Consecutive Sampling Technique Research Articles

Analysis of Factors Affecting The Body Temperature of Postoperative Patients At RSUP Dr. M Djamil Padang

Introduction: Surgery is a medical procedure carried out using invasive methods by opening, cutting or slashing parts of the body to provide treatment to the patient. Changes in body temperature can occur in post-operative patients which are influenced by age, gender, body mass index (BMI), duration of surgery, and type of surgery. Objective: To analyze the factors that influence the body temperature of post-operative patients at RSUP Dr. M. Djamil Padang. Methods: This study is a correlative analytical research using cross sectional design. This study was conducted using primary data and the samples were selected by consecutive sampling technique with a total of 56 samples. Results: The results of this study show that there is a relationship between age with body temperature of the patients after surgery (p=0,021, r=-0,308), there is no relationship between gender with body temperature of the patients after surgery (p=0,876, r=0,021), there is a relationship between BMI with body temperature of the patients after surgery (p=0,033, r=0,140), there is a relationship between duration of surgery with body temperature of the patients after surgery (p=0,027, r=-0,482), and there is no relationship between type of surgery with body temperature of the patients after surgery (p=0,762, r=0,041). Conclusion: There is a significant relationship between age, BMI and duration of surgery with body temperature of the patient's after surgery and there was no significant relationship between gender and type of surgery with body temperature of the patient's after surgery.

ASSOCIATION BETWEEN ESTROGEN LEVELS WITH INTRAOCULAR PRESSURE IN PRIMARY OPEN ANGLE GLAUCOMA PATIENT

Introduction & ObjectivesThere are studies that state that estrogen deficiency can exacerbate visual disturbances in glaucomapatients. To determine the relationship between estrogen levels and intraocular pressure (IOP) inpatients with POAG.
 MethodsThis study used a case-control design in 30 POAG patients who came to the OphthalmologyPolyclinic at the University of North Sumatra Hospital and Network Hospital. The data collectionmethod in this study used a consecutive sampling technique starting from February 2022 until thesample was filled. The inclusion criteria in this study were all women with POAG who were ?40years old and willing to be the research sample. The exclusion criteria for this study were patientswith a history of secondary glaucoma or a history of optic nerve disease, a history of ocular surgery(except cataracts), a history of orbital trauma, menstrual disorders, or currently on hormonaltherapy, a history of systemic or autoimmune disease. Data is then collected and analyzed.
 ResultsOf the 30 patients with POAG, the majority were aged 45-65 years (46.7%) with an average age of55.87(±12.91) years and had suffered from POAG for an average of 1.62(±2.08) years. The averagepatient had an intraocular pressure of 25.07(±6.12) mmHg, MD -12.99(±8.28) dB, VCDR0.78(±0.13) mm, and estrogen levels 2.47(±2.11) pg/dL. There was no significant relationshipbetween estrogen levels and intraocular pressure (p=0.851).
 ConclusionThere was no significant association between estrogen levels and intraocular pressure in patientswith POAG.

Outcome of Olecranon Fracture Treated with Tension Band Wiring Versus Anatomical Locking Plate Fixation

Aim: Up to 10% of all upper limb fractures involve the olecranon, and this type of fracture is the most common osseous injury of the elbow joint. These show a bimodal distribution occurring in younger patients due to high-energy trauma and in elderly cohorts with low bone quality after low-energy falls. Objective: To compare functional outcome of tension band wiring versus anatomical locking plate fixation for reduction of olecranon fracture Materials and Methods: This randomized controlled trial study was conducted in the Department of Orthopedic, Lady Reading Hospital, Medical Teaching Institute Peshawar from December 2022 to June 2023. Non-probability consecutive sampling technique was used in this study. Sample size was calculated using WHO calculator keeping 95% confidence interval 80 % power of study, 10% absolute precision, mean Mayo elbow score was 84.0±9.3 in the TBW group and 88.3±9.1 in the locking plate fixation group (4). Expected sample size is 32 patients in each group, total 72 patients. Patients of both genders have age range from 20 to 70 year with Mayo type 2A olecranon fractures, more than 2 mm of joint displacement determined on X-ray elbow, and elbow extension loss determined on physical examination presented within 7 days of the injury were included in the study while Patients with open fracture and revision surgery were excluded from the study. Results: In this study age distribution among 72 patients was analyzed as n= 20-30 Years 17(27.4%) 31-40 Years 14(22.6%) 41-50.Years 11(17.7%) 51-70 Years 20(32.3%). Mean age was 47.1 Years with SD ± 2.87. Gender wise Distribution among 72 Patients was analyzed as Male were 31(50.0%) and female were 31(50.0%). Distribution of duration of disease among 72 patients were analysed as n= 1-2 weeks were 47(75.8%) and 3-4 weeks were 15(24.2%) Practical Implication: There are no established guidelines for the treatment of olecranon fracture in our institution. Most olecranon fractures are treated according to surgeon preferences and surgical experience of the surgeon. Previous studies showed variables results with no consensus. We will provide rationale basis for universal use of standard treatment of olecranon fracture. Conclusion: Although there were no statistically significant differences in clinical outcomes between the two groups, the ALP group had a higher proportion of any complication than the RP group. Keywords: Anatomical locking plate; complications; eyelet wire; olecranon fracture; tension band wiring.

Frequency of microorganisms in children presenting with acute fever at the outpatient department.

Objective: To determine the incidence of blood stream bacterial infection and the frequency of microorganisms involved as evaluated by blood culture in children presenting with acute febrile illness at the outpatient department. Study Design: Cross-sectional study. Setting: Department of Pediatrics and Child Health, Mardan Medical Complex, Mardan, Pakistan. Period: 1st March 2023 to 31st of August 2023. Material & Methods: A total of 252 children from both genders between the ages of 1 month to 15 years presented at outpatients department with fever (≥ 38.0 °C or 100.4 °F) for ˃ two days were included in the study using consecutive sampling technique. The blood cultures of these children were sent to the laboratory for investigations. Bacterial strains were isolated and identified using standard microbiological techniques. The primary outcome was to determine the incidence of blood stream bacterial infection and the frequency of microorganisms involved. Results: The Mean±SD of age is this study was 4.20±3.42 years with an age range of 0.5-14 years. Male gender was 51.59% while female gender was 48.41%. The results of blood culture report showed that bacterial growth was present in 37 (14.68%) of total study patients. Out of these positive blood cultures, Gram-positive Cocci was reported in 16 (43.24%) of the children while Gram-negative bacilli were present in 21 (56.76%). The prevalence of E Coli was highest in these children 10 (27.02%) followed by S Typhi 8 (21.62%), Streptococcus pneumonia 5 (13.51%) and S aureus 4 (10.81%). Conclusion: It was concluded that the Gram-negative bacilli are the common cause of bacterial infection in children presenting with fever at outpatient department of a tertiary care hospital in this region with most frequent presence of E Coli and S Typhi.

Frequency and distribution of co-morbidities in protein energy malnutrition children admitted in nutrition unit DHQ Hospital, District D.I. Khan, Pakistan.

Objective: To determine frequency and distribution of co-morbidities by type, age groups and gender in PEM children. Study Design: Cross-sectional study. Setting: Department of Pediatric (Nutrition Unit) and Community Medicine, GMC. Period: 15-8-2022, to 30-12-2022. Material & Methods: Data for diagnosed PEM cases was retrieved from Nutrition Unit DHQ Hospital DI Khan for which non-probability consecutive sampling technique was used. Research variable was type of comorbidities while demographics variables were age groups and gender. Association of gender and age groups with the presence or absence of co-morbidities in PEM children were found using Chi Square test. Results: Out of 400 participants, most frequent co-morbidity was gastroenteritis (GE) in 157(39.3%) patients in which females were 87(55.41%) and males 70(44.58%). 101(64.33%) were in 1–5-year age group and 56(35.66%) in under 1 year. Second to GE was pneumonia with 84(21%) patients in which females were 45(53.57%) and males 39(46.42%). Pneumonia in 1-5 year affected 61(72.61%) and 23(27.38%) patients were less than 1 year. Anemia affected 74(18.5%) patients in which females were 45(60.81%) and males 29(39.18%). 58(78.37%) patients were in 1-5 years and 16(21.62%) in less than 1 year. Other co-morbidities were seen in small number of patients. Difference in age groups were statistically significant at p-value of 0.005006 (<0.05) while there was no association of gender with comorbidities at p-value of 0.459344 (>0.05). Conclusion: Most common comorbidities were GE, pneumonia and anemia and their prevalence was higher in females and 1–5-year age group.

THE RELATIONSHIP OF FAMILY SUPPORT WITH THE LEVEL OF PRE-ANESTHESIAN SECTIO PATIENTS IN THE HOSPITAL PEKALONGAN REGIONAL GENERAL

Background: Sectio Caesarea (SC) is a surgical procedure to save a mother and baby. Most SC preoperative patients experience mild and severe anxiety; this anxiety will affect the patient's recovery process. Anxious conditions cause vasoconstriction of blood vessels, so that blood supply to the heart decreases. One of the other factors causing anxiety in preoperative patients is family support. Families who always support the patient's recovery will be able to reduce patient anxiety. Objective: The purpose of this study was to determine the relationship between family support and the pre-anesthesia anxiety level of sectio-caesarea patients at Bendan Pekalongan Hospital. Methods: Using quantitative observational and analytic research methods with a cross-sectional approach. The place of research was in the reception room of IBS Bendan Pekalongan Hospital. sample 36 patients with consecutive sampling techniques. Data analysis in the form of bivariate data produces the frequency distribution and percentage of each variable. Results: The results of the correlation coefficient of -493** indicate that there is a fairly strong and significant correlation with a negative or unidirectional direction, meaning that the greater the level of family support, the lower the patient's anxiety level. Conclusion: The results of the spearman rank test analysis of 36 respondents showed a p value of 0.001, <0.05, which means that there is a relationship between family support and the level of pre-anesthesia anxiety of Sectio Caesarea patients at Bendan Pekalongan Regional General Hospital.
 Keywords: Family support, anxiety level, and pre-anesthesia of Sectio Caesarea patient

The Correlation between Body Mass Index (BMI) and Recovery Time on General Anesthesia Patient Using Endotracheal Tube (ET)

Conscious recovery time is the time it takes for the patient to be removed from the conscious recovery room when the patient is fully conscious. Patients who are unconscious within more than 15 minutes are considered prolonged, even to respond to a stimulus in highly susceptible patients requires 30-45 minutes after general anesthesia drugs are stopped. One of the causes of lengthening the time to recover consciousness is the Body Mass Index (BMI) in patients which can increase the potential of anesthetic drugs given. The purpose of this study was to determine the relationship between Body Mass Index (BMI) and conscious recovery time in general anesthesia patients using Endotracheal Tube (ET) at RSUD Dr. Soedirman Kebumen. The method of ths study was correlation analitik with a cross-sectional approach. The sample of this study amounted to 48 respondents with consecutive sampling technique. Data analysis was carried out using the Kendall Tau test. The results of the study obtained 86.5% of respondents had a fast conscious recovery time (<15 minutes) and 13.5% of respondents had a prolonged conscious recovery time (>15 minutes). Of the results of the kendall tau correlation test obtained results with a significancy p value of 0.000 < 0.05 which means there is a relationship between the body's mass index to the recovery time of consciousness after general anesthesia with the endotracheal tube. The conclusion of this study is that majority of respondents who have a quick recovery time of less tha 15 minutes are respindents with a normal body mass index. Patient with a fat or obese BMI will receive a higher dose of anesthetic medication compared to patients in the thin category. When the anesthetic drug is given a higher concentration, the effect of the ansthetic drug will be longer.

Depression care integration in tuberculosis services: A feasibility assessment in Pakistan.

The co-occurrence of depression among tuberculosis (TB) patients is a critical issue, contributing to poor treatment outcomes, prolonged hospitalisations and increased healthcare expenses. The objective of this study was to assess the feasibility of delivering a co-designed depression care pathway within TB services in Pakistan. Mixed-method study. Routine depression screening for TB patients was conducted at three TB facilities in Peshawar, Pakistan, encompassing primary, secondary and tertiary care settings. All patients aged 18 or above (male and female) attending the three TB facilities between November 2021 and February 2022 were included in the study using the consecutive sampling technique. A total of 301 people with confirmed TB, within the past 4 weeks, visited the three TB care facilities; 191/301 patients were screened for depression. Approximately 35% of the 191 TB patients screened positive for depression, with varying severity levels. Qualitative findings highlighted the acceptability of integrated depression care, emphasising the importance of open communication and empathetic attitudes. Barriers to integration include stigma, logistical challenges, patient noncompliance and cost burdens. Facilitators included the empathetic attitude of healthcare providers and the availability of mental health services within the same facility. There is a high burden of depression in patients with TB, highlighting the pressing need for mental health support in this population. Acceptability of integrated care was evident, with factors such as co-located mental health services, training healthcare providers and provider empathetic attitudes playing a crucial role. Further research is required to evaluate the effectiveness of the integrated TB-depression screening systems towards improved health outcomes, implementation, scalability and impact on the broader healthcare system. To create a more inclusive and comprehensive TB and depression care pathway, we gathered input from both service providers and service users (TB patients, their carers). Reflective meetings with community leaders, social activists and health professionals from various sectors were also conducted during pathway delivery to get their insights. Power, gender and age imbalances were addressed by encouraging participation of patients and carers across gender and age groups. This approach ensured that the perspectives of all stakeholders were considered in the development of the care pathway.

THE RELATIONSHIP BETWEEN AGE AND DURATION OF SURGERY WITH THE INCIDENCE OF POST ANESTHESIA SHIVERING IN SECTION CAESAREAN PATIENTS AT BENDAN HOSPITAL PEKALONGAN CITY

Background: Shivering is a physiological response to exposure to cold and the body's next steps to maintain heat after peripheral vasoconstriction. The incidence of shivering is caused by several factors including age and length of surgery. Postanesthesia shivering is involuntary oscillatory muscle activity during early recovery after anesthesia. Objective: This study aims to determine the relationship between age and duration of surgery with the incidence of shivering after anesthesia in caesarean section patients at Bendan Hospital, Pekalongan City. Methods: This research includes quantitative research with the type of analytical correlational observational research with a cross sectional approach. The subjects or samples used were 50 caesarean section patients. Determination of subjects was carried out using consecutive sampling technique. Data collection was carried out using an observation sheet for the degree of shivering. Result: Based on the research, the results of the Spearman rank test were obtained with a value of (p) 0.0004 < 0.05 between age and the incidence of shivering and p 0.000 < 0.05 between the length of operation and the incidence of shivering. Conclusion: The conclusion of this study is that there is a relationship between age and length of operation and the incidence of post-anesthesia shivering in caesarean section patients.

Edukasi Dapat Menurunkan Kecemasan Pada Pasien Abortus Imminens

Background: Abortion patients often experience unstable conditions which are influenced by the condition of the fetus, one of which is anxiety. Abortion and anxiety have an impact on morbidity and death in the mother and fetus, so education is needed to reduce anxiety. Objective: This study aims to analyze the effect of education on anxiety. Method: quantitative research with research design, namely quaisy experimental design with One Group Pre-test Post-test design method. Using a consecutive sampling technique with 32 respondents using the HARS measuring instrument. The statistical test used is the Wilcoxon Signed Ranks Test. Research Results: The results of the univariate analysis showed that 87.5% of the respondents were early adults and the results of the bivariate analysis showed that the pre and post values ​​for providing education on anxiety in abortion patients obtained a p-value of 0.0001 (<0.05). So it can be concluded that H0 is rejected, which means that there is a significant effect of providing education on the anxiety of patients with imminent abortion. Suggestion: It is hoped that future researchers will be able to expand the scope of research to make it more perfect and the benefits of further researchers can be developed regarding mothers' perceptions of abortion. Apart from that, you can add or combine education with other interventions.

Airborne Benzene Concentrations Increase Trans, Trans-Muconic Acid (tt-MA) Levels and Liver Function in Workers in The Manufacturing Industry

The use of benzene as a solvent in the manufacturing industry can be dangerous because it is volatile, toxic, and carcinogenic. Exposure to benzene occurs through inhalation of the chemical in the air, which can enter the human body through the respiratory system. The levels of trans, trans-Muconic Acid (tt-MA), which is used to metabolize benzene, can be affected by the amount of exposure to the chemical. This study aims to determine the differences in exposure to benzene in the air by measuring the tt-MA indicators and liver function of workers in the manufacturing industry. This research uses an observational and cross-sectional approach, with a population of 158 employees from both administration and production units. The sample size for the study is 16 respondents, selected using the consecutive sampling technique. The research instrument uses a questionnaire and examines urine samples using the in-house method. Blood samples are examined using IFCC 37 C. The data is processed using the independent-sample t-test and Pearson correlation. The results show that the level of benzene in the air is below the threshold of 0.5 ppm. However, there is a significant difference in the results of tt-MA and SGOT (p<0.05), while the levels of SGPT (p>0.05) show no significant differences. In conclusion, there are differences in the tt-MA and SGOT exposure levels between workers in the production and toxicity units, while SGPT does not show significant differences. It is recommended that the industry maximizes the use of local exhaust ventilation and prohibits smoking.

Comparison Between Maximum Bite Force on First Molar with Prosthesis and Contralateral First Molar Without Prosthesis

Background: Bite force is an indicator of the functional state of the masticatory system that results from the action of jaw elevator muscles modified by the craniomandibular biomechanics. Bite force measurement is essential in dental treatment as an extreme bite force on tooth may affect health of periodontium and increase risk of prosthesis fracture. A patient with low biting force may be helpful for the successful long-term outcome of prosthesis. A variety of devices has been used to record human bite force. Nowadays, sensitive electronic devices are used those are both accurate and precise enough. Recently, T-scan has been more popular to record the pattern of occlusion. The T-scan system precisely and dynamically records the occlusal contact time, force, and area in percentage. T-scan identify both force and timing which are the most fundamental parameters for measuring occlusion. The present study was designed to compare maximum bite force on first molar with prosthesis and contralateral first molar without prosthesis by using T-scan. Objectives: To compare maximum bite force (MBF) on first molar with prosthesis and contralateral first molar without prosthesis. Materials and Methods: This quasi-experimental type study was conducted in the Department of Prosthodontics, BSMMU. The patients were selected by a consecutive sampling technique, requiring permanent restoration in endodontically treated first molar on one side and natural first molar on contralateral side. The selected tooth was prepared for full veneer crown following standard procedure with armamentarium. Symptomless patients up to 3 months were measured bite force on cemented prosthesis and contralateral natural tooth. Bite force was measured with T-scan for three times with 30 sec interval and highest value was recorded in a data collection sheet for each patient to compare maximum bite force on first molar with prosthesis and contralateral first molar without prosthesis in the same patient. Result: The maximum bite force at the first molar without prosthesis was 14.30 ±4.2% and first molar with prosthesis was 12.05 ±3.55%. Tooth without prosthesis maximum bite force was significantly more than the tooth with prosthesis. Conclusion: Maximum bite force was significantly higher in tooth without prosthesis than the tooth with prosthesis. The difference of maximum bite force was not statistically significant in relation to gender, age and BMI.

Fatigue and Mental Illness Symptoms in Long COVID: Protocol for a Prospective Cohort Multicenter Observational Study.

The aftermath of the COVID-19 pandemic continues to affect millions worldwide, resulting in persisting postvirus complaints and impacting peoples' quality of life. Long COVID, characterized by lingering symptoms like fatigue and mental illness, can extend beyond a few months, necessitating further research to understand its implications. This study aims to quantify the degree of physical and psychological fatigue in patients following COVID-19 infection and examine its correlation with mental health disorders. Using a consecutive nonrandom sampling technique, we will conduct a prospective cohort multicenter observational study in 5 Portuguese hospitals. Symptomatic adult patients with previous COVID-19 attending follow-up consultations will be enrolled. We will include patients who had mild, moderate, and severe acute disease. We will assess clinical outcomes related to COVID-19, including the type of respiratory support such as high-flow nasal cannula, noninvasive ventilation, and invasive mechanical ventilation. The exclusion criteria will include previous severe psychiatric disorders confirmed by a psychiatrist; refusal or inability to respond to the questionnaire; concomitant neurological disorder; persistent fatigue symptoms during the 6 months before infection; and the need for invasive mechanical ventilation during COVID-19 infection due to a high prevalence of postintensive care syndrome. Our primary outcome is the prevalence of fatigue in patients with post-COVID-19 depression and/or anxiety, as measured by the Chalder Fatigue Scale (CFQ-11) and the Hospital Anxiety and Depression Scale (HADS). The secondary outcomes will include an assessment of health-related quality of life via the EQ-5D questionnaire and an exploration of the prevalence of symptoms of posttraumatic stress disorder (PTSD) using the 14-item Posttraumatic Stress Scale (PTSS-14). We will also examine the association between mental health symptoms and the severity of acute COVID-19. The post-COVID-19 data will be collected at least 6 months after the positive test and no longer than 9 months during the clinical appointment. We expect our multicenter study on patients post COVID-19 to reveal a significant link between mental illness symptoms and both physical and psychological fatigue. Patients with heightened depression and anxiety may report increased levels of fatigue. Additionally, we expect to find persistent PTSD symptoms in a subset of participants, indicating the enduring psychological impact of the virus. This study may underscore the need for integrated care addressing physical and mental health in patients post COVID-19. The observed connections emphasize the importance of considering mental well-being for long-term health outcomes. Despite study limitations, our findings contribute valuable insights for future treatment strategies and highlight the necessity for comprehensive mental health support in post-COVID-19 care. This research provides valuable insights into the mental health implications of COVID-19 and its impact on post-COVID-19 fatigue and the overall well-being of affected individuals. ClinicalTrials.gov NCT05323318; https://clinicaltrials.gov/study/NCT05323318. DERR1-10.2196/51820.

A Comparison of Ureterorenoscopy and Extra-Corporeal Shock Wave Lithotripsy for the Treatment Of Upper Ureteric Stone Measuring Less than 1cm.

Objective: To compare the efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureterorenoscopy (URS) in the management of upper ureteric stone measuring <1cm. Methodology: Randomized clinical trial (RCT) was conducted by targeting the patient admitted in urology ward, Jinnah Hospital Lahorethrough a period of one year. A sample size of 132 patients fulfilling inclusion criteria were selected by employing Non-probability consecutive sampling technique was employed to select 132 (sample size) patients fulfilling inclusion criteria. Patients were randomly allocated into two groups (66 in each group A&B) using lottery method. In group-A, stones were treated using ESWL, while in group-B, URS was performed, and stones were broken with pneumatic energy. Data were analyzed using SPSS version 27, and a Chi-square test was conducted to compare the proportions of qualitative variables, while an independent sample t-test was applied to assess mean differences between two groups of quantitative variables. Asignificance level of ≤0.05 was adopted for determining statistical significance. Results: The sociodemographic profile of the two groups was comparable. It was seen that stone free rate nextto first session was higher in URS (81.8%) as compared to ESWL (63.6%) which later increased to 87.7% after completion of three session. The complaint of pain in ESWL was more as compared to URS (22.7% vs 12.1% p= 0.05)while the differences betweenthe rate of complications like fever, UTI, mucosal abrasion, hematuria or perforation were not statistically significant in both group. (p> 0.05) Conclusion: ESWL outperforms URS for the treatment of upper ureteric stones measuring <1cm in terms of efficacy and safety.Although not statistically significant, ourfindings suggest that URS achieves stone-free rates earlier than ESWL. However, according to our findings, ESWL is recommended as the treatment of choice for the majority of patients due to better compliance. Keywords: Extra-corporeal Shock Wave Lithotripsy, Nephrolithiasis, Ureterorenoscopy

Assess the Quality Of Life of Nurses Working In Shift Duties In Public Sector Hospital

Working in shifts is a prerequisite for nurses to help patients, jeopardizing their own physical and mental health as well as having an influence on their social and family life, consequently leading to a lack of attentiveness and subpar job performance, putting the patients' lives in peril. This study aims to assess the nurses’ quality of life working in shift duties. 255 nurses participated in a cross-sectional analytical study of a public sector hospital. Participants were selected through consecutive non-probability sampling techniques. Data was collected using demographic characteristics and the WHO SF36 questionnaire and analyzed through SPSS version 21.0. The mean age was 31.6 ±7.3 years with the majority of 67.8% female nurses. The mean experience was 8.7 ± 6.4 years, duty hours 39 ± 11.7 hours, and 31% were working night shifts. Comparing the shift duties with all seven health parameters of quality of life, and general health, social activities energy and emotions were found statistically significant P<0.05. Compared with experience, only general health was found to have a statistically significant association at P<0.005 whereas no other parameter was found to have any association. Age and marital status showed a statistically significant association moreover, education also had an association with 3 health parameters. However, the experience was found to have a statistically significant association with mental health (P<0.007). The current study concluded that the health and quality of life of nurses are negatively impacted by the stress of their shift work. It may also cast a shadow over the delivery of care, which may be one of the variables influencing patients' outcomes.

Perbedaan Efektivitas Terapi Audiovisual Dan Coolpack Terhadap Tingkat Nyeri Pada Prosedur Pengambilan Darah Anak Usia Pra Sekolah

Pain is an unpleasant sensory-nervous response experience associated with tissue damage. Pain in children during invasive procedures that are not handled properly can make them uncooperative and refuse action, which can hinder the treatment process. Long-term effects that can arise if a child's pain is not reduced or treated are the psychological and physical stress suffered by the child, such as insomnia, depression, changes in appetite, and fatigue. Efforts to overcome pain during blood sampling procedures include audiovisual therapy and cool packs. This study aims to analyze the differences in the effectiveness of audiovisual therapy and cool packs on pain levels during blood sampling procedures in preschool children. This research is quantitative with a quasi-experimental two-group posttest design. The number of samples in this study was 44 respondents, who were divided into two groups using the consecutive sampling technique. Based on the Mann- Whitney test, the results showed that there were differences in the effectiveness of audiovisual therapy and cool packs on pain levels in blood sampling procedures for preschool children, with a p-value of 0.000 (<0.05). Audiovisual therapy and cool packs can be used as nursing actions to reduce pain during blood sampling procedures in preschool children.

Effectiveness of Chlorhexidine and Povidone Iodine in Preventing Surgical Site Infections (SSIs) in C-Section Deliveries

Objective: To compare the effectiveness of Chlorhexidine and Povidone iodine in preventing SSIs in C-section deliveries. Methodology: The study was conducted at a medical university and hospital in Karachi, from January 2021 July 2021. A non-probability consecutive sampling technique was used to select 35 participants. The study included women aged 18 to 45 years. The efficacy of Chlorhexidine and Povidone iodine in preventing SSIs was evaluated. Two groups were randomly assigned, with Group 1 receiving Chlorhexidine gluconate and Group 2 receiving Povidone-Iodine for skin preparation. Data on various factors were recorded, and the occurrence of SSIs within ten days of cesarean delivery was assessed. Results: The study included women aged 18 to 45 years. The efficacy of Chlorhexidine and Povidine iodine in preventing SSIs was evaluated. The results showed that Chlorhexidine was effective in preventing SSIs in 94.3% of cases, while Povidone iodine was effective in 91.4% of cases. However, no significant difference was observed between the two groups. The study results were consistent with previous research showing a reduction in SSI rates with the use of Chlorhexidine or Povidone- iodine. The overall rate of SSI was lower in the Chlorhexidine group, but contextual factors and adherence to infection control practices may influence outcomes. Conclusion. This study augments existing knowledge on preventing SSIs in C-section deliveries. While both Chlorhexidine and Povidone-iodine demonstrated comparable efficacy, Chlorhexidine appeared slightly more effective in reducing SSIs. Nonetheless, the study's limitations underscore the necessity for further research in diverse healthcare settings.

Frequency of Vitamin D deficiency in women with polycystic ovarian syndrome.

Introduction: Approximately 20% of women who are of reproductive age suffer from the common endocrine illness known as polycystic ovarian syndrome, or PCOS. Vitamin D insufficiency is common among PCOS-affected women. The symptoms of PCOS seem to be regulated by the vitamin D pathway. According to studies, women with PCOS had high frequencies of vitamin D insufficiency, ranging from 65.0% to 70.3%. Thus, we aimed to discover how common vitamin D deficiency was in women diagnosed with PCOS.
 Methodology: This cross-sectional study was conducted at the Department of Obstetrics & Gynecology, CMH- Rawalpindi, from January to July 2022. A total of 90 women with polycystic ovarian syndrome diagnosed on Rotterdam criteria, 18 to 40 years of age, were included through a non-probability consecutive sampling technique. Pregnant female patients with chronic illnesses were excluded. After informed consent, data was collected from patients on a self-developed questionnaire. In all patients, a 3 ml blood sample was taken and sent to the institutional pathology laboratory to measure vitamin D levels. 
 Results: The patients' average age was 28.91 ± 4.85 years—ages 18 to 30 comprised most of the 48 patients (53.33%). The average time a person had PCOS was 3.64 ± 1.58 years. The average body mass index was 29.02 ± 2.43 kg/m2. Forty-one (45.56%) of the PCOS patients had vitamin D insufficiency.
 Conclusion: As the frequency of vitamin D deficiency in women with PCOS is relatively high, we recommend that early identification through screening of the affected patients should be done.

Pain intensity, physical activity, quality of life, and disability in patients with mechanical low back pain: a cross-sectional study

BackgroundPoorly managed mechanical low back pain (MLBP) and its sequelae, such as severe pain, physical inactivity, and disability, negatively impact patients’ quality of life (QoL). The study aimed to determine the pain intensity (PI), physical activity (PA), QoL, and disability, the association between selected sociodemographic variables and PI, PA, QoL, and disability, and the relationship between PI, PA, QoL, and disability among Nigerians with chronic MLBP.MethodsThis cross-sectional study employed a consecutive sampling technique. Outcome measures included the Numeric Pain Scale, International Physical Activity Questionnaire-Short Form, WHO Quality-of-Life Brief, and Oswestry Disability Index for PI, PA, QoL, and disability, respectively. Descriptive statistics were used to summarize participants’ sociodemographic variables. Chi-square, Spearman’s correlation, and structural equation modeling (SEM) were used for inferential analyses.ResultsTwo hundred and fifty chronic MLBP patients comprising 154 females and 96 males, completed the study. The mean PA, PI, QoL, and disability levels were 1118.03MET ± 615.30, 5.97 ± 2.69, 73.45% ± 14.21, and 21.7% ± 18.94, respectively. There was a significant correlation between PA and QoL (rho = 0.36, p = 0.001), PA and disability (rho = −0.42, p = 0.010), QoL and disability (rho = −0.21, p = 0.008), QoL and PI (rho = −6.72, p = 0.025), PI and disability (rho = 0.90, p = 0.022). Aside from age and PA (χ2 = 8.52, p = 0.045), there was no significant association between the sociodemographic variables and PI, PA, QoL, or disability. SEM showed a strong positive association between PI and disability (β = 0.80, p < 0.001).ConclusionIndividuals with chronic MLBP had a low PA, moderate QoL, and significant disability. Incorporating PA, QoL, and disability assessments may enhance the evaluation and management of MLBP.

Bacteriology of Otitis Externa in a Tertiary Health-care Institution in Nigeria

Abstract Background: Otitis externa is the inflammation of the external auditory canal (EAC); it may be acute, subacute, or chronic in nature and the causative agents are usually bacteria, though occasionally fungi. Aim: This study aimed to determine the prevalence of bacterial acute otitis externa (AOE) and the pattern of bacterial isolates in AOE. Material and Methods: This was a cross-sectional, hospital-based study involving 100 patients with otitis externa. Patients were recruited from ear, nose, and throat (ENT) outpatient clinic using consecutive sampling technique until the required sample size was achieved. The discharge from discharging ears was taken with ear swabs and evaluated for microbial agents. Data analysis was done using SPSS-IBM version 25. Results: A total of 100 patients were recruited; the patients aged from 4 to 57 years (mean age is 18.78 ± 10.67) years, with a male-to-female ratio of 1:1.1. One hundred and twenty-four external ear discharge samples were cultured among 100 study groups, of which bacteria was isolated in 77 (62.1%) and no bacterial agent was isolated in 47 (37.1%). Pseudomonas aeruginosa 32 (41.6%) was the most common bacteria isolated, followed by Staphylococcus aureus – 13 (16.9%); others include Proteus mirabilis – 7 (9.0%), Escherichia coli – 4 (5.2%), Streptococcus pneumonia – 4 (5.2%), Klebsiella pneumoniae – 3 (3.9%), Streptococcus pyogenes – 3 (3.9%), and Enterobacter aerogenes – 2 (2.6%). Conclusion: Otitis externa affects all age groups and genders; bacteria are a more prevalent causative agent. The common predisposing factors are the use of objects in scratching or cleaning EAC, use of earpiece, and swimming. The prevalence of bacterial otitis externa was 7.1%, and Gram-negative aerobes are the most prevalent.