Different Hospitals Of Karachi Research Articles

Occurrence of Coccydynia in Healthcare Professionals of Karachi; Pain and Straight Leg Raise Test Perspective

Coccydynia is a condition in which pain is experienced around the tailbone or coccyx region. The sitting position triggers the pain in the coccyx region especially when while patient comes from sitting to a standing position. The prevalence of coccydynia is unknown in the general population but it is more common in females than males. Objective: To determine the occurrence of coccydynia in healthcare professionals of Karachi. Methods: A cross-sectional study was conducted among healthcare professionals in Karachi from August 2023 to Feb 2024. The sample size of the study was 543 healthcare professionals. The sampling techniques which was used in this study were convenient. For the collection of data, a self-administered questionnaire was used while for the evaluation of data, two tests Visual Analog Score (VAS) and Straight Leg Raise( SLR) were used. The data were analyzed through the SPSS version 23.0 software in which we calculated the frequencies and percentages. Results: The study was done on 543 healthcare professionals between the ages of 20 to more than 59 years old who were recruited from different hospitals in Karachi. Pain intensity which was evaluated by the visual analog scale observed 223 (41.06 %) of participants found to lie in the moderate pain category while confirmation of coccydynia was done by the application of SLR and was found to be positive in 426 (78.85%) of healthcare professional's. Conclusions: The occurrence of coccydynia was found in the majority of the healthcare professionals of Karachi while the complaints of pain were found in the moderate category.

Frequency of urinary incontinence in post-partum multiparous women

Background: Urinary incontinence (UI) is a widespread condition of uncontrollable urine leakage that has been strongly linked to natural delivery problem impacting one's wellbeing and quality of life. Objective: The objective of study was to determine frequency of urinary incontinence in postpartum multiparous women in Karachi. Methods: A descriptive cross-sectional study by using non-probability convenient sampling technique was conducted at different hospitals of Karachi in a duration of seven months, June 2020 to December 2020. A total of 267 women aged between 18 to 40 years, undergoing postpartum period after normal deliveries in last one year were included in the study. Ethical permission was taken from the Institutional review board of Hayat Institute of Rehabilitation Medicine. A consent form in their native language was taken before recruiting into the study. They were asked to fill the questionnaire Bristol Female Lower Urinary Tract Symptoms (BFLUTS). Data entry and analysis was done through SPSS version 26 and descriptive analysis was done. Data was presented in frequency and percentages, however, demographic information was presented in mean and standard deviation. Results: A total of 267 women were recruited, the mean ±SD of age in years was 30.6 ±5.087 while all women were housewives. Females experienced symptoms like urgency 13.48%, bladder pain occasionally at 80.15%, and frequent visits to the toilet to urinate 41.2%. The current study discloses that 61.16% experienced urinary incontinence. Conclusion: This study concludes that urinary incontinence is moderately found in postpartum multiparous women.

Stress and its Influencing Factors among Intern Nurses during Pandemic Outbreak of Covid - 19

Objectives: To investigate the frequency of stress and its influencing factors among intern nurses during the pandemic outbreak of Covid-19 in Karachi, Pakistan.Methodology: This descriptive study was conducted among intern nurses who were working in different hospitals of Karachi, Pakistan from 15th August to 15th September 2021. A total of 400 intern nurses were enrolled by using purposive sampling technique. Inclusion criteria: Intern nurses who were assigned in Covid-19 department/units. Exclusion criteria: Intern nurses who were not willing or absent at the time of data collection. Data were collected through a questionnaire and consists of three sections: First section included a General Health Questionnaire (GHQ-12). Second section is about influencing factors of stress, and third section encompassed with demographic information. The data were analyzed by using SPSS 20.Results: Out of total 400 intern nurses, n=305 (76%) were in a high stress and n=95 (24 %) were reported a low stress. Four influencing factors were significantly (P-value<0.05) associated with level of stress of intern nurses. i.e.: Chances of having an infection (P- value=0.005), inadequate personal protective equipment (P- value= 0.000), guilt to be a nurse (P- value= 0.003), and long hours of duties (P- value= 0.001).Conclusion: Present study had explored that majority of intern nurses were in high stress and four influencing factors were significantly associated with level of stress. Such as chances of having an infection, inadequate personal protective equipment and guilt to be a nurse, long duty hours.

Mediating Role of Burnout Between the Job Demands-Control Model and Psychological Well-being in Healthcare Professionals in Pakistan

Integrating the Job Demand-Control model (JDC) with the Conservation of Resource Theory, this study tested the JDC model for the direct and indirect effects of job demands (JD) and control (JC) on the psychological well-being (PWB) of healthcare professionals working in hospitals in Karachi, along with the mediating effects of burnout. The study employed Structural Equation Modelling using SMART PLS for data analysis of a sample of 316 healthcare providers from different hospitals in Karachi. The results supported the direct effects of JD and JC on PWB and the mediating effects of burnout The findings of the study add further empirical evidence to current literature on job stress. The results indicated that healthcare professionals in Pakistan are confronted with a demanding job that causes burnout and ultimately becomes a reason for their decreased PWB. The study also presented various practical implications for different stakeholders. From a sustainability standpoint, this study indicated the need to balance job demands and job control in order to design psychologically healthy jobs.

Relationship between obesity and frailty in an old age population of Sindh, Pakistan

Objective: To identify the Relationship between Obesity and Frailty in an old age Population of Sindh, Pakistan. Methodology: A cross sectional survey was conducted in many different hospitals of Karachi, Pakistan in December 2017. A self-constructed questionnaire was used which includes which includes the demographics, health status of patients, the Body Mass Index (BMI) and to analyze the data acquired, we used SPSS version 23. Results: 89.1% (n=339) of the participants belong to age group of 60-65 years and 57.3% (n=216) were male. Moreover, the Majority (n=183, 78.8%) of the participants reported with poor health status. After checking the level of Frailty among the participants, (n=218, 58%) of the participants were found to be frail. Conclusion: This Study concluded that there is significant impact of obesity on Frailty, because as the people ages the level of calcium and vitamin D in the bones decreases, bone become fragile and cannot support the increased weight of an individual which leads to weakness and susceptibility to disease.

Influence of COVID-19 on the Mental Health of Nurses dealing with COVID-19 Patients (A Study on Nurses within Karachi)

Background: Globally Corona virus (COVID-19) has become a huge challenge for all of the population. In South Asia, country Pakistan city Karachi the 1st case of this breakdown was identified on 26th February 2020 (Waris et al., 2020). This disease has developed psychological distress among all the population. COVID virus is one of the leading threats to all the healthcare organizations and due to increase rate of patients day by day, it has given enormous burden to all healthcare workers especially nurses the front line fighters who are always ready to give care towards the patient whom they encountered so it’s very crucial part to assess the impact of COVID -19 on the mental health of the nurses. Objective: The objective of the study is to identify the frequency level of stress, anxiety and depression among nurses while dealing with those patients who were admitted in various hospitals in Karachi for treatment of COVID-19. Method: A cross-sectional study was conducted from 20th November to 31st December 2020 from different hospitals in Karachi, Pakistan. Those Registered nurses who were assigned in isolation ward of Covid-19 were the part of the study. For data collection survey form was designed based on Depression Anxiety Stress scale (DASS-21) scale (Lovibond & Lovibond 1995). Results: The total mean score of depression among nurses was 50 (68%), Anxiety was 32 (43%) and stress was 34 (46%). 50 nurses suffered from moderate depression, 24 nurses reported from extremely severe anxiety and 50 nurses suffered from moderate stress level. From 74 participants 41(55.4%) were females and 33 (44.6%) were males. Furthermore, it shows that 25 (76%) males and 25 (61%) females suffered from moderate depression, 32 nurses 14 (42%) male and 18(43.90%) females reported from extremely severe anxiety. Conclusion: This pandemic is highly complex, contagious and vulnerable. The study results portrait that nurses working with COVID-19 patients have affected a lot of various psychological distress such as anxiety, stress, and depression. It is very vital for higher management to take major steps and take preventive intervention which would be beneficial towards their mental health in decreasing negative psychological outcomes, because they all are working under pressure environment. Key Words: Stress, Anxiety, Depression, Pandemic, Registered Nurse

Psychological Wellbeing of Healthcare Workers in Different Hospitals of Karachi (Pakistan) During COVID-19 Pandemic

Background: With increasing morbidity and mortality rates throughout the world, COVID-19 has caused a universal psychological impact on the lives of people.
 Aims: To examine psychological wellbeing of frontline healthcare professionals and compare mental health among doctors, paramedical staff and allied health workers.
 Methods: This cross-sectional study included 225 healthcare professionals from 13 different hospitals in Karachi, Pakistan. The symptoms of depression, anxiety and insomnia were assessed using the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the 7-item Insomnia Severity Index (ISI) respectively.
 Results: Major findings of the study were that 44.7% participants had no depression, 38% were reported to have mild anxiety and 3.5% had severe insomnia. Insomnia was correlated with anxiety and depression leading to moderate correlation of 0.516 and 0.694 in both with a highly significant p value (p=0.001 and p=0.001). A significant association of depression was seen with healthcare providers and years of experience with (p=0.009) and (p=0.010) respectively. Levels of anxiety were associated with occupation and years of experience that led to the finding that doctors suffered more from mild anxiety (83.5%) whereas years of experience had no significant association. Correlation of insomnia with occupation and years of experience led to the finding that sub threshold insomnia was found in 29% participants, where majority of participants were allied health workers. However, borderline significant association was found between insomnia and the number of years of work experience (p=0.049).
 Conclusion: It is concluded that frontline workers experienced different levels and symptoms of psychological distress in this pandemic.

Rapid detection of ceftriaxone resistance in clinical isolates of extensively drug resistant Salmonella enterica serovar Typhi.

To see the efficacy of rapid colour test for the sensitivity of ceftriaxone against clinical isolates of salmonella typhi. The cross-sectional validation study was conducted at the Department of Microbiology, Pakistan Navy Ship Shifa Hospital, Karachi, from Nov 2018 to April 2019, and comprised clinical isolates of salmonella typhi that were obtained from five different hospitals in Karachi and Hyderabad. The isolates were tested using the rapid colour test. All the isolates were also tested using the conventional disc diffusion method and minimum inhibitory concentrations on the Vitek-2 version 8.01. Of the 97 isolates, 83(85.5%) were ceftriaxone-resistant and 14(14.4%) were ceftriaxone-sensitive. Sensitivity and specificity of the rapid colour test were 100% when compared with the results of the other methods. All the results were readable within 2 hours on the colour test. The colour test was found to be a rapid, accurate and inexpensive tool to screen for ceftriaxone resistance in typhoid-endemic areas.

Evaluation of Knowledge, Practices, Attitude, and Anxiety of Nurses towards COVID-19 during the Current Outbreak in Karachi, Pakistan

Background: Since the emergence of the novel coronavirus, the front line soldiers during this pandemic are the healthcare professionals because of their direct association with COVID19 patients. In the management of such patients, nurses play a significant role through proper care and preventive measures. Due to its contagious nature, fatality, and no proper medicine, it is a risk to the health and life of nurses and has an impact on their psychological health. The aim of the current study was to assess the knowledge, attitude, practices, and anxiety levels of the frontline nurses. Methods: It was an online questionnaire-based cross-sectional survey targeting only those nurses involved in the management of COVID-19 patients from different hospitals of Karachi, Pakistan. SPSS 21 was used for data analysis. Descriptive analysis, Chi-Square, and t-tests were applied. P-value <0.05 was considered significant. Results: Data of 78 nurses were analyzed. We observed that nurses possess good knowledge about COVID-19, its sources, symptoms, and routes of transmission of the Virus, etc. The knowledge mean score was calculated at 14.67 ± 3.36. Health Department /Hospital and social media are the main sources of information regarding COVID-19. We investigated that 92.3% of the nurses had mild to severe anxiety and anxiety levels are significantly higher among females (P<0.05). Conclusion:-We concluded that the nurses performing their duties with COVID-19 positive patients have good knowledge and attitude. But their anxiety levels are high. Psychological interventions along with training should be given.

A Cross-sectional Analysis of Prevalence, Coping Strategies and Potential Causes of Depression among Doctors of Karachi

Aims: The aim of current study is to find out the prevalence of depression in doctors in different hospitals of Karachi and its association with lifestyle, the field of specialty and coping mechanisms.
 Place and Duration of Study: The sample was collected from 10 different hospitals of Karachi, in a period of one Year i.e., March 2019 to February 2020.
 Methodology: A descriptive cross-sectional study design using non-probability consecutive type of sampling technique was used. Sample size was calculated at 95% confidence interval and was found to be 368. The sample was classified in two broader categories Surgery & Allied and Medicine & Allied. For identification of depression level, Public Health Questionnaire (PHQ-9) was used. A 28-item questionnaire Brief COPE was used to asses coping mechanisms.
 Results: In total 400 forms were used for data analysis. The mean age of doctors was 35 ± 4 years, 65% were males while 35% were females, there was a statistically significant association of female gender with depression. Chi-Square was applied to determine the association of depression and departments and it was found to be highly significant with a P < .001. Highest level of depression was found in Orthopedics and Psychiatry departments followed by Surgery and Gynecology. While Otolaryngology was the least depressed department. Chi-square was applied and a statistically significant association of low monthly income and depression with a p-value of 0.02. In Surgery and allied there was a statistically significant association of depression with extensive working hours and lack of facilities with a p-value of 0.01 and 0.04. While in Medicine and allied there was a statistically significant association of depression with a harsh attitude of seniors and an uncomfortable working environment with a p-value of 0.02 and 0.03. A linear regression model comparing depression and its associations with coping strategies was applied.
 Conclusion: Our study shows that depression is present in a vast majority of doctors from multiple specialties. Various risk factors for depression have also been identified so appropriate coping strategies should be formulated to deal with it.

Hearing assessment and status of tympanic membrane pre and post-operated tympanoplasty in cases of CSOM.

Objectives: To compare assessment of hearing by PTA and status of tympanic membrane by oto-endoscope, pre-operative and post-operative tympanoplasty. Study Design: Retrospective/ Comparative study. Setting: Two different hospitals in Karachi. 1-Social Security Landhi Hospital Karachi. 2- Al-Tibri medical College & Hospital, Old Thana, Malir, Karachi. Period: July 2017 to June 2018. Material & Methods: 76 patients were included for this study with both genders who had dry tympanic membrane perforations. Age ranges between 18 to 40 years. Made two groups A (pre-operative and B (post-operative). In group-A, examined tympanic membrane perforations. 45 patients had small size (25%) perforations, 15 medium size (50%) and 16 subtotal (75%). Hearing assessment done by Pure tone Audiometry (PTA). After 1. 2 and 3 months post-tympanoplasty, examined grafted tympanic membrane and compared pre-operated status of tympanic membrane with post-operated status of tympanic membrane. PTA done after 3 months and compared it with pre-operated PTA. Results: Examination of tympanic membrane before tympanoplasty performed, perforations noted in all patients with different sizes in their tympanic membrane. PTA (pure tone audiometry) advised before tympanoplasty to all patients. Weber test performed on 1st post-operated day, it was lateralized towards operated ear which indicate the safety of inner ear. Post-operated 1, 2 and 3 months examined tympanic membrane with oto-endoscope. Intact grafted tympanic membrane seen in 70 patients after 1 months. After 2 months 72 patients had intact grafted tympanic membrane and after 3 months 73 patients out of 76 patients had intact grafted tympanic membrane. PTA also advised after 3 months of tympanoplasty and compared it with pre-operated pure tone audiometry (PTA). Air conduction (AC) decreased 15.39dB after tympanoplasty. AB-gap reduction 13.95dB seen in 73 patients which showed hearing improvement. P value is < 0.001 significant. Conclusion: Tympanoplasty is a good and safe procedure for hearing improvement by reduction of AB-gap as well as provide protection of middle ear mucosa from infections due to closure of perforations of tympanic membranes.

PHYSIOTHERAPISTS’ APPROACH REGARDING SPASTICITY MEASUREMENT SCALES IN PATIENTS WITH UPPER MOTOR NEURON SYNDROME

OBJECTIVE: To determine the physiotherapists’ approach regarding spasticity measurement scales in patients with upper motor neuron syndrome.METHODS: This cross-sectional study was conducted in different hospitals of Karachi from January 2018 to June 2018. One hundred physiotherapists with an interest in the neurological rehabilitation were enrolled by using convenience-sampling technique. After taking written informed consent, a questionnaire comprising of close-ended questions was distributed among the participants. Extraction sheet was used to extract the recorded response; later was analyzed using SPSS v 21.0.RESULTS: Out of 100 physiotherapists, 90 responded (response rate of 90%), where 60 (66.6%) participants were males and 30 (33.3%) were female. Fifty-five (61.11%) participants responded that they use assessment scale of tone for shoulder complex, seven (7.78%) used biomechanical approaches, five (5.56%) used neurophysiological, three (3.33%) use both biomechanical as well as neurophysiological approach for the assessment of tone in shoulder complex and twenty (22.22%) did not use any measurement scale. Out of 55 participants using any assessment scale, twenty (36.4%) used Modified Ashworth Scale (MAS), while rest of thirty-five (63.6%) used three grade muscle tone scale with different combination: mild/moderate/severe] by twenty (36.4%); flaccid/normal/spastic by five (9.1%), and +/++/+++ by ten (18.1%) participants.CONCLUSION: Majority of participants in this study use unreliable assessment tools for the assessment of tone in upper motor neuron syndrome. They need to be encouraged to use valid and reliable tools for assessment.

Determination of antimicrobial effect of protamine by transmission electron microscopy and SDS PAGE on Pseudomonas aeruginosa isolates from diabetic foot infection.

Objective(s):Diabetic foot infection is one of the major complications of diabetes leading to lower limb amputations. Isolation and identification of bacteria causing diabetic foot infection, determination of antibiotic resistance, antimicrobial potential of protamine by electron microscopy and SDS-PAGE analysis, arethe aims of this study.Materials and Methods:285 pus samples from diabetic foot infection patients were collected from different hospitals of Karachi and Capital Health Hospital, Halifax, Canada. Clinical history of each patient was recorded. Bacterial isolates were cultured on appropriate media; identification was done by morphology, cultural and biochemical tests. Effect of protamine against multi drug resistant strains of Pseudomona aeruginosa was checked by minimum inhibitory concentration in 96 well micro-titer plates. The isolates were grown in bactericidal concentration of protamine on plates to isolate mutants. Effect of protamine on protein expression was checked by SDS- PAGE and ultra-structural morphological changes by transmission electron microscopy.Results:Results indicated prevalence of foot infection as 92% in diabetic patients. Major bacterial isolates were Staphylococcus aureus 65 (23%), P. aeruginosa 80 (28.1%), Klebsiella spp. 37 (13%), Proteus mirabilis 79 (27.7%), and Escherichia coli 24 (12%). These isolates were highly resistant to different antibiotics. MIC value of protamine was 500 µg/ml against P. aeruginosa. SDS-PAGE analysis revealed that protamine can suppress expression of various virulence proteins and electron micrographs indicated condensation of cytoplasm and accumulation of protamine in cytoplasm without damaging the cell membrane. Conclusion: P. aeruginosa and S. aureus were the major isolates expressing multi-drug resistance and protamine sulfate represented good antimicrobial potential.

Relationship Between Job Satisfaction And Turnover Intention

This study examines the level of job satisfaction and turnover intention among nurses in Karachi. The objectives of this study is to examine the impact and relationship of satisfaction with organizational policies and strategies, satisfaction with supervision, compensation levels, task clarity, and career development on turnover intention. An instrument based on five facets of job satisfaction and turnover intention was developed based on literature reviews to find out the level of job satisfaction and turnover intention. For this purpose data were collected from 400 nurses working in different hospitals of Karachi. The findings shows that satisfaction with organizational policies and strategies, satisfaction with supervision, compensation levels, task clarity, and career development all have significant negative correlation with turnover intention and overall job satisfaction was found to have a significant negative association with turnover intention.

Frequency, Awareness, and Symptoms of Chikungunya Among Patients in a Tertiary Care Hospital of Karachi: A Cross-Sectional Study.

Background Chikungunya fever (CHIKF) is an infectious illness spread by the bite of mosquitoes and caused by an arbovirus known as Chikungunya virus (CHIKV). This disease has become an epidemic in Karachi and various other cities of Pakistan, affecting a large population, especially those from poor, socioeconomically underdeveloped areas. It is proving to be a severe and alarming cause of debility due to its prolonged detrimental effects on the joints. A significant number of cases are reported daily in different hospitals of Karachi, with Civil Hospital being one of the major tertiary care hospitals. The aim of this study is to determine the frequency and symptoms of chikungunya as well as to assess the participants’ awareness about the spread and preventive measures of this disease.MethodsThis is a cross-sectional study that was carried out in Civil Hospital Karachi by approaching patients in the out-patient department (OPD) and the emergency department with complaints of fever and joint pain. All the data was collected via a pre-coded questionnaire during May-June 2017 by taking prior informed verbal consent and were analyzed through Statistical Package for the Social Sciences (SPSS) version 22 software.ResultsThe age group most affected by this disease was the 21-30 years range, which represented almost a quarter of the cases (n=83, 32.17%). Majority of the respondents (n=214, 82.95%) had heard of the disease, mainly due to their own prior experience with it (n=100, 38.76%). Lethargy (n=219, 84.88%), difficulty in walking (n=213, 82.56%), and headache (n=209, 81.01%) were the major symptoms reported apart from fever (n=258, 100.00%) and arthralgia (n=258, 100.00%).ConclusionCHIKF is proving to be a great threat to people as it impairs their quality of life to a great extent. The recent outbreak of chikungunya has victimized a considerable population of Karachi. This study mainly assessed the severity of the disease and its symptoms as well as the lack of awareness among patients. Proper and effective preventive measures can further help to eradicate this disease on a large scale and prevent future epidemics.

Hospital Waste Management in Hospitals of Karachi, Sindh, Pakistan

Hospital Waste (HW) constitutes a special category of waste because they contain potentially infectious materials. The problem of how to manage HW has become one of critical concerns in developing countries. The present study was conducted to evaluate the awareness regarding different constituents of wastes, their handling, treatment and disposal methods in different hospitals of Karachi, Sindh, Pakistan. Four (4) hospitals, 2 Government and 2 Private Hospitals were surveyed using a modified survey questionnaire for hospital waste management. This questionnaire was designed in the light of regulation of Sindh Hospital Waste Management Rules 2014, established by Government of Sindh, with the aim of implementing these rules in healthcare processing systems for HW handling, treatment and disposal. As result, hazards associated with poor HW management and shortcomings in the existing system were identified. Keywords — Hospital waste disposal, Waste management, Biohazardous Waste, Infectious waste, Segregation, Incineration, Sindh Hospital Waste Management Rules 2014, DOI : 10.7176/JNSR/9-12-06 Publication date :June 30 th 2019

Study of class 1 integrons in multidrug-resistant uropathogenic Escherichia coli isolated from different hospitals in Karachi.

Objective(s): Escherichia coli is the key pathogen in the family producing ESBL (extended spectrum β-lactamase) and associated with community-acquired infections. Therefore, this study was planned to determine the antibiotic susceptibility pattern of uropathogenic E. coli, prevalence of the ESBL gene group and class 1 integrons.Materials and Methods:Clinical isolates of uropathogenic E. coli were isolated from different hospitals of Karachi. Antibiotic susceptibility test was performed by Kirby-Bauer Methods. Presence of β– lactamases genes (CTX, TEM, and SHV) and integron 1 were identified by polymerase chain reaction (PCR).Results:Out of 500, 105 isolates were identified as multi-drug resistant (MDR) uropathogenic E. coli. The subject MDR isolates showed the highest resistance to aztreonam, amoxil/ clavulanic acid, ampicillin, cotrimoxazole, ceftriaxone, cefipime, and cefuroxime. Genetic analysis showed that the majority of the MDR E. coli carry CTX M1 (57.1%) followed by TEM (33.3%) and SHV (9.5%). Moreover, 79% of MDR E. coli harbored class 1 integrons, whereas all three conserved genes for class 1 integrons were present in 58% of MDR E. coli. Conclusion:This study is helpful to provide information regarding the antibiotic susceptibility pattern, distribution ESBLs and class 1 integrons among uropathogenic E. coli.

IMPACT OF PRESSURE WORKLOAD EXERCISES ON FUNCTIONAL ACTIVITIES OF HEMIPLEGIC PATIENTS

OBJECTIVES Stroke is the progressive neurological disorder with the global prevalence of around 2.67%. Many patients with hemiplegic stroke encounter mobility restriction, particularly having difficulty with independent walking. Pressure Workload exercises will help to improve active daily living (ADLs), balance problems and muscular weakness in stroke patients. The present study aims to identify the effects of pressure workload exercises on reducing functional limitations and disability in stroke survivors. METHOD A Randomized control trial (RCT) was conducted on sixty (60) patients recruited from the outpatient departments of different hospitals in Karachi. The patients were randomly assigned in one of the two groups after making the initial assessment on Barthel index. Control group received conventional physiotherapy treatment including active or active assisted range of motion exercises, stretching of upper and lower limbs, weight bearing and balancing exercises whereas the experimental group received pressure workload exercises of upper and lower limbs and 20 minutes gait training. RESULTS Pressure workload exercise significantly improves functional activities and quality of life (QoL) of hemiplegic patients (p<0.05).

Utilization and Impact of Electronic and Print Media on the Patients' Health Status: Physicians' Perspectives.

Aims:Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors’ opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients.Setting and Design:The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence.Methods and Materials:Physicians’ perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance.Results:In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource.Conclusions:Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media.

PNEUMONIA SEVERITY INDEX (PSI)

Morbidity and mortality due to community acquired pneumonia has beenincreased in our country. Children and old age patients are mostly effected due to communityacquired pneumonia Study design: Cross sectional study. Setting: Patients hospitalized forCommunity acquired pneumonia in four different hospitals located at different areas werestudied. Period: Three years period from August 2011 to August 2014. Objectives: To assessdemographic profile, pneumonia severity index and length of stay of community acquiredpneumonia patients hospitalized at different hospitals in Karachi. Method: 800 patients bothmale and females patients were included in this study. Results: It was found that 480 (60%)were males and 320 (40%) were females, males were significantly more frequent (c2=0.48,p˂0.05) than the females patients. There was a significance difference in numbers of differentage group patients. According to the age distribution, there were 222(27.75%) from 1-5 years,which was the highest among the patients and there were 44(5.5%) from 81-90 years of agegroup patients, which was least among the different age group patients. According to thecomorbidity most of the patients were found without comorbidity there were 456(57%) patientspossess no comorbidity. Patients with comorbidity were 344(43%), and comorbidity was foundin patients with hypertension were 131(16.4%) and patients with diabetes were 105(13.1%) thesewere the two most commonly comorbidity disease found. According to the socioeconomicstatus (SES) status there were 482(60.25%) patients from lower SES class, 270(33.8%) patientfrom middle SES class and 54(6.8%) patients from high Socioeconomic class. patient with lowSES were much higher at hospital C and hospital D.(c2=127.88,p˂0.05). CAP is more frequentin married patients, married patients status were much higher at hospital C and hospital D(c2=60.31, p˂0.05). According to the PSI segregation there were 424(53%) patients from PSIclass I, 168(21%) were from PSI class II, 128(16%) patients were from PSI class III, 44(5.5%)were from class IV and 36(4.5%) were from PSI class V. Mean length of stay (LOS) was greaterat hospital C and D as compare to other two hospitals. Conclusion: CAP is frequent amongmales, low socio-economic, hypertensive individuals and patients from 1-5 years of age. Theshortest mean length found was 3.6days at hospital A and the longest mean length of stayfound was 7.6 days at hospital D.