Tehsil Headquarter Hospital Research Articles

Impact of Laboratory Biomarkers on COVID-19 Severity: First Cross-sectional Study in a Remote Area of Pakistan

Objectives: The study aimed to evaluate the performance of rapid antigen test (RAT) and reverse transcription polymerase chain reaction (RT-PCR) in detecting COVID-19 and the impact of laboratory biomarkers on the severity of the disease. Material and Methods: A total of 150 nasopharyngeal swabs and blood samples were collected from symptomatic COVID-19 patients in Tehsil head-quarter Hospital, Dargai from August 2021 to March 2022. Results: RAT revealed a sensitivity of 86.67% and specificity of 100%, while RT-PCR revealed a sensitivity of 93.33% and specificity of 100%. The highest infection rate was found in males, and the average age of patients was 53.87 years. The most common symptoms were fever and sore throat. Patients were categorized into four groups based on cycle threshold values and blood biomarkers: mild, moderate, severe, and critical. White blood cell count, platelet count, and C-reactive protein were significantly different between the groups. Lactate dehydrogenase, D-dimer, and serum ferritin were significantly increased in critical patients. The receiver operating characteristic curve showed that inflammatory biomarkers had a comparative performance in predicting disease severity in COVID-19 patients. Conclusion: Blood biomarkers are associated with the disease severity in COVID-19 patients, and further studies, such as metabolomics, are recommended to explore the immunological mechanisms behind these biomarkers.

EFFECTIVENESS OF UTERINE BALLOON TAMPONADE IN MANAGEMENT OF PRIMARY POSTPARTUM HEMORRHAGE

Objectives: To determine the effectiveness of uterine balloon tamponade in the management of primary post partum hemorrhage.Materials and Methods: This cross sectional descriptive study was conducted in Tehsil Headquarter Hospital Swabi from 1st May 2023 to 31st October 2023. A total of 177 women presenting with primary PPH regardless of parity were included in the study. All were treated with standard protocols for PPH treatment .The balloon was removed 12 hours after its insertion to determine the effectiveness in terms of less than 100 ml loss of blood. Slow deflation of balloon tamponade with simultaneous monitoring for resumption of bleeding.Results: Mean age of the patients were 28.497±2.43 years, gravidity 2.638±1.19, parity 1.638±1.19, gestational age 38.689±1.12 and mean BMI was 26.1±1.35 Kg/m2. Uterine atony was the cause of PPH in 78.6%. Those who underwent normal vaginal delivery were 66.1% while 33.9% underwent C-section. Out of the total 177 cases, uterine balloon tamponade was effective in 129 cases (72.9%) with a statistically significant diff erence of 0.001 in combine spontaneous or induced labor.Conclusion: The intended study concludes that balloon tamponade is a successful and reliable approach in addressing PPH. This method effectively aids in controlling excessive bleeding following delivery, highlighting its significance as an effective treatment option in managing PPH.

Prevalence of Self Medication in Pregnancy in Secondary and Tertiary Care Hospitals of Pakistan and Factors Contributing Towards this Malpractice

Introduction: Self-medication during pregnancy is of special concern as it can lead to serious maternal and fetal adverse effects. By controlling the factors responsible for this practice, we can promote safer health practices during this critical period of a woman’s life. Aims & Objectives: Comparison of the prevalence of self-medication among pregnant women presenting in secondary and tertiary care hospitals of our country. Exploring the factors that contribute to the practice of self-medication in pregnant women. Place and Duration of Study: A multi-centric cross-sectional study was performed at the Heavy Industries Taxila Education City Institute of Medical Sciences (HITEC-IMS) for one-year duration i.e from September 2022 to September 2023. Material & Methods: The study population consisted of 354 pregnant women who were being consulted for antenatal checkups at Gynecology and Obstetrics OPD of Heavy Industries Taxila Hospital (HIT Hospital Taxila) and Tehsil Headquarter Hospital Taxila (THQ Hospital Taxila). Pregnant females of any age and gestation who presented to the OPD for antenatal checkups were included in the study. Any pregnant lady who was unwilling to participate or any of the women who were too critically ill to give a response were excluded from the study. Non-probability convenience sampling was used for the selection of participants. Data was collected using an interviewer-administered structured questionnaire. SPSS software version 25 was used to analyze the data.Results were deemed significant if the P value was less than 0.05. Results: The prevalence of self-medication in our study came out to be 35.59% in the current pregnancy. There is no significant difference in the prevalence of self-medication in previous and current pregnancies. Prevalence of self- medication in current and previous pregnancies is greater in THQ Hospital than HIT Hospital. Residence, education, monthly income, gestation, gravidity, parity, number of alive children and place of birth are significantly associated with the practice of self-medication in the current pregnancy. Cost and time savings were the two main justifications for self- medication. Headaches were the most frequent complaints treated by self-medication, and leftover medication and drug stores were the most popular sources. Antipyretics and painkillers were the two medications that were most frequently used for self-medication. Conclusion: The prevalence of self-medication in pregnant women was found to be more in a secondary care hospital as compared to the tertiary care hospital. This concludes that the quality of health care services provided to the patients can significantly impact their attitudes towards the management of their conditions. Thus countries who have lack of tertiary care facilities should try to provide better quality of health care. The factors found responsible should be confronted so that this malpractice can be reduced significantly.

Empowering Lower Limb Disorder Identification through PoseNet and Artificial Intelligence.

A novel approach is presented in this study for the classification of lower limb disorders, with a specific emphasis on the knee, hip, and ankle. The research employs gait analysis and the extraction of PoseNet features from video data in order to effectively identify and categorize these disorders. The PoseNet algorithm facilitates the extraction of key body joint movements and positions from videos in a non-invasive and user-friendly manner, thereby offering a comprehensive representation of lower limb movements. The features that are extracted are subsequently standardized and employed as inputs for a range of machine learning algorithms, such as Random Forest, Extra Tree Classifier, Multilayer Perceptron, Artificial Neural Networks, and Convolutional Neural Networks. The models undergo training and testing processes using a dataset consisting of 174 real patients and normal individuals collected at the Tehsil Headquarter Hospital Sadiq Abad. The evaluation of their performance is conducted through the utilization of K-fold cross-validation. The findings exhibit a notable level of accuracy and precision in the classification of various lower limb disorders. Notably, the Artificial Neural Networks model achieves the highest accuracy rate of 98.84%. The proposed methodology exhibits potential in enhancing the diagnosis and treatment planning of lower limb disorders. It presents a non-invasive and efficient method of analyzing gait patterns and identifying particular conditions.

Incidence of surgical site infection following open hernioplasty and comparison of infection rate among ventral and groin hernia repairs at a THQ hospital Lahore: a single surgeon experience.

To determine the incidence of surgical site infection following open hernioplasty, and to compare the infection rate among ventral and groin hernia repairs. The retrospective study was conducted from April 2 to November 30, 2021, at the Government Tehsil Headquarter Hospital Sabzazar, Lahore, Pakistan, and comprised data form June 2018 to December 2020 of patients with ventral abdominal and groin hernia. All patients underwent hernioplasty by a single consultant surgeon and were discharged within 2 days of surgery. Surgical-site infections were recorded on follow-up visits up to 30 days of operation, and were compared between ventral and groin hernia cases. Data was analysed using SPSS 22. Of the 218 patients with mean age 37.07±4.94 years, 117(53.67%) were males, 108(49.54%) smokers and 127(58.25%) hypertensive, while 110(50.45%) had ventral abdominal hernia and 108(49.54%) had groin hernias. Mean operative time and mean hospital stay were 56.53±6.20 minutes and 3.06±1.31days, respectively. Mean wound drainage in abdominal hernia cases was 8.99±2.02 days. Surgical site infection incidence following open hernioplasty was 2(0.91%). Infection rate among ventral abdominal and groin hernioplasty were 1(0.90%) and 1(0.92%) (p=0.50). Incidence of surgical site infection following open hernioplasty showed no significant difference between ventral abdominal and groin hernia repairs.

Frequency of Iron Deficiency Anemia and Its Association with Persistent Diarrhea, Weight and Parasitic Infestation in Children, 1-2 Years of Age in Semi-Rural Area of District Sialkot, Pakistan

Iron deficiency anemia (IDA) is a common health problem in Pakistan and persistent diarrhea under two years of age is one of its major reasons. Objectives: To determine the frequency of IDA among children 1-2 years of age and to find its association with persistent diarrhea and parasitic infestation. Methods: In this hospital-based study, 345 children 1-2 years of age visiting OPD of Tehsil Headquarter Hospital, with persistent diarrhea were included. Socio-demographic characteristics of children and their parents collected with the questionnaire while total body iron stores determined by checking Hemoglobin (Hb), Serum Ferritin and Total Iron Binding Capacity (TIBC) in the blood while parasitic infestation was determined by Ova and Cyst in the stool samples. Chi-square test was used to test association. Results: Out of total children, 55.9% children were bottle fed, weaning was started among 97.7% children at the age of 6 months, 44.9% had weight <8 kg, 53.0% children were anemic, had TIBC >450 µg/dl and serum ferritin level <7 ng/ml. The association of IDA with age, gender, mode of feeding, food allergies and vaccination history were significant while it was insignificant with persistent diarrhea and parasitic infestation. Conclusions: Study concluded that IDA was very frequent among children in less than 2 years of age and among contributing factors, lack of beast-feeding and diarrhea are important. Correlation was significant between IDA with age and feeding mode while association was insignificant with persistent diarrhea and parasitic infestation

A Case Report of Solitary Median Maxillary Central Incisor Reported in Tehsil Headquarter Hospital, Gujjar Khan, Pakistan

Solitary median maxillary central incisor is a rare dental anomaly and a complex disorder consisting of multiple mainly midline defects of development. In SMMCI, only one central incisor is present, and it develops exactly at the midline. It results from unknown factors(s) operating in utero. Early diagnosis and recognition of SMMCI are important for all practicing dentists, as it may be a sign of other severe congenital or developmental abnormalities. This case report discusses important aspects of SMMCI and presents a clinical case of a 2-year-old female patient of single median maxillary central incisor with missing maxillary and mandibular frena, along with brain growth retardation in Tehsil Headquarter Hospital, Gujjar Khan, Pakistan. Aligned with the literature early diagnosis and correction of SMMCI is of prime importance as the condition is associated with developmental problems. Moreover, the case should be managed by a multidisciplinary team of health professionals to ensure optimum health-related outcomes. Keywords: Solitary, median, maxillary, central incisor, case report

Effects of Anti-Tuberculosis Drugs on Lipid Profile in Pulmonary Tuberculosis Patients

Objective: To determine the anti-tuberculosis drugs effect on the lipid profile parameters in pulmonary tuberculosis (TB) patients.Methods: A prospective cross-sectional study was conducted at Tehsil Headquarter Hospital, Taunsa Sharif and District Headquarter Teaching Hospital, Dera Ghazi Khan from December 2020 to May 2021. The blood samples from 84 positive pulmonary TB patients were collected in three different intervals of the study, before the start of the treatment, and after the use of first four baseline drugs isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), and ethambutol (EMB) respectively to check out the variation in lipid profile parameters such as total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG) and very low density lipoprotein (VLDL). Results: Of 84 pulmonary TB patients, the mean age was 38.1 ± 19.8 years. There were 44 (52.4%) males and 40 (47.6%) females. The mean difference of cholesterol level significantly increases from baseline to 6th and 10th week, (p-value <0.001). Similarly, HDL (p-value <0.001) and LDL (p-value <0.001) also increases significantly from baseline to 6th week and 10th week. However, no significant difference of TG (p-value 0.908) and VLDL (p-value 0.367) was observed from baseline to 6th and 10th week.Conclusion: Patients with pulmonary TB showed low lipid profile in our cohort. This shows that pulmonary TB may be a causative agent of low lipid profile. After anti-TB therapy, cholesterol, HDL, and LDL levels seem to be increased.

Relationship between Refractive State and Nutritional Status among the children

Objective: Refractive error and malnourishment both are common issues in developing countries therefore in this study main aim is to find the relationship between refractive state and nutritional status. Material and Methods: This was a cross-sectional observational study conducted at Tehsil Headquarter Hospital Kamoke. The sample size was 200 children equally divided into well-nourished and malnourished groups with their age range between 3-12 years of both gender. First visual acuity was measured monocularly with Snellen’s Chart The amount and type of refractive error were assessed using cycloplegic refraction with cyclopentolate 1% eye drops. Eyes with amblyopia, strabismus and any other ocular pathology that affects vision were excluded. All children were referred from eye department to the nutritionist of this hospital to determine the nutritional status through WHO provided guidelines. Results: There were a total of 101 (50.5%) males and 99 (49.5%) females in this study. The most common type of refractive error was Astigmatism which was present in 29 (29%) well-nourished and 31 (31%) malnourished children. The least common was hypermetropia which was present in only 3 children and all were females. However, myopia was present in 12 (12%) well-nourished and 11 (11%) malnourished children. Conclusion: Thus, Refractive errors were present in both groups. The most common was Astigmatism and the least common was hypermetropia in both groups. The inferential statistics of this study concluded that refractive errors were not related with nutritional status but may be due to some factors.

Diabetes as a Risk Factor of Pancreatic Cancer

Objective: The aim of this study is to determine the relation between diabetes and pancreatic cancer. Study Design: Retrospective study Place and Duration: Tehsil Headquarter Hospital Minchinabad. May 2021-Dec 2021 Methods: There were two hundred and fifty patients of pancreatic cancer were included in this study. Age of the patients was between 20-90 years. Informed written consent was taken from all the patients for detailed demographics age, sex, body, mass index. Patients were underwent for CT scan and ultrasonography. Outcomes were association of diabetes among enrolled cases was measured. Age duration of diabetes among all the cases were measured. Prevalence of cancer among different regions of pancreas was studied. SPSS 24.0 version was used to analyze complete data. Results: There were 160 (64%) males and 90 (36%) cases were females. Mean age of the patients was 65.4±6.45 years with mean BMI 27.3±4.67 kg/m2. Tobacco smoking was found in 151 (60.4%) among. Frequency of diabetes was found among 80 (28%) cases. Among 80 cases of diabetes, 72 (90%) patients had recent onset diabetes. Mean age of diabetes diagnose was 56.34±5.34 years and mean age of pancreatic cancer diagnosed was 58.9±6.77 years. Head in pancreas was the most common affected side of tumor among 58 (72.5%), followed by body 12 (15%) and tail in 10 (12.5%) cases. Conclusion: In this study we concluded that frequency of diabetes among pancreatic cancer patients was 28% and majority of the cases had new-onset diabetes. Except this tobacco smoking was significant causing factor for pancreatic cancer. It may be possible to screen for pancreatic cancer in new-onset diabetes by identifying a particular biomarker for pancreatic cancer. Keywords: Diabetes Mellitus, Pancreatic cancer, Causes

NT PROBNP'S Prognostic Value Among Patients of Covid-19 without Heart Failure

Objective: If Nt Pro BNP's prognostic value increased the mortality rate and hospitalization of covid-19 patients. Study Design: Retrospective study Place and Duration: Tehsil Headquarter Hospital Minchinabad. April 2021-Dec 2021. Methods: This research included 85 patients of both sexes with ages 18-65 years had coronavirus disease. After obtaining informed written permission, demographic data such as age, gender, height, weight, and place of residence were collected on all recruited participants. Comorbidities among all cases were assessed. NT proBNP> 88.64 pg/mL was considered as high and low was NT-proBNP≤88.64 pg/mL. Hospitalization and death rate among all cases were calculated. Results: There were 52 (61.2%) males and 33 (38.8%) females among all cases. The mean age of the enrolled cases was 55.7±17.76 years and had mean BMI 26.4±11.44 kg/m2. Hypertension was found in 35 (41.2%), chronic pulmonary disease in 20 (23.5%) cases, diabetes mellitus in 18 (21.2%) cases and 12 (14.1%) patients had chronic heart disease. Among 85 cases, 49 (57.6%) patients had high NT proBNP> 88.64 pg/mL and 36 (42.3%) patients had NT-proBNP≤88.64 pg/mL. We found higher level of CRP, creatinine and urea among patients of higher Nt ProBNP's value. Mortality in patients of higher Nt ProBNP's was found among 20 (40.8%) cases and no any death case found among patients of lower Nt ProBNP's value. Conclusion: We concluded in this study that increase in Nt ProBNP's value among patients of coronavirus cause higher number of deaths. Keywords: Covid-19, HTN, Nt ProBNP, Mortality

THE PREVALENCE OF CHRONIC HEPATITIS C IN PATIENTS PRESENTING WITH VAGUE RHEUMATIC SYMPTOMS IN A LOCAL COMMUNITY IN DISTRICT PUNJAB, PAKISTAN

Objective:
 This study has been conducted to highlight the prevalence of chronic hepatitis in patients presenting with vague symptoms such as generalized body aches and weakness.
 Methods:
 A cross-sectional study was conducted in Tehsil Headquarter Hospital Sharaqpur, Sheikhupura, Pakistan. During a period of two and a half months, 751 patients presenting to general outdoor department with vague symptoms were selected through random sampling. They were tested for Anti Hepatitis C Virus Antibodies, Hepatitis B Surface Antigen, and Anti Human Immunodeficiency Virus Antibodies with Rapid Immunochromatographic Test Kits. Statistical analysis was performed using IBM SPSS Statistics version 23.
 Results:
 Of the 751 randomly selected patients, 28 were eliminated due to missing data. Out of 723 included participants, 36% were male and 64% were female with a mean age of 53.11±11.2 years. 26.42% people were screened positive for Hepatitis C (N=191). 1.7% people were screened positive for Hepatitis B (N=13). Whereas only 0.12% (N=1) were HIV positive.
 Conclusion:
 This study established that Chronic Hepatitis often presents with mild and vague symptoms. Also, the prevalence of HCV is significantly higher in our population in spite of the ongoing hepatitis control programs and is rising in contrast to the global decline.

Frequency of Placenta Previa on Ultrasonography in Females with History of Caesarean Section

Background: Placenta previa (P.P) is a condition where the lower edge of the placenta lies close to the internal os. It may partially or completely cover the internal os. Objectives: To determine the frequency of placenta previa on ultrasonography in females with history of Caesarean section. Methodology: This descriptive study was held in Ghurki Trust Teaching Hospital Lahore and Tehsil Headquarter Hospital, Pattoki. Convex Probe Esotae 2.5 5-7MHz and Logiqv3 (5-7MHz) was used in the study. 140 pregnant women with history of previous Caesarean section were included in the study and were examined through convenient sampling. Data was collected after signing the consent form. Statistical software for social sciences (SPSS version 22.0) is used for the analysis of data. Results: According to the data analysis, minimum age patient was of 18 years and maximum age was 41 years. 37(26.4%) women had 1 previous Caesarean section. 57(40.7%) women had 2, 31(22.1%) women had 3, 15(10.7%) had 4 of previous Caesarean sections. 86(61.4%) women had a history of bleeding. 54(38.6%) women had no history of bleeding. According to analysis of placenta previa, 126(90.0%) women did not have a placenta previa and 14(10.0%) women had placenta previa. Cross tabulation analysis between frequency of patients with placenta previa and previous Caesarean cases evaluated that 126 patients with previous Caesarean rate did not placenta previa confirmed on ultrasound whereas 14 patients with previous Caesarean section had placenta previa on ultrasound. Conclusion: Placenta previa is seen in ten percent of subsequent pregnancies in females who have a history of previous Caesarean section.

The Role of Speech-language Pathologists in the Hospitals of Pakistan

Objectives: This study aimed to assess the knowledge and perception of the role of speech therapists by other medical professionals in public hospitals. Methods: This cross-sectional study recruited 200 healthcare professionals with >1year of job experience at the workplace of both genders and any age. Besides, the study subjects were selected using a non-probability convenience sampling approach. The study sample was recruited from 25 District and Tehsil Headquarter Hospitals from April 1, 2019, to September 30, 2019. A basic demographic datasheet and the Knowledge, Attitude, and Practices (KAP) survey were used for data collection. Statistical analysis was performed in SPSS. Results: Out of the total 200 eligible professionals from different departments, the Mean±SD scores of the responses were highest (75.14±24.87) in pediatric medical professionals. Moreover, the lowest scores (46.70±0.01) concerned Intensive Care Unit (ICU) experts; this difference was statistically significant (P<0.001). Similarly, a significantly higher Mean±SD score of 74.05±20.04 was noted for those working day shifts, compared to that of (35.01±8.52) those working in night shifts (P<0.001). Discussion: The knowledge and perception of different healthcare professionals serving in public hospitals vary regarding the role of SLPs. Such differences concern their profession, with pediatrics presenting the highest level of understanding, followed by general medicine. However, psychiatry and ENT professional provided the least understanding in this area. The professionals working in day shifts suggested better knowledge and perception, compared to night shifts staff.

EFFECT OF DIFFERENT DIMENSIONS OF ORGANIZATIONAL CULTURE ON JOB SATISFACTION OF NURSES WORKING IN RURAL AREAS OF PUNJAB, PAKISTAN

Purpose of the study: The current study has explored the effect of different dimensions of organizational culture on the job satisfaction of nurses working in the rural areas of Punjab, Pakistan.
 Methodology: Present study used a cross-sectional, face-to-face approach. The researcher collected data from 452 nurses working at tehsil headquarter hospitals and rural health centres across Punjab with the help of an interview schedule. The effect of culture on the job satisfaction level of nurses Investigated with the help of Multiple regression techniques.
 Main Findings: The analysis showed a 52% variation in job satisfaction because of the culture. Values and belief systems, feedback systems, innovation, growth and development opportunities, relationship patterns, autonomy, work environment were the significant determinants of job satisfaction. Whereas the facilities, communication, and vision were the nonsignificant determinants of job satisfaction in the present study.
 Application of this study: The current research will be helpful to understand the prevailing culture of health care organizations. That will help the administrators and policymakers to understand the different factors which are responsible for low productivity.
 Novelty /originality of this study: The study is novel in organizational studies because it adopts a holistic approach to consider all the significant components of culture.

Comparison of social support, depression and anger in diabetic and cardiac patients

Abstract Objective: The present study explores the role of social support, depression and anger among diabetic and cardiac patients. Method: This cross sectional study comprised of 200 patients who were selected through purposive sampling strategy from outpatient departments (Cardiology and Endocrinology) of Government hospitals of Lahore (Jinnah Hospital and Services Hospital) and Muridke (Tehsil Headquarter Hospital) from April 2015- September 2015. Cardiac patients were 101(Men=51, Women=50) and diabetic type II patients were 99 (Men= 50, Women= 49). Siddiqui-Shah Depression scale (SSDS), Interpersonal Support Evaluation List (ISEL) and Trait Anger and Expression Scale (TAES) were administered on the patients. Result: The findings revealed that cardiac patients exhibit higher level of depression and receive more social support than diabetic patients. Furthermore, results reveal that low social support is a significant negative predictor of anger and depression among diabetic and cardiac patients. Conclusion: On the basis of findings, it is concluded that social support is a significant factor in the treatment of diabetes and cardiac diseases. This research is helpful for hospital administration in the counseling/management of such patients. Continuous...

Prevalence of Obstructive Sleep Apnea and Factors Affecting It among Old Age Population of Rural Area of Pakistan

Although Obstructive sleep apnea is now recognized as one of the major public health problems because of the improvement in standards of life, however, with increasing its prevalence, it adversely affects the quality of life. So, our study was set to assess the prevalence of OSA and the factors that affect it. This may make new opportunities available by which we could bring a decline in OSA incidence after measuring its prevalence and identification of factors that affect it. This cross-sectional study was conducted in a nearby rural area of (THQ) Tehsil Headquarter Hospital, Phalia, Punjab for around three months from August 2020 to October 2020. Data was collected with the help of two questionnaires including a self-structured proforma and STOP scale. People with age less than 51years and more than 60 years were excluded and only people with age above 50 years and below 61 years were included. Data analysis was accomplished with the help of SPSS version 25 and various tests including the Chi-square test, Independent Sample t-test, and One-Way ANOVA were applied to assess the study variables. Results of the study showed an overall high prevalence of OSA higher risk (41.7% participants had a higher risk of development of OSA) Association, between OSA risk and age groups (p=0.001) and between OSA risk and Educational status (0.000) was significant statistically, while it was not significant between OSA risk and gender (p=0.394). The difference in score on the STOP scale was significant, across gender (p=0.032), three age groups (p=0.002), and four levels of education (p=0.000). Our study indicates an increased prevalence of higher risk for OSA development particularly among men, higher age, and lower education. So, proper planning is required to deal with the increasing prevalence of obstructive sleep apnea.

Hepatitis C Virus and Helicobacter pylori infections in Patients with Pulmonary Tuberculosis

Aims and objectives: The control of pulmonary tuberculosis (PTB) mainly depends upon prompt diagnosis and effective treatment which can be hindered by co-infections affecting organs like gastrointestinal system and liver involved in drug bioavailability and metabolism. Among those, Helicobacter pylori (H. pylori) causes chronic gastritis leading to peptic ulcer and related gastric malignancies and liver malfunctions induced by Hepatitis C virus (HCV) co-infections increase the risk of anti-tuberculosis drug-induced hepatotoxicity. The rates of Hepatitis C virus and Helicobacter pylori infections seem to increase day by day in pulmonary tuberculosis patients which need proper investigation followed by timely control and prevention form disease. Methods: The hospital-based study was performed in the area of Southern Punjab, Pakistan. The Tehsil Headquarter hospital in the area, where the study was conducted contained TB Clinic. Inclusion and exclusion criteria of suspected patients of pulmonary tuberculosis included in the study. A total of 132 subjects were screened for PTB, HCV and H. pylori infections for finding the role of co-infection. The positive PTB subjects were screened for HCV and H. pylori infections. Both infections (H. pylori and HCV) were also found among TB patients. Results: A total of 52.27% were positive for PTB in which 50.72% and 17.39% cases were found in H. pylori and HCV infections respectively. H. pylori had increased rate of infection among PTB cases when compared with that of non-TB cases. HCV was also found to be associated with PTB when compared with non-TB cases. Non-significant gender and age-based differences were present, among study population. Among all PTB patients, HCV and H. pylori coinfections were also found in 5.8% patients in current study. Conclusions: Our study showed a high prevalence of HCV and H. pylori infections among PTB patients, which suggest that PTB patients must be screened for the two infections which might be helpful in the control of further complications during the treatment of PTB.

Serious Inadequacies in High Alert Medication-Related Knowledge Among Pakistani Nurses: Findings of a Large, Multicenter, Cross-sectional Survey.

IntroductionDeaths-related to medications errors are common in Pakistan but these are not accurately reported. Recently, the death of a 9 months old baby due to abrupt administration of 15% potassium chloride injection sparked the issue of high alert medications (HAMs) related errors in the country. Since drug administration is the prime responsibility of the nurses, it is pivotal that they possess good knowledge of HAMs. Since there is no published data regarding the knowledge of HAMs among Pakistani nurses, we aimed to assess knowledge of HAMs among registered nurses of Pakistan.MethodsA cross-sectional study was conducted among registered nurses, recruited using a convenient sampling technique, from 29 hospitals all over the Punjab Province. Data were collected using a validated self-administered instrument. All data were entered and analyzed using SPSS version 22.ResultsThe study sample was comprised of 2,363 registered nurses (staff nurses = 94.8%, head nurses = 5.2%). Around 63% were working in tertiary hospitals whereas almost 25 and 12% were from district headquarter hospitals and tehsil headquarter hospitals, respectively. Around 84% of the study participants achieved scores <70%, indicating majority of Pakistani nurses having poor knowledge of HAMs administration as well as regulation. There was no significant difference of overall knowledge among age, hospitals, departments, training, designations, qualification, and experience categories. Major obstacles encountered during HAMs administration were “getting uncertain answers from colleagues” (72.9%), “unavailability of suitable person to consult” (61.1%) and “receiving verbal orders” (55.6%).ConclusionOur study revealed the serious inadequacies in HAMs knowledge among Pakistani nurses which may lead to adverse patient outcomes. Nurses should receive comprehensive pharmacology knowledge not only during in-school nursing education but also as hospital-based continuing education. Moreover, it is of immense importance to bridge the gaps between physicians, clinical pharmacists, and nurses through effective communication as this will help reduce medication errors and improve patient care.

Prevalence of Adhesion Genes fnbA &amp; fnbB of Staphylococcus aureus Isolated from Dental Patients Attending Dentistry Department of Tehsil Headquarter Hospital Pasrur, Pakistan

Introduction: The present study was intended to isolate, characterize and investigate the prevalence of virulence genes encoding fibronectin (fnbA and fnbB) adhesive molecules of S. aureus from dental patients attending outpatient department of THQ Hospital Pasur.&#x0D; Methodology: A total of 100 oral samples were collected from dental patients, pure cultures was segregated and identified through conventional microbiological methods to evaluate the prevalence of S. aureus. Isolates were further characterized by using specific primers for genotype fnbA and fnbB.&#x0D; Results: Results of the study declared that 68 samples were positive (68%) for staphylococcus aureus on the basis of growth on selective media and appearance of typical colonies supported by gram staining. These gram positive staphylococci were positive (86.7%) in coagulase and catalase testing. The results of polymerase chain reaction (PCR) revealed that 47 (69.1%) and 23 (33.8%) isolates showed amplification with type specific primer 23Sr RNA and NUC gene respectively. Furthermore, fnbA and fnbB type specific genes of S. aureus did not show any amplification in PCR reaction.&#x0D; Conclusion: Irrespectively the data in the present study showed the prevalence of S. aureus is significantly high in males and of age group of 20-40 years but no positive result was found for prevalence of fnbA and fnbB genes. All the S. aureus isolates were highly sensitive to vancomycin, linezolid and clindamycin.