Sarosh Saleem | Aga Khan University (original) (raw)
Papers by Sarosh Saleem
Journal of Shalamar Medical & Dental College - JSHMDC
Background: Medical Ethics (ME) is considered an integral component of medical education around t... more Background: Medical Ethics (ME) is considered an integral component of medical education around the world. However, limited training is being offered to medical students in Pakistan. Objectives: This study was designed to evaluate medical students' perspectives regarding medical ethics and to explore their experiences about medical ethics as a subject at a private medical college in Lahore, where Medical Ethics was formally introduced as part of the undergraduate curriculum in 2017. Methods: This mixed-method study included medical students from all five years of medical college. Quantitative component included a survey questionnaire, and the sample size was 410. Convenient sampling technique was used. Qualitative component included focus group discussions. The students who have attended medical ethics lectures were included in the study. Results: The response rate was 82.72%. There were more females in gender distribution; 76.1% were female and 23.9% were male. Most respondent...
Journal of Advances in Medical Education & Professionalism, 2021
Introduction: Medical professionalism is an essential part of training and professional developme... more Introduction: Medical professionalism is an essential part of training and professional development of medical students. Unprofessional behavior in medical school may lead to professional misconduct in the future careers. The Learner’s Attitude of Medical Professionalism Scale (LAMPS) is a self-assessment questionnaire. It has been used in this study to assess and compare self-reported attitudes about different domains of medical professionalism among First and Final Year students and Faculty of Shalamar Medical and Dental College (SMDC). LAMPS has been used to identify the gaps in the attitudes of medical students and professionals, which can be addressed through a training program of professionalism. Methods: This is a cross-sectional survey conducted in SMDC from June to Dec 2018. First Year and Final Year Students and Faculty were recruited by non-probability convenience sampling. The sample size was calculated by the Cochran’s Formula, keeping the level of significance at 5% an...
BMJ Open, Nov 1, 2022
Objective The COVID-19 pandemic resulted in medical institutes being shut down. Face-to-face acti... more Objective The COVID-19 pandemic resulted in medical institutes being shut down. Face-to-face activities were shifted to online medium. The unpredictability of the situation impacted medical faculty and students alike, creating panic and anxiety. Since these students are to take hold of the healthcare system of the country soon, it is important to learn their perspective on how COVID impacted them. Therefore, this study aimed to explore the lived experiences of Pakistani medical students indepth by a qualitative observation of their personal and educational experiences. Design A phenomenological qualitative study interviewing medical students of Pakistan was conducted. Participants/Methodology This study was designed to interview medical and dental students from various cities in Pakistan using a semistructured, open-ended questionnaire. A total of 34 interviews were recorded and transcripts were prepared. All authors (SI, SS, IA and MS) were involved in the thematic analysis of the data, whereby transcripts were read thoroughly, and codes were developed. Similar codes were then combined to generate themes. Results Three major themes emerged after the analysis of results. The students' 'diverse experiences' of panic and anxiety or excitement were high initially but gradually reduced as time progressed. The 'unprecedented academic experiences' of students included teaching/ learning, communication and technical challenges that they faced during online classes. Despite facing a lot of challenges, the students still saw 'light at the end of the tunnel' and looked forward to going back to their college. Conclusion The effects of COVID on the physical, psychological, social and academic life of medical students were enormous. It is highly recommended that institutes and faculty provide support for personal and professional development of students in these unprecedented times in the form of counselling, provision of technical facilities or leniency in fee process. Peer support is also considered crucial in reducing anxiety among students.
Introduction: Medical professionalism is an essential part of training and professional developme... more Introduction: Medical professionalism is an essential part of training and professional development of medical students. Unprofessional behavior in medical school may lead to professional misconduct in the future careers. The Learner’s Attitude of Medical Professionalism Scale (LAMPS) is a self-assessment questionnaire. It has been used in this study to assess and compare self-reported attitudes about different domains of medical professionalism among First and Final Year students and Faculty of Shalamar Medical and Dental College (SMDC). LAMPS has been used to identify the gaps in the attitudes of medical students and professionals, which can be addressed through a training program of professionalism. Methods: This is a cross-sectional survey conducted in SMDC from June to Dec 2018. First Year and Final Year Students and Faculty were recruited by non-probability convenience sampling. The sample size was calculated by the Cochran’s Formula, keeping the level of significance at 5% an...
The Journal of clinical ethics, 2019
In this article, we first review the development of clinical ethics in pediatrics in the United S... more In this article, we first review the development of clinical ethics in pediatrics in the United States. We report that, over the last 40 years, most children's hospitals have ethics committees but that those committees are rarely consulted. We speculate that the reasons for the paucity of ethics consults might be because ethical dilemmas are aired in other venues. The role of the ethics consultant, then, might be to shape the institutional climate and create safe spaces for the discussion of difficult and sometimes contentious issues. Finally, we report how pediatric clinical ethics has evolved differently in a number of other countries around the world.
Malnutrition is a major health problem and causes death of nearly one million infants and childre... more Malnutrition is a major health problem and causes death of nearly one million infants and children across the globe, annually. A large population of children in Pakistan aslo, suffers from malnutrition. Objective: The study aims to review the morbidity and mortality patterns of Pediatric in-patients with Severe Acute Malnutrition (SAM) at The Indus Hospital (TIH), Karachi in period of one year. Methods: A retrospective audit review of Pediatric inpatients with diagnosis of Severe Acute Malnutrition during June 2014 to June 2015 was performed. The electronic medical records of all malnourished children under five years of age were included in the review. Results: The total of 341 children with average age of 2.2 years were admitted at The Indus Hospital, Karachi. In all, 54.5 percent (n=186) children were female while rest of them were male. The mean weight of children subjected to SAM was 5.42kgs. The majority of the children had Marasmus malnutrition (96.3%) while the Khawashkor wa...
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COVID 19 has brought about a complex array of clinical as well as ethical challenges for the heal... more COVID 19 has brought about a complex array of clinical as well as ethical challenges for the healthcare community around the world. We are reporting a case, managed by a team of experienced clinicians at a local tertiary care hospital, where the patient’s wishes conflicted with those of the family. The case under discussion may be approached from legal, social, and clinical perspectives. However, the lessons learned range from an individual to the policy level. The issue of the validity of a verbal advanced directive by the patient was called to attention when the patient lost the capacity and the wishes of his family conflicted. Effective communication with patients and their families, adequate documentation, and prompt involvement of a clinical ethics committee are recommended to avoid conflicts. The significance of ethics education and clinical/hospital ethics committees in healthcare organizations cannot be undermined.
BMC Research Notes
Objective: To assess knowledge and practice trends in managing acute pain in patients infected wi... more Objective: To assess knowledge and practice trends in managing acute pain in patients infected with human immunodeficiency virus (HIV+) or having acquired immunodeficiency syndrome (AIDS) among emergency physicians of four tertiary care hospitals. Acute pain management in such patients is complex because of multiple concomitant painful conditions related to their disease. After obtaining ethical approval and written informed consent, emergency physicians were requested to fill out a questionnaire. Results: Out of 84 physicians who participated, 49 had managed HIV+/AIDS patients during the preceding year. Out of the 49, 30 (61.2%) physicians stated that they used a combination of analgesics for acute pain in these patients. Forty-two (50%) out of the 84 participants believed that routine doses of opioids were adequate for pain relief, while 42 (50%) agreed that pain management was more complex in these patients mainly due to presence of multiple coexisting problems and psychological issues. Only 26 (31%) respondents considered that pain was under-reported and under-treated in these patients, mainly because physicians were more focused on patients' other disease related complications and issues. Formulation of guidelines are recommended for effective acute pain management in these patients encompassing associated issues, including concomitant painful conditions, opioid dependence, psychiatric problems, etc.
Journal of Shalamar Medical & Dental College - JSHMDC
COVID 19 pandemic has had a significant impact on social, physical, mental and financial aspects ... more COVID 19 pandemic has had a significant impact on social, physical, mental and financial aspects of human life. Among the sickness and despair experienced for last more than a year, COVID vaccination is a ray of hope. The uptake of COVID vaccines has remained low. The government, institutions as well healthcare professionals should take this responsibility of promoting vaccination. A strong will and simple nudges are what it takes to fight the menace of the COVID pandemic.
Journal of Shalamar Medical & Dental College - JSHMDC
Background: Medical Ethics (ME) is considered an integral component of medical education around t... more Background: Medical Ethics (ME) is considered an integral component of medical education around the world. However, limited training is being offered to medical students in Pakistan. Objectives: This study was designed to evaluate medical students' perspectives regarding medical ethics and to explore their experiences about medical ethics as a subject at a private medical college in Lahore, where Medical Ethics was formally introduced as part of the undergraduate curriculum in 2017. Methods: This mixed-method study included medical students from all five years of medical college. Quantitative component included a survey questionnaire, and the sample size was 410. Convenient sampling technique was used. Qualitative component included focus group discussions. The students who have attended medical ethics lectures were included in the study. Results: The response rate was 82.72%. There were more females in gender distribution; 76.1% were female and 23.9% were male. Most respondent...
Journal of Advances in Medical Education & Professionalism, 2021
Introduction: Medical professionalism is an essential part of training and professional developme... more Introduction: Medical professionalism is an essential part of training and professional development of medical students. Unprofessional behavior in medical school may lead to professional misconduct in the future careers. The Learner’s Attitude of Medical Professionalism Scale (LAMPS) is a self-assessment questionnaire. It has been used in this study to assess and compare self-reported attitudes about different domains of medical professionalism among First and Final Year students and Faculty of Shalamar Medical and Dental College (SMDC). LAMPS has been used to identify the gaps in the attitudes of medical students and professionals, which can be addressed through a training program of professionalism. Methods: This is a cross-sectional survey conducted in SMDC from June to Dec 2018. First Year and Final Year Students and Faculty were recruited by non-probability convenience sampling. The sample size was calculated by the Cochran’s Formula, keeping the level of significance at 5% an...
BMJ Open, Nov 1, 2022
Objective The COVID-19 pandemic resulted in medical institutes being shut down. Face-to-face acti... more Objective The COVID-19 pandemic resulted in medical institutes being shut down. Face-to-face activities were shifted to online medium. The unpredictability of the situation impacted medical faculty and students alike, creating panic and anxiety. Since these students are to take hold of the healthcare system of the country soon, it is important to learn their perspective on how COVID impacted them. Therefore, this study aimed to explore the lived experiences of Pakistani medical students indepth by a qualitative observation of their personal and educational experiences. Design A phenomenological qualitative study interviewing medical students of Pakistan was conducted. Participants/Methodology This study was designed to interview medical and dental students from various cities in Pakistan using a semistructured, open-ended questionnaire. A total of 34 interviews were recorded and transcripts were prepared. All authors (SI, SS, IA and MS) were involved in the thematic analysis of the data, whereby transcripts were read thoroughly, and codes were developed. Similar codes were then combined to generate themes. Results Three major themes emerged after the analysis of results. The students' 'diverse experiences' of panic and anxiety or excitement were high initially but gradually reduced as time progressed. The 'unprecedented academic experiences' of students included teaching/ learning, communication and technical challenges that they faced during online classes. Despite facing a lot of challenges, the students still saw 'light at the end of the tunnel' and looked forward to going back to their college. Conclusion The effects of COVID on the physical, psychological, social and academic life of medical students were enormous. It is highly recommended that institutes and faculty provide support for personal and professional development of students in these unprecedented times in the form of counselling, provision of technical facilities or leniency in fee process. Peer support is also considered crucial in reducing anxiety among students.
Introduction: Medical professionalism is an essential part of training and professional developme... more Introduction: Medical professionalism is an essential part of training and professional development of medical students. Unprofessional behavior in medical school may lead to professional misconduct in the future careers. The Learner’s Attitude of Medical Professionalism Scale (LAMPS) is a self-assessment questionnaire. It has been used in this study to assess and compare self-reported attitudes about different domains of medical professionalism among First and Final Year students and Faculty of Shalamar Medical and Dental College (SMDC). LAMPS has been used to identify the gaps in the attitudes of medical students and professionals, which can be addressed through a training program of professionalism. Methods: This is a cross-sectional survey conducted in SMDC from June to Dec 2018. First Year and Final Year Students and Faculty were recruited by non-probability convenience sampling. The sample size was calculated by the Cochran’s Formula, keeping the level of significance at 5% an...
The Journal of clinical ethics, 2019
In this article, we first review the development of clinical ethics in pediatrics in the United S... more In this article, we first review the development of clinical ethics in pediatrics in the United States. We report that, over the last 40 years, most children's hospitals have ethics committees but that those committees are rarely consulted. We speculate that the reasons for the paucity of ethics consults might be because ethical dilemmas are aired in other venues. The role of the ethics consultant, then, might be to shape the institutional climate and create safe spaces for the discussion of difficult and sometimes contentious issues. Finally, we report how pediatric clinical ethics has evolved differently in a number of other countries around the world.
Malnutrition is a major health problem and causes death of nearly one million infants and childre... more Malnutrition is a major health problem and causes death of nearly one million infants and children across the globe, annually. A large population of children in Pakistan aslo, suffers from malnutrition. Objective: The study aims to review the morbidity and mortality patterns of Pediatric in-patients with Severe Acute Malnutrition (SAM) at The Indus Hospital (TIH), Karachi in period of one year. Methods: A retrospective audit review of Pediatric inpatients with diagnosis of Severe Acute Malnutrition during June 2014 to June 2015 was performed. The electronic medical records of all malnourished children under five years of age were included in the review. Results: The total of 341 children with average age of 2.2 years were admitted at The Indus Hospital, Karachi. In all, 54.5 percent (n=186) children were female while rest of them were male. The mean weight of children subjected to SAM was 5.42kgs. The majority of the children had Marasmus malnutrition (96.3%) while the Khawashkor wa...
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COVID 19 has brought about a complex array of clinical as well as ethical challenges for the heal... more COVID 19 has brought about a complex array of clinical as well as ethical challenges for the healthcare community around the world. We are reporting a case, managed by a team of experienced clinicians at a local tertiary care hospital, where the patient’s wishes conflicted with those of the family. The case under discussion may be approached from legal, social, and clinical perspectives. However, the lessons learned range from an individual to the policy level. The issue of the validity of a verbal advanced directive by the patient was called to attention when the patient lost the capacity and the wishes of his family conflicted. Effective communication with patients and their families, adequate documentation, and prompt involvement of a clinical ethics committee are recommended to avoid conflicts. The significance of ethics education and clinical/hospital ethics committees in healthcare organizations cannot be undermined.
BMC Research Notes
Objective: To assess knowledge and practice trends in managing acute pain in patients infected wi... more Objective: To assess knowledge and practice trends in managing acute pain in patients infected with human immunodeficiency virus (HIV+) or having acquired immunodeficiency syndrome (AIDS) among emergency physicians of four tertiary care hospitals. Acute pain management in such patients is complex because of multiple concomitant painful conditions related to their disease. After obtaining ethical approval and written informed consent, emergency physicians were requested to fill out a questionnaire. Results: Out of 84 physicians who participated, 49 had managed HIV+/AIDS patients during the preceding year. Out of the 49, 30 (61.2%) physicians stated that they used a combination of analgesics for acute pain in these patients. Forty-two (50%) out of the 84 participants believed that routine doses of opioids were adequate for pain relief, while 42 (50%) agreed that pain management was more complex in these patients mainly due to presence of multiple coexisting problems and psychological issues. Only 26 (31%) respondents considered that pain was under-reported and under-treated in these patients, mainly because physicians were more focused on patients' other disease related complications and issues. Formulation of guidelines are recommended for effective acute pain management in these patients encompassing associated issues, including concomitant painful conditions, opioid dependence, psychiatric problems, etc.
Journal of Shalamar Medical & Dental College - JSHMDC
COVID 19 pandemic has had a significant impact on social, physical, mental and financial aspects ... more COVID 19 pandemic has had a significant impact on social, physical, mental and financial aspects of human life. Among the sickness and despair experienced for last more than a year, COVID vaccination is a ray of hope. The uptake of COVID vaccines has remained low. The government, institutions as well healthcare professionals should take this responsibility of promoting vaccination. A strong will and simple nudges are what it takes to fight the menace of the COVID pandemic.