Factors associated with postoperative pain among patients after cardiac surgery in the tertiary care teaching hospital of Karachi, Pakistan

Background: Pain is the subjective feeling of an individual, which affects the overall recovery of patients after cardiac surgery. Postoperative pain is the most inadequately managed symptom of cardiac surgery. Subsequently, there are many factors that can either hinder or facilitate pain management, including patients\u27 beliefs, cultural values, physiological features, hospital policies, and healthcare providers\u27 knowledge and beliefs. The purpose of this research was to identify factors associated with postoperative pain and its management, after cardiac surgery, among patients in a tertiary care hospital in Karachi, Pakistan.Methods: Quantitative correlational study design was employed to attain the study purpose. Data were collected from 136 adult cardiac surgery patients admitted in the Cardiothoracic Surgery (CTS) Department, of tertiary care hospital. A self-developed questionnaire tool was used to gather information from patients. Data was then analyzed on SPSS version 19. Mann-Whitney U, Kruskal Wallis, and Spearman tests were applied to find the associations between the pain levels and of the independent variables.Results: The mean pain scores of the first, second, and third postoperative days were found to be 2.98, 2.96, and 2.98, respectively. The findings also showed that BMI and the types of surgery were significantly associated with postoperative pain. Patients\u27 beliefs regarding drug dependency, fear of adverse effects, and postoperative physical activities were also associated with pain. Furthermore, the nurses\u27 education level and reluctance in medication administration due to fear of adverse effects were found to be significant too.Conclusion: The study identified some of the important factors that were associated with postoperative pain. The results suggest the need for the enhancement of patients\u27 education on drug dependency, adverse effects, and physical activity, before cardiac surgery. The nurses should be educated on pain management keeping the patients\u27 culture and other perceptions of pain in mind

Psychological distress and its associated factors among informal care givers of disabled young adults with traumatic brain injuries

Objective: To measure the psychological distress among the informal caregivers of disabled young adults with traumatic brain injuries (TBI) and to identify its associated factors.Methods: An analytical cross sectional study was conducted with 76 informal caregivers of young adults (19 - 50 years) with TBI, using admission records of one of the tertiary care hospitals in Karachi, Pakistan from 2015 to 2016. Data were collected using a structured questionnaire comprising a general demographic questionnaire and the General Health Questionnaire- 28. The effect of the predictors on the psychological distress was determined by applying multiple linear regression analysis.Results: The mean score of the psychological distress was found to be 23.5±14.28. The findings indicated that anxiety and insomnia, and social dysfunction were the most affected domains of psychological distress; whereas, depression was the least affected. Factors including the management of finances, number of children, patient\u27s gender, and patient\u27s level of disability and lack of socialization were positively associated with the level of distress. As reported by participants, religious beliefs served as a coping mechanism for most of them.Conclusions: The study showed a high level of distress among informal caregivers of young adults with TBI. For recognizing the psychological effects of TBI in patients and their informal caregivers, it is important to initiate and ensure the provision of psychological support to the patients and their families

Characterization of Mutations Linked with Second Line Anti-TB Drug Resistance in Pakistan

Background: The incidence of multiple drug resistance tuberculosis is on the rise worldwide and Pakistan is one of 30 high TB burden countries. Resistance to second line drugs especially fluoroquinolones is being reported by many laboratories. This is increasing the gravity of the situation resulting in extensively drug resistant cases, which is difficult to treat, and has more side effects.Methods: One hundred and thirty-three (133) clinical isolates of M. tuberculosis, collected by convenience sampling, were characterized for mutations in eth-A, gyrA, msh-A, rrs genes, and the promoter region of inh-A gene that confer resistance to second line anti-TB drugs. The mutations were detected by allele-specific-PCR and PCR amplification followed by SSCP and DNA sequencing.Results: Mutations in gyrA gene at codon 91, 94 and 95 were found in 4 (3.0%) M. tuberculosis isolates. Mutations in rrs gene were found in 17 (12.8%) isolates, ten (7.5%) isolates had mutation at A1401G position, 5 (3.76%) isolates at C1402T position and 3 (2.25%) isolates had G1484T mutation. For resistance to ethionamide, none of the isolates showed mutation in eth-A gene. In promoter region of inh-A gene, mutations were detected at -C15T, -A112G, -C110T in two samples. Two mutations, A312T and A332G, were found in msh-A gene in one sample. Collectively, 24 (18%) isolates were found to harbor mutations associated with second line anti TB drug resistance.Conclusion: Our work revealed high frequency of mutations (18%) associated with resistance against second line anti-TB drugs. This situation can lead to increase in XDR-TB cases. We, therefore, recommend improved diagnostic and drug sensitivity testing, better prescription, and development of superior drugs to control tuberculosis.   Keywords: Antibiotic resistance; Mycobacterium tuberculosis; Second line anti-TB drug

Defining the cultural milieu for implementing faculty practice in Pakistan

Faculty practice can promote a collaborative partnership mutually beneficial to both nursing education and service. However, little is known about its implementation in developing countries. The purpose of this study was to explore the potential for introducing faculty practice within the cultural milieu of Karachi, Pakistan. Focus groups of nursing faculty, staff and students were conducted in various settings: government, semi government and private institutions to elicit the data. Data analysis revealed that a more comprehensive definition of faculty practice is needed that will provide the foundation for a culturally acceptable model of faculty practice in Pakistan. Hierarchy dominates the current cultural milieu and must be addressed before faculty practice can be implemented

قائد اعظم پہ لکھا منٹو کا خاکہ __ ’’میرا صاحب ‘‘ تحقیقی و تنقیدی جائزہ

Character sketching is not an easy goal. It is like walking upon a tightened rope. However, Manto has proved himself successful in this field also his character sketch "Maira Saheb" throws light upon even those dimensions of Quaid-e-Azam's personality which escape the eyes of a common man. A lot has been written on Quaid's political struggle and professional life but very little is available regarding his private life. The basic reason for this issue is Quaid's stance to keep his personal and professional life apart. Except a few friends and servants nobody can throw light upon his personal life as he always condemned obstentation. This single character sketch is far better than many volumes

DISCURSIVE REPRESENTATION OF WOMEN IN CRIME NEWS STORIES OF PAKISTANI ENGLISH PRINT MEDIA

Media are a powerful source that reflects and mirrors societal attitude to culture. It also constructs and reconstructs our approaches and ideological inclinations. Pakistani media hold mirror up to the cultural influence on ideas and thoughts. The present study endeavors to explore the representation of women victims in crime news stories in Pakistani English newspapers. Data were collected from widely read main stream English newspapers and pragmatic approach was used to analyze linguistic choices which represent women. To analyze media discourse, Mill’s approach of Feminist Stylistics was used along with Corpus Linguistics. Data were quantified with the help of corpus software WMatrix (Rayson, 2008) to discover the frequency of lexical choices being used to represent women. The findings reveal that the female victims were mostly asymmetrically constructed and they were chiefly described in term of their age, social and marital status

تصویرِ کشمیر ازحفیظ جالندھری۔ایک جائزہ: AN OVERVIEW OF “TASWEER-E- KASHMIR” BY HAFEEZ JALANDHRI

Abu Al-Asar Hafeez Jalandhari  (1900–1982) was a Pakistani Urdu language poet who wrote the lyrics for the National Anthem of Pakistan. In all genres of poetry like ghazal, poem, masnavi song, salam etc. "Tasweer-e-Kashmir" is a long book poem by Hafeez Jalandhari. This poem was written by him in 1937. Kashmir is a  valley between the Great Himalayan range and the Pir Panjal mountain range. Kashmir is a place of beautiful simplicity and pristine natural beauty. It is painted with a unique culture that keep the human intrigued.This article presented an over view of his poem Tasweer-e-Kashmir

"رحلِ نظر"، کا تجزیاتی مطالعہ: ANALYTICAL STUDY OF “RAHL-E-NAZAR”

“Rahlle-e-Nazar” is a long Poem written by Mahdi Nazmi. This long poem consisits a complete book. It’s a religious poetry about the life and seerah of our beloved Prophet Muhammad ﷺ and His family. It is about the Holy prophet PBUH Seerat and sunnat. Before Islam, the Arabs were plunged into the darkness of ignorance. They worshiped idols. After the arrival of our prophet enlightened the world. This poem shows Mahdi Nazmi’s love, affection and respect for the Prophet Muhammad ﷺ

حاؔلی کے"مرثیہ غالب" کا ایک مطالعہ: A STUDY OF “MARSIYYA-E-GHALIB” BY HALI

“Marsiyya e Ghalib” is a long Poem by Molana Altaf Husain Hali. This poem is a symbol of love and grief for Ghalib. Hali w as the student of Mirza Ghalib in poetry. He spend a great time with Ghalib and was much inspired by Mirza Ghalib. Hali got motivation for poetry from Ghalib. Ghalib never encourage any young generation for poetry. But he praised a lot for Hali and encourage him for poetry. After his death he feel a great loss. He write this marsiyya to relief his grief. Hali express his feelings and also pointed out the good habits of Mirza Ghalib in noteable words