Factors affecting compliances with physiotherapy among stroke patients: physiotherapist\u27s perspective: a study from Peshawar Pakistan.

Non-compliances to physiotherapy are common. Outside the Western nations, little is known to the factors responsible for non-compliances with physiotherapy. This study aimed to evaluate the factors affecting non-compliances with physiotherapy among stroke patients, in Peshawar, Pakistan. METHOD: Seven in practice physiotherapists from Peshawar, Pakistan, were invited to focus group discussion to discuss their opinions about factors affecting stroke patient\u27s non-compliances and the strategies to manage with these factors. The dialogues were transcribed and analyzed. Significant words and statements describing noncompliances were identified. The cluster of meanings developed and used to write a combined description presenting the real meaning of discussion

Language and the Culture of Gender: Constructing Women Identities in Pakistani Society

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SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/> <w:LsdException Locked="false" Priority="19" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title"/> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} The present study sets out to investigate gender as performative construct and its importance for feminists in general and especially for women in Pakistani society. Different ways of conceptualizing gender-difference along with various social, cultural and psychological dimensions have been explored. The study looks into the factors in which discursive language practices in various dimensions work to construct women identities. Subsequent parts of the study examine different reasons and mechanisms that can account for dichotomous speech patterns and asymmetries which exist between participants in social discourse. Moreover, the two-way function of language has been focused as on the one hand language reflects the social identity of women performed through the language itself, and the realities about the social position of women in Pakistan on the other.</p

Feminism, Language Choice and Discourse Practice: A Pakistani Perspective

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mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} The present study focuses on investigating the nature of linguistic choices made by Pakistani women in interpersonal discourse in the background of feminism. The relationship between attitudes, social backdrop and language was explored. It was hypothesized that the exploitation of linguistic choices in the spoken discourse  would correspond the explanations provided by Dominance approach about the difference in language use between men and women. For the purpose of the present study, we observed and analyzed thirteen groups of subjects (women), varied in number of subjects. All the participants were students of university level, approximately aged between18 to 25. Data were obtained by recording the conversation. The participants did not belong to any particular social class.The topics of their conversation were various, and ranged from personal and general to quite universal and emotional. Results indicate that the extensive uses of linguistic choices, significantly, support the feminist view of language use, and that there are certain distinctive features that characterize women language. For instance, there is a considerable correlation between the power structures in society and language use.</p

Adherence to Lifestyle Advice and reatments in Pakistani Patients with Type 2 Diabetes Mellitus.

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease that has become a major health care concern, especially in developing countries like Pakistan. Lifestyle modification and appropriate pharmacotherapy are shown to improve blood glucose levels, lipid abnormalities and blood pressure. It is not known how many patients adhere to advice and drugs prescribed. This study aimed to determine adherence to lifestyle and therapeutic advice. Methods: A cross sectional hospital based study was conducted among patients attending the diabetic clinic at the Aga Khan University Hospital, using a structured questionnaire. Adult patients with T2DM and with at least one year duration of diabetes were included in the study. Results: Participants were aged between 32 and 92 years old with a mean age of 55.7 years old (SD ± 10.7). Mean duration of diabetes was 10.7 years old (SD ± 7.7). Majority (94%) of the patients were literate. Around half (47.3%) of the patients have had achieved glycemic target (HbA1c \u3c 7%). Above target glycemic control was more common among patients with ischemic heart disease (68.1%), neuropathy (64.8%) and those on insulin (62.5%). Self-reported non-adherence for blood sugar monitoring (9.5%), physi cal activity (61.7%), tobacco use (43.4%) and foot care (43.9%) were noted. About 25% of the participants were not fully adherent to dietary advice. None of the patients from our study reported non-ad- herence to medications. Good adherence to physical activity was found in males with college degree. The highest percentage of tobacco use (33.3%) was reported among businessmen. Conclusion: We noted low adherence to advice for physical activity, tobacco use and SMBG, but a high adherence to prescribed medications and insulin. This was a selected group visiting a teaching hospital. This will need to be studied further in the community and efforts are required to motivate patients

Leadership Effectiveness, Turnover Intention and the Mediating Role of Employee Commitment: A Case of Academic Institutions of Pakistan

According to its scope of practice and research, Leadership is one of the most important areas these days. Many scholars have theorized different definitions and dimensions of this very construct leadership that gives a clear indication about its importance both in society and also in the context of people management in organizations in different countries. In today’s world where complexity driven by different factors has changed the face of organizations, different procedures have been devised to retain the employees in the organization. But apart from all the system level changes, there is one important factor that directly links with the employee turnover intention and that is leadership effectiveness. There has been much focus on leadership effectiveness and many researches have been done to study it. This study is trying to address the issue at hand that is about studying the effectiveness of leadership. For this purpose this study is investigating the relationship of leadership effectiveness and turnover intention along with a third variable participation that is employee commitment in the academic sector of Pakistan. This study is focusing on the relationship of leadership effectiveness and employee turnover intention specifically in the academic institutions and implying the facts that how these institutions are constructing this relationship according to the specific culture and norms posed by the Pakistani context. In this study the predictor is leadership effectiveness and outcome is turnover intention. Besides, this study is also focusing on the third variable involvement that is employee commitment. So this study is testing and reflecting upon whether such relationship exists in this context or not. This study uses the sample size of 345. The population is faculty members of different academic institutions. The software used is SPSS along with process plugin to run the regression (mediation) analysis. This study has presented some important findings related to the nature of the relationship of leadership effectiveness, employee commitment and turnover intention that will be an important knowledge addition in the literature and will be helpful for the management to make important decisions regarding the management and turnover of employees in the academic institutions of Pakistan

Leadership Effectiveness, Turnover Intention and the Mediating Role of Employee Commitment: A Case of Academic Institutions of Pakistan

According to its scope of practice and research, Leadership is one of the most important areas these days. Many scholars have theorized different definitions and dimensions of this very construct leadership that gives a clear indication about its importance both in society and also in the context of people management in organizations in different countries. In today’s world where complexity driven by different factors has changed the face of organizations, different procedures have been devised to retain the employees in the organization. But apart from all the system level changes, there is one important factor that directly links with the employee turnover intention and that is leadership effectiveness. There has been much focus on leadership effectiveness and many researches have been done to study it. This study is trying to address the issue at hand that is about studying the effectiveness of leadership. For this purpose this study is investigating the relationship of leadership effectiveness and turnover intention along with a third variable participation that is employee commitment in the academic sector of Pakistan. This study is focusing on the relationship of leadership effectiveness and employee turnover intention specifically in the academic institutions and implying the facts that how these institutions are constructing this relationship according to the specific culture and norms posed by the Pakistani context. In this study the predictor is leadership effectiveness and outcome is turnover intention. Besides, this study is also focusing on the third variable involvement that is employee commitment. So this study is testing and reflecting upon whether such relationship exists in this context or not. This study uses the sample size of 345. The population is faculty members of different academic institutions. The software used is SPSS along with process plugin to run the regression (mediation) analysis. This study has presented some important findings related to the nature of the relationship of leadership effectiveness, employee commitment and turnover intention that will be an important knowledge addition in the literature and will be helpful for the management to make important decisions regarding the management and turnover of employees in the academic institutions of Pakistan

Head and Neck Cancer: Epidemiology and Role of MicroRNAs

Head and neck cancer (HNC) is referred to the cancers of aerodigestive tract covering number of structures viz, oral and nasal cavity, paranasal sinuses, lips, salivary glands, oropharynx, hypopharynx, pharynx, larynx, and local lymph nodes. It is the sixth most common cancer in the world. MicroRNAs (miRNAs) are small single‐stranded noncoding RNAs (ncRNAs) of about 19–25 nucleotides. These miRNAs have been reported to influence number of biological activities, i.e., gene regulation, differentiation, organ formation, cell death, cell proliferation, and stress responses. The first ever study involving miRNAs in HNC was published in 2005. Since then, association between dysregulation of miRNAs and head and neck tumorigenesis has been documented by a number of researchers. This chapter has covered a comprehensive state of the art literature review of the recent studies about the role of miRNAs in HNC including oral squamous cell carcinoma (OSCC) and human nasopharyngeal carcinoma. Despite significant improvement in multimodal treatment, the prognosis of advanced HNC is quite poor. Recent studies are promising regarding the potential role of miRNAs as prognostic indicators. Recently, some miRNAs have been discovered as important diagnostic biomarkers. In fact, miRNAs are found circulated stably in different body fluids, i.e., urine, blood, saliva, as well as in breath. Hence, these miRNAs can be assessed easily with noninvasive methods. miRNAs are the key therapeutic targets in addition to their prognostic and diagnostic value. Use of synthetically designed “miRNAs sponges,” miR mimics (agomiRs), miR antagonists (“antagomiRs”), and miR inhibitors (antimiRNAs oligonucleotides) is an innovative strategy to modulate oncogenic and tumor‐suppressive pathways. Our understanding of miRNAs involvement in HNC is in its infancy. The discovery of miRNAs heralds a complete new paradigm in the understanding of exact molecular pathways involved in HNC development. More detailed studies are required for better understanding and therapeutic targets to treat HNC

Clino-pathological features of urinary tract infection: a study at Nishtar University Hospital Multan, Punjab, Pakistan

Background: Urinary tract infection (UTI) is a common clinical issue among pediatric population and might progress into renal scaring, hypertension as well as end stage kidney disease. This study was aimed at finding clino-pathological features of UTI and antibiotic sensitivity against most common causative agents involved at a tertiary care hospital of South Punjab, Pakistan.Methods: This descriptive case series study was conducted at department of Paediatric Medicine, Nishtar University Hospital Multan from July to December 2019. A total of 100 children fulfilling the inclusion criteria, presenting in outpatient department or emergency section of paediatric medicine department, having positive urine culture and sensitivity were selected. Their detailed history, clinical examination and relevant investigations were done.Results: Out of the 100 children, 73 (73.0%) were female and 27 (27.0%) were male. There were 57 (57.0%) children from 1 year to 4 years age group and 43 (43.0%) were of more than 4 years. Most common clinical presentations were fever 83 (83.0%), urinary symptoms, vomiting 52 (52.0%) and pain abdomen 48 (48.0%). Most common aetiological agents were Escherichia coli 74 (74.0%) and Klebsiella pneumoniae 9 (9.0%).Conclusions: UTI is more common in female children. Most common presentation observed was fever and/or urinary symptoms while most common aetiological agent was E. coli

RELATIONSHIP OF LEARNED HELPLESSNESS AND SOCIAL INTEGRATION WITH PSYCHOLOGICAL DISTRESS IN MEDICAL STUDENTS

OBJECTIVE: To explore the relationship of learned helplessness with psychological distress and relationship of social integration with psychological distress in medical students. METHODS: This quantitative correlational survey research was conducted from September 2019 till January 2020, on 315 medical students, aging between 18-24 years, recruited from private and public medical colleges from Karachi, Pakistan. Data was collected through purposive sampling technique from students of all five medical years. To measure the variables, Learned Helplessness Scale, Social Inclusion Scale and Depression, Anxiety and Stress Scale were used. The institutes were visited as a part of survey-based methodology for this research. RESULTS: Out of 315 medical students, 223 (70.8%) were females and 92 (29.2%) were males. Mean age of students was 21.33±2.19 years and mean time spent by participants in university was 7.49±2.06 hours. Majority (n=272/315; 86.3%) were single. About 41.6% (n=131/315) completed three years of medical education. Majority (n=250/ 315; 79.4%) lived with their parents and 303 (96%) student’s parents could afford their medical education. Twenty-seven (8.6%) students consulted psychiatrist/psychologist at least once and 33 (10.5%) students had family history of psychological illness. Thirty-six (11.4%) students had other health-related problems. Outcomes depicts a weak positive correlation between learned helplessness and psychological distress (r= 0.218, p<0.01) and a weak negative correlation between social integration and psychological distress (r = -0.272, p<0.01). CONCLUSION: Medical students who had more robust social networks had a reduced chance of psychological distress than their counterparts who had weaker ties

Ischemia-Modified Albumin as a Predictor Tissue Ischemia Marker in Patients With Acute Coronary Syndrome

ABSTRACT: Background: Ischemia-modified albumin (IMA) has gained attention as an important biochemical marker of oxidative stress in acute myocardial ischemia. This study assessed the screening ability of IMA in acute coronary syndrome and its correlation with the severity of obesity, arterial blood pressure, and lipid profile. Methods: A cross-sectional study using a non-probability sampling technique with 200 patients was conducted at the Physiology Department of Liaquat University of Medical and Health Science (LUMHS) from 1st September 2021 to 1 May 2022. Obese patients from the general population who had a positive family history of cardiovascular disorders were recruited and a biophysical examination was conducted. Afterward, 5cc of blood was drawn and sent for laboratory assessment of IMA and Lipid profile by using ELISA-based assay kits. Using SPSS v.25, ANOVA and student's T-test were used to assess the quantitative data. The Chi-Square Test was employed to assess the qualitative data, and a p<0.05 was considered significant. Results: Among 200 participants, 86 participants had increased IMA. Median body mass index (BMI), high-density lipoprotein, low-density lipoproteins, triacylglycerol, cholesterol and ischemia-modified albumin was 39.00(5.00)kg/m2, 29.00(22.25)mg/dL, 165.00(75.00)mg/dL, 189.00(94.25)mg/dL, 294.50(91.75)mg/dL and 111.00(35.00)IU/mL, respectively. A strong relationship of IMA was seen with low-density lipoproteins (r=0.608), triacylglycerol (r=0.680), and cholesterol (r=0.646). An even stronger correlation was observed between ischemia-modified albumin and both systolic and diastolic blood pressure (r=0.903 and 0.839, respectively). Conclusion: IMA levels are altered with changes in BMI, lipid profile, and arterial blood pressure. Thus, IMA can be utilized to predict the risk of cardiovascular diseases in high-risk patients. Keywords: Myocardial Infarction, Cardiovascular diseases, Hypertension, Oxidative stress