Applying community participatory methods to meet women\u27s mental health needs in Karachi, Pakistan

Poor mental health is a global epidemic with women affected more often compared to men. Compromised mental health jeopardizes women\u27s health and functioning and also the health and wellbeing of their children. To promote women\u27s mental health, principles of community participatory methods were used to design and implement a mental health program, which was predicated on empirical research, sensitive to community culture and needs, and delivered by Lady Health Workers in an urban slum area of Karachi, Pakistan. The sequential steps of community participation, program development, implementation and strategies for sustainability are described

Ultrasonographic Comparison of Previous Caesarean Scar Thickness in Second and Third Trimester of Current Pregnancy

Background: The rate of caesarean section is increasing in the world. With which there is an increase in complications of pregnancy. There is risk of the uterine rupture if there is trial of the normal delivery. The aim of study is to determine and compare previous caesarean scar thickness in second and third trimester of pregnancy. Objective(s): To determine previous caesarean scar thickness in second and third trimester of current pregnancy. Methodology: An analytical study was conducted in the Saima medical center Shalimar link road Lahore. Sixty-two patients were enrolled in this study with convenient sampling. Toshiba nemio 10 ultrasound machines with convex transducer frequency range 3.5 MHz.patients with placenta previa and twin gestation were excluded from this study. Transabdominal technique was used in this study. Data were collected through data collection sheets and was tabulated and analyzed using statistical package for the social sciences (SPSS)version 24(SPSS, IBM, Armonk, NY, United States of America) Microsoft excel. Results: A total of 62 patient were examined in the study. The age incidence of the cases in this study varied between 22 years to 36 years. The mean age of the patients in the study was 27. 2903.The mean gestational age was 27.47. The mean scar thickness at 24-28 weeks was3.3925. parity varied patient to patient.16(25.8%) females had para 2.23(37.1%) had para 3 and 16(25.8%) had para 4.3(4.8%) females had para 5 and 4(6.5%) had para 6. In the current study out of sixty-two patients 13(21%) were gravida1,24(38.7%) was gravid 2,17(27.4) were gravid 3,4(6.5%) gravid 4 and (6.5) gravid. A statistical significance difference found in mean scar thickness at 24-28 weeks of gestation and at 32-36 weeks of gestation-value = 0.000 < α = 0.05. Conclusion(s): ultrasound is the useful modality for determining scar thickness. The scar thickness of previous c section in the current pregnancy. Keywords: Analytical study, cesarean scar thickness DOI: 10.7176/JHMN/93-02 Publication date:September 30th 202

Association of depression and resilience with fertility quality of life among patients presenting to the infertility centre for treatment in Karachi, Pakistan

Background: In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors.Methods: An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version 12. FertiQoL tool, Beck II Depression Inventory Tool and Resilience Scale 14 (RS-14) were used for assessing the quality of life, depression and resilience respectively of infertile patients.Results: Total 668 infertile patients, 334 males and 334 females participated in the study. The mean age was 35.53 ± 6.72, among males, and 30.87 ± 6.12 among females. The mean resilience scores were significantly higher among males, (77.64 ± 8.56), as compared to females (76.19 ± 8.69) (95% CI; - 2.757, - 0.1347). However, a significantly higher proportion of females were depressed (13.8%) as compared to males (6%). The mean QoL scores for the general health domain, emotional domain, mind and body domain, and relational domain, and the total QoL were significantly higher in males as compared to females (p value\u3c 0.001); however, QoL for the social domain was not significantly different in both the groups. On multivariable linear regression resilience and depression among males had a significant association with QoL, after adjusting for the covariates educational status, monthly income, and number of friends. Similar association was observed among females after adjusting for the covariate monthly income only.Conclusion: Fertility related QoL of men and women has a significant association with no formal education, number of friends, income, depression and resilience. Therefore, health care professionals in the field of infertility must be adequately trained to respond to the needs of individuals going through these psychological problems

Synthesis, characterization and antibacterial activity of silver nanoparticles using Rhazya stricta

Background Green synthesis of metallic nanoparticles has gained significant attention in the field of nanomedicine as an environment-friendly and cost-effective alternative in comparison with other physical and chemical methods. Several metals such as silver, gold, iron, titanium, zinc, magnesium and copper have been subjected to nanoformulation for a wide range of useful applications. Silver nanoparticles (AgNPs) are playing a major role in the field of nanomedicine and nanotechnology. They are widely used in diagnostics, therapeutic and pharmaceutical industries. Studies have shown potential inhibitory antimicrobial, anti-inflammatory and antiangiogenesis activities of AgNPs. Methods AgNPs have been synthesized using silver nitrate and methanolic root extract of Rhazya stricta that belongs to the Apocynaceae family. Stability and dispersion of nanoparticles were improved by adding xylitol. Synthesized nanoparticles were characterized by UV–Vis spectroscopy, scanning electron microscopy, energy dispersive spectroscopy, X-ray diffractometer and Fourier transforms infrared spectroscopy. Furthermore, the antibacterial effect of the plant extract and the nanoparticles were evaluated against gram-positive (Bacillus subtilis) and gram-negative (Escherichia coli) bacteria. Results The average size of AgNPs synthesized, was 20 nm with the spherical shape. Rhazya stricta based nanoparticles exhibited improved antibacterial activity against both gram-positive and negative strains

Exploration of Two Cucurbitaceae Fruit (Muskmelon and Watermelon) Seeds for Presence of Phytochemicals, and Antioxidant and Antimicrobial Activities

Cucurbitaceae family fruits, especially melons, offers significant quantities of minerals carotenoids and phenolic compounds, contributing to their antioxidant activity. However, seeds of these fruits are usually discarded as waste by products. In current study, seeds of watermelon (Citrullus lanatus) and muskmelon (Cucumis melo) were separated, dried, grounded and extracted, with 70% ethanol, to investigate total phenolic content (TPC), flavonoid content (TFC), carotenoid content (TC) content, and total antioxidant activity (TAA). Further, antimicrobial activities of these extracts were tested against selected bacterial and fungus strains. Results showed that extracts of both cucurbits presented significant amounts of phytochemicals, with higher quantities presented by watermelon seeds. In watermelon seeds, TPC were found 156.50 mg/GAE 100 g, TFC 56.78 mg CE/100 g, TC 36.65 mg/100 g, and TAA 71%, and these amounts were significantly higher than those found in muskmelon seeds. Antimicrobial study results showed that extracts of both seeds exhibited significant zone of inhibitions against three bacterial and three fungal species, and these values were very comparable to the reference antimicrobial drug used, Ciprofloxacin. Findings of current research work provided significant grounds for presence of phytochemical bioactives in two melon fruits seeds, providing the basis for extraction and utilization of these bioactives, through processing and fortification different pharma foods

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Case report : discontented life versus peaceful death

In today’s healthcare system, health professionals deal with many challenging dilemmas and controversies that are difficult to resolve. Among several issues, the issue of refusal of blood transfusion by the patient in an emergency situation has been debated a lot in the literature. It is a crucial issue that puts health care professional in a state of confusion, and creates ethical and legal dilemma to deal with. The health professional engage in ethical inquiry to identify the best possible option, based on ethical grounds and discover morally-justifiable solution while prioritizing a patient’s interest. The pioneers in ethical theories and principles provide us a framework to ethical decision making. The widely used ethical theories include Utilitarian, and Kantism

Testing a community derived intervention to promote women’s health: preliminary results of a 3-arm randomized controlled trial in Karachi, Pakistan

Depression and domestic abuse are serious problems for women throughout the world. There is some evidence that skills in economic independence may empower women in developing countries. There is a need to determine if such skill-building may help women to improve mental health and decrease victimization by domestic violence. A 3-arm randomized controlled trial tested the differential effectiveness of an 8-week community-derived intervention of Economic Skill Building (ESB), developed through community based participatory methods, and an empirically tested 8- week counseling model. Cluster random assignment was used to assign urban economically disadvantaged women in Pakistan to ESB, counseling, and control groups. Outcome measures included depression, measured by the Beck II, self-reports of abuse, self-efficacy as measured on the General Self-Efficacy Scale, and self-reported employment status. Twenty four women completed signed informed consent and completed outcome measures. Women in ESB (n=9) reported statistically significantly higher (

Community health nursing clinical teaching models practiced in undergraduate nursing programme at a private university in Pakistan

Objective: To explore the perceptions and experiences of students and faculty about the modified community clinical model.Methods: The descriptive qualitative study was conducted at a nationally-accredited Baccalaureate School of Nursing and Midwifery in Pakistan in November 2016, and comprised final year students enrolled in Advanced Concepts in Community Health Nursing course, and experienced community health nursing faculty members. Individual interviews were conducted with students while faculty members were requested to write out their reflections. On the basis of this data, codes and categories were identified which led to two broader themes; window of opportunities, and challenges in practice.Results: Of the 17 subjects, 12 (70.6%) were students and 5(29.4%) were faculty members. All subjects were females. The window of opportunities theme had three categories: perceived comfort and safety; stakeholder\u27s involvement and support; and open door for personal recognition and self-image. The challenges in practice theme had two categories: time consuming, and home visits. Faculty reflections highlighted the need for sustaining student-related activities within the communities.Conclusions: The findings are suggestive of a wide range of application of the modified clinical model at undergraduate nursing education level

Applying community-based participatory research methods to improve maternal and child health in Karachi, Pakistan.

To achieve health for all, the development of partnerships between community residents and researchers is essential. Community-based participatory research (CBPR) engages community members, uses local knowledge in the understanding of health problems and the design of interventions, and invests community members in the processes and products of research. CBPR pivots on an iterative process of open communication, mutual respect, and power sharing to build community capacity to sustain effective health interventions. This article describes how the tenets of CBPR were applied by a multidisciplinary, international research team of maternal-child health specialists toward better health for women and children in multilingual, multiethnic, low socioeconomic communities in Karachi, Pakistan