination and unsatisfactory performance.

Objective: To assess the level of academic procrastination and its association with academic performance and the demographic characteristics of undergraduate students.

Methods: This cross-sectional analytical study using a convenient sampling technique was conducted on 250 health sciences undergraduate students at Sohail University, Karachi, Pakistan from August to October 2022. Ethical approval and data collection permission were obtained. The Procrastination Assessment Scale for Students was used to gather data. The SPSS version-24 was used for statistical analysis. Simple descriptive statistics, spearman’s rank order correlation coefficient tests and independent sample t-test was applied.

Results: Mostly participants (53.6%) were female, 93.2% were single, and 46 % in the generic nursing program and 54% were in 3rd & 4th year. Students’ academic performance was insignificant with all the domains except writing a term (p-value 0.22, 0.5, 0.26, 0.37, 0.31 and 0.041 respectively). A significant relationship of students’ gender, education level and study program with academic procrastination was found (p-value 0.004, 0.021 and 0.002 respectively). Bachelor of Science in Nursing (BSN) and Pharm-D programs did not show as much procrastination as compared to Doctor of Physical Therapy (DPT) program (p-value 0.021).

Conclusion: This study showed the considerable behaviour of procrastination among undergraduates. There was a significant association between writing a paper and academic achievement. In addition, academic procrastination was significantly associated with gender and the enrolled program of the participants.

Emotional Intelligence and Empathy among Ophthalmologists

Muhammad Shaheer, Asima Rafique, Zahid Kamal Siddiqui — Sat, 30 Dec 2023 00:00:00 +0000

Background: Emotional intelligence and empathy plays a key role in coping with varying situations in daily
life.
Objective: The purpose of this study was to determine emotional intelligence and empathy among
ophthalmologists.
Methods: This cross-sectional study was carried out at the College of Ophthalmology & Allied Vision
Sciences from 1st June 2022 till 31st December 2022. After the ethical approval of the study, a Google form was developed which included Schutte‘s scale (Emotional Intelligence) and Davis‘s Interpersonal index (Empathy) questions in addition to those related to basic demographic information. A sample size of 19 was calculated and sampling was done by non-probability convenient sampling. The proforma was sent via social media application (WhatsApp) to study participants. A total of 39 ophthalmologists including residents and faculty members of either gender responded to be part of the study. A comparison of emotional intelligencescores was done by applying Independent sample t-test and one-way ANOVA.
Results: A total of 39 ophthalmologists participated in the study with a mean age of 35.31 ± 9.83 years. The Emotional Appraisal‖ mean score was found to be highest in post-graduate residents (p = 0.05) and the mean
scores of the sub-scale ―Non-Verbal Communication‖ was highest in faculty (Assistant professor or above in designation) followed by Postgraduate resident (PGR), (p=0.04). Comparison of empathy scores revealed asignificant difference in the sub-scales of the Davis scale ―Perspective taking‖ (p = 0.04) and Personal distress (p=0.03) between the male and female participants.
Conclusion: Among ophthalmologists, postgraduate residents were better in terms of emotional intelligence than faculty who had better skills with regards to non-verbal communication.

Noncompliance to Treatment and Its Associated Factors among Patients with Diabetes Mellitus in Karachi

Sannia Perwaiz Iqbal, Rubia Farid, Ainan Arshad — Sat, 30 Dec 2023 00:00:00 +0000

Background: Noncompliance to treatment is a widespread problem globally, particularly among people with chronic conditions like diabetes mellitus.

Objective: We aimed to assess the frequency of treatment noncompliance and its associated factors among patients with type 2 diabetes.

Methods: The study was conducted at the family medicine outpatient clinics at the Aga Khan Hospital during one month from 1^st to 30^th December, 2019. Using a cross-sectional design, we recruited 151 patients with type 2 diabetes who willingly agreed to participate in the research. We employed a pre-approved, self-administered, and structured questionnaire to gather data on demographics, clinical features, and treatment compliance among patients.

Results: There were 77 female and 74 male participants. The average age of the participants was 54.7±11.5 years. Among the 151 individuals in the study, 112 were noncompliant with their prescribed treatment. There was a significant association between treatment non-compliance and lower monthly income (p=0.039), participant’s age (p=0.020), and duration of the disease exceeding 5 years (p<0.001). The group of patients with noncompliance also had a higher risk of diabetic foot (p = 0.002) and retinopathy (p = 0.009). When asked about their reasons for noncompliance, participants cited drug side effects (91%), forgetfulness to take medications (81%), and complexity of drug therapy (66%).

Conclusion: Our findings revealed a notable prevalence of noncompliance among participants, which was associated with an elevated risk of complications. The Older age and disease duration for longer than 5 years were factors associated the most with noncompliance. Such interventions could significantly reduce the likelihood of developing diabetes-related complications.

Knowledge, Attitude, and Practice Regarding Disaster Preparedness among Undergraduate Nursing Students

Aftab Ghouri, Raja, Badil — Sat, 30 Dec 2023 00:00:00 +0000

Background: Disaster is "the sudden onset of an event that disrupts regular living conditions and causes severe suffering, increasing the impact of community maladaptation. Nurses’ knowledge and understanding of disaster management can play an important role in reducing casualties and complications.

Objective: This study aimed to determine the level of knowledge, attitude, and practice about disaster preparedness and its association with demographic variables among undergraduate nursing students.

Methods: The cross-sectional descriptive study was conducted at two institutes, Ziauddin University Faculty of Nursing and Midwifery, Karachi, and Benazir College of Nursing, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan. This study was conducted among 175 nursing students of semester-II and IV from July 2021 to March 2022; the sample size was determined by using OpenEpi version 3.0. The target population was approached by a non-probability consecutive sampling method. A pretested, validated, and self-administered questionnaire was used for data collection. The Statistical Package for Social Sciences version 22, independent t-test, and ANOVA were used for inferential analysis.

Results: Most (63.43%) of the participant’s age was between 21-30 years, majority of them were females (58.29%) with 1–10 years of clinical experience (84.57%). The highest mean and standard deviation were identified among 31–40 years of age; the variables are knowledge, attitude, and practice (6.32±2.5), (5.7±2.05), and (6.37±2.2), respectively. The clinical practice was found to be significant with a p-value < 0.05.

Conclusion: It is concluded that undergraduate nursing students elicit a moderate level of knowledge, attitude, and practice regarding disaster preparedness. Knowledge, attitude, and practice can be improved by organizing periodic training sessions at the undergraduate level.

Development of Surgical Functional Service Quality scales for Tertiary Care Hospitals: Consumer’s Perspective

Iram Fatima, Muhammad Shafiq, Ayesha Humayun, Asad Aizaz Chatha — Sat, 30 Dec 2023 00:00:00 +0000

Background: Surgical department is the economically viable and resource generation department of a hospital. Its services not only focus to build a long-term image of the hospital but also to generate a positive word of mouth in the community because the consumers have longer hospitalization

Objective: This study is aimed to design a scale for measuring functional service quality of surgical department based on service user’s perspective.

Methods: This was a mix method research with a cross-sectional study design. Survey questionnaire was used to get primary data from the respondents (patients admitted to wards). Out of 835 self-administered questionnaires, 499 valid responses were received for further data analysis. Simple descriptive, Exploratory Factor Analysis, Confirmatory Factor Analysis were employed using SPSS version 21 and AMOS version 21.

Results: The scale identified five constructs that can be used as contributing factors to measure and evaluate surgical department functional service quality. These dimensions include skill, empathy, food, responsiveness and promptness. The model fit values include CFI (0.98), RMSEA (0.055), and GFI (0.96) which show goodness of fit.

Conclusion: Though the method of assessment and development of scale is not novel but according to our knowledge based on published literature this study is novel to identify the scale based on service quality dimension in surgical facilities in the developing countries.