BackgroundAn increased interest in professionalism has been reported in the field of medical education due to concerns regarding deterioration of humanism and professional values in the teaching and practice of medicine. The primary aim of this study was to assess attitudes of Pakistani and Pakistani heritage students at a medical college in Pakistan about important elements of professionalism that an ideal medical doctor should possess. A further objective of the study was to determine students’ preferred ways of learning professionalism.MethodsA written survey was distributed to undergraduate medical students at a public sector medical college at Karachi, Pakistan in 2011. Using the Penn State College of Medicine (PSCOM) Professionalism Questionnaire, attitudes of medical students of semester 1, 5, and 8 regarding professionalism were assessed anonymously.ResultsThe mean age of the students was 21.11 ± 2.72 years. Forty-three percent of the respondents were male. Forty percent of the students held Pakistani citizenship. Thirty-five percent students were US citizens with Pakistani parents and twenty-five percent were Pakistani heritage students that had dual citizenships. No significant differences in the elements of professionalism (Accountability, Altruism, Duty, Excellence, Honesty & Integrity and Respect) mean scores or in the overall mean score of professionalism among the various classes were found. The total overall Cronbach alpha value for all elements of the professionalism in the selected classes was above 0.9. The most preferred methods for learning professionalism were role modeling by faculty, case based scenarios and role plays.ConclusionThe students rated all the attributes of professionalism as important and there was no difference across the study years. The overall internal consistency of each element of professionalism was high in different classes. Faculty role models, case based scenarios and role plays may be used to teach professionalism. As a great majority of students were having a Pakistani heritage rather than complete Pakistani born and bred background, hence findings of the survey may not be taken as representative of typical Pakistani medical students.

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Background: Ischemic Heart Disease (IHD) is a leading cause of morbidity and mortality worldwide. IHD results from myocardial ischemia, and occurs whenever perfusion outgrows the demand. Though lethal, but can be prevented by modification of predisposing conditions, most important are diabetes and hypertension. Almost fifty percent of IHD patients are found hypertensive with or without being diabetic. The objective of the study was to determine association of diabetes and hypertension as risk factors for IHD patients Methods: This was a hospital-based cross-sectional study that included 199 IHD patients of 35-70 years age, visiting Civil Hospital Karachi, a tertiary care public sector hospital, from September 2017 to January 2018 by using non-probability convenient sampling technique. The patients were approached in the hospital and briefed about the purpose of the study. A pre-tested, structured close ended questionnaire was used to collect the data. Data entry and analysis were done by using SPSS version 20.0. A p-value of <0.05 was considered as statistically significant. Results: Out of 199 participants, 156 (78%) were males while 43 (22%) were females; 119 60%) were 56-65 years of age. Family history of ischemic heart diseases was unremarkable in 126 (63%) patients. In total, 122 (61%) were diabetic; among them, 24 were of less than 40years and 98 of more than 40years of age. The older age of the diabetics had a direct association with the risk of IHD (p-value <0.05). About 83% had a non-significant family history for diabetes; and 83% of the total study participants were having a sedentary lifestyle. Out of 199, 166 (83%) had never checked their blood pressures earlier. The lifestyle, diet, addiction, and duration of hypertension had a strong association with IHD (p-value <0.05). Conclusion: IHD occurs more frequently in males of 56-65 years age, with insignificant family history for IHD and diabetes. The IHD is associated with hypertension and diabetes along with sedentary lifestyle, unhealthy diet and smoking/tobacco addiction.

Background: House Officers report significant levels of work-related stress that demands to be immediately addressed as it adversely affects their ability to function their best as doctors. This study aimed to assess the risk factors of psychological distress among the currently working house officers (2016-2017). Objectives: To assess the various risk factors of work-related stress amongst the house officers working in tertiary care hospitals, Karachi Methods: A cross sectional study was carried out in Civil Hospital, Jinnah Postgraduate Medical Centre and Abbasi Shaheed Hospital, Karachi during October 2016 and March 2017. A total of 384 house officers were approached for the study as per the sample size calculated using the Open-epi software. The questionnaire comprised of demographic data, 10-items perceived stress scale, and 12-items list of potential stressors. The severity of each stressor was measured using a five-point Likert scale (1-5) ranging from always (1) to never (5). Results: A total of 384 house officers were approached out of whom 315 (82%) participated. Among them, 115 (36.50%) were found to be under stress of whom 24 (20.8%) were males and 91(79.2%) were females. Significant difference for stressors by gender was found, these included their job having an effect on their health, change in eating habits and lack of paramedical staff cooperation (P < 0.05). Factors like increased hesitancy to take on tasks and increased tendency to make errors were found to have an impact on clinical performance (P value <0.05). Conclusion: There is high level of perceived stress in house officers of tertiary care hospitals, Karachi. Therefore, adequate steps are needed for stress management which should be dealt in terms of preventive rather than curative strategy.

Background: Hepatitis C is among one of the major global health issues; which may cause chronic liver disease, end stage liver disease, and hepatocellular carcinoma; subsequently requiring liver transplant. For HCV, standard treatment is a combination therapy of ribavirin and interferon for six months. Ribavirin fostered hemolysis is a major treatment-associated adverse effect. Our study aimed to assess ribavirin induced anemia among Hepatitis C patients visiting Civil Hospital, Karachi. Methods: A hospital-based cross-sectional study which included 106 Hepatitis C patients, of 15-60 years' age, visiting CHK, a public sector tertiary care hospital, from October 2017 to January 2018 by using non-probability convenient sampling technique. Results: Total 106 patients participated, 53 (50.0%) were males and 53 (50.0%) were females. Mean (±SD) age was 37.05 (±10.793). Mean (±SD) duration of ribavirin use was 3.03 (±1.523) months. Around 16.0% had ribavirin dose reduction. All of them experienced weakness, fatigue and light-headedness, 59.4% developed microcytic hypochromic anemia, 23.6% had severe anemia. Mean (±SD) hemoglobin level before the onset of treatment was 12.78 (±1.555). Mean hemoglobin level during treatment was 10.72g/dL. Mean reduction in hemoglobin levels was 2.07g/dL. The reduction in hemoglobin levels and the duration of therapy were correlated (p-value <0.05). The severity of anemia was related to age of the patients (p-value <0.05) but not with gender and RBC morphology. Conclusion: Ribavirin induces anemia. The duration of ribavirin therapy and initial hemoglobin levels were related to the severity of anemia, significant enough to cause dose modification and subsequently suboptimal levels affecting efficacy. In return hemoglobin reduction, dose modification and age of the patient were also related.