Tariq Mufti

Introduction : Student satisfaction is taken as the most important denominator of defining quality control & success of a curriculum; an integrated curriculum particularly affects the students’ reception and retention. Student satisfaction with teachers of different disciplines is representative of the overall instructional program. The study was conducted to determine student satisfaction with teachers’ instructional performance in an innovative MBBS curriculum. Materials & Methods : The questionnaire based survey was conducted on first and second year MBBS students of Rehman Medical College; feedback forms containing 18 items of teacher performances were distributed to all 200 students. Scoring was on a 5-point Likert scale. Scoring of individual teachers was also done and based on categories of Satisfied, Uncertain and Dissatisfied. Results : The response rate comprising of 186 students was 95% for first year and 91% for the second year MBBS class. Satisfaction with teachers on d...

A cross-sectional study to determine the diagnostic accuracy of clinical impression and graded compression abdominal ultrasonography in acute appendicitis used individually or complementary to each other was conducted in a busy surgical unit. Eighty-nine cases subjected to categorized clinical impression and ultrasonography preoperatively achieved fairly high sensitivity (84.3% and 81.81% respectively) but low specificity (23.68% and 38.23%) with an overall negative predictive value of 31%, implying it to be a poor indicator to avoid negative appendectomies.

Introduction: The Mercury sphygmomanometer, a global gold standard Blood Pressure (BP) recording device is being replaced by Automated Wrist, Arm and Finger devices due to the hazardous effect of mercury on health. The present study was conducted to test the accuracy of blood pressure measurements taken with two Automated blood pressure devices (Arm and Wrist) keeping Mercury sphygmomanometer as the Gold Standard. Materials & Methods: A cross sectional comparative study was done in April 2016 on 120 employees of Rehman Medical College aged 20-69 years (mean age 34.39 ± 10.49 years), based on convenience sampling and informed consent; known hypertensive cases and those on anti-hypertensive medication were excluded on account of  lability of blood pressure recordings. Two readings were obtained from both arms and wrists by three trained researchers through calibrated Mercury and Automated Arm and Wrist devices using standard techniques. Data were analyzed by SPSS 15.0. Comparisons wer...

Introduction: Modern education emphasizes the building up of an effective educational environment as a tool to enhance learning. To optimize the educational environment, it is imperative to diagnose its strengths and identify weaknesses for remediation. The present study was conducted to evaluate the Integrated Medical Curriculum at Rehman Medical College, Peshawar, Khyber Pakhtunkhwa, based on students’ perception of the curriculum, so that weak areas of the program could be identified and remediation done. Materials & Methods: The cross sectional survey was conducted on MBBS students of professional years 1-5 at Rehman Medical College (RMC) in June 2015 (towards the end of the academic session), through convenience sampling, maintaining confidentiality of   identity. All students present on the days of questionnaire distribution were enrolled and the standardized 50-item Dundee Ready Educational Environment Measure (DREEM) administered to them after informed consent and relevant i...

Introduction: Relatively little research has been done on academic stress in medical faculty both nationally and internationally. The present study was conducted to document whether teaching faculty of a private medical college developed academic stress due to their routine educational activities. Materials & Methods: The 33 members of the teaching faculty (junior and senior faculty, heads of departments and administrators) of Rehman Medical College, Peshawar, Khyber Pakhtunkhwa attending a one-day workshop on Stress Management (October 10, 2014) were administered the10-items based Stress Self-Assessment Exercise Questionnaire after informed consent, to be filled and returned before the end of the workshop. Scoring was done as per authors’ instructions. Categories of No Stress, Average Stress, Above Average Stress and High Stress were designated and assigned to respondents. Data were analyzed by SPSS 15.0 for descriptive statistics; comparisons were done by gender and designation th...

Research has been realized as an important focus of training in medical education. It is in place as part of the program at postgraduate level globally, however it is not reflected as mandatory in the undergraduate medical programs. In Pakistan, the traditional system of education as a legacy of British rule continues in most of the undergraduate institutions to date. A mandatory research project is required in the discipline of Community Medicine at year 4 level. These projects are mostly done and filed at individual institution level even if these are worthwhile to be published. However, there is good evidence that in the initial years of Pakistan three well defined goals were tailored for medical education, namely: to provide medical practitioners, to evolve a locally suited education and a continued program of research. 1

Introduction: Construction of proper MCQs form the basis of effective assessment. Strong distractors help to increase the value of the MCQ; hence the presence of Non-Functional Distractors (NFD) reduces the assessment potential of such questions. The present study was conducted to determine the effect of Non-Functioning distractors on Difficulty Index based on a Physiology MCQ internal assessment of 1st Professional MBBS class of Rehman Medical College (RMC), Peshawar, Khyber Pakhtunkhwa, Pakistan.Materials & Methods: The descriptive study was conducted in November 2015 on the Physiology Theory Test performance of 100 First Professional MBBS students of RMC, Peshawar. The study included 50 one-best type MCQs; these were marked manually based on the keys provided and analyzed by MS Excel 2013. Students were categorized by top and bottom 27%; Difficulty Index (P) was calculated, Distractor analysis was done, and NFDs were identified. NFD and P were correlated by Pearson’s r, using S...

Abstract: All the hospitals of Hazara Division with facilities for major surgical procedures were surveyed from 1981 to 1 986 and their work load was assessed.10205 cases collected in this survey were categorized. Male to female ratio was calculated to 3.5:1 and age group of 16-30 was predominantly represented (44%). Grude rate for work load was calculated which shows an increasing rise of four fold in six years (1981—1986)

To assess the performance of students on clinical skill factors and to measure the satisfaction level of students related to the training. The descriptive study was conducted at Rehman Medical College, Peshawar, Pakistan, from August 1 to September 15, 2013, and comprised all third-year medical students who had undergone clinical skill training. Their performance was evaluated through end-of-module objective structured clinical examination. Students' feedback measuring satisfaction on a five-point Likert scale was obtained on a designed validated tool. Monitoring of the clinical skills centre training programme was done by the quality enhancement cell at the college. SPSS 16 was used for statistical analysis. Of the 98 students who took the examinations, 94(96%) cleared generic stations and 70(72%) to 96(98%) discipline-based stations. Overall, 94(96%) cleared the first objective structured clinical examination, ranging from 83(84.6%) for Persian language conversation training t...

Spontaneous epistaxis, nasal trauma and foreign bodies are common causes of nasal bleed in children. Epistaxis and haematemesis due to leeches have been reported in literature. Here we present a rare case of severe anemia caused by a single leech infestation of nasal cavity that required blood transfusion.

A paraplegic infant due to meningomyelocele, a terminal cancer case in severe distress due to pains and a post traumatic comatose patient on life support equipment with minimal hopes of revival are some of the obvious examples in common medical practice today posing serious question of management plan specially regarding continuing efforts to sustain the life. The answer is not simple. All above like situations concerns whether or not a physician assists the patient for a merciful ending of the life to relieve him/her of sufferings and to cause a dignified death. EUTHANASIA is a term coined to do this job. This Greek word means ‘ good death’. The practice of intentional mercy killing was customary in Greek and Roman times. In city of Sparta the newborns with sever birth defects and elderly were put to euthanasia. Most religions including, Islam, Christianity or Judaism prohibit intentional mercy killing (ACTIVE EUTHANASIA). However, in comatose patient with brain death the situation could be different. The patient may have short life if left alone or may carry on living for years if assisted with respirator etc. Many relatives insist to remove patient from life support equipment in this situation. This  ‘ not doing something ’  in preventing death is known as ‘ PASSIVE EUTHANASIA’. In another scenario the physician is perplexed where for good reasons a person is asking for an assistance of some sort in causing euthanasia i.e. ‘ VOLUNTARY EUTHANASIA’. There is only one state ‘Oregon’ of USA in the world, which allows prescription but not actually administering lethal drug, on person’s request in certain medical situations. At present in United States and some other countries, under a legal Act, people make ‘Living Wills’ in which they may give advanced directives allowing doctors for passive euthanasia. A recent development in this regard was witnessed in Holland where the court allowed euthanasia in a special case. Debating on the justification or otherwise of the Euthanasia is a complex issue involving legal, religious and cultural implications. Books on Jurisprudence mention it sparingly without coating any legal authority, but most probably the practice of passive euthanasia may be going on. Factual situation in our circumstances in the developing world  (regarding passive euthanasia) is that the attendants willfully take a number of seriously ill patients away. The respirators are switched off on relative’s request or even on doctor’s decision. At times the only available life support equipment is transferred to another but better candidate for survival. Many patients cannot be facilitated to prolong their life because of non-availability of the equipment, expertise or funding etc. Finally terminal patients are commonly being used as donors for organ transplants, which is considered as a very noble cause.                 Answer to the question becomes still more difficult in view of the fact that medical science is progressing so fast that many of the conditions considered certainly fatal have become remediable. Relief of pain and symptoms of incurable disease are being made available. So, how to handle these situations is real dilemma. Recently in many of the developing countries including Pakistan the subject of the ethics for medical practitioners is being under popular discussion. Pakistan Medical & Dental Council is known to be in the process of preparing its current document in this regard. Guidelines are required addressing the issue specially considering the realities on ground.

In a randomised controlled prospective trial, different antibiotic regimens were evaluated as prophylaxis in wound infection following elective surgical procedures. Four hundred and four consecutive cases were divided in four groups. Two groups were allotted two different conventional postoperative antibiotic regimens while the fourth group received short term perioperative antibiotic; group one served as control. A higher frequency of postoperative wound infection was observed in the controls. Results showed reduction in gross infection in only group III where short term perioperative antibiotic was used. Combination of penicillin and streptomycin were not found effective, and low infection rate was observed with Cephamendole used perioperatively.

This study was carried out to estimate the prevalence, severity and mode of splenic trauma and management technique from amongst the abdominal trauma cases admitted in Ayub Teaching Hospital. The study was carried out at Surgery units of Ayub Teaching Hospital, Abbottabad, the only referral hospital for major trauma cases, from July 2001 to Dec. 2002. One hundred consecutive abdominal trauma patients admitted to all surgical units which were followed up through complete documentation were included in the study. Their injuries were classified, treatment strategies outlined and complications were documented. Out of the 100 patients presenting in emergency, 25% presented with blunt and 75% with penetrating trauma. 97 patients underwent laparotomy and 03 treated conservatively. Mean age was 27.26 (range 19-49) years. Out of these cases 19 patients had splenic injury, 6 (31.57%) with Type-I & II while 13 (68.42%) with Type-III & IV. 11(57.89%) of the splenic injuries were due to blunt ab...

Cancellation of operations in hospitals is a significant problem with far reaching consequences. This study was planned to evaluate reasons for cancellation of elective surgical operation on the day of surgery in Ayub Teaching Hospital, Abbottabad. From July 2006 to June 2007 the medical records of all the patients who had their operations cancelled on the day of surgery in all the three General Surgical units of Ayub Teaching Hospital, Abbottabad were audited prospectively. The number of operation cancelled and reasons for cancellations were documented. 3756 patients were scheduled for surgery during the study period. 2820 (75%) patients were operated upon. 936 (25%) operations were cancelled out of which 338 (36%) were cancelled due to shortage of time, 296 (31.6%) were cancelled due to medical reasons, 152 (16.2%) were cancelled due to shortage of beds while 55 (5.8%) were cancelled due to shortage of anaesthetists. Three operation lists were lost completely. The Anaesthetist can...

Misdiagnosis of acute appendicitis is a common and crucial problem in general surgery. Graded compression ultrasonography is one of the new diagnostic technique that is reported to have improve the diagnostic accuracy and clinical outcome. The aim of current study is to assess the role of this diagnostic modality in the management of acute appendicitis. This is a cohort observational study comparing the adverse outcome in two different groups of patients admitted with suspected acute appendicitis at two different hospitals in two different countries. The first group of 200 patients at Ayub Teaching Hospital Abbottabad, Pakistan, was managed without preoperative ultrasonography. In the second group of 200 patients admitted at Najran General Hospital Najran Saudi Arabia, graded compression abdominal ultrasonography was routinely performed preoperatively. Diagnostic accuracy of the protocol in each group was measured statistically and rates of negative appendicectomy and perforation we...

Publication View. 46199041. OPERATIVE MANAGEMENT OF SPLENIC TRAUMA (1995). TariqMufti. Abstract. A case series report of eleven splenic injuries is presented with a view to etiological factors, surgical treatment,prospects of splenic conservation and follow up. ...

We report a 2 1/2 years old female child who presented with Malignant Sacrococcygeal Yolk sac (Endodermal Sinus) tumor as presacral mass with ulceration of overlying skin. Her ultrasonography (USG)abdomen revealed a huge presecral mass with irregular margins extending in to the pelvis, pushing the rectum antero-laterally. CT scanning of abdomen confirmed USG finding with out enlargement of retroperitoneal lymph nodes and no involvement of the liver. Serum AFP was abnormally elevated. The tumor was excised along with Coccyx in-toto through posterior approach dividing the sacrum and 3-Drugs (VAC) Chemotherapy started postoperatively i.e. 2-weeks after surgery. Here we discuss our experience with this extremely rare malignant extra-gonadal germ-cell tumor and review of literature.

Although admission criteria are standardized by Pakistan Medical & Dental Council (PM&DC), medical colleges can conduct aptitude tests as admission criteria. The present study aimed to determine the correlation of Rehman Medical College's (RMC) admission criteria with students' academic performance in the Khyber Medical University (KMU) First Professional Part-1 examinations. A descriptive study was done at RMC from December 2012 to March 2013 based on computerized records of first and second year MBBS students (years 2010 and 2011; 100 students per year). Students who dropped out or were stricken off from RMC before the university exam were excluded. Pearson's correlation coefficient was calculated by using SPSS-15. For 2010, highest correlation was observed between combined marks of all admission criteria components and KMU professional examination (r=0.466, p<0.001) followed by RMC aptitude test (r=0.424, p<0.001). For females, combined marks of admission criter...