Being an effective physician, one must possess both clinical expertise and a specific range of emotional competencies, including empathy. Objective: To determine the empathy scores among medical and dental students and to correlate them with demographic factors like age, gender and academic year. Methods: A cross-sectional survey was conducted involving 324 students from medical and dental programs at a private medical and dental college in Lahore. Empathy levels were measured using Jefferson Scale of Physician Empathy- student version (JSPE-S). Data analysis was done using SPSS 24.0. Non-parametric tests were applied to find the significant difference between average scores of JSPE-S and all sub-scales across gender, age, academic year and medical program. Results: The mean empathy score on JSPE-S was 66.7. Difference of JSPE-S overall empathy score between age-groups was statistically significant (p-value 0.02). Among the medical and dental students significant difference was found between average scores of perceptive taking and compassionate care. No correlation was found between empathy scores and gender. However, empathy scores were low during initial years of medical school, being the highest in fourth year and then declining again. Conclusions: It was concluded that empathy is associated with demographical factors. Among the medical and dental students’ significant difference was found between average scores of perceptive taking and compassionate care. Although no difference in empathy scores was found between the two genders however, it declined as students gained more exposure to patients in their senior years
Professionalism and ethical behavior are critical components of medical practice, yet gaps in ethical education among medical students remain a concern. This study addresses the need to assess perceptions and experiences regarding professionalism among medical students. This study aims to evaluate medical students' awareness, perceptions, and experiences related to professionalism and ethical practices. A cross-sectional study was conducted using stratified random sampling across seven medical institutions (both public and private). A structured, self-administered questionnaire was distributed to 815 Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Surgery (BDS) students, yielding a response rate of approximately 90%. Data analysis involved IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York, United States), using descriptive statistics, Mann-Whitney U, and Chi-square tests. The sample comprised predominantly young adults (67.4% aged 20-22), with more females (64%) than males (36%). While 94% of participants were familiar with professional ethics, only 40% had completed a formal course in medical ethics, and 26.1% had received additional professional ethics training. A majority (59.3%) engaged in self-directed study on professionalism. Regarding unprofessional behavior, 61% observed a lack of medical dignity, 48.5% witnessed disrespect for cultural differences, and 48.5% noticed the failure to introduce oneself. Other observed unprofessional behaviors included performing procedures without supervision (50.3%) and unprofessional behavior in hospital corridors (46.5%). Eating or drinking in hospital hallways was observed by 43.8% of participants. These findings reveal a high awareness of professionalism and medical ethics, although unprofessional behavior remains common in healthcare settings. Gender differences were significant for training and self-directed ethics study (p < 0.05). The instrument used for the study demonstrated good reliability (Cronbach's alpha = 0.82). There is a critical need for integrating comprehensive ethics training into medical education to address observed gaps and improve professional conduct among future healthcare providers. The findings underscore the urgent need for integrating comprehensive ethics training into medical education. Addressing observed gaps in ethical understanding and behavior could inform curriculum development and foster professionalism among future healthcare providers. Such enhancements may ultimately improve the quality of patient care and strengthen public trust in the healthcare system.
Schizophrenia patients demonstrate variations in response to different therapies that are currently being used for the treatment of disorders, such as augmentation therapy (ECT or mood stabilizer) and combination therapy (with antipsychotics). These therapies are also used to treat schizophrenia patients in Pakistan; however, patients show poor overall response. Therefore, this study was conducted to investigate the association between the patients’ response to treatment and the use of antipsychotic agents, with variability in overall response, within different groups of patients. Methods: We conducted a retrospective study that included schizophrenia subjects (N = 200) belonging to different age groups, ethnicities, and regions from different outpatient and inpatient departments in psychiatric institutes located in different cities of Pakistan. These patients were assessed for their response to treatment therapies and categorized into four groups (non-responders (N-R), slow response (S-R), patients with relapse, and completely recovered patients (C-R)) according to their responses. Results: The final analysis included 200 subjects, of which 73.5% were males. Mean age was 34 ± 10 years. Percentage of N-R was 5%, S-R was 42%, patients with relapse were 24%, and C-R was 1.5%. The generalized linear regression model shows a significant association between medication response and age (p = 0.0231), age of onset (p = 0.0086), gender (p = 0.005), and marital status (p = 0.00169). Variability within the medication responses was a result of the treatment regime followed. Antipsychotic agents were significantly associated with the treatment response (p = 0.00258, F = 4.981) of the patients. Significant variation was also observed in the treatment response (p = 0.00128) of the patients that were given augmentation therapy as well as combination therapy. Conclusion: The data suggests proper monitoring of patients’ behavior in response to treatment therapies to implement tailored interventions. Despite several genetic studies supporting the heritability of schizophrenia, an insignificant association between characteristic features and family history might have been due to the limited sample size, suggesting collaborative work with massive sample sizes.
An insulinoma in a neuroendocrine tumor of the beta cells in the pancreas. An effect of insulinoma is an excessive secretion of insulin more than the requirement of body. Features of the condition include confusion, sweating, weakness, palpitation, seizures and even coma in severe cases. We report this case of a 61-year-old male presenting with acute confusion, on a background history of dizziness, palpitations and seizure disorder for which he is being managed medically for the last 5 years.
Objective: To understand and recognise why some patients leave the medical facility against physicians medical advice as it has clear significance in identifying those at risk and planning interventions for them beforehand. Study Design: Exploratory Research. Setting: Department of Psychiatry, Gujranwala Medical Collage/ Teaching Hospital. Period: September 2018 to September 2019. Material & Methods: The record included 73 cases that left against medical advice. Results: Highest ratios of variables present in the patients who left AMA were educational level of patients up to matriculation (34.2%), unemployment (54.8%), primary diagnosis of schizophrenia (20.5%), residence in Gujranwala (57.5%), attending physician’s residence up to 2 years (27.4%), and non availability of attendants (16.4%). Conclusions: Knowing what variables perpetuates the patient’s need to leave against medical advice can help in taking preliminary measures to prevent it.
Background: Professionalism in healthcare is crucial for maintaining patient trust and delivering high-quality care. Unprofessional behaviors among house officers (recent medical graduates undergoing training) raise concerns about their impact on healthcare outcomes. This study aims to assess the prevalence and perceptions of unprofessional behavior, as well as participation in it, among house officers in both public and private hospitals in Pakistan. Methods: A cross-sectional survey was conducted among 212 house officers from seven hospitals across Pakistan. The hospitals included both public and private institutions: 57% were private (Avicenna Medical College, Rashid Latif Medical College, Amna Inayat Medical College, Nawaz Sharif Medical College) and 43% were public (Quaid-e-Azam Medical College, Gujranwala Medical College, Khyber Medical College). A pre-validated and pre-tested questionnaire was used, covering demographic data and 29 questions related to unprofessional behaviors, including perceptions, observations, and self-reported participation. Data were collected through an online platform and analyzed using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used to summarize variables, and Chi-square tests for independence were applied to compare proportions between groups (graduates from private and public universities) for each variable. Associations between demographic factors and knowledge of professionalism were analyzed, with a significance level set at p ≤ 0.05. Results: Out of 212 participants, almost all (99.1%, n=210) were familiar with the concept of professionalism, but over half (53.8%, n=114) had not completed a formal medical ethics course, while 52.4% (n=111) engaged in self-directed study. Although 78.3% (n=166) had completed additional professional ethics training, Chi-square analysis revealed no significant associations between ethics training and changes in unprofessional behaviors, nor between gender, department, or type of institution, and the likelihood of observing or participating in unprofessional behavior (p > 0.05). However, certain unprofessional behaviors were significantly associated with previous ethics training (p < 0.05). Conclusion: While house officers demonstrated a strong awareness of professionalism, unprofessional behavior persisted regardless of gender or type of institution. These findings emphasize the need for enhanced ethical training and stricter monitoring to address and mitigate unprofessional behaviors in healthcare settings. Policymakers should consider mandatory integration of comprehensive ethical training in medical curricula to ensure better alignment between ethical knowledge and practice.
Objective: To determine whether the international standard recommendations of reporting CTPA are being followed in Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, to identify areas of weakness and give suggestions for improvement. Material and Methods: A retrospective study was performed during a six month period from January 2010 to June 2010 in the radiology department of SKMCH&RC. The study included 20 admitted patients who underwent CTPA during this period. Data was analyzed to evaluate whether the international standard recommendations of CTPA turn-around time were being followed at SKMCH&RC. Areas of improvement were identified and proposals for betterment were given. Re-audit after implementation has been suggested. Result: Average Request-to-Scan time was 3 hour and 13 min, compared to the recommended standard of 24 hours for non-massive Pulmonary Embolism (PE) and 1 hour for massive PE. (Half of the reported cases were non-massive and rest were un-specified) Average Scan-to-Report time was 34 min, compared to recommended standard of 30 min for CT done in acute emergency situations. There was 1 case which crossed the 24 hour limit of recommended standard for request-to-scan time and 9 cases which exceeded the 30 min limit for reporting. Conclusion: The audit shows that despite having no documented protocol of CTPA turn-around time at SKMCH&RC, the average time intervals of physician’s request to scan and scan to report come very close to the international standard protocol.
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