Tertiary Care Hospital In Lahore Research Articles

ASSESSMENT OF KNOWLEDGE REGARDING EVIDENCE BASED GUIDELINES ON VAP PREVENTION AMONG NURSES

Ventilator-associated pneumonia (VAP) is a serious healthcare-associated infection that increases morbidity, mortality, and healthcare costs, particularly in intensive care units (ICUs). In Pakistan, the high prevalence of VAP in ICUs underscores the importance of adherence to evidence-based preventive practices among nursing staff. However, knowledge gaps and inconsistencies in VAP preventive practices remain a challenge, largely due to limited training resources and high patient-to-nurse ratios. Objective: This study aimed to assess the knowledge of ICU nurses on evidence-based guidelines for VAP prevention at a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study design was utilized. Data were collected from 140 registered nurses working in the ICU of Sir Ganga Ram Hospital, Lahore, using a structured questionnaire consisting of 17 questions related to VAP prevention guidelines. Convenience sampling was employed to recruit participants who met the inclusion criteria. Data analysis was performed using SPSS, with descriptive statistics applied to summarize findings and identify knowledge gaps. Results: The study revealed varied levels of knowledge among ICU nurses regarding VAP prevention. While the majority demonstrated awareness of core practices, such as semi-recumbent positioning and regular oral care, there were notable gaps in understanding related to the frequency of ventilator circuit changes and the optimal use of suction systems. Approximately 67.9% of nurses were aware of general VAP guidelines, but only 47.1% correctly identified all recommended practices. Additionally, knowledge disparities were observed based on educational background and years of ICU experience.Conclusion: This study highlights critical knowledge gaps among ICU nurses regarding evidence-based VAP prevention practices. The findings underscore the need for targeted educational interventions and standardized training programs to improve adherence to VAP guidelines. Strengthening nurse education on VAP prevention can contribute to reduced infection rates, enhanced patient safety, and better utilization of healthcare resources in Pakistan’s ICUs.

Perceptions about hypertension in an urban population in Pakistan

Background: As the risk factors and prevalence of hypertension continue to increase in Pakistan, it is imperative to understand the perceptions of patients about its prevention, symptoms, diagnosis, treatment, and management to inform the design of programmes to improve management. Objective: To explore patients’ perceptions about the treatment, management and control of hypertension in an urban population in Pakistan. Methods: Using a semi-structured questionnaire, we conducted one-on-one interviews with 30 hypertensive patients at 2 urban government tertiary care hospitals in Lahore and Sargodha. The patients were aged 35–70 years, diagnosed with hypertension by a registered medical doctor, and being treated with anti-hypertensive medication. The interviews were recorded, transcribed and analysed using Quirkos. Results: Almost all the patients recognized the potential long-term consequences of hypertension. Most of them said regular use of prescribed medication was beneficial, including for blood pressure control and relief of symptoms. They understood the benefits of lifestyle modification, such as engaging in physical activity, for the management of blood pressure. They however had inadequate knowledge of their treatment regimens; some of them took their medications irregularly, while some took them only when they felt symptoms. Most patients relied solely on medical management. Conclusion: We identified major challenges with the management of hypertension among the study population. Patients and caregivers relied mostly on medical management, with insufficient follow-up after initiating treatment. There is a need to improve patient follow-up and provide better patient education on the benefits of adhering to treatment regimens and adopting lifestyle changes including dietary and exercise management.

PREVALENCE OF DENTAL CARIES AMONG SMOKERS OF A TERTIARY CARE HOSPITAL OF LAHORE

Dental caries is a common chronic oral health condition globally, with an increased prevalence among smokers. Smoking contributes to caries risk by affecting saliva production, oral microbiota, and oral hygiene practices. In Pakistan, where smoking is prevalent. Objective: This study aims to assess the prevalence of dental caries among smokers attending a tertiary care hospital in Lahore. Methods: A cross-sectional study was conducted at Jinnah Hospital, Lahore, from January to July 2024. The sample included 100 adult smokers aged 18 years and above. Data on demographics, smoking frequency, oral hygiene practices, and dental caries were collected using structured interviews and clinical examinations. Caries severity was assessed using the Decayed, Missing, and Filled Teeth (DMFT) index. Statistical analyses, including chi-square tests, were conducted to explore associations between smoking habits and caries prevalence. Results: The majority of participants were aged 26-35 (30%), with 35% smoking 6-10 cigarettes daily. Oral hygiene practices were suboptimal, with only 25% brushing twice daily, and 15% reporting no regular hygiene routine. The prevalence of dental caries was strongly correlated with smoking frequency and duration. Participants smoking more than 21 cigarettes daily had an 80% caries prevalence, while those with a smoking history of over 16 years had a mean DMFT score of 7.6. These results align with previous studies linking smoking with higher caries risk and severity. Conclusion: The study highlights a high prevalence of dental caries among smokers, with significant associations between smoking frequency, duration, and caries severity. These findings underscore the need for preventive dental health interventions, including smoking cessation programs and targeted oral hygiene education, to mitigate the burden of dental caries in this high-risk population.

UNDERSTANDING THE LEVEL OF KNOWLEDGE AMONG NURSES ABOUT FIRE SAFETY IN TERTIARY CARE HOSPITAL LAHORE

Fire safety in healthcare facilities is an important but frequently disregarded part of hospital administration and patient care. Despite substantial study on different aspects of healthcare delivery, there is still a significant gap in understanding and measuring fire safety knowledge and practices among healthcare personnel, particularly in Pakistan's tertiary care facilities. Objective: The purpose of this study was to assess the degree of fire safety knowledge among medical personnel at a tertiary care hospital in Lahore, Pakistan, to identify any shortcomings that may affect their capacity to respond effectively in the event of a fire. Methods: A cross sectional quantitative descriptive study was conducted at Public Tertiary care hospital in Lahore involving 202 nurses. A customized questionnaire was administered to assess the participant’s fire safety knowledge, selected through successive sampling. Data analysis was performed using SPSS version 22.0, categorizing knowledge level as poor, average and good. Results: 85% of survey participants were aware of fire response procedures. However, only 15% knew the fire department contact numbers, and 25% were unaware that foam or water extinguishers are ineffective against grease fires. Additionally, a significant proportion of participants struggled to correctly identify different types of fire extinguishers (65%) and fire categories (50%). The finding underscore the importance of comprehensive fire safety training to address significant knowledge gaps. Conclusions: Healthcare institutions should develop comprehensive fire safety training programs that extend beyond basic emergency protocols. Regular fire drills and simulations should be held to check staff members' understanding and reinforce fire safety procedures. Administrators should examine and update fire safety protocols on a regular basis to reflect new technology, legislation, and lessons learnt from previous events.

SEDATION ASSESSMENT IN MECHANICAL VENTILATED PATIENTS: THE LEVEL OF KNOWLEDGE ASSESSMENT AMONG CRITICAL NURSES IN A PUBLIC TERTIARY CARE HOSPITAL LAHORE

By appropriately evaluating and controlling sedation in patients on mechanical ventilation, nursing problems can be prevented. However, critical care nurses in public tertiary care hospitals with limited training and resources continue to lack certain expertise. Critical care nurses need to assess and manage sedation. Patients are at significant risk from both over and insufficient sedation. Critical care nurses must possess adequate expertise in sedation assessment and management. Objective: The study's objective is to evaluate critical care nurses' knowledge in sedation management for patients on mechanical ventilation at Pakistan's public tertiary care hospitals. Method: A cross-sectional study with a descriptive design was carried out at the public tertiary care hospital in Lahore. Convenience sampling techniques were used to recruit study participants from the critical care unit. Knowledge levels were divided into three categories: poor, fair and good. Data was collected through questionnaires, which were evaluated using descriptive statistical analysis. Results: The result showed that 36% had fair knowledge, just 16% of the nurses had a strong understanding of sedation management, and 48% of the nurses had low knowledge. Conclusion: The study highlighted a significant lack of sedation management knowledge among critical care nurses in public tertiary care hospitals. Addressing these gaps through targeted training and standardized sedation protocols is essential for improving patient safety in critical settings.

ASSESSMENT OF NURSES' KNOWLEDGE REGARDING PERSONAL PROTECTIVE EQUIPMENT AT TERTIARY CARE HOSPITAL LAHORE

Personal Protective Equipment (PPE) is crucial for protecting healthcare workers from occupational hazards and infections, particularly in high-risk environments such as hospitals. Adequate knowledge and proper use of PPE are essential to ensure the safety of both healthcare workers and patients. This study aimed to assess the knowledge, attitudes, and practices of nurses regarding PPE at a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study design was utilized. A structured questionnaire was used to collect data from 152 nurses working in various departments of the hospital. Purposive sampling was employed, and the sample size was determined using RaoSoft with a 95% confidence interval and a 0.5% margin of error. The questionnaire comprised sections on demographic information, knowledge assessment, and attitudes and practices evaluation. Data were analyzed using SPSS version 25.0, with descriptive statistics and chi-square tests to identify associations between demographic characteristics and knowledge levels. Results: Of the 152 participants, 77% were female, with a mean age of 36.5 years (SD ± 9.05 years). Most participants held a diploma in nursing (46%), and the majority (93.4%) had less than 12 years of professional experience. The findings revealed that 67% of nurses demonstrated good knowledge of PPE, 20% had average knowledge, and 13% exhibited poor knowledge. While 92% of participants reported being knowledgeable about PPE usage, inconsistencies were noted in the adherence to specific practices, such as glove and mask usage. Additionally, only 34% of participants believed that consistent use of PPE would reduce their risk of infection, indicating a potential gap between perceived and actual knowledge. Conclusion: The study highlights both strengths and gaps in nurses' knowledge and practices regarding PPE at a tertiary care hospital in Lahore. While most nurses demonstrated a satisfactory understanding of PPE, inconsistencies in practical application underscore the need for targeted training and reinforcement of guidelines. Regular training sessions, active monitoring, and continuous professional development are essential to enhance adherence to PPE protocols and safeguard healthcare workers in resource-limited settings like Pakistan.

The Pharmacotherapy Practices and Clinical Outcomes of Pre-eclampsia/Eclampsia: An Observational Study

Background: This study observes fetal, pregnancy, and maternal outcomes with different regimens of Magnesium sulphate (MgSO4), used for prophylaxis and treatment of convulsions in eclampsia. Methods: In this observational study, the current prescribing practice and management outcomes of pre-eclampsia/eclampsia were observed in three tertiary care hospitals in Lahore, Pakistan. Data were collected by using data collection form, containing information related to patient demographics, history, laboratory findings, drug administration record, and therapeutic outcomes for pregnancy, fetus, and mother. Results: Of the 50 patients studied, most (74%) were of eclampsia. The mean age of the patients was 25.7 (+5.05) years with the majority (36%) in the age range 21–25 years. Forty-one patients received MgSO4, of which most received the Pritchard regimen (n = 35), whereas only 5 patients were managed with Zuspan regimen. Liner logistic analysis revealed better fetal outcomes (OR 0.217, CI –0.283 – 1.543) and pregnancy outcomes (OR 0.186, CI –0.164 – 0.635) with Zuspan regimen as compared to Pritchard. Whereas, both regimens showed no difference in maternal outcomes (OR 0.044, CI –0.129 – 0.170). Conclusion: Zuspan regimen proved to be better in morbidity and mortality associated with eclampsia. Additionally, national as well as institutional guidelines should be developed, implemented, properly monitored, and evaluated for management of preeclampsia/ eclampsia. Mandatory in-service training and expertise should be provided for health professionals at all levels of the healthcare system, especially those working in gynecological setup.

Persistently high plasma procalcitonin levels despite successful treatment of tuberculous pleuritis and tuberculous lymphadenitis patients

In a prospective cohort study, we evaluated plasma PCT levels in 48 TB lymphadenitis (TBLN) and 41 TB pleuritis (TBPE) patients. Measurements of PCT were done in unstimulated plasma of microbiologically and clinically confirmed TBLN and TBPE patients registered for anti-TB treatment at a tertiary care hospital in Lahore, Pakistan. Plasma levels of PCT were found to be raised in 89% of the patients at baseline with a median of 1.5 ng/ml. Levels were higher (p = 0.001) in TBLN as compared to TBPE (2.69, 0.96 ng/ml). PCT levels were not related to the bacterial burden depicted by culture positivity in these patients. PCT showed a negative correlation with the severity of constitutional symptoms (rho = − 0.238, p = 0.034), and inflammatory biomarkers; ferritin (rho = − 0.43, p < 0.001), INF-γ (rho = − 0.314, p = 0.003), TNF-α (rho = − 0.220, p = 0.039), IL-6 (rho = − 0.224, p = 0.035), and several chemokines of CCL and CCXL group. Raised plasma levels of PCT did not decrease with anti-TB treatment, indicating it is not a good biomarker to monitor treatment response in TBLN and TBPE patients. More studies with a larger number of confirmed EPTB cases are needed to define the role of PCT and its interaction with other biomarkers in EPTB.

Long-Term Safety and Efficacy of Janus kinase (JAK) Inhibitors in the Treatment of Rheumatoid Arthritis

Background: Janus kinase (JAK) inhibitors are a new class of drugs for the treatment of rheumatoid arthritis (RA); however, the long-term consequences of using these drugs are still not well understood. Objective: The primary objective of this research was to examine the effectiveness and safety of JAK inhibitors for the management of rheumatoid arthritis (RA) patients. Methodology: Clinical raw data of 150 RA patients receiving JAK inhibitors was collected in different tertiary care hospitals in Lahore, Pakistan from March 2023 to June 2024. till were conducted. The anti-inflammatory effect was evaluated by the Disease Activity Score in 28 joints (DAS28) and the safety profile through adverse events, laboratory markers, and patients self-reported outcomes. The SPSS version 27 applied for raw data analysis which used the paired t-tests and multiple regression models to establish the factors that determine favorable outcomes and complications. Results: JAK inhibitors also reduced the DAS28 scores from baseline to 24 months by a mean of 3. 2 ± 1. 1 (p&lt;0. 001). The findings stated that 12 percent of the patients at baseline and 45 percent of the patients at 24 months had achieved remission. The reported side effects were infections, 25%; gastrointestinal problems, 18%; and abnormal liver function tests, 10%. Severe adverse reactions were noted in 5% of the patients and no new safety issues were observed over the course of the treatment. Conclusion: JAK inhibitors have been shown to be useful in decreasing the activity of RA for the long-term use with reasonable side effects. The results provided evidence that JAK inhibitors were best treatment of rheumatoid arthritis (RA) but for best efficacy results closely monitoring and specific approach should be applied.

THE ASSESSMENT OF SELF-PERCEIVED EDUCATIONAL NEEDS AND COMPETENCY LEVEL OF EMERGENCY NURSES AT TERTIARY CARE HOSPITAL LAHORE

Competency in emergency nursing is crucial for ensuring high-quality patient care in fast-paced healthcare environments. Understanding emergency nurses' self-perceived educational needs and skill competencies is essential for guiding future training and improving patient outcomes. Objective: To assess emergency nurses' self-perceived educational needs and skill competencies at a tertiary care hospital in Lahore. Methods: A descriptive cross-sectional study was conducted using convenience sampling. The study population comprised 125 emergency staff nurses. Data were collected using a structured questionnaire and analyzed using descriptive statistics. Frequency distribution and data normality checks were performed to assess the nurses' educational background and skill competencies. Results: Most respondents (71.2%) held an associate diploma in general nursing, 13.6% had a post-RN qualification, and 15.2% held a Generic BSN. Regarding skill competency, 44% of respondents perceived themselves as highly competent, 40.8% as qualified, and 15.2% as least competent, particularly in areas like defibrillation and neurological assessment. Furthermore, 60% of the nurses needed additional education to enhance their patient care skills. Conclusion: The study concluded that emergency nurses at tertiary care hospitals require further education and training to enhance their knowledge and improve patient care outcomes. Continuous professional development programs focusing on skill enhancement are recommended to bridge the identified competency gaps.

Assessment of psychosocial work environment of doctors

Introduction :Psychosocial work environments pertain to interpersonal and social interactions that influence behavior and development in the workplace.Objective :To test a comprehensive and theory-based psychosocial work environment questionnaire and analyze associations with mental health in a sample of doctors in a tertiary care hospital in Lahore, Pakistan. METHODOLOGY :The design of study is cross-sectional study. It took place at Shaikh Zayed Hospital Lahore, from March 2017 to june 2017.A sample size of 100 working doctors was selected. Technique was non probability. After an informed consent each doctor was given the NRCWE’s Copenhagen short questionnaire consisting of 39 questions. The analysis of data was entered in SPSS 21. . After calculating frequency of data and explaining demographic variables, Independent t test sampling was applied and tables and pie chart was drawn.Results : Results reported worse working conditions in terms of stress, burnout, work family conflict and social support from superiors. High levels of stress and burnout were found. Doctors were almost satisfied with their jobs ( scores near to average but less than average ). Male doctors were found to be more satisfied with their jobs than female doctors.

Risk factors associated with influenza A (H1N1)pdm09: a nested case control study of TB patients with ILI in Lahore District, Pakistan

BackgroundCo-morbidity with respiratory viruses including influenza A, cause varying degree of morbidity especially in TB patients compared to general population. This study estimates the risk factors associated with influenza A (H1N1)pdm09 in TB patients with ILI.MethodsA cohort of tuberculosis (TB) patients who were admitted to and enrolled in a TB Directly Observed Therapy Program (DOTs) in tertiary care hospitals of Lahore (Mayo Hospital and Infectious Disease Hospital) were followed for 12 weeks. At the start of study period, to record influenza-like illness (ILI), a symptom card was provided to all the participants. Every participant was contacted once a week, in person. When the symptoms were reported by the participant, a throat swab was taken for the detection of influenza A (H1N1)pdm09. A nested case control study was conducted and TB patients with ILI diagnosed with influenza A (H1N1)pdm09 by conventional RT-PCR were selected as cases, while those who tested negative by conventional RT-PCR were enrolled as controls. All cases and controls in the study were interviewed face-to-face in the local language. Epidemiological data about potential risk factors were collected on a predesigned questionnaire. Logistic analysis was conducted to identify associated risk factors in TB patients with ILI.ResultsFrom the main cohort of TB patients (n = 152) who were followed during the study period, 59 (39%) developed ILI symptoms; of them, 39 tested positive for influenza A (H1N1)pdm09, while 20 were detected negative for influenza A (H1N1)pdm09. In univariable analysis, four factors were identified as risk factors (p < 0.05). The final multivariable model identified one risk factor (sharing of towels, P = 0.008)) and one protective factor (wearing a face mask, p = < 0.001)) for influenza A (H1N1)pdm09 infection.ConclusionThe current study identified the risk factors of influenza A (H1N1)pdm09 infection among TB patients with ILI.

Pattern of diseases in medical wards of a tertiary care hospital of Lahore: a retrospective study

AimThe study was conducted to determine the frequency of different diseases encountered in a medical ward of a tertiary care hospital.Subject and methodsThis was a cross-sectional study carried out in the Department of Medicine at Mayo Hospital Lahore using medical records of admitted patients from September to November 2021.ResultsA total of 381 patients were included in the study. The age group with the highest admission was 56–60 years. Decompensated Chronic Liver Disease was the most common disease (19.4%), followed by Ischemic Heart Disease (17.3%), Septic shock/Septicemia (9.4%), Cerebrovascular Accident (8.4%), Meningoencephalitis (7.3%) & Chronic Kidney Disease (6.6%).ConclusionKnowledge about the most prevalent diseases in medical wards can help guide future policy making & better management of diseases on a day to day basis.

Ergonomic Practice in Medical Laboratory Workers in a Tertiary Care Hospital in Lahore

Objective: To evaluate the ergonomics practice pattern among medical laboratory professionals to determine the ergonomic deficiencies to improve the workplace quality and safety at a tertiary care hospital in Lahore Methodology: This was a cross-sectional study conducted in department of pathology, King Edward Medical University/Mayo Hospital, Lahore from November 2019 to January 2020. All the workers engaged in all the sections of the clinical laboratory were included in the study. The results were collected using a self-administered questionnaire, which included demographic information, ergonomic practices, workplace layouts and equipment utilization pattern. Individuals were instructed to complete the questionnaires in accordance to their own specific time range and return it after filling. All the data was gathered from the surveys and then coded and securely stored in a database for further analysis and interpretation. Results: Average age of the participants was 26.80±5.70 years. Several participants reported appropriate bench heights (70.7%) and tools within arm’s reach (62.2%), deficiencies were noted in foot and knee clearance, with only 50.0% and 53.7% respectively. Limited provision of foot rails (11.0%) and floor mats (31.7%) for prolonged standing tasks was seen. Seated benches showed similar disparities, with notable deficiencies in adjustable armrests (32.9%) and footrests (29.3%). Microscope usage demonstrated challenges in maintaining neutral posture (65.1%), while pipette use and micro-manipulation tools highlighted the need for improved accessibility and ergonomic support. Conclusion: Study revealed the varying levels of ergonomic appropriateness across the workplace and equipment among medical laboratory workers, with significant inadequacies in foot and knee clearance, the presence of foot rails, floor mats, adjustable armrests, and foot rests. Difficulties in using a microscope, as well as concerns about pipettes and micro-manipulation equipment, underscored the need for improved accessibility and ergonomics.

Knowledge Regarding Needle Stick Injury Among Nurses of Tertiary Care Hospitals of Lahore

Knowledge Regarding Needle Stick Injury Among Nurses of Tertiary Care Hospitals of Lahore

PREVALENCE AND IMPACT OF WORKPLACE VIOLENCE AMONG NURSES IN TERTIARY CARE HOSPITALS

Workplace violence is a significant issue among nurses, particularly in tertiary care hospitals, impacting their well-being and job performance. Understanding the prevalence and types of violence can help develop effective strategies to mitigate these incidents. Objective: To investigate the prevalence, types, frequency, and impact of workplace violence among nurses in tertiary care hospitals in Lahore. Methods: This descriptive cross-sectional study was conducted in various tertiary care hospitals in Lahore over a six-month period following approval. The study population comprised registered nurses, aged 18-65, employed in these hospitals for over a year. A sample size of 108 nurses was calculated using Salvia's formula, with convenient sampling employed for selection. Data were collected using a self-administered structured questionnaire distributed via Google Forms. The questionnaire covered demographics, experiences of violence, perception of safety measures, coping strategies, and suggestions for improvement. Descriptive statistics were calculated, including frequencies, percentages, means, and standard deviations. Comparisons were made using the independent t-test and chi-square test, with a p-value &lt;0.05 considered significant. Results: Verbal abuse was the most prevalent type of violence, experienced by 62.96% of respondents. Other forms of violence included discrimination (11.11%), physical assault (4.63%), bullying (4.63%), and sexual harassment (1.85%). In terms of frequency, 42.59% of nurses experienced violence rarely, 32.41% frequently, and 25.00% occasionally. The impact of workplace violence included increased stress levels (46.30%), negative impacts on mental health (24.07%), reduced work productivity (16.67%), decreased job satisfaction (11.11%), and physical injuries (1.85%). Conclusion: The study highlights the high prevalence and significant impact of workplace violence on nurses in tertiary care hospitals in Lahore. Verbal abuse was the most common form, with substantial proportions of nurses experiencing frequent violence. These findings underscore the urgent need for targeted interventions to mitigate workplace violence and support affected healthcare workers.

Prevalence of Diabetic Nephropathy among Patients of Type 2 Diabetes at Tertiary Care Hospital Lahore

Background: Diabetic nephropathy is a significant complication of Type 2 Diabetes Mellitus, often leading to chronic kidney disease (CKD) and potentially progressing to End-Stage Renal Disease (ESRD). Approximately 90% of individuals with diabetes and hypertension may develop ESRD in the later stages of the disease. Objective: The study aimed to determine the prevalence of diabetic nephropathy among patients with type 2 diabetes at a tertiary care hospital in Lahore. Methods: This retrospective study included 100 reports from the chemical pathology and microbiology laboratory at Fatima Memorial Hospital, Lahore, covering renal function tests (RFT) such as Urea, Blood Urea Nitrogen (BUN), Creatinine, and estimated Glomerular Filtration Rate (eGFR), as well as HbA1c levels and Albuminuria. Data collection involved accessing electronic medical records (EMRs) to obtain comprehensive clinical data, including patients' medical history, duration of diabetes, glycemic control measurements, blood pressure, and prescribed medications. The study included patients with type 2 diabetes and kidney disease, excluding those without renal disease. Ethical approval was obtained from the Institutional Review Board (IRB) of FMH College of Medicine and Dentistry, adhering to the principles of the Declaration of Helsinki. Data were analyzed using IBM SPSS version 25, with categorical variables expressed as frequencies and percentages and continuous variables as mean ± standard deviation (SD). Correlation analysis was conducted, with a p-value of less than 0.05 indicating statistical significance. Results: The study included 100 participants, with 53% being male and 47% female. The mean age was 59.19 years (SD = 18.812), ranging from 18 to 91 years. Albuminuria was present in 88% of participants. Elevated serum creatinine was observed in 93%, HbA1c levels &gt;6.4% in 68%, high urea levels in 87%, and eGFR &lt;60 in 14%. Correlation analysis showed a significant positive correlation between HbA1c and eGFR (Spearman's rho = 0.432, p &lt; 0.001) and between urea and serum creatinine (Spearman's rho = 0.701, p &lt; 0.001). Conclusion: The high prevalence of albuminuria and elevated renal function markers among individuals with type 2 diabetes underscores the importance of early detection and comprehensive management. Regular screening for urinary albumin, stringent glycemic control, and optimal blood pressure management are crucial for preventing the progression of diabetic nephropathy.

The Assessment of Knowledge Regarding Anemia in Primigravida In Tertiary Care Hospital

Background: Anemia remains the most common nutritional deficiency worldwide, particularly among pregnant women. It significantly impacts maternal and fetal health, contributing to both morbidity and mortality. The problem is exacerbated by a general lack of awareness about the condition, its prevention, and management. Objective: The objective of this study was to assess the level of knowledge regarding anemia among primigravida women attending a tertiary care hospital in Lahore, aiming to identify key educational gaps that could be addressed to improve health outcomes. Methods: This descriptive cross-sectional study was conducted at the Gyne Out-Patient Department of a Public Hospital in Lahore. A total of 150 primigravida women were purposively sampled. Participants were excluded if they were visiting the labor room only or had a medical background. Data were collected through self-administered questionnaires, which included sections on demographic information and knowledge about anemia. Ethical approval was obtained from the institutional review boards, and informed consent was secured from all participants. Statistical analysis was performed using SPSS version 25, employing descriptive statistics and chi-square tests for categorical data. Results: Out of the 150 participants, 41.3% demonstrated poor knowledge regarding anemia, 30% had moderate knowledge, and 28.7% exhibited good knowledge. Awareness of dietary sources of iron and the impact of dietary habits on iron absorption was notably low among the respondents. Conclusion: The study revealed a significant lack of knowledge about anemia among primigravida women at the surveyed hospital, highlighting an urgent need for targeted educational interventions. Improving anemia awareness can potentially enhance maternal and fetal health outcomes.

Evaluation of Knowledge among Nurses about Pressure Ulcer in a Tertiary Care Hospital, Lahore

Background: Pressure ulcers are a prevalent issue in healthcare settings, leading to significant morbidity and increased healthcare costs. Nurses play a crucial role in the prevention and management of these conditions, yet gaps in knowledge can affect patient outcomes. The study aimed to assess the knowledge of nurses at a tertiary care hospital in Lahore, Pakistan, a setting where pressure ulcer management is critical yet understudied. Objective: This study aimed to evaluate the current level of knowledge among nurses regarding pressure ulcer prevention and management, and to identify any significant differences in knowledge across various critical care settings within the hospital. Methods: A cross-sectional descriptive study was conducted at Shalamar Hospital, Lahore, involving 125 staff nurses and nursing interns selected via simple random sampling. Participants were required to have at least six months of experience in general wards. Data were collected using a validated questionnaire, assessing knowledge of pressure ulcer management. Ethical approval was obtained from the Shalamar College of Nursing's ethical committee. Data analysis was performed using SPSS version 25 and Microsoft Excel, applying descriptive and inferential statistics, including the Chi-square test, with a significance level set at p&lt;0.05. Results: The study revealed that 68.8% (86/125) of nurses had average knowledge, 29.6% (37/125) demonstrated good knowledge, and only 1.6% (2/125) exhibited poor knowledge regarding pressure ulcer management. Notably, nurses in the Surgical Intensive Care Unit (SICU) and High Dependency Unit (HDU) displayed the highest levels of knowledge, whereas those in the Medical Intensive Care Unit (MICU), Cardiac Care Unit (CCU), and Emergency Room (ER) had comparatively lower knowledge levels. Conclusion: The majority of nurses at Shalamar Hospital possessed an average level of knowledge concerning pressure ulcer management. There is a critical need for targeted educational interventions to enhance knowledge and practices, particularly in units where nurses showed lower knowledge levels. Improving nurse education in pressure ulcer management could significantly impact the quality of patient care and reduce the prevalence of these injuries.

Post-Cholecystectomy Biliary Leak and its Management in a Tertiary Care Hospital of Lahore City: A Cross Sectional, Descriptive Study

Background and Objective: Leakage of bile after open or laparoscopic cholecystecmy is rare, but if occurred, is associated with higher risk of morbidity and mortality. The objective of this study was to describe the experience of managing post-cholecystectomy biliary leak in a tertiary care hospital of Lahore, Pakistan.Methods: In this descriptive, cross sectional study, twenty-two cases were included using purposive sampling technique. These cases presented with bile leakage after cholecystectomy (open and/or laparoscopic) over the period of 3.5 years in a surgical unit. The patients were managed on case-to-case basis using a standardized revised algorithm. All patients were managed by ultrasonography guided drainage, and laparoscopic wash with control of sepsis. Magnetic Resonance cholangiopancreatography (MRCP) was conducted to classify injury using Strasberg's classification and managed according to the injury type. Data were managed and analyzed using SPSS version 25 and described using frequency and percentages.Results: Cases were aged between 30-60 years and out of 22 patients, twelve presented with bile leaks through drain left in-situ (55%), six presented with peritonitis with drain in-situ (27%), four patients (18%) had abdominal distension and peritonitis. Firty-one percent patients were managed by ultrasound guided drainage and in 9/22 patients laparoscopic wash and drain placement was done. In six patients, ERCP with stent was used. In 5/22 patients, hepaticojejunostomies were performed.Conclusion: Post-cholecystectomy iatrogenic biliary leak can be managed by drain placement, abdominal wash and antibiotics. Presented algorithm will help surgeons to manage post-cholecystectomy biliary leak effectively with low risk of mortality and morbidity.Keywords: Bile duct disease, post-operative complications, Common bile duct injuries, Biliary fistula , fistula biliary, biliary leakage, Cholecystectomy