ZU Journal System (Ziauddin University)
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Wake-Up Call to Public Health Crisis: Floods driving Looming Outbreaks in Pakistan
No full textFloods in Pakistan are among the most recent recurring national disasters since the last three decades that have exposed several times the fragility of infrastructures, leading to the silent emergency of disease outbreaks beyond repair. The 2010, 2022, and 2025-based floods clearly depicted that Pakistan is in constant war with not only climate change but also with the devastating epidemics of vector-borne diseases 1. The World Health Organization (WHO) in 2022 reported more than 33 million people as direct victims of floods, more than 1,400 damaged health facilities, along with 8 million displaced people, including children and women 2. United Nations Children\u27s Fund (UNICEF) reported over 3.4 million children with urgent need of medical and nutritional assistance over this period of time 3. Thousands of people (displaced)with the symptoms of diarrheal diseases, malaria, and dengue, followed by the monsoon rains, flooded Punjab and Khyber Pakhtunkhwa 4.
Emphasizing waterborne diseases, a hub of Pathogens spreading among displaced populations by dint of poor sewage systems and scarcity of clean drinking water. The most typical culprits are cholera, typhoid, hepatitis A and E, and acute watery diarrhea 5. During the floods in 2022, the Sindh province recorded almost 90,000 cases of diarrhea in one day, which is an absolute question mark over the sanitation infrastructure of Pakistan 6. Stagnant water creates breeding areas of mosquitoes, resulting in dengue, malaria, and chikungunya spikes. In 2022, the cases of dengue and malaria were seen as reportedly increased in Sindh and Punjab within weeks of the monsoon floods 7. Children bearing malnourishment (under-five populations) are particularly vulnerable to increased mortality rates, and over 600,000 pregnant women were reported to require emergency maternal care 8,9
Dental Materials in Pain Management: Exploring the Role of Endodontic Sealers in Reducing Post-Treatment Inflammation
No full textBackground: Post-operative pain and inflammation are often the result of endodontic treatment because of the extrusion of root canal filling materials and host tissue reaction. These undesirable consequences could be minimized through the development of dental materials, specifically bioactive and anti-inflammatory endodontic sealers. This study evaluated the clinical effectiveness of various endodontic sealers in reducing pain intensities among patients undergoing root canal treatment. Methods: This cross-sectional study was conducted between January and July 2024 among 90 participants, underwent single root canal treatment. Root canal obturation was performed using zinc oxide eugenol-based sealer, epoxy resin-based sealer, and bio-ceramic-based sealer. Pain intensity with the help Visual Analog Scale (VAS) and clinical signs at the time of assessment were measured. ANOVA and Chi-square tests were used to analyze data, where p < 0.05 was defined as significant. Results: There was a significant difference in the mean VAS scores across groups (p = 0.0008), with the highest figure given by zinc oxide eugenol (2.7 ± 1.0), followed by epoxy resin (1.6 ± 0.8), and bio-ceramic (2.6 ± 0.5). Periapical inflammation (tenderness, swelling) was significantly decreased in the bio-ceramic group (p = 0.01). Pain types distribution indicated that zinc oxide eugenol was significantly more prevalent with moderate and severe pain (p < 0.05). Conclusion: Bio-ceramic-based sealers demonstrated significant lower pain intensity and inflammation signs compared to epoxy resin and zinc oxide eugenol sealers. Their enhanced biocompatibility offers a possibility of better patient outcomes during endodontic treatment
Comparative Analysis of Lidocaine vs. Bupivacaine for Local Anesthesia in Minor Surgical Procedures: A Meta-Analysis
No full textBackground: Local anesthetics such as lidocaine and bupivacaine are the most commonly employed in simple surgical operations, but their relative efficacy is controversial. This systematic review and meta-analysis aimed to perform a comparative analysis of the local anesthesia agents, lidocaine and bupivacaine in minor surgical operations. This review was aimed at facilitating evidence-based clinical decision-making in the choice of the most effective anesthetic to use when applying minor surgical practice.
Methods: A search for lidocaine versus bupivacaine in minor surgical procedures was conducted in PubMed, Scopus, Web of Science, and Google Scholar for randomized controlled trials (RCTs). The studies were filtered in accordance with PRISMA 2020 criteria. The Cochrane tool was used to measure risk of bias, and the certainty of evidence was measured with GRADE. RevMan 5.4.1 was used to perform meta-analyses through random-effects models, subgroup and sensitivity analyses to test the robustness.
Results: 12 RCTs were included. Quantitative data on onset were available in eleven studies, and duration in seven. No statistically significant difference in onset between lidocaine and bupivacaine was observed in a pooled analysis (SMD -0.27; 95% CI -0.70 to 0.16; I2 =92%). Contrarily, duration of anesthesia preferred bupivacaine (SMD -2.47; 95% CI: -3.16 to -1.79; I2 = 85%), and the findings were strong regardless of sensitivity analyses. The risk of bias was low-to medium-moderate, and the general evidence certainty was moderate.
Discussion: Lidocaine has a better onset, and bupivacaine, a better analgesia, which validates their complementary roles in clinical indications. The two agents were safe, and intertrial heterogeneity demonstrates the necessity of standard protocols and multicenter, large-scale studies that could help guide an evidence-based anesthetic choice in the minor surgery practice
A Schematic Insight to Virtual Reality in Inter-professional Simulation for Enhancing Teamwork among Medical Professionals: A Systematic Review and Meta-Analysis
No full textBackground: Virtual reality (VR)-based interprofessional simulation is a growing educational method of improving teamwork and communication between healthcare professionals. This systematic review and meta-analysis intended to determine the relevance of VR simulation to improve teamwork performances and the communication attributes in different healthcare disciplines.
Methods: A comprehensive literature search was conducted across PubMed, Web of Science, and Google scholar in accordance with the PRISMA 2020 guidelines. Interventions that targeted the aspects of interprofessional teamwork and communication attitudes were eligible. Risk of bias was assessed using Cochrane risk of bias tool and Newcastle Ottawa for Randomized control trials (RCTs) and Observational studies, respectively. The certainty of evidence was evaluated with GRADE criteria. Standardized mean differences (SMDs) were determined and were expressed as 95 % confidence intervals (CIs) and the heterogeneity was compared as I2 statistics.
Results: A total of 10 studies were included in which VR-based interprofessional simulation was found to produce a substantial positive impact on the performance of teamwork among nursing students (SMD = 0.73; 95% CI: 0.17-1.29; p < 0.0001) or surgeons (M = 7.81; 95% CI: -2.52 to 18.16; p = 0.0007). As a secondary outcome, there was a large positive impact of communication attitudes as well (SMD = 1.02; 95% CI: 0.66 to 1.37; p < 0.0001). These results were stable as confirmed by sensitivity analyses.
Discussion: VR-based Inter professional simulations may be utilized in training healthcare workers in building teamwork and communication skills in order to facilitate better collaboration and increased patient safety
OCCUPATIONAL HEALTH POLICIES AND ENVIRONMENTAL SAFETY STANDARDS AS PREDICTORS OF EMPLOYEE PERFORMANCE IN THE NIGERIAN MANUFACTURING SECTOR
No full textBackground and Aim: The importance of work in the lives of employees cannot be over-flogged; thus, the safety of the environment where their jobs are carried is crucial and serves as a principal ingredient for maximising employees’ performance. The study was anchored on the theory of reasoned action, the human factors theory and Incident theory of accident causation.
Methodology: A total of 173 employees of five manufacturing organisations in Ota Area of Ogun State were selected for the study through the purposive sampling method. The data obtained from respondents were analysed using descriptive and inferential statistics.
Results: Findings revealed that there exists a strong positive effect of occupational health policies on employee performance with (r= .909, p-value<0.05) and also, there is a strong correlation between environmental safety standards and employees performance with (r=0.915, p-value<0.05).
Conclusion: The study concluded that the manufacturing industry is expected to constitute and inaugurate a safety committee to take charge of issues bordering on health and safety; therefore, ensuring the right storage procedures of inflammable liquids and other dangerous materials and arming employees with enough information and insight on the risks inherent in their jobs through education and periodic trainings would help in minimizing accidents in the workplace
Effectiveness of Core Stabilization Exercises and Routine Exercise Therapy in Management of Pain in Chronic Non-Specific Low Back Pain
No full textBackground of the study: Chronic non-specific low back pain causes significant disability worldwide. This study compared the effectiveness of core stabilization exercises versus routine exercise therapy in managing pain and functional disability.
Methodology: A randomized controlled trial included 34 patients with chronic non-specific low back pain at Mayo Hospital, Lahore. Participants were randomly allocated to Group A (core stabilization exercises, n=17) or Group B (routine exercise therapy, n=17). Both groups received conventional hot pack therapy. Treatment was administered three times weekly for four weeks. Outcomes were measured using Visual Analogue Scale (VAS) for pain and Oswestry Disability Index (ODI) for functional disability.
Results: Both groups showed significant improvements (p<0.001). Group A demonstrated superior outcomes with post-treatment VAS scores of 1.24±0.66 versus Group B\u27s 4.18±0.81 (mean difference 2.94, p<0.001). ODI scores were 11.65±2.85 in Group A versus 21.65±2.96 in Group B (mean difference 10.00, p<0.001).
Conclusion: Core stabilization exercises were significantly more effective than routine exercise therapy in reducing pain and improving functional disability in chronic non-specific low back pain patients
Antibiogram Profile of Patients Having Urinary Tract Infection Treated with Most Commonly Used Antibiotics
No full textBackground: Urinary tract infections (UTIs) are the most common infections in humans, primarily caused by bacteria, with Escherichia coli (E. coli) responsible for 75-90% of cases. The rise in bacterial resistance is largely due to inappropriate antibiotic use, posing significant public health concerns. This study investigated UTI prevalence and antibiotic resistance to inform optimized treatment guidelines. This study aimed to identify the bacterial pathogens causing UTIs and assess their antimicrobial sensitivity and resistance to commonly used antibiotics.
Method: A descriptive cross-sectional study was conducted over six months at Khyber Teaching Hospital\u27s Microbiology Department to assess the antibiogram profile of uropathogens from urine cultures. Urine samples were cultured on CLED media, and biochemical tests were used to identify the uropathogens. Antimicrobial susceptibility testing was performed on the isolates using the Kirby-Bauer disk diffusion method on Mueller Hinton Agar (MHA), following CLSI guidelines. A total of 384 patients\u27 urine samples were collected through a convenient technique and processed as per standard guidelines. The collected data was analyzed using SPSS-22 and shown in tables.
Results: Escherichia coli was the most common uropathogen, found in 48.17% (n=185) of cases, with a higher prevalence in females at about 48.4% (n=125). Fosfomycin was the most frequently prescribed antibiotic (31.5%) and showed the highest sensitivity (50.2%). Cefotaxime exhibited the highest resistance (38.45%), followed by Amoxicillin-clavulanic acid (34.8%).
Conclusion: Escherichia coli remains the dominant pathogen, with Fosfomycin proving generally effective, while resistance to cefotaxime is notable. These reports show the importance of antibiotic use responsibly. By selecting appropriate antibiotics, we can minimize the resistance rate of uropathogens.
Analysis of Lipid Profile and Vitamin E Status in Pregnancy-Induced Hypertension
No full textBackground: Pregnancy-Induced Hypertension (PIH) affects 5-10% of pregnancies worldwide and is associated with oxidative stress, endothelial dysfunction, and dyslipidemia. It is particularly prevalent in low-income regions. This study examines the correlation between lipid profiles, Vitamin E levels, and PIH in pregnant women to identify potential therapeutic interventions.
Methods: A cross-sectional study was conducted at Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Pakistan, from March 2022 to March 2023. A total of 150 pregnant women were included, with 75 diagnosed with PIH and 75 normotensive controls, selected using non-probability consecutive sampling. Lipid profile parameters (total cholesterol, triglycerides, HDL, LDL) and Vitamin E levels were measured using standard biochemical assays. Statistical analyses were conducted using SPSS 24.0, applying chi-square tests, descriptive statistics, and Pearson’s correlation coefficient, with significance set at p<0.05.
Results: The PIH group exhibited significantly higher systolic and diastolic blood pressure (p=0.001). No significant differences in lipid profile parameters were found between the two groups. However, Vitamin E deficiency was more prevalent in the PIH group 59 (78.67%), compared to the normotensive group, 25 (33.33%). No significant correlation was observed between lipid profiles and Vitamin E levels.
Conclusion: Vitamin E deficiency may contribute to PIH pathogenesis, despite no observed lipid profile differences between groups. Further research on antioxidant supplementation and lipid regulation in PIH is recommended
Assessing The Effectiveness of Ultrasound-Guided Injections of Steroid for Knee Osteoarthritis on Three Different Sites: A Randomized Controlled Trial: Ultrasound-Guided Injections of Steroid for Knee Osteoarthritis on Three Different Sites
No full textBackground: Osteoarthritis is one of the immobilizing musculoskeletal diseases of knee joints. To reduce the symptoms of knee OA, intra-articular injections and ultrasound guidance have been reported to improve. This study aimed to explore the impact of ultrasound-guided injections at various sites at the knee joint.
Methods: A single-blinded randomized controlled study was carried out at Civil Hospital Hyderabad, Memon Hospital Hyderabad, and Tando Adam Hospital. The duration of the Study was from January 2024 to June 2024. One hundred and twenty subjects having grade III and IV knee OA were enrolled in the study. Participants were randomly divided to receive ultrasound-guided intra-articular injections of Steroids using the envelop method of simple random technique into three of the treatment groups i.e. Group A, B, and C receiving Superolateral US-guided IA, mid-medial US-guided IA, and mid-lateral US-guided IA injections respectively. The study involved grade III and grade IV osteoarthritis patients with bilateral knee, with age from 50 to 70 years. Data was analyzed as a Chi-square Test by using SPSS (version 22, p≤0.05, 95% confidence).
Results: 100% injection accuracy was observed in subjects with grade III and IV OA patients for the medial approach and 95% for the mediolateral approach. There was no difference seen statistically in all three methods.
Conclusion: The effectiveness of ultrasound-guided intra-articular steroid injections at the Superolateral, mid-medial, and midlateral in treating knee osteoarthritis (OA) supports the clinical use of ultrasound guidance to enhance treatment outcomes for knee OA.