Introduction An important aspect of a modern academic curriculum is assessment, which can be clinical and written. Written assessment includes both multiple-choice questions (MCQs) and short answer questions (SAQs). Debate continues as to which is more reliable. It is important to assess the correlation between the two different formats of written assessments, especially in the clinical subjects as they are different from the basic science subjects. Moreover, data are lacking in the correlation of the two formats of the written assessment in the clinical subjects. Therefore, we conducted this study to see the correlation between MCQs and SAQs in the end-of-clerkship examinations for final-year medical students. Materials and methods The end-of-clerkship written assessment results of the four disciplines of medicine, surgery, gynecology, and pediatrics were included. This was a retrospective correlational analytical study conducted at Shifa Tameer-e-Millat University, Islamabad, from 2013 to 2017. Data were analyzed using IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, NY); mean, standard deviation, Pearson coefficient, and p values were calculated both for MCQs and SAQs. Results A total of 481 students were involved in our study. The mean percentage scores of MCQs and SAQs in medicine were the most similar, and scores in obstetrics and gynecology had the most disparity. As compared to MCQs, the wider standard deviations were found in SAQs. Pearson correlations were 0.49, 0.47, 0.23, and 0.38 for medicine, surgery, gynecology, and pediatrics, respectively. Conclusion While we found mild to moderate significant correlation between MCQs and SAQs for final-year medical students, further investigations are required to explore the correlation and enhance the validity of our written assessments.

Introduction: Total thyroidectomy has been considered to be a treatment of choice for thyroid malignancies. It has recently gained popularity as gold standard for benign thyroid disorders requiring surgical treatment. Because of higher number of complications associated with total thyroidectomy, it is still considered an adventurous endeavor. Most important improvements in thyroid surgery include laparoscopic thyroidectomy, energy based devices (EBD) like Harmonic Focus® and LigaSure® for dissection and hemostasis, intraoperative neuromonitoring, and parathyroid hormone (PTH) assay technology. Aim of Study: Recent studies have suggested that despite lesser complication rates with LigaSure dissection method in total thyroidectomy, it is associated with prolonged operation time. Aim of our study was to compare conventional suture tie technique and LigaSure thyroidectomy, in terms of perioperative complications including bleeding, recurrent laryngeal nerve (RLN) injury, postoperative hematoma, hypocalcemia, operation time, and costeffectiveness.

Background & Objectives: The novel coronavirus (SAR-CoV-2) pandemic has revolutionized medical education worldwide. Most medical schools have adopted the online teaching and assessments. Students attending modified clerkships and assessments under the stress of the pandemic, perform and score differently when compared to normal clerkships. We aimed to identify the impact of COVID-19 on final year MBBS students’ EOC (End of Clerkship) examination by comparing them with their scores prior to the COVID and with scores of the previous final year. Methods: This cross-sectional study was conducted at Shifa College of Medicine. Final year MBBS students’ scores of years 2019 and 2020 were included. Students’ EOC MCQ and OSCE scores were compared in pre-COVID and COVID affected rotations of the same year and with the previous year (2019). Data were analyzed in SPSS version 21, means scores were calculated, and one-way ANOVA was applied. Pearson correlation was calculated for correlation assessment of MCQ and OSCE scores. Results: There were 118 students. The mean EOC, OSCE, and MCQ scores in rotations one to four were 72.8±6.4, 73.3±8.1, 71.6±7.4, 72.7±6.7 and 44.4±8, 47.2±8.4, 46.1±8.2, 48.8±8.1, respectively. One-way ANOVA results before and after COVID lockdown were statistically insignificant (p=0.3) for OSCE and significant for MCQ in the final year class of 2020 (p=0.001). The Pearson correlation assessment between MCQ and OSCE scores (n=416) had a significant positive correlation (r=0.42, p=0.000). The overall comparison between scores of the final year class of 2019 and 2020 showed significant improvement in Surgery and Obstetrics/Gynae scores in 2020. Conclusion: During the COVID pandemic, the final year students’ performance in EOC MCQ and OSCE over all remained unaffected. doi: https://doi.org/10.12669/pjms.38.1.4645 How to cite this:Aaraj S, Farooqi F, Saeed N, Khan S. Impact of COVID Pandemic and Hybrid teaching on Final year MBBS students’ End of clerkship Exam performance. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4645 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Background: Gall stone disease (GSD) is one of the commonest gastrointestinal disorders. Causative factors can be non-modifiable as genetics and modifiable like dietary habits. High-fat diet and high BMI are well known contributing factors world-over. Local and regional data is deficient about these factors. Moreover, Indo-Pakistani dietary patterns are very different from the western population. This study was conducted to see the association of high BMI and diet with GSD in our population.Materials and Methods: This case-control study was conducted in Shifa International Hospital, Islamabad, from 2012 to 2017. We included all female patients above 25 years of age with symptomatic gall stones on ultrasonography as cases and all females above 25 years of age with no gall stones on ultrasonography (done for any reason) as controls. The patients with gall stones having some other clear predisposing cause for gallstone formation, e.g., stoma, sudden weight loss, etc. were excluded. BMI, demographic details, dietary habits, and clinical profile of cases and controls were recorded. Data were analyzed by SPSS v 21. p-values were calculated.Results: A total of 396 patients were included in this study, with 103 cases and 293 controls. The mean BMI of GSD cases was 27.576±5.753, while controls had a mean BMI of 25.638±7.008 (p=0.08). About 26.4% of cases had an average fat consumption greater than 100g/day as compared to 11.9% controls (p=0.035). The average red meat intake per week was 222g among cases while 210g among controls (p=0.001). The average intake of fried food per week was 270g among controls and 250g among cases (p=0.012). The average intake of bakery items per week was 240g among cases and 210g among controls (p=0.038). Conclusion:Gall stone disease is significantly related to high BMI and high dietary fat and meat intake in our population.

Objective End‐stage renal disease patients with vein diameter of ≤2.2 mm can undergo autogenous arteriovenous fistula (AVF) formation with the acceptable results. Methods This observational retrospective study of prospectively collected data analyzed end‐stage renal disease patients with a vein diameter of ≤ 2.2 mm, who underwent AVF formation at Shifa International Hospital Islamabad from January 2009 to December 2017. The fistulae were observed for immediate success and maturity at 3 months. The chi‐square test was used to determine the effect of vein diameter on final maturity. All data were analyzed using SPSS. Results The total number of patients with vein diameter of ≤2.2 mm was 38, with a mean age of 46.76 ± 12.790 years. Vein diameters ranged from 1.6 to 2.2 mm. Immediate success was observed in 35 (92.1%) cases. Veins of 31 (81.6%) patients showing maturity at 3 months and were used for hemodialysis. The overall success rate for the small caliber veins was 82%. Conclusion Although end‐stage renal disease patients present late with very small diameter veins, these veins should still be accommodated for permanent vascular access, because their maturity rates are still acceptable, even though these are lower than those of patients with adequate sized veins.

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Basilic vein transposition (BVT) is the preferred permanent haemodialysis access due to better patency and lower infection rates compared to synthetic grafts. The outcomes of BVT cases, performed at Shifa International Hospital, Islamabad, from March 2006 to June 2018, were ambispectively investigated. The primary patency of the fistula was assessed immediately after surgery, at 24 hours, at 7-14 days, at 6-8 weeks and then at 3-6 months. A total of 160 patients were included in the study, out of which 83 (51.87%) were males while 77 (48.12%) were females. Of the total 160 patients, 119 (74.4%) underwent one stage BVT, while 41 (25.6%) underwent two stage BVT. One hundred and thirty-five (84.4%) procedures were successful and survived while in 25 (15.6%) cases it failed. Mean basilic vein diameter was 2.712 (±0.772) mm. Overall, 10(6.3%) patients had bleeding, 15(9.4%) fistulae thrombosed, 6(3.8%) had steal syndrome and only 1 (0.6%) patient developed pseudo aneurysm. We conclude that BVT is a feasible technique with very good patency rate especially for those patients who have multiple forearm AVF surgeries. Key words: Arteriovenous Fistula (AVF), Basilica Vein Transposition (BVT), Permanent Vascular Access, End Stage Renal Disease (ESRD).