Journal of Islamabad Medical & Dental College 2022-04-21T09:28:40+05:00 Prof. Dr. Syed Shoaib Hussain Shah Open Journal Systems <p>The Journal of Islamabad Medical &amp; Dental College (JIMDC) is a new quarterly Journal of Islamabad Medical &amp; Dental College. <strong>Its is recognized By Pakistan Medical and Dental Council (PMDC</strong>) <strong>and Higher Education Commission of Pakistan</strong>. It includes original research papers, reviews, case reports<strong>,</strong> and short communication related to health, medicine and dentistry. Submitted manuscripts must be original, written in English, and will be accepted for publication with the understanding that it has not been submitted simultaneously to any other journal, not published or under consideration elsewhere and has not been published previously. The manuscripts will be reviewed through double-blind peer review process.&nbsp;</p> Challenges for the Academia for Producing Future Doctors 2022-04-21T08:54:15+05:00 Bazmi Inam <p>&nbsp; &nbsp;</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Impact of Caffeine and Vitamin D3 on the Development of Neonate Mice Femur Growth Plate 2022-04-21T08:54:43+05:00 Maimoona Khan Abdullah Qamar Ayesha Ali Faiza Umbreen Fareeha Mushtaq <p><strong>Background: </strong>&nbsp;High dosage of caffeine can influence histological changes during bone development in the newborns, while vitamin D<sub>3</sub> has also its effect on such changes.&nbsp; Main objectives of the study were to determine the effects of caffeine on the histomorphology of developing femur and the role of vitamin D3 along with caffeine on the femur of BALB/c mice.</p> <p><strong>Methodology:</strong> The animal experimental study was carried out in the National Institute of Health, Islamabad in collaboration with the Anatomy Department, Army Medical College, Rawalpindi, from October 2014 till October 2015. &nbsp;Thirty pregnant mice, weighing 26-28g, were chosen and grouped into 3 equal sets of ten mice each.&nbsp; Control group G<sub>1</sub> was fed normal diet with ad libitum access to water.&nbsp; Experimental group G<sub>2</sub>, along with the above diet, was provided caffeine at 10mg/100g body weight as a single dose on every second day using oral gavage for 3 weeks. &nbsp;Experimental group G<sub>3</sub> was administered with caffeine at 10mg/100g body weight on every second day along with vitamin D<sub>3</sub> 0.1µg/day for 3 weeks.&nbsp; At completion of the study, neonate mice femurs were analysed to see the changes on the proliferative and hypertrophy zone heights of growth plate.&nbsp;</p> <p><strong>Results:&nbsp; </strong>Proliferative and hypertrophy zones of control group G<sub>1</sub> mice mean height ±SD was measured as 540±10.99μm and 164±6.609μm, respectively, while for experimental group G<sub>2</sub> the same height was observed as 443.5±12.258μm and 138.25±6.129μm, respectively. &nbsp;For experimental group G<sub>3</sub> mice mean height ± SD of these zones was found as 474±3.839μm and 144.25±3.726μm, respectively.</p> <p><strong>Conclusion:</strong> &nbsp;Ingestion of caffeine modified the femur's proliferative and hypertrophy zones height of the growth plate; however, vitamin D<sub>3 </sub>dosage mitigated this consequence.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Impact of Resveratrol in Attenuating Cisplatin Induced Testicular Toxicity in Male adult Rats 2022-04-21T08:55:08+05:00 Shahnaz Memon Sajjad Ali Almani Muhammad Saqib Baloch Samreen Ali Tanveer Ahmed Talpur Harender Kumar <p><strong>Background:</strong> Resveratrol is a poly-hydroxy phenol plant toxin that reduces oxidative stress and prevents tissue damage by increasing endogenous antioxidant levels. The study aimed to investigate the protective effects of Resveratrol by histochemical, ultrastructural and biochemical methods in testicular toxicity induced by the Cisplatin in Wistar Albino rats.</p> <p><strong>Methodology: </strong>The quasi-experimental study was carried out at the department of Pharmacology, Anatomy and Postgraduate Laboratory of ISRA University Hyderabad from October 2020 to March 2021. Twenty-four male, healthy Wistar Albino rats of age from 8-10 weeks and having body weight 250-300 grams, were included in the study. <em>R</em>ats were divided into three groups; each group have same number (n=08) of rats. Group-A (Control), Group-B (Experimental group or Cisplatin group), Group-C (Experimental group or Cisplatin + Resveratrol combination group). Pre- and post-experimental body weight of all animals was measured, blood samples were collected for the biochemical analysis for the oxidative markers, semen parameters, and histo-morphology. Data was analyzed using SPSS version 24.0.</p> <p><strong>Results:</strong> Statistically significant decline in the bodyweight and testicular weight in group B and C respectively (p&lt;0.05). While Group-B had lower sperm count, motility, and viability when compared to Group-C (p&lt;0.05). Group-B also had significantly lower levels of oxidative markers than Group-C (p&lt;0.05). Group- B's testicular histology significantly differed from Group-C's (p&lt;0.05). Seminiferous tubules in Group-B were irregular, regressive, and atrophic.</p> <p><strong>Conclusion:</strong> Resveratrol is a powerful antioxidant shows potential in reducing cisplatin-induced oxidative stress and, eventually, testicular toxicity in mice models.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Histo-Pathological Effects of Raphanus Sativus Leaf Extract on Carbon Tetrachloride Induced Hepatotoxicity 2022-04-21T09:27:06+05:00 Ahsan Aslam Muhammad Saleh Farzana Rahim Memon Sadia Khan Soobia Pathan Kazbano Ramsha <p><strong>Background: </strong>Raphanus sativus is a cruciferous plant which possesses free radical scavenging properties that defend the body against the deleterious effects of reactive oxygen species. The study objective was to assess the protective effect of Raphanus sativus in carbon tetrachloride induced hepatotoxicity in albino Wistar rats.</p> <p><strong>Methodology:</strong> This animal based experimental research was conducted from September 2019 to March 2020 at the Postgraduate Research Laboratory, Isra University, Hyderabad. Non-random purposive sampling technique was used for selection of study animals. Rats were distributed evenly in three different groups: Group 1 (control group), Group 2 (CCl4 induced experimental group), and Group 3 (CCl4 plus Raphanus sativus treatment group). Data was analyzed using SPSS version 24.</p> <p><strong>Results:</strong> Liver weight and serum markers of hepatic function were high in group 2 as compared to group 1 and C rats (p&lt;0.05). Treatment with Raphanus Sativus significantly reduced serum levels of LFTs (p&lt;0.05). There was a significant decline in the plasma levels of oxidative markers in group 2 while marked histo-pathological changes like necrosis, sinusoidal dilatation and congestion observed among animals of group 2.</p> <p><strong>Conclusion:</strong> Raphanus Sativus wields anti-oxidative as well as hepato-protective effect against carbon tetrachloride induced hepatotoxicity and tissue damage.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Determination of Difficulty Index in End of Block Examinations of Preclinical Undergraduate Medical Students 2022-04-21T09:28:40+05:00 Ifra Saeed Arsalan Manzoor Mughal Sidra Hamid Tehmina Qamar Ayesha Yousaf Aneela jamil <p><strong>Background:</strong> Multiple Choice Questions (MCQs) are considered a good choice for undergraduate formative assessment as they have higher reliability and are generally feasible. The objective of this study was to evaluate the difficulty index of Multiple-Choice Questions in the end of block examination of preclinical undergraduate medical students at Rawalpindi Medical University.</p> <p><strong>Methodology:</strong> This descriptive cross-sectional study was conducted at Rawalpindi Medical University. End of Block assessment data was collected from Department of Medical Education, RMU. A total of 60 MCQs scores were randomly selected and the difficulty index was calculated after entering data in MS Excel. Data was then entered in SPSS version 24. Means and standard deviations of Difficulty indices were calculated and compared between first-year and second-year students by independent samples students t-test and between subjects by ANOVA.</p> <p><strong>Results:</strong> Out of 120 Multiple Choice Items analyzed, in the first year MBBS block exam, 30% were easy, 65% were acceptable and 5% were difficult. In the second year MBBS block exam, 36.67% were easy, 56.67% were acceptable and 6.67% were difficult. There was no significant difference (p=0.986) between the mean difficulty index of first-year MBBS students and second-year MBBS students. However, the mean difficulty index was highest in physiology (66.53 ± 16.262) followed by biochemistry (64.36 ± 16.756) and anatomy (54.80 ± 17.665), and the mean difference between the subjects was statistically significant (p=0.005). The mean difficulty index in first-year MBBS students was highest for Biochemistry followed by Physiology and Anatomy. In second-year MBBS students, the mean difficulty index was highest in Physiology followed by Biochemistry and Anatomy.</p> <p><strong>Conclusion: </strong>The difficulty index of Anatomy MCQs was lower indicating that the students find them more difficult than the other two subjects i.e., Physiology and Biochemistry in the first two years of their undergraduate medical studies.</p> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Anxiety Experienced By People Searching Internet For Medical Information 2022-04-21T09:27:56+05:00 Mohi Ud Din Syed Fawad Mashhadi Shahrob Khan Tehreem Safdar Bilal Ashraf Zeeshan Khalid Awan <p><strong>B</strong><strong>ackground: </strong>A large proportion of people use internet to search for information on medical symptoms. The objective of the study was to assess the frequency of internet use for medical information and its association with anxiety levels.</p> <p><strong>Methodology: </strong>A cross-sectional study was conducted in tertiary care hospitals affiliated with National University of Medical Sciences, Islamabad from August to December 2020. Ethical approval was taken. A total of 414 Participants aged 20 and above, belonging to either gender, and having at least primary level education were included in the study, while participants belonging to medical background were excluded. Non-probability convenient sampling technique was used to collect data through a validated questionnaire. Frequencies and percentages were calculated. Chi-square test of significance was applied. P-value less than .05 was considered as statistically significant.</p> <p><strong>Results: </strong>Majority i.e., 301 (80%) of the participants stated that the health-related searches exacerbated their anxiety. Participants from lower income groups were more prone to anxiety, while participants from higher income groups were more likely to visit a doctor. There was a significant association between age groups and perceptions, that and web searches lead to review of content on serious illness, persistence of query for illness after web search, and increase in web searches related to perceived condition (p&lt;0.05).</p> <p><strong>Conclusion: </strong>There was an increase in Anxiety levels after web searches. It was more pronounced in lowest income group people. Higher income group were more likely to trust web searches results.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Prophylactic use of Amiodarone in Coronary Artery Bypass Graft Patients with Less Ejection Fraction 2022-04-21T00:38:53+05:00 Shumaila Ali Rai Chaudhry Amjad Ali Muhammad Arsalan Qureshi <p><strong>B</strong><strong>ackground: </strong>Dysrhythmias like atrial fibrillation are most common in post-CABG patients, with an incidence of around 40%. Prophylactic amiodarone treatment decreases the occurrence of dysrhythmias in low ejection fraction patients. Some studies have reported that the benefit of giving amiodarone is more in high-risk patients such as those having older age, higher angina class, diabetes, and severe coronary artery disease (CAD). This study aims to determine the role of amiodarone prophylaxis in the prevention of dysrhythmias following CABG in patients with low ejection fractions.</p> <p><strong>Methodology: </strong>In this non-randomized study, we included150 patients who underwent CABG at Multan Institute of Cardiology from Jan-2019 to Aug-2019, having EF ≤35%. In the amiodarone group (N=75), 3 mg/Kg of amiodarone was given through CPB machine after removal of the X-clamp and before weaning from cardiopulmonary bypass. While in the remaining 75 patients, no anti-arrhythmic drug treatment was given during the peri-operative period. &nbsp;The occurrence of postoperative arrhythmia during the primary hospital stay after surgery was a primary study endpoint.</p> <p><strong>Results: </strong>There was no significant difference between patients' mean age, gender, BMI, and the number of grafts in the amiodarone group 3.9±0.53 and control group 3.04±0.50 (p-value 0.20). The frequency of Post operative Atrial fibrillation (POAF) was significantly different in both groups. In the amiodarone group, 13 (17.3%) patients developed POAF, and in the control group, POAF occurred in 25 (33.3%) patients (p-value 0.024).</p> <p><strong>Conclusion: </strong>Amiodarone prophylaxis significantly lowers the incidence of POAF after CABG in low EF patients.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Ototoxic Hearing Loss in the Multidrug Resistant Tuberculosis 2022-04-21T00:38:17+05:00 Laraib Bakhat Nazia Mumtaz Ghulam Saqulain <p><strong>B</strong><strong>ackground: </strong>The recommended treatment of MDR TB lasts for 20 months following therapy with second line anti - tuberculosis drugs (SLDs) which carry the risk of adverse effects including hearing loss. The objective of this study was to determine the frequency of hearing loss and its association with demographic and clinical variables in multidrug resistant tuberculosis patients on second line drugs.</p> <p><strong>M</strong><strong>ethodology: </strong>This cross-sectional study was carried out at the Audiology Department of the Civil Hospital Bahawalpur, over a period of 6 months, from 1st May 2019 to 31st October 2019. The study included 65 diagnosed cases of tuberculosis, aged 12-70 years, of either sex, who were on second line antituberculous therapy. Non-probability purposive sampling technique was used for patient selection. Screening was performed using medical history sheet, otoscopy and hearing assessment. Data was entered and analyzed using SPSS- Version 21.</p> <p><strong>Results: </strong>Among a total of 65 patients,43 (66.2%) were males and 22(33.8%) were females. Mean age of study population was 35.87±9.35 years. Hearing loss was seen in 14(21.5%) cases, with mild hearing loss in 15.4% cases and moderate hearing loss 6.2%. Hearing loss was associated with type of drug used, its duration and associated symptoms of tinnitus and vertigo (p=0.000).</p> <p><strong>Conclusion: </strong>It was found that hearing loss is quite frequent (21.5 %) with multidrug resistant anti-tuberculous therapy in this region and is significantly associated with the type of drug used and its duration. Majority of affected cases were seen with the use of streptomycin.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College KAP Survey of Dental Students About Scientific Research 2022-04-21T00:37:48+05:00 Aisha Wali Talha Siddiqui Naqibullah Ajmir <p><strong>B</strong><strong>ackground</strong>: Research is an essential component of the academic curriculum and its importance in health care must be appreciated. It enables the students to critically analyses the information in clinical decision making and care of patients. The objective of the study was to evaluate research-oriented knowledge, attitude, and practices amongst undergraduates and house surgeons.</p> <p><strong>M</strong><strong>ethodology: </strong>A cross-sectional study was conducted among undergraduate dental students and house surgeons of Baqai Dental College from November to December-2018. Ethical approval was obtained from the ethical committee of the Baqai Dental College. Permission for data collection was obtained from the Research and Development Department, and the Principal of the Dental College. The sample size was calculated to be 243 using Open Epi version 3.03 by taking 20% prevalence rate with 95% confidence interval and ????=5%. Participants were selected by convenience sampling technique and a pretested Questionnaire, was distributed.</p> <p><strong>Results: </strong>Out of total,84 participants were males and 159 females. 1st and 2nd year students were more confident in interpreting and writing research paper. Final year students and house surgeons were more interested in reading research journals and participating in research methodology workshops. 41.2% of the respondents preferred Google scholar for literature search.</p> <p><strong>Conclusion</strong>: Adequate knowledge about research was found among all the participants while research-based practice was more among final year dental students and house surgeons.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Nasopharyngeal Angiofibroma 2022-04-21T00:37:02+05:00 Ahmad Liaquat Nabeela Riaz Tahmasub Faraz Tayyab Ayaz Mehmood <p>Nasopharyngeal angiofibroma (NA) is a rare, highly vascular, benign lesion typically affecting young males. It is prone to spontaneous bleeding even after minor trauma. Reported here is a case of an 18 years old male with almost 8x8cm swelling in the left cheek. There was nasal obstruction due to mass in the left nostril and he had a history of obstructive sleep apnea and frequent epistasis. Surgery was done through Weber- Ferguson approach.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Management of Empyema Gallbladder During COVID-19 Pandemic 2022-04-21T00:42:12+05:00 Muneeb Ullah Muhammad Faisal Murad Muhammad Kashif Khan Faisal Nadeem Adil Shafi Aqsa Adeel <p>Cholecystostomy is performed in high-risk patients with gall bladder disease. These patients are generally elderly with multiple comorbidities; in particular cardiac patients with uncontrolled diabetes, and present late with acute cholecystitis with systemic inflammation. The management of such high-risk patients requires multi-departmental approach. COVID-19 pandemic has widely affected the management guidelines including timing of surgery, extent of pre-operative optimization, use of laparoscopy for surgery and intensive care requirement. We report a case of elderly hypertensive and diabetic patient who presented during the first wave of COVID-19 pandemic with fever, vomiting and pain abdomen. He was diagnosed with empyema gallbladder. Cholecystostomy was performed as a temporizing measure which was followed by elective laparoscopic cholecystectomy as daycare admission. This averted the need for possible intensive care stay and emergency surgery whereas providing equally good outcome.</p> 2022-03-31T00:00:00+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College