Frequency and impact of slow flow / no flow in primary percutaneous coronary intervention

Objectives: To determine the frequency of slow/no flow in primary percutaneous coronary intervention, to know the clinical and angiographical predictors of the phenomenon, and to investigate the immediate impact of slow/no flow on hemodynamics. Method: The cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from June 2018 to July 2019, and comprised patients presenting with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention. Demographic and clinical details of the patients were recorded. The antegrade flow was assessed and determined using the thrombolysis in myocardial infarction criterion. Patients were assessed for the occurrence, predictors and impact of slow/no flow. Data was analysed using SPSS 21. Results: Of the 559 patients, 441(78.9%) were males. The overall mean age of the sample was 55.86±11.07 years. Angiographical slow/no flow during the procedure occurred in 53 (9.5%) patients, while normal flow was achieved in 506(90.5%). The thrombolysis in myocardial infarction grade in the affected patients was 0 in 10(1.8%), 1 in 15(2.7%), and 2 in 28(5%) patients. Smoking status, Continuous..

Etiological Spectrum of Obstructive Jaundice in Tertiary Hospital of Quetta

Objective: To identify the etiological spectrum of obstructive jaundice in patients presenting in Bolan Medical Complex Hospital Quetta.Study type,settings& duration:This descriptive cross-sectional study was conducted at Department of General Surgery, Bolan Medical Complex Hospital, Quettafrom December 2017to June 2018.Methodology:A total number of 211 patients having age 15 to 65 years with diagnosis of obstructive jaundice were included. All radiological tests like ultrasound, CT scan and Magnetic Resonance Cholangio-pancreatography of the patients was done to determine the etiology of obstructive jaundice. After surgery,the histopathological examination of the biopsy was also done. Data analysis was done through SPSS v23 software.Results:Mean age of study patients was 47.86±12.40 years. There were 131 (62.09%) female patients and only 80 (37.91%) male patients. There were 87 (41.23%) patients who presented with benign causes while remaining 124 (58.77%) patients who presented with malignant causes. Among the benign causes, stone in common bile duct (CBD) were most common presented in 51 (24.2%) patients while 36 (17.1%) patients presented with stricture. Although pancreatic head carcinoma was the most prevalent disease diagnosed in 69 (32.7%) patients with malignant conditions, peri-ampular carcinoma in 24 (11.4%) patients, gallbladder carcinoma in 22 (10.4%), and cholangio-carcinoma in just 9 (4.3%) patients.Conclusion:As compared to benign causes, malignant causes of obstructive jaundice are more frequent. The highest prevalent tumour among malignant causes is pancreatic head carcinoma, while stones inthe common bile duct are highly prevalent among benign causes of obstruction in our population

Analysis of adolescents' perception and awareness level for Sexual and Reproductive Health Rights in Pakistan

Abstract Background Awareness of rights is a precondition to establishing rule of law in society. Sexual and Reproductive Health and Rights (SRHR) are closely knitted in the human rights framework as they overlap with other human rights such as the right to health and life. However, awareness about these rights remains a challenge. Considering the importance of these rights this study has measured the awareness of adolescents about SRHR in Bahawalpur (Division) of Pakistan. Methodology We conducted a cross‐sectional study in the Divison of Bahawalpur, Pakistan from October 2019 to December 2019. The study included a sample size of 500 respondents which included 250 young females of age 15–19 and 250 their parents (mother). The reasoning behind including only females in this study was the increased vulnerability and greater impact of SRHR in their life compared to males. The age range 15–19 was primarily selected as females this age will better understand and respond to the questionnaire compared to females in their early adolescent years. The quantitative research was conducted using two‐stage cluster sampling. Detailed structured questionnaires were distributed among the respondents to obtain their points of view on the awareness of SRHR. The population was divided into multi‐clusters with 25 households comprising 250 households for the division of Bahawalpur. The information was also gathered from the doctors and the teachers through interviews. The data were analyzed using SPSS version 21. Results The study explored the knowledge and understanding of adolescent SRHR thereby highlighting the key restrictions in Bahawalpur, Pakistan, which prohibit adolescents from gaining access to SRHR and exercising it. There is a significant portion of adolescents who strongly agreed with the importance and awareness level and think they should be more aware of information regarding SRHR. However, they are of the view that they are less independent in practicing them. Conclusion The study found a low level of awareness about SRHR among young female and their parents in Bahawalpur, Pakistan. It is a need of time and responsibility of the local government of the Bahawalpur region to devise clear and proper policies which give access to these rights. This can be done by including the information on these rights in the course curriculum and teachers keeping in view the cultural and regional restrictions that guide the young female about SRHR

Perceived barriers to facemask adherence in the covid-19 pandemic in Pakistan-A cross-sectional survey.

ObjectiveTo explore perceived barriers associated with facemask adherence to prevent spread of COVID-19 spread in Pakistani population.MethodologyA cross sectional study was conducted from 25-July 2020 to 5-August 2020. Participants of both genders of age >17 years, currently residing in Pakistan, who had access to internet and understood English were included in the survey. The survey was designed on Google form and was distributed digitally across different areas of Pakistan via social media. Survey included questions regarding socio-demographics, facemask adherence and perceived barriers related to facemask adherence such as perceived risks, health concerns, comfort, social influences, religious/cultural norms and social protocols and health recommendations. SPSS version 23 was used to analyze data. Independent t-test/One-way ANOVA was applied to assess significant difference between perceived barriers to wear face mask and socio-demographic factors, p-value ≤0.05 was taken as statistically significant. Post-hoc LSD test was also applied where applicable.ResultsOnly 20% of the participants reported non-adherence to facemask. Amongst these participants, majority agreed that comfort was the main barrier precluding them from wearing a mask, 89.4% subjects saying that it was too hot to wear it and 84.1% saying that a mask was too uncomfortable to wear. Whereas, 82.1% highly agreed that difficulty in breathing is perceived barrier related to facemask usage. Statistically significant difference was found between health concerns with gender (p = 0.031), locality (p = 0.001) and religion (p = 0.03); comfort with locality (p = 0.007); social influences with gender (p = 0.001), ethnicity (p = 0.001) and locality (p = 0.017); cultural/religious norms with religion (p = 0.001) and social protocols and health recommendations with age (p = 0.015).ConclusionDespite of satisfactory facemask adherence, still there are perceived barriers to it. In order to increase utilization of face masks among the general population, strict health policies should be implemented and awareness regarding the importance of face masks should be enhanced by educational interventions

Change in mean postoperative pain in patients undergoing tonsillectomy with cold water versus usual practice: A pragmatic trial

Introduction: Tonsillectomy is one of the most common procedures performed in otolaryngology. There are various methods to perform tonsillectomies (cold and hot). Thermal damage and inflammation of the surrounding tissue using monopolar cautery is said to point to increased pain whereas immediate cooling of the burnt area is thought to reduce pain owing to heat dissipation. Our objective was to determine the difference in mean post-tonsillectomy pain scores among patients irrigated with cold water (4°C) and in patients not irrigated with cold water.Material and methods: A quasi-experimental trial was conducted from January 2016 to December 2017 at a tertiary care hospital. All tonsillectomies were carried out with monopolar cautery at a power of 20 W. Patients either received cold water irrigation post tonsillectomy of the tonsillar bed (intervention arm) or no irrigation (control arm). The pain score was measured on Days 0, 1, 3, 5, and 7. Pain scores were charted on a visual analog scale on the respective days.Results: Seventy-eight patients were included in the study. The mean age of our patients was 10.26 (4.24) years old in the intervention arm, and 11.95 (4.19) years old in the control arm. It was observed that the pain was significantly lower in patients with cold water irrigation of the tonsillar fossa on Days 1, 3, 5, and 7 (p = 0.001). There were no readmissions postprocedure and none of our patients developed any complications postsurgery.Conclusions: In this trial, we report a reduced pain score at all days of observation in the intervention group. Irrigation of the tonsillar fossa is a safe, cost-effective, and less technically demanding technique that could be employed to reduce postoperative pain. Further studies with randomization, blinding and a larger sample size could further improve on our results

Validation of postnatal growth and retinopathy of prematurity (G-ROP) screening guidelines in a tertiary care hospital of Pakistan: A report from low-middle income country

Retinopathy of Prematurity (ROP) significantly contributes to childhood blindness globally, with a disproportionately high burden in low- and middle-income countries (LMICs) due to improved neonatal care alongside inadequate ROP screening and treatment facilities. This study aims to validate the performance of Postnatal Growth and Retinopathy of Prematurity (G-ROP) screening criteria in a cohort of premature infants presenting at a tertiary care setting in Pakistan. This cross-sectional study utilized retrospective chart review of neonates admitted to the neonatal intensive care unit (NICU) at The Aga Khan University Hospital, Pakistan from January 2018 to February 2022. The complete G-ROP criteria were applied as prediction tool for infants with type 1 ROP, type 2 ROP, and no ROP outcomes. Out of the 166 cases, 125 cases were included in the final analysis, and remaining cases were excluded due to incomplete data. ROP of any stage developed in 83 infants (66.4%), of whom 55 (44%) developed type 1 ROP, 28 (22.4%) developed type 2 ROP, and 19 (15.2%) were treated for ROP. The median BW was 1060 gm (IQR = 910 to 1240 gm) and the median gestational age was 29 wk (IQR = 27 to 30 wk). The G-ROP criteria demonstrated a sensitivity of 98.18% (95% CI: 90.28–99.95%) for triggering an alarm for type 1 ROP. The G-ROP criteria achieved 100% sensitivity (95% CI: 87.66 to 100%) for type 2 ROP. The overall sensitivity of G-ROP criteria to trigger an alarm for any type of ROP was 98.8% (95% CI: 93.47 to 99.97%). Thus, the G-ROP screening model is highly sensitive in detecting at-risk infants for ROP in a Pakistani tertiary care setting, supporting its use in LMICs where standard screening criteria may not suffice

The evolving role of social media in enhancing quality of life: A global perspective across 10 countries

Background: Excessive or inappropriate use of social media has been linked to disruptions in regular work, well-being, mental health, and overall reduction of quality of life. However, a limited number of studies documenting the impact of social media on health-related quality of life (HRQoL) are available globally.Aim: This study aimed to explore the perceived social media needs and their impact on the quality of life among the adult population of various selected countries.Methodology: A cross-sectional, quantitative design and analytical study utilized an online survey disseminated from November to December 2021.Results: A total of 6689 respondents from ten countries participated in the study. The largest number of respondents was from Malaysia (23.9%), followed by Bangladesh (15.5%), Georgia (14.8%), and Turkey (12.2%). The prevalence of social media users was over 90% in Austria, Georgia, Myanmar, Nigeria, and the Philippines. The majority of social media users were from the 18-24 age group. Multiple regression analysis showed that higher education level was positively correlated with all four domains of WHOQoL. In addition, the psychological health domain of quality of life was positively associated in all countries. Predictors among Social Media Needs, Affective Needs (β = -0.07), and Social Integrative Needs (β = 0.09) were significantly associated with psychological health.Conclusion: The study illuminates the positive correlation between higher education levels and improved life quality among social media users, highlighting an opportunity for policymakers to craft education-focused initiatives that enhance well-being. The findings call for strategic interventions to safeguard the mental health of the global social media populace, particularly those at educational and health disadvantages

Adapted digital health literacy and health information seeking behavior among lower income groups in Malaysia during the COVID-19 pandemic

Background: Misinformation has had a negative impact upon the global COVID-19 vaccination program. High-income and middle-income earners typically have better access to technology and health facilities than those in lower-income groups. This creates a rich-poor divide in Digital Health Literacy (DHL), where low-income earners have low DHL resulting in higher COVID-19 vaccine hesitancy. Therefore, this cross-sectional study was undertaken to assess the impact of health information seeking behavior on digital health literacy related to COVID-19 among low-income earners in Selangor, Malaysia.Methods: A quantitative cross-sectional study was conducted conveniently among 381 individuals from the low-income group in Selangor, Malaysia. The remote data collection (RDC) method was used to gather data. Validated interviewer-rated questionnaires were used to collect data via phone call. Respondents included in the study were 18 years and older. A normality of numerical variables were assessed using Shapiro-Wilk test. Univariate analysis of all variables was performed, and results were presented as means, mean ranks, frequencies, and percentages. Mann-Whitney U test or Kruskal Wallis H test was applied for the comparison of DHL and health information seeking behavior with characteristics of the participants. Multivariate linear regression models were applied using DHL as dependent variable and health information seeking behavior as independent factors, adjusting for age, gender, marital status, educational status, employment status, and household income.Results: The mean age of the study participants was 38.16 ± 14.40 years ranging from 18 to 84 years. The vast majority (94.6%) of participants stated that information seeking regarding COVID-19 was easy or very easy. Around 7 percent of the respondents cited reading information about COVID-19 on the internet as very difficult. The higher mean rank of DHL search, content, reliability, relevance, and privacy was found among participants who were widowed, had primary education, or unemployed. An inverse relationship was found between overall DHL and confidence in the accuracy of the information on the internet regarding COVID-19 (β = -2.01, 95% CI = -2.22 to -1.79).Conclusion: It is important to provide support to lower-income demographics to assist access to high-quality health information, including less educated, unemployed, and widowed populations. This can improve overall DHL

Perception towards vaccine effectiveness in controlling COVID-19 spread in rural and urban communities:a global survey

INTRODUCTION: Several studies exhibited varying reports of perception toward vaccine effectiveness, vaccine hesitancy, and acceptance of COVID-19 vaccines. As this fluctuated with evidence generation, this study explored the perception toward vaccine effectiveness in rural and urban communities among various countries. METHODS: A cross-sectional study was conducted online from April to August 2021 using convenience sampling among people from different countries approved by the Asia Metropolitan University Medical Research and Ethics. We adapted the questionnaire from the World Health Organization's (WHO) survey tool and guidance on COVID-19. The logistic regression models were performed to show perception toward vaccine effectiveness. RESULTS: A total of 5,673 participants responded to the online survey. Overall, 64% of participants agreed that the vaccine effectively controlled viral spread, and 23% agreed that there was no need for vaccination if others were vaccinated. Males had 14% higher odds of believing that there was no need for vaccination. Less social media users had 39% higher odds of developing the belief that there is no need for vaccination than all other people vaccinated. CONCLUSION: People's perceptions toward vaccine acceptance have fluctuated with the information flow in various social media and the severity of COVID-19 cases. Therefore, it is important that the current scenario of peoples' perception toward vaccine acceptance and determinants affecting the acceptance are explored to promote the vaccination approach against COVID-19 prevention and transmission effectively