YouTube as a learning modality for clinical procedures among medical and dental students: A study in public sector teaching institutes.

Objective: To evaluate the effectiveness and analyse the influence of YouTube as a learning modality for clinical procedures among medical and dental students in a public-sector setting. METHODS: The cross-sectional study was conducted at the medical and dental constituent institutes of Jinnah Sindh Medical University and Jinnah Postgraduate Medical Centre between August and October 2023, and comprised undergraduate, graduate, and postgraduate students of either gender aged 18-40 years. Data was collected using a self-administered, structured, closed-ended 16-item questionnaire, which was developed in the English language and explored the usage of YouTube as a source of information about medical and dental clinical procedures. Data was coded and analysed using SPSS 26. RESULTS: Of the 314 participants, 153(48.7%) were medical students and 161(51.3%) were from the dental stream, 175(55.7%) were females, and 139(44.3%) were males. YouTube was a helpful tool for 143(45.5%) students who used it when needed, 172(54.8%) used it occasionally before attempting procedures, while majority of the dental students 140(44.6%) used it to study for prosthodontics. There were 154(49%) students who supported the idea that faculty should recommend watching relevant videos on YouTube, while 256(81.5%) preferred other websites. Conclusion: YouTube was mostly used for learning clinical procedures by the students.

Retraction: Frequency and Predictors of Acute Kidney Injury in Patients With Acute Coronary Syndrome in a Tertiary Care Hospital: A Retrospective Study.

[This retracts the article DOI: 10.7759/cureus.21869.].

Frequency and Predictors of Acute Kidney Injury in Patients With Acute Coronary Syndrome in a Tertiary Care Hospital: A Retrospective Study.

Introduction Acute kidney injury (AKI) is a complex condition marked by rapid deterioration of renal function (within hours or days), with clinical symptoms ranging from a minor rise in serum creatinine to anuric renal failure needing renal replacement therapy. AKI is one of the complications of acute coronary syndrome (ACS). This study aims to determine the frequency of AKI among patients with ACS and identify its predictors. Method This study is a retrospective observational study conducted at the Dow University of Health Sciences, a tertiary care hospital located in Karachi, Pakistan. This study was conducted from January 2020 to June 2021. All patients aged 18-75 years admitted with ACS and admitted for more than 48 hours were included in the study. A pre-set questionnaire was used to collect data from the hospital management information system (HMIS). Results The frequency of AKI among patients with ACS was 24.18%. The factors associated with AKI among patients with ACS on multivariable logistic regression included the age of patients (odds ratio (OR) = 1.04, p-value = 0.018), having diabetes mellitus (OR = 2.33, p-value = 0.031), admission Killip ≥ II (OR = 2.12, p-value = 0.041), previous history of myocardial infarction (MI) (OR = 3.64, p-value = 0.001), baseline glomerular filtration rate (GFR) (OR = 0.94, p-value = 0.001), in-hospital ejection fraction (EF) (OR = 0.93, p-value = 0.001), and serum creatinine at admission (OR = 1.02, p-value = 0.001). Conclusion Age, comorbidities including diabetes mellitus and previous history of MI, admission Killip ≥ II, baseline GFR, in-hospital EF, and serum creatinine level at admission are significant independent predictors of AKI in patients with ACS.

COVID 19 pandemic: Effect on management of patients with breast cancer; single center retrospective cohort study.

BACKGROUND: (SARS-COV-2) infection, led to a pandemic affecting many countries, resulting in hospitals diverting most of their resources to fight the pandemic. Breast cancer, already a healthcare dilemma, is also affected in this scenario. Our aim was to find out the impact of COVID-19 on presentation of breast cancer stage and its effects on overall onco-surgical management. METHODS: This cohort single-centered retrospective review was carried out at our hospital, over a period of 18 months. Females with known breast cancer were included in the study. Data was collected on performas by a single researcher. Effect of COVID pandemic on presentation stage and its impact on overall management was studied. SPSS 23.0 used for data analysis. A 95% CI was used. Descriptive statistics were presented as range/means. Categorical data was analyzed by Fisher exact test, t-test was applied to numerical data, p value ≤ 0.05 was considered significant. RESULTS: Out of 87 patients presenting with suspicious lump, 69 who had malignancy on histo-pathology were included in study. Twelve out of 69 were COVID positive. Sixty patients presented with advanced stage (≥stage 2b) out of which 21 underwent upstaging of disease due to delay in presentation/management. We found that 9 out of 12 (majority) Covid positive patients had disease upstaging. Overall main reason for delay in presentation was found to be unawareness of disease. CONCLUSION: We concluded that COVID-19 pandemic had no impact on presentation delay, breast cancer management/treatment and disease upstaging as compared to figures available for our population before the pandemic. However, our study showed significant correlation between disease upstaging and COVID status. This led us to reconsider our preformed protocols for COVID positive breast cancer patients. Our results can be used by future researchers to investigate if COVID itself can contributes in patho-physiology of upstaging in breast cancer or not.

Incidence and Recurrence of Allergic Fungal Sinusitis at Tertiary Care Facility.

To assess the incidence and recurrence of patients of allergic fungal sinusitis after administration of topical steroids for 24 months this is a cross-section study. Total 90 patients diagnosed with nasal pathology were enrolled from January 2011 to December 2015 at Liaquat National Hospital, various sign and symptoms were tabulated. Patients clinical, radiological and histopathological reports were analyzed. Post operative steroid dose and recurrence rate was noted. Post stratification, Chi-square test and Fisher's exact test was applied to see the association between CT Scan and endoscopic findings and recurrence considering P value ≤ 0.05 as significant. Total 90 patients of either sex aged between 12 and 63 years fulfilled the inclusion criteria and were enrolled in the study. The results showed that among all study patients, 53(58.9%) were male and 37(41.1%) were female. Common presenting symptoms included nasal obstruction, nasal discharge & headache followed by proptosis. From 90 cases, 73(81.2%) had chronic rhinosinusitis and 17(18.9%) cases had Aspergillus. Postoperatively patients were given topical steroids and recurrence was seen in twelve (17.8%). All were aspergillus positive. The incidence of AFRS is (17) 18.9% of CRS which is slightly higher as reported in previous literature. Endoscopic finding may differ from CT scan finding. Patients presented with CRS should receive steroids for at least 2 years to prevent recurrence.

Risk of Multiple Sclerosis in Epstein-Barr Virus Infection.

Multiple sclerosis (MS) is a chronic neuro-inflammatory, immune-mediated disorder of the central nervous system; however, less is known about its cause. It causes neurological disability in young adults, more commonly in women. Several risk factors including environmental, genetics, and infections have been identified, which contribute to the abnormal immune response. Viruses belonging to the Herpes family have been indicated as a potential risk for MS; their biological mechanisms are not known but several possibilities have been discussed. Epstein-Barr virus (EBV) is the leading and most common virus associated with MS. It is a potential oncogenic virus that hosts the B lymphocytes and has been associated with numerous cancers such as Burkitt's lymphoma, Hodgkin's lymphoma, and nasopharyngeal carcinoma. The risk of MS is low in patients who are EBV negative but increases by several folds in individuals who have a history of infectious mononucleosis (IM). Several ecological studies, co-occurring pathologies, and experimental laboratory-based research provide evidence to support the relationship between EBV and MS.