Pakistan Journal of Health Sciences

Global Health Security

Riffat Mehboob — 2023-09-30

To reduce the risk and effect of sudden incidents of public health that put people at risk across national and international boundaries, it is necessary to take both preventive and reactive measures. These measures are referred to as global health security. Discussions on health security in scientific gatherings have become more prevalent in recent years after the Covid pandemic. Health security is for the whole world, irrespective of age, race, gender, or financial stability. However, it has been noted that there are many different concepts of health security, that the whole purpose of this is to accommodate only the upper-class societies. The disturbed equilibrium of the microbial world due to rapid urbanization, population increase, environmental deterioration, and the improper use of antimicrobials makes people realize the importance of health security that requires a collaborative approach focused on preparedness for any future pandemics and equal access to health care products.

The covid-19 pandemic has had a great influence on people’s lives and their ability to think. Now the main race is not about defence systems; it has shifted towards more and better health security and the ability to deal with any future pandemics. The coronavirus outbreak was associated with severe acute respiratory syndrome, the Middle East respiratory syndrome coronavirus outbreak in 2012, the swine flu pandemic in 2009, and the West African Ebola virus disease epidemic in 2013–2016. All these epidemics are primarily caused by the significant travel of infected people across borders. This highlights the need for global health security, which helps coordinate surveillance and policymaking. This limits disease transmission and reduces the damage.

While infectious diseases have no limits, inadequate health systems in poor nations make them worse and more out of control. Africa and other third-world states face many problems in securing global security. The spread of infectious diseases among susceptible areas is due to inadequate public healthcare fundings, vaccine coverage, poverty, armed conflict, and climate-related disasters, which damage developing countries. This only serves to increase susceptibility to the disease. The continuous transmission of polio and measles in different parts of Africa and Asia, as well as recent Ebola outbreaks in West Africa, highlights the need to overcome this in order to stop the spread of diseases to other areas. No nation can be completely protected from the spread of diseases due to a lack of social services and a strong health infrastructure; hence, global security demands global equality and progress towards health for everyone.

To advance global health security in all nations, there is a need for multi-stakeholders and governance, justifiable finance through the proposed pandemic funds, and common goods for health. Future outbreaks can be efficiently managed by funding basic healthcare and enhancing the response systems. Equity in pandemic preparedness and response measures depends on high-level political commitment and global leadership irrespective of colour and gender. False contradictions between countries can be dismissed by focused investments in strengthening health emergency infrastructure, particularly through primary healthcare, ensuring that the world is better prepared to handle complex public health emergencies.

Assessment of Visual, Auditory and Kinesthetic Style of Learning among Undergraduate Nursing Students of Sindh

Lubna Soomro — 2023-09-30

Learning styles refer to the ability of learner to perceive and process information in learning framework. Visual, Auditory, and Kinesthetic are modes by which students use three sensory perceptions to receive information. Objective: To assess visual, auditory, and kinesthetic learning style among nursing students. Methods: Cross sectional study among students of diploma in general nursing, of nursing schools of Jacobabad and Jamshoro- conducted during May- October 2017 with sample size of 88 via simple random sampling. After the approval, the data were collected from the concerned school with their permission. Data were entered into SPSS 23.0 version in which frequency, percentages were generated and chi square were applied. Results: Eighty-eight participated in among them 52(59.1%) were from SON-LUH (Female) Jamshoro and 36(40.9%) were from SON (Male) Jacobabad. Most of the students were from 2^nd and 3^rd year 34(38.6%) and 36(40.9%). Auditory style of learning was at the highest among male students 36.12% whereas females were at the highest in visual style of learning 34.62%. Forty years students learnt at the highest in visual and kinesthetic style of learning 3311%. Conclusions: Undergraduate nursing students of both gender & academic years were equally inclined towards all learning styles.

Factors Influencing Adherence to Anti-Hypertensive Medication Regimens in Diabetic Patients: A Cross-Sectional Analysis at Hayatabad Medical Complex, Peshawar

Ashfaq Ali — 2023-09-30

Adherence to anti-hypertensive medication among diabetic patients is of paramount importance. Objective: To delve deeper into the influential factors that dictate this adherence behavior, thereby leading to improved healthcare outcomes. Methods: A structured questionnaire grounded on the Morisky Medication Adherence Scale (MMAS-8) was employed to gather data from a sample of 301 diabetic patients diagnosed with hypertension at Hayatabad Medical Complex, Peshawar. Parameters such as demographic characteristics, duration of diabetes, and patients' adherence to medication were meticulously recorded and analyzed. Statistical tests such as Chi-square and binary logistic regression were used for data analysis. Results: The study results brought forth that demographic factors like age and gender, coupled with patients' perceptions of their medication, significantly influenced their adherence to anti-hypertensive medication. The study discovered that females were 1.3 times more prone to forget to take their medication relative to males. Furthermore, patients aged below 50 were twice as inclined to discontinue medication when they felt their condition improved. Of particular note, those patients who nurtured misconceptions about the effectiveness and necessity of their medication showed a 1.8 times higher propensity of displaying poor medication adherence. Conclusions: The study underscores the importance of implementing individualized interventions aimed at enhancing medication adherence, especially focusing on female patients, younger patients, and those harboring misconceptions about their medication regimen.

Concomitant CABG vs. CABG Alone - A Comparative Analysis of Early Outcomes

Muhammad Wasim Sajjad — 2023-09-30

Concomitant CABG is performed in combination with other cardiac procedures (VHD, CHD) while CABG is performed exclusively for CAD. Objective: To compare the mortality and perioperative outcomes between CABG and concomitant CABG for proper quoting of risk & optimizing the treatment decision for improved patient outcomes. Methods: The observational study on retrospective data was conducted at Rehman Medical Institute from December 2020 to December 2022. A total of 169 patients were included, with 89 in the CABG and 80 in the concomitant CABG group. Ethical approval was granted and inclusion criteria were met. Data were analyzed using SPSS 25. Results: A total of 169 patients were included with a mean age of 57.72±10.65 & the majority of the male population (77.5%). Most of the patients had NYHA III (56.1%) & CCS III (43.9%) class symptoms. Hypertension was our most common co-morbidity (58.0%), followed by dyslipidemia (52.3%) & DM (47.3%). Concomitant CABG has the worst parameters in terms of intraoperative characteristics such as a statistically significant higher rate of intraoperative transfusion (p <0.001), prolonged perfusion (p <0.001) & cross-clamp time (p<0.001). Similarly, concomitant CABG patients have the worst postoperative outcomes with a significantly higher incidence of mortality (p <0.001), post-operative transfusion requirement (p 0.008), increased duration of mechanical ventilation hours (p 0.005), extended hours of ICU stay (p 0.02) & higher rates of re-intubation (p 0.03). Conclusions: Concomitant CABG is no doubt a high-risk procedure as signified by its worst outcomes.

Prevalence of Symphysis Pubis Dysfunction in Pregnant Women

Huma Firdous — 2023-09-30

Pregnancy is a period when a woman’s body leads to various musculoskeletal issues including Symphysis Pubis Dysfunction (SPD). The term symphysis pubis dysfunction refers to a collection of distressing symptoms that occur in the pelvic area and cause limitation while performing activities of daily living. Objective: To find the Prevalence of symphysis pubis dysfunction in pregnant women. Methods: From June 2022 to January 2023, following a duration of 6 months, a descriptive cross-sectional study was conducted on 267 pregnant women aged 20-35 years. Those with pelvic pain during any trimester were enrolled from gynecology department of Riphah International Hospital and Al-Khidmat Razi Hospital, Rawalpindi. Participants meeting inclusion criteria were evaluated for symphysis pubic pain based on specific criteria, including (signs and symptoms, palpation, and diagnostic tests like the Positive Patrick Faber and Trendelenburg tests). Pain severity was assessed using visual analogue scale. Results: Out of 267 participants, 32% participants were diagnosed with symphysis pubis dysfunction while 68% participants did not have SPD. The most prevalent symptoms are turning over in the bed (79 %), bending down (75%), and standing on one leg (71%) which is mostly reported by the majority of women in the third trimester with moderate pain perception. Conclusions: Study concluded the notable prevalence of SPD with the most prevalent symptoms turning over in the bed, bending down, and standing on one leg. These symptoms were predominantly noted among women in the third trimester, accompanied by a moderate level of pain.

Prevalence of Factor V Leiden Mutation in Healthy Females of Sindh, Pakistan and Comparison of Three Detection Methods in Resource-Limited Settings

Feriha Fatima Khidri — 2023-09-30

Factor V Leiden (FVL) mutation is related to venous thromboembolism and pregnancy complications. It is highly prevalent among Caucasians; however, few studies have been conducted on the Asian population. Objective: To find the prevalence, genotype, and allelic frequency of FVL mutation in females of Sindh, Pakistan, and to develop a valid and economical method for the detection of FVL mutation in resource-limited settings. Methods: Hundred (n=100), unrelated healthy females of Sindh, Pakistan, were recruited. FVL was detected using three methods, i.e., tetra primer amplification refractory mutation system (ARMS)-polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism (PCR-RFLP), and PCR-sequencing. Prevalence, genotype, and allele frequencies were calculated. We compared the three mutation detection methods to find a suitable protocol for FVL detection in developing countries.

Results: The prevalence of FVL mutation was 3% in healthy females of Sindh, Pakistan. No homozygous FVL mutation was found. The results from tetra primer ARMS-PCR, PCR-RFLP, and PCR-sequencing were 100% concordant. Tetra primer ARMS-PCR was a valid, reliable, faster, economical genotyping and screening method. Conclusions: In conclusion, FVL mutation was found in our population, and further studies should be conducted to find its role in thromboembolic and obstetrical complications. In addition, we have suggested tetra primer ARMS-PCR as an appropriate method for FVL detection in resource-limited settings.

Immunophenotyping of Acute Leukemia in Pediatric Patients: Tertiary Care Centre Experience from Lahore

Farhana Shahzad — 2023-09-30

Acute Leukemia is the most prevalent malignancy of childhood, globally. Immunophenotyping by flowcytometry has developed as an important technique for its outstanding contributions in diagnosis and management of leukemia patients. Objective: To determine the frequency and immunophenotyping by flowcytometry of Acute leukemia in pediatric age group. Methods: The study was conducted at The University of Child health sciences and Children’s Hospital, Lahore from July-2021 to Feb-2022. Data were gathered from 101 consecutive patients, of age from 0.5 to 15 years, that had acute leukemia immunophenotyping using flowcytometry. Results: Flowcytometric immunophenotyping of 101 leukemia patients over 8-month period showed that 67.3% and 33.6% male were females respectively. AML, T-ALL, and B-ALL prevalence was highest in patients with 5 to 10 years of age. Out of 101 leukemia patients, 16 (15.8%) and 85 (84.1%) had AML and ALL diagnosis respectively. Of these 85 ALL cases, 72 (84.7%) were B-ALL and 13 (15.2%) were T-ALL. Study founded that most frequent CD markers in B-ALL, were CD79 and CD19 (100%) whereas CD3 and CD5 in T-ALL and CD13 (93.8%) and CD34 (87.5%) in AML. CD34 was a common marker among B-ALL, T-ALL and AML. Among B-ALL and T-ALL, AntiTdt was a common CD marker whereas HLA-DR was common among AML and B-ALL. Conclusions: Results of Acute leukemia immunophenotyping were homologous to worldwide published research. For accurate leukemia lineage, immunophenotyping of AML and ALL is essential since, if therapy is started based solely on morphological diagnosis, approximately 25% of patients may not respond or recure.

A Comparative Study of Manual and Digital Methods and Stereopsis Assessment in Young Adults

. Gul e Lala — 2023-09-30

Reduced stereopsis or depth perception may be the early indicator of abnormal motor functions in people therefore, the stereopsis test is considered ideal for visual screening. It can accomplish the need for the assessment of stereopsis by using a cost-effective smartphone application. Objective: To compare the stereo acuity values of manual and digital stereopsis tests by using the Random Dot Stereo Acuity test with Lea Symbols (Manual) and the SAT App for Android (Digital). Methods: A comparative cross-sectional study was carried out in the Eye department at The University of Lahore Teaching Hospital from February 2023 to May 2023. A total of 62 subjects aged 15-35 years were included in our study, out of which 31 were emmetropes and 31 were ametropes. Screening of subjects was done which included torch light examination and basic refraction. Manually stereopsis was measured using Random Dot stereo acuity test with Lea symbols and digitally it was measured by SAT application. Results: The mean ± SD stereo acuity value of the manual test (N=62) was 60.5242 ± 36.47607 seconds of arc and the mean stereo acuity value of the digital test (N=62) was 70.0968 ± 28.29569 seconds of arc. P-value was 0.006 which confirmed that our results were statistically significant. Conclusions: Our study highlighted the comparison of digital and manual stereopsis tests. We obtained different stereo acuity values from both tests on the same individuals. Hence, the manual test gave better values of stereopsis than the digital test.

Correlation of Menopausal Symptoms with Serum Estradiol in Pre and Postmenopausal Women of Nawabshah (SBA)

Nosheen Aghani — 2023-09-30

The term menopause accurately incomes termination of menstrual cycle. A diversity of physiological changes proceeds in the body, certain of these are the consequence of cessation of ovarian function and decreased production of estrogen. Objective: To determine the serum estrogen levels and to study menopause related symptoms in pre and postmenopausal women due to declined estrogen levels. Methods: This was a cross sectional study. Participants were recruited from the Gynecology and Obstetrics and Medicine OPD/Ward PMCH and from the general public. After explaining the study's goal to all participants, they gave their written and verbal agreement. Blood samples were collected for biochemical testing and stored at -20℃ in the laboratory. ANOVA test was applied for comparison of estrogen among the study participants. This study involved 400 individuals who were separated into two groups, Premenopause and Postmenopause. Results: The mean ±SD of age of Premenopausal participants was 44.44±2.61 years and the mean ±SD of Postmenopausal females remained 54.78±2.80 years. The mean value of serum estradiol of pre and postmenopausal participants was noted as 13.03±11.42 pg/ml 8.21±4.7 pg/ml. The predominant symptoms among the premenopausal women experienced were depressive mood and irritability (61%) while the symptoms experienced by postmenopausal women were dryness of vagina (59%) and heart discomfort (54%). Conclusions: The decrease in estrogen may lead to symptoms like vaginal dryness, mood changes, night sweats and hot flashes. The symptoms experienced are similar as elsewhere in the world, although occurring with varying frequencies.

Quality of life in Children with Cerebral Palsy

Sidra Hanif — 2023-09-30

Cerebral palsy refers to a non-progressive brain disorder that affects the development of brain in developing infant and reduces the quality of life. Quality of life (QOL) is assessed using the CPQOL tool. Objectives: To assess the quality of life of children with CP. Methods: A cross-sectional study was conducted at the National Institute of Rehabilitation Medicine, Islamabad during Oct-2022 to Mar-2023. The sample was raised using slovin’s formula and non-probability convenient sampling technique was used. Data were collected using standard CP-QOL tool. All types of CP diagnosed cases both gender, presence of a caregiver and an age range of 4 to 12 years were included. Patients with non-availability of a caregiver and presence of any other illness not associated with CP were excluded. Results: Out of 129 participants, 105 were included on the basis of inclusion and exclusion criteria. The mean ± SD of patients overall score came out to be 46.83 ±9.75. CPQOL score of males were 47.36±9.96 and of female was 46.19±9.56. CPQOL score of age 4-6years was 45.12±10.58, 7-9 years was 47.70±9.15 and 10-12 years was 49.21±8.54 while overall CPQOL score of children with diplegic CP was 48.38±9.11, hemiplegic CP was 48.66±7.74, quadriplegic CP was 37.92±11.16. Conclusions: study showed that among both genders, females had poor QoL than males. This study also concluded that quadriplegic children had poor QoL than any other types of cerebral palsy. The overall status of QoL of children having Cerebral Palsy was low.

Parents’ Spirituality, Parenting Practices and Disruptive Behaviour Disorders among Pakistani Children

Sameena Iqbal — 2023-09-30

This study looked at the relationship between parent’s spirituality, parenting practices and the growth of Disruptive Behavior Disorder (DBD) in Children. Objectives: To assess the relationship between Parents’ Spirituality, Parenting Practices and Disruptive Behavior Disorder. To find out gender differences on parents ‘spirituality scale and DBD rating Scale. Methods: 500 Pakistani children aged 7 to 11 who were subjected to standardized screening procedures for disruptive behaviour disorders made up the sample. The sample was collected from Islamabad and Rawalpindi public and private schools. Using the Spirituality Scale, the spirituality of the parents was assessed. Parenting styles based on self-report and disruptive behaviours based on parent/teacher reports were the outcome variables. Results: The study's results revealed a noteworthy positive association between DBD and parenting practices while a significant negative association was found between parents' spirituality and their parenting practices which indicates that parents who exhibit a heightened level of spirituality are less likely to use ineffective parenting practices resulting in better management of disruptive behavior problems among their children. Children in private schools have less behavioral issues than those in public schools. Additional research shows that boys are more likely than girls to have DBD. Conclusions: Disruptive behavior disorders are linked to the spirituality of the parents as well as the parenting styles they use to discipline their kids. The study's targeted constructs may help in the early detection, prevention, and management of disruptive behavior disorders.

Frequency of Low Birth Weight in Patients with Gestational Hypertension

Anum Farhan — 2023-09-30

Preterm birth and low birth weight are just two negative fetal outcomes that are linked to PIH. The WHO divides infants into three categories based on birth weight and gestational age: Small for gestational age, Appropriate for gestational age, and Large for gestational age. LBW babies are those who weigh less than 2.5kg within 24 hours of birth, according to these standards. Objectives: To determine the frequency of low birth weight in patients with gestational hypertension. Methods: This Descriptive study was done in department of Obstetrics and Gynecology unit III, Civil Hospital Karachi from 16^th February 2019 to 15^th August 2019. We enrolled 89women diagnosed with gestational hypertension meeting the criteria. Informed consent was taken. Results: Age range in this study was from 20 to 45 years with majority of the patients 52 (58.43%) were between 18 to 30 years of age. Mean gestational age was 39.51±2.7 weeks. Frequency of low birth weight in patients with gestational hypertension was found in 27 (30.34%) patients. Conclusions: This study concluded that frequency of low birth weight in patients with gestational hypertension is very high.

Oral Health Status of Health Care Workers in Tertiary Care Hospitals of Rawalpindi, Islamabad Pakistan

Muhammad Farrukh Habib — 2023-09-30

Studies from all around the world have shown that healthcare professionals may encounter a number of obstacles to receiving dental care, which raises the prevalence of oral disorders in this population. In recent years, Pakistan has not done a national oral health assessment on the state of oral health among healthcare workers. Objective: To determine the oral health status of health care workers in tertiary care hospitals using Decayed, Missed, Filled tooth Index. Methods: Descriptive cross-sectional study was conducted utilizing a simple random selection and 385 healthcare workers between the ages of 20-50 years. Healthcare workers were assessed in tertiary care hospitals, and information on caries and gingival health was gathered. For the oral examination, the standards and procedures of the WHO were applied. Results: Only 9.8% of the respondents were healthy and mean DMFT score came out to be 3.28 ± 1.12. Conclusions: Healthcare workers in tertiary have unsatisfactory dental practices, poor attitude related to oral health and general lack of awareness about oral health.

Quasi Experimental Study to Ascertain Link of PPI to Bone Profile in Healthy Individuals

Yasra Memon — 2023-09-30

Proton pump inhibitor (PPI) is only acid blocking agent used for treating the disease known as gastroesophageal reflux (non-erosive), erosive esophagitis disease, dyspepsia disease and the peptic ulcer disease because of its efficacy and potency. However, overuse of it is examined an immediate result of absence of determination of need for steady treatment in many outdoor subjects Objective: To evaluate impact of proton pump inhibitor (PPI) on bone biochemistry in young individuals of Hyderabad. Methods: The study contained 227 young individuals of age 20-45 years, it was conducted in Liaquat University Hospital, Hyderabad City and Medicine OPD’s of Jamshoro. The research study is undertaken using Quasi experimental study. The study duration is 6 months starting from 15^th March 2020 to 15^th September 2020 and sampling technique is non – probability convenience. SPSS 21 software is used to analyze the data. The post stratification chi – square test is performed at the interval of 95% confidence, besides it the P-value is observed ≤ 0.05. Results: There is no effect on serum calcium and vitamin D levels with use of proton pump inhibitor PPI. P-value was observed 0.7 for the serum calcium and the p- value for Serum Vitamin D was 0.1. Conclusions: Hence, the study showed that proton pump inhibitor PPI use for less than 6 months have no effect on bone biochemistry.

Relationship between Patient’s Satisfaction and level of emotional Intelligence in Nurses Working in Tertiary Care Hospital

Orung Zaib Masih — 2023-09-30

Emotional intelligence is the ability to sense what is going on, to understand how it feels while in that circumstance, to effectively analyses and consider other people's thoughts and feelings, and to respond accordingly. It can be defined as the ability to correctly recognize one's own and others' emotions. Objectives: To determine the association between patients’ satisfaction and level of emotional intelligence (EI) in nurses working in medical and surgical department in tertiary care hospitals, Lahore. Methods: A correlational study design was used to carry on this study. This study was conducted at Mayo Hospital and Social Security Hospital Kot Lakh Pat Lahore. The duration of the study was six months from Jan, 2023 to June; 2023.The study participants were registered nurses (both male and female) and admit patients (both male and female) there. Purposive sampling technique was used n=265 participants were recruited. To assess the performance among nurses and patients, an observational checklist was used. Data of the study participants was entered in statistical software SPSS version 21.0 and was analyzed accordingly. Results: This study shows that there are statistically non-significant differences between patient’s satisfaction and emotional intelligence. The results revealed a non-significant association between nurses' emotional intelligence and patient’s satisfaction, as p-value is p=.381 which is non-significant. So, we reject the alternative hypothesis and accept the null hypothesis. Conclusions: It is concluded that nurse’s emotional intelligence has no relationship on patient’s satisfaction, Nurse’s emotional intelligence and its association with patient’s satisfaction, which results were non-significant.

Analysis of Serum Electrolytes Variation in Onset and Progression of Preeclampsia

Tamseela Mumtaz — 2023-09-30

Preeclampsia is one of the most common, life-threatening complications of pregnancy that is related to maternal as well as perinatal morbidity or mortality. One of the significant causes of preeclampsia is elevated blood pressure which is directly linked with concentrations of electrolytes in the blood. Objective: To evaluate the possible variations of electrolytes in preeclamptic pregnant females. Methods: A total of 90 pregnant females of 20 to 45 years of age were divided into three groups (n=30 in each group) viz normotensive, hypertensive, and preeclamptic pregnant females. All anthropometric and biophysical variables were measured. Among biochemical parameters, serum sodium, potassium, chloride, and calcium levels were determined using colorimetric assays while bicarbonate levels were determined by an enzymatic test using phosphoenolpyruvate carboxylase and a stable nicotinamide dihydrogen phosphate analogue. A comparison of serum electrolytes among different groups was executed by one-way analysis of variance. Results: Preeclamptic females had significantly higher BMI, and systolic and diastolic blood pressure than hypertensive and normotensive pregnant females (p<0.0001). Serum concentrations of sodium and calcium were significantly lower in preeclamptic pregnant females compared to hypertensive pregnant and normotensive pregnant females (p<0.0001). Conclusions: Alteration in the electrolyte levels may contribute to the onset and progression of preeclampsia. Nutritional sodium restriction along with adjuvant supplementation of Ca⁺⁺, Na⁺, K⁺, and Clˉ may minimize the risk of preeclampsia. On the basis of outcomes, it is recommended that pregnant females should eat a balanced diet that contains appropriate amounts of minerals micronutrients, and vitamins.

Association between Poly Cystic Ovaries and Non-Alcoholic Fatty Liver Disease in Young Females on Ultrasonography

Tehreem Malik — 2023-09-30

PCOS and nonalcoholic fatty liver disease are both associated with the metabolic syndrome, which is characterized by central adiposity, hypertension, diabetes, and dyslipidemia. Objective: To determine the association between poly cystic ovaries and non-alcoholic fatty liver disease in young females. Methods: In this cross-sectional study at Chughtai Medical Center in Lahore, 272 patients with polycystic ovaries and fatty liver disease were selected. Utilizing a convex abdominal instrument with a frequency range of 3-5 MHz, the Toshiba Nemio 17 was utilized. Results: In this study, 74 out of 272 female patients diagnosed with PCOS also had fatty liver, highlighting a significant association (p-value = 0.025). Notably, within the 17-25 age group, 45 to 46 patients exhibited fatty liver, suggesting a link between PCOS and fatty liver in younger individuals experiencing hormonal issues. Conclusions: This study demonstrates association between polycystic ovary syndrome in adolescent females and with nonalcoholic fatty liver disease. The findings support the notion that PCOS is more prevalent in individuals with NAFLD.

Awareness about Breast self-examination among Nursing Students

Khawer Saeeda — 2023-09-30

Breast cancer is an invasive tumor which mainly affect females and it has high mortality rate in developing countries due to lack of awareness and late diagnosis. The early diagnosis of breast cancer is not as much dangerous. The tools to detect breast cancer include mammography, breast self- examination (BSE) and fine needle aspiration cytology. The studies conducted shows the lack of perception about knowledge, attitude and practice about BSE. Objective: To determine the perception of BSE among nursing students. Methods: It was observational descriptive study conducted at College of Nursing DHQ Hospital Narowal. 174 nursing students between age 19 to 30 were enrolled in the study. A self-structured questionnaire was used which includes information about demographic data, knowledge, attitude and practice regarding BSE. Data were analyzed by using IBM- SPSS V-23. Results: The level of knowledge among nursing students about BSE was high and most of them know the accurate way of conducting BSE. The attitude of nursing students about BSE was positive. Most of them were agreed about the regular BSE. The practice about BSE shows mixed responses. Conclusions: In conclusion we can say that knowledge about BSE among nurses is good. However students seem to be unaware of the frequency and time of practicing BSE. This indicates the importance of conducting workshops to enhance perception about BSE.

Role of Abdominal Ultrasound to Detect Benign Prostatic Hyperplasia with Significant Factor of Age

Muhammad Ahmad Raza — 2023-09-30

Mostly in men, benign prostatic hyperplasia is serious issue. The volume of BPH increasing withurinary retention and is mostly determined by transabdominal sonography.Prostatic volumeinteractednegatively withhigh density lipoprotein cholesterol. Mostly occurrenceof BPHinmen with age of 45 to 60 years. BPH have lower urinary tract symptoms. About 20 recentpublicationssuitableforliteraturereviewwereretrievedfromdifferentdatabaseslikePubMed, sci.hub, and google scholar. The search on databases & search engines identified 27articles related to topic, among which only 20 articles were as per requirement. Only 20 articleswere usedfor extraction of data related to role of Abdominalultrasound todetectbenignprostatic hyperplasia. The current study looked at the detection of BPH with age. This review hasconclusionsthatultrasoundisamodalityofchoiceforevaluatingthepatientwithBPH,ithelpsin diagnosis as well as prediction of urinary retention and age has a significant factor in BPH.

Phytochemicals and Therapeutic Potential of Pomegranate

Madiha Khan Niazi — 2023-09-30

A significant source of polyphenolic chemicals is the pomegranate (Punica granatum). Due to the several pharmacological functions attributed to its phytochemicals, it has been gaining importance. An extensive list of the phytoconstituents present in pomegranate fruits, peel, blossoms, and seeds as well as their pharmacological actions were the goals of this in-depth analysis. The flavonoids and tannins (gallotannin and ellagitannin), which are the active phytochemicals in pomegranate extract, are what give it its anti-inflammatory, antioxidant, anti-angiogenic, and anti-aging qualities. Pomegranate bioactive components are used industrially to create foods with additional value. Wide-ranging applications for its reducing properties in the creation of nano formulations. Its phytoconstituents may play a safer role in managing environmental contamination than the use of pesticides or other chemicals. The numerous human clinical investigations assessing its pharmacological importance have received special attention.

Application of Chitosan-Based Polysaccharide Biomaterials in Tissue Engineering

Azeem Azam — 2023-09-30

Chitosan-based polysaccharide biomaterials have gained interest as viable options in tissue engineering due to their distinctive properties and wide range of potential applications. Biomaterials play a crucial role in regenerative medicine because they foster an environment conducive to cell growth and tissue repair. The chitin-derived polysaccharide chitosan is superior than synthetic materials in several ways: it has a similar structure to the extracellular matrix, is biocompatible, biodegradable, antimicrobial, and can incorporate bioactive chemicals. In this article, check how chitosan can be used in tissue engineering as a scaffold for different types of tissue, a hydrogel for wound healing, and a carrier for gene therapy, stem cell culture, and drug delivery. Scaffolds made from chitosan have shown tremendous promise in tissue engineering for the neurological system, bone and cartilage transplantation, and skin regeneration. Hydrogels made from chitosan have been shown to be useful in treating wounds and stopping bleeding. Chitosan's medicinal potential in gene therapy, stem cell culture, and targeted medication administration is further enhanced by the addition of bioactive components such as growth factors, genes, or medicines. In addition, using chitosan in tissue engineering can pave the way for future developments in stem cell techniques, nanotechnology, biofabrication, and 3D bioprinting, among other areas of study. These advances may one day lead to individualized and highly effective therapies for tissue repair and regeneration. The use of chitosan in tissue engineering has the potential to advance regenerative medicine and address the growing demand for more effective techniques to heal damaged tissues. Tissue engineers can revolutionize the field of regenerative medicine and enhance patient outcomes by taking use of chitosan's adaptability and bioactivity to create cutting-edge biomaterials and therapeutic techniques.

Pharmacotherapy in Cardiovascular Disease with Chronic Kidney Disease Medications: A Comprehensive Literature

Maryam Azhar — 2023-09-30

A progressive decrease of renal function is a symptom of chronic kidney disease, commonly known as chronic kidney failure. The body may accumulate hazardous amounts of fluid, electrolytes, and wastes if the patient has advanced chronic kidney disease. There are several causative factors which lead to CKD which include high or low blood pressure, more accumulation of cholesterol, diabetes and many more. According to WHO global health statistics in 2012, 864,226 mortalities (or 15% of all deaths worldwide) were attributed to this illness. CKD was categorized 14^th on the index of principal causes of death, having 122 mortalities per 100,000 persons. Most of the causes of deaths were due to sudden cardiac arrests in CKD patients. In this review, we made a list of 10 FDA approved medications which has proven to decrease CKD and fatalities caused by cardiac arrests. SGLT-2 inhibitors have shown promising results in manipulating kidney functions to improve the efficiency of heart.

Emerging role of MRI to assess the Volume of Pineal Glands in Schizophrenia and Mood Disorders: Literature Review

Muhammad Ahmad Raza — 2023-09-30

Most patients with manic depression and diseases have issues with their circadian rhythms and sleep. Melatonin, which is vital for circadian rhythm and sleep, is secreted by pineal gland. This study evaluated and compared the volume of pineal gland in individuals with psychotic symptoms and manic depression. The aim of study is to find out volume of Pineal glands in Schizophrenic Patients. The data included in this literature review were found using several search engines. Using magnetic resonance imaging, the total mean pineal volume compared with the total pineal gland volume of all patients. In this research's literature evaluation, only 26 articles were used for extraction of data related to topic statement. The current study looked role of MRI to assess volume of pineal gland in in Schizophrenic patients. Patients with manic depression had considerably lower mean volume of pineal gland than the other groups. It is concluded that although more research is needed to fully understand the aspects of medications and more mediating agents on the volume of pineal gland. This difference is not present in patients with manic depression. Pineal gland abnormalities in schizophrenia patients may contribute to the disease's etiology.