A dire need for recruitment of rehabilitation professionals for provision of geriatric care

This editorial is an introspection of recruitment of rehabilitation professionals. The rapid surge in Pakistan’s population has highlighted the dearth and demand of rehabilitation professionals. This has also highlighted the largely ignored geriatric care. Hence, it is imperative that the need of recruitment of rehabilitation professionals especially keeping in view the geriatric population.

Family caregivers’ expectations and needs in Critical Care Units

Introduction: Patient admission into the critical care unit is usually an unpleasant and unexpected life experience for the family members, and unusual for family members to cope with stress and anxiety during their hospital stay. Purpose: This study aimed to explore the expectations and needs of family members of the patients in critical care units at two tertiary care hospitals in Islamabad. Methodology: An exploratory descriptive design was used to address the study questions. Using purposive sampling, 14 family members were individually interviewed through a semi- structured interview guide. A conventional content analysis method was used to analyze the data through which categories and sub-categories were identified. Findings: The data analysis revealed three roles of the family members, which included assistance in physical care, facilitator in the provision of treatment and the decision maker. The participants expressed that their needs for information and assurance were being met to some extent; however, their need for support and comfort were not. Although the physical facilities for meeting the comfort were available in private hospital, it did not match the family members’ expectations. Conclusion: This study revealed that despite some similarities in the role and needs, the expectations and satisfaction of the family members is linked to their awareness of the healthcare system as well as the cost of the obtained services. The suggestions of the family members are implementable to improve their experiences and satisfaction in critical care units, which can enable them to perform their roles better.

Niemann-pick disease: Type A presenting as a case of protein energy malnutrition

We hereby report a rare case of a young child with Niemann-Pick disease who had multiple hospital admissions due to repeated gastrointestinal and respiratory tract infections. The disease is overall quite rare in our population however, our case highlights the fact that in any young child with repeated infections of unknown etiology, this condition should be considered and evaluated.

Role of defensins in innate immunity

Immune system of living organisms ranging from fungi, plants, vertebrates and invertebrates are all aided by polypeptide chains like defensins and cathelicidins. In humans the defensisns are quite fundamental part of innate immune system in combating with day-to-day exposure to unknown pathogens. The defensins are classified as alpha beta and sigma defensins expressed at chromosome 8 at nearly same positions, the sigma defensin is however synthetically developed as reterocyclin, as it has been stopped producing because of evolutionary development of stop codon 7.5 million years ago. The expression of Defensins can be either constitutive or inducible through epithelial cells, Paneth cells or other respective immune cells to regulate the activation of the innate immune responses. These impart their role either by direct microbicidal action, antiviral activity, inactivation or neutralization of microbial products, mobilization or activation of phagocytes and mast cells. Further to this there is lot more to explore about the availability of similar genetic expressions as defensins with unclear functions and in vivo experimental models development.

Effect of sleep quality on academic performance of undergraduate University level students

Introduction: emory processing and learning are enhanced by adequate, high-quality sleep of the appropriate duration. It aids memory processing, executive cognitive functioning and concentration. Academic performance of university students suffers as a result of poorer sleep quality. Objectives: To determine the effect of sleep quality on academic performance of undergraduate university level students. Methodology: This is analytical cross-sectional study and non-probability purposive sampling technique was used. The study population comprised a total 300 students, out of which 50 students were not completed the questionnaire. A total of 250 students, 113 male and 137 female students were participated in this study. A structured questionnaire was circulated among bachelor-level students of different universities in blinded from August 2018 to December 2018. The questionnaire was based on Pittsburgh Sleep Quality Index along with other relevant data about the students’ age, gender, and discipline of study, respective semester and grades (CGPA or percentage total). The data obtained was analyzed using SPSS 21. Results: Majority of the students had moderately poor sleep quality (Global PSQI score=5). The 17.6% of subjects scored 5 in PSQI and 14.8% of subjects scored 6 in PSQI. However, the students who scored high CGPA (>3.5) had better sleep quality as compared to those who got CGPA <3.5. Conclusion: Majority of the students having poor sleep quality and their grades might be affected. Furthermore, the students who attaining good CGPA (>3.5) had on an average good sleep quality.

Current landscape of pharmacovigilance in Pakistan

Drug Regularity Authority of Pakistan came into being in 2012 after multiple casualties were reported due to dispensation of counterfeit & adulterated drugs. The primary purpose was to address any quality & efficacy issues related to medicines and encourage healthcare professionals to play their role in provision of safe medication therapy by practicing pharmacovigilance. Currently, a Medicine Surveillance portal for reporting is available for ADR reporting along with ADR and Drug & Device complaint forms. A new mobile app, MedSafety was recently launched to encourage public to report.

The correlation and determinants of cost-benefit analysis of measles vaccines among the medical centers providing Expanded Program on Immunization (EPI)

Introduction: Measles is a highly contagious viral infection, vaccine-preventable diseases claim the lives of nearly 30 million people each year around the world, including 17% of children under the age of 5. Methodology: This was a descriptive and cross-sectional investigation. Retrospective data collection was used. We looked at medical centers that provided EPI administrations. Results: Around 8% of the youngsters in the study were found to have measles, according to the health center's records. There are an undetermined number of measles-infected children. Only 12% of those surveyed had received the measles vaccine, and the vast majority (88%) had never received the shot. According to statistical analysis, the study's r square value is r=0.35, which is considered to be an intermediate direct relationship (Wastage of vaccine and total cost). It illustrates that if there is no system of checks and balances on vaccine waste, it could have an impact on the overall cost of the vaccination. Vaccines wastage shows a positive association with Dose wastage x2= 438.8 (p-value 0.002). the breakage of vaccine vial x2 = 369.6 (p-value 0.015), expiration of vaccines x2 = 1068 (p-value 0.006), cold chain maintenance x2 = 79.99 (p-value 0.014) & inventory missing was x2 646.9 (p-value 0.004) showed statistical significance. Conclusion: The elimination of any disease would be contributed by the parallel factors one of that includes also financial state. In less time and cost we can vaccinate the number of children and can achieve universal coverage of immunization.

Critical thinking dispositions’ level among neophyte nursing students

Introduction: Critical thinking dispositions (CTD) are valued across the health professions disciplines being essential for decision-making, critical judgment and managing complex health situations. Promoting critical-thinking dispositions in undergraduate nursing students can support the students to utilize critical thinking during challenging patient care and problem-solving situations. Objective: This study aimed to assess the level of critical thinking disposition among neophyte nursing students in a private nursing college. Methodology: An analytical cross-sectional study design was adopted. Neophyte students (n=98) of the BSN program participated in the study. Critical Thinking Dispositions Scale (CTDS) of 54 items under seven constructs was utilized to assess CTD level. Data was analyzed at descriptive and inferential level using SPSS 23.0 version. Results: Overall, CTD among neophytes nursing students is at 75% a progressive level. Contextual and inquisitiveness construct of CTDs are at positive CTD level while other constructs are at the progressive level. Students have completed their matriculation from public 55(56.1%) while FSc (Faculty of Science) from private sector 57(58.2%). Mothers of most neophytes 73(74.5%) were housewives and fathers were working in private organization 32(32.7%). There was no statistically significant association between CTD’s construct with demographic variables (P-Value, >0.05). FSc marks showed a significant association with overall CTD scores, intellectual and inquisitiveness, while admission entry test scores associate significantly with intellectual construct. Conclusion: The CTD level of neophyte is at a progressive level which suggest that different teaching and learning strategies could be implemented to improve this level.

Spike protein of SARS-COV-2 as a potential target for phytochemical constituents: A literature review

SARS-CoV-2 belongs to well-known SARS Coronaviridae family. One of the main structural proteins of SARS-CoV-2 is the spike protein that is present around the surface of a viral cell and plays an essential role in viral attachment, fusion and invasion in host cell. Once a virus invades a cell, it replicates and infects other cells. The fundamental role of spike protein in the progression of viral infection has led to an increased interest in exploring agents that target the viral spike protein for effective control of CoVID-19. The related data from published articles reviewed and numerous phytochemicals that reportedly target the spike proteins of coronaviruses by computational studies briefly discussed. These active constituents possess the potential to develop as therapeutic and antiviral agents against SARS-CoV-2.

Knowledge, attitude and practices study regarding current COVID-19 pandemic in patients presenting to rheumatology clinic of a Tertiary Care Hospital

Introduction: The most important step in controlling the spread of any communicable disease is to stick to preventive measures and COVID-19 pandemic is no exception. Keeping this in mind, a KAP study was performed in the rheumatology unit of a tertiary care hospital of Islamabad. The main idea was to know the level of understanding of rheumatologic patients with respect to COVID-19 pandemic and its preventive measures. Objective: The objective of the study was to understand the knowledge, attitude and practices of rheumatologic patients towards COVID-19 pandemic. Methodology: A descriptive cross-sectional study in which consecutive, non-probability sampling technique was used. Results: There were 37 males and 73 females in the study group, with mean age of 38.75±13.9 years. The total knowledge score was 17 points. It was found that 12 (10.9%) participants had poor knowledge regarding COVID-19, whereas 27 (24.5%) and 71 (64.5%) had good and excellent knowledge respectively. The total attitude score of study participants 7 points. It was found that 11 (10.0%) participants had poor attitude, whereas 72 (65.5%) and 27 (24.5%) had good and excellent attitude. The total practice score was 11 points. It was calculated that 30 (27.3%) study participants had poor practices regarding COVID-19 prevention, whereas 78 (70.9%) had good practices and only 2 (1.8%) had excellent practices. Conclusion: Overall, it was noted that KAP of our rheumatologic patients towards COVID-19 infection was reasonable, however, there is always room for improvement.