RESUMO
Existe un debate considerable en la literatura sobre cómo el narcisismo predice diversos comportamientos asociados con la utilidad de los sitios de redes sociales, pero los investigadores han prestado menos atención a explorar los mediadores potenciales de esta relación. Con base en la literatura existente, anticipamos que el narcisismo predice comportamientos de autopromoción en los sitios de redes sociales. El estudio actual también investigó el papel mediador del perfeccionismo multidimensional entre el narcisismo y el comportamiento de autopromoción. Se recopiló un total de 605 cuestionarios completos de estudiantes de universidades de Rawalpindi e Islamabad, Pakistán, mediante un muestreo conveniente. El estudio utilizó el Inventario de Personalidad Narcisista (Ames et al., 2006), un cuestionario de desarrollo propio sobre comportamiento de autopromoción en sitios de redes sociales y la Escala de Perfeccionismo Multidimensional (Hewitt et al., 1991). Los hallazgos indicaron que las mujeres en comparación con los hombres y las solteras en comparación con las casadas obtuvieron puntuaciones más altas en narcisismo. Los niveles educativos más altos se asociaron con tasas más altas de narcisismo. Los resultados también sugieren que el narcisismo se correlaciona con el perfeccionismo orientado a uno mismo y, más significativamente, con el narcisismo orientado a los demás. El perfeccionismo orientado a uno mismo y a los demás medió significativamente la relación entre el narcisismo y el comportamiento de autopromoción en los sitios de redes sociales.(AU)
There is considerable debate in the literature about how narcis-sism predicts various behaviors associated with the utility of social net-working sites, but researchers have paid less attention to exploring the po-tential mediators of this relationship.Based on the existing literature, we anticipated that narcissism predicts self-promoting behaviors on social networking sites. The current study also investigated the mediating role of multidimensional perfectionismbetween narcissism and self-promoting behavior. A total of 605 complete questionnaires weregathered fromstu-dents from universities from Rawalpindi and Islamabad, Pakistan using convenient sampling. The study used Narcissistic Personality Inventory (Ames et al., 2006), self-developed Self-promoting Behavior on social net-working sites questionnaire, and the Multidimensional Perfectionism Scale (Hewitt et al., 1991). Findings indicated that females as compared to males and single as comparedto married individuals scored higher on narcissism. Higher educational levels were associated with higher rates of narcissism. The results also suggestthat narcissism correlated with self-oriented per-fectionism, and more significantlywith others-oriented narcissism. Self-oriented and others-oriented perfectionism significantly mediated the rela-tionship between narcissism and self-promoting behavior on social net-working sites.(AU)
Assuntos
Humanos, Masculino, Feminino, Saúde Mental, Perfeccionismo, Narcisismo, Comportamento, Estudantes/psicologia, PaquistãoRESUMO
BACKGROUND: The pursuit of medical and dental education is challenging and can affect the overall quality of life of medical students. Assessing the quality of life of medical students is the first step in the preparation of efficient future health care professionals. This study used the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) to evaluate the quality of life of medical and dental students in Karachi, Pakistan. OBJECTIVES: The study objectives include: assessing the QoL of medical and dental students and their general health satisfaction and self-satisfaction. MATERIALS AND METHODS: This cross-sectional study was conducted among 344 medical and dental students from different medical and dental schools in Karachi, Pakistan. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was used to assess QOL, which included 26 items covering four domains: physical, psychological, social, and environmental. All scores for the domains ranged from 4 to 20. Scoring was done according to the WHOQOL-BREF procedure manual. The questionnaire was disseminated to medical students using Google Forms. SPSS software was used to analyze the data. Cronbach's alpha and the Kaiser-Meyer-Olkin (KMO) test were used to evaluate the reliability and sampling adequacy of the data for factor analysis. Descriptive statistics were computed for each variable and QoL domain, including frequencies, percentages, averages, and standard deviations. Domain scores were compared using a t-test and one-way ANOVA, with p-values less than 0.05, indicating statistical significance. RESULTS: Among the 344 medical students, 56.7% (n = 195) were female and 43.3% (n = 149) were male. The WHOQOL-BREF demonstrated excellent reliability, with a Cronbach's alpha of 0.918. Most medical students rated their overall QOL (62.2%) and health satisfaction (46.8%) as good, and were able to get around well (71.3%). No significant sex differences were found across the various QOL domains. Marital status significantly affected QOL scores (p < 0.005). Single students had significantly higher QOL scores than married/separated/divorced students did. Overall, the environmental domain had the highest mean score (26.81 ± 6.17), while social relationships had the lowest mean score (9.68 ± 2.93). CONCLUSION: The findings of this study provide valuable insights into the QoL of medical and dental students. Most participants reported moderate satisfaction with their physical health and lower satisfaction with the psychological, social, and environmental components of QoL. Marital status was found to significantly impact the QoL as compared to single students with greater QoL. These findings can help form targeted interventions to enhance medical students' quality of life and prepare efficient future healthcare professionals.
Assuntos
Qualidade de Vida, Estudantes de Odontologia, Estudantes de Medicina, Humanos, Paquistão, Estudantes de Medicina/psicologia, Estudos Transversais, Masculino, Feminino, Inquéritos e Questionários, Estudantes de Odontologia/psicologia, Adulto Jovem, Satisfação Pessoal, Adulto, Reprodutibilidade dos TestesRESUMO
BACKGROUND: Despite a large burden of life-limitingillness, there exists a dearth of services of palliative care in Pakistan. International guidelines have questionable applicability in Pakistan due to the socioeconomic differences. We generated a protocol describing the process of developing comprehensive palliative care guidelines and palliative care referral pathways for primary care practitioners to adopt in Pakistan. METHODS: A GRADE-ADOLOPMENT approach with modification has been employed to create guidelines for a Pakistani context. The "National Comprehensive Cancer Network Guidelines Insights: Palliative Care, Version 2.2021" was used as the source guideline. Recommendations from the source guideline were reviewed by two local palliative care specialists to either "Adopt," "Adapt" or "Exclude". The finalized recommendations were incorporated into the local palliative care guideline. Clinical diagnosis and referral pathways were made from the finalized guideline. Any gaps in management found in the pathways were filled by taking existing recommendations from other credible guidelines. RESULTS: Twenty-seven recommendations were adopted without modification. No recommendations were deemed to be adapted and 15 were excluded. The referral care pathways created were reflective of the local guideline and included elements of initial assessment, preliminary management, reassessment, and referral. 6 additional recommendations were made. CONCLUSION: The described clinical practice guidelines and primary care clinical referral pathways will aid to standardize palliative care provision in Pakistan. These can be used by other resource constrained settings to develop guidelines within their own local context.
Assuntos
Cuidados Paliativos, Atenção Primária à Saúde, Encaminhamento e Consulta, Humanos, Paquistão, Cuidados Paliativos/normas, Cuidados Paliativos/métodos, Encaminhamento e Consulta/normas, Atenção Primária à Saúde/métodos, Atenção Primária à Saúde/normas, Guias de Prática Clínica como AssuntoRESUMO
To discuss the use of T3™, a data aggregation, visualization, and risk analytic platform in a single centre and its framework for implementation of such a tool in clinical care. We share experience of a tool implemented in a tertiary care Intensive Care Unit (ICU) with limited resources. Superusers were identified and trained. Implementation involved monitoring, evaluation, and user engagement data for continuous emphasis on the use of this tool. Persistent display of T3 data enhanced nursing operational efficiency. Its use was expanded to use in nurses rounds and handover, mortality and morbidity meetings, clinical team teaching through selected teaching cases and analysis of stored data with different research questions. However, lack of infrastructure and technological comprehension, paucity of multidisciplinary teams makes it a challenge in its implementation. Clear framework of implantation and pre-designed studies to determine the clinical usage and effectiveness are important for wide-spread use of such tools.
Assuntos
Algoritmos, Visualização de Dados, Humanos, Unidades de Terapia Intensiva, Paquistão, Países em DesenvolvimentoRESUMO
This study focuses on the current applications, potential, and challenges to Artificial Intelligence (AI) integration in vascular surgery with specific emphasis on its relevance in Pakistan. Despite the benefits of AI in vascular surgery, there is a substantial gap in its adoption in Pakistan compared to global standards. In our context with limited resources and a scarcity of vascular surgeons, AI can serve as a promising solution. It can enhance healthcare accessibility, improve diagnostic accuracy, and alleviate the workload on vascular surgeons. However, hurdles including the absence of a comprehensive vascular surgery database, a shortage of AI experts, and potential algorithmic biases pose significant challenges to AI implementation. Despite these obstacles, the study underscores the imperative for continued research, collaborative efforts, and investments to unlock the full potential of AI and elevate vascular healthcare standards in Pakistan.
Assuntos
Inteligência Artificial, Procedimentos Cirúrgicos Vasculares, Paquistão, Humanos, Procedimentos Cirúrgicos Vasculares/métodosRESUMO
ChatGPT is reported to be an acceptable tool to answer a majority of frequently asked patient questions. ChatGPT also converses in other languages including Urdu, which offers immense potential for the education of Pakistani patients. Therefore, this study evaluated ChatGPT's Urdu answers to the ten most frequently asked questions on Total Hip Arthroplasty, which were then rated by an expert. Out of 10 answers in English, 9 (90%) were satisfactory requiring minimal clarification and 1 (10%) was satisfactory requiring moderate clarification. In both Roman and Nastaliq script Urdu, 1 (10%) answer was satisfactory requiring moderate clarification, while 9 (90%) were unsatisfactory requiring substantial clarification. In conclusion, as opposed to ChatGPT English responses, Urdu responses were much less rigorous, generic, and lacked scientific rigor. We have a long way to go before Pakistani patients with limited English language skills could benefit from AI chatbots like ChatGPT.
Assuntos
Artroplastia de Quadril, Inteligência Artificial, Humanos, Artroplastia de Quadril/métodos, Paquistão, Idioma, Educação de Pacientes como Assunto/métodos, Inquéritos e QuestionáriosRESUMO
Oral cancer (OC) is the most common cancer in Pakistani males and the second most common in females. Major risk factors include peculiar chewing habits, human papillomavirus (HPV) infection and molecular pathways. However, less data is available for this avertible cancer regarding its association with high-risk HPV (HR-HPV) and chewing habits in this region. Therefore, this study was done to determine the prevalence of HR-HPV in oral squamous cell carcinoma (OSCC) and its correlation with p16 and chewing habits. Formalin-fixed paraffin-embedded (FFPE) biopsy specimens of 186 samples were tested for HR-HPV type 16/18 by PCR, followed by p16 immunostaining (IHC) in a subset of cases (n = 50). Appropriate statistical tests were applied to find the association between HR-HPV/p16 and peculiar chewing habits with significance criteria of p<0.05 with 95% CI. HR-HPV (type 16 &18) was present in seven out of 186 cases (3.8%). Of these seven cases, five were positive for HPV16, whereas two were positive for HPV16/18. The overall expression of p16 protein in 50 samples was 38% (n = 19), and among these 19-IHC positive samples, 26% were positive for HR-HPV DNA. No significant association was found between HR-HPV positivity and p16 and chewing habits (p>0.05). It was concluded that HR-HPV prevalence in OSCC was very low in our population, with no statistically significant correlation with p16 and chewing habits. These results suggest the role of HR-HPV as an independent risk factor in OSCC in the local setting.
Assuntos
Carcinoma de Células Escamosas, Papillomavirus Humano 16, Neoplasias Bucais, Infecções por Papillomavirus, Humanos, Neoplasias Bucais/virologia, Neoplasias Bucais/epidemiologia, Masculino, Feminino, Carcinoma de Células Escamosas/virologia, Carcinoma de Células Escamosas/epidemiologia, Pessoa de Meia-Idade, Prevalência, Infecções por Papillomavirus/epidemiologia, Infecções por Papillomavirus/virologia, Adulto, Papillomavirus Humano 16/genética, Papillomavirus Humano 16/isolamento & purificação, Inibidor p16 de Quinase Dependente de Ciclina/metabolismo, Fatores de Risco, Idoso, Papillomavirus Humano 18/isolamento & purificação, Papillomavirus Humano 18/genética, Mastigação, Paquistão/epidemiologia, Papillomavirus HumanoRESUMO
BACKGROUND: The use of medicinal plants to treat various veterinary illnesses has been practiced for millennia in many civilizations. Punjab is home to a diverse ethnic community, the majority of whom work in dairy farming, agriculture, and allied professions and have indigenous practices of treating animal illnesses using native flora. This study was designed to (1) document and preserve information about the applications of medicinal plant species in ethnoveterinary remedies among inhabitants of Punjab, Pakistan, and (2) identify popular plants for disease treatment by quantitative analysis of the obtained data and to assess the pharmacological relevance of these species. METHODS: To collect data from informants (N = 279), questionnaires and semi-structured interviews were used. The ethnoveterinary data were analyzed using principal component analysis, relative frequency citation, fidelity level, relative popularity level, and rank order priority. RESULTS: A total of 114 plant species utilized in the ethnoveterinary medicinal system were found, which were divided into 56 families and used to treat 16 different illnesses. The Poaceae family, with 16 species, was the most common in the region. The most commonly employed growth form in herbal preparation was herb (49%). The most used part in ethnoveterinary remedies was leaves (35%), while powder was the most commonly used way for preparing ethnoveterinary remedies (51 applications). According to principal component analysis, the most typically used species in the research region were grasses. Five grasses (Arundo donax, Desmostachya bipinnata, Eleusine indica, Hordeum vulgare, and Pennisetum glaucum) showed a 100% FL value when used to treat diuretics, helminthiasis, digestive problems, fever, cough, worm infestation, indigestion, galactagogue, oral infections, and genital prolapse. The maximum value of disease cured level (DCL%) was recorded at 87.6% for endo- and ecto-parasitic ailments in the study area. CONCLUSION: This study demonstrates that medicinal plants play an important part in satisfying farmers' animal healthcare demands, making it a feasible practice. The study also provides a wealth of knowledge regarding ethnoveterinary methods for further planning and application, providing an option for farmers who cannot afford allopathic therapy.
Assuntos
Fitoterapia, Plantas Medicinais, Medicina Veterinária, Plantas Medicinais/classificação, Paquistão, Humanos, Feminino, Masculino, Adulto, Pessoa de Meia-Idade, Medicina Tradicional, Animais, Idoso, Etnobotânica, Adulto Jovem, Inquéritos e QuestionáriosRESUMO
OBJECTIVE: The purpose of this study is to explore the perspectives, familiarity, and readiness of dental faculty members regarding the integration and application of artificial intelligence (AI) in dentistry, with a focus on the possible effects on dental education and clinical practice. METHODOLOGY: In a mix-method cross-sectional quantitative and quantitative study conducted between June 1st and August 30th, 2023, the perspectives of faculty members from a public sector dental college in Pakistan regarding the function of AI were explored. This study used qualitative as well as quantitative techniques to analyse faculty's viewpoints on the subject. The sample size was comprised of twenty-three faculty members. The quantitative data was analysed using descriptive statistics, while the qualitative data was analysed using theme analysis. RESULTS: Position-specific differences in faculty familiarity underscore the value of individualized instruction. Surprisingly few had ever come across AI concepts in their professional lives. Nevertheless, many acknowledged that AI had the potential to improve patient outcomes. The majority thought AI would improve dentistry education. Participants suggested a few dental specialties where AI could be useful. CONCLUSION: The study emphasizes the significance of addressing in dental professionals' knowledge gaps about AI. The promise of AI in dentistry calls for specialized training and teamwork between academic institutions and AI developers. Graduates of dentistry programs who use AI are better prepared to navigate shifting environments. The study highlights the positive effects of AI and the value of faculty involvement in maximizing its potential for better dental education and practice.
Assuntos
Inteligência Artificial, Docentes de Odontologia, Paquistão, Humanos, Estudos Transversais, Projetos Piloto, Educação em Odontologia, Atitude do Pessoal de Saúde, Assistência Odontológica, Masculino, Feminino, Previsões, Odontólogos/psicologia, AdultoRESUMO
INTRODUCTION: Influenza is a serious underestimated viral infection in Pakistan and influenza vaccination and vaccination awareness are low. The current work aimed to develop consensus on influenza epidemiology, prevention, vaccination, and awareness in Pakistan. METHODOLOGY: A systematic literature search was conducted to develop recommendations on influenza vaccines in Pakistan. Experts' feedback was incorporated using the modified Delphi method. A three-step process was used, with 18 experts from different specialties from Pakistan who participated in voting rounds to achieve a minimum 75% agreement level. RESULTS: Pakistan has a low-immunization-rate and is susceptible to serious influenza outbreaks and influenza-related complications. Influenza circulates year-round in Pakistan but peaks during January and February. The subtype A/H1N1 is predominant. The experts urged vaccination in all individuals ≥ 6 months of age and with no contraindications. They highlighted special considerations for those with comorbidities and specific conditions. The experts agreed that the inactivated influenza vaccine is safe and efficient in pregnant women, immunocompromised, and comorbid respiratory and cardiovascular patients. Finally, the experts recommended conducting promotional and educational programs to raise awareness on influenza and vaccination. CONCLUSIONS: This is the first regional consensus on influenza and influenza vaccination in Pakistan with experts' recommendations to increase influenza vaccination and decrease influenza cases and its associated detrimental effects.
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Vacinas contra Influenza, Influenza Humana, Vacinação, Humanos, Paquistão/epidemiologia, Influenza Humana/prevenção & controle, Influenza Humana/epidemiologia, Vacinas contra Influenza/administração & dosagem, Vacinação/estatística & dados numéricos, Conhecimentos, Atitudes e Prática em Saúde, Consenso, Técnica Delphi, FemininoRESUMO
INTRODUCTION: Pakistan has been experiencing an extensively drug-resistant (XDR) outbreak of typhoid for some years. We sought to evaluate how the COVID-19 pandemic impacted typhoid epidemiology in Pakistan, from the beginning of the pandemic in 2020 through the end of 2022, and the reduction of COVID-19 cases. METHODOLOGY: We compared national public COVID-19 data with retrospectively obtained patient data of confirmed S. Typhi isolates between January 2019 and December 2022 from Shaukat Khanum Memorial Cancer Hospital and Research Centre and the hospital's extended network of laboratory collection centers across Pakistan. RESULTS: We observed that during the early onset of the COVID-19 pandemic and COVID-19 peaks, typhoid positivity generally decreased. This suggests that restrictions and non-pharmaceutical interventions that limited social interactions and promoted good sanitation and hygiene practices had a positive secondary effect on typhoid. This led to an overall yearly decrease in typhoid positivity between 2019 to 2021. However, the percentage of S. Typhi cases isolated that were ceftriaxone-resistant continued to increase, suggesting the continued dominance of XDR typhoid in Pakistan. In 2022, with the alleviation of pandemic restrictions, we observed increased typhoid positivity and COVID-19 and typhoid positivity started to follow similar trends. CONCLUSIONS: Given the continued presence of COVID-19 along with XDR typhoid in Pakistan, it will be imperative to use differential testing to ensure that the epidemiology of each reported is accurate, the spread of each it contained, and that antibiotics are not misused. The use of approved vaccinations will lessen the burden of both diseases.
Assuntos
COVID-19, Salmonella typhi, Febre Tifoide, Febre Tifoide/epidemiologia, Paquistão/epidemiologia, Humanos, COVID-19/epidemiologia, COVID-19/prevenção & controle, Salmonella typhi/efeitos dos fármacos, Salmonella typhi/isolamento & purificação, Estudos Retrospectivos, SARS-CoV-2, Antibacterianos/uso terapêutico, Antibacterianos/farmacologiaRESUMO
OBJECTIVE: To determine the isotretinoin's effect on fasting lipid profile in patients with acne. STUDY DESIGN: Observational study. Place and Duration of the Study: Outpatient Department of Dermatology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan, from 22nd June to 21st December 2022. METHODOLOGY: Patients of clinically moderate and severe acne were selected and prescribed a dose of 0.5mg /kg cap isotretinoin for 6 months. They were advised to get a fasting lipid profile at the baseline and then after two months of isotretinoin therapy. National Cancer Institute Common Terminology Criteria for Adverse Events v5.0 grading system and Adult Treatment Panel III were used for the grading of abnormalities. McNemar Bowker test was used to assess the difference in variables [serum triglycerides (TGs), cholesterol, high-density lipoproteins (HDL), and low-density lipoproteins (LDL)] at the baseline and after 2 months follow-up. RESULTS: A total of 214 patients were evaluated. After 2 months of isotretinoin therapy, TGs and cholesterol levels were elevated to higher grade in 2% of the patients. Likewise in 1% of patients, LDL levels rised to higher grade. Moreover, HDL levels declined to lower grade in 2% of the patients taking isotretinoin. CONCLUSION: Insignificant alterations in the various serum lipid parameters were observed in acne patients during isotretinoin therapy. It is advisable to obtain a baseline fasting lipid profile in all acne patients on isotretinoin and repeated in those with baseline abnormal levels and in patients with a clinical sign of metabolic syndrome and a family history of dyslipidemias. KEY WORDS: Acne, Hyperlipidemias, Isotretinoin, Laboratory monitoring.
Assuntos
Acne Vulgar, Fármacos Dermatológicos, Jejum, Isotretinoína, Lipídeos, Humanos, Isotretinoína/uso terapêutico, Isotretinoína/efeitos adversos, Acne Vulgar/tratamento farmacológico, Acne Vulgar/sangue, Masculino, Feminino, Adulto, Fármacos Dermatológicos/uso terapêutico, Fármacos Dermatológicos/efeitos adversos, Lipídeos/sangue, Jejum/sangue, Adulto Jovem, Adolescente, Paquistão, Triglicerídeos/sangue, Colesterol/sangueRESUMO
Null.
Assuntos
Poluição do Ar, Humanos, Paquistão, Poluição do Ar/efeitos adversos, Poluentes Atmosféricos/efeitos adversosRESUMO
OBJECTIVE: To compare the effectiveness of intense pulsed light (IPL) and intradermal tranexamic acid (TXA) in treating melasma. STUDY DESIGN: A cross-sectional analytical study. Place and Duration of the Study: Department of Dermatology, Dow International Medical College, Dow University Hospital, Karachi, Pakistan, from 15th January to 15th July 2023. METHODOLOGY: A total of 62 patients with melasma, aged 20-50 years, were divided into two groups. Group A (32 patients) received IPL (560 nm filter was used) treatment, and Group B (30 patients) received intradermal TXA. Each group underwent four treatment sessions with varying intervals. Melasma area and severity index (MASI) scores were used to compare the effects of treatment. RESULTS: After a 3-month treatment period, both groups showed reduced mMASI scores compared to baseline with a significant initial difference between Group A (8.6 ± 4.2) and Group B (5.4 ± 2.7, p <0.001). However, post-treatment, there was no significant difference in mMASI scores (Group A: 3.8 ± 2.6; Group B: 3.2 ± 2.0, p = 0.29). IPL treatment (Group A) demonstrated a significant reduction in mMASI scores (57.1 ± 19.7) compared to intradermal TXA treatment (Group B, 42.2 ± 18.8, p = 0.0034). CONCLUSION: Both IPL and intradermal TXA treatments effectively reduced melasma, with IPL exhibiting superior results. However, post-treatment outcomes converged, emphasising the need for personalised approaches considering the unique characteristics of South East Asian skin. KEY WORDS: Intense pulsed light, Melasma, Intradermal tranexamic acid.
Assuntos
Terapia de Luz Pulsada Intensa, Melanose, Ácido Tranexâmico, Humanos, Ácido Tranexâmico/administração & dosagem, Ácido Tranexâmico/uso terapêutico, Melanose/terapia, Melanose/tratamento farmacológico, Adulto, Feminino, Estudos Transversais, Pessoa de Meia-Idade, Resultado do Tratamento, Masculino, Terapia de Luz Pulsada Intensa/métodos, Injeções Intradérmicas, Paquistão, Antifibrinolíticos/administração & dosagem, Antifibrinolíticos/uso terapêutico, Adulto Jovem, Índice de Gravidade de DoençaRESUMO
OBJECTIVE: To compare the acute toxicities of two radiation treatment techniques, intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (3D-CRT) in localised prostate adenocarcinoma. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Oncology, Dr. Ziauddin Hospital, Karachi, Pakistan, from July 2016 to June 2022. METHODOLOGY: Patients with localised prostate adenocarcinoma who underwent treatment using two different advanced radiotherapy techniques i.e., IMRT and 3D-CRT were recruited during the study period. They were followed up for six months for acute gastrointestinal (GI) and genitourinary (GU) adverse events (acute toxicities) related to both treatment modalities according to Modified radiation therapy oncology group (RTOG) criteria. The acute toxicities were assessed at the 2nd, 4th, and 6th week during treatment and at the 3rd and 6th month after treatment. RESULTS: There were 78 patients, with 39 patients in each group. The mean age was 68 ± 10 years in the 3D-CRT and 68 ± 07 years in the IMRT group. Patients in the IMRT group exhibited markedly lower treatment-related acute GI and GU effects at the end of 4th and 6th weeks for anorectal pain (p = 0.04) and (p = 0.01) and burning micturition (p = 0.003) and (p = 0.01), respectively. Furthermore, at 3 months anorectal pain (p = 0.02), loose stools (p = 0.005), and burning micturition (p = 0.01) were present and at 6 months anorectal pain was (p = 0.01) still present. CONCLUSION: Radiation therapy modalities 3D-CRT and IMRT both showed acceptable toxicity profile in the management of localised prostate cancer, while IMRT group exhibited significantly lower treatment-related acute GI and GU effects. KEY WORDS: 3D-CRT (3-Dimensional Conformal Radiation Therapy), IMRT (Intensity-Modulated Radiation Therapy), Radiation toxicity.
Assuntos
Neoplasias da Próstata, Radioterapia Conformacional, Radioterapia de Intensidade Modulada, Humanos, Masculino, Neoplasias da Próstata/radioterapia, Radioterapia de Intensidade Modulada/efeitos adversos, Radioterapia de Intensidade Modulada/métodos, Idoso, Radioterapia Conformacional/efeitos adversos, Radioterapia Conformacional/métodos, Pessoa de Meia-Idade, Lesões por Radiação/etiologia, Adenocarcinoma/radioterapia, Adenocarcinoma/patologia, Paquistão, Dosagem RadioterapêuticaRESUMO
College of Physicians and Surgeons, Pakistan (CPSP) is a premier postgraduate medical institution of the country. It introduced Objective Structured Clinical Examination (OSCE) in the 1990s, and later came up with its modified form known as Task Oriented Assessment of Clinical Skills (TOACS). This modified assessment has been incorporated in clinical examinations of its majority fellowship programmes. Despite the use of TOACS for so many years at CPSP, it is surprising to note that this form of assessment does not appear in the literature. The objective of this viewpoint is to describe the rationale for the development of TOACS and to compare its structure and functions with OSCE. Key Words: Medical education, Assessment, Objective Structured Clinical Examination, Interactive, Task Oriented Assessment of Clinical Skills.
Assuntos
Competência Clínica, Avaliação Educacional, Humanos, Avaliação Educacional/métodos, Paquistão, Educação de Pós-Graduação em Medicina/métodosRESUMO
OBJECTIVE: To determine if the STONE score is a predictor of blood transfusion and if patient-related factors, i.e., the presence of comorbidities such as urinary tract infection and obesity, can predict blood transfusion post-percutaneous nephrolithotomy. STUDY DESIGN: A cross-sectional descriptive study. Place and Duration of the Study: Department of Urology, The Aga Khan University Hospital, Karachi, Pakistan, between March 2022 and 2023. METHODOLOGY: All patients admitted for percutaneous nephrolithotomy (PNCL) were included in the study. STONE score and patient related factors were assessed. Chi-square or Fisher's exact test was applied to check the association between the dependent variables (blood transfusion) and the independent variables. Logistic regression analysis was applied to compare the variables responsible for the outcome. Results: During the study period, 150 patients underwent PCNL. After exclusion, 89 patients were included in the study. The mean STONE score was 7.87, and the total number of transfusions was 8 (8.9%). BMI (body mass index) >25kg/m2 and STONE score were found to be significant factors predicting the need for transfusion with p-values of 0.02 and 0.03, respectively. On multivariate analysis, only BMI was found to be a significant contributing factor for blood transfusion. CONCLUSION: High BMI and STONE score are significant predictive factors for blood transfusion post-PCNL. Blood product arrangements should be restricted to obese patients. KEY WORDS: STONE score, Body mass index, Blood transfusion.
Assuntos
Transfusão de Sangue, Cálculos Renais, Nefrolitotomia Percutânea, Humanos, Feminino, Masculino, Transfusão de Sangue/estatística & dados numéricos, Estudos Transversais, Cálculos Renais/cirurgia, Adulto, Pessoa de Meia-Idade, Paquistão/epidemiologia, Índice de Massa Corporal, Fatores de Risco, ObesidadeRESUMO
OBJECTIVE: To analyse and compare the assessment and grading of human-written and machine-written formative essays. STUDY DESIGN: Quasi-experimental, qualitative cross-sectional study. Place and Duration of the Study: Department of Science of Dental Materials, Hamdard College of Medicine & Dentistry, Hamdard University, Karachi, from February to April 2023. METHODOLOGY: Ten short formative essays of final-year dental students were manually assessed and graded. These essays were then graded using ChatGPT version 3.5. The chatbot responses and prompts were recorded and matched with manually graded essays. Qualitative analysis of the chatbot responses was then performed. RESULTS: Four different prompts were given to the artificial intelligence (AI) driven platform of ChatGPT to grade the summative essays. These were the chatbot's initial responses without grading, the chatbot's response to grading against criteria, the chatbot's response to criteria-wise grading, and the chatbot's response to questions for the difference in grading. Based on the results, four innovative ways of using AI and machine learning (ML) have been proposed for medical educators: Automated grading, content analysis, plagiarism detection, and formative assessment. ChatGPT provided a comprehensive report with feedback on writing skills, as opposed to manual grading of essays. CONCLUSION: The chatbot's responses were fascinating and thought-provoking. AI and ML technologies can potentially supplement human grading in the assessment of essays. Medical educators need to embrace AI and ML technology to enhance the standards and quality of medical education, particularly when assessing long and short essay-type questions. Further empirical research and evaluation are needed to confirm their effectiveness. KEY WORDS: Machine learning, Artificial intelligence, Essays, ChatGPT, Formative assessment.
Assuntos
Inteligência Artificial, Avaliação Educacional, Aprendizado de Máquina, Humanos, Estudos Transversais, Avaliação Educacional/métodos, Paquistão, Educação Médica/métodos, Estudantes de Odontologia/psicologia, Redação, Pesquisa Qualitativa, Educação em Odontologia/métodosRESUMO
Null.
