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To determine the predictive validity of induction assessment scores of family medicine residency program for performance in final year of residency.Psychometric (predictive-validity) study.The Aga Khan University Hospital, Karachi, from 2008 to 2014.All family medicine residents were evaluated. Family Medicine Residency induction assessment scores were used as independent predictor variables, whereas resident assessment scores during the final year residency program were used as dependent or outcome variables. Data was analyzed using SPSS version 19. Linear regression was used to determine predictive validity of induction scores as independent variables with outcome variables at 95% confidence level.There were 33 residents. MBBS scores accounted for 30.1% of variance in final year Objective Structured Clinical Exam (OSCE) scores; whereas, induction written test accounted for 37.1% of variance in final year written test. Induction communication skill scores did not correlate with in-training communication skill scores or with the final year OSCE scores. Induction professionalism scores accounted for 13.7% of the variation in final year OSCE scores, but not with in-training continuous professionalism scores.Induction knowledge scores have acceptable predictive value for future knowledge and its application. Other valid and reliable assessment methods, such as multiple mini-interviews, should be explored for assessment of noncognitive domains at induction.

Objective: To determine psychosocial risk factors for acute myocardial infarction at a teaching hospital in Karachi. Methods: One hundred and fifty three cases were recruited from cardiology clinics and 153 controls from internal medicine and family medicine clinics of Aga Khan University Hospital, Karachi, through non-probability sampling using a structured questionnaire. Cases were those who were diagnosed with acute myocardial infarction for the first time in past month. Controls were selected from family medicine and internal medicine clinics of the same hospital and included patients above the age of 40 years without acute myocardial infarction. Associations between psychosocial risk factors and acute myocardial infarction were investigated using multiple logistic regressions. Results: The psychosocial risk factors associated with acute myocardial infarction were irritability at home (OR: 4.86, 95% CI: 3.24-7.53), self-illness (OR: 3.33, 95% CI: 2.86-5.23), illness in family (OR: 8.44, 95% CI: 6.21-10.1), loss of job (OR: 3.71, 95% CI: 1.16-8.86) and death in family (OR: 7.42, 95% CI: 3.98-10.12) in fully adjusted models. Conclusions: Psychosocial risk factors are associated with acute myocardial infarction. Therefore, regular screening for these risk factors should be undertaken by physicians to identify high risk patients.

This study considered the factors associated with prolonged ventilation and the effects of reduced extubation times on patient recovery, intensive care unit stay, and overall hospital stay.A retrospective study was performed, including 86 consecutive patients who underwent cardiac surgery from August 2006 to January 2007. The patients were divided into two groups following intensive care unit admission: Group A, duration of intubation4 h (n=34); Group B, duration of intubation4 h (n=52).Two deaths occurred in 86 patients, and overall hospital mortality was 2.32%. Patients in Group A were younger (33.2+/-12 versus 45.8+/-13 years; p=0.001) and had better preoperative left ventricular ejection fraction (LVEF) (62.4+/-9.8 versus 44.6+/-9.4; p=0.003) than those in Group B. Moreover, Group A patients had a shorter intensive care unit length of stay (1.7+/-0.5 versus 2.2+/-0.8 days; p=0.006) and were discharged earlier than Group B patients (2.7+/-2.4 versus 4.01+/-3.96; p=0.014).Early extubation offers a substantial advantage in terms of accelerated recovery, shorter intensive care unit, and hospital stay, suggesting that efforts to reduce extubation times are cost-effective.