Northwest Journal of Medical Sciences

STRATEGIES BASED ON THE PRINCIPLES OF COGNITIVE PSYCHOLOGY FOR IMPROVING LEARNING

iqbal Wahid, Danish Ali Khan, Ejaz Hassan Khan — Thu, 19 Nov 2020 00:00:00 +0600

In the first place, defining of learning and memory would enable us to comprehend their relationship to better.1 Learning is the way toward increasing new and moderately enduring information and behaviours.1 Memory refers to the process of recording and retrieving experiences and information.2 Information Processing Model is a basis for the communication of memory and learning. Whatâ€™s more, the way toward learning is very like this model, individuals see new information, recognize and retain it, and afterward encoding it into individual learning as encoding it into long-term memory.3 Also, the data-preparing model incorporates each part of how memory functions. There are three fundamental memory types in this model which are sensory memory and short term/working memory, and long-term memory.4 In tactile memory, data is put away in the blink of an eye, additionally just 5-9 pieces can be hold for around 15-30 seconds in here and now memory.4 In any case, once the data exchanges to long term memory, it would be last yearly.5 There are two procedures that occur between here and short term /working memory and long term memory, one is called encoding forms that alludes to the way toward moving data from here and now memory to long term memory and the other one is recovery forms which is the procedure of data is conveyed to working memory from long term memory.6 Both the processes play a significant role in learning.6
Essential approaches to approach problem and issues in life, to learn in astounding route and to ceaselessly enhance quality are ventures towards taking care of issues. We require both a hypothesis and quality instruments to cultivate excellent considering and Memorization.6 There are two procedures that occur between here and short term /working memory and long term memory, one is called encoding forms that alludes to the way toward moving data from here and now memory to long term memory, and the other one is recovery forms which is the procedure of data is conveyed to working memory from long term memory. Both of the procedures assume a critical part in learning.7

FREQUENCY OF ORAL SUBMUCOUS FIBROSIS IN 16 â€“ 40 YEAR OLD INDIVIDUALS ATTENDING THE DENTAL OUTPATIENT DEPARTMENT OF CIVIL HOSPITAL KARACHI

Naseer Ahmed — Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
INTRODUCTION: The World Health Organization predicts that tobacco deaths in India may exceed 1.5 million annually by 2020. Oral cancer progress through the transformation of tobacco exposed normal oral mucosa to potentially malignant lesions which ultimately changes to carcinoma. OSMF is now globally accepted as an Indian disease. It has one of the highest rates of malignant transformation among potentially malignant oral lesions.
OBJECTIVE: To determine the frequency of oral submucous fibrosis in 16 â€“ 40 year old individuals attending the Dental Outpatient department of Civil Hospital Karachi.
METHODOLOGY: This was Descriptive cross sectional study, which was conducted at Dental Outpatient department of Civil Hospital Karachi from 1st July to 28th December 2019. The data was collected through pre tested questionnaire. Patientâ€™s attending the OPD of Civil Hospital, Karachi. Having s aged 16 â€“ 40 year olds.with limited mouth opening and OSF and Squamous cell carcinoma.
RESULTS: This was Descriptive cross sectional study, which was conducted at Dental Outpatient department of Civil Hospital Karachi from 1st July to 28th December 2019. The data was collected through pre tested questionnaire. Patientâ€™s attending the OPD of Civil Hospital, Karachi. Having s aged 16 â€“ 40 year olds.with limited mouth opening and OSF and Squamous cell carcinoma. The results were analyzed as: Age distribution among 100 particpants were analyzed as 20-30 Years (36.4%) 31-40 Years (64.6%) Mean age was 33.2 years with standard deviation Â±2.142 Gender distribution among 147 patients was analyzed as n= Gender Wise Distribution Male was (73.5%) Female was (26.5%).
CONCLUSION: We conclude that areca nut chewing has a causal relationship with OSF: additional tobacco insult may be necessary for subsequent carcinoma development.There is a marked difference in literacy, socioeconomic status, areca nut chewing habits, symptoms and disease severity
KEY WORDS: Frequency, Oral Submucous Fibrosis

Persistent neuroinflammation and neurodegeneration after brain injury

Shafiq Ur Rehman, Tahir Ali, Danish Ali Khan, Syed Alamdar Hussain, Usman Farooq — Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
INTRODUCTION: Traumatic brain injury (TBI) is a major global health issue in both civilians and war-affected military personnel and has no proper cure or treatment. Survivors of TBI exhibit long-term cognitive dysfunction and even permanent disabilities. As TBI patients exhibit multiple pathological conditions and the exact mechanism of neuroinflammation and neurodegeneration is still remain elusive. Therefore, we assess the prolonged effects of penetrating brain injury in animal model to further explore the neuroinflammation-associated neuropathological conditions in clinical studies.
OBJECTIVE: To determine the long term neuroinflammatory and neurodegenerative effects after penetrating brain injury in preclinical model.
METHODOLOGY: In the present study, we developed a penetrating brain injury and examined compare the neuroinflammatory effects after seven days and two months following brain injury in animal model. We used confocal laser microscopy to assess the expression of neuroinflammatory mediators in the mice group.
RESULTS: These findings provide evidence that penetrating brain injury have prolonged effects after two months. Using confocal laser microscopy, we found that the expression of GFAP (reactive astrocytes marker) and IL-1Î² (inflammatory marker) in the mice brain were significantly sustained after two months following brain injury, suggesting the prolonged neuroinflammatory effects after penetrating brain injury. Here, we found fascinating results that severity of neuroinflammation was higher at day 7 as compare to two months in animal brains.
CONCLUSION: These findings provide evidence that penetrating brain injury is critically involved in prolonged neuroinflammation which effect the cognitive ability and neurological impairments in the brain. Furthermore, these findings would be supportive in the preclinical and clinical settings.
KEY WORDS: inflammation, Traumatic brain injury, Astrocytes, interleukin beta.

Prevalence of Depression, Anxiety and Stress in College Students of Peshawar

Mustafa Qazi — Thu, 19 Nov 2020 00:00:00 +0600

INTRODUCTION: Through the social media, it has been observed that many students face various mental and psychological issues regarding their studies and exams at the intermediate level.
OBJECTIVE: To investigate the prevalence of depression, anxiety and stress in college students in the pre-final examination period.
METHODOLOGY: This was cross sectional study consisted of randomly selected of HSSC 11th and 12th grade male (89%) and female (11%) students with an average age of 18.6 years attending Islamia College, Peshawar. The participants completed a survey consisting of demographic questions, a section instructing the participants to rate the level of concern associated with challenges related to their personal lives and daily activities, and the question version of the Depression, Anxiety and Stress Scale (DASS 42).
RESULTS: The results indicated that mild and moderate levels of depression were found in 59% and severe and extremely severe levels were found in 38% of students. Mild and moderate levels of anxiety were found in 9% whereas severe and extremely severe levels were found in 89% students. Mild and moderate levels of stress were found in 19% and severe and extremely severe levels were found in 79% of students.
CONCLUSION: These results are alarming as far as the studentsâ€™ mental health and wellbeing is concerned therefore, it is vitally important that all the stakeholders related to the education sector should devise proper health treatment programs for their students in order to achieve their educational and developmental objectives.
KEY WORDS: Anxiety;College students; DASS; Depression; Islamia College University; Stress

COMPARISON OF HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND INTUBATION WITH PROPOFOL AND PROPOFOL PLUS INTRAVENOUS LIGNOCAINE IN KNOWN HYPERTENSIVE PATIENTS

Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
INTRODUCTION: Endotracheal intubation is a stressful stimulus, which is responsible for the complications mostly in patient with high BP and cardiovascular diseases. Propofol is an ideal intravenous (I.V) anesthetic agent that decreases cardiovascular response to laryngoscopy and endotracheal intubation. However mere use of Propofol has not shown complete satisfactory results and a need of further attenuation is felt. Various studies have been conducted on Lignocaine to check its effects on hemodynamic response to intubation. Aim of this study was to see effects of Lignocaine on cardiovascular response to intubation, when used as adjunct to Propofol.
Objective: To evaluate the attenuation of hemodynamic response to laryngoscopy and intubation in response to I.V lignocaine in known hypertensive patients.
Material and Methods: Following Institutional Review Board approval, data of 60 patients who went under general anesthesia was collected. Patients with ASA (American Society of Anesthesiologist) physical status grade II and III (known hypertensive) belonging to any gender ranging from 30 to 65 years of age were included. These Patients were randomly divided into two groups, group P and group PL. Patients in group P received injection of propofol with a dosage of 2mg/kg and group PL patients received injection of lignocaine 1.5mg/kg in addition to propofol dosed at 2mg/kg. Hemodynamic indicators (HR, SBP and DBP) were noted down before induction, three minutes before intubation, thirty seconds and 5 minutes after intubation followed by statistical analysis performed on the obtained data.
Results: A significant increase in haemodynamic response (Increased HR, SBP, DBP and MAP) was seen after the insertion of ETT in group P. On the contrary, response to intubation was less significant, in fact quite diminished in group PL. It was also observed that the haemodynamic response to ETT insertion is significantly greater than that to laryngoscopy alone.
Conclusion: Lidocaine is an effective medication to minimize hemodynamic responses (HR, SBP and DBP) in patients undergoing intubation for general Anesthesia.
KEYWORDS: Hemodynamic response, Laryngoscopy, Intubation, Propofol, Propofol plus, Intravenous lignocaine, Hypertensive patients

WORK RELATED NECK PAIN AMONG THE DENTISTS WORKING IN ISLAMABAD & RAWALPINDI; A CROSS-SECTIONAL SURVEY

Rohail Amir Babar, Aleeza Sadiq, Syed Alamdar Hussain, Usman Farooq — Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
INTRODUCTION: Work related neck pain is common among different professionals, dentists being one of those. They often suffer from neck related issues mainly because of the postures they adapt while performing dental procedures. Symptoms may vary from slight ache to debilitating pain. There could be numbness, tingling or weakness in the arm and hands as well.
OBJECTIVE: To determine the frequency of work related neck pain in dentists of Islamabad and Rawalpindi.
METHODOLOGY: This study was a cross-sectional survey conducted in the different health care centres of Islamabad and Rawalpindi, with an approximately sample of 385. The study was conducted in the duration of 6 months and Neck Disability Index (NDI) was used to report the neck pain among the dentists.
RESULTS: The NDI score showed that 44.7% of the dentists showed mild disability and 33.8% dentist showed moderate disability subsequently showing total (MeanÂ±SD) 2.28Â±0.80.
CONCLUSION: Approximately half of the dental population have mild disability of neck, whereas upper cervical region gets more effected then other segments.
KEY WORDS: Dentist, Neck Disability Index, Musculoskeletal Disorders & World Health Organization.

Effect of Stretching Exercise on Preeclampsia; Quasi Experimental Study

Nida Ijaz, Fahad Tanveer, Danish Ali Khan — Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
INTRODUCTION: Preeclampsia is a pregnancy induced hypertensive disorder mostly appear in second trimester onwards. Pregnancy results in increase in volume of blood, cardiac output and increase in stroke volume as well. Role of physical activity has been tested previously with no definite results. Focusing on specific methods such as stretching is under debate in order to find out active ingredient of physical activity that stabilizes blood pressure.
OBJECTIVE: To determine effect of stretching on preeclampsia in pregnancy.
MATERIAL AND METHODS: This was quasi experimental study conducted on pregnant women with symptoms of preeclampsia dividing into two groups on stretching exercise program and routine care, without randomization on basis of convenient. The outcome measures were systolic and diastolic pressure, heart rate. Demographics included age, body mass index, gestational age, number of pregnancies and daily routine. Data was analyzed in SPSS 20.0. Frequency/ percentage, mean standard deviation was calculated for demographics. Active variables were tested with independent samples t test and paired samples t test.
RESULTS: The results of comparison of systolic/ diastolic blood pressure and heart rate means after treatment showed difference of 4.160/ 4.440 and 2.240, respectively, with p value 0.000 showing significant difference all variables. Within group difference was significant for stretching group for all variables while routine care group showed a non-significant difference for diastolic blood pressure and heart with p values 0.634 and 0.791, respectively.
CONCLUSION: The findings of this study concluded that stretching exercises can prevent and reduce preeclampsia as compared to routine care in pregnant women.
KEYWORDS: Preeclampsia, Physical Activity, Stretching, Physical Therapy, Hypertensive Disorder

STEM CELL THERAPY: A RAY OF HOPE FOR REVERTING THE AFFECTED BRAIN CELLS

Waheed Ahmad, Tazeen Tazeen, Nawal Naveed, Maham Irfan, Andleeb Farooq — Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
INTRODUCTION: Stem Cells therapy mainly focuses on the use of stem cells, which have the potential, to revert back the affected brain cells into healthy brain cells which provides a ray of hope for the individual that is affected with traumatic brain injury. Traumatic brain injury is sudden damage to the brain brought about by a blast or shock to the head. Traumatic brain injury (TBI) is the main cause of morbidity and mortality in individuals below the age of 45 years in the world. Stem cell therapy uses.
Mainly there are two modes by which stem cells are employed to treat traumatic brain injuries. Exogenous and Endogenous stem cell approaches to treat damage brain. Although the use of stem cell therapy has brought about various ethical concerns which needs to be addressed carefully in order to take full advantage of this mysterious technology being introduced recently.
Stem cell therapy withstands the most effective approach for treating affected brain cells which will further bring plethora of wonders for the human beings if allowed to continue in a progressive way.
CONCLUSION: Stem cell therapy as a new alternative to all previous technologies to treat the damage brain cells have emerged as one of the most effective, long lasting and applicable in true means. All previous therapies that were and are used for the treatment of brain cells have not proven successful due to its low applicability. Stem cell therapy as a technology in its early days also faces various ethical challenges and concerns regarding its use to revert back the affected brain cells.
KEYWORDS: Exogenous stem cells, Endogenous stem cells.

SOCIAL FACTORS AFFECTING FERTILITY OF FEMALES

Munifah Khalil, Fahad Tanveer, Danish Ali Khan — Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
BACKGROUND: Infertility is one of the most worrisome women health issue in todayâ€™s world. The reason of its yearly increase may be the increasing reporting rate that previously people do not talk about unless decades pass. Non-fertile females may develop number of correlating social dilemmas. These factors need to be identified whether these are associated with status of fertility.
OBJECTIVE: To determine social factors affecting fertility of females of Lahore
METHODS: This was cross sectional survey conducted in Teaching Hospital of University of Lahore and Social Security Hospital, Multan Road. Total of 126 females surveyed through a sample of convenience, distributed 63 as fertile and 63 as non-fertile.
RESULTS: The results showed that mean and standard deviation for age, duration of infertility and body mass index for fertile group was 23.285+3.470, 0.174+0.382 and 24.222+1.853, while for non-fertile group were those of 26.523+4.211, 5.44+3.251 and 26.333+1.722, respectively. There found factors significantly associated with status fertility, while the factors which were not associated found to be residing place and the change in attitude towards sexual intimacy p value 0.323 and 0.843.
CONCLUSION: The factors significantly associated with status of fertility were age, occupation, quality of life, life stress, overall satisfaction, relationship with in mother and father in law, relationship with community and that of Body Mass Index. While the factors which were not associated found to be residing place and change in attitude towards sexual intimacy.
KEYWORDS: Social factors, Fertility, Infertility, Physical Therapy

UNEXPLAINED BRUCELLOSIS IN A 12 YEARS-OLD GIRL, A CASE REPORT

Fahad Khan, Saad Khan, Zeeshan Ahmad — Thu, 19 Nov 2020 00:00:00 +0600

ABSTRACT
Brucellosis is the most common zoonotic infection in the world. It is caused by a gram negative aerobic intracellular coccobacillus called Brucella. The most common modes transmission of the pathogen are the consumption of raw unpasteurized milk and other dairy products, inhalation of aerosols and contact with various bodily secretions (placenta, urine, blood) of the infected animal. All age groups are susceptible to human brucellosis, however, a considerable proportion of patients in endemic regions are younger than 14 years. Brucellosis is a neglected and endemic disease in Pakistan. We will be discussing a case of symptomatic brucellosis in a 12-year-old girl.
KEY WORDS: Brucellosis, prevalence, children, Pakistan

BLENDED PEER-ASSISTED LEARNING NEED OF TODAY IN UNDERGRADUATE MEDICAL EDUCATION

iqbal Wahid, Danish Ali Khan, Ejaz Hassan Khan — Thu, 19 Nov 2020 00:00:00 +0600

The methodologies applied in classroom and consequently the successful learning is a constant concern and a focus of attention for the scientific community. This concern leads to the exhaustive search for more and better means to strengthen these two elements â€œmethodology and successful learningâ€. Therefore, different methodologies, paradigms, and tools have been proposed to provide an insight on the studentâ€™s academic and professional development and to consolidate the content taught in classroom, such as Blended Learning and Peer-Assisted Learning (PAL).1
The field of medical education cannot remain immune to the effects of this aptly called E-revolution.1 The three primary characteristics of e-learning are the nature of the learning experience, synchronicity of participation, and presence or absence of face-to-face instruction.2 The integration of e-learning in medical education is the need of the hour.3
Therefore, there is a growing need of new methodologies, approaches and tools, in order to foster studentsâ€™ socialization and to improve their learning outcomes. In this context, methodologies, techniques and innovating tools, supported by Information and Communication Technologies (ICTs) have been developed to promote better educational experiences.4
However, with conditions ever changing, PAL also facing new areas and challenges like increased utlisation of digitalisation, web-based PAL or blended-learning formats of it might receive greater interest. More research is needed to identify formats and combinations that could work in favour of PAL.5
Blended learning (BL) is an e-learning approach that combines the strengths of both online and face-to-face learning, creating meaningful interactions between students, teachers, and resources
Blended Peer-Assisted Learning (ePAL) platform consists basically on the integration of different existing e-Learning tools and platforms in a coordinated way in order to provide the implementation of PAL strategies.6
The CoI framework has been used to reflect student experiences in blended learning, its strength being in explaining such educational experiences through inquiry learning. The CoI model assumes that deep and meaningful learning, particularly in online environments, takes place within the community through the interaction of three core elements. These elements comprise social presence (participants seem like actual people), teaching presence (the design and development of learning experiences), and cognitive presence (the ability of learners to use online communication to construct meaning).7,8
Blended Peer Assisted Learning can be seen as a merge of different learning methodologies and technologies, combining these with different online educational environments, thus developing a more efficient learning process. Blended Learning is very useful, especially when applied to lessons that address complex or dull concepts, since the combination of face-to-face and on-line training (e-Learning) with different didactic resources allows the students to improve their learning outcomes. For instance, a lesson with a complex theme would use face-to-face sessions in order to introduce the theme, while e-Learning sessions could be applied to present complementary information, thus giving additional information about the concepts addressed in the lesson.
Blended Learning increases the options for greater quality and quantity of human interaction in a learning environment. This paradigm provides realistic practical opportunities for learners and teachers to make learning independent, useful and sustainable.9