Tertiary Care Hospitals Of Rawalpindi Research Articles

Study of the Effect of Treatment of Helicobacter pylori Infection in Rheumatoid Arthritis Patients

Objective: To assess the disease activity after treatment of Helicobacter pylori infection in rheumatoid arthritis patients at a tertiary care hospital of Rawalpindi.
 Study Design: Comparative cross-sectional study.
 Place and Duration of Study: Department of Rheumatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun to Nov 2021.
 Methodology: A total of 197 adult patients diagnosed with rheumatoid arthritis and with symptoms of dyspepsia were inducted into this study. First, the disease activity was measured considering parameters such as clinical swollen and tender joints count, disease activity scores 28(DAS-28), visual analogue scale (VAS) and laboratory parameters like erythrocyte sedimentation rate at the start as the baseline. Then, these were repeated after six months, and the differences between the two groups were compared.
 Results: At the start of the study, patients who were positive for H. pylori had markedly more swollen and tender joint counts and raised ESR values than those in the negative group. In addition, the disease activity score of 28 and pain scores was markedly raised in the positive group. After H. pylori eradication, the H. pylori-positive patients differed significantly (p<0.001) from patients group negative for H. pylori infection in terms of improvement in DAS-28 score, visual analogue score and clinically. Laboratory indices like ESR showed significantly decreased values (p<0.001) in the H. pylori-treated group compared to those not infected with H. pylori.
 Conclusion: From our results, it is suggested that H. pylori infection has a role in the pathogenesis of rheumatoid arthritis.

Association of Pharmacy Services with Patient Satisfaction in Public and Private Tertiary Care Hospitals of Rawalpindi And Islamabad

Background: The healthcare system in Pakistan is facing a shortage of human resources and appropriate and sustainable financial measures and therefore fails to provide optimum services to the population of Pakistan. Furthermore, research is limited in the healthcare institutes; therefore, there is a scarcity of information about patient satisfaction with pharmacists and pharmacy services in Pakistan. As evident from the inadequate information in the literature, patients’ opinions about the pharmacy services in Pakistan are important. Therefore, the current study was designed to assess patient satisfaction with the pharmacy performance of the outpatient pharmacy and its variation with socio-demographic characteristics in twin cities of Pakistan (Rawalpindi and Islamabad). Method: A cross-sectional study design was used to assess the patient satisfaction through convenience sampling technique. Minimum sample size of 250 respondents who visit pharmacy department of public and private hospital for pharmaceutical care were included in this study. A pre-validated tool was used to assess the patient satisfaction. Data was clean coded and import into spss for analysis. Descriptive and inferential statistic was applied to calculate frequency, standard deviation, mean deviation and p value to find the association among different domain of patient satisfaction with different demographic characteristics of respondents. Result: Current study shows overall patients were satisfied from pharmacy services provided by government and private hospitals. Furthermore, patient satisfaction towards pharmacist medication advice was very good however patient satisfaction towards pharmacist approach was good while patient perception with pharmacy setting, drug availability and cost were underrated. Significance difference (p ≤ 0.05) was observed in pharmacist’s approach with different gender, age groups and qualification. No significant difference (p ≥ 0.05) was observed in pharmacy setting drug availability and cost with different gender, age groups and marital status of respondents. However, Significance difference (p ≤ 0.05) was observed in pharmacy setting drug availability and cost with different level of education patients with less education had better satisfaction as compared to highly educated respondents. Furthermore, Significance difference (p ≤ 0.05) was observed in pharmacy setting drug availability and cost with occupation. Self-employee and government employee had low satisfaction score while other had better satisfactory score. Significance difference (p ≤ 0.05) was observed in pharmacist’s approach with different gender, age groups and qualification. Females had better satisfactory score as compared to female. Younger age group had better satisfaction as compared to elderly. Patients belong to higher educational groups had better satisfaction toward pharmacist approach as compared to low qualification groups respondents. Furthermore, no significant difference (p ≥ 0.05) was observed in pharmacist’s approach with marital status and number of visits Conclusion: Current study concluded that overall patient had average satisfaction score. Patients shows a better satisfaction towards pharmacist behavior/ way of handling the patients, information provided by pharmacist regarding medicine. Patient had less satisfaction towards the location of pharmacy, Availability and affordability of medicine. Patient shows negative satisfaction regarding waiting area and counselling area at indoor patient pharmacy. It has been observed that educated respondents shows high level of satisfaction towards pharmacist availability and information provided by the pharmacist.

Risk Factors of Pilonidal Sinus in a Tertiary Care Hospital of Rawalpindi: A Descriptive Cross-sectional Study

Purpose: Pilonidal sinus incidence is increasing in surgical departments all over the world. Pilonidal sinus is under the influence of several factors. These factors are studied well in various parts of the world; however, these factors are understudied in Pakistan. This study aimed to find out the risk factors of pilonidal sinus among the patients diagnosed with pilonidal sinus.
 Methodology: This descriptive cross-sectional study was conducted among one hundred and eight patients with pilonidal sinus at Benazir Bhutto Hospital Rawalpindi, for one year from January 2021 to January 2022. Ethical approval and informed consent were obtained before the start of study. Patients’ enrollment was done according to a developed inclusion and exclusion criteria. Convenient sampling technique was also applied for recruitment of participants. Data was collected through a self-designed questionnaire. Descriptive statistics were utilized for the data analysis. Data analysis was performed by SPSS version 25.0 (IBM Corp., Armonk, NY).
 Findings: Pilonidal sinus frequency was high among the patients who had age group of 11 to 30 years (68.52%), male gender (62.96%), driving profession (37.96%), family history of pilonidal sinus (64.82%), high body mass index(60.18%), daily sitting for more than 6 hours (79.62%), sitting on hard surfaces (63.88%), hairy skin (55.55%), excessive sweating (68.52%), poor hygiene of sacrococcygeal region (77.78%), number of baths less than three times per week (61.11%), and light colored skin (62.04%).
 Recommendations: This study recommends that health authorities should make people educated regarding the risk factors that lead to pilonidal sinus. The study also recommends that people should reduce their body weight, sit over soft places and should avoid continuous sitting for long periods. People should take care of hygiene, especially of sacrococcygeal regions by shaving hair, drying moisture, and taking frequent baths.

Assessment of the Awareness of Warning Signs and Risk Factors of Stroke in a Tertiary Care Hospital of Rawalpindi: A Descriptive Cross-Sectional Study

Purpose: Stroke incidence is high all over in the world. It has a list of specific warning signs and risk factors. Awareness of people about those warning signs and risk factors is low especially in third world countries. This study aimed to identify the awareness of people about the warning signs and risk factors of stroke.
 Methodology: This descriptive cross-sectional study was performed in a tertiary care hospital, Rawalpindi, among one hundred for one year from June 2021 to June 2022. Ethical approval and informed consent were waived before the start of study. Patients’ selection was made via a well-defined inclusion and exclusion criteria. Convenient sampling technique was also used for enrollment of participants. Data was collected by using a self-designed questionnaire. Descriptive statistics were put into action for the data analysis. Data analysis was carried out by SPSS version 25.0 (IBM Corp., Armonk, NY).
 Findings: The warning sign of the stroke about which most of the people were aware was sudden body weakness or numbness (74%) while warning sign about which people were least aware was sudden difficulty in seeing objects by one or both eyes (29%). The most common identified risk factor in people was hypertension (70%) for stroke while least common identified risk factor was family history of stroke (36%). In short, this study indicates people awareness about the warning signs and risk factors of stroke was not up to the mark in study population.
 Recommendation: There is need to increase the awareness level of people about the warning signs and risk factors of the stroke. This could lead to timely and effective management of stroke and its prevention as well.

Antibiotic Sensitivity Pattern of Serratia Species from Clinical Samples at a Tertiary Care Hospital in Rawalpindi

Objective. To determine the antibiotic resistance profile of Serratia spp isolated from various clinical specimens. Study Design and Settings: A descriptive cross-sectional study on antibiotic resistance profile of Serratia spp isolated from various clinical specimens was carried out in the Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi, from 1st July 2017 to 30th June 2021. Methodology: 464 clinical specimens yielding growth of Serratia spp were included in the study. Serratia spp were identified by using Standard Microbiological procedures. Modified Kirby Bauer disc diffusion method was used for Antibiotic Susceptibility testing. The clinical data was analyzed prospectively from July 2017 to June 2021 for a period of 4 years. The spectrum of diseases caused by Serratia spp along with resistance profiles were analyzed. . Data obtained was analysed using SPSS 24. Results: High yield of this bug was obtained from pus and tissue specimens 150 (32%).130(28%) isolates were retrieved from blood cultures, whereas respiratory specimens contributed to 89(19 %) isolates of Serratia spp. According to the antimicrobial susceptibility pattern, 154 (33.3%) isolates were sensitive to Meropenem, 150(32.2%) were susceptible to Doxycycline and 118 (25.5%) to Amikacin, making them the preferred antibiotics to be used in our setup. Conclusion: Serratia marcescens isolates are increasingly resistant to antibiotics. Clinical isolates of Serratia exhibited highest resistance to Ciprofloxacin, Ceftriaxone, Gentamicin and Piperacillin/tazobactam

Effectiveness of Short Message Service (SMS) based Glycaemic Control

Objective: To find out the effectiveness of short message service (SMS) on glycaemic control among patients with diabetes at a tertiary care hospital in Rawalpindi.
 Study Design: Quasi-experimental study.
 Place and Duration of Study: Department of Endocrinology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jul 2020.
 Methodology: A total of 218 patients with diabetes were included in the study. Patients were randomized into two groups by lottery method. Group-A received a tailored SMS package daily for six months along with printed dietary instructions, while Group-B was given only printed dietary instructions. After six months, HbA1c levels and other sociodemographic factors were compared among the two Groups A and B.
 Results: In Group-A (SMS-Group) mean HbA1c levels reduced from 9.3±2.0 to 7.0±0.4 compared to Group-B (non-SMSGroup) with mean HbA1c levels from 9.7±1.8 to 8.8 ±1.4. Before SMS intervention, all variables, including HbA1c levels between the two groups, were insignificant. However, the use of structured SMS-based intervention in Group-A showed a statistically significant reduction in HbA1c levels compared to Group-B (p-value <0.05). The mean difference was 1.77(95% CI:-2.44 to -1.10).
 Conclusion: This study showed Short Message Service (SMS) effectiveness by significantly reducing glycaemic levels (HbA1c)among people with diabetes compared to conventional methods of diabetic education for glycaemic control.

Perceptions and Practices of Sanitary Workers toward Hepatitis B Virus Infection and Vaccination in Tertiary Care Hospitals of Rawalpindi: A Cross Sectional Analytical Study

Objective: The purpose of this study is to evaluate the sanitary staff at selected tertiary care hospitals of Rawalpindi.
 Study Design: Cross-sectional analytical study.
 Place and Duration of Study: study was conducted from Nov 2021 to May 2022. In four Tertiary Care Hospitals in Rawalpindi Pakistan.
 Methodology: The sample size of 200 was calculated as per the reference study. Convenience sampling technique was used.Hospital cleaners over the age of 18 who worked daily in all clinical units and were involved in cleaning, waste collection and disposal.
 Results: In this study majority of the participants were males 178(89%) and majority 75(38%) were of age group 35-44 years and 45-54 years 69(35%). More than two third 156(78%) were married. Almost equal proportion of participants had middle 83(42%) and primary 77(39%) education There was significant association of gender with knowledge of Hepatitis-B (pvalue=0.004), knowledge of cure (p-value=0.001) and symptoms (p-value=00.02), transmission through blood transfusion (pvalue=0.027). There was also significant association between age group and provision of HBV vaccination to the staff (pvalue=0.009), knowledge of availability of HBV vaccination at hospital (p-value=0.001), screening for HBV (p-value=0.025),handling of sharps carefully (p-value=0.000), vaccination status for HBV (p-value=0.010), wearing gloves during work (pvalue=0.017).
 Conclusion: the study offers helpful information into potential idiosyncrasies of sanitary workers and hospital cleaners that may serve as the foundation for future, more extensive studies.

Sugar Sweetened Beverages (SSBs)-Awareness, Intention and Self-Efficacy Among Low-Income Adults in a Tertiary Care Setting

Objective: To assess the awareness, self-efficacy and intention of Sugar Sweetened Beverages (SSBs) among low-income staff members of a tertiary care hospital.
 Study Design: Cross sectional analytic study.
 Place and Duration of Study: Tertiary care hospital in Rawalpindi Pakistan, for 4 months, from May to Aug 2022.
 Methodology: The research was conducted among low-income urban adults of a tertiary care hospital in Rawalpindi Pakistan.A non-probability purposive sampling technique was used to select a sample of 200 participants. After taking informed consent the data was collected using a validated questionnaire to assess the SSB-related awareness, self-efficacy and intention.The association between SSB-related constructs and demographic factors was analyzed by using chi-square test and a p-valueof ≤ 0.05 was considered as significant.
 Results: The mean age of the participants was 21(SD=2.9). Majority 124(62%) of the participants were male, while almost two third 150(75%) had a higher secondary education. Remarkably participants had good SSBs related awareness 170(85%), selfefficacy 151(75.5%) and intention 177(88.5%). Whereas 60(30%) of the participants rarely using sugary drinks, comprised of 35(58.3%) females and 25(41.7%) males. However, association between these two variables was statistically significant (p=0.001). Association analysis between sociodemographic with SSB-related constructs, reported significant association between awareness with employment status (p-value=0.05) and self-rated health status (p-value=0.001). 
 Conclusion: The current study concluded that despite less education level and monthly income. Majority of the participants consumed sugary drinks once weekly but not daily with good awareness, self-efficacy and intention, whereas no significant association was evident between gender and SSBs related awareness, self-efficacy and intention.

Post-Traumatic Stress Disorder (PTSD) Among Healthcare Workers of Tertiary Care Hospitals of Rawalpindi; Amid the COVID-19 Pandemic

Objective: To determine the prevalence of PTSD symptoms and its severity among HCWs, amid the COVID pandemic in a tertiary care setting.
 Study Design: Cross sectional analytic study.
 Place and Duration of Study: Pakistan Emirates Military Hospital, Rawalpindi Pakistan, from May to Aug 22. 
 Methodology: The study was conducted on 173 healthcare workers of a tertiary care hospital. The sample size was calculated using the Rao-soft calculator. Validated questionnaires such as the Impact of Event Scale-Revised (IES-R) and PTSD Checklist Civilian Version (PCL-C) were used to collect the data. Data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 26.
 Results: Out of 173 participants, majority of participants 90(52%) were male and single 103(63%). Mean age of the participating HCWs was 27(SD= 2.3). HCWs performing duties the in COVID-19 ward for one year were 66(38.2%) and majority were from Emergency medicine 61(35.3). Almost 150(86.71%) of HCWs did not experiencing any PTSD symptoms and those exhibiting a higher severity of symptoms were only 5(2.9%). There was no statistically significant difference in total and sub scales mean scores of IES-R among males and females (p= 0.28). 
 Conclusions: Our study concluded that prevalence of symptoms of PTSD was significantly low in Health Care Workers despite of the fact, majority of doctor participants were working in COVID-19 ward for one year. The symptoms were evident among healthcare professionals, however there was modest severity.

Risk Factors of Osteoporosis in a Tertiary Care Hospital of Rawalpindi

Purpose: Osteoporosis is a common health problem all over the world. Loss of bone mass with aging leads to osteoporosis. Different factors affect the bone mass loss and consequencltly osteoporosis prevalence. However, these factors are under-studied in the Pakistan.This study aims to identify the risk factors of osteoporosis among patients in Holy Family Hospital Rawalipindi.
 Methodology: This descriptive cross-sectional study was carried out in among 120 diagnosed patients of osteoporosis for six months from April 2021 to September 2021 in a tertiary care hospital of Rawalpindi. Patients were recruited in the study via a set of inclusion and exclusion criteria and non-probability convenient sampling technique. A self-strcutured questionnaire was used to collect data. Before data collection information consent was acquired from all participants. Data analysis was performed on SPSS version 25. Descriptive statistics were applied.
 Findings: Osteoporosis was more prevalent among the patients who had, age group with more than 45years (79.16%), female gender (72.50%), low education level (64.16%), lower socioeconomic status (68.33%), family history of osteoporosis (61.67%), sedentary lifestyle (57.50%), history of corticosteroids therapy (53.33%), no milk use (69.20%), no fresh vegetables and fruits use (80.00%), no inatke of calcium supplements (78.33%), no sunshine exposure (77.50%), and overweight (48.33%). In short, age group with age above 45years, female gender, low education level, lower socioeconomic status, family history of osteoporosis, sedentary lifestyle, overweight, history of use of corticosteroids, no milk use, no intake of fresh vegetables and fruits, no intake of calcium supplements, and no sunshine exposure, all raise the incidence of osteoporosis.
 Recommendations: People should take milk, fresh fruits and vegetables, calcium supplements, and sun bath. Furthermore, people should spend active life with proper weight.

Risk Factors of Hemorrhoids in a Tertiary Care Hospital of Rawalpindi: A Descriptive Cross-Sectional Study

Purpose: Hemorrhoids/Hemorrhoidal disease is one of the commonest diseases in surgical outdoor patient department. Several factors play role in the development of hemorrhoids and subsequently their prevalence. However, these factors are under-researched in Pakistan. This study aims to recognize the risk factors of hemorrhoids among patients in a surgical unit of Holy Family Hospital Rawalpindi. This may lead to a decrease in hemorrhoids incidence and its associated social and economic burden through the prevention of risk factors that would have the main role in the development of hemorrhoids.
 Methodology: This descriptive cross-sectional study was conducted among one hundred and three diagnosed patients with hemorrhoids for seven months from April 2021 to October 2021 in the surgical outdoor patient department of Holy Family Hospital Rawalpindi. Patient enrollment was made in the study via a set of inclusion and exclusion criteria and a non-probability convenient sampling technique. A self-designed questionnaire was applied for the collection of data. Inform consent was taken before the data collection from all participants. Data analysis was performed via SPSS (Statistical package for social sciences) version 25. Descriptive statistics were applied (IBM Corp., Armonk, NY).
 Findings: Hemorrhoids were more prevalent among the patients who had, an age group above 40 years (73.78%), male gender (66.99%), a low education level (56.31%), lower socioeconomic status (62.14%), family history of hemorrhoids (55.34%), constipation (78.64%), longer duration of stay in the toilet for evacuation (58.25%), chronic cough (51.46%), no daily intake of fresh fruits and vegetables (66.99%), daily intake of spicy foods (50.48%), inadequate intake of water (60.19%), sedentary lifestyles (73.78%), and overweight (41.75%). In brief, the age group above 40 years, male gender, low educational level, lower socioeconomic status, family history of hemorrhoids, constipation, longer duration of stay in the toilet for evacuation, chronic cough, no daily consumption of fresh fruits and vegetables, daily intake of spicy foods, inadequate intake of water, sedentary lifestyles, and high body mass index, all promote the risk of development of hemorrhoids.

Therapeutic Guidelines and Antimicrobial Resistance of Helicobacter Pylori in Patients with Peptic Ulcer at Tertiary Care Hospitals of Rawalpindi and Islamabad

Objective: The purpose of this study was to investigate the prevalence of antibiotic resistance among Helicobacter pylori isolates obtained from patients suffering from peptic ulcer disease in Rawalpindi and Islamabad, Pakistan, and to propose a novel anti-H. pylori therapy strategy for use in these locations. Methodology: A total of 132 H. pylori from the patients suffering with peptic ulcer disease were reported for clinical treatment in institutions in the twin Cities that provide tertiary care. Antibiotics such as ciprofloxacin, clarithromycin, amoxycillin, metronidazole, and tetracycline were tested on the isolates to determine their levels of susceptibility to these drugs. The Epsilometer test, often known as the E-test, is a quantitative disc diffusion method that is used to determine antibiotic sensitivity. This test was utilised for the purpose of verifying isolates. Results: The overall rate of resistance among H. pylori was found to be 27.9% for amoxycillin, 38.9% for clarithromycin, and 73.6% for metronidazole. 47 out of 132 isolates exhibited multiple drug resistance, with metronidazole, clarithromycin, and amoxycillin showing the highest frequency of two, three, and four drug resistance patterns. Ciprofloxacin had a low level of tetracycline resistance, ranging from 1.2 to 4%, whereas metronidazole resistance was substantial. In the population of Pakistan, the frequency of H. pylori resistance to metronidazole is quite high, whereas it is moderate in response to clarithromycin and amoxycillin, and low in response to ciprofloxacin and tetracycline. The rates of resistance to clarithromycin and amoxycilin were higher in Rawalpindi than they were in Islamabad. It is imperative, for the sake of the public's health, that Pakistan make an adjustment to its policy regarding antibiotics, one that will permit the use of antibiotic rotation in the treatment of H. pylori. Keywords: Peptic ulcer, Helicobacter pylori, antibiotic susceptibility.

Risk factors of acute otitis media among infants in a tertiary care hospital in Rawalpindi: a descriptive cross-sectional study

<p><strong>Background: </strong>Acute otitis media (AOM) is the second most common disease of childhood. Many factors play role in the causation of AOM. However, the research-based data on risk factors for AOM in infants is still inadequate. Objective were this study<strong> </strong>aimed to determine the risk factors for AOM in infants with AOM.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted among 189 infant patients with AOM in the otorhinolaryngology outpatient department of allied hospital of Rawalpindi medical university, Rawalpindi. Established inclusion and exclusion criteria and non-probability convenience sampling technique were utilized for the selection of patients. After taking informed consent, data were collected through a self-adapted questionnaire. Descriptive analysis was accomplished through SPSS version 25.</p><p><strong>Results: </strong>AOM was more common among patients who had, an age group with a range of 9-12 months (41.28%), male gender (55.02%), lower birth order (49.73%), mothers with illiterate educational status (53.96%), mothers with the job (57.14%), lower socioeconomic status (59.25%), used bottle-feeding (46.56%), supine position during feeding (61.37%), used a pacifier (67.73%), poor feeding hygiene (58.21%), unvaccinated pneumococcal status (57.15%), and large family (63.50%). In the case of family ear infection and passive smoking, AOM incidence was more frequent among infants whose family had no history of ear infection (69.85%) and no smoking exposure (53.44%).</p><p><strong>Conclusions: </strong>In short, the age group with a range of 9-12 months, male gender, low birth order, illiterate mothers, mothers with the job, lower socioeconomic status, bottle-feeding, supine feeding position, pacifier use, poor feeding hygiene, unvaccinated pneumococcal status, and large family size, all raise the risk of AOM incidence in infants.</p>

Risk Factors of Nephrolithiasis in a Tertiary Care Hospital in Rawalpindi: A Descriptive Cross-Sectional Study.

BackgroundNephrolithiasis (renal stones) is the most common urological disease. Its prevalence is high in every part of the world. Several factors lead to renal stone formation. In Pakistan, nephrolithiasis prevalence is also high as Pakistan is located in a region which is known as the salt belt. However, nephrolithiasis and its possible risk factors are under-researched in Pakistan.ObjectiveThis study aims to identify the risk factors for nephrolithiasis among admitted patients with renal stones. This may lead to a reduction in renal stone incidence and its allied complications by the prevention of risk factors that would have a major role in renal stone formation.Material and methodsThis descriptive cross-sectional study was performed among the 143 admitted patients with renal stones in the urology ward of Benazir Bhutto Hospital, Rawalpindi, for approximately six months from November 2021 to April 2022. Non-probability convenient sampling and developed inclusion and exclusion criteria were used for the recruitment of patients. After elaborating on the objectives, the study data were collected by interviewers through a self-structured questionnaire. Descriptive analysis was carried out using SPSS version 25.0 (IBM Corp., Armonk, NY).ResultsNephrolithiasis was more prevalent among patients who had an age group range of 15-30 years (47.55%), male gender (56.65%), illiterate educational status (53.14%), lower socioeconomic status (66.43%), inadequate intake of water (61.53%), used tap water (56.64%), a habit of daily vegetable intake (65.04%), sedentary lifestyle (51.74%), family history of renal stones (57.34%), no diabetes mellitus (62.94%), no hypertension (52.45%), and overweight (48.23%).ConclusionIn brief, the age group of 15-30 years, male gender, illiteracy, lower socioeconomic status, insufficient water intake, tap water, high vegetables, inactive lifestyle, family history of nephrolithiasis, and a high BMI all increase the risk of nephrolithiasis.

Plasmapheresis in Neurological Disorders: Frequency and Type of Adverse Effects Associated with this Procedure in Atertiary Care Hospital in Pakistan

Objective: To determine the frequency and type of adverse effects associated with plasmapheresis among the patients with neurological disorders at a tertiary care hospital in Pakistan.
 Study Design: Prospective longitudinal study.
 Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2019.
 Methodology: The sample population comprised 150 patients with various neurological disorders requiring plasmapheresis at a tertiary care hospital in Rawalpindi, Pakistan. The consultant neuro physician diagnosed the underlying disorder, and a management plan of plasmapheresis was given after the departmental meeting. The presence of adverse effects was observed during the session of plasmapheresis till 48 hours after the session.
 Results: Out of 150 patients with neurological illness undergoing plasmapheresis at our department, 18 (12%) developed one or more adverse effects due to the procedure, while 132 (88%) did not experience any adverse effects. The mean age of the patients was 30.2 ± 2.698 years. GB syndrome 61 (40.6%) was the commonest disease for which plasmapheresis was done. Allergic reaction 4 (2.6%) was the commonest side effect among the patients undergoing plasmapheresis, followed by abdominal pain 3 (2%). 146 (97.4%) patients were shifted toward, and 4 (2.6%) required intensive care unit admission after the procedure due to complications. Mortality due to this procedure was nil in the given period.
 Conclusion: Plasmapheresis is a relatively safe procedure for neurological illnesses with an immunological basis. Patients should be told about the common adverse effects they could face during the procedure especially allergic reactions and...

COVID-19 Vaccine Hesitancy Among Health Care Professionals of Allied Hospitals of Rawalpindi Medical University: A Mediation Analysis

AimsThis research assessed healthcare workers' vaccination practices for influenza, hepatitis, and pneumonia, as well as their desire to get COVID-19 vaccine when accessible, and investigated their 7C psychological antecedents (confidence, complacency, collective responsibility, compliance, calculation, constraints and conspiracy). Stress variables and vaccination intention for COVID-19 were also compared to see whether psychological stress had a meditative impact on the relationship.MethodsAn analytical cross-sectional survey was conducted among health care professionals including nurses and doctors of tertiary care hospitals of Rawalpindi. Data were collected from February to April 2021 to get the COVID-19 vaccination when it became available, and looked into their 7C mental forebears (confidence, complacency, collective responsibility, compliance, calculation, constraints and conspiracy). A total of 642 health care professionals voluntarily participated in our research. Demographic Details, questions like pneumonia vaccination, hepatitis vaccination, influenza vaccination and 7C questions were asked. Data were entered and analysed through SPSS 26.0 and Python. Correlation, linear and non linear regression, and mediation analysis were applied.ResultsThe immunization rates for influenza, hepatitis, and pneumonia vaccines, as well as the percentage of those who received COVID-19 vaccination, were 43.4%, 65.2%, 42.8%, and 39.7%, respectively. Hepatitis vaccination was significantly associated with the 7C model, influenza vaccination with conspiracy, whereas pneumonia was significantly associated with compliance. confidence (r = 0.11), complacency (r = −0.19), constraints (r = −0.20), calculation (r = 0.08), collective responsibility (r = 0.18), and compliance (r = 0.19) were significantly corelated with the COVID-19 Vaccine Intention. Contrary to direct effect, the indirect effect of patient contact frequency (β = −0.01, ρ<0.05) and terrified of contracting virus (β = −0.05, ρ<0.05) via psychological stress on COVID-19 Vaccination intention were significant depicting full mediation.ConclusionFor herd immunity, the probability for COVID-19 vaccination uptake among healthcare professionals was less than optimal. The 7C structures may help predict immunization against influenza, hepatitis, and pneumonia, but not vaccination against COVID-19.

Assessment of Legibility and Completeness of Prescriptions at Tertiary Care Hospitals: A Cross-Sectional Study

AimsThe aim of this study was to assess the legibility as well as components of a prescription prescribed by doctors in tertiary care hospitals of Rawalpindi, Pakistan.MethodsAn analytical cross-sectional study was conducted in pharmacies of two allied hospitals of Rawalpindi Medical University. Data were collected using stratified randomized sampling. A total of 661 prescriptions were selected and analysed for legibility by three experts. SPSS version 26.00 and Graph Pad Prism were used to enter and analyze the data. Descriptive statistics, correlational model and multinomial logistic regression were applied.ResultsA total of 1982 drugs were prescribed in 661 prescriptions. A total of 46.0% prescriptions were classified in grade 2 and 32.1% in grade 3. On average, 55.74% prescriptions were found to be complete. On average, prescriber's information, patient's information and medication details were present in 72.64%, 57.25%, and 36.73% prescriptions, respectively. Grade 1 (AOR = 0.62), grade 2 (AOR = 0.83), and grade 3 (AOR = 0.85) prescriptions had less odds of being complete compared to grade 4 prescriptions.ConclusionMajority of the prescriptions prescribed at tertiary care hospitals were barely legible and also quite a number of prescriptions were incomplete.

Frequency of otitis media with effusion among children aged 1-5 years presenting to immunization center of tertiary care hospitals, Rawalpindi.

We conducted this study to assess the etiopathogenic relation of otitis media with effusion (OME) in a group of children aged 1-5 years among the local population of Rawalpindi. This was a cross-sectional retrospective study. Study was conducted among the children presenting to the immunization center of three tertiary care hospitals of Rawalpindi. Otitis media was assessed by clinical examination and tympanometry from August 2019 to January 2020. Multi-factor regression analysis was then applied to recognize the statistical significance and association of various risk factors to OME. Out of 400 children enrolled in this study, 108 (27.0%) had OME, out of which 65 (60.2%) were males and 30 (27.8%) were of age group 2-3 years. Multivariable regression analysis of risk factors associated with OME showed it was strongly associated with snoring (P < 0.001), last year symptoms (attack of ear aches with hearing loss [P = 0.002]), drugs (URTI antibiotics [P = 0.026], All 3 drugs [P = 0.013]). We found out that OME is a common disease which if not identified or treated timely can lead to other hard to cure health problems. Control of its etiopathogenic factors can play a major role in its prevention.

Urinary Tract Infection and Its Risk Factors in a Tertiary Care Hospital

Background: Urinary tract infection (UTI) is common health issue all over the world and several factors predispose the people to urinary tract infection.&#x0D; Objective: The study aimed at determining the incidence of Urinary tract infection and factors associated with it.&#x0D; Material and Methods: This cross-sectional study was performed among 205 patients in a tertiary care hospital of Rawalpindi, Pakistan. Simple convenient sampling and an established inclusion and exclusion criteria was applied to select the participants. After obtaining the informed consent from all participants, data was acquired via a self-designed proforma. Data analysis was carried out through SPSS version 25. Chi square test was applied to check the association between urinary tract infection and predisposing factors. The p-value less than 0.05 was taken as statistically significant.&#x0D; Results: The incidence of urinary tract infection was 12.68%. Urinary tract infection was significantly associated age group (p=0.003), gender (p=0.001), marital status (p=0.004), educational status (p=0.0001), socioeconomic status (p=0.005), previous history of UTI (p=0.0002), family history of UTI (p=0.0004), history of stone in urinary tract (p=0.003), history of recent use of antibiotics (p=0.04), history of catheterization (p=0.001), hygienic condition of external genitalia (p=0.0005), frequency of intercourse (p=0.04), history of diabetes mellitus (p=0.002), and hydration status (p=0.0007), whereas, association of urinary tract infection with holding urine was insignificant (p=0.05).&#x0D; Conclusion: The incidence of urinary tract infection was high among research population. Risk factors that could lead to UTI were young age, female gender, married marital status, lower educational status, lower socioeconomic status, previous history of UTI, family history of UTI, history of stone in urinary tract, history of recent use of antibiotics, history of catheterization, poor hygienic condition of external genitalia, high frequency of intercourse, history of diabetes mellitus, and dehydration.&#x0D; Recommendations: People should be educated about the UTI and its causes and prevention. People should also take special care when they are on antibiotics or when they are diabetics, to prevent UTI. People should maintain hygiene when they are catheterized and during intercourse. People should stay hydrated.

Experiences of Web Searches for Medical Information Purposes on Health Anxiety in the general population reporting to tertiary care hospitals of Rawalpindi

Objective: To assess the prevalence of internet use for medical purposes by the general public and to correlate it with anxiety levels.&#x0D; Materials and methods: An analytical cross-sectional study was conducted in tertiary care hospitals of Rawalpindi from August to December 2020. Ethical approval was taken. A sample size of 385 was calculated through Rao software. Non-probability convenient sampling technique was used. Informed consent was taken. A validated questionnaire was used. The data was analysed using IBM SPSS Statistics Version 25. Frequencies and percentages were calculated. Chi-square test of significance was applied. P-value less than .05 was considered as statistically significant.&#x0D; Results: A majority of the participants used the internet to obtain health-related information. Majority of the subjects stated that the health-related searches exacerbated their anxiety. The negative effects of excessive or inappropriate internet use are stronger in women than in men. Participants from lower income groups were more prone to anxiety, however participants from higher income groups were slightly more likely to visit a doctor for a perceived health condition. The internet was helpful in understanding the terminology used by doctors for majority of the participants.&#x0D; Conclusion: The study found that most people who use the internet also use it for health related searches. There is a positive correlation between excessive health-related internet use and health anxiety. This correlation is stronger in women. Looking up medical terminology on the internet makes it easier for patients to communicate with doctors and understand their condition.&#x0D; Keywords: Anxiety, web searches, internet, cyberchondria