BackgroundThe diagnosis and treatment of Autism in Pakistan occurs in multiple settings and is provided by variety of health professionals. Unfortunately, knowledge and awareness about Autism is low among Pakistani healthcare professionals & the presence of inaccurate and outdated beliefs regarding this disorder may compromise early detection and timely referral for interventions. The study assessed the baseline knowledge and misconceptions regarding autism among healthcare professionals in Pakistan which can impact future awareness campaigns.MethodsPhysicians (psychiatrists, pediatricians, neurologists and family physicians) and non-physicians (psychologists and speech therapists) participated in this study. Knowledge of DSM-IV TR criteria for Autistic Disorder, beliefs about social, emotional, cognitive, treatment and prognosis of the disorder were assessed. Demographic information regarding the participants of the survey was also gathered.ResultsTwo hundred and forty seven respondents (154 Physicians & 93 Non-physicians) participated in the study. Mean age of respondents was 33.2 years (S.D 11.63) with 53% being females. Reasonably accurate familiarity with the DSM IV-TR diagnostic criteria of Autistic Disorder was observed. However, within the professional groups, differences were found regarding the utilization of the DSM-IV-TR criteria when diagnosing Autistic Disorder. Non-Physicians were comparatively more likely to correctly identify diagnostic features of autism compared with Physicians (P-value <0.001). Significant misunderstandings of some of the salient features of autism were present in both professional groups.ConclusionResults suggests that current professionals in the field have an unbalanced understanding of autism due to presence of several misconceptions regarding many of the salient features of autism including developmental, cognitive and emotional features. The study has clinical implications and calls for continued education for healthcare professionals across disciplines with regards to Autism in Pakistan.

ObjectiveTo evaluate the knowledge and attitudes towards handwashing of clinical year medical and dental students and health-care professionals (HCPs) working in the departments of medicine, surgery, dentistry, nursing, and physiotherapy in Lahore, Pakistan.MethodologyThis was a cross-sectional survey conducted during May and June 2016. After approval from the institutional review board, a modified form of the World Health Organization (WHO) Hand Hygiene Knowledge Questionnaire for Healthcare workers that included 18 items was sent to 400 clinical year students and HCPs from six medical colleges and affiliated hospitals of Lahore. The data obtained was entered and analyzed by using IBM SPSS version 20 (IBM, NY, USA). Chi-square was used as the test of significance. A p-value of <0.05 was considered statistically significant for all purposes.ResultsThe response rate was 79%. Less than half of the respondents (149, 47.9%) were satisfied with their knowledge regarding hand hygiene. Statistically significant associations of various groups of HCPs were observed with their satisfaction regarding knowledge about hand hygiene (p-value = 0.022), their awareness of the proper technique required for handwashing proposed by the WHO (p-value = 0.001), and their awareness about other preventive techniques proposed by the WHO and Centers for Disease Control (CDC) (p-value = 0.021).ConclusionsThe majority of the clinical year students and HCPs were not satisfied with their knowledge regarding hand hygiene. HCPs working in different departments have varying knowledge and attitudes towards hand hygiene. Females were found to be more satisfied with their handwashing practices. Teaching proper technique of handwashing to medical students and starting refresher courses regarding hand hygiene for HCPs are dire needs. The WHO-recommended guidelines should not only be taught but also implemented in the medical field as poor hand hygiene techniques have led to the spread of many diseases around the globe.

Autism is a condition in which abnormal development of the brain takes place, manifesting in the first 3 years of life. Visual impairment is one of the major factors of autism spectrum disorder (ASD), and measurement of visual impairment is necessary for proper management of the disorder. The purpose of this study is to determine the frequency of visual impairment associated with ASD in Lahore Pakistan. A descriptive cross-sectional study was conducted. A convenient and purposive sample of 127 students enrolled in various autism schools of Lahore was enrolled. Written informed consent of teacher’s autistic children was taken. Children having diseases like cerebral palsy, other developmental disorders, and/or serious cognitive disability were excluded from this study. Participant’s undergone ocular assessment including visual acuity, ocular motility examination, refraction, and fundoscopy. Data analysis was performed using SPSS-20 and Pearson’s chi-square analysis was conducted to determine the associations of refractive error and squint with ASD. A total of 127 participants were included in this study, of which 77 (60.6%) were male and 50 (39.4%) were female. More than 60% were emmetropes (having no refractive errors), 19 (15%) were having myopes, 15 (11.8%) were hypermetropic, and 9 (7.1%) were Astigmatic, while 20 were diagnosed with a squint. The major cause of visual impairment in autistic children was refractive errors 33.8% and squint 15.7%. A high frequency of visual impairment was present in autistic children in Lahore autistic schools. As vision is a basic right so we have to pay attention also toward autistic children, in that way every child should have screened for factors that are responsible for visual impairments, Identifying refractive errors in these children early and providing appropriate corrective lenses may help optimize their visual functioning and impact their activities of daily life positively.

Vitamin D, also known as "sunshine vitamin", has long been established as an essential component for the maintenance of adequate bone health. Large number of studies are available which demonstrate the various biochemical pathways of vitamin D in bone physiology and its important role in musculoskeletal health. In last five decades, data regarding the non-bone effects of vitamin D have started to emerge, and now many important non-bone physiological processes are explained by the biochemical pathways and functions of vitamin D. However, majority of the data regarding extra-skeletal effects of vitamin D are available regarding adult population. In this chapter, we try to focus on the role of vitamin D in aging and various diseases which are frequently seen in children, adolescents, and young adults such as cancer, type 1 diabetes mellitus, allergies, asthma, and various autoimmune diseases.

BACKGROUND & OBJECTIVE: In-person attendance at medical school is a growing concern since the inception of readily available online resources. In Pakistan, a student who fails to keep up with what has been taught in class often finds academic assessments in jeopardy. The present study aimed to assess the role of attendance in academic performance among preclinical male and female students in the subject of Physiology. METHODOLOGY: Overall attendance in lectures, tutorials, and practical classes was recorded from first and second-year MBBS students’ records during the academic session of 2016-17. Scores in all written, viva voce and formative assessments were used to represent the academic performance. Data were analyzed by SPSS version 23.0. Shapiro-Wilk’s statistics were used to determine distributions. The median interquartile range (IQR) was used for non-normally distributed variables. A p-value of ≤ 0.05 was considered statistically significant. RESULTS: A total of 287 preclinical students were included in the study. Out of them, 110 (38.3%) were male, and 177 (61.7%) were females. Girls had higher overall attendance, 91% (87.2-95) as compared to the boys, 88.9% (85.6-93.2) of both MBBS years (p = 0.015). Girls also had a significantly higher percentage of scores in all formative assessments in tutorials, 65.7% (59.2-73.9) as compared to the boys, 59.6% (53.1-66.4) (p < 0.001). A positive correlation of all academic performance parameters was observed with the overall attendance (p < 0.001). The same correlations were also seen among the groups based on gender as well as the MBBS year. CONCLUSION:  Attendance at medical school, especially in the subject of Physiology, is related to better academic performance. Female students are more regular and have the habit of attending classes which reflects on their better performance in formative assessments. A satisfactory overall attendance observed in our study might be due to the mandatory attendance policy of our medical school.