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1.
BMC Med Educ ; 21(1): 436, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407810

RESUMO

BACKGROUND: The educational efficacy in neonatal resuscitation relies on the subject and teaching strategies. Therefore, it is imperative to test diverse educational methods if they are more instructive to engage students in active learning and practicing knowledge. Hence, the present study aims to investigate the efficacy of a pedagogical framework in neonatal resuscitation skill learning among nursing students in a resource-limited setting. METHODS: A single-blind randomized controlled trial was conducted between October 2020 to March 2021. Sixty nursing students in the 3rd and 4th year of professional training were randomly allocated to the pedagogy and the traditional group. The pedagogy group learned via 6-step LSPPDM (Learn, See, Practice, Prove, Do, Maintain) pedagogy including lectures, video, clinical observation, skill sessions under supervision, and self-directed practice. The traditional group learned through 2-step (Learn, Practice) method that included lectures and skill sessions under supervision. The outcomes measured included technical and non-technical skills in neonatal resuscitation. The technical skill deals with steps such as stimulation, ventilation, oxygenation, intubation, chest compression, medications, and reporting. Non-technical skills refer to teamwork skills that focus on the interaction between leader and helper. Both skills were measured through previously published validated tools two times before and after the intervention by blinded assessors in a simulated delivery room. RESULTS: Overall, the skill was significantly improved in both groups after intervention. Yet, the results showed that the mean difference of technical skill score in the pedagogy group (24.3 ± 3.5) was significantly higher (p <  0.001) compared to the traditional group (16.2 ± 2.4). Likewise, the mean difference of non-technical skill score in the pedagogy (36.9 ± 1.9) was highly significant (p <  0.001) compared to the traditional group (31.2 ± 1.7). CONCLUSIONS: The LSPPDM pedagogy was found more effective in enhancing technical and non-technical skills in neonatal resuscitation compared to the traditional method. The results of this study support the efficacy of the 6-step LSPPDM pedagogy in the education of nursing students regarding neonatal resuscitation in a resource-limited setting. TRIAL REGISTRATION: Prospectively registered at ClinicalTrials.gov ( NCT04748341 ).


Assuntos
Ressuscitação , Estudantes de Enfermagem , Competência Clínica , Humanos , Recém-Nascido , Aprendizagem , Método Simples-Cego
2.
J Bodyw Mov Ther ; 27: 698-704, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34391309

RESUMO

OBJECTIVE: To assess the effect of Whole-Body Vibration (WBV) and Routine Physiotherapy (RP) on obstacle crossing and stair negotiation time in chronic stroke patients. METHODS: The current study was randomized, parallel-group, assessor-blinded, clinical trial conducted in Physiotherapy Department of Lahore General Hospital, involving 64 patients with chronic stroke. Patients were randomly allocated to 2 groups, i.e., the WBV group (n = 32) and the RP group (n = 32). The WBV group was given additional twelve sessions of vibration therapy (amplitude of 3 mm and frequency of 20 Hz), 6 days/week for 2 weeks. The outcome measures were change in score of height and depth of obstacles cleared, i.e., 6, 8, 10 & 12 inches height and 6, 8, 10 & 12 inches depth and stair negotiation time, i.e., Stair-Climb Test. Chi square test, Independent sample t-test and Paired sample t-test were used to analyze the data. RESULTS: Results show that higher number of patients improved in crossing the maximum height and maximum depth of obstacles in the WBV group but improvement was significant only in height, i.e., (p < 0.05). In the WBV group, Stair Negotiation Time decreased significantly as compared to the RP group, i.e., (p < 0.05). CONCLUSIONS: The present study concluded that both study groups, i.e., RP and WBV, improved despite better results for the latter. Speed of stair climbing and capacity to cross obstacles improved with the WBV therapy in chronic stroke survivors. TRIAL REGISTRATION: IRCT, IRCT20190328043131N1. Registered 03 august 2019 - Retrospectively registered, https://www.irct.ir/user/trial/38832/view.


Assuntos
Acidente Vascular Cerebral , Vibração , Humanos , Negociação , Modalidades de Fisioterapia , Projetos de Pesquisa , Acidente Vascular Cerebral/terapia , Vibração/uso terapêutico
3.
NeuroRehabilitation ; 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34420984

RESUMO

BACKGROUND: The Stroke Impact Scale version 3.0 (SIS 3.0) is a self-reported outcome measure designed to assess quality of life (QoL) following a stroke. Although the psychometric properties of the SIS 3.0 are identified as superior to the generic QoL scales, it has not been translated and tested in Pakistan. OBJECTIVE: To validate the Urdu version of the SIS 3.0 (USIS 3.0) for Pakistan. METHODS: A prospective cohort of 116 patients with mild to moderate stroke reported their recovery using the USIS 3.0. The patients were concurrently assessed on the established tools to assess the validity and were re-evaluated to determine the test-retest reliability, precision, minimal detectable change (MDC), and minimal clinically important difference (MCID). RESULTS: The reliability and internal consistency of USIS were satisfactory except for the emotion domain. The correlations of USIS with the established tools were strong. The discriminant validity was also significant across the levels of the modified Rankin scale (MRS). Only hand function and communication domains exhibited significant floor and ceiling effects, respectively. Regarding weighted K, values ranged from 0.53 to 0.88. CONCLUSIONS: The USIS 3.0 has satisfactory psychometric properties and can be used in clinical and research settings for stroke survivors.

4.
J Pak Med Assoc ; 71(6): 1627-1632, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111086

RESUMO

OBJECTIVE: To explore current evidence on the effectiveness of shockwave therapy in patients with rotator cuff tendinopathy. METHODS: The meta-analysis study was conducted at University of Lahore from May 2019 to December 2019 and comprised search on Cochrane, Medline, Embase, Physiotherapy Evidence Databasedatabases and other sources as well as unpublished grey literature related to shockwave therapy in patients with rotator cuff tendinopathy published between 2000 and 2019. Methodological quality assessment was performed using Cochrane risk of bias tool and the included studies were critically appraised using the Physiotherapy Evidence Databasescale. RESULTS: Of the 11 studies shortlisted, data was not extractable from 2(18%). Of the 9(82%) studies analysed, 8(89%) were randomised trials and 1(11%) was randomised pilot study. Overall, 4(44.4%) studies had high quality and 5(55.6%) fell in the fair category. CONCLUSIONS: There was no consensus found on the efficacy of extracorporeal shockwave therapy compared to traditional rehabilitation among patients with rotator cuff tendinopathy.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Tendinopatia , Humanos , Modalidades de Fisioterapia , Projetos Piloto , Manguito Rotador , Tendinopatia/terapia
5.
Biomed Res Int ; 2021: 5593520, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34041298

RESUMO

Substance P (SP) is a peptide involved in many biological processes, including nociception and inflammation. SP has a high affinity for its receptor neurokinin-1 (NK-1R). SP/NK-1R complex plays a major role in the interactions going on during the onset of dental pain and inflammation. Objective. To identify the expression of NK-1R in healthy and inflamed human dental pulp, as well as to identify any association with severity of dental pain. Methods. This case-control study included ten irreversibly inflamed samples of dental pulp, which were extirpated from patients presenting with chief complaint of dental pain due to caries. Ten healthy pulps, extirpated from those teeth which were indicated for extraction due to orthodontic reasons, were used as the control group. Visual analog scale (VAS) and modified McGill Pain Questionnaire were used to assess the characteristic and severity of pain. Immunohistochemical study was performed using monoclonal antibodies against NK-1R. Results. The results showed that the NK-1R was expressed intensely in patients with higher pain score. The mean pain score in cases was 7.0 ± 2.0. The healthy dental pulps had negative or mild NK-1R staining of +1 intensity. The NK-1R score in cases was 2.4 ± 0.516 and 0.2 ± 0.4216 in controls. There was significant difference in NK-1R score between both groups (p value <0.05). There was a strong positive correlation between the pain score and NK-1R expression score. As the pain increased, the NK-1R expression score was also increased (0.95∗∗, p value 0.000). Conclusions. NK-1R is overexpressed in inflamed dental pulp. SP/NK-1R modulation may provide a novel approach for the treatment of pulpal inflammation and pain.


Assuntos
Polpa Dentária/metabolismo , Inflamação , Dor , Receptores da Neurocinina-1/metabolismo , Adolescente , Adulto , Estudos de Casos e Controles , Polpa Dentária/patologia , Feminino , Humanos , Masculino , Medição da Dor , Substância P/metabolismo , Adulto Jovem
6.
BMC Musculoskelet Disord ; 22(1): 311, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33781267

RESUMO

BACKGROUND: Oswestry Disability Index (ODI) is broadly used in clinical and research settings for assessing the disability level in patients with lumbar radiculopathy but it has not been translated into Urdu language according to the pre-established translation guidelines as well as the validity and reliability of ODI Urdu version has not been tested yet. The aim of this study was to translate ODI in native Urdu language (ODI-U) according to recommended guidelines and to measure its psychometric properties in Urdu speaking patients suffering from lumber radiculopathy. METHODS: Out of 108 participants, 54 were healthy (who filled ODI-U) and 54 were patients of lumber radiculopathy. The patients were administered through ODI-U, visual analogue scales for disability (VAS disability), pain intensity (VAS pain) and SF-36 at baseline and after 3 days. Reliability was investigated through test-retest method, internal consistency, standard error of measurement (SEM) and smallest detectable change (SDC). ODI-U was assessed for exploratory factor analysis, construct (convergent and discriminative) validity and content validity. Alpha level < 0.05 was considered statistically significant and psychometric standards were evaluated contrary to priori hypothesis. RESULTS: ODI-U revealed excellent test-retest reliability for total score (ICC2,1 = 0.95) and for all item (ICC2,1 = 0.72-0.98). Cronbach's alpha of 0.89 showed excellent internal consistency and moderate correlation between ODI-U total score and each item through spearman's correlation coefficient (r = 0.51-0.76). One factor structure was created, explaining 52.5% variance. There was no floor and ceiling effect of total ODI-U score. Content validity was assessed through conducting interviews with patients and incorporating expert's opinions. The discriminative validity was measured by independent sample t-test, where significant difference between healthy and patients (P < 0.001) was observed. The convergent validity was evaluated through Pearson's correlation showing moderate positive correlation of ODI-U with VAS pain (r = 0.49) and VAS disability (r = 0.51) but moderate negative correlation with all SF-36 domains (r = - 0.43to - 0.63). CONCLUSION: ODI-U showed adequate psychometric properties. ODI-U was found to be a reliable and a valid tool to measure the level of disability in Urdu-speaking patients with lumber radiculopathy.


Assuntos
Idioma , Dor Lombar , Avaliação da Deficiência , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
7.
J Infect Public Health ; 14(3): 311-319, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33618275

RESUMO

Infectious diseases remain a complex, recurring, and challenging public health hazard. Coronaviruses have led to multidimensional consequences on health, mobility, and socio-economic conditions. Despite the significance and magnitude of impact from epidemics to the pandemic, literature is sparse on comprehensive coronaviruses related research performance over time. This study aimed at a scientometric evaluation of coronaviruses related literature including COVID-19. Data related to Coronavirus research was extracted from the Web of Science (WoS). All types of publications (28,846) were included and retrieved. To measure the quantity and quality of the publications, "R-Bibliometrix" package was used for detailed analysis exploring a wide range of indicators. Generally, an increasing trend was observed over time led by the USA and China followed by the United Kingdom, Europe, and few other developed countries. The last two decades contributed around 39.5% of documents while only 06 months of 2020 additionally contributed around 46.5% of total documents. Earlier shorter spikes of increased post epidemic publications followed by decreased productivity were detected in the last 2 decades and showed a lack of continuity-'a research epidemic following a disease epidemic'. Articles (53.4%) were the most common publication type. Journal of Virology, British Medical Journal (BMJ), and Virology were leading sources while BMJ, and Lancet showed increased contributions recently. Overall, similar trends of top authors were observed in terms of productivity, impact, collaborations, funding sources, and affiliations with few exceptions mainly from affected regions. Top 20 countries contributed >89% of documents suggesting a lack of global efforts. Networking was found to be mainly among developed nations with limited contributions from resource-limited countries perhaps requiring more cooperation. Recent post-COVID publications rise is highest, unprecedented, and rapidly growing. Authors strongly recommend recent COVID-19 pandemic as a call for continuous, more cooperative, and collective global research.


Assuntos
Bibliometria , Pesquisa Biomédica/tendências , COVID-19 , China , Europa (Continente) , Humanos , Pandemias , SARS-CoV-2 , Reino Unido , Estados Unidos
8.
BMC Musculoskelet Disord ; 21(1): 770, 2020 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-33220710

RESUMO

BACKGROUND: The objective of the study was to compare the effects of neuromobilization (NM) techniques and routine physiotherapy on pain and functional disability in patients having shoulder impingement syndrome (SIS). Present study was aimed to discover evidence based conservative and cost effective remedy on pain and functional disability. STUDY DESIGN: Single blinded randomized control clinical trial. METHODS: A total of 80 patients with SIS were randomly assigned into care and experimental groups (40 in each group). After the baseline assessment routine physiotherapy was executed on both groups, while NM was applied additionally to experimental group. Pain and functional disability score were evaluated by Visual Analogue Scale and University of California at Los Angeles rating score at baseline, 5th and 11th week. Differences in outcome between groups were evaluated with clinical improvement. RESULTS: The experimental group compared with care group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), - 2.38 to - 1.25; P < 0.001 and Partial ƞ2 = 0.33, similarly functional disability score 28.58(27.32-29.83) vs 20.10(18.84-21.36); between group difference,5.62; 95%CI, (4.32-6.92); P< 0.001 and Partial ƞ2 = 0.49 respectively. In experimental group NM was a more effective technique to reduce the pain severity and disability in SIS patients as compare to care group. CONCLUSION: Neuromobilization techniques in addition to routine physiotherapy were significantly effective for the treatment of SIS. TRIAL REGISTRATION: IRCT20190121042445N1 , Registered 19 February 2019.


Assuntos
Síndrome de Colisão do Ombro , Humanos , Dor , Medição da Dor , Modalidades de Fisioterapia , Dor de Ombro , Resultado do Tratamento
9.
J Food Prot ; 83(8): 1387-1395, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32693410

RESUMO

ABSTRACT: Food safety is a current challenge that needs to be addressed globally to overcome burden of foodborne diseases. In this study, food samples collected from Pakistan Institute of Medical Sciences, Islamabad, were analyzed for microbial quality. Parameters to measure the presence or absence of Salmonella, Staphylococcus, coliform, fungi, enteropathogenic Escherichia coli, and total viable counts in foods were studied. Enumeration of aerobic mesophilic bacteria and coliform bacteria was carried out to check the quality of water. The results showed that there was microbial contamination in the foods served at hospital under investigation for this study. Most of the contamination existed because of nonhygienic practices by individuals and serving places. Salmonella, fecal coliforms, and fungal cross-contamination was reported. A hazard analysis and critical control point system was implemented to study what areas are at greater risk and are a reason of contamination in the hospital. The study concluded that high prevalence of the microbial contamination was observed in facilities of the Pakistan Institute of Medical Sciences hospital, requiring strict preventive and precautionary measures to be taken to ensure the safety and health of patients and attendants in the hospital.


Assuntos
Microbiologia de Alimentos , Análise de Perigos e Pontos Críticos de Controle , Contagem de Colônia Microbiana , Contaminação de Alimentos/análise , Hospitais , Humanos , Paquistão , Salmonella
10.
J Ultrason ; 20(81): e111-e115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32609961

RESUMO

Objective: To determine the association between spectral Doppler cardiac activity in the lower limb veins and echocardiographic findings in patients with tricuspid regurgitation. Material and methods: A cross-sectional analysis was performed in the Gilani Ultrasound Center over a period of 13 months. The total study sample comprised 400 subjects. All individuals referred for abdominal ultrasound having cardiac activities in external iliac vein, popliteal and posterior tibial vein, individuals having normal venous Doppler ultrasound, both genders and all ages, were included, and unwilling and non-cooperative patients were excluded from the study. Results: Out of 400 individuals, 200 showed cardiac activity in the lower limb veins on Doppler vascular ultrasound, while 200 did not show cardiac activity. On echocardiography, 204 individuals were diagnosed with tricuspid regurgitation, and 196 individuals had a competent tricuspid valve. According to the independent sample t-test the mean difference in the posterior tibial vein was 25.54 (95% CI: 24.09; 26.98), while the mean difference in the iliac vein was 2.34 (95% CI: 0.64; 4.03) among normal and tricuspid regurgitation. Conclusion: A correlation was found between the cardiac activities in the lower limb veins and tricuspid regurgitation.Objective: To determine the association between spectral Doppler cardiac activity in the lower limb veins and echocardiographic findings in patients with tricuspid regurgitation. Material and methods: A cross-sectional analysis was performed in the Gilani Ultrasound Center over a period of 13 months. The total study sample comprised 400 subjects. All individuals referred for abdominal ultrasound having cardiac activities in external iliac vein, popliteal and posterior tibial vein, individuals having normal venous Doppler ultrasound, both genders and all ages, were included, and unwilling and non-cooperative patients were excluded from the study. Results: Out of 400 individuals, 200 showed cardiac activity in the lower limb veins on Doppler vascular ultrasound, while 200 did not show cardiac activity. On echocardiography, 204 individuals were diagnosed with tricuspid regurgitation, and 196 individuals had a competent tricuspid valve. According to the independent sample t-test the mean difference in the posterior tibial vein was 25.54 (95% CI: 24.09; 26.98), while the mean difference in the iliac vein was 2.34 (95% CI: 0.64; 4.03) among normal and tricuspid regurgitation. Conclusion: A correlation was found between the cardiac activities in the lower limb veins and tricuspid regurgitation.

11.
J Ultrason ; 20(81): e95-e99, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32609969

RESUMO

Introduction: Preeclampsia is a medical condition characterized by hypertension and proteinuria during pregnancy, with the symptoms generally manifesting in the 3rd trimester. Hypertension brings hemodynamic changes; it is therefore expected that arterial blood flow velocity waveforms will be different in the uterine and ophthalmic arteries in preeclampsia. Vascular changes do occur in preeclampsia, which in turn induces hemodynamic changes. Aim: To compare mean values of the resistive index of the ophthalmic and uterine arteries in patients with preeclampsia and normotensive individuals in Doppler US. Methods: In this cross-sectional observational study, ultrasound of the uterine and ophthalmic arteries was performed in 60 pregnant women in the 2nd and 3rd trimester of pregnancy to compare the resistive index of these arteries in preeclamptic and normotensive individuals. All the patients, i.e. 30 preeclamptic and 30 normotensive pregnant women, took part in this study voluntarily. The study was approved by the institutional review board (IRB) of the University of Lahore. Results: The mean resistive index of the uterine artery was 0.50 ± 0.08 in normotensive participants and 0.64 ± 0.09 in preeclamptic women, with the p-value <0.001. The mean resistive index of the ophthalmic artery was 0.70 ± 0.05 in normotensive participants and 0.63 ± 0.04 in preeclamptic women, with the p-value <0.001. Conclusions: There was a significant negative correlation between the resistive index of the uterine and ophthalmic arteries among the patients with preeclampsia and a significant positive correlation among normotensive individuals. Preeclampsia could be easily diagnosed with Doppler ultrasound based on hemodynamic changes in response to vascular changes in the ophthalmic and uterine arteries.Introduction: Preeclampsia is a medical condition characterized by hypertension and proteinuria during pregnancy, with the symptoms generally manifesting in the 3rd trimester. Hypertension brings hemodynamic changes; it is therefore expected that arterial blood flow velocity waveforms will be different in the uterine and ophthalmic arteries in preeclampsia. Vascular changes do occur in preeclampsia, which in turn induces hemodynamic changes. Aim: To compare mean values of the resistive index of the ophthalmic and uterine arteries in patients with preeclampsia and normotensive individuals in Doppler US. Methods: In this cross-sectional observational study, ultrasound of the uterine and ophthalmic arteries was performed in 60 pregnant women in the 2nd and 3rd trimester of pregnancy to compare the resistive index of these arteries in preeclamptic and normotensive individuals. All the patients, i.e. 30 preeclamptic and 30 normotensive pregnant women, took part in this study voluntarily. The study was approved by the institutional review board (IRB) of the University of Lahore. Results: The mean resistive index of the uterine artery was 0.50 ± 0.08 in normotensive participants and 0.64 ± 0.09 in preeclamptic women, with the p-value <0.001. The mean resistive index of the ophthalmic artery was 0.70 ± 0.05 in normotensive participants and 0.63 ± 0.04 in preeclamptic women, with the p-value <0.001. Conclusions: There was a significant negative correlation between the resistive index of the uterine and ophthalmic arteries among the patients with preeclampsia and a significant positive correlation among normotensive individuals. Preeclampsia could be easily diagnosed with Doppler ultrasound based on hemodynamic changes in response to vascular changes in the ophthalmic and uterine arteries.

12.
Pak J Med Sci ; 36(4): 596-602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32494240

RESUMO

Background & Objective: Routine physiotherapy has been advocated was an effective treatment for internal shoulder impingement syndrome. However, there is lack of best exercise treatment and lots of studies are under consideration. The objective of the study was to compare the effects of Neuromobilization and routine physiotherapy on pain in patients having shoulder internal impingement syndrome. Methods: This is a single blinded randomized control clinical trial that was conducted at Social Security Hospital Gujranwala in which 80 patients with SIS were participated. The duration of study was from September 2016 to March 2018. Patients were recruited after giving an informed consent and were randomly assigned to either control or experimental group which was treated with routine physiotherapy and routine physiotherapy plus neuromobilization respectively; pain was assessed by Numeric Rating Scale at base line, 5th and 11th week. Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), -2.38 to -1.25; P < 0.001 and Partial Ŋ2=0.33. These results show that pain score is much improved in experimental group. Conclusion: Neuromobilization along with physical therapy is more effective as compared to physiotherapy alone.

13.
Arch Med Sci Atheroscler Dis ; 5: e79-e84, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32529110

RESUMO

Introduction: Cardiovascular diseases (CVD) are the main cause of premature deaths worldwide, and atherosclerosis (AS) is a major risk factor associated with them. B-mode ultrasound is a well-validated research tool that has been translated increasingly into clinical practice. The aim of the study was to assess the diagnostic accuracy of carotid intima media thickness by B-mode ultrasonography in coronary artery disease patients. Material and methods: This was a case control study, including 100 cases and the same number of controls. Patients with positive angiographic findings and chest pain were considered as cases and those without as negative. Duplex carotid ultrasound was used to detect intima-media thickness (IMT). B-mode real-time ultrasonic images were obtained with a 7 MHz transducer. An intima media thickness of 0.6 mm was considered as being without plaque. Results: The angiographic findings were single-vessel disease, double-vessel disease, and triple-vessel disease in 18%, 11.5%, and 20.5% of cases, respectively, while there were no findings in controls. There was plaque formation in 14.5% and calcification in 12% of the cases. Sensitivity of B-mode ultrasonography was found to be 78%, specificity 75%, positive predictive value 75.72%, and negative predictive value 77.31%. Conclusions: Carotid ultrasonography can be utilised as a valuable screening tool due to having several advantages, including ease of application, reproducibility, low cost, and strong correlation with atherosclerosis.

14.
Biomed Res Int ; 2020: 6432580, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32462008

RESUMO

Typhoid fever is the result of a human host-restricted Salmonella enteric serotype typhi infection that causes enteric fever. Around 21 million people contract typhoid annually, with Pakistan's inhabitants at most risk amongst Asian countries where typhoid remains prevalent. Decades of indiscriminate antibiotic usage has driven the evolution of multidrug-resistant strains and more recently, extensively drug-resistant (XDR) strains of Salmonella enteric serotype typhi. Current reports of extensively drug-resistant typhoid fever outbreak in Pakistan are not only a major concern for Pakistan but also for health authorities worldwide: intercontinental transmission, spread, and replacement of native strains in neighboring countries and a major impediment to Pakistani health care management. The WHO records that there are 5274 cases of extensively drug-resistant (XDR) typhoid fever out of a total of 8188 total cases of typhoid fever reported in Pakistan. The last remaining feasible oral antibiotic that XDR typhoid remains susceptible to is azithromycin; this is a cause of major concern. Additionally, several cases of XDR typhoid fever have also been reported in patients travelling from Pakistan to the USA, UK, and Canada. This review article attempts to raise the issue of XDR typhoid with respect to its epidemiology, prevention, management, and future outlook and stresses a better understanding of antimicrobial stewardship and general surveillance of the disease. Although progress is being made to combat XDR typhoid locally, efficient, unified efforts on a national and international scale are required to contain the XDR outbreak before it is no longer manageable and leads us back to the preantibiotic era.


Assuntos
Surtos de Doenças/prevenção & controle , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Febre Tifoide/tratamento farmacológico , Febre Tifoide/epidemiologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Inocuidade dos Alimentos , Pessoal de Saúde , Humanos , Higiene , Paquistão/epidemiologia , Salmonella typhi/efeitos dos fármacos , Salmonella typhi/genética , Febre Tifoide/microbiologia , Febre Tifoide/prevenção & controle , Abastecimento de Água
15.
Inj Prev ; 26(Supp 1): i36-i45, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-31857422

RESUMO

BACKGROUND: Past research has shown how fires, heat and hot substances are important causes of health loss globally. Detailed estimates of the morbidity and mortality from these injuries could help drive preventative measures and improved access to care. METHODS: We used the Global Burden of Disease 2017 framework to produce three main results. First, we produced results on incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years from 1990 to 2017 for 195 countries and territories. Second, we analysed these results to measure mortality-to-incidence ratios by location. Third, we reported the measures above in terms of the cause of fire, heat and hot substances and the types of bodily injuries that result. RESULTS: Globally, there were 8 991 468 (7 481 218 to 10 740 897) new fire, heat and hot substance injuries in 2017 with 120 632 (101 630 to 129 383) deaths. At the global level, the age-standardised mortality caused by fire, heat and hot substances significantly declined from 1990 to 2017, but regionally there was variability in age-standardised incidence with some regions experiencing an increase (eg, Southern Latin America) and others experiencing a significant decrease (eg, High-income North America). CONCLUSIONS: The incidence and mortality of injuries that result from fire, heat and hot substances affect every region of the world but are most concentrated in middle and lower income areas. More resources should be invested in measuring these injuries as well as in improving infrastructure, advancing safety measures and ensuring access to care.

16.
J Nurs Manag ; 28(1): 120-129, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31733151

RESUMO

AIM: The aim of this study was to determine the association of high-commitment human resource practices (HCHRPs) with nurses' compassionate care behaviour. BACKGROUND: The extant research highlights the key role of compassionate care behaviour in achieving quality health services. However, scant attention has been paid to identifying the factors that augment compassionate care behaviour among health care professionals. METHODS: This study took place from September 2018 to March 2019, collecting data from 340 nurses of either gender aged 24-60 years with at least 1 year experience. The study follows a cross-sectional research design by collecting data through a personally administered survey. RESULTS: A statistically significant association was found between the four dimensions of HCHRPs and organisational commitment. Moreover, organisational commitment positively related to compassionate care behaviour and mediated the relationship between HCHRPs and compassionate care behaviour. CONCLUSION: The findings reveal that four dimensions of HCHRPs positively influence nurses' compassionate care behaviour via the indirect path of organisational commitment. IMPLICATIONS FOR NURSING MANAGEMENT: The study marks the first attempt to delineate the role of HCHRPs in enhancing the compassionate care behaviour. The hospital administration and human resource managers should use HCHRPs as strategic imperative to attract competent employees and enhance compassionate care behaviour.


Assuntos
Empatia , Enfermeiras e Enfermeiros/psicologia , Recursos Humanos/normas , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos , Cultura Organizacional , Inquéritos e Questionários , Recursos Humanos/estatística & dados numéricos
17.
Skin Pharmacol Physiol ; 33(6): 331-341, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33401283

RESUMO

BACKGROUND: Capsaicin, the main pungent ingredient in hot chili peppers, causes excitation of small sensory neurons. It also provides the basic pungent flavor in Capsicum fruits. SUMMARY: Capsaicin plays a vital role as an agonist for the TRPV1 (transient receptor potential cation channel, subfamily V, member 1) receptor. TRPV1 is essential for the reduction of oxidative stress, pain sensations, and inflammation. Therefore, it has many pros related to health issue. Activation and positive impact of TRPV1 via capsaicin has been studied in various dermatological conditions and in other skin-related issues. Past studies documented that capsaicin plays a vital role in the prevention of atopic dermatitis as well as psoriasis. Moreover, TRPV1 is also very important for skin health because it acts as a capsaicin receptor. It is found in nociceptive nerve fibers and nonneural structures. It prompts the release of a compound that is involved in communicating pain between the spinal cord nerves and other parts of the body. Key Messages: Here, we summarize the growing evidence for the beneficial role of capsaicin and TRPV1 and how they help in the relief of skin diseases such as inflammation, permeation, dysfunction, atopic dermatitis, and psoriasis and in pain amplification syndrome.


Assuntos
Capsaicina/uso terapêutico , Capsicum/química , Inflamação/prevenção & controle , Pele/efeitos dos fármacos , Especiarias/análise , Animais , Humanos , Inflamação/metabolismo , Inflamação/patologia , Canais de Cátion TRPV/metabolismo
18.
Pak J Pharm Sci ; 33(5(Supplementary)): 2355-2360, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33832912

RESUMO

To determine the prevalence of prenatal depression and explore its association with socio-demographic risk factors, stressful life events and women autonomy/decision-making. The recognition of these problems would play a substantial role in the strategic development of interventions for those Pakistani women who have been suffering from prenatal depression. Analytical cross-sectional study conducted in Allied hospital Faisalabad during a period of 18 months (1st Jan 2019 to 30 June 2020). Data was collected by using simple random sampling technique. EPDS was used to measure prenatal depression. A modified kuppuswamy scale, Life Events and Difficulties Schedule (LEDS) and women autonomy/decision making scale was used to assess the risk factors. A total of 380 women were included in the study. The mean age (in years) ± SD was 29.37±5.27. According to cut-off score >10 on Edinburg postnatal depression scale the prevalence of depression was found as 51.6%. The findings revealed that women education, socio-economic class, BMI, pregnancy duration, history of miscarriage, contraception, stressful life events and women autonomy had significant association with prenatal depression (P<0.05). Socio-demographic factors, stressful life events in previous life and women autonomy are significant predictors of prenatal depression that need to be addressed in order to sustain safe motherhood.

19.
J Pak Med Assoc ; 70(12(B)): 2322-2327, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33475536

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of neuromobilization (NM) on the pain and active forward flexion in participants with shoulder impingement syndrome (SIS). METHODS: A randomized control trial was conducted in Social Security Hospital, Gujranwala. The duration of study was September 2016 to March 2018. A sample of 80 participants was selected and allocated in to two groups using computer generator method in simple random sampling technique. Consent was taken from patients with SIS for this trial. At the first session, participants were randomly assigned to either control group (n=40) or experimental group (n=40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and active forward flexion (AFF) were evaluated at baseline, 5th week and 11th week. The data were entered and analyzed using SPSS (version 22.0). RESULTS: The experimental group compared with control group at 11th week had lower mean pain score 2.15 (1.66-2.64) vs 4.90 (4.41-5.40); between group difference, 1.82; 95% confidence interval (CI), -2.38 to -1.25; P ˂0.001 and Partial ƞ2=0.33, similarly with AFF 147.13 (142.46-151.79) vs 123.45(118.79-128.11); between group difference ,19.35; 95% CI, (12.86-25.83); P ˂ 0.001 and Partial ƞ2=0.30. Over all pain and AFF were improved among experimental group relative to control group at 11th week. CONCLUSIONS: In an experimental setting, the delivery of neuromobilization led to significantly different outcomes in participants of SIS than in control group.


Assuntos
Síndrome de Colisão do Ombro , Terapia por Exercício , Humanos , Modalidades de Fisioterapia , Amplitude de Movimento Articular , Projetos de Pesquisa , Síndrome de Colisão do Ombro/terapia
20.
Case Rep Med ; 2019: 5623530, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781231

RESUMO

A case of geyser sign with acromioclavicular (AC) joint cyst with underlying rotator cuff tear is presented. Ultrasound modality is used to diagnose the clinical case of the AC cyst with positive geyser sign. A 91-year-old male patient presented with a complaint of right-sided shoulder and neck pain. The physical examination revealed a large lump on his right shoulder with restricted shoulder movements. During ultrasound examination, a chronic supraspinatus tendon (ST) tear and AC joint cyst with a positive geyser sign was observed. The ultrasound diagnosis was also confirmed with magnetic resonance imaging (MRI). AC joint cyst with geyser sign is a rare condition. Few cases have been published with this type of pathology. To our knowledge, this is the first report of its kind from Pakistani population.

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