Care Hospitals Of Peshawar Research Articles

Effectiveness of Educational Session on Acute Poisoning Management of Nurses Working in Tertiary Care Hospitals: A Quasi-Experimental Study

Background: Acute poisoning is a major global health concern, particularly in developing countries, where emergency department nurses often serve as first responders. However, limited data exist regarding their preparedness, especially in the Pakistani context, revealing a significant gap in knowledge and clinical practice related to poisoning management. Objective: This study aimed to evaluate the effectiveness of a structured educational session on the knowledge and clinical practices of nurses working in public tertiary care hospitals in Peshawar, focusing on their ability to manage acute poisoning cases. Methods: A quasi-experimental pre- and post-intervention design was employed among registered nurses (n = 58) from the emergency departments of three public-sector hospitals. Participants were selected through simple random sampling based on eligibility criteria, excluding those unwilling or absent. Data were collected using a validated self-administered questionnaire assessing knowledge (15 items) and clinical practice (35 items). Following a 1-hour intervention comprising a presentation and practical demonstration, post-test data were collected after one week. Ethical approval was obtained from the Khyber Medical University Ethical Review Board, and all procedures adhered to the Declaration of Helsinki. Statistical analysis was conducted using SPSS v22, with paired t-tests, ANOVA, and correlation applied where appropriate. Results: Mean knowledge scores improved significantly from 7.08 ± 0.78 to 14.47 ± 0.75 (t = 50.83, p < 0.001), and practice scores rose from 12.81 ± 3.19 to 33.63 ± 1.56 (t = -42.60, p < 0.001). No demographic variable showed a significant association with pre-intervention scores, indicating a uniform benefit of the intervention across all groups. Conclusion: The educational session effectively enhanced nurses' knowledge and clinical practices in managing acute poisoning, underscoring the need for routine competency-based training to improve emergency response and patient outcomes in resource-limited healthcare settings.

Risk Factors and Outcomes of Pediatric Poisoning: A Cross-Sectional Study From a Tertiary Care Hospital in Peshawar, Pakistan

Risk Factors and Outcomes of Pediatric Poisoning: A Cross-Sectional Study From a Tertiary Care Hospital in Peshawar, Pakistan

Abstract 6637: Whole exome analysis of oral squamous cell carcinoma in local patients at tertiary care hospitals in Peshawar, Pakistan

Abstract The Precision Medicine Lab (PML) was established by the Federal Government in 2018 to pilot precision medicine in Pakistan using genomics in oral cancer. Oral squamous cell carcinoma (OSCC)—often called the “poor man's cancer”—constitutes 90% of all head and neck cancers and is the most common cancer in Pakistani males. Supported by a bio-repository of clinical samples and primary cell lines, PML employs a multi-omic approach to identify actionable biomarkers for diagnostic, prognostic, and therapeutic applications. With ethical approvals from IRBs and informed consent, treatment-naive biopsy-confirmed OSCC patients were recruited from two tertiary care hospitals in Peshawar, Pakistan. The cohort predominantly included older individuals (37.84% aged 41-60 years), late-stage cases (78.46% in stage IV), and self-reported non-alcohol consumers (96.9%). Smokeless tobacco use was reported by 44.6%, while 30.8% reported both smoked and smokeless tobacco use. Tumors were mostly located in the buccal mucosa (29.2%), alveolar region (27.7%), or vestibular region (24.6%). Blood and tumor samples were collected for whole exome sequencing, transcriptomics, and metabolomics, along with saliva for oral microbiome analysis. Combined with clinical history and histopathology, this multi-omic dataset enables machine learning experiments. For somatic mutation analysis, raw reads were aligned to the GRCh38.p14 genome, and variants were identified using GATK (v4.5). Mutational analyses with maftools (v2.18.0) in R (v4.3) referenced the COSMIC SBS Signature database (v3.2). Results revealed CASP8 (39%), TP53 (38%), FAT1 (29%), and NOTCH1 (29%) as frequently mutated genes. Pathways such as NOTCH (80.3%), RTK-RAS (64.3%), and Hippo (60.7%) were commonly affected. Deletions were observed in over 60% of samples in chromosomal regions 5q13.2, 6p21.32, 6p21.33, 11p15.5, 19q13.42, and 22q11.23, along with loss of heterozygosity at chromosome 17. The top three mutational signatures included those linked to DNA mismatch repair (SBS6). This study is the first to report the mutational landscape of an OSCC cohort from Pakistan. Our findings highlight potential targets for further investigation and emphasize the utility of a multi-omic approach. With matched primary cell lines for each patient, experimental validation of identified biomarkers is underway to assess their diagnostic, prognostic, and therapeutic relevance. Our integrated dataset offers a resource for machine learning studies to identify novel mutational signatures and actionable biomarkers for OSCC in local populations. Citation Format: Faisal Khan, Hina Zamir, Khudeja Salim, Madina Shirdel, Arsalan Riaz, Aqsa Hussain, Yusra Ilyas, Momal Agha, Zainab Jahan, Saba Saeed, Khadim Shah, Yasir Rehman, Fahim Uddin, Zahid Qayyum, Zubair Durrani, Muhammad Mushtaq Khattak, Johar Ali. Whole exome analysis of oral squamous cell carcinoma in local patients at tertiary care hospitals in Peshawar, Pakistan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6637.

Prevalence of Post-traumatic Stress Disorder in Adult Burn Patients: A Study From Urban Tertiary Care Hospitals in Pakistan.

Introduction Post-traumatic stress disorder (PTSD) is one of the main psychological conditions that develops after a traumatic event such as a burn injury. Patients often experience flashbacks, nightmares, anxiety attacks, and endless thoughts about the traumatic burn injury, which deteriorate their quality of life. These patients are usually socially isolated, have low self-esteem, and are more likely to commit suicide.Burn patients, who are particularly vulnerable, often do not receive adequate post-burn care, and psychological disorders like PTSD are often overlooked in developing nations such as Pakistan. Hence, this study investigated the prevalence of PTSD among adult burn patients in tertiary care hospitals and examined its distribution across different age groups, genders, and socioeconomic classes to highlight its overall burden as well as differences among these groups. Materials and methods This cross-sectional study was conducted from January 2024 to July 2024, recruiting 275 adult burn patients from tertiary care hospitals in Peshawar, Pakistan, using non-probability convenience sampling. Non-cooperative, unwilling, unconscious,and severe burn injury patients were excluded from the study. Additionally, individualsunder the age of 18 years and those whose burn injuries occurred less than a month prior were omitted, as PTSD requires the traumatic event to have happened more than a month ago for diagnosis. All the burn patients were at different stages of recovery. A provisional diagnosis of PTSD was made by using the PTSD checklist for DSM-5, a 20-item checklist that assessed the symptoms of PTSD via a five-point Likert scale. The socioeconomic status was determined via a modified form of the Kuppuswamy Socioeconomic Status Scale. Results The diagnosis of PTSD was made in 52% (143 out of 275) of people who suffered burn injuries. The prevalence of PTSD in males and females was 40% (59 out of 148 males) and 66% (84 out of 127 females), respectively. Sixty-two percent of retirement-aged and 57% of middle-aged patients were mostly affected by PTSD. Similarly, PTSD was more prevalent in lower-class patients, i.e., 69% of patients with burn injuries from lower socioeconomic backgrounds were affected. Conclusion An alarmingly high prevalence of PTSD was found in burn patients. It was more prevalent in females than in males. A greater percentage of retirement-age and middle-aged adults were diagnosed with PTSD. When compared to patients from various socioeconomic backgrounds, burn patients from lower socioeconomic backgrounds were found to have a higher prevalence of PTSD.

STRATIFYING EYELID MALIGNANCIES: A STUDY OF THE TUMORS PRESENTING TO A TERTIARY CARE HOSPITAL IN PAKISTAN

Background: Eyelid malignancies are relatively uncommon, but because of their propensity for local invasion and impact on ocular function due to the complexity of reconstruction, they pose a significant challenge. Objective: To evaluate the histological subtypes, clinical outcomes, and demographic trends of patients with malignant eyelid tumors in a tertiary care hospital in Peshawar, Pakistan. Methods: A descriptive cross-sectional study was conducted at the Ophthalmology Department of Hayatabad Medical Complex, Peshawar, Pakistan. Eyelid tumors were classified based on histological examination of biopsy samples. Statistical analysis was performed with SPSS Version 25.0, with statistical significance set at p <0.05. Results: A total of 125 patients had malignant eyelid tumors. The majority 52% were males; ages ranging from 30 to 60 years, while females constituted 48%. Basal cell carcinoma had the highest prevalence of all the malignancies at 72% and typically involved the lower lid in about 56%, whereas surgical resection was the standard treatment in almost all cases. Malignant melanoma and sebaceous gland carcinoma showed the highest recurrence rates at 20% each, whereas basal cell carcinoma had the lowest rate at 5.6%. Conclusion: The most common type of malignant eyelid tumor in this study was basal cell carcinoma, consistent with local and global epidemiological patterns. The main course of treatment is still surgical excision, supplemented with adjuvant and reconstructive therapies according to necessity.

EFFECTS OF BELL’S PALSY ON PSYCHOSOCIAL HEALTH OF PATIENTS IN TERTIARY CARE HOSPITALS PESHAWAR

Background: Bell’s palsy is an acute unilateral facial nerve disorder resulting in partial to complete facial muscle paralysis, significantly affecting communication and social interactions. The condition is associated with viral infections, immune responses, and vascular ischemia. Its prevalence increases with age and is observed more frequently in rural populations. Recovery depends on the severity of the condition and timely intervention. Recent cases have been linked to COVID-19 and its vaccines. Physiotherapy plays a crucial role in improving functional outcomes at all stages of the disease. Objective: To evaluate the effects of Bell’s palsy on the psychosocial health of patients in tertiary care hospitals in Peshawar. Methods: A cross-sectional study was conducted in three tertiary care hospitals in Peshawar. A total of 121 patients diagnosed with Bell’s palsy were included using non-probability convenience sampling. The sample size was calculated using the OpenEpi sample size calculator. Data were collected using the House-Brackmann Grading Scale (HBGS) to assess disease severity and the Psychosocial Scale of Facial Appearance (PSFA) to evaluate psychosocial distress. Statistical analysis was performed using SPSS version 22. Descriptive statistics, including frequencies and percentages, were calculated, and the chi-square test was applied to determine associations between Bell’s palsy severity and psychosocial distress. Results: Among the 121 patients, 58.7% experienced moderate psychosocial distress, while 41.3% reported severe psychosocial issues. A statistically significant association was found between Bell’s palsy severity and psychosocial health (p<0.001). Patients with severe facial paralysis had higher rates of emotional distress, social withdrawal, and self-esteem issues. The psychosocial impact was more pronounced among young, unmarried females, who expressed concerns about societal acceptance and future relationships. Conclusion: Bell’s palsy has a profound impact on psychosocial health, leading to moderate to severe psychological and social distress due to facial disfigurement, loss of facial expressions, and societal reactions. These findings highlight the need for comprehensive patient education and psychological support alongside medical treatment.

Knowledge, attitude and practice among healthcare professionals regarding the use of personal protective equipment at tertiary care hospitals in Peshawar

Background: Personal protective equipment is designed to safeguard healthcare workers and patients from potential risks during healthcare activities. The proper utilization of PPE serves as a crucial strategy for mitigating the transmission of infections within healthcare settings, thereby minimizing the risk of both healthcare-associated infections and community spread. In this study we tried to explore and assess the knowledge, attitude and practice of healthcare professionals regarding use of Personal protective equipment (PPE). Methods: A cross-sectional study was conducted at Northwest General Hospital (a private sector tertiary healthcare hospital) and Hayatabad Medical Complex (a public sector tertiary care hospital) from March to August 2023. Data was collected from 260 healthcare workers i.e. Doctors and Nurses from both institutions through a preformed questionnaire containing a total of 27 questions. Results: There was a slight positive correlation between increasing years of practice and knowledge regarding PPE (Pearson correlation = 0.017). There was a slight positive correlation between increasing years of practice and attitude (Pearson correlation = 0.035). There was a positive correlation between increasing years of practice and practice of PPE (Pearson correlation=0.147), and there was also a significant association (0.018) between increasing years of practice and practice of PPE Conclusion: Study shows that the healthcare professionals have good knowledge and attitude regarding use of PPE, but there are still gaps in practicing PPE.

YEAR-WISE TRENDS AND ANALYSIS OF MATERNAL MORTALITY IN AN OBSTETRIC UNIT OF A TERTIARY CARE HOSPITAL

Objective: to review the trends and causes of maternal mortality in a tertiary care hospital in Peshawar. Study design: A retrospective observational study. Place of study: Obstetrics and Gynecology Department Khyber Teaching Hospital MTI Peshawar. Duration of study: 5 years. From 1st January 2019 to 31st December 2023. Materials and methods: This was a retrospective observational hospital-based study. Mothers who were admitted and died due to pregnancy-related causes were included in the study. Deaths due to accidental causes were excluded from the study. All the relevant information was extracted from the hospital records, labour registers, and maternal mortality register of the ward and was recorded on a pre-designed proforma. Descriptive statistics were used to calculate frequencies and percentages for different variables. Results: Total numbers of live births during the study period were 19222 and total numbers of maternal deaths were 61. It gives the maternal mortality ratio of 317 per 100,000 live births. The majority of women (n=37-61%) were in the age groups of 31—40 years. Number of patients with great grand multiparty was 22(36%). All patients were un-booked with no proper ante-natal care received during pregnancy. Common causes of maternal mortality in descending order of frequency were eclampsia, post-partum hemorrhage, and ante-partum hemorrhage, all being preventable causes of death. Direct causes of death were seen in 50(82%) patients while 11 (18%) died due to indirect causes. Conclusions: The maternal mortality ratio of 317 per 100,000 live births is quite high. The top 3 causes in our study are all preventable. We all have to work hard to reduce the maternal mortality ratio.

EXPLORING THE SILENCE: BARRIERS TO MEDICAL ERROR REPORTING IN UROLOGY

Objective: To explore barriers to medical error reporting among urology healthcare professionals at tertiary care hospitals in Peshawar. Methodology: This qualitative study utilized a case study approach. Maximum variation purposive sampling was employed to select faculty of Urology (assistant professor and above) with at least two years of experience, resulting in five interviews using a structured interview guide. The interviews were recorded, transcribed, and analyzed through thematic inductive analysis. Data collection and analysis were done concurrently. Results: Four main themes precipitated from the data. Understanding the medical error landscape focuses on what constitutes a medical error. Reporting Roadblocks identified the barriers to reporting medical errors. Institutional Bottlenecks originate from the hurdles in the healthcare system to report medical errors. The last theme, pathways to progress, shows how to improve the process of reporting medical errors. Conclusion: The study highlights the complex systemic, organizational, and human factors contributing to the underreporting and mismanagement of medical errors in urology units. Addressing these challenges is essential for advancing patient safety and fostering a culture of accountability in healthcare.

Clinical and Radiological Outcomes of Minimally Invasive vs Conventional Surgery for Lumbar Spinal Stenosis: A Prospective Cohort Study

Objective The objective of this study is to compare the clinical and radiological outcomes of minimally invasive surgery (MIS) versus conventional surgery for patients with lumbar spinal stenosis (LSS). Methods: This prospective cohort study was conducted at a tertiary care hospital in Peshawar, Pakistan, the study enrolled 200 patients diagnosed with symptomatic LSS, confirmed by MRI. Patients were assigned to MIS (n=100) or conventional surgery (n=100) groups based on surgeon discretion and patient preference. Preoperative and postoperative evaluations included clinical assessments using the Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI), and patient satisfaction scores, alongside radiological assessments of spinal canal diameter and residual stenosis. Data analysis was performed using SPSS version 25.0, with a significance level set at p<0.05. Results: The MIS group exhibited significantly lower VAS scores (6 months: 2.8±1.2 vs. 4.5±1.5, p<0.01; 12 months: 2.5±1.1 vs. 4.2±1.3, p<0.01) and ODI scores (6 months: 18.4±5.2 vs. 25.6±6.3, p<0.01; 12 months: 17.8±4.9 vs. 24.8±6.0, p<0.01) compared to the conventional surgery group. Patient satisfaction was higher in the MIS group (85% vs. 70%, p<0.05). Radiological outcomes showed a greater increase in spinal canal diameter in the MIS group at 6 months (13.5±1.4 mm vs. 12.1±1.5 mm, p<0.01) and 12 months (13.2±1.3 mm vs. 11.8±1.4 mm, p<0.01) postoperatively. The incidence of residual stenosis was lower in the MIS group at both follow-ups (6 months: 10% vs. 25%, p<0.05; 12 months: 12% vs. 28%, p<0.05). Conclusion: MIS offers superior clinical and radiological outcomes compared to conventional surgery for LSS, with better pain relief, functional improvement, and patient satisfaction. The study supports MIS as a viable alternative to conventional surgery, though further research is needed to explore its long-term efficacy and safety. Keywords: lumbar spinal stenosis, minimally invasive surgery, conventional surgery, clinical outcomes, radiological outcomes, prospective cohort study.

Microbiological Spectrum and Antibiotics Sensitivity Pattern of Chronic Suppurative Otitis Media (CSOM) Patients: A prospective study from a Tertiary Care Hospital in Peshawar.

Chronic suppurative otitis media is a fatal condition owing to its propensity for intracranial extension. The inadvertent use of antibiotics has led to resistance among causative organisms. The objectives of this study were to determine causative bacteria, their antibiotic resistance and susceptibility patterns, and their response to antibiotics after a one-month follow-up. It was a prospective study conducted in the ENT department of Khyber Teaching Hospital, Peshawar from June 2023 to March 2024. Ear swabs were collected for microscopy and bacterial culture. Statistical analysis was done using IBM-SPSS-20, and GraphPad Prism. Data was collected from 113 patients. The mean age of the patients was 22 + 2 years. Out of 113 samples, 97(85.5%) showed growth on culture whereas 16(14%) showed no growth, with 95 (98%) unimicrobial, while 2 (2%) showed polymicrobial growth. Pseudomonas aeruginosa was the commonest bacteria isolated 38(38%), followed by S. aureus, Proteus species, and S. saprophyticus. Gram-positive bacteria were susceptible to Linezolid (80%), followed by Vancomycin (76%), with resistance to Ciprofloxacin (75-84%), Ampicillin (70%), and Ceftriaxone (75-80%). Gram-negative bacteria showed susceptibility to carbapenem (50-100%) and Piperacillin/Tazobactam (50% to 93%), with resistance to Ciprofloxacin (50-87%), Ceftriaxone (87%), and Amoxicillin/Clavulanate (72-90%). After one month of follow-up, 82% of patients showed improvements, with noncompliance significantly associated with the persistence of symptoms (p<0.01). Moderate to high resistance against ciprofloxacin, third-generation cephalosporin, ampicillin, amoxicillin plus clavulanate, and clindamycin is an eye-opener. Our results underscore the critical need for judicious administration of empirical antibiotics.

Risk Factors of Relapse in Patients with Bipolar Affective Disorder in Tertiary Care Hospitals of Peshawar, Pakistan

Bipolar affective disorder characterized by the symptoms of recurring episodes of mania, hypomania, and depression. It is a chronic psychological disorder impairs quality of life of both individuals and families. The research was based on cross-sectional observational research design to investigates different risk factors of relapse among BPAD patients in three tertiary care hospitals in Peshawar, Pakistan. Sample of 150 patients aged ranges from 18-65 years was assessed using structured interviews, medical records, and validated scales including Medication Adherence Rating Scale (MARS), Perceived Stress Scale (PSS) and Multidimensional Scale of Perceived Social Support (MSPSS). Results identified low medication adherence, high perceived stress and low social support are the critical factors and contributors of relapse. The research also identified some comorbid conditions like anxiety, depressive symptoms, and substance use (e.g., smoking, marijuana) further aggravate the risks of relapse. This research highlights the multifaceted nature of BPAD relapse, offering valuable insights for mental health professionals in resource-constrained settings. Key Words: Bipolar affective disorder, Relapse, Perceived Stress, Perceived Social Support

Frequency of Gallbladder Carcinoma in Patients Operated for Symptomatic Cholelithiasis.

Background Gallbladder carcinoma (GBC) is a rare but highly aggressive malignancy, often discovered incidentally during cholecystectomy for symptomatic cholelithiasis. Despite significant geographic variation, the association between gallstones and GBC is well-documented, with chronic inflammation from gallstones potentially contributing to carcinogenesis. Objective This study aims to determine the prevalence of incidental GBC in patients undergoing cholecystectomy for symptomatic cholelithiasis at a tertiary care hospital in Peshawar, Pakistan. Materials and methods This retrospective cohort study was conducted at the General Surgery Department, Hayatabad Medical Complex, Peshawar, from February 2, 2021, to July 1, 2024. A total of 230 patients, aged 18-55 years and diagnosed with symptomatic cholelithiasis, were included. Cholecystectomy was performed, and all excised gallbladders were histopathologically examined for carcinoma. Statistical analysis was conducted using IBM SPSS (version 26), with a significance threshold of p ≤ 0.05. Results Out of 230 patients, 7 (3.04%) were found to have incidental GBC upon histopathological examination. Among these, five had adenocarcinoma, and two had papillary carcinoma. The carcinoma was confined to the mucosa (T1a) in four cases, while three cases had deeper invasion (T1b). Patients with incidental carcinoma had a significantly longer symptom duration (mean: 14.2 ± 3.1 months) and were older on average (mean age: 49.2 ± 4.3 years) compared to non-carcinoma patients (p = 0.001 and p = 0.002, respectively). No malignancy was suspected intraoperatively in any case. Conclusion Incidental GBC was present in 3.04% of patients undergoing cholecystectomy for symptomatic cholelithiasis, with longer symptom duration and older age as significant risk factors. The findings underscore the importance of histopathological examination of cholecystectomy specimens in regions with high gallstone prevalence, as early detection of incidental carcinoma can facilitate timely oncological intervention.

Molecular Characterization Of Mbl In Uropathogenic E. Coli Isolated From Patients Of Tertiary Care Hospital.

Antibiotic resistance is on an increasing trend, particularly in gram-negative bacteria. The production of metallo β-lactamase (MBL) puts the health sector at great risk as it further limits the treatment option for MDR strain. The current study aims to determine the prevalence, antibacterial sensitivity pattern, and molecular characterization of MBL in Uropathogenic E. coli from clinical samples of hospitalized patients in Khyber Pakhtunkhwa. From tertiary care hospitals in Peshawar, 250 Urine samples were collected from indoor hospitalized patients. Gold standard microbiological methods were used to identify UPEC from these clinical samples.For that,urine samples was inoculated onto Cysteine Lactose Electrolyte. Deficient (CLED) agar plate, and MacConkey Agar.Positive growth of E. coli identified through Gram staining, colony morphology, Biochemical Tests and E.coli 16srRNA gene amplification .Antibiotic sensitivity was determined by the disc diffusion method on Muller Hinton agar. For the detection of MBL production double disc synergy, and a combination disc test of the antibiotics were used. Furthermore, multiplex PCR was used for the molecular characterization of the MBL (blaIMP, blaVIM, and blaNDM) genes. Of the 250 samples, only 110 samples were confirmed as Uropathogenic E. coli based on colonial morphology, biochemical testing, and molecular level by targeting the 16SrDNA. Female was found more susceptible to UTI compared to male. High prevalence was found in the age group 45-65 years. UPEC was found highly resistance to Ciprofloxacin (90%), followed by Cefotaxime and Ceftriaxone (86%), Ceftazidime and Augmentin (81%), Tazobactam (61%). while the lowest resistance was reported against Meropenum (20%) Imipenem (18%) and Amikacin (37%). PCR-based confirmed prevalence of MBL encoding genes was blaNDM (42%), blaVIM (32%), and blaIMP (26%). The study proposed a higher prevalence of urinary tract infections (UTIs) in females aged group 54-65 years compared to males. An analysis of antibiotic sensitivity revealed Imipenem and Meropenem to be the most effective antimicrobial agents, while Ciprofloxacin, Cefotaxime and Amoxicillin were found to be the less effective. UPEC were found highly resistance to Ciprofloxacin 91%, and ceftazidime 86%, while comparatively less resistance to meropenem, and imipenem,20% and 18% respectively. Genotype BlaNDM of the MBL is highly prevalent (42%) among UPEC.Furthermore, the presence of MBL genes was detected in over 19% of UPEC, and in different combinations.The upraise of the MBLs resistance in uropathogenic E. coli is an alarming sign for clinicians to decide on treatment options for complicated UTIs.

Are the discoveries directed to applications? Translating the status of translational research in Peshawar, Pakistan

Background: Translational research plays a pivotal role in transforming basic scientific discoveries into practical applications, such as drugs and treatments, to address community health needs. This study aims to assess the awareness and perceptions of translational research among healthcare professionals in Peshawar, Pakistan. Methods: A cross-sectional descriptive design was employed, with data collected between January and July 2023 from public and private tertiary care hospitals in Peshawar, Pakistan. The study was approved by Ethical review board of Northwest School of Medicine via letter number: IRB &amp; EC/2022-SM/074 dated: 15 Nov 2022. A sample size of 472 healthcare professionals was determined using the OpenEpi sample size calculator. The study utilized a self-structured questionnaire covering demographic information, awareness of translational research, and knowledge of its various aspects. Data analysis was performed using SPSS version 26, employing descriptive statistics and a one-sample t-test. Results: The study included 472 participants, with a mean age of 30.8 years, comprising various healthcare roles. Gender distribution showed 62.7% males and 37.3% females. Only 25% of respondents reported familiarity with translational research, while 75% indicated a lack of awareness. Information sources varied, with conferences/seminars (16.1%) and colleagues (5.5%) being prominent. Regarding the understanding of translational research, 64.2% admitted to having no idea. Identified barriers included lack of resources (14.8%), lack of awareness (7.6%), and lack of a sense of responsibility (1.3%). A significant majority (87.3%) reported poor knowledge of translational research, while only 12.7% indicated good knowledge. Conclusion: The findings highlight a substantial lack of awareness and understanding of translational research among healthcare professionals in Pakistan.

The Correlation of Red Cell Distribution Width With Peripheral Blood Smear: A Study From a Tertiary Care Hospital in Peshawar.

Anemia is a condition characterized by a shortage of red blood cells (RBCs) and hemoglobin (Hb). A peripheral blood smear (PBS) test involves examining a blood sample to identify important abnormalities in the red blood cells, white blood cells (WBC), and platelets. The aim of this study was to correlate the red cell distribution width (RDW) with peripheral blood smear findings in anemic patients presenting to a tertiary care hospital in Peshawar. This cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar, from January 15, 2023, to July 14, 2023. A total of 450 patients aged 18 years and above with confirmed or suspected anemia (Hb of <13 g/dL in men and <12 g/dL in women), hemolytic disorders, or conditions affecting RBC morphology were included. Peripheral blood smear analysis was performed by two independent hematologists to minimize observer bias. Spearman's rank correlation coefficient was applied to determine the correlation between red cell distribution width and the morphological findings on the peripheral blood smear. Among 450 anemic patients, 232 (51.6%) were women, and 218 (48.4%) were men. The mean age was 25.72 ± 23.23 years. RBC indices showed microcytic RBCs in 270 (60.0%) patients, normocytic RBCs in 157 (34.9%), and macrocytic RBCs in 23 (5.1%). Hypochromic RBCs were found in 301 (66.9%) cases and normochromic in 109 (24.2%). Peripheral blood smear analysis revealed polychromasia in 37 (8.2%) patients and hypochromia in 247 (54.9%). Statistically significant correlations were observed between red cell distribution width and most PBS findings. Microcytic hypochromic anemia was the most prevalent type on the peripheral blood smear, showing a significant correlation with red cell distribution width. The strong correlation between RDW and anisocytosis suggests the potential utility of RDW as a screening tool in clinical practice.

EPIDEMIOLOGY OF FALLS AMONG ELDER POPULATION IN PESHAWAR, PAKISTAN: A CROSS-SECTION ANALYSIS

Background: Falls among the elderly are a significant public health concern that can lead to severe injuries and diminished quality of life. In Peshawar, Pakistan, the unique cultural, environmental, and socioeconomic factors may specifically influence the prevalence and risk factors of falls within this demographic. Objective: The aim of this study is to determine the prevalence of falls and to identify critical risk factors for falls among the elderly in Peshawar. Methods: Conducted from March to August 2024, this cross-sectional study enrolled 68 elderly individuals aged 60 and above from three tertiary care hospitals in Peshawar—Jinnah Teaching Hospital, Lady Reading Hospital, and Hayatabad Medical Complex. Participants were selected through non-probability convenient sampling. Data collection was performed using a validated Likert scale questionnaire. Statistical analysis involved descriptive statistics and Chi-square tests, utilizing SPSS version 26. Results: Of the participants, 34% reported at least one fall in the previous year, with falls more frequently occurring at night (38%) than during the day (34%). Most falls took place either at home (34%) or in public areas (37%). Significant injuries were reported by 34% of those who fell, including bone fractures (34%) and head injuries (32%). Notably, 38% of participants were regularly taking medications known to increase fall risk. Conclusion: The findings indicate a high prevalence of falls among the elderly in Peshawar, often resulting in serious injuries. Effective fall prevention strategies should focus on improving home safety, managing medication side effects, and encouraging regular physical activity to mitigate the risk of falls in this vulnerable population.

FREQUENCY OF PIPERACILLIN/TAZOBACTAM RESISTANCE IN SPONTANEOUS BACTERIAL PERITONITIS PATIENTS

Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with chronic liver disease, requiring prompt antibiotic therapy. Due to growing resistance to first-line antibiotics like ceftriaxone, piperacillin/tazobactam is often used as a second-line treatment. However, emerging resistance to piperacillin/tazobactam poses a significant clinical challenge. Identifying local resistance patterns is crucial for optimizing treatment, particularly in resource-limited settings like Peshawar, Pakistan. Objective: To determine the frequency of piperacillin/tazobactam resistance among patients with spontaneous bacterial peritonitis at a tertiary care hospital in Peshawar, Pakistan. Methods: This cross-sectional study was conducted over five months at Lady Reading Hospital, Peshawar from 18th April to 18th September. A total of 169 patients aged 16 to 75 years with SBP secondary to chronic liver disease were included using non-probability consecutive sampling. Demographic and clinical data were collected, and ascitic fluid samples were cultured to assess resistance to piperacillin/tazobactam. Data were analyzed using descriptive statistics and chi-square tests to examine associations. A p-value &lt; 0.05 was considered statistically significant. Results: Piperacillin/tazobactam resistance was found in 9.5% (16/169) of SBP patients. Resistance was observed in 8.0% (7/88) of Escherichia coli isolates and 11.1% (9/81) of other bacterial isolates (p = 0.04). Resistance rates were slightly higher in the 46–75 age group (11.0%, 11/100) compared to the 16–45 age group (7.3%, 5/69). Male patients had a resistance rate of 10.2% (11/108), while female patients showed 8.2% (5/61). Conclusion: This study highlights significant resistance to piperacillin/tazobactam among SBP patients in Peshawar, particularly in non-E. coli bacteria. These findings underline the need for personalized antibiotic regimens and ongoing surveillance to address growing antimicrobial resistance in chronic liver disease patients.

Analyzing the Role of Mechanical Bowel Preparation on Surgical Outcomes in Colorectal Surgery

Despite improved postoperative recovery from the use of minimally invasive procedures and enhanced recovery after surgery protocols in recent decades, colectomy is still associated with morbidity. Surgical site infections range from trivial wound infections to potentially deadly colonic anastomotic leaks. Objectives: To compare the outcome results regarding postoperative complications of Mechanical Bowel Preparation and Non-Medical Bowel Preparation groups in elective colorectal surgery at a Tertiary Care Hospital in Peshawar, Pakistan. Methods: The research was a quasi-experimental study. In this study, 210 patients were included; they were divided into 2 groups: Mechanical Bowel Preparation Group and the Non-Mechanical Bowel Preparation Group. Data were collected through electronic health records. The data were analysed using SPSS software version 26.0. Descriptive statistics, such as the Chi-Square test, were applied to the results. Results: There was no statistically significant difference regarding the surgical outcomes and the demographics between the Mechanical Bowel Preparation and Mechanical Bowel Preparation groups. The escalation of the surgical site infection looked lower when the Mechanical Bowel Preparation was not in use i.e 20 (19.05%) in the Mechanical Bowel Preparation group and 14 (13.33%) in the Non-Mechanical Bowel Preparation group, but it did not seem to be, statistically significant; p-value=0.261014. The anastomotic leak rates and intra-abdominal collection rates do not differ significantly between the two groups; p&gt;0.05. Conclusions: It was concluded that there was no statistical significance between the groups of mechanical bowel preparation and non-mechanical bowel preparation concerning surgical site infections, anastomotic leakages, and other colorectal surgery complications.

Retrospective, cross-sectional study of the determinants of acute flaccid paralysis among children in Pakistan.

Timely diagnosis of acute flaccid paralysis is very crucial in developing countries like Pakistan, because this will have significant impact on management. To assess the surveillance, aetiology and epidemiology of acute flaccid paralysis in a tertiary care hospital in Peshawar, Pakistan. This retrospective, observational study was conducted at the Paediatric Department of Lady Reading Hospital, Peshawar, in 2022. Data on all children aged 1 month to 15 years and diagnosed with acute flaccid paralysis were retrieved from the electronic medical records and patient files of the hospital. The data were analysed using SPSS version 27. Eighty-eight (1.34%) of the 6544 patients admitted to the paediatric ward met the inclusion criteria for acute flaccid paralysis; 63 (71.6%) of them were male, 25 (28.4%) female, mean age 6.68 ± 3.86 (mean ±SD) years. Guillain Barre Syndrome was diagnosed in 36 (40.9%) of them, meningoencephalitis in 26 (29.5%), septic arthritis in 6 (6.8%), and hypokalaemia paralysis and cerebrovascular accidents in 5 (5.7%). Three (3.4%) of the patients had post-diphtheria neuropathy and 1 (1.1%) had poliomyelitis. In-hospital mortality was 2.3% (2). Although acute flaccid paralysis is vaccine-preventable and its infectious aetiology is low, its surveillance in Pakistan should be continued to reduce occurrence and progress towards polio eradication.