Rehman Journal of Health Sciences

AWARENESS OF PHYSICAL THERAPY AMONG FOOTBALL CLUB-LEVEL PLAYERS OF KARACHI

Saad Saleem — 2024-06-30

Introduction: Physical therapy is a profession which is basically concerned with identifying and maximizing the quality of life (QoL) and movement potentials with the aim of promotion, prevention, intervention, habitation, and rehabilitation of an individual. This encompasses social, psychological, physical, and emotional wellbeing. The importance of the Physical Therapy profession cannot be neglected and ignored, from inpatient rehabilitation to outpatient rehabilitation. It is noteworthy that correct biomechanics provides accurate movement and reduces the risk of injuries, abnormal biomechanics are always a potential cause of non-traumatic sports injury, while poor techniques can cause abnormal biomechanics which contributes to subsequent injuries. This highlights the importance of the profession for athletes. However, there is scarcity of data whether the athletes in our region have a reasonable knowledge of this profession.

Material & Methods: This is an observational, cross-sectional study that was conducted with various Football (Soccer) club-level players in Pakistan. A total of 150 participants were required for this study. Participants were between the ages of 15-35 years, with no physical disability, and co-morbidities. A self-structured questionnaire was used to collect the data.

Results: Data analysis showed that more than 57% of players were aware of Physical Therapy, among which 26% of club level players were informed about Physical Therapy by their Physicians, 14% from friends, 9% from print, electronic media, and 8% from family members. Whereas 43% of players were totally unaware of Physical Therapy. It was also noteworthy that only 10% of players received physical therapy guidance for fitness and ailments.

Conclusion: Physical therapy interventions are evidently the first-line treatment option for injuries related to training and sports. It is the need of the day to raise awareness in our athletes about the scope and importance of physical therapy.

EFFECTS OF POST STROKE SHOULDER PAIN ON UPPER LIMB MOTOR FUNCTION AND PROPRIOCEPTION

Sardar Changez Khan — 2024-06-30

Introduction: Stroke is a leading cause of death and disease. Stroke causes hemiplegic shoulder pain, which leads to many central and mechanical disorders such as spasticity and shoulder subluxation. Hemiplegic shoulder pain is thought to interfere with proprioception and motor function, reducing the patient's quality of life and hindering their ability to recover. The main objective of this study was to determine whether hemiplegic shoulder pain affects motor function and proprioception of the affected upper limb.

Material & Methods: After ethical approval from ethics board and providing informed consent, a total of 130 participants took part in this study, who were 18 years and above, divided into two groups of 65 each based on pain presence i.e. hemiplegic shoulder pain (HSP) and no hemiplegic shoulder pain (NHSP). Motor function was assessed through Fugl Myer Motor Assessment Scale-Upper Extremity and Proprioception was assessed via Laser pointer assisted angle reproduction test (LP-ART). The angle deviations from normal were recorded. Visual Analogue Scale (VAS) was used to assess pain intensity. SPSS 25 was used for analysis.

Results: Mean age of the participants was 58.97(13.05). Males were 105 (80.8%) and females 25(19.2%). HSP group had 48 males and 17 females, whereas NHSP group comprised of 57 males and 8 females respectively. Demographic data had no differences at baseline. Motor function and proprioception was highly associated with increase pain (P<0.001) i.e. stroke individuals with hemiplegic pain had decreased motor function and proprioception in the painful limb compared to stroke individuals without pain.

Conclusion: Hemiplegic shoulder pain affects motor function and proprioception. Increase intensity of pain leads to an increase in movement errors as well as decreased motor function.

INVESTIGATING THE LEVEL OF KNOWLEDGE REGARDING TRIAGE MANAGEMENT AMONG NURSES WORKING IN PUBLIC SECTOR HOSPITAL OF PESHAWAR

Khurshid Ali — 2024-06-30

Introduction: Emergency departments worldwide handle a large number of patients, causing overcrowding and affecting the quality of care, as life-threatening conditions often go untreated due to the overwhelming workload. Triage was designed to facilitate the emergency staff as well as the patients, and with the passage of time, it became an integral part of the emergency department that prioritizes patients on the basis of their severity and attention. Nurses present in the triage are experienced and trained for this role to assess patient for their presenting complaint.

Material & Methods: The study design of the study was descriptive cross-sectional, while the study was conducted in the public sector hospitals of Peshawar Pakistan. Through convenient sampling technique data from 200 registered nurses were collected from May to July 2021. The data was collected through a questionnaire as a tool for the assessment of nurses’ knowledge regarding triage management.

Results: The findings show that the nurses were aware regarding the 4-color coding (82.5%), in case of road traffic accident (80.9%), in head injury (61.5%). The participants also had a good knowledge regarding the principles of triage and what is the precaution used in triage management. The overall knowledge of the nurses was good (45.23%), followed by average (30.65%), excellent (12.56%) and low (11.56%).

Conclusion: The result of this study showed that a major portion of the respondents have satisfactory knowledge, while a good portion of participants have deficient knowledge because the (40%) respondents had not got any formal training on triage management. Answering few basic and critical questions on triage management the respondent replies were incorrect.

COMPARISON OF PAIN NEUROPHYSIOLOGY KNOWLEDGE AMONG HEALTH SCIENCES STUDENTS

Khurram Shahzad — 2024-06-30

Introduction: Pain has been known to be the Fifth vital sign since the 1990’s. The chronic pain is of special consideration in the modern era, as its prevalence is increasing day by day. To treat these patients, a multi disciplinal approach is followed, which involves Pain Re-education and reconceptualization. The notion of healthcare practitioners is of prime importance. However, most educational programs, especially for health graduation students, include minimum or no content about pain and/or its management. The notion of pain retained by health care professionals is therefore essential for efficient therapy of patients.

Material & Methods: This cross-sectional study was carried out in April 2019 in Khyber Medical College and Institute of Physical Medicine & Rehabilitation, KMU Peshawar. The sample size was 190. The data was collected by stratified sampling technique. Data collection was done using the latest version of Neurophysiology of Pain Questionnaire (NPQ). The collected data was entered into IBM SPSS v.25. The normality of the data was checked via One Kolmogorov Smirnov’s test. Our data distribution was not normal thus, we used non- parametric test. Frequencies of the demographics were calculated. The percentage of correct responses was calculated then, the total score for each participant was calculated. Finally, the mean score for each institute was found and compared with each other to see any statistically significant differences.

Results: The response rate of our study was 98% with 186 participants out of 190. 150 students (79%) participated from Khyber medical college while 36 students (19%) from Institute of physical medicine & rehabilitation. Mean Score on the NPQ-14 items was 7.01±1.9. There was no significant difference found between the level of knowledge held by students of KMC and IPM&R (p=0.10).

Conclusion: This study indicates that the students at Khyber Medical College and Institute of Physical Medicine and Rehabilitation of KMU, as shown a satisfactory level of knowledge about Pain Neurophysiology. The inclination physiotherapy students to answer some questions more than medicine students were observed on the subject of ‘Perception of pain’.

PRESCRIPTIONS MESHING BASED ON THE WHO THREE-STEPS ANALGESIC LADDER: AN OBSERVATIONAL STUDY

Ihsan Khan — 2024-06-30

Introduction: Pain is an unpleasant sensory and emotional experience associated with either actual or potential tissue damage. This study aims to compare prescriptions with the benchmark of the three-step analgesic ladder recommended by the World Health Organization (WHO). Given Pakistan's membership in the WHO, adherence to the WHO analgesic ladder is essential.

Material & Methods: The current two-month observational study was conducted at Lady Reading Hospital (LRH) in Peshawar, Pakistan, the data collected on prescription practices based on a specialized proforma, categorizing them based on their pain condition and therapy. Lastly, the data analyzed using Microsoft Excel and Graph pad Prism. The study assessed compliance with the WHO analgesic ladder for patients experiencing mild, moderate, or severe pain and categorized them based on therapy.

Results: A total of 81 cases were gathered from various hospital wards, including orthopedic, psychiatric, and surgical wards. Out of all patients, 64 (79%) were male and 17 (21%) were female. The study revealed that 77 patients were found to be complying and only four patients deviating from the ladder. Among the four patients who deviated, three had moderate pain, and one had severe pain. The study revealed that the WHO analgesic ladder was predominantly followed, with only a few deviations noted. Physicians demonstrated a good understanding of the gold standard in analgesic therapy. Many patients (95%) adhered to the ladder, indicating a high level of awareness among physicians regarding rational analgesic prescribing practices.

Conclusion: The findings suggest that the WHO analgesic ladder was largely adhered to at LRH, with a negligible deviations observed. This underscores the importance of benchmarking practices in prescribing analgesics in hospitals to ensure rational and effective pain management for patients.

SAFETY OF EXTRACORPOREAL KNOT LIGATION OF WIDE CYSTIC DUCT IN LAPAROSCOPIC CHOLECYSTECTOMY AT A THQ HOSPITAL

Sidra Dil Muhammad — 2024-06-30

Introduction: Laparoscopic cholecystectomy is the gold standard treatment of cholelithiasis and is a well-known procedure among patients globally because of less post-operative pain and early recovery. Wide cystic duct is one of the challenges which encountered in laparoscopic cholecystectomy and managing it laparoscopically demands expertise and gadgets. Although several studies are available in literature which compared outcomes of knot ligation versus clip ligation of cystic duct in laparoscopic cholecystectomy but, only few studies have discussed the wide cystic duct management and reported the outcomes of suture ligation of wide cystic duct.

Material & Methods: This retrospective study was conducted at Government THQ Hospital Sabzazar, Lahore from May 2021 to October 2023 and included 63 patients with wide cystic duct. Cystic duct was ligated by extracorporeal Roeder's knot in all cases. Patient`s demographics and Outcome were recorded.

Results: Mean age of patients was 41.30±3.92 years. There were 12.69% males and 87.30% females with male to female ratio of 1:6.8. Mean BMI was 32.98±4.01 Kg/m². Previous history of obstructive Jaundice and ERCP was found in 4.76% and 3.17% patients, respectively. There were 36.50% diabetic and (65.07%) hypertensive patients. Mean time taken for extracorporeal Roeder's knot formation and application was 2.01±0.46 min. Bile leak, retained cystic duct stone, sub-hepatic collection, postoperative jaundice and mortality were not observed in any patient.

Conclusion: Extracorporeal knot ligation of wide cystic duct with Vicryl 1 in laparoscopic cholecystectomy is safe.

FREQUENCIES OF SPORT-SPECIFIC INJURIES IN PESHAWAR'S SPORTS COMPLEX

Zulekha Nasar — 2024-06-30

Introduction: Athletes are more vulnerable to sports injuries, that’s why International Sporting Agencies are very concerned about the health and injury prevention of athletes. The key to delivering crucial epidemiological data is a standardized estimation of sports injuries. It also includes the nature of the injury and its contributing factors. At the national team level, Asia has a greater injury rate than Europe. It is important to know the frequency of injuries in sports like football, hockey, karate, cricket, table tennis, badminton and volleyball as they are common sports within Pakistan.

Material & Methods: This was a cross-sectional study involving 313 athletes (aged 10 to 30) from the Peshawar Sports Complex. The convenience sampling strategy was used to collect data. A questionnaire that has been self-modified was used. SPSS version 20 was used to analyze the data.

Results: Overall, 65.2 percent of injuries were reported; football (20.1%) had the largest proportion of injuries, followed by hockey (17.2%) and cricket (14.2%). Lower limb injuries accounted for 36.1 percent of the total. A total of 22.7 percent of the upper limb injuries were recorded. Shoulder injuries were the most common among all players (12.8 percent), regardless of the game.

Conclusion: Football, followed by hockey and cricket, had the highest proportion of injuries. Lower limb injuries were more common than upper limb injuries combined, while the shoulder had the largest proportion of injuries overall.

LEARNING STYLES ASSOCIATION WITH ACADEMIC PERFORMANCE AMONG NURSING STUDENTS

Sahib Jahan — 2024-06-30

Introduction: Nursing education is an evolving sphere and knowing learning styles of the students may play a crucial role as a foundation for designing suitable teaching strategies. Integration of instructional strategies according to the preferred learning styles of students in nursing education may bring excellence in their academic performance. Therefore, the impact of learning styles in association to the academic success of the nursing students need to be researched in order to have better outcomes in teaching and learning process.

Material & Methods: A cross-sectional study was carried out to determine the association of learning styles with academic performance among nursing students. Permission was granted from the review boards, concerned departments and participants of the study. Data was collected through VARK questionnaire. Data were analyzed using SPSS version 20. Chi-square tests were applied for comparison between grades of students with different learning style while ANOVA was used to compare mean marks obtained and Grade Points, where P-value <0.05 was considered as significant.

Results: A total of 177 sampled population with mean age of 23.9 ± 5.515 participated in the study. Around 60 (33.9%) males and 117 (66.1%) female participated in the study. Most 99(54.8%) of them liked students centered teaching approach. The most common learning style was noted as Kinesthetic 56 (31.6%) followed by 38(21.5%) of read and write. There was no significant difference regarding the pattern of learning styles among Generic and Post RN BSN students (p=0.201).

Conclusion: Kinesthetic and visual learning styles were found the most preferred learning styles among nursing students as compared to the auditory or reading styles. Results showed that preferred learning style had a positive impact on the academic performance. Findings of the study further reflected that academic performance has a significant association with the learning styles of the student in nursing education therefore teaching and learning strategies must planned according to the learning styles of the students to excel the overall learning process and academic achievement of the students.

PARENTAL AWARENESS OF AUTISTIC SYMPTOMS IN CHILDREN

Shazia Bibi — 2024-06-30

Introduction: Autism spectrum disorder is a collective term for a set of pervasive neurodevelopmental disorders characterized by moderate to severe impairments in expressive and receptive communication, social skills and socialization, and repetitive or stereotypical behaviors and interests. Evaluation and analysis of ASD includes a multidisciplinary group. Guardians should be made mindful of the angles identified with, social association troubles, discourse and language abilities delay, formative aptitudes delay, engine formative abilities delay for early distinguishing proof.

Material & Methods: The study design for this research was cross sectional survey. This study was carried out at Riphah International University Lahore Campus. Data was collected from Multan. The study duration was six month after the approval of BASAR. The study duration was January 2020 to August 2020. The study population included parents of Autistic children and parents of typically developing child. Children with age of 3 to 8 years were included. The inclusion and exclusion criteria were recruited to carry out the study after informed consent. The sample size for this study was 200. Autistic children with comorbidity were excluded. Children with above the age of 8 years were excluded. It consists of 24 questionnaires. A total of 5 speech and language pathologist were asked to give their responses according to the expert opinion Instrument’s reliability confirmed with the help of Cronbach’s alpha, the value of which was 0.809.

Results: The study findings provide a useful comparison of how people with and without autism view autism spectrum disorder in terms of awareness and perception. According to the study, there is a notable difference in the awareness and knowledge of autism between people who have it and those who do not.

Conclusion: It was concluded that both parents who have Autistic children and those who have normally developing children lack knowledge of the signs and symptoms of autism. However, somehow, parents of children with autism have little knowledge compared to normally developing children's parents.

LEARNING CURVE OF FULL ENDOSCOPIC LUMBAR SPINE SURGERY; A RETROSPECTIVE ANALYSIS AT FAROOQ NEUROSPINE INSTITUTE, PESHAWAR

Muhammad Farooq — 2024-06-30

Introduction: Learning curve for minimally invasive endoscopic spine surgeries is the required time in which a surgeon becomes proficient in the skill of operating through the endoscope along with the quantity and number of cases needed to master specific Minimally Invasive endoscopic spinal procedures .The aim of this retrospective study was to investigate the learning curve of full endoscopic lumber spine surgery from the experience of an individual practicing endoscopic spine neurosurgeon.

Material & Methods: The records of patients who underwent full endoscopic spine surgery from March 2018 to March 2022 were evaluated at Afridi Medical Complex, Peshawar. To evaluate the learning curve, cases were categorized into four sequential groups based on the order of surgeries performed. Group 1 comprised the initial cases encompassing first year (2018-2019), and subsequent cases were grouped into Group 2, 3 and 4 representing year 2019-2020,2020-2021,2021-2022. The learning curve was assessed through the analysis of various outcome parameters, including operative time, intraoperative complications, postoperative complications, length of hospital stay, and patient-reported outcomes.

Results: A total of 543 patients met the inclusion criteria and were included in the analysis. The majority of patients were males (n =346, 64%) and 194(36) % were female. Mean operative time reached to plateau level at 160th surgery. Mean operative time decreased throughout each year from 90 minutes (Group 1) to 75 (Group 2), 60 (Group 3) and 45 (Group 4).

Conclusion: Progressive reduction in operative time and favorable patient-reported outcomes along with decreased complications are noted as surgical experience increased in operating endoscopic spine surgeries. These results underscore the importance of ongoing training and proficiency in full endoscopic techniques, ultimately enhancing patient care and outcomes in neurosurgical practice.

LEVEL OF PHYSICAL ACTIVITY AND ASSOCIATION WITH QUALITY OF LIFE IN OLDER ADULTS

Syeda Rida Fatima — 2024-06-30

Introduction: Physical activity is the movement of the body that results in energy expenditure. In daily life, it can be characterized into sports, conditioning, household work, or any other activities. There is a linear relationship between physical activity and health status; therefore, increasing level of physical activity has great impact on quality of life especially in older population.

Material & Methods: A cross sectional study was conducted on a sample of 151 participants between age group of 60 to 80 years, including both male and female participants. Individuals with any mental and physical disability, history of trauma or any balance problems were excluded. Informed consent was obtained and the data was collected over a period of 6 months from Jan uary 2018 to July 2018. The International Physical Activity Questionnaire Short Form (IPAQ-SF) and Older People Quality of Life Brief Questionnaire (OPQOL-Brief) were used to determine the levels of physical activity and quality of life, respectively.

Results: Results revealed that the frequency of correspondents with low level of physical activity were 82 (54.3%), with moderate level of physical activity were 24(15.9%) and with vigorous level of physical activity were 45(29.8%). Pearson correlation coefficient R-value of 0.407 and a P value of <0.001 indicated that a moderate correlation existed between the two quantitative variables of physical activity and quality of life.

Conclusion: In conclusion, the participants with low level of physical activity were the highest in number as compared to moderate and vigorous activity. Lower levels of activity among the participants resulted in poor quality of life.

COMPARISON OF ASSOCIATED FACTORS IN SYMPTOMATIC KNEE OSTEOARTHRITIS AMONG FEMALE POPULATION OF RURAL AND URBAN AREA

Zarafsheen Zia — 2024-06-30

Introduction: Osteoarthritis (OA) is a long-term condition that impacts joints, leading to pain and stiffness as a result of ongoing destruction of articular cartilage. As the prevalence of OA is expected to rise, a clearer insight into the factors for disease development and disease progression is required. Although extensive studies have been conducted on knee osteoarthritis and its factors worldwide, but limited data is available in Pakistan, especially concerning rural and urban female population separately.

Material & Methods: A total of n=110 female participants (n=55 Rural; n=55 Urban) who fulfilled ACR (American College of Rheumatology) criteria for symptomatic knee osteoarthritis (SKOA) were included in the study. A self-structured questionnaire was used. Data was analyzed using SPSS software version 21.0

Results: The results of this study showed that overall, most frequent associated factors for SKOA in both Urban and Rural females were Menopause (91.8%), kneeling/squatting (89.1%), housewives (83.6%). Between Urban females more prevalent associated factors were high BMI (81.8%) and prolonged standing (61.8%) among others. While less education (81.8%) and heavy lifting (80%) were more frequent factors among Rural females. Least associated factors among both populations were quite similar i.e., smoking, family history, use of high heel shoes, and history of previous knee injury. Less education was one of the topmost associated factors in Rural females while least prevalent in Urban females.

Conclusion: It was concluded that both the urban and rural females had some common associated factors related to SKOA i.e., Menopause, kneeling, squatting, housewives and High BMI. Urban females had high BMI and prolonged standing whereas Rural females had less education and heavy lifting as more frequent factors.

IMPACT OF BARIATRIC SURGERY ON CONCEPTION AND PREGNANCY OUTCOMES IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME (PCOS): A PROSPECTIVE STUDY OF ONE YEAR

Mushtaq Ahmad — 2024-06-30

Introduction: In obese patients with PCOS, even a small weight loss of up to 5% of the initial body weight can cause spontaneous ovulation, the restoration of regular menstrual cycles, and conception. The aim of this prospective study was to determine the outcomes of Bariatric Surgery in terms of Conception and Pregnancy in patients with Polycystic Ovary Syndrome (PCOS).

Material & Methods: This prospective study was conducted at International metabolic and bariatric center, Afridi medical complex, Peshawar on patients who underwent bariatric surgery from February 2021 till February 2022 with one year follow up period. A total of 518 premenopausal women who attended the facility during the study period were included in the study. Patients who met the Rotterdam criteria for PCOS and were between the ages of 18 and 45 were recruited. It was mandatory for the participants to have had bariatric surgery, such as a sleeve gastrectomy or gastric bypass, within the previous year. Baseline demographic and clinical data was noted while conception rate and pregnancy outcomes were assessed in follow up. Data was analyzed using SPSS version 26.

Results: A total of 62 patients (12%) had Polycystic Ovary Syndrome (PCOS) diagnosis. Following one year after the bariatric surgery, forty of the participants became pregnant accounting for conception rate of 65% of the total individuals. The majority of pregnancies resulted in live births, accounting for 38 (95%) of cases. Miscarriages occurred in only 1(3%) of pregnancies. Additionally, 5(12%) of newborns were underweight while 2(5%) were overweight at birth.

Conclusion: The findings of our study concluded that bariatric surgery is a safe and effective therapeutic alternative for enhancing reproductive function, conception rate and better pregnancy outcomes in females suffering from polycystic ovary syndrome.

CLINICAL OUTCOMES OF LAPAROSCOPIC SLEEVE GASTRECTOMY IN REMISSION OF TYPE II DIABETES: A RETROSPECTIVE ANALYSIS

Mushtaq Ahmad — 2024-06-30

Introduction: In recent years, sleeve gastrectomy has emerged as a potential treatment option for obese patients with type 2 diabetes, as it has been shown to improve glycemic control and even induce remission of the disease in some cases. The aim of this study was to determine the clinical outcomes of laparoscopic sleeve gastrectomy in remission of type-II diabetes.

Material & Methods: This retrospective observational study was carried out at Shifa International Hospital, Islamabad, Pakistan and the records of patient data were analyzed from January 2012 to January 2019 who were treated for morbid obesity. We included adult patients (aged 18-70 years) with severe obesity (BMI >35 Kg/m2) diagnosed with type II diabetes (baseline HbA1C >6.5) who had completed 36 months of follow-up post-operatively at our center. We excluded patients with type 1 diabetes and those who presented for revision bariatric surgery. T2DM diagnosis was established according to American Diabetes Association criteria.

Results: In this study a total 55 patients were enrolled. After three years of surgery, complete remission of diabetes mellitus was observed in 22 (59.46%) patients, partial remission in 10 (27.03%) while 5 (13.51%) patients were reported to have some improvements out of the total improved group patients 37(67.27%).On 3 years follow up after surgery; the mean HbA1C, BMI and fasting blood glucose level was 5.98%,31.64kg/m2 and 98.23 respectively.

Conclusion: This study concluded that laparoscopic sleeve gastrectomy is an effective, safe and reliable surgical procedure in the management of obese patients with type II diabetes mellitus and is associated with promising results in the type II diabetes remission and improving the BMI and glycemic control in terms of HbA1C, and fasting blood sugar levels.

FACTORS ASSOCIATED WITH APGAR SCORE AMONG NEWBORNS DELIVERED BY CESAREAN SECTIONS; A CROSS-SECTIONAL STUDY

Maooz Ahmad — 2024-06-30

Introduction: Despite the widespread utilization of the Apgar score as a critical tool for assessing neonatal well-being following cesarean section (C/S) deliveries. To investigate the factors associated with Apgar score among newborns delivered by cesarean section.

Material & Methods: A cross-sectional was conducted to examine factors associated with Apgar scores in neonates delivered via cesarean section. All eligible parturient were included, and rigorous training was provided to data collectors. Bivariate and multivariate analyses were employed to identify factors associated with Apgar scores, with logistic regression models used to assess associations.

Results: The majority of participants were aged 25-29 (38.22%) years, with Gravida II (44.59%) being the most prevalent pregnancy state. Single gestation (94.27%) was predominant, and most (91.40%) mothers had a normal medical condition, undergoing emergency cesarean sections with spinal anesthesia. Newborns were evenly distributed by sex, with a majority weighing between 2.5-4kg and being born at term gestation, exhibiting favorable Apgar scores. Factors influencing neonatal outcomes included spinal anesthesia being associated with better outcomes compared to general anesthesia, while prolonged skin incision to delivery times (>3 minutes) (OR: 1.2, 95%CI:1.0-1.4) and uterine incision to delivery times (>3 minutes) (OR: 1.2, 95% CI: 1.0-1.4) were linked to adverse outcomes. Higher birth weight (2.5-4 kg) (OR: 1.5, 95% CI: 1.3-1.7), normotension (OR: 1.1, 95% CI: 1.0-1.3), term gestation (OR: 16, 95% CI: 14-18), and single gestation (OR: 34, 95% CI: 32-36) were associated with better outcomes compared to their respective counterparts.

Conclusion: Optimizing perioperative factors such as anesthesia type and incision times affecting neonatal outcomes in cesarean deliveries. Moreover, the observed associations between favorable neonatal outcomes and factors like higher birth weight, term gestation, normotension, and single gestation underscore the importance of comprehensive obstetric care strategies in enhancing maternal and neonatal health during cesarean sections.

FREQUENCY OF MUSCULOSKELETAL INJURIES AND ASSOCIATED RISK FACTORS AMONG THE VOLLEYBALL PLAYERS IN PESHAWAR

Sardar Ahmad — 2024-06-30

Introduction: Volleyball is one of the most commonly played game from the top five international sports in the world amongst male and female due to its ability to play both indoors and outdoors and its minimal equipment requirements. Sports injury is an important public health issue. Sports have many numerous health benefits; however, injury is their potential outcome. Specific tasks of volleyball like jumping, spiking, twisting, diving, turning movements, and blocking the ball require a lot of energy from the MSK system for the fast movements and rapid action in the game which can lead the player towards the risk of MSK injuries. Volleyball represents a higher injury rate than other games for practice. This study aimed to determine the frequency and associated risk factors of MSK injuries among volleyball players.

Material & Methods: This cross-sectional study was conducted from August 2019 to February 2020 in the Peshawar sports complex, Hayatabad sports complex, and the University of Peshawar. 170 participants; only males with age ranged from 15-35 years, were recruited while using convenient sampling technique. Data were collected and analyzed through SPSS version 21. A Chi-square test was applied to determine the association of injury.

Results: Among 170 players, Participants were having mean age 27.5 ± 4.5 years, weight 63.02 ± 4.2 kg, height 5.7 ± 0.3 feet, and 20.65 ± 2.3 BMI 101 (59.5%) players were having MSK injuries. The most injured anatomical sites of volleyball players were ankle (21.8%) and knee joint (12.9%). The most risky position for getting injured in volleyball on track was spiker (42.9%), followed by a blocker (30%), setter (15.3%), and libero (11.8%) respectively.

Conclusion: This study concluded that MSK injuries have a high frequency in volleyball players. Demographics and position of players are the most important risk factors causing MSK injury.

HEALTH INSURANCE SYSTEM IN DEVELOPED COUNTRIES AND WHAT EXISTS IN PAKISTAN: A REVIEW OF THE LITERATURE

Sajida Mazhar — 2024-06-30

Introduction: It is essential to compare health insurance plans across the world in order to identify best practices and enhance the delivery of health insurance. With a comparison to Pakistan's health insurance system, this review seeks to better understand health insurance throughout the world and assist policymakers in raising quality and availability.

Material & Methods: To examine health insurance policies globally, a comprehensive review of the literature was carried out, incorporating information from official websites, and academic databases. The comparison of these results with Pakistan's health insurance system was the main objective. We looked for patterns and similarities in the policies of other nations, considering factors like accessibility, features, coverage, and exclusions. In order to identify discrepancies and possible areas where Pakistan's health insurance system could be strengthened, the final stage of the study comprised a thorough comparison of international and domestic health insurance plans.

Results: Private health insurance dominates in the US and the UK, but Norway's publicly funded system, supported by the Patients' Rights Act, provides complete coverage, including free healthcare services for children under sixteen while on the other hand in Pakistan, citizens have restricted access to medical treatments due to inadequate healthcare coverage provided by both the government and private sectors.

Conclusion: The Forbes statistics shows that 92.1% of Americans are covered by health insurance, indicating a comparatively high level of coverage in the US. On the other hand, Norway's government-funded healthcare system, which is backed by the Patients' Rights Act, guarantees healthcare services for all its residents. However, the grave situation in Pakistan, where a small fraction of the population is covered by health insurance programs. The study highlights the urgent need for improved medical coverage and access in the nation.

ARTIFICIAL INTELLIGENCE: REDEFINING THE FUTURE OF NURSING EDUCATION

Hassan Karim — 2024-06-30

Artificial Intelligence (AI) technology has revolutionized higher education, offering students more effective and individualized learning experiences.¹ AI, a computer-controlled system designed to learn, reason, perceive, communicate, and make decisions similar to or better than humans, has become integral part of our daily lives through gadgets like smart TVs, wearable fitness trackers, and cell phones.²

In nursing education, AI plays a crucial role and nursing educators are preparing nurses and nursing students for future exposure to AI health technologies (AIHTs). As AIHTs transform health systems, unchecked technological advancements could have unintended consequences for patients and the nursing profession. Therefore, active participation from nurse educators and students in this evolving landscape is essential. Many institutions and clinical skills labs have already integrated AI for educational purposes.³

Integrating AI into nursing education offers benefits such as better learning outcomes and increased productivity. However, it also presents challenges like privacy and security concerns, ethical issues, and resistance to adoption. Faculty members may be worried about AI's impact on their workload and classroom roles or fear that AI might replace human teachers. Addressing these concerns involves emphasizing that AI, when used properly and ethically, enhances the teaching and learning process for both students and instructors.⁴ AI tools can streamline administrative tasks, such as tracking students’ progress, monitoring attendance, and grading, allowing nurse educators to focus on more complex topics and learning outcomes that require specialized knowledge and skills. The ethical use of AI can lead to better learning outcomes, increased productivity, and more effective teaching strategies.⁵

Nurse educators are key stakeholders in developing compassionate and competent caregivers. Nursing schools can create a comprehensive and successful learning environment by balancing AI-powered resources and human interaction. Proper training for nurse educators on applying and incorporating AI into current teaching methods is crucial.⁶ Implementing AI-based tools in nursing curricula requires funding for simulation labs, staff training, software, and hardware while AI applications can assist nurses in clinical decision-making, comprehensive education in undergraduate nursing programs must include clinical information systems, data quality, standardization, data mining, and analytics for accurate results.⁷