Objective: To compare motivation to become a doctor in both genders Study Design: Observational cross-sectional study Place and Duration of Study:  Rawalpindi Medical University in March 2019. Materials and Methods: First and second-year M.B.B.S students were included in the study. Age, year of study, and gender were recorded.  The questionnaire included 18 questions assessing six motivational dimensions: status and security; nature of the occupation; career opportunities; patient care and working with people; use of personal skills; and interest in science. Responses were recorded as ‘agree’ or ‘disagree’ for each question and results were analyzed using SPSS v19. Results: Out of 350 medical students, 247 (70.6%) were female and 103 (29.4%) were male. Most frequent motivational factors for females were “Opportunity to care for/ help people” (n=240; 97.1%) followed by “responsible job” (n=220; 89%) and “use of mental skills” (n=217; 87.8%). Male students were motivated mostly by “use of mental skills” (n=90; 87.3%) followed by “provides secure career” (n=87; 84.4%) and “challenging field” (n=83; 80.5%). In our study, (n=61; 25%) of females responded in agreement that boosts in marriage perspective was an underlying motivational factor for their choice of studying medicine while (n=41; 40%) males agreed to it. There was a significant difference between both genders with a p-value of 0.005.  Conclusions: We infer that female medical students have more humanitarian grounds for choosing the medical profession and are more motivated than their male counterparts.

Abstract Objective: The study objective is to compare the pain frequency and mean hospital stay in patients with and without drain insertion, following laparoscopic cholecystectomy for acutely inflamed gallbladder. Methods: Randomized control trial was carried out in General Surgery Department Shifa International Hospital for a period of 1 year from October 2017 to October 2018. All patients with acutely inflamed gallbladder admitted underwent laparoscopic cholecystectomy using conventional 4 port method. Applying Lottery method patients were sorted into two groups; (Group A) – without drain and (Group B) – with drain. Post operatively parameters of pain and total hospital stay were assessed. Data was entered into a standard SPSS sheet version 15.0. Results: Mean age of patients in without drain (group A) was 52.00±14.84 years and in with drain (group B) was 47.50±18.28 years. In without drain (group A), there were 9 (30.0%) males and 21 (70.0%) females, mean VAS was 2.37±1.22, 16.7% (5 of 60 patients) had pain, and mean hospital stay was 1.93+/-0.79 days. In with drain (group B), 13 (43.3%) were males and 17 (56.7%) were females, mean VAS was 3.2 +/-1.36, 36.7% (11 of 60 patients) had pain and mean hospital stay was 3.17+/- 0.87 days. The difference between the two groups for mean VAS was significant (P<0.05), for mean hospital stay was significant (P<0.05) but for pain frequency was insignificant (P>0.05). Conclusions: It has been concluded that without drain, more appropriate results have been obtained as compared to drain. Clinical Trial Number: NCT04346550

Objective: To analyze radiological spectrum of HRCT in COVID-19 patients, clinically symptomatic but initially having negative RT-PCR. Study Design: Prospective cross sectional descriptive study. Place and Duration of Study: Radiology and Medicine Department, DHQ Hospital Rawalpindi, from June to November 2020 Methodology: The study included 90 patients presenting with clinical symptoms of COVID-19 but with negative RT-PCR. All patients underwent chest computed tomography (CT). Patients with positive COVID-19 RT-PCR test or serology on subsequent repeat test were included in the study. Patients having non COVID-19 HRCT features with negative RT-PCR were excluded from the study. Results: Out of 90 symptomatic, RT-PCR negative patients, 7 had normal chest CT. According to BSTI classification, 50 patients showed classic, 11 had probable and 22 had indeterminate features. Despite supportive clinical and CT features, 17 (18.89%) patients had negative RT-PCR tests on subsequent testing. Unilateral changes were in 8 (8.9%) and bilateral in 75 (83.3%). Most common finding was mixed pattern of peripherally distributed GGN and bronchocentric nodules in 37 (41.1%) patients. Consolidations were in 19 (21.1%), pure ground glass haze in 13 (14.4%), crazy paving in 4 (4.4%), fuzzy bands and arcades in 7 (7.8%), and subtle gravitational GGH in 3 (3.3%) patients. CT-SS classified 69 (76.7%) patients as mild, 10 (11.1%) as moderate and 4 (4.4%) as severe disease. Conclusions: HRCT with CTSS is an important tool for diagnosing and prognosticating COVID-19 infection despite negative RT-PCR, timely identifying and isolating COVID-19 cohorts preventing cross infection and also aiding in prompt symptomatic management.

Objective: To determine the diagnostic yield of cell blocks, prepared by the vapour fixation method, using laboratory supplies easily available at any low resource laboratory setup or outpatient department of a basic healthcare unit. Methods: Prospective descriptive study was carried out at Healthways Laboratories Rawalpindi, for 6 months from 1st January 2017 to 30th June 2017. Walk in patients referred to the lab for FNAC were selected by non probability convenient sampling. After preparing FNAC slides from first pass, the patients were briefed about the cell block material and after informed consent second dedicated passes were done to make cell blocks. Results: Out of 47 cases, there were 25 (53.2 %) breast lumps, 8 (17%) superficial collections, 7 (15.1%) lymphadenopathies, 6 (12.8%) thyroid swellings and 1 salivary gland swelling. Technique yielded moderate to high cellularity in 33 (70.2%) cases, 16 from malignant and 1 from benign breast lumps, 5 from thyroid, 3 from reactive and 3 from metastatic lymphnodes, 3 from abscesses, 1 from lipoma and 1 from salivary gland. Low cellularity 14 (29.8%) cases were from 5 benign and 3 malignant breast lumps, 2 hematomas and 1 case each from thyroid, metastatic lymphnode, abscess and lipoma. Good cellularity was achieved in 16 (84.2%) of 19 cases of malignant breast lesions, 3 (15.8%) were hypo cellular of which 1 was non-diagnostic on FNAC smear. Cell block diagnosis was comparable to FNAC in 35 of 47 (74.4%) cases. Non diagnostic cases on cell block were more, 13 versus 3 cases on FNAC. The kappa value of agreement in diagnosis was 0.64. Conclusions: Poor man’s cell block method is simplest and effective method of cell block preparation which must be advocated at basic healthcare units and low tech laboratory. Its diagnostic potential must be further explored.

IntroductionStrain ultrasound-guided elastography (USE) could be used to differentiate malignant from benign thyroid lesions if its sensitivity and specificity are significantly high. Data on whether to rely on USE in differentiating thyroid nodules are unavailable, and fine-needle aspiration cytology (FNAC) remains the gold standard. However, FNAC carries a significant financial burden on hospitals and psychological stress on patients. Therefore, we conducted this study to determine the diagnostic accuracy of strain USE in thyroid lesions.