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The objective of this study was to assess the impact of social media integration in teaching methods on exam outcomes. Methods: This study was conducted at Poonch Medical College, Azad Kashmir, Pakistan from November 2018 to January 2019. All 125 students of 4th year MBBS were included in the study. The mean age of all respondents was 22.96 ± 3.25 years. One unit of special pathology was taught using traditional teaching methods and a second unit was taught using traditional teaching methods supplemented by social media. One exam was taken before the integration of social media and a second exam after its integration. Written informed consent was secured from all the participants before starting the project. Results: The mean difference in examination score after social media integration was 8.97 ± 5.23 which was statistically significant (95% CI −7.954-9.988, p <0.001). However, classroom attendance was significantly higher before social media integration (95% CI 0.668-0.197, p <0.001). Social media integration provided better examination outcomes for the students and gave voice or space to those who never previously asked questions or participated in the class. Conclusion: Social media broke down the barriers and students communicated with confidence. Educationists may work together to create a guideline on how social media can be efficiently incorporated in the education system.

To determine the frequency and determinants of dental caries among children with special health care needs in the special needs schools of Karachi, Pakistan METHODS: This cross-sectional study was conducted among 196 children (aged 6-18 years) attending the public and private sector special-needs schools of Karachi, Pakistan. Children with mental and/or physical disability were included in the study. Prevalence of dental caries determined oral examination using the Decayed Missing Filled Teeth and Decayed Filled Teeth (DMFT/dft) index. Parental education level, oral health knowledge and household level socioeconomic status were measured through a structured questionnaire. Data were analyzed in SPSS version 20. RESULTS: The overall frequency of dental caries was 58.2% with 70.3% and 55.3% prevalence in the public and private special needs schools. The mean DMFT/dft value was 1.85±2.28. The Down syndrome group had the highest mean (DMFT/dft=2.45±2.65), followed by the group including vision impairment, autistic and cerebral palsy children. (DMFT/dft=2.05±2.51), Intellectual disability (DMFT/dft=1.70±2.01) and the deaf or hard of hearing group (DMFT/dft =1.49±2.27). Caries status was not significantly associated with gender (p=.518), socioeconomic status (p=.067), father education (p=.158) and mother education (p=.758). CONCLUSION: The frequency of dental caries was high among children with disabilities in the Karachi district of Pakistan. The most important factor in improving the oral health status of these children is the awareness of their families by continuous community oriented medical and dental education programs.

IntroductionRegulatory compliance in the retail environment is integral to the success of tobacco control. We assessed compliance among naswar (smokeless tobacco product widely used in South Asia) vendors with tobacco control laws. We also assessed their awareness of tobacco-related harms and policies and perceived effect of policies on their sales.MethodsWe surveyed 286 naswar vendors in three districts of the Khyber Pakhtunkhwa province of Pakistan. We recruited general and specialty vendors from urban and rural areas through multistage cluster sampling. Compliance was measured for promotion, sale to/by minors and tax paid on naswar. We used logistic regression analyses for assessing the association between the outcome variables (awareness of tobacco harms and laws, perceptions about the effect of policies on business and compliance with laws) and their predictors.ResultsMost vendors (70%) were aware of tobacco-related harms of naswar. Although educated vendors were more aware of tobacco control policies, the greatest awareness was for a ban on sales to/by minors (21% overall). The majority of vendors (76%) violated this policy (measured by self-report), and violations were more common among rural than urban vendors (OR 2.27, 95% CI 1.05 to 4.96). Most vendors (71%) violated a ban on promotion of naswar. Vendors perceived tax increases and sales ban to/by minors as most detrimental for business.ConclusionsThere was poor awareness and compliance among naswar vendors in Pakistan with tobacco control laws. This study finds potential areas for policy interventions that can reduce urban/rural disparities in implementation of and compliance with tobacco control laws.

Mycobacterium tuberculosis infection continues to be a major global challenge. All patients with pulmonary tuberculosis are treated with a standard 6-month treatment regimen. Historical data suggest that even with shortened treatment, most patients achieve long-term remission. Risk stratification is a goal for reducing potentially toxic prolonged treatment. This study aimed to determine the factors associated with the early clearance of sputum acid-fast bacilli (AFB). A total of 297 freshly diagnosed patients with pulmonary tuberculosis were included and enrolled in this study. Information related to their ethno-demographic and anthropometric characteristics was collected. We also assessed their complete blood counts, and blood iron, folate, and vitamin B12 levels. We found that the presence of higher levels of acid-fast bacilli (AFB) in diagnostic sputum microscopy was the single most significant prognostic factor associated with early clearance of sputum AFB after 2 months of treatment. All of our patients achieved treatment success after 6 months of treatment and were disease free. Our results support the data obtained from previous studies indicating that AFB clearance at 2 months is unlikely to be a clinically useful biomarker or indicator for therapeutic stratification. Furthermore, demographic, anthropometric, and nutritional factors are not clinically useful biomarkers.

Objectives: To explore the perception of postgraduate public health students regarding e-learning in context to Covid-19 pandemic and its effect on their academic performances Methods: This cross-sectional study was conducted at Sarhad Institute of Health Science, SUIT Peshawar from 3rd October 2020 to 4th February 2021. The Census method was incorporated for sample selection. Participation in the study was subjected to consent by participants. A self-administered questionnaire was used for data collection. Data was analyzed using SPSS Version-26. Results: Out of 95 participants, 72 (75.8%) were males and 23 (24.2%) were females. The mean grade point average (GPA) of previous semester-1 and semester-2, when they were having a conventional education system on campus before the pandemic was 2.741±0.499 and 2.643±.498 respectively. The current mean GPA of semesters 1, 2, and 3 who had online classes during this pandemic was 2.41±0.66, 3.06±0.51, and 2.80±0.47 respectively. Fifty-one (53.7%) students preferred to use mobile for e-learning. Convenience to the use-learning management system (LMS) was 67.4% and 72.6% responded that their academic performance was positively affected by e-learning. Logistic regression revealed that source of learning (p 0.99), uninterrupted internet (p 0.87), convenience with LMS (p 0.17), stress (p 0.505), convenient communication with faculty (p 0.69), and compatibility with professional routine (p 0.21) were not significantly associated with good academic performance, however, students of semester 2 (p 0.001) and those using laptops (p 0.02) were more likely to get a GPA of 3.0 or above Conclusions: Students in this study had a positive perception regarding e-learning however, there is a definite need to amalgamate both online and on-campus learning modalities for post-graduate students especially during the uncertain situations. doi: https://doi.org/10.12669/pjms.38.3.4626 How to cite this:Aleem S, Mahsood N, Kibria Z, Gul R. Perception of Master of Public Health Students regarding E-Learning in Covid-19 Era: A New Normal in Lower- and Middle-Income Countries. Pak J Med Sci. 2022;38(3):---------.  doi: https://doi.org/10.12669/pjms.38.3.4626 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.

OBJECTIVES: our study was to study the impact of terrorism on the people of Khyber Pukhtunkhwa handto assess the post traumatic effects of terrorism, in particular the Post Traumatic Stress Disorder anddepression in the people of Khyber Pukhtoonkhwa.METHODS: A descriptive, cross sectional study design was conducted in KPK from May 2011 toSeptember 2011.In this study subjects were people of KPK including IDPs, shopkeepers, students. Selfadministered questionnaires were filled by a sample of 450 respondents.RESULTS: The results showed that out of 51.2% people affected, 23.6% people had Post Traumatic StressDisorder and 6.9% were suffering from depression. 20.7% people were suffering from both Anxiety andDepression. 48.2% people were unaffected. SPSS and MS-Excel were used for the analysis of data.CONCLUSION: The study concludes that a majority of people in KPK were suffering from PostTraumatic Stress Disorder and depression due to constant threat of terrorism. These people have beenaffected in one or more ways. Some have lost their business and shelter and some have been personallyexposed to terrorism. These people who are positive for anxiety and depression need to be targeted forcounseling. Moreextensive research is needed in this area.KEYWORDS: Post Traumatic Stress Disorder, Depression and Terrorism

Objective: To assess household poverty, sanitation and hygiene practices, and food security in both urban and rural settlements of district Peshawar. Methods: We conducted this cross-sectional study from March 2019 to October 2019 in the urban and rural households of Peshawar, KPK. Using stratified random sampling, 554 households (HH) having children and young adolescents of age 5-19 years, adult men > 19 – 62 years, and adult women >19 - 62 years were included in this study. Data was collected using comprehensive tool comprised of all validated questionnaires and was analyzed using SPSS Version 24.0. Results: Within the urban clusters, the maximum number of households (n=29) were from Gari Baloch and the minimum number of households (n=7) were from Gulberg. In the rural clusters, the maximum number of households surveyed (n=41) were from Lamara, minimum(n=21) was from Chargula. The average age of household heads was 44.5 ±12.5 with mean age slightly higher in urban areas (45.1 ±11.8) compared to 44.0 ±13.2 in rural areas. The mean poverty score was 56.8 (±11.6) with 72.1% non-poor households, and 94.2% households being food secure. Handwashing practices were highly prevalent among all the HH, however, handwashing practices before eating were comparatively lower in all HH (45.2%), lowest (37.8%) among rural households. Conclusion: The findings of the study revealed both non-poor and food secure households with satisfactory water, hygiene and sanitation practices. doi: https://doi.org/10.12669/pjms.39.2.7122 How to cite this: Kibria Z, Khan MN, Aleem S, Zia ul Haq. Linkages between poverty and food insecurity in Pakistan: Evidence from urban and rural households in Peshawar. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.7122 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.