Journal of Wazir Muhammad Institute of Paramedical Technology

Capacity Building of Healthcare Professionals for Disaster Readiness in Pakistan

Mohsin Khurshid — Mon, 05 Dec 2022 00:00:00 +0000

Disasters are devastating happenings that lead to extensive deaths and suffering. During the past few decades, the world has seen a fourfold increase in the occurrence of various disasters. The disasters have profound economic and social impacts on the communities. They threaten the health of local populations concerning the increasing death toll and injuries as well as disrupt the healthcare services in the affected areas owing to loss of healthcare professionals, structural damage to the health facilities, and burden of health services. Disasters can easily overwhelm any healthcare system due to the sudden and large influx of human beings that immediately need healthcare services. Pakistan is included among those countries of the world that are widely affected by natural disasters including floods, Earthquakes, storms, wildfires, landslides, and cyclones. Moreover, man-made disasters also affected various parts of Pakistan such as mass shootings, suicide attacks, and armed conflicts. Both natural and man-made disasters have severely stricken Pakistan during the last two decades directly and indirectly costing Pakistan nearly US$126.79 billion.¹ Healthcare professionals are considered a major driving force at the back of any healthcare system. Their pivotal role in the management of public health emergencies and disasters gets more important for the effective management of emergencies inside the healthcare systems as well as the field hospitals. Human resource is quite important for the efficient performance of any health system, however, there is a substantial shortage of healthcare professionals in most countries. The shortfall of healthcare workers is estimated at 17.4 million globally. The World Health Organization (WHO) has included Pakistan in the list of 57 countries that are facing a shortage of health workforce.^1,2

Disasters pose a severe physical and mental burden on the healthcare team members, therefore, the awareness and training to face the challenges during any type of disaster are of paramount importance as healthcare professionals serve as the frontline in the management of disasters. The healthcare workers should work in connection with the emergency medical teams, national or provincial disaster management authorities, and other public health agencies for the region and community-wise partnership building, education, and training prospects sharing of resources and staff incentivizing the input of clinical partners in awareness activities and effective communication with the public. The engagement of stakeholders, funding, staffing, rural needs, proper education, and training are some of the challenges that need to be addressed. The Strengthening of healthcare and disaster management teams as well as building an integrated system could help improve national strength in disasters. The studies need to be conducted to assess the existing knowledge and attitude toward disaster preparedness among health professionals. The country is grossly lacking formal teaching as well as training programs in “emergency and disaster medicine”. It is suggested to train key personnel such as medical teachers, public health providers, health administrators, first responders, facility managers, clinical practitioners, and all allied health professionals. Moreover, disaster medicine could be added either to the core curriculum of undergraduate allied and medical schools or in the undergraduate and postgraduate courses in the universities as well as in the continuing medical education (CME) programs.

Restoration Methods Preferred by Dental Practitioners for Ensuring the Longevity of Composites in Extensive Posterior Restoration

Mon, 05 Dec 2022 00:00:00 +0000

To find the restoration methods preferred by dental practitioners for ensuring the longevity of composites in extensive posterior restoration.

METHODOLOGY

A cross sectional descriptive study was conducted in 150 dentists of Sharif College of Dentistry, SMDC, Lahore from June 2019 to July 2020. All participants irrespective of their age, gender and clinical experience were included. Practitioners who had never used composites for posterior restoration were excluded from the study. Data was collected using a pre validated questionnaire.

RESULTS

There was a statistically non-significant association between designation of the clinicians and the techniques used for ensuring longevity of extensive restorations (P=0.255). That majority of the house officers (46%), postgraduate residents (7.3%) and consultants (29.3%) used incremental curing.

CONCLUSION

Most of the house officers used incremental curing, majority of the postgraduate students used the incremental curing technique while most of the faculty members preferred incremental curing for the longevity of the restorations.

Distribution and Antibiotic Sensitivity Profile of Skin Infection Causing Pathogens in District Peshawar, Pakistan

Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

The study aimed to evaluate the distribution and antibiotic sensitivity profile of dermatophytes fungi and skin infection-causing bacterial pathogens in the district of Peshawar, Pakistan.

METHODOLOGY

A cross-sectional study was conducted from February 2022 to July 2022 in Microbiology Section, Complex Medical Laboratory Peshawar, Pakistan. A total of 100 skin-infected patients’ pus, nail, and skin scraping samples were processed for the isolation of fungal and bacterial pathogens.

RESULTS

Out of 100 skin-infected patient samples, the distribution of Escherichia coli was higher at 44.23%, followed by Staphylococcus aureus at 25%, Proteus species at 21.15%, Klebsiella spp. 5.76%, and Pseudomonas aeruginosa 3.84%, respectively. Among fungal pathogens, the distribution of Candida spp. was higher at 44.44%, followed by Aspergillus spp. 22.22%, Rhizopus spp. 16.16%, Mucor spp. 11.11%, Paecilomyces lilacinus 5.55%, respectively. The E. coli showed high resistance to amoxicillin 86.95%, S. aureus was high resistance to ciprofloxacin, levofloxacin 84.61%, Klebsiella spp. was found high resistance to amoxicillin and meropenem 100%, Proteus spp. has found high resistance to ciprofloxacin, amoxicillin 81.81%, and P. aeruginosa was highly resistant to doxycycline, aztreonam 100%. The candida spp. was found high resistance to nystatin at 87%, Aspergillus spp. were founded highly resistant to nystatin at 100%, Mucor spp. was high resistance to fluconazole, ketoconazole, and clotrimazole (100%), Rhizopus spp. was found resistant to itraconazole 100%, P. lilacinus was found highly resistant to itraconazole, nystatin 100%.

CONCLUSION

The study of antibiotic resistance pattern is suggested, which help the basis for modifications in skin infection therapy. A molecular study was also needed to identify the resistance gene among these pathogens and their immunogenicity.

Determination of Antibacterial Activity of Nicotiana Tabacum Against Bacteria Isolated From Teeth Gums of Smokers and Non Smokers

Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

This study aimed to determine the antibacterial activity of Nicotiana tabacum against bacteria isolated from the gums of smokers and non-smokers.

METHODOLOGY

For this study, 100 gum samples were collected from dental clinics in Peshawar using sterile disposal swabs. The samples were transferred to Abasyn University in Peshawar, streaked on Nutrient agar plates. The obtained cultures were sub-cultured and processed for further identification by Gram staining and biochemical tests.

RESULTS

It was found that, out of a total of 100 samples, 60 were positive (35 non-smokers and 25 smokers), and 40 were negative. Among 60 samples, 12 species were identified, of which M. mucilaginous (24% of the smoker) and S. aureus (44% of the non-smoker) showed high prevalence. After the analysis of both the dried and chewed N. tabacum’s antibacterial activity, it was observed that dried tobacco extract showed maximum activity against S. hyicus (16.33 ± 0.57), M. mucilaginous (16.33 ± 0.57) and least activity against E. coli (10.7 ± 0.46). In contrast, chewed tobacco extract showed maximum activity against S. cohnii (15.33 ± 0.57), while the remaining isolates were resistant.

CONCLUSION

The outcome of the studies concluded that the prevalence of bacteria isolated from smoker's samples was higher and more pathogenic than in non-smoker’s samples.

The Prevalence of ABO Blood and RhD Postive and RhD Negative among the Students of Peshawar, Pakistan

Saifullah Bacha, Murad Ali , Izaz Ullah , Fawad Ahmad Noor — Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

This study aims to find the prevalence of ABO blood Group and Rh D among the Students of Peshawar, Pakistan.

METHODOLOGY

It was a cross-sectional study conducted at the private paramedical institute of Peshawar over six months. Three hundred and fifty (350) students from different paramedical institutes participated. This study was conducted to determine blood groups in the paramedical institute. The blood of each student was collected by venipuncture techniques. Lancet was used for blood taking. Blood groupings were performed using commercially available Anti-sera A, B, and D as reagents for blood grouping.

RESULTS

Blood group A was prevalent (31.7%), followed by blood group B (31.1%), O (28.3%), and AB (8.9%). The Rh D distribution also varies among the four ABO blood group types. The total percentage of Rh D positive was (86.3%), and the Rh D negative was (13.7%).

CONCLUSION

This study concluded that blood group A was the most common among the other blood groups: B, O and AB.

Prevalence of Helicobacter Pylori among Paramedical Students of Peshawar, Pakistan

Saqib Ullah, Afaq Khan, Tasbih Ullah, Abdul Majid — Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES:

This study aims to determine the frequency of H. Pylori infection among the Paramedical students and to determine the hygienic environment of their lifestyle.

METHODOLOGY:

A cross-sectional population based study was conducted during the month of March 2022 to Jun 2022 among the Paramedical students to determine the prevalence of h. pylori by using the immunochromatographic Test (ICT). , and then we collected blood by vein puncture technique, and then draw blood into heparinized tube. All obtained data was arranged and analyzed by statistical packages for social sciences on Microsoft excel.

RESULTS:

A total of 300 sample were collected from different Paramedical student. Both male and female paramedical students were included in the study. The prevalence of H.pylori positive cases were 173(57.6%) and negative cases were 127(42.3%).. Male were 259(86.3%) and female were 41(13.6%). %). In which 110 (42.2%) males were negative and 149 (57.5%) were positive. Total number of female were 41 (13.6%) in which 17 (41.4%) female were negative and 24 (58.5%) female were results positive.

CONCLUSION:

This study conclude that H. pylori are highly prevalent 57.6% in Paramedical students. Infection were highly prevalent in students who were using tap water and also we compared the students related to urban and rural areas in which the prevalence of h. pylori was higher in students related to rural area. Higher prevalence was also found in older students than those from low social class.

Factors Causing Tooth Extraction among Patients Visiting DHQ Hospitals Dir Lower and Chitral Kpk, Pakistan

Muhammad Adnan Ullah, Shams Ul Islam, Farooq Hussain, Masroor Israr — Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

This study aimed to assess the factors and diseases that can lead to tooth extraction in lower Dir and Chitral, Khyber Pakhtunkhwa, Pakistan.

METHODOLOGY

The cross-sectional study was conducted at DHQ Hospitals lower Dir and Chitral from March to August 2022. Patients were informed about the nature and objectives of the study, and consent was obtained before the procedure. The total number of participants was 400, and data was collected through a convenient sampling technique. Below 18 years and edentulous patients were excluded. The Institutional Review Board approved the study of the DHQ Hospital Lower Dir and Chitral. Data were analyzed by using SPSS version 22.0 software.

RESULTS

The male participants were 53.3 per cent, and the female was 46.7. Dental caries was the most common reason for tooth extraction (52.5 per cent), followed by own option of the patients for tooth extraction (46.0 per cent), wisdom tooth extraction (22.8 per cent), extraction due to dental plaque (22.0 per cent) due to periodontal disease (21.8 per cent), and orthodontic purposes were (12.0 %).

CONCLUSION

Our findings show that dental carries are the most common cause of tooth extraction

Pre-Analytical Errors in Haematology and Chemistry at Hayatabad Medical Complex Peshawar

Gurdeet Singh, Muhammad Khalid, Abdur Rahim, Fawad Ahmad Noor — Thu, 08 Dec 2022 00:00:00 +0000

OBJECTIVES

To determine the frequency of pre-analytical errors in haematology and chemistry at Hayatabad Medical Complex Peshawar.

METHODOLOGY

A descriptive cross-sectional study was conducted at the MTI/Hayatabad Medical Complex (HMC), Peshawar, from February to July 2022. Through the purposive sampling technique, 480 samples were collected. Each sample was tested to analyse and assess errors in haematology and chemistry. For statistical analysis, SPSS version 26.0 was used.

RESULTS

Four hundred eighty samples were studied during the project with the following pre-analytical errors, mainly 27.11% insufficient quantity, 22.91% clotted sample, 17.70% hemolysis, and 12.5% of the investigation were incorrect vacuum sealers or collection tubes. The analysis's error rate for the EDTA mix samples was 15.83, and 03.95% was the Hypervolumic sample in the study.

CONCLUSION

It was concluded that human error, technical error, and insufficient staff knowledge were the major errors in haematology and chemistry.

Prevalence of Hepatitis B Virus Markers in Blood Donors at Hayatabad Medical Complex Peshawar, Pakistan

Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

This study aimed to find out the prevalence of Hepatitis B Virus (HBV), and the ratio among the Hepatitis B Virus markers, including Hepatitis B surface Antigen (HBsAg), Hepatitis B surface Antibody (HBsAb), Hepatitis B envelop Antigen (HBeAg), Hepatitis B envelop Antibody and Hepatitis B core Antibody.

METHODOLOGY

A cross-sectional study was conducted from February to July 2022. Three hundred sixty blood donors were selected at Medical Teaching Institute Hayatabad Medical Complex Peshawar, Pakistan. The information about donors was received through a predesigned questionnaire.

RESULTS

The prevalence of HBV marker HBsAg was 2.8%, with the highest reactivity followed by HBcAb at 2.2% and HBeAb at 1.1%. Among HBV markers, no reactivity founded in HBsAb and HBeAg.

CONCLUSION

The highest positivity reactivity rate was found in HBsAg among HBV markers, while the second and third prevalent markers were HBcAb and HBeAb among blood donors.

Levels of Vitamin B12 and Homocysteine in Pre-Eclamptic Patients with and Without Placenta Abruption

Firdous Jamil, Muhammad saeed, Maria Karim, Tahoor Khan — Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

This study aimed to determine vitamin B12 and homocysteine levels in pre-eclamptic patients with and without placenta abruption.

METHODOLOGY

A case-control study comprised 60 participants (cases n =30 and control n = 30) ages 17-28 years to evaluate the correlation between vitamin B12 and homocysteine. Each participant was interviewed for data collection regarding their age, education, income, gestation weeks, and family history of hypertension and their blood pressure, urinary albumin, height, weight, and body mass index in kg/m2 (BMI). Blood samples (5 ml) were collected from each subject through sterilized syringes; 3 ml of blood was transferred to the ETDA tube and 2 ml into the clot activator Gel tube. Each sample was centrifuged and stored at -20C. Vitamin B12 and homocysteine ELISA kits were used for measuring the vitamin B12 as well as homocysteine levels in each blood sample. Vitamin B12 was analyzed by Chemiluminescent Microparticle Intrinsic Factor assay. For both Vitamin B12 and homocysteine analysis, a commercially available ARCHITECH kit was used. SPSS version 26.0 was used.

RESULTS

It was observed that vitamin B12 in both cases and control were the most frequent. In case twenty-three (77%) and control twenty-two (73%) are in the normal range. Five (17%) and seven (23%) are deficient in both case and control, respectively. Only two (7%) and one (3%) had a high vitamin b12 in the case and control, respectively. On the other hand, none of the cases was deficient with homocysteine, while only three (3%) in control were deficient with homocysteine. Three (10%) and six (20%) had high homocysteine levels than normal in the case and control, respectively.

CONCLUSION

Our results highlight the importance of Vitamin B12 and homocysteine in pregnancy. Further large-scale studies should evaluate the relationship between Vitamin B12 and homocysteine in pre-eclampsia and abruption.

Prevalence of Dental Anxiety among School-Going Children (9-15 Years) in District South Waziristan, Khyber Pakhtunkhwa

Akram wazir, Adnan Durrani, Kiramat Ullah — Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

This study aimed to assess the prevalence of dental anxiety among 9 to 15 years old school-going children in South Waziristan Wana, Khyber Pakhtunkhwa (KP).

METHODOLOGY

A cross-sectional study was conducted in south Waziristan. A sample size of 300 male and female children ages 9 to 15 were taken through convenient sampling. The data was collected through well-developed questionnaires from different school-going children. Data were analysed through SPSS version 26.0.

RESULTS

40.7% of children had moderate dental anxiety, 37.3% had severe, and 22.0% had mild dental anxiety. Before dental treatment, 46.7% of children reported that the cause of dental anxiety was fear of pain, whereas, after the dental treatment, the extraction (45.7%) caused dental anxiety. Children reported high dental anxiety during the dental treatment.

CONCLUSION

Dental anxiety was high among 9 to 15 years school students in Waziristan.

A Review on Association of Anemia with Chronic Heart Failure in Elders

Naeem Ullah, Muhammad Umair, Salman Ahmad, Abdul Majid — Mon, 05 Dec 2022 00:00:00 +0000

OBJECTIVES

Primary aim of the study was to find association of anemia with chronic heart failure in elders.

ABSTRACT

Anemia is a condition that develops when a person’s red blood cell count or hemoglobin level is less than the normal range. It is a problem mostly associated with people having congestive heart failure and is more widely recognized as a serious and treatable illness. The majority of the patients having congestive heart failure tend to be females who have hardly any heart disease or the associated risk factors, but have increased rates of diseases other than cardiovascular disorders and diastolic failures. The two most influential risk factors for congestive heart failure are hypertension & diabetes, especially in those females having coronary heart failure. Hospitalization of patients over the age of 65 is largely concerned with congestive heart failure, and it has a significant clinical and financial impact. Co-occurring, poly-pharmacy, as well as impairments related to congestive heart failure, account for around half of all hospital readmissions. Furthermore, congestive heart failure comes at a high price due to poor prognosis, having an average 1-year mortality rate of 33% to35%. Even though more than half of congestive heart failure patients fall under the category of 75 years, still certain trials have included younger patients having an average age of 61 years. It is concluded that anemia is prevalent as co-morbid condition. Furthermore, iron deficiency was identified as common reason for anemia in heart failure patients.