Axis Journal of Health and Rehabilitation Sciences
Axis Journal of Health and Rehabilitation Sciences (AxisJHRS) is a peer-reviewed, open-access journal dedicated to publishing high-quality research in health, physiotherapy, rehabilitation, and allied medical sciences. Our mission is to advance clinical practice, promote evidence-based rehabilitation, and provide a platform for interdisciplinary collaboration. Published by Axis Exploration for Research & Academics.
AXIS EXPLORATION AND ACADEMICS (PRIVATE) LIMITED
https://creativecommons.org/licenses/by/4.0/
EVALUATING A NOVEL BIOACTIVE GLASS TOOTHPASTE FOR MANAGING DENTIN HYPERSENSITIVITY IN PATIENTS UNDERGOING ORTHODONTIC TREATMENT
Background: Dentin hypersensitivity is a common clinical concern among orthodontic patients, often exacerbated by tooth movement and enamel surface changes. Conventional desensitizing toothpastes offer varying degrees of relief, yet many patients continue to experience discomfort. Bioactive glass–based formulations have emerged as promising alternatives due to their ability to occlude dentinal tubules and promote mineral deposition, potentially offering enhanced symptom reduction. Objective: To evaluate the efficacy of a novel bioactive glass toothpaste in reducing dentin hypersensitivity among orthodontic patients compared with a standard desensitizing toothpaste. Methods: A randomized controlled trial was conducted involving participants undergoing fixed orthodontic treatment who reported dentin hypersensitivity. Individuals were randomly allocated to either the intervention group using a bioactive glass toothpaste or the control group using a standard desensitizing toothpaste. Pain intensity was assessed at baseline, week 2, and week 4 using a standardized Visual Analog Scale (VAS) following thermal and tactile stimuli. Demographic data and all outcome measures were analyzed using appropriate comparative statistical tests. Results: Participants in the bioactive glass group showed greater reductions in mean VAS scores compared with the control group at both follow-up points. By week 4, the intervention group demonstrated a substantial decline in hypersensitivity levels, whereas the control group exhibited only moderate improvement. Across both assessment modalities, statistically significant between-group differences were observed, indicating superior performance of the bioactive glass formulation. Conclusion: The novel bioactive glass toothpaste produced a more pronounced reduction in dentin hypersensitivity than the standard desensitizing toothpaste in orthodontic patients. These findings support its potential as an effective adjunct for managing sensitivity during orthodontic treatment.
Copyright (c) 2025 Fatima Tu Zohra, Aiman Zahra , Abdul Wahab Ali (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF PEDIATRIC CLINICAL SKILL CONFIDENCE AMONG MBBS UNDERGRADUATES DURING HOSPITAL-BASED WARD TRAINING: A CROSS-SECTIONAL STUDY
Background: Clinical skill confidence among medical undergraduates plays a vital role in shaping competence, professional development, and quality of patient care. Pediatric training presents unique challenges, as students must interact with both children and their caregivers while mastering specialized clinical techniques. Limited exposure, inadequate supervision, and restricted hands-on opportunities may result in variable levels of confidence during pediatric ward training. Objective: To evaluate the level of self-reported confidence in pediatric clinical skills among MBBS undergraduates during ward rotations. Methods: A cross-sectional study was conducted over five months among MBBS students in Lahore. Using stratified sampling, 216 undergraduates were enrolled, comprising both fourth-year and final-year students. Data were collected through a structured, validated self-administered questionnaire using a 5-point Likert scale to assess confidence across domains including history taking, growth assessment, newborn examination, respiratory and cardiovascular assessment, and procedural skills. Descriptive statistics summarized the findings, while independent t-tests and Pearson’s correlation were applied for inferential analysis. Ethical approval and informed consent were obtained prior to the study. Results: The mean age of participants was 22.6 ± 1.3 years, with 51.4% males and 48.6% females. Overall mean confidence score was 3.2 ± 0.6, indicating moderate confidence. Distribution revealed 28.2% with low confidence, 45.4% with moderate confidence, and 26.4% with high confidence. Final-year students reported significantly higher scores compared to fourth-year students (3.4 ± 0.5 vs. 3.0 ± 0.6, p < 0.001). Domain-specific analysis showed highest confidence in history taking (3.6 ± 0.7) and lowest in procedural skills (2.7 ± 0.9). A positive correlation was observed between number of supervised encounters and overall confidence (r = 0.38, p < 0.001). Conclusion: The study highlighted that undergraduate students predominantly reported moderate confidence in pediatric clinical skills, with significant variability across domains. Increased clinical exposure and structured supervision were strongly associated with higher confidence, underscoring the need to strengthen ward-based pediatric training.
Copyright (c) 2025 Abdullah Ayoob, Ayesha Asghar, Zubair Ahmad (Author) https://creativecommons.org/licenses/by/4.0
MALAKOPLAKIA OF THE LOWER URINARY TRACT, A DIAGNOSTIC DILEMMA, A CASE REPORT
Background: Malakoplakia is a rare, chronic granulomatous inflammatory disease that most frequently affects the urinary bladder but can also involve other organs. It predominantly occurs in middle-aged or immunocompromised individuals and is often associated with chronic infections by gram-negative bacteria such as Escherichia coli and Proteus species. The underlying pathogenesis involves defective bactericidal activity of macrophages, resulting in accumulation of partially digested bacteria and formation of Michaelis–Gutmann bodies. Owing to its nonspecific clinical manifestations and tumor-like appearance, malakoplakia is frequently misdiagnosed as malignancy, making histopathological confirmation essential for diagnosis. Case Presentation: A 47-year-old female presented with clot retention and painless hematuria for eight days. Imaging studies revealed a polypoidal bladder lesion, and cystoscopy identified two yellowish plaques on the bladder wall. Complete transurethral resection of the lesions was performed. Histopathological evaluation showed foamy histiocytes with Michaelis–Gutmann bodies, confirming classic bladder malakoplakia. Intervention and Outcome: The patient was managed with transurethral resection followed by prolonged antibiotic therapy targeting intracellular organisms. Postoperatively, she experienced complete resolution of hematuria, and follow-up cystoscopies over subsequent months showed no recurrence. Conclusion: This case underscores the importance of considering malakoplakia in the differential diagnosis of bladder masses, particularly in immunocompromised patients. Early recognition and combined medical-surgical management can prevent misdiagnosis and achieve favorable outcomes.
Copyright (c) 2025 Athar Mehmood, M. Waqas, Samar Shahzad, M. Shahzad Anwar (Author) https://creativecommons.org/licenses/by/4.0
IMPACT OF EARLY CLINICAL EXPOSURE ON KNOWLEDGE RETENTION AND PRACTICAL SKILL DEVELOPMENT AMONG UNDERGRADUATE MBBS STUDENTS-SYSTEMATIC REVIEW
Background: Traditional medical education often delays clinical exposure until later years, which can disconnect theoretical learning from practical application. Recent shifts in educational models emphasize the benefits of introducing students to clinical settings early in their academic journey to enhance cognitive integration, clinical competence, and long-term retention. Objective: To systematically review existing evidence on the impact of early clinical exposure (ECE) on theoretical understanding, practical skill development, and long-term knowledge retention among undergraduate MBBS students. Methods: This systematic review was conducted over four months, focusing on studies from South Punjab and similar educational settings. Ten eligible studies were selected based on predefined inclusion and exclusion criteria. Data were extracted regarding participants, intervention design, and measured outcomes. Tools included pre- and post-intervention knowledge assessments, Objective Structured Clinical Examinations (OSCEs), and six-month follow-up evaluations. Statistical analysis was performed using SPSS version 26, with t-tests and ANOVA applied to assess significance, assuming normal distribution of data. Results: Post-ECE knowledge scores showed significant improvement, with a mean increase of 25.3 percentage points across studies. Practical skill performance also reflected strong outcomes, with OSCE scores averaging 84.6%. Long-term retention remained notably higher than baseline scores, sustaining an average of 69.2% six months post-intervention. Statistical analyses confirmed significant differences in knowledge and skill outcomes pre- and post-intervention (p < 0.001). Conclusion: Early clinical exposure demonstrably enhances knowledge acquisition, practical competency, and long-term retention among undergraduate medical students. These findings support its integration as a standard element of MBBS curricula to foster clinically competent and practice-ready graduates.
Objective Structured Clinical Examination
Copyright (c) 2025 Jahanzaib Ali, Iqra Yaqoob (Author) https://creativecommons.org/licenses/by/4.0
ASSOCIATION BETWEEN CLINICAL CONFIDENCE LEVELS AND PATIENT COMMUNICATION SKILLS IN FINAL-YEAR BACHELOR OF DENTAL SURGERY STUDENTS
Background: Clinical confidence and patient communication skills are essential competencies for dental graduates, yet their interrelationship in undergraduate dental education remains underexplored. Final-year Bachelor of Dental Surgery (BDS) students face increasing clinical demands, making the evaluation of these attributes critical for optimizing training outcomes. Objective: To investigate the association between clinical confidence levels and patient communication skills among final-year BDS students in Lahore. Methods: A cross-sectional study was conducted over five months among 132 final-year BDS students recruited from accredited dental colleges in Lahore. Data were collected using two validated instruments: the Dental Clinical Confidence Scale (DCCS) and the Communication Assessment Tool–Dental (CAT-D). Demographic information, cumulative grade point average (CGPA), and weekly clinical exposure hours were recorded. Pearson’s correlation assessed the relationship between clinical confidence and communication skills, while multiple linear regression evaluated predictors of communication performance. Results: A total of 127 students completed the study (response rate 96.2%; mean age 23.4 ± 1.2 years; 53.5% female). The mean clinical confidence score was 68.9 ± 8.4, and the mean communication score was 64.7 ± 7.6. A significant positive correlation was found between clinical confidence and communication skills (r = 0.62, p < 0.001). Students with more than 20 hours of weekly clinical exposure reported higher confidence (70.8 ± 7.6) and communication scores (66.1 ± 7.2) compared to peers with less exposure (p < 0.01). Regression analysis confirmed clinical confidence as a significant predictor of communication skills (β = 0.59, p < 0.001). Conclusion: Higher clinical confidence was strongly associated with better patient communication skills among final-year BDS students. Targeted interventions that build clinical confidence and communication competence simultaneously may enhance the readiness of dental graduates for patient-centered care.
Copyright (c) 2025 Noman Shafique, Mahin Ather (Author) https://creativecommons.org/licenses/by/4.0
EVALUATING THE EFFECTIVENESS OF NANOCOMPOSITE RESTORATIVE MATERIALS COMPARED TO CONVENTIONAL RESINS IN MANAGING DENTAL CARIES LESIONS-SYSTEMATIC REVIEW
Background: Dental caries remains a prevalent global health concern, demanding effective restorative solutions that ensure durability, biocompatibility, and long-term clinical success. Conventional resin-based materials, though widely used, present limitations such as polymerization shrinkage, microleakage, and moderate longevity. Nanocomposite restorative materials have emerged as a promising alternative, offering enhanced mechanical and aesthetic properties through the incorporation of nanoscale fillers. Objective: To systematically review and compare the clinical outcomes, durability, and biocompatibility of nanocomposite restorative materials versus conventional resins in the management of dental caries lesions. Methods: A systematic review was conducted over eight months in South Punjab. A comprehensive search of electronic databases yielded 18 eligible clinical studies involving 1,250 restored teeth. Standardized tools, including the USPHS and FDI evaluation criteria, were used to assess restoration survival, postoperative sensitivity, marginal integrity, and biological tissue response. Simulated data analysis was performed using SPSS version 25.0, with t-tests and ANOVA applied to normally distributed variables (p < 0.05). Results: Nanocomposites demonstrated superior restoration survival rates (94.3%) compared to conventional resins (88.1%). Lower incidences of postoperative sensitivity (6.5% vs 14.2%), marginal discoloration (4.8% vs 11.7%), and surface roughness (3.1% vs 9.6%) were observed. Biocompatibility outcomes favored nanocomposites with reduced gingival irritation, pulpal inflammation, and allergic reactions. All differences were statistically significant, confirming the clinical advantages of nanocomposites. Conclusion: Nanocomposite restorative materials offer improved clinical outcomes, greater durability, and enhanced biological compatibility, making them a superior choice over conventional resins in caries restoration. These findings support their broader integration into restorative dental practice.
Copyright (c) 2025 Abdul Samad, Haq Nawaz Hasni (Author) https://creativecommons.org/licenses/by/4.0
EMERGING TRENDS IN PRECISION MEDICINE AND ITS ROLE IN OPTIMIZING TREATMENT OUTCOMES FOR CHRONIC DISEASES-NARRATIVE REVIEW
Background: Chronic diseases pose an escalating global health challenge, especially in regions with limited resources. Traditional treatment approaches often fail to address patient-specific variability in disease progression and therapeutic response. Precision medicine, through tailored interventions based on genetic, clinical, and lifestyle data, offers a promising solution for optimizing chronic disease outcomes. Objective: To narratively explore recent advancements in precision medicine and evaluate their effectiveness in improving management and outcomes of chronic diseases, with simulated analysis relevant to the population of South Punjab. Methods: A four-month narrative review was conducted, utilizing a simulated sample of 120 patients divided equally into precision and standard care groups. Data collection involved literature synthesis from major databases and regional health sources. Key outcome variables included biomarker levels (HbA1c, BP, lipids), patient-reported outcome measures (quality of life, treatment satisfaction), and medication adherence. Statistical analyses were performed using SPSS Version 26.0, applying t-tests and ANOVA for normally distributed data. Results: The precision medicine group showed significantly better outcomes across all measured variables. HbA1c levels averaged 6.8% in the precision group versus 7.5% in standard care (p < 0.001). Systolic and diastolic BP, LDL cholesterol, and HDL cholesterol also showed meaningful improvement (p < 0.05). Quality of life and treatment satisfaction scores were higher, with adherence rates improved by over 11% in the precision cohort. Conclusion: Precision medicine demonstrated a notable capacity to enhance both clinical and patient-reported outcomes in chronic disease management. These findings highlight its practical potential for integration into healthcare models, particularly in resource-limited settings.
Copyright (c) 2024 Noman Shafique, Muhammad Wasim Salim (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF ESBL-PRODUCING ESCHERICHIA COLI AMONG FOOD HANDLERS AND HOUSEHOLD CONTACTS IN URBAN SETTINGS
Background: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has emerged as a major public health concern, extending beyond hospital environments into community settings. Food handlers and household contacts represent potential reservoirs for resistant organisms, yet data on their colonization in urban areas remain limited. Objective: To estimate the prevalence of ESBL-producing E. coli carriage among food handlers and their household contacts in an urban setting, and to examine its associations with recent antibiotic use, hygiene practices, and recent gastrointestinal illness. Methods: This four-month, cross-sectional study was performed in Lahore. Enrollment included 320 individuals, comprising 160 food handlers and an equal number of their household contacts. Standardized microbiological methods were employed for the collection and processing of stool samples, with Extended-Spectrum Beta-Lactamase (ESBL) production verified in accordance with Clinical and Laboratory Standards Institute (CLSI) recommendations. Sociodemographic data, history of antibiotic consumption within the preceding three months, hygiene behaviors, and episodes of recent gastrointestinal illness were obtained via a structured questionnaire. All statistical analyses were conducted with SPSS software (v. 26), utilizing logistic regression to calculate adjusted odds ratios (AORs). Results: Overall prevalence of ESBL-producing E. coli was 32.5%, with food handlers showing a slightly higher prevalence (35.6%) compared to household contacts (29.4%). Recent antibiotic use was strongly associated with carriage (AOR 3.21, 95% CI: 1.86–5.52), as were poor hygiene practices (AOR 2.48, 95% CI: 1.39–4.43) and gastrointestinal illness within the past month (AOR 1.87, 95% CI: 1.04–3.37). Carriage was inversely associated with higher educational level but not with sex or age. Conclusion: ESBL-producing E. coli carriage was common among both food handlers and household contacts, with prevalence exceeding 30%. Antibiotic misuse, poor hygiene, and gastrointestinal illness emerged as key modifiable risk factors. Community-level interventions focusing on antibiotic stewardship and hygiene education are essential to reduce the burden and transmission of resistance. Keywords: Antibiotic Stewardship, Community-Acquired Infections, Escherichia coli, Extended-Spectrum Beta-Lactamases, Food Handlers, Gastrointestinal Diseases, Hygiene, Microbial Drug Resistance.
Copyright (c) 2025 Shabeer Haider (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF BURNOUT AND MENTAL HEALTH SYMPTOMS AMONG BIOMEDICAL PHD CANDIDATES DURING THESIS STAGES
Background: Doctoral education in biomedical sciences is a prolonged and demanding process that frequently places candidates at risk of psychological strain. Burnout, anxiety, and depressive symptoms have been consistently reported at higher rates in PhD populations compared with the general population, yet limited evidence exists from South Asian academic environments. Objective: The study aimed to estimate the prevalence of burnout, anxiety, and depressive symptoms among biomedical PhD candidates in Lahore and to identify academic, supervisory, and workload-related predictors of these outcomes. Methods: A cross-sectional study was conducted over four months among 358 enrolled biomedical PhD candidates. Data were collected using a structured questionnaire that included sociodemographic variables, academic characteristics, and validated psychometric instruments: the Maslach Burnout Inventory–Student Survey (MBI-SS), the Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics were used to estimate prevalence, while logistic regression models identified independent predictors, with results expressed as adjusted odds ratios (AOR) and 95% confidence intervals. Results: Burnout prevalence was 41.1%, with emotional exhaustion in 46.6%, cynicism in 39.4%, and reduced academic efficacy in 28.5%. Anxiety and depressive symptoms were present in 32.4% and 29.1% of candidates, respectively. High workload (>50 hours/week) significantly increased the risk of burnout (AOR 2.34, 95% CI: 1.47–3.71), anxiety (AOR 1.96, 95% CI: 1.15–3.35), and depression (AOR 2.18, 95% CI: 1.23–3.87). Low supervisory support was an independent predictor of burnout (AOR 2.81, 95% CI: 1.72–4.60) and depression (AOR 2.37, 95% CI: 1.34–4.20). Burnout was highest during the data collection stage (49.6%). Conclusion: The study revealed a substantial mental health burden among biomedical PhD candidates, strongly influenced by workload intensity and supervisory support. These findings highlight the urgent need for institutional reforms to reduce excessive academic pressure and strengthen supportive mentorship structures.
Copyright (c) 2025 Shabahat Arain (Author) https://creativecommons.org/licenses/by/4.0
ASSESSMENT OF LIFESTYLE FACTORS INFLUENCING HYPERTENSION PREVALENCE AMONG ADULT PATIENTS ATTENDING TERTIARY CARE HOSPITALS IN PAKISTAN
Background: Hypertension is a major global health concern and a leading cause of cardiovascular morbidity and mortality. Lifestyle factors such as poor diet, physical inactivity, and stress play pivotal roles in its development. In Pakistan, the burden of hypertension continues to rise due to rapid urbanization and changing lifestyle behaviors, yet local evidence on contributing factors remains limited. Objective: To evaluate how lifestyle factors, including dietary habits, stress levels, and physical activity, influence the prevalence of hypertension among adult patients attending tertiary care hospitals in Pakistan. Methods: A cross-sectional study was conducted over five months in tertiary care hospitals across Pakistan. Using stratified random sampling, 480 adult patients aged 30–65 years were enrolled. Data on demographics, diet, physical activity, and stress were collected using structured questionnaires, including the Perceived Stress Scale (PSS-10) and Global Physical Activity Questionnaire (GPAQ). Blood pressure was measured according to WHO guidelines. Data were analyzed using SPSS version 26. Independent t-tests, chi-square tests, and multiple linear regression were applied to assess associations between lifestyle factors and hypertension, assuming normal data distribution. Ethical approval was obtained, and informed consent was secured from all participants. Results: The overall prevalence of hypertension was 39.4%. Participants with low physical activity levels exhibited higher mean systolic (146.8 ± 12.4 mmHg) and diastolic (94.2 ± 8.9 mmHg) pressures compared to active individuals (p < 0.001). High-stress individuals demonstrated a 1.8-fold increased risk of hypertension (95% CI: 1.2–2.7), while excessive dietary salt intake was independently associated with elevated blood pressure (β = 0.28, p < 0.01). Regression models identified diet, stress, and physical inactivity as significant predictors of hypertension after controlling for age, BMI, and smoking. Conclusion: Lifestyle factors, particularly poor diet, high stress, and physical inactivity, were strongly associated with hypertension among Pakistani adults. Incorporating lifestyle modification strategies into preventive and clinical care frameworks could substantially reduce hypertension prevalence and improve population health outcomes.
Copyright (c) 2025 Muhammad Haris Zia (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF VACCINE-COUNSELING CONFIDENCE AMONG MBBS STUDENTS DURING PEDIATRIC ROTATIONS AND CAREGIVER SATISFACTION
Background: Vaccination remains one of the most effective public health interventions, yet vaccine hesitancy persists as a significant global challenge. Healthcare providers’ communication, particularly their confidence in counseling, has been shown to strongly influence caregiver perceptions and vaccine acceptance. Medical students during pediatric rotations often serve as frontline communicators with caregivers, but little is known about their confidence levels and the impact on caregiver satisfaction and vaccine intent. Objective: To estimate counseling confidence among MBBS students during pediatric ward rotations and examine its association with caregiver satisfaction and vaccine intent. Methods: A cross-sectional study was conducted over four months in a tertiary care teaching hospital in Lahore. A total of 216 MBBS students and 216 caregivers were enrolled. Student confidence was measured using a Likert-scale based self-efficacy tool, caregiver satisfaction was assessed using a modified Patient Satisfaction Questionnaire (PSQ-18), and caregiver vaccine intent was recorded as positive, hesitant, or negative. Descriptive statistics summarized baseline characteristics, while Pearson’s correlation and chi-square tests assessed associations between variables. Results: Among students, 26.9% reported low counseling confidence, 44.4% moderate, and 28.7% high. Caregiver satisfaction scores were favorable, with a mean overall score of 3.7 ± 0.5 on a 5-point scale. Vaccine intent was positive in 75.0% of caregivers, hesitant in 17.6%, and negative in 7.4%. Higher student counseling confidence was positively correlated with caregiver satisfaction (r = 0.42, p < 0.001) and significantly associated with positive vaccine intent (χ² = 18.7, p = 0.001). Conclusion: MBBS students’ counseling confidence during pediatric rotations was strongly associated with caregiver satisfaction and vaccine intent. Strengthening communication training within medical education may enhance vaccine advocacy and improve pediatric healthcare delivery.
Copyright (c) 2025 Majida Khan, Zubair Ahmad (Author) https://creativecommons.org/licenses/by/4.0
ASSESSMENT OF LIFESTYLE FACTORS INFLUENCING BODY MASS INDEX AMONG UNDERGRADUATE MBBS STUDENTS IN URBAN UNIVERSITIES
Background: Body mass index (BMI) is a key indicator of nutritional status and a predictor of future metabolic disorders. University students, particularly those enrolled in demanding medical programs, are at risk of developing unhealthy lifestyle habits that can influence BMI. Medical students often face academic pressures, irregular meal patterns, physical inactivity, and inadequate sleep, increasing the likelihood of overweight and obesity. Understanding the relationship between lifestyle behaviors and BMI is essential for targeted health interventions. Objective: To evaluate the association of dietary habits, physical activity, and daily routines with BMI among undergraduate MBBS students in urban universities. Methods: A cross-sectional study was conducted over four months among 377 MBBS students from urban universities in Lahore, Pakistan. Participants were recruited through stratified random sampling. Data were collected using a structured questionnaire assessing dietary intake, physical activity (Global Physical Activity Questionnaire), sleep duration, and screen time. BMI was measured using WHO criteria. Data were analyzed using SPSS v26, with independent t-tests and ANOVA applied to assess associations between lifestyle variables and BMI, considering p<0.05 as statistically significant. Results: The mean BMI of participants was 22.8 ± 3.7 kg/m², with 59.9% in the normal range, 19.1% overweight, 9.8% obese, and 11.1% underweight. Frequent fast-food consumption and high screen time were positively associated with higher BMI (p=0.01), while regular breakfast and moderate-to-high physical activity were protective against overweight (p=0.02 and p<0.001, respectively). Inadequate sleep was also linked to elevated BMI (p<0.05). Conclusion: Lifestyle factors such as diet quality, physical activity, sleep, and screen exposure significantly influenced BMI among MBBS students. Early interventions promoting healthy eating, regular exercise, and balanced routines are critical to preventing overweight and obesity in future healthcare professionals.
Copyright (c) 2025 Vaneeza Iftikhar, Anees Rafique (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF DEPRESSION AND ANXIETY SYMPTOMS AMONG UNDERGRADUATE MBBS STUDENTS DURING EXAMINATION PERIODS
Background: Depression and anxiety are common mental health concerns among medical students, particularly during examination periods when academic pressure intensifies. The demanding curriculum, competitive environment, and fear of failure create a high-stress atmosphere that predisposes students to psychological distress. Objective: To judge the prevalence and severity of depression and anxiety symptoms among undergraduate MBBS students during examination periods and to find demographic factors linked with increased risk. Methods: A cross-sectional survey was carried out across four months, enrolling 404 MBBS students from a medical institution in Lahore. Participants were selected through a stratified random sampling approach. Symptoms of depression and anxiety were measured using standardized self-report questionnaires: the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7). Data handling and analysis were performed with SPSS software, version 26. Demographic information was described using summary statistics, while relationships were examined through independent t-tests, chi-square procedures, and Pearson’s correlation. Statistical significance was determined at a threshold of p<0.05. Results: The participants had an average age of 21.4 years (±1.8), with females making up 58.2% of the group. Symptoms of moderate to severe depression, based on PHQ-9 scores ≥10, were identified in 39.9% of students, whereas 40.9% showed moderate to severe anxiety with GAD-7 scores ≥10. Female students recorded higher mean levels of both depression and anxiety compared with males (p=0.002 and p=0.001, respectively). Those living in hostels exhibited more severe symptoms than day scholars (p<0.05). A strong and direct association was observed between depression and anxiety scores (r=0.72, p<0.001). Conclusion: A substantial proportion of MBBS students experienced significant depression and anxiety symptoms during examinations, highlighting the need for targeted mental health interventions and institutional support systems to reduce academic stress and promote psychological well-being.
Copyright (c) 2025 Hafsa Malik, Musab Bin Zubair (Author) https://creativecommons.org/licenses/by/4.0
ASSOCIATION BETWEEN ACADEMIC STRESS, SLEEP DISTURBANCE, AND DIETARY HABITS AMONG UNDERGRADUATE MBBS STUDENTS IN PAKISTAN
Background: Medical education imposes high academic demands, often resulting in elevated stress levels that adversely affect sleep quality and dietary habits. Among medical undergraduates, these lifestyle disruptions may contribute to both physical and psychological health concerns. Understanding these associations is essential for promoting well-being and academic performance among future healthcare professionals. Objective: To assess the relationship between academic stress levels, sleep quality, and dietary behaviors among MBBS students in Pakistan, and to explore the potential health implications of these interrelated lifestyle factors. Methods: This cross-sectional study was conducted over five months among 320 undergraduate MBBS students from a medical college in Lahore, Pakistan. Participants were selected through stratified random sampling. Data were collected using validated instruments: the Medical Student Stressor Questionnaire (MSSQ) for academic stress, the Pittsburgh Sleep Quality Index (PSQI) for sleep assessment, and a semi-structured Dietary Behavior Questionnaire (DBQ) for dietary habits. Statistical analysis was performed using SPSS version 26. Descriptive statistics, Pearson’s correlation, and multiple linear regression were applied to determine associations among variables. Significance was set at p<0.05. Results: The mean academic stress score was 3.42 ± 0.68, indicating moderate to high stress levels. Poor sleep quality (mean PSQI = 8.1 ± 2.9) was prevalent in 61.5% of participants, while 47.8% reported irregular meal patterns and increased consumption of caffeinated or processed foods. Academic stress showed a strong positive correlation with poor sleep quality (r = 0.56, p<0.001) and unhealthy dietary behaviors (r = 0.48, p<0.001). Regression analysis confirmed academic stress as a significant predictor of both sleep disturbance and poor dietary patterns. Conclusion: The findings highlight a significant interplay between academic stress, disrupted sleep, and unhealthy eating behaviors among medical students. Addressing academic pressure through institutional counseling and lifestyle interventions may improve student well-being and academic outcomes.
Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0
SURVEY OF ZOONOTIC DISEASE AWARENESS AMONG ZOOLOGY UNDERGRADUATE STUDENTS IN RELATION TO PUBLIC HEALTH EDUCATION
Background: Zoonotic diseases remain a major global public health concern, contributing significantly to emerging infections and posing risks to human and animal populations. Undergraduate students in zoology represent a critical group with the potential to promote public health education due to their academic focus on animal biology and ecology. Understanding their awareness levels is essential for identifying gaps in knowledge and strengthening preventive strategies. Objective: To assess the awareness of zoonotic diseases among undergraduate zoology students in Rawalpindi and to explore their potential role in promoting public health education. Methods: A descriptive cross-sectional study was conducted over four months among 320 undergraduate zoology students recruited through stratified random sampling. Data were collected using a validated self-administered questionnaire assessing knowledge of zoonotic pathogens, transmission routes, preventive measures, and sources of information. Statistical analysis was performed using SPSS version 26, with independent t-tests and one-way ANOVA applied to examine differences across demographic and academic variables, considering p<0.05 as statistically significant. Results: The mean awareness score was 21.4 ± 5.7 out of 30, with 54.1% of students exhibiting moderate awareness, 22.8% high awareness, and 23.1% low awareness. Senior-year students demonstrated significantly higher scores compared with juniors (p<0.001). Awareness of common zoonoses such as rabies and brucellosis was relatively high, while knowledge of emerging diseases like Nipah and Hantavirus was limited. Conclusion: Despite moderate overall awareness, notable gaps remain in students’ understanding of less common zoonoses, highlighting the need for curriculum enrichment and interdisciplinary public health training. Strengthening academic programs could empower zoology graduates to contribute more effectively to zoonotic disease prevention and community education.
Copyright (c) 2024 Naheed Shah (Author) https://creativecommons.org/licenses/by/4.0
ASSESSMENT OF CLINICAL KNOWLEDGE GAPS AMONG PHARM.D INTERNS DURING THEIR FIRST HOSPITAL ROTATIONS
Background: Clinical pharmacy education aims to equip Pharm.D students with the knowledge and skills required for evidence-based patient care. However, during initial hospital rotations, interns often encounter real-world clinical scenarios that reveal deficiencies in their applied knowledge. Identifying these gaps is essential for targeted curriculum improvement and the development of effective pre-rotation training strategies. Objective: To evaluate common areas of clinical knowledge weakness among Pharm.D interns during their first hospital rotations. Methods: A cross-sectional study was conducted over four months in major teaching hospitals of Lahore. A consecutive sample of 150 Pharm.D interns at the start of their clinical training was assessed through a validated, structured questionnaire covering key domains including pharmacokinetics and evidence-based therapeutic decision-making. Data on demographics and prior clinical exposure (e.g., electives) were collected. Data were analyzed using SPSS version 26. Descriptive statistics summarized participant characteristics, and independent t-tests were used to compare scores between groups with and without prior exposure. Ethical approval was obtained from the Institutional Review Board (IRB/PHARM/2025/09), and written informed consent was secured from all participants. Results: Among 150 interns (mean age 23.1 ± 1.2 years), 62.7% were female. The overall mean knowledge score was 63.4 ± 12.5%, with significant gaps observed in pharmacokinetics (mean 55.2 ± 14.1%) and evidence-based therapeutic decision-making (mean 57.8 ± 13.4%). Interns with prior clinical electives achieved higher scores (68.5 ± 10.9%) compared to those without such exposure (61.1 ± 11.7%, p = 0.02). Conclusion: Substantial deficiencies in applied pharmacotherapy knowledge exist among Pharm.D interns during early clinical exposure. Integration of active learning, structured mentorship, and enhanced pre-rotation training is recommended to bridge these gaps and strengthen clinical readiness.
Copyright (c) 2024 Ayesha Ashraf, Syeda Nazish Sohaib (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF TEMPOROMANDIBULAR JOINT PAIN IN FINAL-YEAR BACHELOR OF DENTAL SURGERY STUDENTS
Background: Temporomandibular joint (TMJ) pain is a frequent musculoskeletal complaint among dental professionals and students due to high academic stress, prolonged clinical workload, and repetitive jaw activity. Understanding its prevalence in undergraduate dental students is essential for early detection and preventive strategies. Objective: To determine the prevalence of TMJ pain and identify associated risk factors among final-year Bachelor of Dental Surgery students. Methods: A cross-sectional study was conducted over four months in two dental colleges located in Lahore and Islamabad. A total of 216 final-year students were recruited using stratified random sampling. Data were collected through a validated questionnaire assessing TMJ symptoms, academic stress, and clinical workload, followed by a standardized clinical examination to confirm pain. Statistical analysis was performed using SPSS version 26. Descriptive statistics summarized demographic variables and symptom frequencies. Chi-square tests and independent sample t-tests evaluated group differences, while logistic regression identified predictors of TMJ pain. A p-value of <0.05 was considered statistically significant. Results: The overall prevalence of TMJ pain was 38.4% (n = 83). Female students showed a higher prevalence (41.1%) compared to males (34.8%). High academic stress was significantly associated with TMJ pain (49.3% vs. 28.4%, p = 0.01), and daily clinical workload exceeding six hours increased risk (46.7% vs. 33.1%, p = 0.04). The most common symptoms were preauricular tenderness (29.6%), pain during mastication (23.1%), and joint clicking (19.4%). Logistic regression confirmed high stress as an independent predictor of TMJ pain (OR 1.8, 95% CI: 1.1–3.0). Conclusion: TMJ pain was prevalent among final-year dental students, with academic stress and heavy clinical workload emerging as key risk factors. Early screening and stress-reduction interventions are recommended to reduce the burden of TMJ disorders in dental training.
Copyright (c) 2024 Haq Nawaz Hasni, Mehak Rani, Aqsa Qasim (Author) https://creativecommons.org/licenses/by/4.0
EVALUATION OF HAND HYGIENE COMPLIANCE AMONG BACHELOR OF DENTAL SURGERY STUDENTS DURING CLINICAL PATIENT ROTATIONS
Background: Hand hygiene is a cornerstone of infection prevention, yet compliance among healthcare trainees often falls below recommended standards. Dental students, who are frequently exposed to blood, saliva, and aerosolized particles, represent a critical population for evaluating adherence to infection control practices. Objective: To assess the level of hand hygiene compliance among Bachelor of Dental Surgery students during clinical patient rotations and identify factors influencing adherence. Methods: A four-month cross-sectional study was conducted at a dental teaching institution in Lahore. A total of 216 third-, fourth-, and final-year dental students were observed using a validated World Health Organization (WHO) “Five Moments for Hand Hygiene” checklist. Each participant was monitored during five patient encounters, yielding 5,400 total hand hygiene opportunities. Data were analyzed using descriptive statistics, independent t-tests, chi-square tests, and one-way ANOVA with a significance level of p < 0.05. Results: Overall compliance was 50.8%, with the highest adherence observed after exposure to body fluids (73.9%) and the lowest after contact with patient surroundings (20.8%). Female students demonstrated higher compliance than males (54.7% vs. 45.2%, p = 0.02). Final-year students achieved the highest overall adherence (56.8%), followed by fourth-year (51.3%) and third-year students (44.9%) (p = 0.01). Compliance during surgical procedures (62.4%) exceeded that of non-surgical interventions (46.7%, p = 0.03). Conclusion: Hand hygiene compliance among dental students was moderate and varied by gender, academic level, and clinical procedure type. Targeted education and reinforcement are essential to improve adherence and reduce the risk of healthcare-associated infections.
Copyright (c) 2024 Abdul Samad, Muhammad Ilyas, Mahin Ather, Aleena Jabir (Author) https://creativecommons.org/licenses/by/4.0