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Objective: To determine the diagnostic value of rapid COVID-19 antigen test (Panbio, Abbott) in comparison with Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in suspected community cases of SARS-CoV-2 infection at a tertiary care center in Pakistan Study Design: Cross sectional study. Place and Duration of Study: Pathology Department, Combined Military Hospital, Lahore Pakistan, from Jun 2020 to Jun 2021. Methodology: The diagnostic value of the Panbio®COVID-19 Antigen Rapid Test (Panbio, Abbott), was determined in comparison with RT-PCR in suspected community cases of SARS-CoV-2 infection at a tertiary care center on samples taken simultaneously. 200 individuals reporting to the hospital with signs and symptoms of potential COVID infection or history of significant contact exposure (>1 hour without masking and social distancing) to a RT-PCR positive COVID patient and concurrently requiring a rapid COVID antigen test due to an underlying health condition were included in the study by consecutive sampling. Results: Out of 200 individuals, 53(26.5 %) were COVID positive by RT-PCR whereas 147(73.5%) were clearly negative with no cases of indeterminate viremia on RT PCR. 32(60.3%) out of 53 RT-PCR positive COVID cases were also found to be positive by COVID-19 Antigen Rapid Test, whereas 21(39.6%) were negative. Out of 147 RT-PCR negative COVID cases, 146(99.3%) were negative by COVID-19 Antigen Rapid Test as well whereas 1(0.68%) was positive. Conclusion: COVID-19 Antigen Rapid Test is suitable adjunct to RT-PCR testing in suspected cases in emergent settings in early days of admission. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of intravenous phenylephrine infusion versus boluses for blood pressure management in elective caesarean sections. Study Design: Quasi-experimental study. Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Jul 2022. Methodology: Three hundred ninety patients requiring elective caesarean section were divided into an Infusion Group (n=195) and a Bolus Group (n=195). The Infusion Group received phenylephrine with 100 mcg/ml titration immediately after spinal anaesthesia as per weight and height at a 1 ml/minute rate and continued for 5 minutes. Infusion stopped if MAP at 5 minutes was above baseline and restarted if dropped below baseline in subsequent readings. In the case of bradycardia, 600mcg of Glycopyrrolate was administered. Parameters recorded at 1, 5, 10 and 15-minute intervals. In the bolus group, total numbers of 100mcg boluses at the end of fifteen minutes were recorded. Protocol for bradycardia and data record intervals was the same. The primary variables were mean arterial pressure (MAP), heart rate(HR), the total dose of phenylephrine used, and nausea and vomiting. Results: Primary outcome variables showed consistent improvement in maintaining MAP in the Infusion Group versus the Bolus Group (p<0.05). A similar trend was seen with heart rate between both groups (p<0.05). However, the infusion group had an average fall in heart rate compared to the bolus group at all-time intervals. Conclusion: Phenylephrine infusion offers better hemodynamic stability, requiring less ephedrine support than when given in boluses. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic value of rapid COVID-19 antigen test (Panbio, Abbott) in comparison with Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in suspected community cases of SARS-CoV-2 infection at a tertiary care center in Pakistan Study Design: Cross sectional study. Place and Duration of Study: Pathology Department, Combined Military Hospital, Lahore Pakistan, from Jun 2020 to Jun 2021. Methodology: The diagnostic value of the Panbio®COVID-19 Antigen Rapid Test (Panbio, Abbott), was determined in comparison with RT-PCR in suspected community cases of SARS-CoV-2 infection at a tertiary care center on samples taken simultaneously. 200 individuals reporting to the hospital with signs and symptoms of potential COVID infection or history of significant contact exposure (>1 hour without masking and social distancing) to a RT-PCR positive COVID patient and concurrently requiring a rapid COVID antigen test due to an underlying health condition were included in the study by consecutive sampling. Results: Out of 200 individuals, 53(26.5%) were COVID positive by RT-PCR whereas 147(73.5%) were clearly negative with no cases of indeterminate viremia on RT PCR. 32(60.3%) out of 53 RT-PCR positive COVID cases were also found to be positive by COVID-19 Antigen Rapid Test, whereas 21(39.6%) were negative. Out of 147 RT-PCR negative COVID cases, 146(99.3%) were negative by COVID-19 Antigen Rapid Test as well whereas 1(0.68%) was positive. Conclusion: COVID-19 Antigen Rapid Test is suitable adjunct to RT-PCR testing in suspected cases in emergent settings in early days of admission. [ABSTRACT FROM AUTHOR]

Objective: To compare the ease of placement of arterial catheters using palpation versus ultrasound guidance under aseptic measures. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2022. Methodology: Patients of either gender, aged 18 to 90 years presenting to a paranesthesia clinic that required intra-arterial blood pressure monitoring were included in the study. After induction, under General Anaesthesia, arterial lines were placed following an aseptic technique using ultrasound or palpatory method; in Group-U (ultrasound) or Group-P (Palpation), respectively. Demographic variables of the patient along with hemodynamic readings and success rate at first or multiple attempts, along with the total time of cannulation, were recorded. Results: Out of the total 74 patients, 59(79.7%) patients belonged to ASA-1 Grade, and 15(20.3%) patients in ASA-2 Grade. The mean age of the patients was 48.3±16.3, while mean BMI was 25.42±2.8kg/m2. In Group-P, the first-pass success was achieved in 19(51.4%) patients as compared to 32(86.5%) in Group-U when ultrasound was used (p<0.05). Conclusion: The success rate in placing an arterial line using ultrasound was significantly greater than the conventional palpatory method. Therefore, ultrasound should be a preferred modality during intra-arterial line placement. [ABSTRACT FROM AUTHOR]

Objective: To compare the ease of placement of arterial catheters using palpation versus ultrasound guidance under aseptic measures. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2022. Methodology: Patients of either gender, aged 18 to 90 years presenting to a paranesthesia clinic that required intra-arterial blood pressure monitoring were included in the study. After induction, under General Anaesthesia, arterial lines were placed following an aseptic technique using ultrasound or palpatory method; in Group-U (ultrasound) or Group-P (Palpation), respectively. Demographic variables of the patient along with hemodynamic readings and success rate at first or multiple attempts, along with the total time of cannulation, were recorded. Results: Out of the total 74 patients, 59(79.7%) patients belonged to ASA-1 Grade, and 15(20.3%) patients in ASA-2 Grade. The mean age of the patients was 48.3±16.3, while mean BMI was 25.42±2.8kg/m2. In Group-P, the first-pass success was achieved in 19(51.4%) patients as compared to 32(86.5%) in Group-U when ultrasound was used (p<0.05). Conclusion: The success rate in placing an arterial line using ultrasound was significantly greater than the conventional palpatory method. Therefore, ultrasound should be a preferred modality during intra-arterial line placement. [ABSTRACT FROM AUTHOR]

Objective: To assess the self-reported attitude and behavior of MBBS students towards academic misconduct and to identify the differences of responses. Study design: Analytical cross-sectional study. Place and Duration of study: Army Medical College, Rawalpindi Pakistan, from May to Sep 2022. Methodology: MBBS students from first to final year of both genders who consented to participate were included in the study while excluding unwilling students. Data were collected from 396 medical students by convenience sampling using a validated questionnaire by the University of Dundee. After formal ethical approval responses were obtained on 14 scenarios. Data were analyzed by using IBM SPSS Statistics version 26. For descriptive statistics frequency and percentages were identified, and Pearson's Chi-Square test was used to find out the differences in responses among all year (p<0.05). Results: Among participants with mean age 20.93±1.57, there were 285(72%) males and 111(28%) females. In attitude response a significant difference was found for year one students as copying answers or asking about OSCE, copying from published papers, and submitting already submitted work were not considered wrong. In behavior response a significant difference was found for final year students in copying answer or discussing OSCE for degree exam. Conclusion: Participants of this study were morally alert when it involves patients' well-being, however there is vulnerability to commit academic misconduct in all years. Perspective of medical students on cheating, plagiarism, signature forgery is same regardless of seniority and gender. Students' own consideration along with institutional policies may help creating culture against academic dishonesty. [ABSTRACT FROM AUTHOR]