Independent Journal of Allied Health Sciences

A META-ANALYSIS: DEPRESSION AS A RISK FOR THE ONSET OF DIABETES MELLITUS 2.

Dr Ufaque Batool Samo — 2024-11-22

Aims/hypothesis: Evidence and studies strongly suggest that depression and type 2 diabetes are associated, but the direction of the association is still unclear. Although much research is going on to conclude this theory, still its association is unclear. Depression may occur as a consequence of having diabetes, but may also be a risk factor for the onset of type 2 diabetes. This study examined the latter association by reviewing the literature and conducting a meta-analysis of longitudinal studies on this topic.

Methodology: Articles published on Medicine, Psychology, Human Behavioral changes, and Psychiatric Information were searched up to December 2020. All studies that examined the relationship between depression and the onset of type 2 diabetes were included. Concluded relative risks were calculated using fixed and random effects models. To explore sources of heterogeneity between studies, subgroup analyses and meta-regression analyses were performed.

Results: 1099 studies met our inclusion criteria for this meta-analysis. The concluded relative risk was 3.26 (3.13–3.39) using the fixed effects model and 3.37 (3.14–3.63) using the random-effects model. The differences and heterogeneity between studies could not be explained by the following 1. whether studies controlled for undetected diabetes at baseline; 2. the method of diabetes assessment at follow-up; 3. the baseline overall risk of diabetes in the study population; and 4. follow-up duration.

Conclusions: Depressed persons have a 41% increased risk of developing type 2 diabetes mellitus. The pathophysiological mechanisms underlying this relationship are still unclear and need further research. A randomized controlled study is needed to test whether effective prevention or treatment of depression can reduce the incidence of type 2 diabetes and its health consequences.

PSYCHOLOGICAL STRESS OF INCREASINGFREQUENCY OF COVID-19 PATIENTS AMONGFRONT LINERS/ EMERGENCY HEALTH CAREWORKERS

Alvia Saad — 2024-11-22

Objective of the Study: To determinepsychological stress of increasing frequency of covid-19 patients among front liners/ emergency health care workers at Ziauddin hospital.Methodology: This is a hospital based descriptive studyconducted in Emergency department of Ziauddin Institute and Hospital from 1^st April 2020 to 1^st May 2020.The inclusion criteria involved all front line health care workers working in emergency department including medical (physicians, nurses, postgraduates) and nonmedical personnel visiting emergency departments (administrators, technicians, maintenance staff, allied health professionals. The exclusion criteria involved other health care professionals not being exposed to suspected COVID patients. Results: Out of 65 working staff enrolled the mean age was 34.02 ± 6.017 years. Mostly working staff in emergency included males compared to females 48:17 (73.8%: 26.2%). During the first wave of Covid-19, there was increasing stress n=16 (24.6%) most commonly seen compared to isolated anxiety n= 6(9.2%), and depression n=4(6.2%). The severity of symptoms was mostly mild to moderate, very less patients had severe symptoms of depression, anxiety or stress or combined symptoms with statistical significant correlation found among severity and symptoms p value 0.000. Conclusion:Our study showed the psychological impact of first wave of COVID19 among front liners with nearly almost all had symptoms of depression, stress and anxiety. The impact of pandemic seemed to be greater especially among our frontline team.

Frequency of urinary complaints in Gynecological patients of Nishtar Hospital Multan

syeda Ali — 2024-11-22

Objective: To assess the frequency of urinary complaints in patients reporting to Gynaecology outpatient department Study Design: Cross Sectional Descriptive Study. Setting: Outpatient Department of Gynaecology, Nishtar Hospital Multan. Period: From 20th February 2019 to 20th August 2019. Material and Methods: A total of 308 women with the complaints of lower abdominal pain, painful micturition and inability to control urine either on coughing, sneezing or while rushing to the toilet were included. Convenience sampling was done. Basic demographics such as age, duration of complaints and body weight were taken. Urine for pregnancy test was done and free of cost ultrasound was performed to exclude any pelvic pathology. Women with pregnancy, previous uterine surgery, diabetes and other pelvic pathology like endometriosis were excluded from the study. Patients were interviewed on a predesigned proforma for the symptoms of infection and incontinence and their urine was collected and sent to laboratory for urine analysis. Results: The age range in this study was from 15 to 70 years with mean age of 36.428±9.40 years. Mean duration of complaints were 12.873±7.13 days and mean BMI was 23.979±2.05Kg/m2. . Most of the patients were from 21-40 years (72.1%). Incontinence was seen in 24.4% patients and UTI was seen in 39% patients. Conclusion: Urinary tract infections and incontinence are a common problem of women attending our hospital. With the help of simple history and examination and very simple investigations such as urine analysis the burden of disease can be estimated. We should be knowing the burden of the disease in our hospital and area so that necessary steps in the prevention and treatment can be taken.

PERCEPTIONS ON UTILITY AND PRACTICES OF TELE-DENTISTRY AMONG DENTAL PRACTITIONERS IN COVID-19 PANDEMIC

Farah — 2024-11-22

Objective: To explore the perceptions of tele-dentistry benefits in improving dental practice and patient care among the dental professionals of Karachi in COVID-19 pandemic. Study Design: Cross-sectional survey-based study Setting: Dental professionals of Karachi. Period: Jan 2020 to jun 2020. Material and Method: Questionnaire was distributed among three hundred dental professionals through social media. The inclusion criteria included post-graduation residents, general dental practitioners and dental specialists. Dentists with less than 1 year of clinical experience were excluded from the survey. Data was analyzed using SPSS, version 21.0. p-value<0.05. Results: Responders were 191(57%) general dentists, 84(30%) postgraduate trainees, 8(3%) dental specialists. A large majority 236 (83.4%) of responders were afraid of getting infected even with proper SOPs. 146(76.4%) general dentist, 77(91.7%) postgraduate trainees and 8(100.0%) consultants agreed that tele-dentistry will help in decrease in spreading the infection during this pandemic. Conclusion: In the current study, it was observed that majority of participants accepted the idea of tele-dentistry but due to limited availability of technology it is limited in practice. In Australia, dentists denied the usefulness of technology in clinical diagnosis. Various studies conducted worldwide supports the result of our study and agreed upon the fact that tele-dentistry favors adequate consultation in different fields of dentistry.

Attitude, Awareness and knowledge of Evidence Based Medicine among postgraduate students of Liaquat University of Medical & Health Sciences Jamshoro/Hyderabad Pakistan.

Arsalan Ahmed Uqaili — 2024-11-22

Objective: Attitude, Awareness and knowledge of Evidence Based Medicine among postgraduate students of Study design: A cross-sectional survey. Setting: Liaquat University of Medical & Health Sciences Jamshoro/Hyderabad Pakistan. Period: month of August 2013. Methodology: A pre-tested self-administered questionnaire, was distributed among 150 Post Grduate. previously used for similar type of surveys, was used. Results: Overall response rate was 94%.of the participants 68.1% (n=96/141) heard the word of EBM first time during post-garduation training. Teaching of EBM at both under- and postgraduate level was strongly suggested. 95.7% (n=135/141) of the participants never attended a workshop on EBM. 70.2% (99/141) use both books and internet to update their knowledge. 53.2 % (n=75/141) agreed that doctors practice needs to be audited. 85.1 % (120/141) replied that they have no one around them who practice EBM. 46.8% (n=66/141) admitted that only sometimes they discuss the need of evidence based guideline during ward rounds and OPD. 51.1% (72/141) were of the opinion introducing EBM in undergraduate education will help produce better doctors. 38.2% (n=50/141) research articles/reports are not readily available, 17% (22/141) lack of postgraduate interest to change or try new ideas were the barriers faced by postgraduate. Conclusion: Although attitude of postgraduate students towards EBM practice in Pakistan is welcoming nevertheless, they need more knowledge and training in this regard. Therefore, there is a strong need of incorporating the teaching of EBM at undergraduate as well postgraduate level to promote the practice of EBM.

HIV AIDS A GROWING PANDEMIC KNOWLEDGE, ATTITUDES AND INFECTION CONTROL PRACTICES OF NURSES ABOUT HIV/AIDS IN A TERTIARY CARE HOSPITAL OF PESHAWAR

Kashif Ur Rehman Khalil — 2024-11-22

Objective: To estimate the knowledge, attitudes and infection control practices of nurses about HIV/AIDS. Study Design: Cross Sectional Study Setting: Hayatabad Medical Complex, Peshawar, Pakistan Period: 6 months, from October, 2015 and March, 2016 Material and Methods: Nurses were interviewed using a semi-structured questionnaire. The sample was composed of 92 female nurses. Sample was selected randomly from the random numbers list using a computer sheet. Data collected were analyzed using SPSS version 16 for windows. Results: The subjects had fair level of knowledge regarding disease transmission, prevention and treatment, generally positive attitudes but deficient knowledge and poor practices about standard precautions and use of personal protective equipment (PPE). Most of the respondents reported course textbooks followed by television and radio as the source of knowledge about HIV/AIDS. Conclusions: The study showed lack in knowledge which can be addressed by revising the basic nursing curriculum to provide a sound and practical knowledge base to the nurses who are the first line and primary care providers. Furthermore the institutions/employers should feel their responsibility to provide PPE in adequate quantities to guarantee the safety of its employees.

IMPAIRED SERUM ELECTROLYTES ASSOCIATED WITH NON-ADHERENCE TO DIABETIC MEDICATION

Muhammad Ahsan — 2024-11-22

Objective: To find out comparison between impaired electrolytes level and adherence to diabetic medication in diabetic patients. Study design: Cross-Sectional and Observational study. Settings: Fatima Memorial Hospital and Turab Hospital, Lahore. Period: 04-Months. Material and Methods: The data was gathered by applying convenient sampling technique from 74 diabetic patients from Fatima Memorial Hospital, Shadman, Lahore and Turab Hospital,
Township Lahore, Pakistan. They were undergoing diabetic medication (loosely or strictly). All results of their serum glucose (random) levels, HbA1c levels, serum electrolytes included Na+,
K+, and Cl-, clinical history and medical history were documented through a pre-designed proforma. Patients included in this research were, aged between 24 to 90 years, known case of diabetes mellitus whereas non-diabetic persons were excluded from this study. Results: Out of 74, 23 i.e., 31.1% patients were strictly adherent with medicine and have controlled diabetes and electrolyte levels, whereas 14 i.e., 18.9% patients were loosely adherent to their medications but 37 i.e., 50% were those who were non-adherent to their diabetic medicine and have uncontrolled diabetes and electrolytes levels. Conclusion: Electrolytes imbalance were a major problem in diabetic patients who didn't take diabetic medicines properly have life-threatening complications. It was statistically observed that low level of sodium and chloride significantly
occurred whereas the level of potassium were significantly higher in them

compare the awareness of the ergonomics among bankers of public and private sector in Islamabad and Rawalpindi.

Anum Rehman — 2024-11-22

Objective: To compare the awareness of the ergonomics among bankers of public and private sector in Islamabad and Rawalpindi.

Study design: comparative cross sectional survey.

Place /duration: Private and Public Sector Banks in Islamabad and Rawalpindi within duration of 6 months.

Materials and Methods: After getting approval from institutional review committee, Data was collected using non-probability purposive sampling technique.120 bank employees of both genders within age range of 20-60 years, with at least 6 months’ experience were included and those with any previous musculoskeletal disorder/dysfunction, following any physiotherapist, physician etc. for correction of ergonomics were excluded. Maastricht Upper Extremity Questionnaire (MUEQ) was administered for data collection. Data was analysed using SPSS version 20.

Results: Score of neck pain (36.67% in public bankers, 35% in private sector) and shoulder pain (28.33.67% in public bankers, 20 in private sector) showed that its more prevalent in public sector bankers as compare to private sector. On the other hand, private sector bankers have more access to ergonomically friendly environment, including use of back care material (16% in public bankers, 32% in private sector), adjustable height chair (54% in public bankers, 63 in private sector), monitor level adjustments (58% in public bankers, 63% in private bankers), freely moveable elbow, wrist and knee (28.33%, 28.33% and 27.50% in public and 37.50%,40.00 and 45.87% in private bankers) as compare to pubic sector bankers.

Conclusion: The results show that private sector bankers were more aware about their health and postures as compared to the public sector bankers.

PSYCHOLOGICAL STRESS OF INCREASING FREQUENCY OF COVID-19 PATIENTS AMONG FRONT LINERS/ EMERGENCY HEALTH CARE WORKERS

alvia — 2024-11-22

Objective of the Study: To determine psychological stress of increasing frequency of covid-19 patients among front liners/ emergency health care workers at Ziauddin hospital.

Methodology: This is a hospital based descriptive study conducted in Emergency department of Ziauddin Institute and Hospital from 1^st April 2020 to 1^st May 2020. The inclusion criteria involved all front line health care workers working in emergency department including medical (physicians, nurses, postgraduates) and nonmedical personnel visiting emergency departments (administrators, technicians, maintenance staff, allied health professionals. The exclusion criteria involved other health care professionals not being exposed to suspected COVID patients.

Results: Out of 65 working staff enrolled the mean age was 34.02 ± 6.017 years. Mostly working staff in emergency included males compared to females 48:17 (73.8%: 26.2%). During the first wave of Covid-19, there was increasing stress n=16 (24.6%) most commonly seen compared to isolated anxiety n= 6(9.2%), and depression n=4(6.2%). The severity of symptoms was mostly mild to moderate, very less patients had severe symptoms of depression, anxiety or stress or combined symptoms with statistical significant correlation found among severity and symptoms p value 0.000.

Conclusion: Our study showed the psychological impact of first wave of COVID19 among front liners with nearly almost all had symptoms of depression, stress and anxiety. The impact of pandemic seemed to be greater especially among our frontline team.

Keywords

COVID19, Health care workers, Emergency

Frequency of malaria species in Lahore and its relation with hematological changes

Sameen Amjed — 2024-11-22

Objective: To determine the incidence of malaria species in our area and to evaluate degree of variation of hematological abnormalities. Study Design: Descriptive study Settings: Farooq Hospital west wood branch affiliated with Akhter Saeed Medical and Dental College Period: August 2015 to July 2017. Material and Methods: Total 320 malaria positive patients fulfilling our inclusion criteria were enrolled in this study. Patients with known thrombocytopenia history, chronic liver disease and dengue co-infection were excluded. Complete blood counts of patient were performed on Sysmex KX-21 analyzer. Thick and thin blood film examinations were performed for malarial parasite confirmation and specie identification. Patients were divided in 5 groups on basis of age including<15, 16-30, 31-45, 46-60 and >61 years. Thrombocytopenia was categorized as mild, moderate and severe if platelets count was 51-150 x 109/l, 20-50 x 109/l and <20 x 109/l respectively. Anemia was categorized as mild, moderate and severe if Hemoglobin level was above 10 g/dl but below normal level, 8.0-10 g/dl and <8.0 g/dl respectively. Data was analyzed using SPSS version 24.0. Results: Out of 320 enrolled malaria positive patients, 278 (86.9%) were infected with Plasmodium vivax and 42 (13.1%) were positive for Plasmodium falciparum. Overall 258 (80.6%) patients presented thrombocytopenia, 55 (17.2%) patients presented leukopenia and 190 (59.4%) patients presented anemia. Anemia was more frequently observed in two age groups including <15years and 16-30 years whereas <15 years age group presented significantly high incidence of microcytic hypochromic anemia (p-value 0.000). Significant variations in results of hematological findings were observed in patients infected with different malarial species. Finding of anemia was more common in P. falciparum malaria whereas frequency of severe and moderate thrombocytopenia was also significantly highin Falciparum infected patients (p-value 0.000). Statistically significant variation in relative and absolute neutrophils and lymphocytes count was observed. Conclusion: In our setup P. vivax infection is more prevalent than P. falciparum. Malaria causes significant variation in hematological findings. Thrombocytopenia is commonly observed especially in patients infected with P. falciparum. Addition of absolute differential leukocyte counts in reporting of complete blood counts can improve sensitivity of results and improvement in diagnosis.

Role of Probiotics Saccharomyces Boulardii in The Management of Acute Watery Diarrheas in Children

Sadia Hussain — 2024-11-22

Objective: To determine role of probiotics saccharomyces Boulardii in management of acute watery diarrhea in children Study Design: The study was conducted on 64 children. Setting: Bahawal Victoria Hospital's pediatrics wards in Bahawalpur. Period: Sep 2017 to Nov 2017. Material and Methods: This was placebo controlled randomized control trial. Ethical issue was solved by taking permission from the institutional committee. Informed consent from parents or guardians were taken of every child. All children with age from two months to twelve years, who presented with acute watery diarrhea, were recruited by non-probability consecutive sampling and were divided into two groups by lottery method. Group A was treated by recommended WHO protocol plus saccharomyces Boulardii (250mg twice a day orally for three days). Group B was treated with recommended WHO protocol plus placebo. Results: The mean age and weight of the patients of group A was 22.25±10.09 months and 8.65±2.84 kg respectively. There were 68.8% (n=22) boys and 31.2% (n=10) girls. While, the mean age and weight of the patients of group B was 25.81±6.75 months and 9.46±2.62 kg respectively. There were 56.2% (n=18) boys and 43.8% (n=14) girls. Bacteria isolated noted as 68.8% (n=22) and 18.8% (n=6) for the group A and B respectively. Mean number of stools reported on d 0, mean number of stools reported on d 3 and duration of diarrhea (d) of the patients of group A was 10.25±1.03, 2.72±1.82 and 3.16±1.80 days respectively. While, the Mean number of stools reported on d 0, mean number of stools reported on d 3 and duration of diarrhea (d) of the patients of group B was 9.33±1.25, 4.66±1.55 and 4.95±1.11 days respectively. The differences were statistically significant among the groups at (p=0.000). Conclusion: Study concluded that use of probiotics saccharomyces Boulardii is significantly associated with reduction of duration and frequency of diarrhea. It should be used with oral rehydration in treating acute watery diarrhea. It can result in early recovery.