Journal of Liaquat University of Medical & Health Sciences

Addressing the Issue of the Decline in Nurses in Pakistan

2023-03-29T13:38:31+05:00

The shortage of nurses is a global issue harming the international healthcare system. According to the WHO, Health care nurses deficiency is assessed to be 7 million and is anticipated to reach 12.9 million by 2035¹. Around 57 countries in the mainstream continent of Africa, and Asia, were facing severe healthcare worker crises². Thus policies should be made to cover this ratio of shortfall in Pakistan.

Concerns are articulated by the authors about the shortage in nursing, nursing downsizings, decreasing student admissions, faculty leavings, the ageing workforce, and worldwide hiring. Some of the reasons for these concerns are Poor management and infrastructure of the hospitals, low wages, lack of recognition of the values of nursing as a profession, scarce resources in education and clinical settings, medical dominance, and limited opportunities for career advancement, these all factors contribute to powerlessness and harassment among nurses, working in Pakistan. Thus, these are considered the main reasons for the migration of nurses to our country. In Pakistan, the management has paid little attention to developing an approach for nursing personnel. Thus, the passage of Pakistani-educated nurses overseas has an undesirable effect and has already damaged our healthcare system.

Viewpoint on the Application of Virtual Microscopy in Teaching at a Medical College in Saudi Arabia

2023-05-17T18:27:26+05:00

Conventional light microscopy (CLM) was the primary technique used to teach histology and pathology for a long time. However, it cannot view slides simultaneously, making it difficult for group discussions and cooperative learning. Multiple microscopes, glass slide production and storage, are expensive and require time-consuming maintenance. The invention of projectors and digital video cameras in the early 20th century made using CLM more effective. However, these tools could only be used by one person at a time, which prevented them from totally replacing CLM.¹ the 1980s, the initial digital images were generated from histological slides, but it wasn't until the availability of personal computers with sufficient memory capacity that digital microscopy advanced rapidly, this led to the development of imaging converter programs and servers that facilitated the uploading of virtual slides to the internet, enabling image viewing and zooming capabilities. Presently, numerous systems can generate high-quality virtual images of histological tissues. Users can browse the images using a mouse or joystick, allowing them to navigate through different areas of the slide and simulate the zooming functionality of an optical microscope.

Social Obligation of Medical Colleges and Teaching Medical Students Social Responsibility to Health

2023-06-20T12:07:05+05:00

World Bioethics Day 2022 was celebrated on 19^th October 2022. The theme was 'Social Responsibility and Health'¹. This is a reminder for medical schools to emphasize one of the important aspects of Social Responsibility and Health,' i.e. Social obligation of medical colleges and teaching health professions students' social compulsion to health". The medical schools have to develop socially trustworthy and accountable physicians/doctors who volunteer for activities that give contentment to the people and provide socially acceptable healthcare, thereby contributing towards the prosperity of communities².

We may ask two questions to ourselves; 1) Are our medical schools producing socially responsible physicians/doctors who engage themselves in activities contributing towards the bliss, well-being, and fortune of their communities? 2) "Are our medical education programs have state-of-the-art curriculums that produce a positive, constructive effect on the well-being of our communities?

Relationship of Serum Prostate Specific Antigen with Hirsutism in Women Having Polycystic Ovary Syndrome Belonging to the Province of Khyber Pakhtunkhwa, Pakistan

2023-02-02T10:17:22+05:00

Objective: To find the relationship of serum PSA with Hirsutism in PCOS females of Khyber Pakhtunkhwa.

Methodology: It was a cross-sectional/comparative study. This study was conducted in Khyber Teaching Hospital, Lady Reading Hospital, and Hayatabad Medical Complex from June to December 2021. A total of 172 study subjects were involved in this study. Serum PSA, testosterone and DHEAS levels of 86 newly diagnosed cases of PCOS (Group A) were compared with 86 healthy age-matched controls (Group B). These parameters were estimated using the ELISA method. Distribution of Hirsutism of the study subjects was also established with FGS. SPSS version 21 was used to analyze the data.

Results: The results showed that serum PSA significantly increased (0.325±0.243 Vs 0.119±0.209, P <0.0001) in females with PCOS. Serum total testosterone (1.639±0.773 vs 0.739±0.965, P<0.0001) and DHEAS (3.397±1.243 Vs 2.035±1.203, P <0.0001) levels were also raised. A highly significant positive relationship was seen between PSA with Hirsutism through FGS (r 0-609, P 0.000), testosterone (r 0.352, P 0.000) and DHEAS levels (r 0.432, P 0.000)

Conclusion: This study observed significantly high PSA correlating positively with Hirsutism in females with PCOS.

Keywords: Prostate Specific Antigen, Hirsutism, Polycystic Ovary Syndrome

Frequency of Urinary Tract Infection, Microbial Patterns and Drug Resistance in Diabetic Patients in a Tertiary Care Unit

2023-01-30T10:25:49+05:00

Objective: To determine the frequency of UTIs in people with diabetes and identify local bacterial flora and antibiotic resistance.

Methodology: An observational, analytical, cross-sectional study was conducted at the Medicine Ward of Jinnah Medical and Dental College Hospital (now Sohail Trust Hospital) from January-December 2020. A convenient sampling technique was applied, and the sample size was 132. Diabetic patients >18 years of age were included. Data was collected on a structured questionnaire. A urine sample was sent for culture sensitivity. Any growing flora and their sensitivity/resistance to antibiotics were recorded. All the data were analysed using SPSS version 21.

Results: UTI was found in 31(23.5%) patients. Female gender, insulin therapy, and lower creatinine clearance were related to UTI, as shown by significant p values. Most common flora was E. Coli 26(84%), followed by Klebsiella 4(13%) and S. aureus 1(3%). E.Coli was 100% resistant to 3^rd generation cephalosporins, 83.9% resistant to quinolones and 67.7% resistant to Penicillin (amoxicillin/clavulanic acid) and 43% resistant to aminoglycosides. Klebsiella was 100% resistant to Penicillin and quinolones and 85% to 3^rd generation cephalosporin. E. coli and Klebsiella were 100% sensitive to carbapenems, nitrofurantoin and Fosfomycin, whereas S. Aureus was resistant to cloxacillin, clindamycin and clindamycin and quinolones, while sensitive to vancomycin., linezolid and aminoglycosides.

CONCLUSION: UTI was found in 23.5% of our diabetic patients; the most common organisms prevalent were E. Coli, Klebsiella and S. aureus, which was primarily resistant to Penicillins, Cephalosporins and quinolones while sensitive to nitrofurantoin, Fosfomycin and carbapenems.

Association of Dry Eye Disease and Diabetic Retinopathy with Glycated Hemoglobin at a Tertiary Care Unit of Karachi Pakistan

2023-03-06T10:19:47+05:00

Objective: To investigate the association of dry eye disease and diabetic retinopathy (DR) with glycated haemoglobin at a tertiary care unit in Karachi, Pakistan.

Methodology: This cross-sectional observational study was conducted at Baqai Institute of Diabetology and Endocrinology, Baqai University Karachi, Pakistan, from July to December 2020. A total of 238 subjects having type 2, type 1, and gestational diabetes mellitus participated in this study. They went through a routine ophthalmic examination, breakup tear film time (BUT) test, Schirmer I test, staining fluorescein, and fundus photography performed to diagnose the DR. Baseline detail and biochemical parameters were recorded. Data analysis was done on statistical packages for the sciences social (SPSS) 20 version.

Results: A total of 72 participants had dry eye disease (DED) conforming to a total prevalence of 30.25%; 11(4.6%) had severe dry eyes, 26(10.9%) had moderate dry eyes, 35(14.7%) had mild dry eyes whereas, 166(69.7%) participants had normal eyes. There was no significant association between gender, index mass body (BMI), smoking habits, history of family diabetes, and duration of Diabetes with DED. The frequency of diabetic retinopathy (DR) was registered as 23.5%; 29(24%) males and 27(23.1%) females, respectively.

Conclusion: Overall, a 30.3% frequency of dry eye in diabetic individuals was observed. It should improve by having consistent follow-ups after three to six months, providing a distinct difference in the condition compared to the non-affected individuals.

Sonographic Ultrasound Evaluation of Mastalgia and to Determine the Relationship between Breast Duct Diameter and Severity of Mastalgia

2023-02-27T11:17:13+05:00

OBJECTIVE: To determine the breast ultrasound findings in patients with Mastalgia and the relationship between breast duct diameter and severity of Mastalgia.

METHODOLOGY: A prospective cross-sectional study carried out at Dow Institute of Radiology, Dow University of Health Sciences from June-December 2021. Female patients, irrespective of age, presenting with Mastalgia without any prominent finding on clinical examination were included. A fellowship-trained radiologist performed an ultrasound. Data analysis was performed on SPSS 22.0

RESULTS: Total 380 patients were included. The mean age of the patients was 36.3±11.5 years, and the mean VAS score was 3.2±1.2. A total of 234(61.6%) had mild pain, 139(36.6%) had moderate pain and 7(1.8%) had severe pain. The mean duct diameter in patients with Mastalgia was 2.9±3.7 mm, with 220(57.9%) patients having a diameter <2.0 mm and 160(42.1%) having a diameter >2.0 mm. Duct ectasia was found in 161(42.4%). Mastalgia was significantly higher in patients with duct ectasia (p-value <0.001) and in patients with fibrocystic change (p-value <0.001).

CONCLUSION: Duct ectasia, fibrocystic changes, infective/inflammatory changes, and axillary lymphadenopathy were sonographic features of Mastalgia. Mastalgia was significantly higher in patients with duct ectasia, duct diameter >2.0 mm and in patients with fibrocystic changes.

Keywords: Mastalgia, Duct ectasia, fibrocystic changes, breast pain.

Effect of Dietary Counselling on Anthropometric Measurements of Liposuction Patients

2023-02-06T10:12:58+05:00

Objective: To observe the effects of dietary counselling on various anthropometric parameters in patients after liposuction.

Methodology: This non-randomized educational intervention study was performed at a cosmetic surgery centre in Islamabad, Pakistan, from July to December 2017. Among 83 subjects, 43 were in the intervention group, and 40 were in the control group from both genders. Patients undergoing primary liposuction, abdominal liposuction, and abdominoplasty with liposuction were included in this study; patients on any weight loss diet or pills in the last six months were excluded. The intervention group was followed up three months after dietary counselling, and the control group was without dietary advice. Anthropometric measurements of both groups were done before liposuction, just after liposuction, and then three months after surgery, which included body weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and mid-upper arm circumference (MUAC). Data analysis was done with SPSS version 20.

Results: Significant changes were found in all parameters except for MUAC in the control group. Independent-sample T-tests showed no statistically significant difference in any parameter at any time.

Conclusion: Liposuction resulted in a reduction in weight, BMI, WC, WHR, and WHtR in both groups, but dietary counselling could not show its effect on any parameter in our study. Further reduction of these parameters in the intervention group could occur if the intervention lasted longer.

Clinico-demographic profile and outcome of neonates born to mothers with COVID-19 infection at a Tertiary Care Hospital

2023-02-16T14:06:12+05:00

Objective: To determine the Clinico-demographic profile and outcome of neonates born to mothers with COVID-19 infection at a Tertiary Care Hospital.

Methodology: This cross-sectional study was conducted at Pediatrics Department, Ziauddin Hospital Karachi, from March 2020 to August 2021. The sample size was 31, non-probability purposive sampling technique was used. Neonates of COVID positive mothers who consented to Covid-19 testing were included. Neonates of Covid positive mothers who refused to participate were excluded. Diagnosis of coronavirus infection was based on Novel Corona Virus-2019 (nCoV-19) qualitative PCR test through nasopharyngeal swab. Clinico-demographic profile and outcome of neonates data were recorded on self-developed proforma. Standard protocols were followed per National Command and Operation Center guidelines. Data were analyzed by SPSS version 20. Frequencies and percentages were calculated, and the chi-square test was applied as a significance test with a P-value of <0.05.

Results: First virology test was positive for 6 (19.4%) neonates, and the second was positive for only 1 (3.2%) neonate; 17 (54.8%) neonates who were negative in the first virology test and stayed less than three days in the hospital refused to undergo a second test by their parents. After 14 days of follow-up, 29 (93.5%) neonates became asymptomatic, while 2 (6.5%) had symptoms of neonatal respiratory distress and required admission to the neonatal intensive care unit.

Conclusion: Vertical transmission of covid-19 can occur if the mother acquires infection in the last trimester. However, these infected neonates' morbidity and mortality rate is negligible; therefore, breastfeeding and rooming should be encouraged.

Sero-prevalence and Perception of Brucellosis among High-Risk Groups, A Cross-sectional Study

2023-03-06T10:28:05+05:00

Objective: To determine the seroprevalence of Brucellosis and assess the disease's perception among high-risk groups.

Methodology: This descriptive cross-sectional, community-based study was conducted among 125 high-risk group individuals vulnerable to infection with Brucellosis and compared to 50 individuals of non-risk groups. Obtained sera were tested for the presence of antibodies to Brucella using the Rose Bengal plate test and standard tube agglutination test. A questionnaire was designed to assess the risk behavior and previous knowledge about the disease.

Results: The males were 78%, and the females were 22%. The seropositivity of Brucellosis was 3.2% among people at high risk and nil for the non-risk groups. The disease was prevalent in dairy farmers, which was more prevalent in dairy farmers (2.4%) and slaughterhouse workers (0.8%). All infected persons were males; the disease is most common in the age group 15-25 years.

Conclusion: There was a statistically significant correlation between education level and the prevalence of Brucellosis. The two laboratory methods used to diagnose Brucellosis gave the same results. Routine checkups and education of at-risk individuals are recommended to help control the disease.

Effectiveness of Mulligan's Movement with Mobilization and Muscle Energy Technique on Pain, Functional Status, and Depression in Students with Sacro Iliac Joint Dysfunction

2023-01-13T09:12:13+05:00

Objective: The study aims to identify the effectiveness of Mulligan's movement with mobilization and Muscle energy techniques on pain and functional disability in students with Sacro Iliac joint dysfunction.

Methodology: This randomized control trial was conducted on college students with sacroiliac joint dysfunction recruited from KMCH Institute of paramedical sciences, Coimbatore, Tamil Nadu, India, from August 2019 to July 2020. Group A included 16 subjects and Group B with 15 subjects. The subjects who fall into the inclusion criteria were included, and subjects who are willing to participate in the study were included in this study. Neurological signs, Radiating pain below the knee, recent surgery & fracture around the hip, and hypermobile joint were excluded. Group A received Mulligan's mobilization and core stability exercise; Group B received muscle energy technique with core stability exercise. Outcome Measures: Pain and functional disability were measured by the modified Oswestry disability index; Kinesiophobia was by the Tampa scale.

Results: The level of significance was 0.05. The mean values of the post-test show marked improvement between the groups, with a p-value of 2.69 for functional disability and a p-value of 0.45 for pain. Significant progress was observed in participants who received Mulligan's movement with mobilization. Statistical calculation was done with the help of SPSS version 18.

Conclusion: Mulligan mobilization is more effective than the muscle energy technique in managing sacroiliac joint dysfunction.

Association of Upper Trapezius Pain with Perceived Exertion and Depression in Workers of the Food Industry

2023-01-23T09:08:58+05:00

Objective: To determine the association of upper trapezius pain with perceived exertion and depression among food industry workers.

Methodology: It was an analytical cross-sectional study carried out from November 2021 to March 2022 after Ethical approval. One hundred food worker samples in Lahore were selected by a non-probability convenient sampling technique. The participants were male and female in the age group of 25-40, with 8-12 hours of duty time/day. The outcome tools were the Visual Analogue Scale, Borg Exertion Scale and Depression Inventory Scale. All the data was entered in SPSS V.25 for analysis of data. Quantitative variables are presented using Mean± SD (Standard deviation) and categorical variables with frequencies, while the association was determined using the Chi-square test.

Results: In the current study, there were 76% male and 24% female participants with a mean age of 30.53±5.30 years. Among the participants, 32% had moderate pain, 24% had severe pain, 21% had strenuous physical activity exertion, and 19% had light physical activity exertion, But 21% had mild depression, and 9% had severe depression. There was a significant association between upper trapezius pain rating with physical activity exertion level at P= 0.007 and depression at P= 0.000

Conclusion: This study concluded that there was a significant association between upper trapezius pain, the level of Physical Exertion and Depression. The upper trapezius pain intensity increases the level of depression and physical exertion.

Application of Biosensors in Diagnosis of Human Parvoviruses

2023-06-20T11:45:41+05:00

Human parvovirus B19 is a viral pathogen that causes acute and usually self-limiting disease. Because the B19 virus predicates erythroid progenitor cells, it can cause a transient aplastic crisis in immunocompromised individuals. This infection has been associated with nonimmunologic fetal hydrops during pregnancy; also, B19 can persist for months in immunocompromised individuals. In B19 infection, viremia with a high titer is observed for approximately one week. After that, a specific immune response is critical to control the infection. Although molecular and serologic tests commonly diagnose the B19 virus, laboratory diagnostic tests have limitations. For the detection of human parvovirus B19, an inexpensive, effective, and rapid biosensor may be considered as an alternative.

Key Words: Human Parvovirus B19, Biosensor, Molecular and Serological Diagnosis.