Journal of the Dow University of Health Sciences (JDUHS)

Addressing the Epidemic of Depression Among Medical Students in Pakistan: Challenges and Solutions

Saqib H. Ansari — 2024-03-30

Medical education is often considered one of the most challenging and demanding fields of study. Medical students are required to acquire vast amounts of knowledge, master complex clinical skills, and navigate high-pressure clinical environments.

Aetiology, Severity and Outcome of Patients Admitted with Acute Pancreatitis: A Cross-Sectional Study

Abdul Samad — 2024-03-30

Objective: To determine the aetiology, severity and outcome of patients admitted with acute pancreatitis at Hamdard University Hospital Karachi, Pakistan.
Methods: This retrospective cross-sectional study was conducted at Hamdard University Hospital Karachi from January 2021 to June 2023. Patients aged 18 years and above who were admitted to the hospital with confirmed acute pancreatitis, admitted through the emergency department or by direct admission were included. Patient’s demographic data, aetiology, along with the severity of disease and outcome, such as alive or dead, were noted. Bedside Index of Severity in Acute Pancreatitis was used to assess the severity of the disease.
Results: Of the 188 patients, the mean age was 59.14 ±9.52 years. Mild acute pancreatitis was observed in 58 (30.9%), moderate in 95 (50.5%), and severe in 35 (18.6%) patients. Biliary pancreatitis was the most common etiology in 129 (68.6%) participants, whereas symptoms of abdominal pain and abdominal distension were observed in all 188 (100%) patients. A significant association of acute pancreatitis was observed with age (p-value <0.001), gender (p-value 0.047), length of hospital stays (p-value <0.001), and Computed Tomography Severity Index (CTSI) severity (p-value <0.001). Mortality was observed in 9 (4.8%) patients with severe acute pancreatitis.
Conclusion: In conclusion, biliary pancreatitis was the most common etiology of patients admitted with acute pancreatitis. Significant associations were found between the severity of acute pancreatitis and various factors including age, gender, hospital stay duration, and CTSI severity. The overall mortality appeared only in patients with severe acute pancreatitis.

Relationship of Computer Misuse-Related Body Pain with Awareness of Workstation Ergonomics during Digital Learning Era

Zohour Ibrahim Rashwan — 2024-03-30

Objective: To investigate the relationship between academicians' computer misuse-related body pain and their awareness of workstation ergonomics during digital learning era.
Methods: This cross-sectional study was conducted at the University of Bahrain from March to June 2022. Faculty members experienced musculoskeletal (MS) pain and utilized the e-learning approach for at least one academic year were included in the study. The outcome of the study was computer misuse-related body pain and aware-ness of workstation ergonomics. Body pain was assessed by using Body Map Tool and ergonomic knowledge questionnaire were used to assess awareness of workstation ergonomics.
Results: Of total 173 academicians, the mean age was 41.4 ±9.9 years. Among them, 108 (62.4%) experienced mild MS pain, while 65 (37.6%) reported moderate to severe MS pain. Academicians' mean scores of knowledge about the definition of ergonomics, MS disorders, and their risk factors were i.e., 3.42 ±1.03. It was found that females were nine times more likely at risk of moderate/severe pain as compared to males (cOR 9.00, 95% CI 2.05 to 39.49, p-value 0.004). There was 0.62 times less risk of moderate/severe pain for individuals had good/ very good level of knowledge about computer workstation ergonomics as compared to individuals had poor/fair levels of knowledge about computer workstation ergonomics (cOR 0.38, 95% CI 0.19 to 0.77, p-value 0.007).
Conclusion: The study revealed that individuals with a better understanding of computer workstation ergonomics demonstrated a reduced likelihood of experiencing moderate/severe MS pain. Gender differences also emerged, with females more susceptible to such pain.

Frequency and Factors Associated with Primary Dysmenorrhea among Adolescents Living in Kendari City, Indonesia: A Cross-Sectional Study

Saida Saida — 2024-03-30

Objective: Dysmenorrheal is pain during menstruation or pain caused by menstruation in the lower abdomen or at the waist, with characteristics including heartburn, aches, pricks, diarrhea, and even fainting that is felt before or during menstruation. This study aims to analyze the determinants of dysmenorrheal among adolescents in Kendari City.

Methods: This cross-sectional research was carried out at SMPN 20 Kendari City from September to October 2022 involving 173 students. Analysis of research data using the chi square test.

Result: The results showed that the majority of respondents did not suffer from primary dysmenorrheal, with a total of 129 adolescents (74.6%), 117 adolescents (67.6%) had menstrual periods between 5-7 days, and 80 adolescents (46.2%) were underweight), and used to exercise with 120 teenagers (69.4%). Statistical analysis of the relationship between the length of menstruation and the incidence of primary dysmenorrheal has a p-value > 0.05. The relationship between nutritional status and the incidence of primary dysmenorrheal has a p-value <0.05. The relationship between exercise habits and the incidence of primary dysmenorrheal has a p-value <0.05.

Conclusion: The study concludes that dysmenorrheal in adolescents in Kendari City is related to a lack of and irregular sports activities, excess and under nutrition status.

Randomized Double Blind Comparison of Prophylactic Tramadol and Tramadol Plus Ketamine for Prevention of Shivering after Spinal Anesthesia in Lower Segment Caesarian Section

Muhammad Arif — 2024-03-30

Objective: To assess the effectiveness of prophylactic intravenous tramadol alone versus a combination of tramadol and ketamine in preventing shivering during spinal anesthesia for lower segment caesarean section.
Methods: This double-blind randomized controlled trial was conducted at Ziauddin Hospital, North Nazimabad, Karachi, Pakistan from August 2023 to October 2023. Pregnant women aged between 18 to 40 years meeting American Society of Anesthesiologist physical status I and II admitted in hospital for lower segment caesarian section were enrolled. One group received an injection tramadol 0.5mg/kg whereas the other group received an injection of tramadol 0.25mg/Kg plus an injection ketamine 0.25 mg/Kg. The primary outcomes were incidence of shivering and severity of shivering. Time to shiver and complications were secondary outcomes.
Results: Of total 190 patients, the mean age was 25.95 ±3.63 years. Shivering was reported in 96 (50.5%) patients. The incidence of shivering was found significantly lower in tramadol plus ketamine group as compared to tramadol group i.e., 18 (18.7%) vs. 78 (81.3%) (p-value <0.001). Severity of shivering was found significantly lower in tramadol plus ketamine group as compared to tramadol group (p-value <0.001). Mean duration of shivering found significantly lower in tramadol plus ketamine group as compared to tramadol group i.e., 4.78 ±0.73 minutes vs. 8.46 ±1.02 minutes (p-value <0.001) respectively.
Conclusion: The incidence of shivering was significantly lower in the group receiving the combination therapy compared to those receiving tramadol alone. Notably, the severity and duration of shivering were also markedly reduced in the tramadol plus ketamine group.