Sehat Hospital Research Articles

Assessment of gastroesophageal reflux disease signs, symptoms, and food behaviors concerning mental health in Herat, Afghanistan: A descriptive study.

Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder with modifiable risk factors that are associated with considerable health and economic burdens. The current study was conducted to assess the signs and symptoms, food behaviors, depression, anxiety, and stress related to GERD in Herat, Afghanistan. A descriptive study was conducted between August 29 and October 20, 2020, among patients with GERD symptoms, who provided informed verbal consent at the Mowaffaq Clinic and Sehat Hospital in Herat, Afghanistan. The minimum sample size was 384. Data were collected using a three-domain questionnaire and Depression, Anxiety, and Stress Scale 42 standard questionnaire. SPSS version 27 was used to perform descriptive statistics and χ 2 tests. The sample consisted of 396 patients, with the majority being female (67.9%), married (78.5%), and illiterate (34.8%). Heartburn (88.1%) and regurgitation (84.3%) were the most common symptoms reported by participants. Tomato consumption (60.1%) was the most frequent type of eating behavior. Most patients reported severe anxiety (45.9%) and showed statistically significant differences in age, sex, education level, and cigarette usage. This study also found that certain demographic status, eating behaviors, and symptoms were associated with significantly different depression, anxiety, and stress scores among patients with GERD. Our study demonstrates the association between GERD and various modifiable risk factors in Herat, Afghanistan. Public health initiatives focusing on preventive measures and raising awareness can potentially alleviate the burden of GERD. Moreover, further research and targeted interventions are essential to improve health outcomes, particularly among patients with GERD, who may experience psychological comorbidities.

Using Mobile Health (mHealth) Applications to Improve Access to Healthcare in Afghanistan

This study investigates the utilization of mobile health (mHealth) applications to improve healthcare access in Afghanistan. The research employs a mixed-methods approach, combining qualitative interviews and quantitative surveys with healthcare providers, patients, technology experts, and health administrators at Sehat Hospital in Kabul. Through thematic analysis of interview data and descriptive and inferential analysis of survey responses, the study explores the current landscape of mHealth applications, including their availability, features, usage patterns, and perceived impact on healthcare delivery and patient outcomes. The findings reveal diverse perceptions among participants regarding the accessibility, relevance, and effectiveness of mHealth interventions in Afghanistan. Challenges related to security, cultural adaptation, and user awareness are identified, alongside opportunities for enhancing the design and implementation of mHealth solutions. The study contributes valuable insights into the potential of mHealth applications to address healthcare disparities and improve patient outcomes in resource-constrained settings like Afghanistan. Recommendations for policymakers, healthcare providers, and technology developers are provided to optimize the use of mHealth technologies and maximize their impact on healthcare delivery. Overall, this research underscores the importance of contextually relevant and user-centered approaches in leveraging technology to advance healthcare access and quality in Afghanistan.

The Correlation between Thrombocyte, Hematocrit, and Leukocyte Count with Length of Hospitalization in Pediatric Patient with Dengue Hemorrhagic Fever (DHF)

Dengue Hemorrhagic Fever (DHF) is a disease caused by dengue virus with mosquito vectors. Supporting examinations to determine the course of DHF include platelet counts, hematocrit values, and leukocyte counts. Length of hospitalization is the number of days when the patient receives treatment in the hospital, calculated when recorded as an inpatient until discharge from the hospital. This type of research is an analytic observational study with a cross sectional research design. Cases of pediatric DHF at Bina Sehat Hospital Jember for the period 2020-2022 totaled 296 patients. Data were obtained using medical records. Of the 296 cases of pediatric DHF, samples were then taken by purposive sampling according to the researcher's criteria until 44 samples were obtained. The data were then analyzed using Rank Spearman. The results of the data analysis showed that there was a strong opposite relationship (p = 0.000; r = -0.562) between platelet count and length of hospitalization, a strong unidirectional relationship (p = 0.001; r = 0.495) between hematocrit value and length of hospitalization, and a strong opposite relationship (p = 0.005; r = -0.415) between leukocyte count and length of hospitalization. Suggestions for future research are to use other variables such as nutritional status, medical history, and other laboratory examinations. Keywords: Dengue Hemorrhagic Fever; Length of Hospitalization; Thrombocyte; Hematocrit; Leukocyte

COMPARISON OF LIMB SALVAGE WITH MEGA PROSTHESIS VERSUS AUTO GRAFT RECONSTRUCTION AFTER CRYOTHERAPY IN LIMB SARCOMA PATIENTS

Osteosarcoma is the most common primary malignant bone tumor, with children and adolescents being the most at-risk population. It accounts for 2% of all childhood tumors. The main goal of this study was to compare the use of limb salvage with mega prosthesis versus auto graft reconstruction after cryotherapy in patients with limb sarcoma. This retrospective study was conducted at Liaquat College of Medicine and Dentistry Darul Sehat Hospital Karachi from June 2023 to August 2023. The data was collected with the permission of the hospital's ethical committee. A standard uniform management protocol was adopted for each case. All patients were skeletally immature, with the predicted overall growth of less than 3 cm calculated using the Multiplier method. The data was collected from 45 patients with a mean age of 13.8±4.6 years. The predominant type of tumor was Osteosarcoma (77.14%) followed by Ewing Sarcoma and Chondrosarcoma. Five patients required a more extended hospital stay after mega prosthesis as compared to the other group. It is concluded that patients with limb sarcomas treated with Mega prosthesis had better functional outcomes than those treated with autograft reconstruction after cryotherapy.

The Correlation between Waiting Time and Patient Satisfaction in the Outpatient Unit at the Gateway Sehat Hospital, Mahulu Ujoh Says

This type of quantitative research uses descriptive analytic methods with a cross sectional approach. In this study, researchers wanted to know the relationship between waiting time and patient satisfaction in the outpatient unit at the Gateway Sehat Mahulu Ujoh Bilang Hospital in 2023. The sampling technique used non-probability sampling with the accidental sampling technique, which is a sampling technique based on chance, so that researchers can sample anyone they meet without prior planning. The population in this study were patients who visited the outpatient unit at the Gateway Pratama Hospital, Mahulu Ujoh Bilang, with a total of 213 respondents. The results of the Chi Square statistical test for the SPSS 25 program in table 4.8 obtained a P-value < α where the P-value (0.000) < α (0.05) so that it can be concluded that there is a significant relationship between waiting time and patient satisfaction in the outpatient unit at the Gateway Sehat Mahulu Ujoh Bilang Hospital in 2023. There is a significant relationship between waiting time and patient satisfaction in the outpatient unit at the Gateway Sehat Mahulu Ujoh Bilang Hospital in 2023.

Association of LH/FSH Ratio with Thyroid Stimulating Hormone and Prolactin Levels in Women with Polycystic Ovarian Syndrome in Pakistan

Objective: The aim of our study is to find the association of Luteinizing Hormone/Follicle Stimulating Hormone ratio (LH/FSH ratio) with Thyroid Stimulating Hormone (TSH) and prolactin levels in women with Polycystic Ovarian Syndrome (PCOS).Methods: An observational cross-sectional study was conducted in the gynecology and endocrine outpatient departments of Darul Sehat hospital from March to December 2019. The demographic data were noted, and lab investigations were done on 2nd and 3rd day of menstrual cycle. All cases were divided into 2 groups, one with LH/FSH ratio ≤2 and other >2. All females of reproductive age 15-44 years who were diagnosed with PCOS according to Rotterdam criteria were included. Results: Of 130 women, the mean age was 26.16 ± 5.81 years. There were 103 (79.2%) women found with LH/FSH ≤ 2 and 27 (20.8%) with LH/FSH > 2. Mean difference of TSH was found significantly higher in PCOS women with LH/FSH > 2 as compared to LH/FSH ≤ 2 i.e., 3.74 ± 6.49 vs. 2.32 ± 1.54 respectively (p-value 0.049). While an insignificant mean difference of PCOS with LH/FSH was found with prolactin (p-value 0.536) and insulin (p-value 0.902). A significantly weak positive correlation of prolactin was found with LH/FSH ratio (r: 0.191, p-value 0.029).Conclusion: A significant correlation was found between LH/FSH ratio and TSH levels in women with PCOS which justifies the need for further evaluation. Therefore, thyroid function should be assessed in women with PCOS with raised LH/FSH ratio which would help in management.

Adult Cancer Patients’ Quality of Life After Outpatient Chemotherapy with JKN Coverage

Adult cancer patients who received chemotherapy with JKN coverage were enrolled on this observational cross-sectional study to evaluate their quality of life (QOL) and to identify the associated variables that affected QOL. Eligible patients who received outpatient chemotherapy at Keluarga Sehat Hospital were asked to complete an EORTC QLQ-C30 questionnaire, as well as a socio-demographic inquiry. We collected answers from 53 patients and converted them into EORTC dimensions and symptoms. One-way analysis of variance was used in addition to descriptive statistics and independent t-tests. The QOL average score was 78.93 ± 20.89, with a 95% CI (73.31-84.55). The highest performance was on the cognitive scale (94.03 ± 16.85), while the poorest was on the role scale (73.27 ± 27.91). Pain (95% CI [24.05, 36.95]) and fatigue (95% CI [23.14, 35.98]) were the most troubling symptoms reported. The marital status (p < 0.05) and cancer treatment history (p < 0.01) were factors affecting our population’s QOL. Through the understanding of the relationship between QOL and socio-demographic and medical variables, oncologists, chemotherapy providers, and health insurers can improve the quality of life of vulnerable populations.

DIFFERENCES IN LEVELS OF KNOWLEDGE AND BEHAVIOR OF COVID-19 PREVENTION BETWEEN MEDICAL PERSONNEL AT CUT NYAK DHIEN GENERAL HOSPITAL AND HARAPAN SEHAT HOSPITAL

The role of health workers is the most important part in tackling the Covid-19 pandemic. All coping policies affect the services provided in hospitals so that they have a negative impact on the health care sector. To reduce the transmission rate, good knowledge and behavior is needed for health workers. The purpose of this research is to know the differencelevel of knowledge and behavior of Covid-19 prevention among medical staff at Cut Nyak Dhien Hospital and Harapan Sehat Hospital. The type of method in this research is quantitative. The data collection technique used a questionnaire with a total sampling technique and the number of samples was 128 people. The analysis used is the chi square test and Independent Sample T-Test. The results showed that there was a relationship between the level of knowledge and behavior of Covid-19 prevention at Cut Nyak dhien Hospital and Harapan Sehat Hospital with scoresP-value= 0.068 and 0.001 (p <0.05) while the Independent Sample T-Test showed that there was a significant difference between the knowledge of health workers at Cut NyakDhien Hospital and Harapan Sehat Hospital with a p valuevalue=( 0.039) < 0.05 while for prevention behavior the value isp-value=(0.009) <0.05 conclusion: There are differences in the level of knowledge and preventive behavior of medical personnel in the hospital.

Factors associated with parental self-medication for common childhood illnesses during the COVID-19 pandemic: a single centre study

Background & Objective: People's interest regarding self-medication increased during the first half of 2020, when the COVID-19 was proclaimed a pandemic, although it has always persisted due to multiple factors. We aimed to identify the factors associated with the use of parental self-medication for their child’s illness during the COVID-19 pandemic.
 Methodology: A cross-sectional descriptive study was conducted at the pediatrics department at Darul Sehat Hospital, Karachi. An interviewer-administered questionnaire was used. We included 275 parents visiting the outpatient clinics with their children of ages 1 to 12 y. Chi-square test of independence was used to check the association of self-medication with studied factors. P-values less than 0.05 were considered significant.
 Results: Out of 275 parents, 85% were practicing self-medication. 60.3% children suffered from some illness. Parents sought medical advice from pharmacists in 65% of cases, and allopathic drugs were preferred in 64% of cases. 70% of the patients used medicine until recovered, while 41.9% had to seek medical advice. Frequent symptoms obsereved and treated with self-medication were headaches 19.2% and fever 18.8%.
 Conclusion: Parental self-medication for common childhood illnesses was substantially more prevalent during the COVID-19 pandemic. Allopathic medicines were preferred choice of parents while pharmacists were commonly consulted for information regarding drugs.
 Abbreviations: OTC: Over-the-counter;
 Key words: Self-medication; Side effects; Pharmacists: Medications; Antipyretics
 Citation: Saeed F, Bham SQ, Mohammed Iqbal M, Sharif UHA. Factors associated with parental self-medication for common childhood illnesses during the COVID-19 pandemic: a single centre study. Anaesth. pain intensive care 2023;27(3):405−412.
 DOI: 10.35975/apic.v27i3.2097
 Received: December 26, 2022; Reviewed: January 15, 2023; Accepted: April 13, 2023

Effectiveness of Basic Life Support Training Workshop among Nurses: A Quasi-Experimental Study

Cardiac arrest is fatal if immediate and fast care is not provided by basic life support within the first three to four minutes following cardiac arrest increases the chances of survival. The cardiac arrest must be considered a medical emergency. Cardiovascular arrest is one of the leading causes of death worldwide. Objective: To evaluate the effectiveness of basic life support training workshop on nurse’s knowledge and practice at a private tertiary care hospital of Karachi. Methods: This hospital-based quasi-experimental study was accomplished at Darul Sehat Hospital, Karachi. The study duration was three months, from January to March 2020. The sample size was calculated through GPower; the estimated sample size was 35 nurses. The collected data was analyzed by using software named SPSS version-20. The mean score of pre- and post-basic life support training was computed by using paired t-test and McNemar. p-value ≤ 0.05 is considered the level of significance. Results: Before the basic life support training session, only 13 (27.1%) participants performed good in the knowledge test, while after training, 35 (100%) participants achieved a good result in the knowledge. In the skill test, the percentage of participants passing the scenarios increased significantly by 94.3%, with a p-value=0.001. Conclusions: It is concluded that basic life support training workshops significantly improved the nurses' knowledge and performance related to cardiopulmonary resuscitation. Hence, it is recommended that periodical training of basic life support is essential for nurses to enhance their knowledge and skills that improve victim survival

Impact of Breast Feeding On Diarrhea and Pneumonia Among Vaccinated Children: Single Center Study

The best way to give babies the nutrition they need to grow and develop is through breast milk. Objective: To assess the combine effect of breast feeding, Rota virus vaccine and Pneumococcal vaccine on frequency of Diarrhea and Pneumonia in children less than 5 years of age. Methods: A descriptive cross-sectional study conducted at Department of Pediatrics at Darul sehat hospital, Karachi. Participants were selected by convenience sampling and interview-based questionnaire was used. 196 Participants were interviewed which included mothers of infant and children from 6 months to 5 years of age, who received complete or partial vaccination according to Expanded program of Immunization (EPI) schedule with information on history of diarrhea and pneumonia. Infant and children with bloody diarrhea were excluded. Results: Among the 196 participants, 152 (77.6%) children received breast feed,72(47.4%) children received two doses of Rota vaccine and 128 (84.2%) children received three doses of Pneumococcal vaccines. Significant impact was seen with breast feeding and Rota vaccine on the frequency of diarrhea with p value of 0.0001. Breastfeeding and the pneumococcal vaccine both had a similar potent effect on the prevalence of pneumonia, with a p-value of 0.006. Conclusions: Our study highlights the importance of breast feeding in vaccinated children, with incidence of diarrhea in breastfed, vaccinated children decreased to (32%), compared to 93% in non-breastfed, unvaccinated infants. Similarly, only 33% of breastfed, vaccinated children developed pneumonia, compared to 85% of unvaccinated, non-breastfed infants.

Clinical and Radiological Correlation of Spinal Tuberculosis

Objective: The aim of this study is to establish a comprehensive understanding of the clinical and radiological features of spinal tuberculosis, and to evaluate their correlation in order to enhance diagnostic accuracy, management strategies, and patient outcomes. Study Design: This was a retrospective, observational, cross-sectional study. Place of Study: The research was conducted at the Department of Neuro-Sugery, Darul -Sehat Hospital and Neurology and Radiology Department of Creek General Hospital, both tertiary care hospital of Karachi. Duration of Study: Data were collected over a period of two years from January 2021 to December 2022. Methodology: A total of 120 patients diagnosed with spinal tuberculosis were included in this retrospective, observational, cross-sectional study.. Demographic data, clinical presentations, laboratory findings, and radiological findings were collected and analyzed. The radiological features were assessed using X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) scans. Statistical analysis was performed to identify correlations between clinical and radiological findings and their associations with patient outcomes. Results: The mean age of patients was 46.3 years, with a slight male predominance. The most common clinical manifestations were back pain (89.3%), neurological deficits (57.3%), and constitutional symptoms (45.3%). The thoracic spine was predominantly affected (61.3%), followed by the lumbar (28%) and cervical regions (10.7%). Radiological findings demonstrated vertebral destruction (90.7%), disc space narrowing (83.3%), paravertebral abscesses (76%), and epidural involvement (58%). A strong correlation was observed between the severity of clinical manifestations and the extent of radiological abnormalities. Patients with extensive vertebral destruction and spinal cord compression showed significantly higher rates of neurological deficits. Conclusion: This study highlights the crucial role of clinical and radiological correlation in the diagnosis and management of spinal tuberculosis. Early recognition of the disease, prompt initiation of appropriate treatment, and regular monitoring of clinical and radiological progress can significantly improve patient outcomes and reduce long-term complications. Keywords: spinal tuberculosis, clinical features, radiological features, correlation, diagnosis, management, prognosis.

EVALUASI PENGELOLAAN OBAT PADA EMERGENCY KIT DI RUANGAN RAWAT INAP PADA RUMAH SAKIT BINA SEHAT JEMBER

Emergency kit management is an important thing to get pay attention because it might be prompt the sentinel event and undesirable effect. Emergency preparations are the medicines that categorized as life saving or life threatening medicines including the medical devices that support emergency condition. The purpose of this study was to determine the percentage of medicine management of emergency kit. The type of research used is descriptive qualitative research and cross sectional (point time approach). The research was conducted in June 2018 at Bina Sehat Hospital Jember. Population and sample in this research is all the medicine management of emergency kit which exist in inpatient room of Bina Sehat Hospital Jember. The sampling technique used is total sampling technique, where all the population used as sample. Research tool of data collection used in this research is using check list. The result of medicine management of emergency kit percentage in inpatient room of Bina Sehat Hospitel Jember regarding the storage management of medicines in emergency kit as much as 59% according to SOP. Distribution of medicines in emergency kit as much as 86,7% according to service guidelines. Replacement medicines that has been used as much as 83% according to SOP. Replacement medicines that damaged or expired as much as 66,6% according to SOP. Monitoring of medicines in emergency kit as much as 84% according to SOP.

Reliability Of Orthopantomogram In Comparison To Lateral Cephalogram For Linear Mandibular Measurements.

Mandibular asymmetries are commonly seen as asymmetric traits among orthodontic and orthognathic patients which require bilateral mandibular assessment for diagnosis and treatment. An orthopantomogram can be used to measure and compare right and left sides of mandible. The objective of this study was to investigate the reliability of left and right sides of orthopantomogram for determining the linear mandibular measurements and to check whether these values are identical with the values of linear mandibular measurements determined from lateral cephalogram. Orthopantomogram and lateral cephalogram were taken from 118 patients of age group 12-35 years from Orthodontic department, Liaquat College of Medicine & Dentistry and Darul Sehat Hospital, Karachi, Pakistan. Linear mandibular measurements were detected and compared between orthopantomograms and lateral cephalograms. Right and the left sides of orthopantomograms were compared for all of the linear mandibular parameters by using paired t-test. Independent sample t-test was performed for the comparison between orthopantomogram and lateral cephalogram using SPSS version 26.0. Statistically significant differences were observed when orthopantomograms were compared with lateral cephalograms for mandibular body length (p=0.000) and total mandibular length (p=0.000). No statistically significant difference was found between orthopantomograms and lateral cephalograms for ramus height (p=0.226, p=0.177). Neither any significant difference was observed between right and left sides of an orthopantomogram. An orthopantomogram can be used to evaluate vertical mandibular measurements as reliably as a lateral cephalogram. However, it is required for clinicians to be vigilant when determining horizontal mandibular measurements from orthopantomograms as they are unpredictable.

Visual live anatomical demonstrations among medical students by Surgeons.

Objective: To determine the results of visual live anatomical demonstrations among medical students by Surgeons. Study Design: Prospective study. Setting: Department of Anatomy, Liaquat Medical and Dental College, Darul Sehat Hospital. Period: Period of 3 years on the students of Batch 2017, 2018 and 2019. Material & Methods: Total 300 students of first year medical students (MBBS) with full attendance in class over the year were included in study. The mode of presentations was theoretical, video and power-point presentations and through live surgeries. Exclusion criteria students with absenteeism in classes. Results: Out of 100 students enrolled every year, only 75 students were included due to full attendees as per inclusion criteria. Total of 225 students were enrolled. The mean age of students was 19.4 ±0.57 years in every year students. The students were assessed in their term exams and pre-prof exams and showed significant difference in pre-presentation and post-presentation scores. Another group scores with live surgical demonstrations compared those without live visual surgical demonstrations 75.89± 3.9 vs 74.7± 4.6 in year 2017, 79.46 ± 4.9 vs 74.8 ±4.3in year 2018) and 84.8± 3.4 vs 76.41± 4.3 in year 2019 students showed statistical significant difference p value<0.000. Conclusion: The teaching of anatomy by surgeons has markedly improved performance and live visual demonstrations showed increase in interest of medical students.

TINJAUAN KELENGKAPAN FORMULIR RINGKASAN MASUK DAN KELUAR PASIEN RAWAT INAP BERDASARKAN ANALISIS KUANTITATIF PENYAKIT CATARACK, UNSPECIFIED DI RUMAH SAKIT ISLAM AMAL SEHAT SRAGEN

Introduction: Efforts to improve hospital quality need to be carried out to assess hospital services, namely by conducting quantitative analysis.
 Objectives: To find out the completeness of filling in and out summary forms for inpatients based on quantitative analysis of catarack disease, unspecified at the Amal Sehat Islamic Hospital, Sragen.
 Methods: This research is a descriptive study, using the method of observation and interviews. The population in this study were 616 medical records of inpatients with cataracts, unspecified by using a random sampling technique where the sample was taken randomly and the Slovin formula was used to determine the sampling.
 Result: analysis in the review of identification of the complete number of 240 documents with a percentage of 98.77% while those that were incomplete were 3 documents with a percentage of 1.23%, in the review of reporting the complete number of 123 documents with a percentage of 50 ,62% while the incomplete ones are 120 with a percentage of 49.38%, in the authentication review the complete number is 236 documents with a percentage of 97.12% while the incomplete ones are 7 documents with a percentage of 2.88% and in the recording review the total number is 2.88%. 236 complete documents with a percentage of 97.12% while 7 documents incomplete with a percentage of 2.88%
 Conclusion: the incompleteness of medical record documents at the Amal Sehat Hospital Sragen is still not optimal, medical and non-medical officers should be more careful in completing medical record documents.

Assessment of physical activity level and glycemic control among patients with type-II diabetes mellitus.

Objective: To assess the physical activity level (PAL) and its impact on glycemic control in patients with T2DM. Study Design: Cross-sectional study. Setting: Darul Sehat Hospital, Karachi. Period: February 2021 to June 2021. Material & Methods: Patients with T2DM were included through convenience sampling method. The sample size was calculated by Open Epi Version 3 assuming 69% frequency of outcome in population, margin of error 5% and confidence level 95%. PAL was assessed by using the short version of the International Physical Activity Questionnaire (IPAQ-SF). Results: Out of 330 patients 225(68.2%) were female and 105(31.8%) were males. The mean age of subjects was 55.2 ± 8.32 and the mean duration of diabetes 9.6 ± 6.4 years. Of the patients, 122 (37%) had low, 175(53%) had moderate, and 33 (10%) had high PAL. The mean sitting duration was 527.4 (95% CI 516 to 538) minutes. The mean weekly total energy was 938 ± 1171 MET-min/week. Conclusion: Our majority of patients were engaged in moderate physical activity level. The study results imply convincing impact of physical activity level and glycemic control. Women and older age Pakistani diabetic patients do not meet the physical activity recommendations.

PENGARUH PELATIHAN DAN LINGKUNGAN KERJA TERHADAP KOMITMEN ORGANISASI YANG BERDAMPAK PADA KINERJA PEGAWAI NON MEDIS DI RUMAH SAKIT MITRA SEHAT SITUBONDO

ABSTRACT
 Mitra Sehat Situbondo Hospital is a private public hospital and is one of the type D hospitals located in the Situbondo Regency area. As a community service, hospital employees certainly need training, as well as a comfortable work environment and there must be organizational commitment. The purpose of this study was to analyze and examine the effect of training and work environment on organizational commitment that has an impact on the performance of non-medical employees at Mitra Sehat Hospital, Situbondo. The sampling technique used was the saturated sampling technique. Data analysis and hypothesis testing in this study used the Structural Equation - Partial Least Square (PLS-SEM) model. 
 The results of the direct influence hypothesis test using the Smart PLS 3.0 application, indicating that the Effect of Training has no significant effect on Organizational Commitment, Work Environment has a significant effect on Organizational Commitment, the influence of training has a significant effect on employee performance, the work environment has a significant effect on employee performance, organizational commitment has a significant effect on employee performance. The results of the indirect effect hypothesis test show that the variable Effect of Training on Employee Performance through Organizational Commitment has a positive but not significant effect, Organizational Commitment on Employee Performance through Organizational Commitment has a significant positive effect.

Risk Factors of Low Birth Weight in Pakistan

Introduction: Birth weight is a reliable and sensitive indicator of a new-born’s chances of long-term survival, growth, and physical and psychosocial development. There is little research in Pakistan that documents valuable data such as detailed maternal consumption data and psychological factors and links them to low birth weight. The aim was to estimate the LBW proportion and to assess the factors influencing birth weight. Methods: This cross-sectional study was held in the community medicine department in collaboration with Obstetrics and Gynecology department of Jinnah hospital, Lahore and Darul Sehat Hospital, Karachi for the duration of four months from February 2021 to July 2021. A total of 130 patients were selected in consecutive samples, and then a questionnaire was given to them. Results: Among 130 women, the LBW frequency was 16.9%, and the mean birth weight was 2.7 ± 0.6 kg. We also found a significant relationship between birth weight and per capita income, maternal weight gain during pregnancy, number of prenatal visits, maternal education, tobacco use and nutritional stress, and egg consumption. Multivariate analysis showed a significant relationship between maternal weight gain and birth weight during pregnancy, tobacco use, and stress. Conclusion: More people were found to have access to basic prenatal care measures such as nutrition, free iron supplements, and regular prenatal checks, indicating a positive effect on birth weight in the study population. While several factors have been shown to be related to each other, the focus should be on psychological and nutritional factors. Keywords: Low birth weight, Related factors, Dietetics, Psychological.

ASSOCIATION OF NEONATAL BIRTH WEIGHT AND NEONATAL SEPSIS ALONG WITH PATHOGEN DISTRIBUTION IN KARACHI POPULATION

Neonatal mortality rates are high in infants with low or very low birth weight (VLBW) as they are prone to sepsis. Early-onset sepsis (EOS) which occurs at 48hr of life remains an important cause of illness and death in VLBW infants. The objective of the study is to analyze the association between Neonatal birth weight and neonatal sepsis in the Karachi population and to study their pathogen distribution in positive isolates. A prospective cross-sectional study took place in Karachi's leading hospitals, Darul Sehat hospital and Abdus Samad hospital. Neonatal birth weight and neonatal blood culture sensitivity tests were studied for positive sepsis. Data were analyzed using SPSS applying the Chi-square test Results out of 120 neonates' blood culture sensitivity test 12 neonates had positive sepsis. The weight of 6 neonates out of 12 positive was 2.1-3kg and the other 6 neonates' weight was 3kg. 3 isolates were Streptococcus pneumonia and 9 were Staphylococcus aureus. Infants with positive sepsis are of healthy weight. Therefore, results were found to have no significant relation between neonatal birth weight and neonatal sepsis. EOS remains an uncommon yet important cause of morbidity and mortality among VLBW infants.