p-ISSN 2410-163X e-ISSN 3079-2924 The Journal of Rashid Latif Medical College (JRLMC), affiliated with the Rashid Latif Khan University of Lahore, is a bi-annual, peer-reviewed open access publication. JRLMC invites original research, covering a wide range of health related topics and adhering to international editorial standards. The journal offers a no-cost publication option for healthcare professionals and includes five sections: editorial, original articles, review articles, case reports/series, and short communications.
Comparative Efficacy of High-Load Strength Training versus Multimodal Physical Therapy in Chronic Plantar Fasciopathy
Background: Plantar heel pain, commonly referred to as plantar fasciopathy, affects a significant percentage of both athletic and sedentary populations. While conventional conservative physical therapy (stretching, manual therapy, and modalistic electrotherapy) remains the standard of care, modern tendinopathy frameworks suggest that targeted collagen loading via high-load mechanical strength training may yield superior structural remodeling and functional outcomes. Objective: To compare the clinical efficacy of high-load progressive resistance strength training against a comprehensive multimodal physical therapy protocol in patients presenting with chronic plantar fasciopathy over a 12-week intervention period. Methodology: A single-blind, randomized controlled trial was conducted with 120 adult participants (ages 21 to 65) diagnosed with unilateral chronic plantar fasciopathy persisting for over three months. Participants were randomized (1:1 ratio) to receive either High-Load Strength Training (HLST, n = 60)—consisting of progressive calf raises with a rolled towel under the toes—or Multimodal Physical Therapy (MPT, n = 60), comprising plantarspecific stretching, joint mobilization, low-level laser therapy, and custom orthotic fitting. Outcome measures included the Visual Analog Scale (VAS) for first-step morning pain, the Foot Function Index (FFI-R), and ultrasound-measured plantar fascia thickness (PFT) at baseline, 4 weeks, 12 weeks, and a 24-week post-intervention follow-up. Results: At 12 weeks, both groups demonstrated clinically meaningful improvements; however, the HLST group achieved significantly greater reductions in first-step morning VAS score compared to the MPT group ($p < 0.001$). FFI-R disability scores demonstrated superior long-term functional recovery in the HLST group at 24 weeks ($p = 0.004$). Sonographic evaluation showed a statistically significant reduction in plantar fascia thickness in the HLST cohort ($p < 0.01$). Conclusion: High-load progressive strength training provides superior short- and long-term functional pain relief and anatomical tissue adaptation compared to traditional multimodal physical therapy in chronic plantar heel pain..
Plantar fasciopathy, High-load strength training, Heel pain, Physical therapy, Rehabilitation, Foot Function Index, Ultrasonography.
Copyright (c) 2026 Journal of Rashid Latif Medical College https://creativecommons.org/licenses/by/4.0
Reading Direction and Sentence Interpretation in Urdu–English Bilingual Readers
Background: Reading direction is a fundamental characteristic of written language that influences visual attention, eye movement patterns, and cognitive processing during reading. Bilingual individuals who routinely read languages with opposite writing directions, such as Urdu (right-to-left) and English (left-to-right), provide a unique opportunity to investigate how script orientation affects sentence interpretation. Despite increasing interest in bilingual language processing, limited research has examined the influence of reading direction on comprehension and interpretation among Urdu–English bilingual readers. Objective: To examine the effect of reading direction on sentence interpretation and reading performance among Urdu–English bilingual adults. Methodology: A cross-sectional experimental study was conducted among 80 Urdu–English bilingual university students aged 18–30 years. Participants completed standardized sentence comprehension tasks presented in Urdu and English under controlled conditions. Reading time, comprehension accuracy, and response latency were recorded. Data were analyzed using paired-sample t-tests, repeated-measures ANOVA, and Pearson's correlation, with statistical significance set at p < 0.05. Results: Participants demonstrated significantly faster reading speed in their dominant language while maintaining high comprehension accuracy in both languages. Response latency differed significantly between left-to-right and right-to-left sentence presentation, indicating that reading direction influenced sentence processing efficiency. Strong positive correlations were observed between language proficiency and comprehension accuracy in both reading directions. Conclusion: Reading direction significantly influences sentence interpretation among Urdu–English bilingual readers. The findings suggest that bilingual readers flexibly adapt cognitive strategies according to script orientation, highlighting the interaction between orthographic systems and language processing. These findings have implications for bilingual education, psycholinguistics, and cognitive neuroscience.
Reading direction, bilingualism, Urdu, English, sentence processing, language comprehension, psycholinguistics, cross-linguistic research.
Enhancing Faculty Competence in MCQs Construction Through Professional Development Workshops: A Qualitative Study
Background: Multiple-choice questions (MCQs) are among the most widely used assessment tools in medical and dental education because they facilitate objective evaluation of students' knowledge, reasoning, and clinical decision-making abilities. However, poorly constructed MCQs can reduce examination validity, encourage superficial learning, and fail to discriminate between different levels of student competence. Objective: To explore faculty members' perceptions regarding the effectiveness of MCQ development workshops and identify perceived benefits, challenges, and recommendations for improving future training programs. Methodology: A qualitative exploratory study was conducted at a private medical college between January and March 2026. Twenty faculty members representing both basic and clinical sciences were selected through purposive sampling after participating in an institutional MCQ development workshop. Semi-structured, face-to-face interviews were conducted using a validated interview guide. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke's six-step thematic analysis approach. Credibility was enhanced through member checking, peer debriefing, and independent coding by two researchers. Results: Four major themes emerged from the analysis: enhancement of assessment knowledge, increased confidence in MCQ construction, barriers to implementing learned practices, and recommendations for strengthening faculty development. Participants reported improved understanding of Bloom's taxonomy, item-writing guidelines, and cognitive level assessment. Time constraints, limited opportunities for feedback, and insufficient post-workshop mentoring were identified as significant barriers. Faculty recommended periodic refresher workshops, structured peer review, and institutional support for sustainable assessment improvement Conclusion: Faculty perceived MCQ development workshops as valuable in improving assessment literacy and confidence in constructing high-quality examination items. Continued mentorship, regular refresher training, and institutional commitment are essential for sustaining improvements in assessment quality and promoting educational excellence.
Faculty development, Multiple-choice questions, Medical education, Assessment, Qualitative research, Professional development, Faculty perceptions.
Association Between Perceived Stress and Periodontal Health Among University Students in Pakistan: A Cross-Sectional Study
Background: Stress perception is a common psychological problem among college/university students that may negatively impact their physical and oral well-being. Psychological stress has been linked to behavior modification, reduced immunity, poor oral hygiene habits, and ultimately, periodontal disease. Although there is growing appreciation for the role of psychological factors in oral health, there are very few reports on the link between stress perception and periodontal health among university students in Pakistan. Objective: For the study of relationship between stress and periodontal health amongst the university students at universities in Lahore, Pakistan. Methodology: The current descriptive cross-sectional study was conducted among 300 university students during the months of December 2025 through April 2026. Students were selected by means of convenience sampling method from different academic departments. Perception of stress among the participants was measured by using the PSS-10, whereas their periodontal condition was measured by CPI. Socio-demographic characteristics along with oral hygiene behaviors were also obtained. Data analysis was done by using SPSS software version 26. Chi square test and logistic regression were done for associations between stress and periodontal conditions. Results: Participants' mean age was 21.8 ± 2.4 years. Participants with high perceived stress were 41.3%, moderate stress was 46.0% and low stress 12.7%. Participants having periodontal disease were 38.7%. High perceived stress showed significant association with prevalence of gingival bleeding, calculus formation and periodontal pockets among students with high perceived stress than students who had low stress levels (p<0.001). High perceived stress was an independent predictor of poor periodontal status even when adjusting for oral hygiene behaviors and demographics (Adj. OR =2.54; 95% CI: 1.48 – 4.36). Conclusion: Perceived stress is positively correlated with periodontal disease among university students. Effective stress reduction strategies and dental health awareness campaigns could play a role in better periodontal outcomes among this group.
Perceived stress, periodontal health, university students, oral health, psychological stress, Pakistan.
Knowledge, Acceptance, and Willingness to Undergo Stem Cell Therapy Among Patients with Spinal Cord Injury in Pakistan: A Cross-Sectional Study
Background: SCI is one of the most devastating neurological disorders that lead to permanent disabilities and reduced quality of life of an individual. Despite the fact that stem cell treatment is not yet clinically approved, rising media reports and advancements in science have impacted the mindset and expectations of individuals. It is essential to know about patients' awareness, acceptance, and willingness towards undergoing treatment using stem cells for further policy-making purposes. Objective: To assess the level of knowledge, acceptance, and willingness to undergo stem cell therapy among patients with spinal cord injury attending rehabilitation centers in Pakistan and to identify factors associated with treatment acceptance. Methodology: A descriptive cross-sectional study was conducted from December 2025 to April 2026 at rehabilitation centers and tertiary care hospitals in Lahore, Pakistan. A total of 250 patients with chronic spinal cord injury were recruited through consecutive non-probability sampling. Data were collected using a structured interviewer-administered questionnaire assessing demographic characteristics, clinical history, knowledge regarding stem cell therapy, acceptance of treatment, and willingness to undergo therapy. Results: Among 250 participants, 61.2% had heard about stem cell therapy, while only 28.8% demonstrated adequate knowledge regarding its indications, benefits, and limitations. Overall, 74.4% of participants expressed acceptance of stem cell therapy, and 68.8% reported willingness to undergo treatment if it became available. The majority of participants believed that stem cell therapy could improve mobility and independence, although concerns regarding cost, effectiveness, and safety were commonly reported. Conclusion: Most patients with spinal cord injury in Pakistan demonstrate positive attitudes toward stem cell therapy and express willingness to undergo treatment. Educational interventions and evidence-based counseling are necessary to ensure realistic expectations regarding stem cell therapies and future regenerative medicine approaches.
Spinal cord injury, stem cell therapy, knowledge, acceptance, willingness, regenerative medicine, Pakistan.
Prevalence and Functional Consequences of Symphysis Pubis Dysfunction in Pregnant Women Receiving Antenatal Care
Background: Symphysis Pubis Dysfunction, a common manifestation of pregnancy-related pelvic girdle pain, significantly affects physical functioning and quality of life among pregnant women. Despite its substantial impact on maternal well-being, limited data are available regarding its prevalence and associated functional consequences in Pakistan. Objective: To determine the prevalence of Symphysis Pubis Dysfunction among pregnant women attending antenatal clinics and to evaluate its association with quality of life and functional mobility. Methodology: A descriptive cross-sectional study was conducted at the antenatal clinics of a tertiary care teaching hospital in Lahore, Pakistan, from December 2025 to April 2026. A total of 250 pregnant women aged 18–40 years with singleton pregnancies were recruited through consecutive sampling. Data were collected using a structured questionnaire, the Pelvic Girdle Questionnaire (PGQ), the Short Form-12 Health Survey (SF-12), and the Timed Up and Go (TUG) test. Statistical analysis was performed using SPSS version 26. Associations between SPD, quality of life, and functional mobility were assessed using Chi-square tests, independent t-tests, and Pearson correlation analysis. Results: Among 250 participants, 88 women were diagnosed with SPD, yielding a prevalence of 35.2%. The mean age of participants was 28.9 ± 4.8 years. SPD was significantly more common among multiparous women (p=0.012), obese women (p=0.008), and those in the third trimester (p=0.001). Women with SPD demonstrated significantly lower SF-12 quality-of-life scores (48.3 ± 8.2 vs. 71.5 ± 7.6; p<0.001) and prolonged TUG test times (13.7 ± 2.8 seconds vs. 9.8 ± 1.9 seconds; p<0.001). PGQ scores showed a strong negative correlation with quality-of-life scores (r=-0.69, p<0.001) and a positive correlation with mobility impairment (r=0.61, p<0.001). Conclusion: Symphysis Pubis Dysfunction is highly prevalent among pregnant women in Pakistan and is significantly associated with reduced quality of life and impaired functional mobility.
Symphysis Pubis Dysfunction, Pregnancy, Pelvic Girdle Pain, Quality of Life, Functional Mobility, Pakistan
Management Practices Of Pelvic Inflammatory Disease In Lahore
Background: Pelvic Inflammatory Disease (PID) is a serious reproductive health disorder that can cause chronic pelvic pain, ectopic pregnancy, and infertility if not well managed. Despite the guidelines for treatment, differences in diagnosis and management continue to exist in different healthcare facilities. Objective: To evaluate the existing practices of diagnosing and managing PID among clinicians working at the Avicenna Medical College Hospital and assess compliance with international treatment guidelines. Methodology: A cross-sectional quantitative descriptive study was done from January to June 2024 in the Department of Obstetrics and Gynecology. Data were gathered using a structured questionnaire administered among 80 clinicians, which consisted of postgraduate residents and consultants. Diagnostic techniques, antibiotic protocols, hospitalization indications, and follow-up strategies were evaluated through the questionnaire. Data were analyzed with SPSS v26. Descriptive statistics (means, frequencies, SD) and chi-square tests were utilized to establish association between clinician experience and guideline compliance. Results: 65 out of 80 participants responded with complete questionnaires (81.2%). Only 58.5% made use of standardized PID diagnostic criteria (cervical motion tenderness, pelvic tenderness, adnexal tenderness). The most commonly used regimen was ceftriaxone with doxycycline ± metronidazole (73.8%), in accordance with CDC recommendations. Still, 26.2% reported broad-spectrum antibiotic use outside guidelines. Consultants demonstrated significantly higher compliance with treatment protocols compared to residents (p=0.03). Follow-up within 72 hours was adhered to by 61.5% of clinicians. Conclusion: Although the majority of clinicians at the University Teaching Hospital, Lahore, adhere to evidence-based treatment protocols for PID, there are differences in diagnostic workup and follow-up. Regular training sessions and institutional guidelines are suggested to implement standardized management practices and enhance outcomes in patients.
Pelvic Inflammatory Disease, Pakistan, Chronic Pelvic Pain, Treatmesnt, Management
Copyright (c) 2025 Journal of Rashid Latif Medical College https://creativecommons.org/licenses/by/4.0
Impact of Mobile Phone Addiction and Procrastination on Student Achievement
Background: Mobile phone addiction and academic procrastination are common challenges among medical students, negatively influencing academic outcomes. Objective: This study explored the influence of demographic factors on mobile phone addiction, academic procrastination, and academic achievement among Pakistani medical students, and examined the association between these variables. Methodology: A cross-sectional study was conducted at University College of Medicine & Dentistry, Lahore, between May and June 2024. A total of 3,511 medical students completed an online questionnaire (response rate = 81.7%). Instruments included a demographic survey, the Scale of Academic Achievement, Mobile Phone Problem Use Scale (MPPUS-10), and Academic Procrastination Scale–Short (APS-S). Data were analyzed using variance analysis and hierarchical regression. Results: Mean scores were: academic procrastination 2.66 ± 0.91, mobile phone addiction 5.13 ± 1.53, and academic achievement 4.51 ± 0.71. Gender, study year, leadership experience, and family income showed significant differences. Mobile phone addiction was negatively associated with learning dedication, learning performance, and relationship facilitation. Academic procrastination was negatively related to learning dedication, learning performance, relationship facilitation, and objective achievement. Conclusion: Mobile phone addiction and academic procrastination are prevalent among Pakistani medical students at University College of Medicine & Dentistry, Lahore with significant negative impacts on academic achievement. Institutional strategies are needed to mitigate these behaviors.
Medical Students, Pakistan, Academic Achievement, Mobile Phone Addiction, Academic Procrastination.
Fear of Failure: Its Prevalence and Impact Among Medical Students
Background: Fear of failure (FoF) is a psychological construct that can affect academic performance and mental health in students. Objectives: This study aimed to assess the level of FoF among medical students at the University Institute of Physiotherapy (UIPT), compare FoF across genders, academic years, GPA categories, and interest in studying medicine. Objective To assess the prevalence and severity of fear of failure (FoF) among medical students at the UIPT, Lahore during the academic year 2024, and to examine its association with gender, academic year, grade point average (GPA), and students’ interest in studying medicine. Methodology: A cross-sectional study was conducted among 420 undergraduate medical students from 2nd to 5th year during the academic year 2024. Participants completed the Performance Failure Appraisal Inventory (PFAI). Data were analyzed using SPSS 26.0, applying Mann-Whitney U-test and Kruskal-Wallis test to compare domain scores across groups. Cronbach’s α was calculated for reliability. Results: The overall mean FoF score was −0.28, indicating a relatively low level of FoF. Female students showed significantly higher fear of devaluing self-estimate, while males had higher fear of important others losing interest. Third-year students exhibited higher levels of FoF than other years. Students with GPA <3.5 and >4.9 reported the highest FoF. Reliability analysis showed excellent internal consistency (Cronbach’s α = 0.92). Conclusion: Although overall FoF was low, significant differences were observed across gender, GPA, and year of study. Targeted counseling is recommended, especially for high- and low-GPA students and those transitioning to clinical years.
Fear Of Failure, Medical Students, Academic Performance, GPA, Psychological Stress, Pakistan, Medical Education, Performance Failure Appraisal Inventory (PFAI)
Attitudes and Awareness about Basic Life Support among Medical School Students in Lahore
Background: The WHO recommends that all healthcare professionals must be equipped with this basic emergency life-saving service and capability. It comprises essential techniques for maintain airway patency, breathing and circulation in life-threatening emergency situations such as drowning, choking etc. Objective: This study aims to assess the awareness, knowledge and attitudes of medical students regarding basic life support (BLS) in Lahore Methodology This was descriptive, cross-sectional quantitative study. A total of 300 MBBS students were recruited for this study. A structured pre tested questionnaire from previously published studies was utilized. Results: In total, 40% of the participants showed sufficient BLS knowledge (score ≥ 6/10). Clinical year students had a higher mean (5.9 ± 1.6) than pre-clinical students (mean 4.1 ± 1.8; p = 0.001). The mean attitude score was 4.2 ± 0.7 overall, reflecting a generally positive attitude toward learning BLS. Conclusion: The research concludes that although medical students in Lahore have very positive attitudes toward Basic Life Support, their knowledge and hands-on exposure in conducting BLS are low. This deficiency can be overcome by incorporating structured, hands-on, and frequent BLS training sessions into the MBBS course of study. Equipping students with BLS will not only augment their professional capacity but also help greatly to enhance out-of-hospital cardiac arrest and other emergency survival rates in Pakistan.
Medical Students, Pakistan, BLS, Life-Saving Service
Text Neck Syndrome And Smartphone Use Among Medical Students In Lahore
Background: Extended smartphone use with continuous neck flexion has been associated with neck pain and musculoskeletal symptoms, which are referred to as Text Neck Syndrome (TNS). Objective: To estimate the prevalence of TNS in medical students in Lahore and to evaluate associations with smartphone use (daily duration and typical neck posture). Methodology: Cross-sectional survey of 320 medical students from two Lahore medical colleges asked for demographics, smartphone exposure (hours/day, years of use), usual neck posture, and symptoms related to TNS. TNS was considered as occurrence of ≥3 characteristic symptoms with smartphone use ≥4 hours/day. Data analysis was performed using descriptive statistics and chi-square tests (α = 0.05). Results: Total TNS prevalence was 61.9% (198/320). Prevalence was greater with daily smartphone use: ≤2 h (42.6%), 2–5 h (61.0%), >5 h (76.5%) (p < 0.001). More frequent neck flexion >30° was predictive of greater TNS prevalence (73.4%) compared with <15° (44.4%) (p = 0.02). These results are consistent with similar student populations and meta-analytic data associating smartphone overuse with neck pain. Conclusion: TNS is prevalent among medical students in Lahore and significantly related to increased daily smartphone use and unfavorable neck posture. Ergonomic training and behavioral therapy to decrease prolonged smartphone use and enhance neutral head posture are advised.
Association of Aging with Fungal Nail Infections Among Diabetic and Non-Diabetic Population
Background: Onychomycosis is a common chronic fungal infection of the nail plate caused by dermatophytes, yeasts, and molds. Advancing age and diabetes mellitus are well-recognized risk factors that predispose people to onychomycosis because of impaired circulation and immunity. Objective: To compare the prevalence and characteristics of fungal nail infections in diabetic and non-diabetic patients, and further to assess the influence of aging on the rates of infection. Methodology: A comparative cross-sectional study was carried out from January to July 2025 in the Departments of Medicine and Dermatology, Sir Ganga Ram Hospital, Lahore, and included a total of 200 patients aged 30 years and above presenting with discolored, brittle, or thickened nails. Of these, 100 were diabetics (Group A) and 100 were non-diabetics (Group B). Nail clippings were collected and examined microscopically by KOH preparation, then cultured on Sabouraud dextrose agar. SPSS version 25 was used for analyzing demographic and clinical data, and chi-square test was applied for comparison. Results: Fungal infection was found in 68% of diabetic patients and 40% in the nondiabetic group; p<0.001. In both groups, the infection rate increases with age and reaches 80% in diabetics above 60 years of age. Trichophyton rubrum was the most prevalent isolate encountered (61%), followed by Candida albicans (22%). Conclusion: Fungal infection of nails is highly prevalent among diabetics and increases with age. Regular examination of nails, good control of blood sugar levels, and early commencement of antifungal treatment will help in reducing morbidity among diabetics and the elderly population.
Fungal Nail Infections, Pakistan, Diabetic, Treatment, Aging
Prevalence and Risk Factors of Diabetic Peripheral Neuropathy
Background: Diabetic peripheral neuropathy (DPN) is a prevalent and severe complication of diabetes mellitus, resulting in high morbidity in the form of foot ulcers, amputations, and reduced quality of life. Early detection and management of risk factors can reduce its burden. Objective: To evaluate the prevalence of diabetic peripheral neuropathy (DPN) and determine its risk factors. Methodology: This descriptive cross-sectional study was carried out at the Diabetic Clinic, Department of Medicine, Arif Memorial Teaching Hospital, Lahore, from January 2023 to December 2023. Consecutive sampling was used to enroll 200 diabetic patients. Demographic information, clinical history, blood pressure, and blood glucose levels were noted. All the participants were recommended HbA1c and lipid profile. DPN was evaluated by the Michigan Neuropathy Screening Instrument (MNSI), and the data were statistically analyzed. Results: Among 200 patients, DPN was diagnosed in 83 patients (41.5%). Significant associations were found with increased duration of diabetes, hypertension, hyperglycemia, and pre-diabetes. Conclusion: DPN prevalence continues to be high among diabetic patients. Early detection, strict control of glycemia, and treatment of related risk factors are the keys to avoid this disabling complication.
Diabetic Neuropathy, Risk Factors, MNSI, HbA1c, Hyperglycemia
Background: The rapid evolution of smartphones has revolutionized healthcare delivery and medical education. Ophthalmology, being a visually intensive specialty, has particularly benefited from mobile technology through apps, imaging tools, and instant access to resources. Smartphones are now playing a vital role in diagnostics, documentation, and communication, helping practitioners enhance patient care and academic collaboration. Objective: This study aims to evaluate the use of smartphones for academic and clinical purposes among ophthalmologists. Methodology: A cross-sectional survey was conducted from June to December 2023 in the Department of Ophthalmology at Sheikh Zayed Hospital. The study involved 100 ophthalmologists, including consultants, postgraduate residents, and registrars from various hospitals. A structured questionnaire was distributed via emails, messaging apps, and phone interviews. Data were analyzed using SPSS version 25. Results: Of the 100 respondents, 50% were consultants, 44% were postgraduate residents, and 6% were registrars. Android phones were used by 55% of participants, while 45% used iPhones. The flashlight feature was frequently used by 18%, occasionally used by 40%, and never used by 42%. Camera usage for documenting ocular findings was frequent among 26%, occasional in 49%, and never in 25% of participants. About 28% did not have any books downloaded on their phones, while 52% had multiple books. Google was the most used online resource (76%), followed by Eyewiki (9%) and PubMed (5%). Notably, 78% of respondents used messaging platforms for group discussions. Conclusion: Smartphones are becoming indispensable tools in ophthalmology. They offer cost-effective solutions by replacing several traditional tools and improving efficiency in clinical practice. Ophthalmologists should further explore these technologies for both educational and clinical advancements
Smartphones, Android, iPhone, Applications, Ophthalmology, Pdf Books, Websites
Tetanus in Children: Risk Factors, Vaccination, and Outcomes
Background: Tetanus remains a life-threatening yet preventable disease, particularly in low- and middle-income countries. Despite global efforts, its burden persists among children due to insufficient immunization coverage, lack of booster doses, and poor awareness of post-exposure prophylaxis. In Pakistan, these challenges continue to contribute to morbidity and mortality associated with post-neonatal tetanus. Aim: This study aimed to evaluate the frequency of risk factors, immunization coverage, and clinical outcomes among children diagnosed with tetanus beyond the neonatal period at a tertiary care center. Methods: Conducted in 2024, this prospective observational study took place at the University of Lahore Teaching Hospital. Pediatric patients aged 1 month to 15 years admitted with clinical tetanus were included. Variables such as age, gender, immunization status (including DTP and TT boosters), identifiable risk factors, duration of hospitalization, and final outcomes were analyzed using SPSS version 16. Results: Among 74 participants, 46 (62.2%) were boys and 28 (37.8%) girls. The mean age was 6.8 ± 3.2 years, with the highest prevalence in children aged 6–10 years (52.7%). Vaccination data revealed 51 (68.9%) children were unvaccinated; none had received booster doses or post-exposure prophylaxis. Trauma accounted for the majority of cases (34; 45.9%), followed by ear discharge (14; 18.9%) and piercing injuries (3; 4.1%). The risk factor remained unidentified in 23 (31.1%) cases. Mean hospital stay was 13.7 ± 11.2 days. A mortality rate of 20.3% (15 patients) was significantly linked with shorter hospital stays (p<0.001) and absence of vaccination (p=0.01). Conclusion: The study revealed significant gaps in routine immunization and post-injury tetanus prophylaxis. Implementation of booster vaccination and early identification of high-risk groups, such as those with otorrhoea, is essential for prevention.
Impact of Energy Drinks on Students’ Health and Academics at a Private Nursing College
Background: Energy drinks are increasingly consumed by college students in Pakistan, primarily for enhanced alertness and academic stamina. However, their potential cardiovascular effects and influence on academic performance remain controversial. Aim: This study aimed to assess the short-term effects of energy drink consumption on academic performance and cardiovascular indicators, including blood pressure and pulse rate, among nursing students in Pakistan. Methods: A randomized controlled experimental design was used. From 193 nursing students in Karachi, 50 habitual energy drink consumers were randomly selected and assigned to either an experimental group (received a commercial energy drink) or a control group (received bottled water). Pre- and post-intervention measures included systolic/diastolic blood pressure, pulse rate, and academic performance via standardized tests. Results: The experimental group showed an increase in mean systolic blood pressure from 119 to 125 mmHg and diastolic pressure from 70 to 74 mmHg. No significant changes were observed in pulse rate or academic performance within the group. However, systolic and diastolic blood pressure differences between the experimental and control groups were statistically significant (p < 0.05). Academic performance showed no significant difference between groups. Conclusion: Energy drink consumption among Pakistani nursing students may elevate cardiovascular indicators such as blood pressure but does not significantly impact academic performance in the short term. These findings highlight the need for awareness campaigns about the potential health risks of energy drink use.
Caregivers' Knowledge for Prevention of Acute Diarrheal Diseases in Children
Background: Diarrhea is a leading cause of childhood mortality worldwide. Timely interventions by caregivers play a crucial role in managing and preventing this condition. Aim: This study aimed to evaluate caregivers' knowledge and practices regarding the prevention of diarrheal diseases in children under the age of 5 years. Methods: A cross-sectional study was conducted from January to July 2023 using a convenience sampling technique. Data were collected from 158 caregivers of children under 5 years old using a self-structured, pre-tested questionnaire. Chi-square test was applied, and a p-value <0.05 was considered significant. Results: A total of 158 caregivers participated in the study. The mean age of respondents was 28.4 ± 7.6 years. Among them, 22.8% were illiterate, 84.2% were housewives, and 37.4% had an income exceeding 31,000 rupees/month. The majority (43.1%) had 'poor' knowledge, 24% exhibited 'poor' attitudes and practices, while 12% demonstrated good practices. Significant associations were observed between caregivers' knowledge and education (p-value=0.004), income (p-value=0.001), frequency of diarrhea in a child (p-value=0.053), and practices with education (p-value=0.039). Conclusion: This study highlights the relationship between caregivers' literacy levels and family income with improved knowledge and feeding practices in preventing diarrhea. It underscores the crucial role of caregivers in managing acute diarrheal diseases.
Public Awareness and Perceptions of Breast and Cervical Cancer
Objective: A serious public health issue is the general population's lack of understanding, ignorance, and ubiquity of myths and misconceptions about breast and cervical cancers (CCs). The purpose of this study was to assess people's knowledge and attitudes on cancer, specifically with regard to breast and cervical malignancies. Methodology In Lahore, Pakistan, a cross-sectional survey with a descriptive focus was administered to 345 individuals. Data on demographics, exposure to chemical and biological carcinogens, lifestyle choices, and individual behaviors were gathered using a pretested, standardized questionnaire. The study population was examined in relation to important factors using frequency distribution and proportions. Results: Cancer awareness and early detection play crucial roles in reducing morbidity and mortality. This descriptive cross-sectional study assessed public awareness and perceptions regarding cancer, particularly breast and cervical cancers, in Lahore. A total of 298 participants were surveyed, with an average age of 25.19 years. Males comprised 52.0% and females 48.0% of the respondents. Mass media (34.6%), schools (28.5%), and health professionals (6.7%) were the primary sources of cancer-related information. While 72.8% of participants reported fear upon first hearing about cancer, 66.7% believed it is preventable. Only 4.7% had undergone cervical cancer screening, indicating low participation in preventive measures. Additionally, 98.1% of respondents had never smoked, though awareness of smoking-related cancer risks was limited to 66.7%. These findings highlight the need for increased public education, awareness campaigns, and access to screening programs to improve early detection and treatment outcomes in Lahore. Conclusion: In Lahore, Pakistan, there is still a lack of awareness and education regarding cancer, especially breast and cervical cancers. The following prioritized risk factors must be addressed in the public health education campaigns’ sexual and reproductive health component: early onset of sexual intercourse, low level of disease knowledge, and unhealthy lifestyles.
Copyright (c) 2025 2025 https://creativecommons.org/licenses/by/4.0
Evaluating the teaching abilities of Residents to assess the effectiveness of their instruction.
Objective: Interns are frequently given teaching responsibilities in Pakistan. Interns are often recruited at the bottom of the teaching scale with little or no teaching experience and usually without any formal teacher training while pursuing undergraduate programs. Methodology: Assess the interns' level of teaching skill, so that if needed, appropriate action can be taken to raise the bar on instruction. This cross-sectional study was conducted by University of Faisalabad, from April to June 2023. Using Medical Education Teaching Readiness Questionnaire (METRQ) the knowledge, skill and attitude of the responders based on different experiences pertaining to medical teaching were accessed from fifty first-year dental interns approached for the questionnaire that was statistically evaluated in SPSS 21. Results: Forty (80%) of the interns considered that mastering the basics of teaching, for example planning "what to teach" was necessary, but they were not prepared to teach. For skills, 38 (76%) respondents said that viewing their lecturers was very helpful, while only 1 (2%) said receiving feedback on their own instruction was helpful. At graduation, most of the factors, ranked as traits of teaching—such as drive, excitement, and competence—began to depreciate. When some experience in teaching had been accumulated during the internship, similar qualities showed clearly higher ratings. Conclusion: In creating teacher-training programs or assessing the current state of those teaching in the health professions, METRQ can be a great tool to conduct needs assessments. Important for improving the quality of instruction and, thereby, the quality of education, are teacher training programs. Keywords: Aptitude, Cross sectional studies, Needs Assessment, Teacher training.
Copyright (c) 2024 Journal of Rashid Latif Medical College https://creativecommons.org/licenses/by/4.0
Artificial intelligence in Medical Education-A Crosssectional study in Private Setup
Objective: For healthcare providers, expectations, duties, and job descriptions must change as the information age fades and the artificial intelligence age becomes more prevalent. In order to identify areas that can benefit from curriculum restructuring, this study looked at how aspiring doctors perceived the potential effects of artificial intelligence on medicine. Methodology: A nationwide study including 3018 medical students was carried out using a cross-sectional approach across multiple centers. An online survey created and disseminated using a web-based service served as the study's instrument. Results: Artificial intelligence was viewed by the majority of medical students as an assistive technology that might ease patients' access to healthcare (76.7%), physicians' access to information (85.6%), and errors (70.5%). Nonetheless, 44.9% of the participants expressed concern over a potential cutback in physician services, which would result in joblessness. Additionally, it was decided that the application of artificial intelligence in medicine would harm patient-physician interactions (42.7%), devalue the medical profession (58.6%), and erode trust (45.5%). Furthermore, almost half of the participants (44.7%) agreed that they could maintain professional secrecy when using AI apps, whereas 16.1% contended that AI in medicine could lead to professional confidentiality violations. Out of all the individuals involved, a mere 6.0% claimed to be knowledgeable enough to advise patients about the advantages and disadvantages of artificial intelligence. Conclusion: The participants indicated that the medical curriculum needed updating in light of the requirements for transforming healthcare through artificial intelligence. In addition to ensuring that professional values and rights are upheld, the update should focus on providing aspiring physicians with the information and abilities they need to use artificial intelligence technologies successfully. Keywords: Medical Students, Medical Ethics, Medical Curriculum, Artificial Intelligence Medicine
Patient Safety Culture in Operation Theatres of Peripheral Teaching Hospitals
Objective: to learn how postgraduate surgical and allied trainees at Arif Memorial Teaching Hospital (AMTH), Pakistan, feel about non-technical abilities in the operating room. Methodology: A cross-sectional survey was conducted at the AMTH theaters, thirty postgraduate trainees filled the Operating Room Management Attitudes Questionnaire (ORMAQ). Results: Except for procedural compliance and error disclosure, which point to differences in implementation and awareness, postgraduate trainees have good opinions about every aspect of the ORMAQ survey. Conclusion: The findings mostly match those of earlier ORMAQ surveys of surgical teams conducted in other nations. Due to shady systematic working practices and cultural norms, the disparities highlight the possible hazard to patient safety. The results validate the use of human factor training and team interventions to apply protocols and guidelines. This survey also aids in gathering information for a hospital's quality assurance program. Keywords: Non-technical skills, ORMAQ, patient safety, surgery, human factors
An analysis of health system experts' viewpoints on strategies for dealing with the aging population: A qualitative investigation
Objective: It is critical to develop planning and action plans to deal with future aging in light of the growing trend of aging, the health system's limited resources, the absence of long-term prior government planning, and the slow expansion of the productive force in society. In this sense, the goal of the study was to determine health system specialists' ideas for addressing the aging population. Methodology 29 Pakistani men and women from Lahore, Karachi, Islamabad, and Faisalabad who were experts in the fields of health and aging willingly took part in the semi-structured interview for the qualitative content analysis research. Data were classified through the use of qualitative content analysis. Results: The opinions of the experts who participated in the discussion revealed two concepts regarding the approaches taken by the Pakistani health system to deal with future aging: "executive policy" strategies, which include "evaluation and standardization," "design, planning and implementation," "strengthening demand-driven," and "modeling national and international experiences." "Preventive policies" strategies, on the other hand, include "Focus on prevention," "Focus on values and competencies," "Educational empowerment," "Knowledge-based empowerment," "Empowerment of age-related groups," "Economic empowerment," and "Social support." Conclusion: The extensive variety of approaches discussed suggests that health care must be completely prepared and tailored to the unique needs and circumstances of the aged. Using workable solutions will enable deliberate planning and prompt program and policy implementation to better handle the health system as the population ages in the future. Keywords: Aging, health system, Pakistan, qualitative, strategy
Exploring Knowledge and Contributing Factors of Gestational Diabetes Mellitus Among Students at a Private Sector Medical University
Objective: Global health concerns about gestational diabetes mellitus (GDM) are growing. For prompt prevention and management, early and precise awareness of GDM is essential, particularly for young individuals. The purpose of this study is to determine the factors impacting the degree of GDM knowledge among students at a private medical university. Methodology: Students at medical universities participated in a cross-sectional study utilizing a validated self-administered questionnaire. The survey evaluated students' knowledge of GDM (classified as poor, fair, or good) and awareness of the condition (i.e., if they had ever heard of it). Factors linked to GDM understanding were found using ordinal logistic regression. Results: 735 students in all, with an average age of 21.0 years, took part in the study. 72.8% of participants said they have heard of GDM. Interestingly, 20.3% of female students and 52.9% of male students were unaware of GDM. Male students' greater GDM knowledge was linked to their age (p = 0.019) and postgraduate status (p = 0.026). Twenty-four percent had weak knowledge, fifty-eight percent had fair knowledge, and seventeen percent had strong knowledge. Out of 12, the average GDM knowledge score was 6.3 ± 2.4. Being married (aOR = 1.82, 95% CI 1.10–3.03) and knowing someone with GDM (aOR = 1.78, 95% CI 1.23–2.60) were factors that were independently linked to greater knowledge. Friends and relatives served as the main information sources. Conclusion: This study shows that medical university students, particularly male students, have a substantial knowledge gap about GDM. Better knowledge is linked to factors like marital status and firsthand experience with GDM. These results highlight the necessity of focused educational initiatives on GDM awareness in order to raise awareness among college students and the general public in Pakistan. Keywords: Gestational Diabetes Mellitus, Students, GDM, Knowledge.
Sleep Quality and Perceived Stress among Students during Online Education
Background: Recently, online education has been gaining prominence in university life. Our survey aimed to examine sleep quality and perceived stress levels among students at the University of Faisalabad, Faculty of Health Sciences. Methods: A cross-sectional, quantitative, descriptive survey was conducted between February and March 2023. The online survey included the internationally validated Athens Insomnia Scale (AIS) and Perceived Stress Scale (PSS). Statistical analysis involved descriptive statistics, independent t-tests, analysis of variance (ANOVA), and Mann–Whitney and Kruskal–Wallis tests (p < 0.05). Results: We analyzed 304 responses, and females dominated (n = 270; 88.8%). Students in a relationship had significantly higher AIS scores (t = −2.470; p = 0.014). Medium average (2.50–3.49) students and those who rarely/never exercise showed significantly higher AIS and PSS (p ≤ 0.05). Conclusion: Students on the phone/watching a series during online education, daily laptop/TV use for more than 2 h, and pre-sleep use of smart devices for more than 60 min also negatively affected AIS and PSS scores (p ≤ 0.05). Nursing, physiotherapy, and radiography students were the most affected regarding insomnia and perceived stress (p ≤ 0.05). Our survey shows that excessive smart device use and lack of exercise are associated with higher stress levels and poorer sleep quality. Keywords: sleep quality; perceived stress; Athens Insomnia Scale; Perceived Stress Scale; student; smart device; online education
Copyright (c) 2024 Journal of Rashid Latif Medical College
The Factors Related to Job Satisfaction of Teachers
Background: Throughout human history, education has been a vital institution in every society. It has significantly contributed to the global migration of nations. In all educational institutions across the globe, teachers are tasked with the mental, physical, and moral upbringing of their students, making them the pivot around which global education revolves. The most significant role in the educational process is that of the teacher. Objective: The purpose of this study is to understand the satisfaction of job in teachers. Methodology: This is a qualitative exploratory study. The investigator chose a range of publications and records pertaining to teachers' job satisfaction. Its goal is to capture the intricacy, richness, and background information of the topic being studied. The study reveals underlying meanings, social processes, and theoretical explanations that can improve our comprehension of the elements that contribute to teachers' feeling more satisfied in their jobs. Conclusion: It's critical to comprehend the elements influencing teachers' job happiness in order to promote a pleasant workplace culture and raise the standard of education in general. The subject matter and grade level taught, together with teaching experience, can influence how environmental, personal, and organizational factors affect job satisfaction. However, based on personal preferences and contextual variations, these characteristics' relative relevance may change. It is imperative that educational institutions customize their approaches to improve job satisfaction by taking into account the unique demands and attributes of their faculty. Keywords: Job Satisfaction, Organizational Factors, Environmental Factors, Personal Factors.
Problem-Based Learning vs. Traditional Lectures among Medical Students at Fatima Jinnah Medical University, Pakistan
Objective: One of the most significant innovations in education during the last forty years is problem-based learning (PBL). In terms of the learning outcomes (such as knowledge, attitude, and skills) obtained from both approaches, the study's goal was to compare medical students' preferences for PBL versus regular lectures. Methods: In 2023, Fatima Jinnah Medical University’s medical students enrolled in the hybrid curriculum (PBL and traditional lectures) participated in a cross-sectional study. A self-administered, pre-constructed, validated, confidentially anonymous questionnaire was used to collect the data. The views of students of PBL and regular lectures were assessed through asking them to rate 20 statements on both forms of instruction on a five-point Likert scale. Software used for the analysis and descriptive statistics was SPSS, version 21 (SPSS Inc., Chicago, Ill., USA). Results: PBL was preferred by learners over traditional lectures because it allowed them to better connect their understanding of basic and clinical sciences (t test=10.16, P<.001). Regarding the quantity of fundamental information recalled using both approaches, there was, however, no statistically significant difference (P>.05. PBL was chosen by students over lectures in terms of improved learning attitudes, skills, outcomes for the future, and learning satisfaction (P<.05). PBL encourages learning more than lectures do (P<.05.05). According to the students, there was a highly significant difference (t test=20.9, P<.001) between the mean total skill gained by PBL (47.20 [10.68]) and lectures (33.01 [9.97]). Conclusions: Students preferred PBL more to traditional lectures for improving most of learning outcome domains, especially, learning attitudes and skills. Keywords: Problem-based learning, Traditional Lectures, Medical Students
Neck Pain among Students and Its Association with Smart Phone and Laptop Usage
Introduction: In the modern era of advancement and technology, use of smart phones and laptops is common. Literature suggests that these digital devices have many negative effects on the health of humans. One of the most common adverse effects associated with prolonged use of mobile and laptop is neck pain. Methods: A cross-sectional study was carried out at University of Lahore from July 2022 to December 2022. A total of 206 undergraduate physical therapy students having age 18 to 25 years participated in the study. For data collection, smart phone & laptop usage and neck pain questionnaire was used. For data analysis, SPSS version 20 was used. Results: The mean age of the subjects was 21.15 ±1.89 years. The prevalence of neck pain was 82.5% (n=170). Neck pain was significantly associated (P-value< 0.05) with smart phone and laptop usage for greater than 4 hours. Surprisingly, neck pain was not associated (p valve>0.05) with different positions (standing/sitting/lying) in which students use smart phones for majority of the time, however, it had significant association (P-value< 0.05) with use of laptops in sitting position for majority of the time. Conclusion: The prevalence of neck pain is high in students who used smart phones and laptops for long hours Keywords: Back pain, Laptop, Neck pain, Phone, Students.
Asthma in Pregnancy: Insights from the Latest Research
Objective: The aim of this study is to present a thorough overview of asthma during pregnancy and to summarize the state of the art and to advance patients' and doctors' understanding of the significance of appropriate asthma care during pregnancy. Methods: A comprehensive literature search in PubMed, Medline, and Taylor and Francis was conducted. We have searched for review articles as well as prospective and retrospective studies published in English, investigating the bilateral relationship between asthma and pregnancy, using the key words mentioned below. Manual search through both national and international guidelines as well as relevant journals and publications on the topic was also conducted. Results: Several studies have highlighted the significant impact of asthma on pregnancy outcomes. Maternal asthma is associated with increased risks of low birth weight, preterm delivery, and preeclampsia. Pregnancy complications linked to asthma include gestational diabetes and placental abnormalities. Asthma exacerbations during pregnancy are linked to a higher incidence of cesarean sections. Conclusions: To reduce the negative effects on the mother and the fetus/neonate, it is crucial to have optimal asthma management and to avoid, diagnose, and treat exacerbations. Active asthma care is advised during pregnancy, according to guidelines. Keywords: Asthma, Pregnancy, Neonatal, COVID-19
Objective: Data obtained through high throughput technologies is increasing our current understanding of the fact that like the hepatitis viruses, hepatitis E virus (HEV) has been difficult to study because of limitations in cell culture systems and small animal models. The objective of this study was to determine the frequency of hepatitis E virus infection in pediatric patients reporting to a tertiary care hospital. Materials and Methods: Six months (1- 04-08 to 31-10-08) study was conducted at Department of Pediatrics, Services Hospital Lahore. One hundred and sixty patients and sampling technique used was Non probability (Purposive sampling). Both genders were included in the study. Results: Hepatitis E was seen in 20 patients, constituting a total of 12.5% of all the patients. Conclusion: Hepatitis E is a fairly common and under diagnosed cause of acute hepatitis in pediatrics patients and introducing adequate preventive measures can reduce the morbidity.
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Agents Targeting Apoptosis Take Center Stage in the Battle against Cancer
Effective therapy of cancer requires elimination of tumor cells through programmed cell death or apoptosis, which is a highly regulated process that avoids the unwanted inflammatory response when cells die. Morphologically, the manifestation of apoptosis is similar across various cell types and species, and is observed as a series of cellular changes that begin with chromatin condensation, followed by nuclear fragmentation, cell shrinkage, blebbing and finally phagocytosis1,2. When tumor cells are exposed to therapeutic agents, the damage to cellular organelles or macromolecules creates substantial intracellular stress, which triggers the onset of the apoptotic cell death program