Annals of Jinnah Sindh Medical University

Team based Teaching: Strategy to Learn Anatomy in Large Group

Surriyya Sarwat — 2026-01-05

Anatomy teaching is the fundamentals for pre-clinical years in medical institutes. Many medical school delivered anatomy content thru cadaveric dissection, prosecuted bodies or plastic models or even 3D visualization in small as well as in large group sessions the theoretical content delivered predominantly through large group teaching. Due to the increased number of students, limitations of cadaveric bodies and increase number of contact session and shortage of trained anatomist resulted in the overcrowding and teacher – centered formats.

Knowledge and attitudes toward the clinical usage of e-cigarettes among medical students in a public sector university of Karachi

Mehreen Fatima — 2026-01-03

Objective:

This study aimed to assess the knowledge and attitudes toward the clinical usage of e-cigarettes among medical students in a public sector university of Karachi.

Methods:

A cross-sectional observational study was conducted among the undergraduate MBBS students from first year to final year including both the genders through convenient sampling technique. A self-administered structured questionnaire was administered to the participants. The questionnaire comprises of four sections.

Results:

Total 301 participants were included in the study with a mean age of 22.88±3.951 years. Most of the study participants were females (58.5%) and majority of the participants were studying in their final year (43.2%). When cigarette smoking status was inquired, it was found that majority of the participants were not smoking conventional cigarettes (77.7%). Most of the participants (73.4%) agreed that they have heard about the e-cigarettes. When participants were inquired if they smoke e-cigarettes, majority of them denied of smoking (n=251, 83.3%), however, of them who smoke e-cigarettes, 52% smoke e-cigarettes daily. Further, most of the female participant

agreed that e-cigarettes are less harmful than conventional cigarettes significantly as compared to males (P-value = 0.002 Vs. 0.597).

Conclusion:

It was found that participants had adequate knowledge about e-cigarettes and a little positive attitude towards the clinical use of e-cigarettes. Further, males were found more knowledgeable than females in most of the aspects.

THYROID PROFILE IN TYPE 2 DIABETES MELLITUS AND THEIR CORRELATION

Noor ul Ain — 2026-01-03

Objective To determine the relationship between thyroid disorders and type 2 diabetes mellitus (DM). Methodology: A case-control prospective study was conducted at the National Medical Center Karachi to find out the correlation analysis between studied parameters and type 2 diabetes (T2D). Results: Age, systolic blood pressure, diastolic blood pressure, fasting blood sugar, random blood sugar, HbA1c and TSH gives positive correlation with cases. The correlation of RBS with HbA1c and TSH was positive, considered statically significant these correlations were also found statistically significant with p <0.05.Conclusion: Type 2 diabetics are more prone to develop thyroid disorder specifically subclinical hypothyroidism because it is closely associated with glucose metabolism.

Key words: Diabetes mellitus, thyroid stimulating hormone, hyperthyroidism, hypothyroidism, thyroid dysfunction.

Faking it? Imposter syndrome: A Tale of two sectors-Public vs Private Institute medical students

Momina Jilani — 2026-01-03

Abstract:

Objectives: To determine, and compare the prevalence of impostor syndrome among public and private medical colleges in Pakistan. Impostor syndrome is known for lasting self-doubt, fear of being seen as a fake, and trouble taking in success. In medical students, it can cause worry, less trust in oneself, and worse medical school grades.

Methods: This cross-sectional study included 430 MBBS students from both public and private medical schools in Pakistan, from March 2025 to June 2025. These Students were picked using simple random sampling. They filled out an online form that used the Clance Impostor Phenomenon Scale (CIPS). Jamovi software was employed to analyze the data. Facts like age, medical school type, and study year were checked to see how deep impostor feelings were.

Results: In total, 91.4% of students in the study had feelings of being an impostor from moderate to severe. Fourth-year students felt it most, showing they may face issues as they begin clinical work tasks. Female students (58%) were affected more than male students. There was no significant difference noted between students from public and private medical schools.

Conclusions: The wide spread of impostor syndrome in all groups shows a big need for quick action on mental health methods in medical schools. Plans should aim to create strong minds, push for guide help, and make it okay to not be perfect. This helps to keep students well, no matter their medical school type.

Keywords: Clance Impostor Phenomenon Scale, Impostor Phenomenon, Medical Students, Mental Health, Perfectionism, Self-doubt

Epidemiological Analysis of Elbow Fractures in Children of Urban Populations of the Third World Country

Ghazanfar Ali Ali Shah — 2026-01-05

Objective:

To evaluate the demographic patterns, injury mechanisms, fracture distribution, factors associated with delayed presentation, in children presenting with elbow fractures at a tertiary trauma center of Karachi.

Methodology:

This retrospective cross-sectional study was conducted at the department of orthopedic surgery SMBBIT Karachi from January 2022 to March 2024. All Pediatric patients (<14 years) with radiologically confirmed elbow fractures requiring surgical intervention were included. The variables analyzed in this study included age, sex, injury mechanism, fracture type, laterality, bonesetter contact, time to presentation, swelling, neurovascular status, and treatment modality. Fisher’s exact test assessed associations between bonesetter visits, delay, and swelling.

Results:

A total of 180 patients with mean age 7.2 ± 3.6 years were included. Supracondylar fractures accounted for 73% of cases, predominantly affecting males (69.5%) and with left side (66.7%). The most common mechanism of injury falls during play (53.9%). Those patients who presented after 24 hours had prior visit to bonesetters and were all associated with significant swelling at presentation, and its association is confirmed with Fisher’s test OR ~ 3.8, p < 0.001). In children presented with RTA about 2.8% had vascular injuries. The most frequently performed procedure was close reduction and percutaneous pinning (CRPP), followed by open reduction and internal fixation (ORIF), accounting for 60% and 35% of the cases, respectively.

Conclusion:

The most common elbow fracture among children in Karachi was the supracondylar fracture. Delay in presentation was mainly due to initial consultations with bonesetters, which is a preventable factor that can be addressed through public awareness and early referral to reduce complications associated with this disabling condition.

The Impact of PF Ratio and Oxygenation on Non-Invasive Ventilation Failure during Acute Exacerbations of COPD

Syed Ali Abbas — 2026-01-05

Abstract

Background Chronic obstructive pulmonary disease (COPD) is a prevalent and potentially fatal illness characterized by restricted airflow in the airways and alveoli. Acute exacerbations of COPD have a significant negative impact on patients and contribute to increased mortality. Noninvasive ventilation (NIV) is increasingly used to manage this condition, but it can fail, leading to intubation and higher mortality rates. Recognition of factors contributing NIV failure is crucial to prevent morbidity and mortality. The PaO2/FiO2 ratio, a measure of oxygenation, has been studied in acute respiratory distress syndrome. This study aims to explore the role of the P/F ratio in predicting NIV failure during acute exacerbation of COPD.

Material and Methods: A Quasi Single Arm Study was conducted in Medical ICU and medicine ward of a tertiary care hospital, including 170 patients presenting with COPD acute exacerbations. Data collected proforma after informed consent for 6 months.

Results: The study included 170 patients with acute COPD exacerbation. Among them, 38% experienced non-invasive ventilation (NIV) failure. The mortality rate was 23.5%. Significant differences were observed in FiO2, SaO2, PaO2, and PF ratio between patients with and without NIV failure and mortality.

Conclusion: This study examined non-invasive ventilation (NIV) outcomes and mortality rates in patients with acute COPD exacerbation. The analysis of oxygenation parameters revealed significant differences between patients with and without NIV failure and mortality. These findings contribute to the understanding of treatment outcomes in acute COPD exacerbation and can help in clinical decision making. More researches can be conducted for further evaluation.

PREMAXILLARY OSTEOTOMY AND FIXATION IN BILATERAL CLEFT LIP AND PALATE: A CASE REPORT

Summera Kanwal — 2026-01-05

OBJECTIVES:

In bilateral cleft lip/palate patients, usually the premaxilla is severely protruded and rotated to right or left side with downward displacement. In such cases, osteotomy of premaxilla is one of the option to reposition premaxilla. In this case report we are documenting a technique for fixation of premaxilla to vomerine bone after osteotomy and ostectomy of vomerine bone without damaging to erupted and unerupted teeth.

METHODS:

The premaxillary osteotomy and ostectomy from bony nasal septum were carried out with Fixation of premaxillary segment to the vomer bone with low profile miniplate. This procedure was performed in one patient, with good labial repair. There was no complication for premaxillary osteotomy in this case.

CONCLUSION:

In protruding premaxilla, osteotomy and fixation of premaxilla with miniplate to the vomer bone yielded satisfactory result without damaging to adjacent vital structures.

KEYWORDS: Stabilization of premaxilla, vomer bone, internal fixation, premaxillary osteotomy.