Rehman Journal of Health Sciences

FREQUENCY OF NON-SPECIFIC NECK PAIN AND ITS RELATIONSHIP WITH PROLONGED USE OF ELECTRONIC DEVICES IN STUDENTS TAKING ONLINE CLASSES DURING COVID-19

Arfa Akhtar — 2023-12-31

Introduction: The prevalence of neck pain among students has been on the rise, attributed to the increased use of electronic devices such as cell phones and computers. This prolonged usage, often coupled with poor posture, has been found to cause damage to nerves, muscles, and tendons in the neck region, as well as in the fingers, wrist, elbow, and shoulders. The purpose of this study was to investigate the relationship between prolonged use of electronic devices and neck pain among students at the Johar Institute of Professional Studies during the COVID-19 pandemic.

Material & Methods: This cross-sectional observational study was conducted at the Johar Institute of Professional Studies, involving a total sample of 385 undergraduate students. The participants were selected using a non-probability purposive sampling technique, encompassing both genders with ages ranging from 17 to 28 years, and who used cell phones, laptops, or computers for more than 3 hours daily. Exclusion criteria included individuals not meeting the specified inclusion criteria, recent history of fall or surgery, or chronic neck pain lasting more than 3 months. Data collection involved the use of the Numeric Pain Rating Scale and the Neck Disability Index, with data analysis conducted using SPSS version 21.

Results: Of the 385 students included in the study, 187 were male and 198 were female. The findings revealed that 35 subjects reported no pain, 152 experienced mild pain, 158 reported moderate pain, and 40 suffered from severe pain. The study indicated a notable increase in the prevalence of neck pain among students due to prolonged use of electronic devices during online classes amidst the COVID-19 pandemic.

Conclusion: The study concluded that there is a significant incidence of neck pain associated with the use of mobile phones and laptops. Furthermore, the duration of mobile and laptop use was found to be correlated with neck pain, particularly during online classes. Notably, students who used cell phones for more than 4 hours a day were found to experience moderate neck pain. These findings underscore the need for awareness and measures to mitigate the impact of prolonged electronic device use on students' neck health.

MEDICAL AND DENTAL STUDENTS’ PERSPECTIVE REGARDING ONLINE EDUCATION DURING COVID-19

Aiman Kamal — 2023-12-31

Introduction: Online education was adopted due to the spread of COVID-19, however, student satisfaction was not assessed before it implementation. This study aims to find out the opinions of students and their perspective regarding online education.

Material & Methods: This cross-sectional study was conducted on a population of 372 students of 7 medical and dental colleges. A convenient sampling method was used and data was collected through an online questionnaire over a period of around 2 weeks.

Results: There was a significant difference (p=.005) regarding perspectives between medical and dental students. There was a difference (p=.007) but not significant among the students of different professional years regarding perspective. However, the maximum number of students showed a positive perspective. There was no significant difference (p=.663) among the different age groups of the participants. There was a significant difference (p=.000) between genders regarding perspectives. Female showed a positive perspective.

Conclusion: Overall students were satisfied with the online learning system.

MEDICALIZED MOTHERHOOD: BOURDIEU’S ELUCIDATION ON MATERNAL HEALTHCARE SERVICES IN PAKISTAN

Adeela Rehman — 2023-12-31

Introduction: In maternal healthcare, each and every step is critical and important, as it is the matter of dealing with two bodies; mothers and newborns. Due to extensive medical intervention in healthcare, the contemporary practices of mothers and newborns healthcare in the hospitals are medicalized. This study was designed to comprehend the system of healthcare for providing safe and quality healthcare services to mothers and newborns as medicalized motherhood.

Material & Methods: Based on the identified gaps in the literature, theories and methodology, this study has adopted the qualitative design to investigate the medicalized motherhood practices at public hospital in Islamabad, Pakistan. In-depth interviews were conducted from 20 patients, six doctors and two staff members from the gynecology department. Pierre Bourdieu’s theory of Practice was used as theoretical framework to describe disposition, position and positioning of the motherhood experience in the medicalized healthcare.

Results: Under the elucidation of Theory of practice, the findings of the study imitated healthcare as a social system, where various stakeholders involved to establish their relations with each other. It is concluded that the application of Bourdieu’s theory of practice strengthens an understanding of the structural-functional matters of the healthcare services delivered at hospitals as social institutions.

Conclusion: The interpretative phenomenological analysis of the study investigated some new aspects of the subject matter which have not been highlighted in any previous research such as process and procedure of care as well nurses-doctor hegemony of power.

PREVALENCE OF LOW BACK PAIN AND EVALUATION OF WORK POSTURE AMONG HEALTHCARE PROFESSIONALS OF DISTRICT HEAD QUARTER HOSPITALS OF HAZARA DIVISION: A CROSS-SECTIONAL STUDY

Hazrat Bilal — 2023-12-31

Introduction: Low Back Pain (LBP) is the muscle tension, pain and stiffness in the area beneath the ribs margins and above the gluteal folds. This pain may be radiating or not radiating to the legs. The important symptoms of LBP are pain and disability.

Material & Methods: A cross-sectional study was conducted in DHQ Haripur, Abbottabad and Mansehra of Hazara division from May 2018 to October 2018. The self-modified questionnaire was distributed among the healthcare professionals of DHQ Haripur, Abbottabad and Mansehra. Professionals of both genders aged between 25 and 60 were included while professionals with specific pathologies i.e. lumbar fracture, neoplasm, trauma, and kidney pain were excluded from the study. SPSS version 22 was used for analysis.

Results: The mean age of participants was 31.29 ± 7.75. The overall prevalence was n=197 (59.7%). The prevalence of LBP was found for Physicians, Physical Therapists, Technicians and Nurses. The participants with the highest prevalence rate were technicians n=111 (33.4%) followed by nurses n=103 (31.2%). A larger population n=222 (67.3 %) has experienced LBP in the past. Male participants with LBP were n = 111 (56.3 %) while females were n = 86 (43.6 %). Most of the healthcare professionals experienced LBP after joining the job (P = < 0.05).

ADVANTAGES, DISADVANTAGES AND LIMITATION OF E-LEARNING AMONG MEDICAL STUDENTS DURING COVID OUTBREAK

Qamar Yasmeen — 2023-12-31

Introduction: Worldwide, the COVID-19 pandemic has resulted in the closure of educational institutions. This examined how equipped academic institutions were to handle a situation where the use of cutting-edge hardware and software to support successful online learning is necessary. Such closure hastened the creation of online learning environments in order to prevent disruptions to instruction. The main issue facing many medical colleges during the COVID-19 pandemic, however, is how to provide and use online learning resources in an e-learning system. During the COVID-19 outbreak an online learning environment is the only alternative in circumstances where access to college and university classrooms is not possible. Given the increased usage of online modalities during COVID-19, it is critical to assess their efficacy in facilitating diverse stakeholder-based teaching and learning. Online learning has been implemented by medical institutions during the COVID-19 outbreak. This study investigates how medical students view its advantages, disadvantages, and limitations.

Material & Methods: A survey was conducted to examine the experiences of 502 medical students from April to June 2021 who were taking online classes during Covid 19 pandemic with Microsoft Teams as an academic tool. For this goal, a digitally self-structured questionnaire was implemented to collect their responses regarding academic coverage, satisfaction, prospects for faculty contribution, and the internet connection, the teachers' varied pedagogical approaches, and recommendations for improvements. The analysis of the data was done with SPSS version 23.0. For each of the factors, percentages were calculated for the responses.

Results: Efficiency, remote learning, immense flexibility, and asynchronous learning were main advantages regarding virtual learning, difficult adaptation, lack of motivation, lack of interaction with teachers and class fellows were prominent disadvantages, technology issues/ weak internet connection and alternative online educational platforms were main limitations during online classes.

Conclusion: During the COVID-19 pandemic, online learning was a savior in disguise, but it also presented certain challenges because it was new to medical students. These issues should be rectified.

PREVALENCE OF NECK PAIN DUE TO PROLONG USE OF SMART PHONE AMONG UNIVERSITY STUDENTS OF FAISALABAD

Nosheen Manzoor — 2023-12-31

Introduction: All around the world, prolong use of electronic devices results in increase prevalence of musculoskeletal disorders (MSD) of hand, wrist, forearm, arm and neck has been increasing. Neck pain is a fourth leading seed with disability. Neck pain may occur due to broad range of differential diagnosis like trauma, infection, malignancy which are life threatening diseases. There negative impact on physical and mental health is found to be associated with use of smart devices like mobile phones, laptops and computer. Mobile phone users adopt forward head posture while using smart phone for extended period of time, which may lead to neck pain.

Material & Methods: A total of 3000 students between 18-45 years of age using mobile phone for the duration ≥1 hour per day from different universities of Faisalabad gave response to questionnaires Confidential Smart Phone Usage and Neck Pain and Neck Disability Index. Students with neck pain due to any other medical condition excluded from study. Data was entered and analyzed through SPSS version 21 and Chi-square (χ2) test was applied to find out the association between pain and disability.

Results: This study showed that most of the participants (85.3%) experience neck pain. Playing games and texting was used more than calling and positively associated with neck pain. Majority of participants were used mobile phone for >4 hours and presents with moderate pain. In addition, a vast proportion 1377(45.9) of students with moderate disability had weekly pain.

Conclusion: The result showed that there is a high prevalence of neck pain among mobile phone users. Moreover, prolonged use of mobile phone is strongly associated with neck pain and neck disability.

FREQUENCY OF EJACULATORY DISORDERS ASSOCIATED WITH TAMSULOSIN THERAPY IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Sajid Ayaz — 2023-12-31

Introduction: Benign prostatic hyperplasia (BPH) is very common condition in elderly male. BPH, overactive bladder, urinary tract infection, tumors, stones, or functional problems of the lower urinary tract are some of the conditions that can cause LUTS. α 1-Adrenoceptor antagonists are routinely used to treat BPH, and urologists are familiar with their safety profiles. It has been noticed that many patients having LUTS due to BPH also experience ED, causing problems in their sexual life but this aspect has been ignored many times by urologists, which adds to the patient burden. Despite the good tolerability of this drug, it still has got high chance of ED. So this study was designed to determine the frequency of ejaculatory dysfunction in our population.

Material & Methods: It’s a descriptive cross-sectional study; conducted in the department of Urology Lady Reading Hospital Peshawar from 1st January 2022 to 31st December 2022. All adult male patients presented to Urology OPD with Lower Urinary Tract Symptoms were included in the study. After a detail history, examination including digital rectal examination (DRE) and investigations like Urine routine examination, urine culture, serum PSA, renal function tests and Ultrasound Kidney, Ureter, Bladder, Prostate and Pre and Post void residual urine the patients were advised alpha adrenergic receptors blocking agents like Tamsulosin 0.4 mg OD at night. Erectile dysfunction was assessed of all patients before starting therapy and after two 2 months. Retrograde ejaculation was assessed by taking the history from the patient and examining first voided urine after ejaculation for spermatozoa.

Results: Total of 111 patients were included in the study. Mean age was 52 years with a standard deviation ± 7.28. Ejaculatory disorders were observed in 72(65%) patients while 21(19%) patients had erectile dysfunction.

Conclusion: The frequency of ejaculatory disorders associated with tamsulosin therapy for BPH was 65%, and erectile dysfunction was observed in 19% of the patients.

COVID-19 INFECTION DURING PREGNANCY: A PERSPECTIVE OF MATERNAL AND FETAL OUTCOMES

Shahinda — 2023-12-31

Introduction: The novel coronavirus illness (COVID-19), which is brought on by the SARS-CoV-2 virus caused a worldwide pandemic declared by the World Health Organization (WHO). With nearly a million people infected as a result of the SARS-CoV-2 worldwide pandemic. The severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemics of human coronaviruses have taught us that pregnant women and their fetuses are particularly susceptible to unfavorable outcomes. Due to their immature immune systems, the foetus and the infant are extremely susceptible to infections. Regarding the COVID-19 pandemic, pregnant women and newborns are considered as potential risk groups.

Material & Methods: Pregnant patients with positive PCR (reverse transcriptase-polymerase chain reaction) reports presented to Hayatabad Medical Complex Peshawar were admitted to the Department of Obstetrics and Gynaecology from November 2020 to July 2021. Total 50 pregnant women with covid-19 positive PCR results were assessed.

Results: Mean age of the patients was 37±5 years and the mean gestational age was 36±7 weeks. Maternal complications of COVID-19 include preterm labor (6%), maternal mortality (2%), premature rupture of membranes (PROM) (6%), and oligohydramnios (17%). As a finding of routine COVID-PCR testing 52% (26) and 44% (22) patients were asymptomatic and mild symptomatic respectively while 4% (2) were having severe symptoms. Fetal complications of COVID-19 include stillbirth (6%), intrauterine growth restriction (IUGR; 17%), preterm birth (6%), fetal distress(2%) and median Apgar score of 5+2 All the neonates were covid negative in the first two days except one.

Conclusion: Pregnant women who test positive for COVID-19 have fewer symptoms than the normal population and may still test negative for viral pneumonia on RT-PCR. Preterm deliveries, low birth weight, C-sections, and NICU admissions appear to be more common than in the general population.

CLINICAL OUTCOMES OF ANTERIOR CERVICAL DISCECTOMY AND FUSION IN CERVICAL RADICULOPATHY: A PROSPECTIVE ANALYSIS FROM IRFAN GENERAL HOSPITAL IN PESHAWAR

Mumtaz Ali — 2023-12-31

Introduction: Cervical radiculopathy is commonly attributed to compression of nerve roots secondary to a herniated disc or cervical foraminal stenosis due to degeneration of the cervical spine. Surgical techniques most commonly used in cervical radiculopathy are anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy (PCF) and cervical disc replacement (CDR). The aim of this study was to evaluate the clinical outcomes of ACDF in cervical radiculopathy in terms of Neck disability index, hospital stay, mortality rate, success rate and complications.

Material & Methods: This prospective study was conducted in Ali Institute of Neurosciences, Irfan General Hospital Peshawar from January 2019 to April 2021. The sampling technique was nonprobability convenience sampling. Patients having diagnosis of cervical radiculopathy through subjective, objective and investigation findings were enrolled in the study. Standard procedure of ACDF was performed after informed consent and outcome measures were assessed post-surgery and after follow-up of eight weeks. Demographic variables such as age, gender, level of surgery and occupation were recorded on a proforma. Neck Pain and Disability scale (NPAD) questionnaire was filled by the participants at eight weeks follow up. Data were analyzed using SPSS version 26.

Results: Data was collected and analyzed of 202 patients as 38 patients did not come for follow ups. Majority of the participants were male 145(72%) while 57(28%) were females. Mean age of the participants were 47 with standard deviation of 3 (Range 31 to 60). When asked about the occupation, 67(33%) were drivers ,81(40%) belonged to labour work while 48(24%) were office workers. Overall the pain and disability scores showed significant improvement as measured by Neck disability index as overall mean score was reported to be 19 post operatively as compared to 45 points pre operatively.

Conclusion: The results of our study concluded that anterior cervical discectomy and fusion is a safe and effective surgical procedure in the treatment of cervical radiculopathy associated with improved patient outcomes and satisfaction. However, the procedure is also associated with complications.

SHUNT-FREE LIFE AFTER ENDOSCOPIC THIRD VENTRICULOSTOMY IN TRIVENTRICULAR HYDROCEPHALUS: A RETROSPECTIVE OBSERVATIONAL STUDY OF THREE YEARS

Mumtaz Ali — 2023-12-31

Introduction: For many years CSF shunts were proposed as the main and only treatment of choice for Hydrocephalus but due to increased rate of infection, malfunction, surgical revisions and other complications along with the advancement in endoscopic technology, the management of hydrocephalus has been completely revolutionized. The aim of this study was to determine the long term efficacy of Endoscopic Third Ventriculostomy in terms of successful and failed surgical procedures along with intra and post-operative complications.

Material & Methods: This case series study was conducted in department of Neurosurgery Prime Teaching Hospital and Irfan General Hospital Peshawar from February 2019 to January 2022. Consent from was taken from the Ethical Committee of Irfan General Hospital and Prime teaching Hospital. All patients of obstructive hydrocephalus were included. Those patients who had ventriculitis, infected CSF or had undergone a previous ventriculoperitoneal shunt were excluded. All information was put in proforma. Results were analyzed by SPSS version 20 and descriptive statistics were used for demographics and clinical outcomes.

Results: Out of 48 patients, 33 patients (68.7%) were between the ages 1-20 years. The majority of participants were males (68%). ETV was successful in 34 patients (70.8%) with most common cause was Tri ventricular Hydrocephalus 21(43.8%) followed by tumors 16(33.4%). When followed for three years the results of the study showed that ETV was effective in long term as only 14 ( 29.2%) patients required a revision surgery which was either shunt or redo ventriculostomy while the majority of patients 34(70.8%) remained shunt free. The most common complication reported was CSF leak in 3(6.3%) patients.

Conclusion: The results of our study concluded that endoscopic third ventriculostomy is a safe, effective and advance surgical procedure for patients with obstructed hydrocephalus. Our results also concluded that ETV is effective in long term management and decreases the need for shunt placement. Better surgical outcomes in terms of lower complication rates, decreased hospital stay and no mortality rate were associated with ETV.

SURGICAL SITE INFECTIONS PREVALENCE AFTER THE APPENDECTOMY OF COMPLICATED APPENDICITIS

Muhammad Salman — 2023-12-31

Introduction: Acute appendicitis, one of the most prevalent intra-abdominal illnesses expecting surgical intervention, and surgical site infection is the more prominent post-operative complication, affecting (5-10%) of all appendectomy patients. The optimal timing and schedule for prophylactic antibiotics, considering the risk of developing microbial resistance, has yet to be established. The aim of our study was to assess the prevalence of surgical site infections following surgical intervention in complicated cases of appendicitis.

Material & Methods: Descriptive study was conducted at Department of Surgery, Mardan Medical Complex, Mardan from June 2021 to January 2022. The study design was cross-sectional in which sample size was 292 patients, 5 percent of Surgical Site Infection having 2.5 proportion of error under WHO database software. For sample collection, a non-probability consecutive sampling technique was adopted.

Results: Per-operative observations in our analysis included adhesions, perforation, and peritonitis, whereas post-operative complications included port-site infection, bowel obstruction, and ileus. Most of the patients recovered within a week. The mean age was 30±7.1 years with (56%) patients were males and (44%) were females. Four percent of patients had perforated appendix while 13% patients had gangrenous appendix. Eight percent of patients had surgical site infection.

Conclusion: We determined that the Laparoscopic appendectomy (LA) procedure should be performed first choice, not only for the cosmetic reasons of deriving a tiny scar, but also for the increased chances of discovering additional pathologies (tumors, ovarian cysts, Meckel's diverticulum, etc.). The patient's early mobility and shorter post-operative hospital stay may also make it a better choice than routine appendectomies.

SHORT TERM OUTCOME AND SATISFACTION RATE FOR THIN LEAN VERSUS OBESE PATIENTS FOLLOWING SUBCUTANEOUS MASTECTOMY FOR GYNECOMASTIA PERFORMED BY GENERAL SURGEONS

Sidra Dil Muhammad — 2023-12-31

Introduction: Benign enlargement of breast in male is labelled as Gynecomastia. This condition is source of cosmetic embarrassment in males and this is why most males are eager to get rid of it as early as possible. All focus is made on cosmesis. Extremes of age are mostly affected by this pathology. Its prevalence varies from 30% to 35% globally. It is mainly idiopathic however, drugs, hormonal disorders, liver cirrhosis, pulmonary & renal diseases are other causative agents. Liposuction and surgical excision are two main modalities to deal with it. The aim of our study was to determine the short-term Outcome and Satisfaction Rate for thin lean versus obese Patients following subcutaneous mastectomy for Gynecomastia performed by General Surgeons.

Material & Methods: This retrospective study was conducted at Government THQ Hospital Sabzazar, Lahore and Rasheed Hospital, Lahore form June 01, 2018, to April 30, 2021 and included 80 male patients with Gynecomastia those divided in two groups (Group A: thin lean, Group B; obese patients). Subcutaneous mastectomy for Gynecomastia was performed. Outcome and Satisfaction rate were recorded and compared between groups.

Results: Mean age, BMI and Serum testosterone level were 24.07±1.94 vs. 31.81±3.06 years (p=0.131), 18.63±2.54 vs. 28.91±0.62 Kg/m2 (p=0.540) and 564.57±100.32 vs. 381.08±63.74 ng/dL (p=1.983) in group A and B, respectively. History of intake of steroid was reported in 15.0% thin lean patients. Mean Operative time and hospital stay were 50.97±9.01 vs. 63.98±26.87 min. (p=1.405) and 2.31±1.04 vs. 2.98±1.63 days (p=0.092) in group A and B, respectively. Mean Durations of wound drainage were 7.68±1.47 and 8.43±0.96 days (p=0.531) in group A and B, respectively. Postoperative bleeding, seroma formation and SSI were reported in 1 (2.5%), 2 (5.0%) and 1 (2.5%) obese patients, respectively. Satisfaction rate was high in thin lean patients as compared to obese patients (100.0% vs. 52.5%; p=0.0001).

Conclusion: Subcutaneous mastectomy yields appreciable short-term outcome and significantly higher satisfaction rate in thin lean patients as compared to in obese patients.

EXCRETORY DYSFUNCTION AND ITS ASSOCIATION WITH PSYCHOLOGICAL DISTRESS AFTER SPINAL CORD INJURY

Tayyab Awan — 2023-12-31

Introduction: Spinal cord injury (SCI) is a medically complex and life-disrupting condition and has been associated with a very high mortality rate. The present study aims to determine the excretory dysfunction in SCI patients and further to find out whether the psychological distress is directly associated with SCI or excretory dysfunction.

Material & Methods: A cross-sectional study was conducted over 6 months and the participants were selected using non-probability convenience sampling. The data from 121 spinal cord injury patients were collected using questionnaires, including the Neurogenic Bowel Dysfunction Score Questionnaire (NBDS), Neurogenic Bladder Symptom Score-Short Form (NBSS-SF), Depression Anxiety Stress Scales-21 (DASS-21). Data were analysed using Statistical Package for Social Sciences (SPSS) version 27. Categorical variables were obtained in the form of frequencies and percentages. Mean was obtained and data were presented in the form of tables. The Chi-square test was used to obtain the p-value.

Results: A total 121 patients, male (n = 76) and female (n = 45) were recruited in this study. The present study revealed that psychological distress has no association with spinal cord injury (Stress P=0.550, Anxiety P=0.721 and Depression P=0.323). Also, there is no association between psychological distress and neurogenic bowel dysfunction (Stress P=0.969, Anxiety P=0. 112 and Depression P=0. 751). Although, dramatically in neurogenic bladder dysfunction clinically stress was present but not theoretically (P= .107). However, we found that anxiety (P=.013**) and depression (P=.014**) were strongly associated with neurogenic bladder dysfunction.

Conclusion: The study findings showed that psychological distress had no link with Spinal cord injury patients. However, neurogenic bladder dysfunction after spinal cord injury in patients is strongly associated with psychological distress.

CHALLENGES FOR NURSE EDUCATORS TO PUBLISH THEIR RESEARCH IN NATIONAL AND INTERNATIONAL JOURNALS

Israr Ahmad — 2023-12-31

Introduction: Research is a structured process of knowledge generation, which means searching again and again either to confirm the existing knowledge or generate new information. In the health care system, research is the foundation for improving standards for better care. The role of nurses as a researcher in qualitative studies is crucial in maintaining standards toward care. Nursing graduates are expected to do more research work to improve evidence-based practice, thus benefiting patients. It is the responsibility of every nurse to conduct research and motivate others for the same purpose. As a researcher, nurses face numerous issues to participate in clinical research, such as negative attitude toward their personal research skill, lack of time and lack of interest, lack of tools and funds.8 Publication is the process that gives value to the research work and plays a significant role in the development and progress of any occupation, especially nursing.

Material & Methods: A qualitative descriptive study was carried out from April 2022 to September 2022 in three private nursing colleges in Peshawar, Pakistan. Both genders were equally appreciated for their participation. Data collection was carried out through semi-structured interviews using an interview guide. The Braun and Clark 6 step method has been used for thematic analysis. Two researchers independently transcribed and analysed the data, which was verified by researchers who have conducted the interviews.

Results: A total of 25 nurse educators, 13 male and 12 female, participated in the study. Two main themes have been generated: barriers to publication and benefits of publications. Each theme consisted of subthemes and codes which were supported with direct quotes from the participants.

Conclusion: Publishing research work is certainly important for nurse educators in many aspects such as improving basic skills, continuous learning, educational achievements, and career development; however, certain challenges based on individual, organizational, and supervision level limit this process.

PREVALENCE OF HEPATITIS B AND HEPATITIS C VIRUSES AND ITS CORRELATION WITH BETA THALASSEMIA MAJOR PATIENTS IN PESHAWAR, KHYBER PAKHTUNKHWA

Asad Ullah — 2023-12-31

Introduction: The term "thalassemia" refers to a group of hereditary blood disorders characterised by anaemia. The two primary proteins that make up the oxygen-carrying HB (haemoglobin) component of red blood cells (RBCs) are beta and alpha chains. To create beta globin chains, two globin genes from each parent are required; if one or both of these genes are defective, beta thalassemia will result. The most common complication of beta thalassemia major that is iron over-loading in vital organ of the body like liver, spleen, heart and endocrine system due to regular blood transfusion, the second most common complication is transfusion transmission infection (TTI) hepatitis B, hepatitis C and HIV infection. Globally, the most common infection is hepatitis B and hepatitis C viruses’ infection.

Material & Methods: Cross sectional correlational study was conducted at the Fatimid Foundation and Hamza in Peshawar, Pakistan. Research study had started from 1st March 2021 to 1st October 2021. In this study 184 beta thalassemia major patients had been included, 105 from Fatimid foundation and 79 from Hamza foundation.

Results: Total of one hundred and eighty-four participants were included in the study. Among them 6= (3.3%) were positive for hepatitis B virus antigen, while hepatitis C virus was found in 43 (23.8%) patients. Furthermore, 4 (2.2%) were infected with both HBV and HCV virus infection.

Conclusion: Cousin or other blood relation marriage was significant or risk factor for thalassemia disease. There was no significant relation found of hepatitis B or hepatitis C virus infection with thalassemia major patients. In order to minimize the risk of HBV and HCV infection, it is essential to utilize the most sensitive and specific Nucleic acid test for donor screening. Safe blood transfusion centres for thalassemia patients are needed which are well-equipped and all the facilities must be available in it.

NURSES’ INVOLVEMENT IN POLICY MAKING AND IMPLEMENTATION PROCESS REGARDING POST CORONARY ARTERY BYPASS GRAFTING PATIENTS. A QUALITATIVE CONTENT ANALYSIS

Israr Ahmad — 2023-12-31

Introduction: The anticipated mortality from coronary artery diseases (CAD) will be 25 million by 2025 throughout the Globe. Coronary Artery Bypass Grafting (CABG) is the most performed procedure in this regard worldwide. The process of preparing a plan and intention to achieve the goals through concerned individuals is called policy making. Policymaking and nurses are closely related to each other which can benefit the health system in terms of patient care. Nurses’ performance is related to their involvement in policymaking and implementation processes at the higher level which makes them competent enough to participate in issues related to patients by addressing the concerned agendas. However, nurses are mostly ignored in policymaking and implementation processes by the leadership and administration. Certain factors such as poor infrastructure, lack of proper goal setting, complex system, the inability of the organization to monitor and evaluate nurses’ abilities for participation in policy-making, negative image of nurses, misunderstanding in the society about nurses, lack of acceptance and empowerment in policy-making, autocratic administration and resistance to move forward are the challenges in this regard.

Material & Methods: The study was conducted at tertiary care government and private hospitals in Peshawar, Pakistan, from November 2020 to May 2021. A phenomenological research design was used, and data was collected through semi-structured interviews with the help of an interview guide and probing questions to understand nurses’ experiences and involvement in policy making and implementation process among Coronary Artery Bypass Grafting (CABG) patients. Dominant constituents, clusters, subthemes, and themes were framed through Moustakas modified van Kaam analysis model.

Results: A total of 16 nurses; 07 male and 09 female participated in the study. Three main themes were generated: no involvement in policy-making, promoting policymaking among nurses, and passion for caring. Most of the participants viewed that nurses are not involved in policymaking about post-CABG patents. Furthermore, nurses have the highest contribution to patient care but still are not accepted by patients, administrators, health workers, and society.

Conclusion: Nurses are involved in providing care to patients but in policy development, nurses are not involved. They must be involved in providing care.

EFFECTIVENESS OF TAPING ON DYNAMIC POSTURAL STABILITY IN ATHLETES WITH CHRONIC LATERAL ANKLE SPRAIN: A RANDOMIZED CLINICAL TRIAL

Atif Dustgir — 2023-12-31

Introduction: The lateral ankle sprain (LAS) is a common injury sustained by athletes. The majority of individuals who undergo LAS develop chronic ankle instability (CAI) as a result of long-term symptoms. The ankle joint can be protected and strengthened with ankle taping to prevent further musculoskeletal issues. This study aimed to investigate effectiveness of tapping on dynamic stability in athletes with chronic lateral ankle sprain.

Material & Methods: Sixty-four participants 64 participants into two groups based on a computer-generated random method. Fibular repositioning taping (FRT) was applied in group A, whereas Kinesio Tape (KT) was applied in group B. Pre-tape assessment used as baseline measurement and taken immediately before tape application. Post taping assessment done after 1 hour & 24 hours while tape still in place. Star Excursion Balance Test (SEBT), Cumberland Ankle Instability Tool (CAIT) and Foot & Ankle disability Index (FADI) were used to evaluate dynamic stability and functional instability respectively. In each direction 3 practice trials were performed by each participant before taking test measurement.

Results: No improvements in postural control were noted with fibular re-positional tape with either rigid or elastic application. Both non elastic and KT tape improved perceived stability but rigid tape served better than KT.

Conclusion: This study concluded that both fibular re-positional tape with rigid and Kinesio application did not immediately improve postural control in CAI participants. However fibular re-positional rigid tape improves perceived stability more than Kinesio tape over 24 hours.

THE IMPACT OF ISLAMIC SALAH ON BALANCE AND ITS IMPLICATIONS FOR REHABILITATION

Rehana Nayab — 2023-12-31

The issue of balance disturbance leading to falls in older individuals is a significant concern, with statistics indicating a high prevalence of falls among those aged 65 and above. According to the World Health Organization (WHO), a substantial percentage of individuals in this age group experience falls each year, with the risk increasing as individuals advance in age.¹ Furthermore, falls have been identified as a major cause of unintentional death across all age groups, emphasizing the critical nature of this issue. While gender differences in falls-related injuries have been noted, it is evident that falls pose a significant threat to both older and younger adults.²

The maintenance of balance is a complex process that involves the interaction of various sensory systems, including somatosensory, visual, and vestibular systems.³ Achieving and maintaining balance is crucial for individuals, particularly in older age, as it directly impacts their physical well-being and overall quality of life. The significance of balance is further underscored by its association with religious practices, such as Salah in the Islamic faith. The performance of Salah involves a multitude of bodily movements, which contribute to enhanced flexibility, equilibrium, and lower leg performance. Considering the frequency of obligatory Rakah in Salah, it becomes evident that this religious practice involves a substantial number of postures on a daily, monthly, and yearly basis.

Given the importance of balance and its association with religious practices, it is essential to explore methods to enhance balance, particularly in the context of rehabilitation. Tai chi Chuan has been recognized as a cost-effective approach to improving balance, with its potential benefits extending to individuals of various age groups. Additionally, the Otago Exercise Program has been identified as an effective means of enhancing balance. Furthermore, virtual reality training (VRT) has emerged as a valuable tool in rehabilitation plans for balance disorders, highlighting the diverse range of interventions available to address balance-related issues.⁴

The influence of Islamic Salah on balance has been the subject of research, with studies indicating a positive relationship between prayer postures and balance. Findings suggest that practicing Salah contributes to improved muscle strength, psychological and cerebral functions, as well as enhanced visual, vestibular, and proprioceptive systems. Notably, individuals who regularly engage in Salah have exhibited improved stability indexes and favorable scores in balance tests, as compared to non-practicing individuals. This underscores the potential of Islamic Salah as a means to enhance balance and its implications for rehabilitation.

THE EFFECTIVENESS OF COMBINED BRACING AND PHYSICAL THERAPY EXERCISES IN ADOLESCENT IDIOPATHIC SCOLIOSIS: A SYSTEMATIC REVIEW

Ayesha Bibi — 2023-12-31

Introduction: Adolescent Idiopathic Scoliosis (AIS) is a prevalent disorder that affects a significant percentage of children between the ages of 10 and 16. Despite its prevalence, the cause of this condition remains unknown. There are several treatment options available for AIS, with bracing and physiotherapy being the most used. However, the effectiveness of combining these two treatments has not been thoroughly evaluated.

Material & Methods: The objective of this essay was to review the existing literature on the effectiveness of combined bracing and physical therapy exercises in treating AIS. To achieve this, a thorough search of databases such as PubMed, PEDro, Cochrane Library, and Google Scholar was conducted. Primary variables, such as Cobb angle reduction, and secondary variables, including balance control and quality of life improvement, were extracted from the selected studies. The quality of the studies was critically appraised using the Newcastle Ottawa Scale.

Results: The results of the review revealed that four prospective cohort studies met the inclusion criteria, with each study scoring an average of 6.5 on the Newcastle Ottawa Scale, indicating their high quality. The findings from these studies demonstrated that the combination of Physiotherapeutic Specific Scoliosis Exercises (PSSE) and Scroth exercises, along with bracing, had a significant impact on reducing the cobb angle when compared to the use of bracing alone.

Conclusion: In conclusion, the review suggests that combining bracing with exercise therapy can lead to improvements in cobb angles, balance control, and quality of life for individuals with AIS. Furthermore, this combined approach has the potential to reverse brace-induced deformities in these individuals. This finding underscores the potential benefits of integrating physiotherapy exercises with bracing in the treatment of AIS and highlights the need for further research in this area to better understand the long-term effects of this combined approach.

INTERPRETIVE DESCRIPTION RESEARCH: A FUTILE OR FERTILE VALUE ADD TO NURSING SCIENCE

Sajid Iqbal — 2023-12-31

The practice of nursing typically adopts qualitative research approaches to inquire the subjective aspects of patients’ experiences in a situation. However, based on their origins and methodological processes, the approaches merely bring up thick descriptions to understand the phenomenon understudy without intent of problem solving. There is need of nursing specific research approaches that could tackle the notion of holistic care approach in their ontological, epistemological, and methodological processes. Interpretive description is one such, nursing specific, emerging research approach that attempts to address the stated issue. However, the approach is still not acknowledged in research inquiries by nurse researchers in South Asian countries especially Pakistan. This paper will inform the nurse researchers about the basic tenets of interpretive description with analysis of its implications for nursing science.