BackgroundMany low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse.MethodsA qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients.ResultsAll of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system.ConclusionThe study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for retaining the nursing workforce. Simple measures requiring better management practices could substantially improve the working environment and hence retention of nurses.

233 Pushtoons (129 males and 104 females), 51 Punjabi Muslims (29 males and 22 females) and 21 Afghans (15 males and 6 females) were screened for the presence of red cell glucose-6-phosphate dehydrogenase (G6PD) variants by a dye decolouration screening test and starch gel electrophoresis. The overall frequency of G6PD deficiency in males was found to be about 10%. 17 male G6PD-deficient samples were further investigated for the C→T substitution at nucleotide (nt) 563 (the Mediterranean mutation) and the C→T substitution at nt 1311 (the ‘silent’ allele) of the G6PD gene by PCR amplification followed by digestion with appropriate restriction enzymes. 10 of the 13 Pushtoon, 2 Punjabi and 1 Afghan males had the 563 mutations. Only 1 (Punjabi) out of 13 G6PD-deficient males with the 563 mutation had the silent mutation at nt 1311. The frequency of the silent mutation was found to be about 0.20 in the 60 Pushtoon and 19 Punjabi non-deficient males.

Objective: To determine the perception of medical students about factors affecting academic performance and to associate them with academic performance. Study Design: Cross sectional.Place and Duration of Study: The study was carried out in the Department of Community Medicine at Wah Medical College, Wah Cantt from January 2018 to August 2018.Materials and Methods: After explaining purpose of the study and taking informed consent, questionnaires were distributed to students and collected after two days. Data was analyzed by SPSS version 19. Frequency tables and charts were constructed for qualitative and quantitative variables accordingly.  Association of academic performance with factors affecting academic performance were determined by chi-square.Results: The factors that affect the academic performance most were parental concern (87.2%), time spent on social media (78.4%), influence of friends (74.4%), silence during study (88.8%) and style of teaching (80.8%). Significant association was found between academic performance and place of residence, daily breakfast, peer academic performance, night study and joining medical profession on own will.Conclusion: Supervision by parents, academically competent peers, apposite institutional environment, pertinent use of media and good teaching strategies mostly affect the academic performance.How to cite this: Khan KW, Ramzan M, Zia Y, Zafar Y, Khan M, Saeed H. Factors Affecting Academic Performance of Medical Students. Life and Science. 2020; 1(1): 8-11.  doi: https://doi.org/10.37185/L&S.1.1.45

Objective: To perform post analysis of multiple-choice questions given in the 2nd term and send up examinations of the years 2016 to 2018, to establish relationship between difficulty (DF) and discrimination indices (DI) and to find out significant mean difference between the two. Study Design: Cross sectional study. Place and Duration of Study: Community Medicine Department, Wah Medical College, Wah, from Nov 2018 to Mar 2019. Methodology: A total of 390 Multiple-Choice Question of second term and send-up were taken for the study from the year 2016, 2017 and 2018. The response sheets were assessed by Optical Machine Reader (OMR) and the level of difficulty, power of discrimination and reliability were obtained. The data was entered in SPSS version 22. Results: A total of 315 test items were included. Results of the study showed that the reliability (KR20) for all the examined items was in the acceptable range i.e. ≥0.7 and there was no association was found between difficulty index and year p=0.310. The mean difficulty index was found to be 0.48 ± 0.22 and discrimination index as 0.24 ± 0.14. Conclusion: The analysis of 390 test items showed that most of the questions were acceptable in terms of difficulty and discrimination. There is still a need to modify and improve the testing ability of the MCQs with negative discrimination and higher difficulty index.

Background: Neonatal period is the duration between 0-28 days of birth and it is the most susceptible period of life because of the large number of problems and diseases which a neonate is likely to face. The objective of the study was to determine the disease pattern and outcome among neonates in Pediatric ward of POF Hospital.Material and Methods: A descriptive study was carried out at Pediatric ward of POF Hospital Wah Cantt. Retrospective data regarding age, sex, reasons for admission, outcome and mode of delivery (from hospital record) was collected for all neonates admitted during the year 2016 from 1st January to 31st December. The data was analyzed by using SPSS V-19.Results: Among total neonates (n=887) admitted during the year, 63.2% were males and 36.8% were females. Mean weight of neonates was 2.54 + 0.75 kg while mean age was 2.39 + 5.8 days. Most common diseases were Prematurity, Respiratory Distress Syndrome, Seizures and Sepsis. Overall, 82.64% recovered from their illness while 17.02% expired.Conclusions: Prematurity, respiratory distress syndrome, seizures and sepsis were the major causes of neonatal admission in this study.Key words: Diagnostic value, Immature-to-total neutrophil ratio, Neonatal sepsis

Introduction: Clinical skills refer to the skills required for a clinician to manage a complete patient encounter. Clinical skill laboratories provide the facility to medical students and medical staff to learn the clinical skills before applying them on patients. Objectives: To evaluate perception of medical students regarding skill lab training. Study Design: Cross -sectional study. Study Setting: Wah Medical College. Period: January 2017 to June 2017. Study Subject: Students of Final Year M.B.B.S. Sample Size: 114 students. Sampling Technique: Convenient sampling. Data Collection Procedure: With informed consent of participants, questionnaires were filled by students themselves. Questionnaire was comprised of two parts; first part comprised of demographic data, second part comprised of 18 questions to determine perception of medical students about skill lab training. The responses of 18 questions were measured on four-point Likert scale from strongly disagree to agree. Data Analysis: Data was analyzed by using SPSS version 19, frequencies and percentages were calculated. The Chi square- goodness of fit test for one sample was applied on various levels of agreement. The p value of less than 0.05 was considered as significant. Results: The mean age of 114 students was 23.4 years with minimum age of 21 years and maximum of 26 years. Male students were 45(39%) and 69(61%) were female students. Out of 114 medical students108 (94.8%) students preferred to practice in skill lab before performing it on patient and they also had an opinion that the mentor must be friendly and helpful during teaching. Among them 107 (93.9%) students desired that procedures in the skill lab should be performed by the mentors first in front of students and 103 (90.4%) students thought that training of practical skills improve their learning. Out of them 94(82.5%) students believed that skill lab training increased their motivation to become a doctor, 102 (89.5%) students thought that skill lab practice provides a feeling of security for learning process and 100 (87.7%) students had an opinion that it should be a compulsory part of medical curriculum and even it should be started from the first year of the medical education. P value of level of agreement of all the variables regarding perception about skill lab training was found to be < 0.001 which was statistically significant. Conclusion: The students believed that skill lab training is very useful for them and they preferred to practice on manikin before dealing with the patients.

Published in August 2021.

To determine the frequency of different causes of iron deficiency anemia in female patients of reproductive age group. 2) To determine the association between lack of balanced diet and iron deficiency anemia. Design: cross-sectional analytical study. Setting: Federal government services hospital, Islamabad. Period: From July 2008 to November 2008. Material and Methods: The study included female patients of reproductive age group i.e. 15-49 years of age having hemoglobin less than 11.5g/dl. The sampling technique was purposive. The data was analyzed using Microsoft excel 2000 and SPSS 10.0. Pearson correlation coefficient was used to determine the direction of relationship between total nutritional score and level of hemoglobin; student’s t-test was used to determine the significance of association. A pvalue of less than 0.05 was considered significant. Results: A positive correlation was observed between total nutritional score and level of hemoglobin (r = 0.402, p-value = 0.008). Correlation between animal protein and level of hemoglobin was 0.438 (p-value = 0.004) while between plant protein and level of hemoglobin was 0.211 (p-value = 0.179). Conclusions: It is concluded that there is a definite role of nutritional deprivation in the development of iron deficiency anemia. Lack of balanced diet especially protein group has much stronger association with thistype of anemia. Animal protein as compared to plant protein has strong association with the development of iron deficiency anemia.