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aima Qadeer,3 Shumaila Naz,4 Najm Ul Hassan51Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan; 2Department of Zoology, Shaheed Benazir Bhutto Women University, Peshawar, Khyber Pakhtunkhwa, Pakistan; 3Department of Zoology, Division of Science & Technology, University of Education Lahore, Lahore, Punjab, 54000, Pakistan; 4Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan; 5Department of Microbiology, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, PakistanCorrespondence: Surrya Khanam, Department of Zoology, Women University Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan, Tel +923348742560, Email [email protected] Purpose: Urinary tract infections (UTIs) are of the most common bacterial infections in Pakistan. Rapid increase in antibiotic resistance has resulted in a limited number of treatment options available. This study aimed to determine the incidence patterns of uropathogens, their antimicrobial susceptibility pattern and risk factors for UTI among the general population.Methods: This laboratory-based cross-sectional study was conducted between November 2020 and March 2021. Urine samples were collected, cultured and bacterial isolates were identified. Bacterial isolates were tested for antimicrobial susceptibility. Data regarding socio-demographic characteristics, clinical features and risk factors were collected using structured questionnaire.Results: Of 459 urine samples, 299 (65.1%) showed positive urine cultures (105 CFU/mL). Both gram-negative and gram-positive isolates were obtained, with a prevalence of 230 (76.9%) and 69 (23%), respectively. Escherichia coli was the predominant bacteria isolated 146 (48.8%), and it showed most susceptibility to cefoperazone and imipenem. Most of the gram-negative isolates were resistant towards ampicillin. Most risk factors were not significantly associated with UTI, except for age, income, and previous history of hospitalization.Conclusion: UTI is an important problem in the study area, with a prevalence rate of 65%. All bacterial isolates developed resistance towards most antibiotics available on the market. Therefore, there is a need to develop management strategies based on susceptibility pattern of uropathogens. Additionally, proper public education regarding causes of disease transmission and control strategies is required. [ABSTRACT FROM AUTHOR]

Objective: To assess the graft take rate and hearing gain in trans-canal endoscopic tympanoplasty Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez, Islamabad Pakistan, form Dec 2015 to Jun 2018 Methodology: All patients with dry central perforations of >3 months history were included in the study. All Patients with perforations of pars tensa were booked for endoscopic cartilage tympanoplasty. All perforations were divided into four types small, medium, large and subtotal or total based on size of the tympanic membrane perforations. Small perforations involving <25% area of Pars Tensa. Medium perforation are Perforations involving 25-50% of Tympanic membrane. Large perforations include Perforations involving 50-75% of pars tensa. Subtotal or total perforations are defined as perforations with >75% perforation of the tympanic membranes. Wet Ears and perforations involving the Pars Flacida were excluded from the study. Preoperative Audiogram was carried out for all patients and A-B Gap were noted for all groups separately so as the demographic data including age and gender. Success was defined as complete closure of Tympanic membrane perforation at 3 months. All patients were operated with 0 Degree 3mm, 14cm rigid endoscope under general anesthesia. Results: Mean age of patients was. 37 years and standard deviation was 12.34 (range 12-58 years). Out of total 157 cases 81 patients male were males (51%) and 76 patients were females (49). Out of 157 ears operated 146 Perforations healed completely an overall success rate of 92%. Patients with small perforations had 100 percent success rate whereas near total or total perforations had 86% Success rate. Average preoperative A-B gap was 35 db and Average Postoperative A-B Gap was 15db. Ossicular discontinuity was noted in 34 (21.6%) cases and occlusion of ventilation including obstruction of eusthachian-tube opening was noted in 61 (38%) cases. Average Operative was 67 minutes. Incision scar was visible only in 2 patients 3 months after surgery. Conclusion: Endoscopic trans canal cartilage tympanoplasty is scarless safe effective procedure with demonstrable tympanic membrane perforation closure rates and hearing gains in all patients with minimum complications. The Technique is single handed and has steep learning curve. [ABSTRACT FROM AUTHOR]

Objective: To explore the perspective of survivors with regards to their experience with COVID-19, in order to provide health care professionals a better insight to the disease and its management. Study Design: Mix method study. Place and Duration of Study: The study was carried out in COVID declared Pak-Emirates Military Hospital Rawalpindi, from Apr to Jun 2020. Methodology: Forty two patients admitted to PEMH Rawalpindi who were Polymerase Chain Reaction (PCR) positive for SARS COV-2 were included in the study. Non-probability purposive sampling was used. Face to face in depth semi structured interviews were carried out by two doctors in which the detailed narrative of each patient was obtained. The findings of the interviews were discussed in front of the panel of research team members and the main recurring themes were sought. Results: Out of the 42 patients interviewed 41 (97.1%) were satisfied with treatment received at PEMH Rawalpindi. Sixty nine percent of the patients believed the fear associated with COVID was most distressing than the disease itself. All of the participants believed that mask and social distancing helped in prevention of disease and 85.7% were in favor of lockdown. 17.17% patients acquired their awareness of COVID through unreliable means like social media. Natural remedies were used by 78.8% of the participants out of which the use of Senna leaves was the greatest (42.86%). Conclusion: Most patients received their information through the media and social media which created superfluous fear among the patients. Patients turned to alternative therapies which need to be evaluated with a scientific approach. The medical care being provided by PEMH is appreciated by the patients, however bed bound patients require attendants for better care. [ABSTRACT FROM AUTHOR]

Objective: To assess the job satisfaction among officers, working in Child Protection and Welfare Bureau of Punjab (CPWB). Study Design: Cross sectional study. Place and Duration of Study: Study conducted in 7 working Child Protection and Welfare Bureaus of Punjab, from Nov 2018 to May 2019. Methodology: There are 7 Child Protection and Welfare Bureaus in Punjab and 75 child protection officers all are selected for census data collection. The study has been done on child protection officers of Punjab. Results: Fifty three percent were male respondents and female were 47% while married respondents were 40 (60%). Education status was postgraduate and M. Phil 18 (25%). Permanent employees were 40 (57%) and mostly (40%) had experience of work more than 10 years. Fifty seven percent (n=40) child protection officers were unsatisfied for nature of work. Sixty two (88.6%) were unsatisfied with their interpersonal relationships with co-workers. Thirty seven (52.9%) were unsatisfied due to their pay & allowances. Thirty eight (54.3%) were unsatisfied from working environment. Thirty eight (54.3%) were unsatisfied from training. Conclusion: In conclusion, this study identified multiple factors that contribute to worker satisfaction. When adequate support is provided, there is a reduction in stress, which leads to higher levels of job satisfaction, and ultimately retention of staff. [ABSTRACT FROM AUTHOR]

Objective: To determine the factors potentially influencing patient safety culture in hospital settings an comparison of patient safety factors in public and private hospital. Study Design: Qualitative study. Place and Duration of Study: The study was conducted in two hospitals in Pakistan; one from public and other from private sector, from Feb 2017 to Jun 2018. Methodology: A multi method approach was used for data collection including interviews and focused group discussions with 50 physicians/doctors & staff from different levels of management hierarchy/department and analysis was done by integrating and coding the two sets of data manually. The data was coded and themes were formed. Results: The different themes obtained from the study included: Human factors like leadership, teamwork, communication work-load and professionalism; physical factors like resources, infrastructure and cleanliness; patient factors like severity of illness, availability of attendant and drug allergies; environmental factors like climate, staff and working conditions and safety culture like safe administration of drugs, blood products, sampling, sterilization and prophylactic antibiotics administration. Conclusion: Multiple factors related to human being and environment were identified to influence patient safety in a hospital setting. Participants from the public hospital were more knowledgeable compared to the private hospital. [ABSTRACT FROM AUTHOR]

Background. It is essential to follow World Health Organization drug prescribing indicators to ensure rational prescribing in every health care setting. Objective. To evaluate the prescriptions in the endocrinology department, according to the World Health Organization (WHO), recommended Ghana guidelines for diabetes management and rational therapy. Methods. Concurrent and retrospective study design was used. The prescriptions of 100 diabetes patients were assessed for the type of medicine, dosage form, number of drugs, diabetes type, and deviation from standard guidelines. Results. In a total of 100 prescriptions, the pattern was reported as injections (31%), antibiotics (18%), and metformin (31.1%). Half of the prescriptions were according to WHO guidelines. The number of drugs per prescription was reported at 5.2. A 70% rational approach was followed in prescribing. 81% of drugs were prescribed from the Essential Drug List (EDL) of the WHO. However, the National Essential Drug List (NEDL) was followed by 27%. The percentage of drugs on generic names was 0.7%. Eighty-four patients showed net improvement in health; 16 patients showed higher glycemic range at the time of discharge. Conclusion. The conclusion of the present study indicates that WHO Ghana guidelines were not followed up to the mark to improve the overall health status of diabetic patients and rational prescribing. [ABSTRACT FROM AUTHOR]

Objective: To compare cross-cultural followership styles of resident trainees. Study Design: Cross-sectional quantitative study. Place and Duration of Study: Followership styles of trainees in four provinces of Pakistan, from Jun 2019 to Dec 2019. Methodology: The survey of 300 resident trainees was done by direct administration of survey packets in the respective institutes. It included, consent form, demographic survey, return envelope and Kelley’s followership survey forms. The participants responded to each question. They were instructed to respond to a question with information that was to the best of their knowledge in the event that they were uncertain of its answer. Results: Total 281 medical trainees participated in the survey. The age ranged from 20 years to 54 years with mean age of 30.62 ± 4.87 years. A total of 139 (49.5%) males and 142 (50.5%) females participated in the study. One hundred and fifty six (55.5%) from civil hospitals and 125 (44.5%) from military hospitals. Most frequent followership style was pragmatist, 62 (44.6%) in male and effective, 64 (45.0%) in females. Effective followership style was most frequent in Hyderabad 14 (50%), Karachi 16 (61.5%), Lahore 18 (35.2%) and Quetta 19 (46.3%). Peshawar had equal effective and pragmatist styles i.e. 29 (42.6%) whereas, in Rawalpindi most common style was pragmatist 33 (41.7%). Conclusion: This article provides new understandings of the multiple ways in which followership is experienced in the healthcare workplace in different cultural settings. Understanding the follower will have the purpose to educate leaders how to be more effective. [ABSTRACT FROM AUTHOR]

Objective: To find the predictive relationship of locus of control with work life balance and job satisfaction. Study Design: Correlational study. Place and Duration of Study: Department of Psychology, University of Gujrat, Sialkot Sub-campus, from May 2017 to Dec 2018. Methodology: A sample of 150 Gazetted administrative offices of 17 grade and above was collected from various government organizations of Gujrat and Sialkot City, Punjab, Pakistan. The sample age ranges from 30-60 years. Work locus of control scale, work life balance scale and Minnesota satisfaction questionnaire were implemented to measure locus of control, work life balance and job satisfaction respectively. Results: Path analysis was carried out by using Amos Graphic. Model summary revealed that locus of control was a significant predictor of work life balance and job satisfaction (p≤0.001) Conclusion: The present study supported the predictive relationship of locus of control with work-life balance and job satisfaction among administrative officers. The findings of the current study will be provided the key information to the policy makers with that they can manage the work-life balance and job satisfaction by working on locus of control. [ABSTRACT FROM AUTHOR]

Objective: The study identifies and determines the frequency and types of non-verbal behaviours of doctors and nurses as perceived by patients and elucidates their effect on healthcare delivery. Study Design: Descriptive study. Place and Duration of the Study: The study is conducted in outpatient departments of Red Crescent Hospital, Dina Nath and Fatima Memorial Hospital, Lahore, Pakistan, for a period of 2 weeks. Patients and Methods: Semi-structured Interviews of 40 patients (20 from each hospital) coming for their appointments are conducted and analysed by Heidegger's Phenomenological principles. Purposive sampling method is used to recruit the volunteer patients from various socio-economic strata in this study. Results: The findings revealed that majority of the patients (80%=32) perceived non-verbal behaviours of the professionals spontaneously. The most frequent behaviours affecting healthcare delivery were facial expressions and the tone of voice. It was found that age, class and education are the factors that affect patients' perceptions. In total fourteen kinds of non-verbal behaviours were perceived by the patients amounting to 139 repetitions. The researchers have analysed only those non-verbal cues in the study that were found most frequently. Conclusion: Non-verbal communication plays a significant role for the development of interpersonal relationship between doctors, nurses and patients. As many messages are transmitted paralinguistically, the health professionals must be trained to understand and gauge their own non-verbal cues towards the patients. [ABSTRACT FROM AUTHOR]

ABSTARCT Objective: To determine the prevalence of Acne Vulgaris, its effects on quality of life of the patient and its associated risk factors. Study Design: Analytical quantitative cross-sectional study. Place and Duration of Study: University of Rawalpindi/Islamabad Pakistan, from Mar to May 2021. Methodology: Non-probability convenience sampling was used. A total sample of 218 diagnosed cases of acne was included in our study. The data was collected via online Google forms and analyzed using SPSS 25.0. Results: The prevalence of acne vulgaris was 16.8% in university students of Rawalpindi/Islamabad Pakistan. Among 218 acne cases, the overall Dermatology Life Quality Index score showed 36(17%) cases had no effect at all and 182(83%) had some effect on their quality of life. The impaired quality of life was associated with education and family history (p<0.05). Relatively more impaired aspects of life were physical symptoms (67%), one's own perception of acne (68%) and interference with work/studies (60%). Conclusion: The impact of acne on physical symptoms and self-confidence of people affected their mental health. As a result, these patients found difficulties in studies, work, and their social life. Knowledge about one's ailment, early access to treatment and improved compliance significantly improves one's quality of life. Acne is a deeply rooted issue with serious psychological and social implications which need to be addressed. [ABSTRACT FROM AUTHOR]

Objective: To explore the barriers and disparities in receiving healthcare faced by Transgender population of Rawalpindi, Pakistan. Study Design: Qualitative study. Place and Duration of Study: Study was conducted in Rawalpindi Pakistan, from Jun to Aug 2022. Methodology: A total of 15 participants were selected via Snowball Sampling technique. An interview guide was generated and semi structured interviews were conducted via telephone calls to explore and understand the discrepancies faced by this population regarding good quality healthcare. Each interview was 30-40 minutes long. The data was collected till saturation and then analyzed by 'thematic analysis' to generate themes and subthemes. Results: Based on the data, 6 themes highlighting the barriers to quality healthcare faced by trans-genders were identified. The themes were as follows: (1) Structural, (2) Financial, (3) Social, (4) Cognitive, (5) Educational, and (6) Religious/Cultural. Conclusion: The healthcare barriers identified were mainly financial as certain services were costly, religious beliefs which influenced the use of services like hormone replacement therapies, social stigma and lack of support, level of education and poor employment. Stigmatization by the community and healthcare providers was also seen. Thus, it was felt that there were limited awareness campaigns to empower transgender population and for the general population including healthcare workers to be more aware and accepting towards transgender healthcare. [ABSTRACT FROM AUTHOR]

The present field study was conducted for confirmation of chicken infectious anemia (CIA) in White Leghorn (WL) commercial layer birds. A total of 60 farms were investigated. Birds from each farm ware necropsied for the presence of lesions on different visceral organs. Samples of blood and different tissues were collected for hematology, histopathology, DNA extraction and PCR amplification using specific primers for CIA virus. There was severe anemia indicated by low hematocrit values (10.9 to 17.2%) and hemoglobin concentration (5.3 to 6.7 g/dl). The petechial hemorrhages were present on subcutaneous tissue, epicardium, endocardium and gizzard mucosa. The liver and bone marrow were pale in appearance. The mortality ranged from 5 to 14 % on different farms. Samples of liver and spleen from 15 farms were subjected to PCR analysis for CIAV infection by amplifying the 186-bp region on highly conserved VP-2 coding gene using CAV1 and CAV2 primer pair. Presence of CIAV was confirmed in 67 and 33 percent samples of liver and spleen, respectively. A total of 13/15 farms (87%) were found positive for CIA. The results of present study confirmed the presence of CAV infection in WL commercial layer birds in current outbreak. It is concluded that extensive molecular epidemiological studies are required at national level to assess the prevalence of disease. Breeder flocks should be vaccinated to control CIA in commercial layer flocks. [ABSTRACT FROM AUTHOR]

Background and objective: Leukemia is one of the fatal diseases and their morbidity and mortality rates increases day by day all over the world. This piece of research study was designed in order to find out the prevalence of different types of leukemia in Khyber Pakhtunkhwa, Pakistan during January 2015 to December 2016. Material and Method: The retrospective research study was carried out at Institute of Radiotherapy and Nuclear Medicine (IRNUM) Peshawar. A data of 400 admitted patients of leukemia were evaluated. Result: It was observed that acute leukemia (80%) was more prevalent than chronic leukemia (20%). Amongst types of leukemia, Acute Lymphocytic Leukemia (ALL) 49.5% (n=198) was more prevalent than Acute Myelogenous Leukemia (AML) 31.25% (n=125), Chronic Myelogenous Leukemia (CML) 10% (n=40) and Chronic Lymphocytic Leukemia (CLL) 9.25% (n=37) was less prevalent in this study. It was also found that leukemia was more prevalent in male patients 64.5% (n=258) as compared to females 35.5% (n=142) and male to female ratio was 1.8:1. Most of the patients were under the age of 20 years. Conclusion: Acute leukemia was more prevalent than chronic leukemia during this study in this part of the country and needs to be address. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the levels of aflatoxin B1 (AFB1) and total aflatoxins (AF) in broiler meat at market age. During one year period a total of 264 samples from 199 healthy and 65 sick flocks were collected. AFB1 residues in liver, kidneys and muscles of healthy birds were detected in 75.9, 44.7 and 21.6% samples, and the highest individual levels were 2.0, 0.99 and 0.49 ng/g, respectively. AFB1 residues in liver muscle and kidneys of sick birds were detected in 89.2, 70.8 and 55.4% and the highest individual levels were 7.99, 3.99 and 1.99 ng/g, respectively. The AFB1 residue level in 0.5% liver samples of healthy birds were 2 ng/g whereas in sick birds 23.1 and 6.2% of liver and kidneys had AFB1 residues above 2.0 ng/g. AFB1 levels in the muscles of both healthy and sick birds were below 2.0 ng/g. Among healthy birds none of the tissues had AF residue levels above 4 ng/g whereas in sick birds, 24.6 and 7.7% liver and kidneys had AF residues above 4.0 ng/g. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis C virus (HCV) commonly causes a chronic infection but few of patients are able to clear the virus naturally. Interleukin-10 (IL-10) is an anti-inflammatory cytokine that can suppress the immune response against HCV. Interindividual variations in IL-10 production are genetically contributed by polymorphisms within the IL-10 promoter region. This study aimed to investigate the association of the IL-10 gene promoter -1082 G/A, -819 C/T, and -592 C/A polymorphisms with HCV infection susceptibility in Pakistani individuals. Methodology: Eighty-nine chronically infected patients and 99 controls were enrolled in the study. IL-10 (-1,082 G/A, -819 C/T, -592 C/A) genotyping was performed by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Results: A suggestive evidence of association with hepatitis C was obtained for the IL-10 -819 C/T (-592 C/A) (p: 0.03) promoter polymorphism at the allele level but not in genotype distribution. The IL-10 -1082 allele showed no association while positive association of GG (p: 0.001) gene and negative association for GA (0.001) gene were observed. Higher frequencies were observed for GTA (p: 0.02), ACC (p: 0.01) haplotype and GCC/GTA (p: 0.005) diplotype in HCV patients than controls while diplotype GCC/ATA showed protective effect against HCV. Conclusions: Our findings suggest that different IL-10 gene polymorphisms may lead to an imbalance between the pro-inflammatory and anti-inflammatory cytokine responses which may in turn influence the susceptibility to HCV infection. [ABSTRACT FROM AUTHOR]