Interplay between leadership and patient safety in dentistry: a dental hospital-based cross-sectional study.

OBJECTIVES: The study aimed to study the association of leadership practices and patient safety culture in a dental hospital. DESIGN: Hospital-based, cross-sectional study SETTING: Riphah Dental Hospital (RDH), Islamabad, Pakistan. PARTICIPANTS: All dentists working at RDH were invited to participate. MAIN OUTCOME MEASURES: A questionnaire comprised of the Transformational Leadership Scale (TLS) and the Dental adapted version of the Medical Office Survey of Patient Safety Culture (DMOSOPS) was distributed among the participants. The response rates for each dimension were calculated. The positive responses were added to calculate scores for each of the patient safety and leadership dimensions and the Total Leadership Score (TLS) and total patient safety score (TPSS). Correlational analysis is performed to assess any associations. RESULTS: A total of 104 dentists participated in the study. A high positive response was observed on three of the leadership dimensions: inspirational communication (85.25%), intellectual stimulation (86%), and supportive leadership (75.17%). A low positive response was found on the following items: 'acknowledges improvement in my quality of work' (19%) and 'has a clear sense of where he/she wants our unit to be in 5 years' (35.64%). The reported positive responses in the patient safety dimensions were high on three of the patient safety dimensions: organisational learning (78.41%), teamwork (82.91%), and patient care tracking/follow-up (77.05%); and low on work pressure and pace (32.02%). A moderately positive correlation was found between TLS and TPSS (r=0.455, p<0.001). CONCLUSIONS: Leadership was found to be associated with patient safety culture in a dental hospital. Leadership training programmes should be incorporated during dental training to prepare future leaders who can inspire a positive patient safety culture.

Predicting Success: A Comprehensive Analysis of High School and Admission Test Scores on Future Academic Performance of Dental Students.

Introduction Dental school admissions in Pakistan traditionally rely on Higher Secondary School Certificate (HSSC), University of Health Sciences (UHS), and National Testing Service (NTS) scores, with limited research available on their predictive validity for dental school performance. This study aims to investigate the correlation between a student's first-year dental school performance and their HSSC, UHS, and NTS scores. Methods A total of 282 records, spanning the years 2016 to 2020, were obtained from a single private dental institution. The data included HSSC, UHS, and/or NTS scores, with the first professional examination results as the dependent variable. Statistical analysis was conducted using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 25.0, Armonk, NY), encompassing descriptive statistics, Pearson's correlation coefficients, and multiple regression analysis. Results Pearson's coefficients revealed weak to moderate positive correlations between the first professional examination and HSSC (r=0.209, p<.01), UHS (r=0.344, p<.01), and NTS (r=0.350, p<.01), all statistically significant at p < 0.01. Multiple regression analysis indicated that UHS scores contributed the highest explanatory power (R² = 0.146) in predicting first professional examination results. Conclusion A positive correlation between HSSC, UHS, and NTS scores with dental students' performance in the first professional examination is observed. However, the correlations are moderate, highlighting the importance of incorporating assessments that consider cognitive, behavioral, and skill-related aspects in admissions processes. Given the evolving landscape of dental education, these findings underscore the need for a holistic approach to identify candidates better equipped to serve the healthcare sector.

Self-efficacy and Online Learning Readiness of Undergraduate Dental Students in Pakistan During COVID-19 Pandemic.

OBJECTIVE: To investigate the correlation between general self-efficacy and online learning readiness among Pakistani undergraduate dental students. STUDY DESIGN: Cross-sectional study. Place and Duration of the Study: Riphah International University, Islamabad, between September 2020 and March 2021. METHODOLOGY: Using cluster sampling, three dental colleges of Islamabad and Rawalpindi were selected. Electronic questionnaires were sent to 750 students. The questionnaire was comprised of two instruments, General Self-Efficacy Scale (GSES), and Online Learning Readiness Scale (OLRS). GSES had 10-items with response measurement on four-point Likert scale, while the OLRS had 18 items in five different domains measured by five-point Likert scale. Data were analysed using SPSS-23. Correlation between dependent variables was calculated using linear regression analysis. RESULTS: The response rate was 59.3% with a predominant response from female students (82.2%) compared with male students (17.8%). The majority of responses were recorded from third year students (27.9%). The year four students' scores for GSE, computer and internet self-efficacy, and self-directed learning differed significantly from other students. The overall mean GSE score was 29.37+4.57. Regression indicated a low degree of correlation between GSE and the five domains of OLRS with r2 values ranging from 0.12 to 0.32. CONCLUSION: A weak to moderate correlation was found between self-efficacy and the five dimensions of online learning readiness among Pakistani undergraduate dental students as depicted by the r-values. KEY WORDS: Cross-sectional studies, Dental education, Dental students, Dentistry, Efficacy, Online learning, Questionnaire.

Clinical profile and outcome of neonatal pneumothorax in resource-limited neonatal intensive care unit.

OBJECTIVE OF STUDY: To determine the frequency, clinical profile, and outcome of pneumothoraxes in neonates in resource-limited neonatal intensive care unit (NICU) setting. STUDY DESIGN: Prospective cohort. PLACE AND DURATION OF STUDY: The study was carried over a period of 4 years and 6 months at two NICUs of Combined Military Hospital (CMH) Multan (January 2011-August 2013) and CMH Abbottabad (September 2013-July 2015). MATERIALS AND METHODS: All neonates fulfilling inclusion criteria were included in the study. Demographic and clinical parameters were recorded. All stable cases were initially managed on headbox oxygen, nasal oxygen, or improvised bubble continuous positive airway pressure devices (B-CPAP). In suspected cases, pneumothorax was confirmed on a portable chest X-Ray (CXR). Hemodynamically stable neonates were closely observed for spontaneous resolution whereas unstable neonates were managed by needle thoracocentesis or thoracostomy with or without ventilator support. End point of the study was either discharge or death of the neonate. RESULTS: Of a total of 1427 included neonates, 66 (4.6%) developed pneumothorax. Pneumothorax was more common in late pre-term and term infants with normal birth weight (>2.5 kg). Primary diseases leading to pneumothorax were respiratory distress syndrome (RDS) 38 (57.6%), meconium aspiration syndrome (MAS) 10 (15.2%), transient tachypnea of newborn (TTN) 9 (13.6%), birth asphyxia syndrome (BAS) 6 (9.1%), and pneumonia 3 (4.5%). Majority of the patients 58 (87.9%), required thoracostomy, 2 (3%) required only needle thoracocentesis while spontaneous resolution occurred in 6 (9.1%) patients. Out of 66 patients, 48 (72.7%) were discharged and 18 (27.3%) died. Average hospital stay was 10.5 ± 5.85 days. CONCLUSION: Pneumothorax is not an uncommon complication in neonates presenting with respiratory distress in resource-limited NICUs. High index of suspicion is required for early recognition and timely management, as delay is associated with significant mortality.

Efficacy of 0.1% tacrolimus in long-term management of erosive lichen planus.

OBJECTIVES: This study documented the response of erosive oral lichen planus (OLP) to exclusive treatment with 0.1% topical tacrolimus over a 12-month period or until the patient became unresponsive to therapy. MATERIALS AND METHODS: A retrospective cohort design was used to acquire data on 12 patients with recalcitrant OLP that were prescribed 0.1% tacrolimus. These patients were prescribed 0.1% tacrolimus after failing to respond to conventional corticosteroid therapy. Information about their response to medication initially and on flare ups were included in this study. RESULTS: The sample consisted of nine women and three men. All patients were given 0.1% tacrolimus to be applied 3 times a day. Two patients did not respond to the treatment at all, 4 patients showed partial response to tacrolimus treatment. Six patients showed complete initial response to treatment. CONCLUSION: 50% of our patients showed a suboptimal response to 0.1% tacrolimus use for erosive OLP, thus, suggesting that in some cases 0.1% tacrolimus may be an ineffective option for managing erosive OLP.