Neonatal Hearing Screening Programme And Challenges Faced By The Developing Country: A Tertiary Care Hospital Experience.

OBJECTIVE: To screen new-borns to diagnose any hearing impairment early. METHODS: The prospective, cross-sectionalstudy was conducted at the Department of Otorhinolaryngology, Head and Neck Surgery Liaquat National Hospital, Karachi, from November 1, 2020, to April 30, 2021, and new- borns of either gender aged >12h born via spontaneous vaginal delivery, induced labour, and Caesarean section. A predesigned questionnaire was used to collect detailed case history, including gestational age, duration of labour, and other prenatal, natal, and postnatal risk factors. Otoacoustic emission test was performed, and infants referred twice were scheduled for complete diagnostic evaluation and brainstem evoked response audiometry. Data was analysed using SPSS 23. RESULTS: Of the 267 neonates, 249(93.3%) passed the first screening. Of the remaining 18(6.7%) neonates, 8(44.4%) passed the second screening, while 10(55.5%) were asked to come for a follow-up after three weeks. Of them, 3(30%) returned for check-up, while 7(70%) did not show up. CONCLUSIONS: Neonatal risk factors associated with hearing loss need to be identified, and a comprehensive hearing screening programme is required for neonates.

The role of family and culture in the disclosure of bad news: A multicentre cross-sectional study in Pakistan.

Objectives: Disclosure of bad news is distressing for patients and family members. Our aim was to assess patients' perceptions and preferences regarding bad news in the health setting. Methods: Cross-sectional, multi-centered study supported by an external grant in 15 Government and Private Hospitals across Pakistan. A sample size of 1673 patients and family members was used. Ethics permission/consent was taken from each participating hospital and participant. Responses were compared across provinces, gender, age, education and income. Results: >80% patients preferred their relatives to know the diagnosis first and they wanted the news to be disclosed to them by doctors. Significant association between education level, income and preference for wanting to know the diagnosis was found. Reasons for wanting to know the diagnosis included treatment, prognosis and prevention options whereas reasons for not wanting to know included fear of emotions and God's will. Conclusion: The majority of Pakistani patients want to be informed and want the family to know first. Preferences for disclosure vary across, age, education and income level. Innovation: First countrywide study on this topic. Identifies need for culturally sensitive guidelines that include the family's role in disclosure of bad news.

Knowledge scores in annual and modular curriculum among medical students from Karachi, Pakistan.

OBJECTIVE: To compare the knowledge scores of basic medical subjects in annual versus modular system among undergraduate medical students. METHODS: A cross-sectional survey was conducted on 4th year undergraduate medical students of annual and modular system of Liaquat National Medical College, Pakistan. Study was conducted from 30th November 2017 to 1st June 2018 for a total of 6 months. Sample size was calculated to be 82 students. The data was collected using a structured questionnaire. The student's t-test was applied to compare the mean difference of knowledge scores between the two groups. RESULTS: Students in modular system retained better knowledge of anatomy as compared to annual students. However, the annual system students retained higher knowledge in subjects of community medicine and pharmacology. Mean knowledge score among students for annual system was 12.98 ± 2.92 and semester system was 13.1 ± 3.03. There was no significant difference observed in overall mean knowledge scores between the two groups (p=0.85). CONCLUSIONS: Students in the annual system scored higher in pharmacology and community medicine. This highlighted the need to address the issues of time allocation and implementation strategies for the subjects in the new system. There was no difference between overall knowledge scores in each group, hence, it would be inappropriate to conclude that one system is superior to the other.

Prevalence of Anger in Medical Students: A Tertiary Care Experience from a Developing Country.

BACKGROUND:  Anger is defined as an emotional state that involves displeasure and consists of subjective feelings that vary in intensity, from mild irritation or annoyance to intense fury and rage. Anger is dangerous because it affects the health of the individual. It also affects relationships between fellow physicians and nurses and can ultimately compromise patient care. Medical school is perceived as stressful and a number of studies have proved the high prevalence of anxiety, stress, and depression in medical students. However, no significant studies have been performed to assess the frequency of anger in medical students. The purpose of our study is to find out whether anger is prevalent among medical students and its effect on different aspects of student's lives. METHODS:  A cross-sectional survey was conducted on the students from all five years of Liaquat National Medical College. Sampling technique used was nonprobability purposive sampling. A self-administered questionnaire was filled by medical students. Data were recorded and analyzed using the IBM statistics SPSS software. RESULTS:  A total of 205 students participated in the survey. Using the questionnaire, it was found that the highest frequency of anger was found in first-year students (97.5%), followed by the fourth year (97.4%), final year (97.2%), third year (95.7%), and second year (91.9%). All five years identified stress as a major predictor of anger. Anger had the greatest effect on decision making, especially in final year medical students. CONCLUSION:  Authors concluded a high frequency of anger in medical students. Increased stress has negative impacts on the mental health and coping strategies of students which greatly affect their decision-making power.

Role Of Radiosurgery In Arteriovenous Malformations.

BACKGROUND: Intracranial arteriovenous malformations (AVMs) consist of an abnormal nidus of blood vessels that shunt blood directly from an artery to a vein and thereby bypass an intervening capillary bed. AVMs may be found as an incidental finding. They may be associated with intracranial haemorrhage, seizures, headaches or neurological deficits. There are different treatment options for AVM. These include observation, microsurgery, Stereotactic radio surgery (SRS), endovascular embolization and intensity modulated radiotherapy (IMRT). METHODS: Data was collected using searching engines like Pubmed, Google scholar, Embase, Cinahl and Medline. MeSH and Non-MeSH terms were used like Arterio-venous malformations, microsurgery, endovascular embolization. RESULTS: Multiple interventional radiosurgical techniques have been introduced in recent years. The most effective and least risk-associated methods are Stereotactic radiosurgery, Microsurgery, Embolization and Intensity modulated radiotherapy (IMRT). However, the outcome of such treatment modalities depends upon Site of malformation, grade of AVM, patient's age/gender, dose and volume of radiosurgery. Digital substraction angiography (DSA) and MR angiography (MRA) are most suitable methods for the follow-up of AVMs. CONCLUSIONS: Stereotactic radiosurgery is the most suitable technique for AVMs considering the good prognosis and the risks associated with this procedure. However, large AVMs require multidisciplinary approach for better results.