International Journal of Endorsing Health Science Research (IJEHSR) <p>International journal of endorsing health science research (IJEHSR)&nbsp;aims to&nbsp;improve health care by providing the most recent research results&nbsp;leading to advancement in health science.</p> <p>IJEHSR&nbsp;is quarterly, open access, peer-reviewed&nbsp;journal keen to endorse the need for finest healthcare globally, it was founded in 2013 as a biannual journal, and converted into quarterly in 2015. &nbsp;IJEHSR is included in the journal list of International Committee of Medical Journal Editors (ICMJE) since 2014. This Journal is indexed by WHO Index Medicus (IMEMR) for Eastern Mediterranean Region.</p> <p>We would like to encourage you to submit your intellectual effort in&nbsp;IJEHSR, we consider manuscripts from all fields of health sciences.&nbsp;The journal publishes original research, reviews, clinical reports, case studies, legal and policy perspectives.</p> Advance Educational Institute and Research Center en-US International Journal of Endorsing Health Science Research (IJEHSR) 2307-3748 <p>By submitting a manuscript in&nbsp;<strong>IJEHSR</strong>, the Author (Authors if a multi-authored paper) confirms all the clause of the <a href="">Copyright Notice</a></p> A recapitulation of rotavirus and reinforcement of the need for vaccination <p align="justify">In 1973, Ruth Bishop discovered Rotavirus, its clinical impacts and public health significance were vastly underrated especially in developed countries. Rotavirus is a double-stranded Ribonucleic Acid (RNA) virus which belongs to the Reoviridae family. So far 10 species (A-J) of this virus have been discovered amongst which Rotavirus A is the most common, that is associated with human infections. Rotavirus diarrhea is a leading cause of under 5-year mortality in children. Several studies have attributed 440,000 deaths in children under 5 years of age.&nbsp;</p> Manoj Kumar Menda Priyanka Anvekar Zainab Abbasi ##submission.copyrightStatement## 2019-09-01 2019-09-01 7 3 113 115 10.29052/IJEHSR.v7.i3.2019.113-115 Vinorelbine as a radiosensitizer in Pakistani patients with locally advanced unresectable head & neck cancer (HNC) in tertiary care hospital of Pakistan <p align="justify"><strong>Background:</strong> Head and neck cancer (HNC) is one of the most common cancers in Pakistan. Disease free survival in HNC remains poor due to inefficient loco-regional disease control. The aim of the present study was to assess the response rate and toxicity of concomitant vinorelbine and External radiation therapy (ERT) in advanced Head and Neck cancer in local Pakistani population. The study as per Good Clinical Practice (GCP) guidelines was conducted at the oncology department of Nishat hospital Multan from 2015 to 2017. &nbsp;</p> <p align="justify"><strong>Methodology:</strong> An observational, prospective study with enrollment of 50 patients of advanced head and neck cancer was followed to analyze the outcome for radiosensitization. Primary tumor sites were tongue in 15 (30%) patients; lower lip in 6 (12%); buccal cavity in 5 (10%); cheek in 5 (10%); tonsil in 4 (8%); larynx in 6 (12%); hypopharynx in 5 (10%); and parotid in 4 (8%) patients. Initial clinical stage was: IV in 23 (46%) patients and III in 27 (54%) patients. Vinorelbine (VNB) was given at dose of 10 mg i.v. infusion weekly with ERT (3D conformal radiation plan). Response rate was evaluated after at least 8 doses. Response evaluation criteria in Solid Tumors (RECIST) was used to assess complete response (CR) and partial response (PR); progressive disease (PD) and stable disease (SD). Toxicity was assessed using common toxicity criteria version 3.0 (CTCV3.0).</p> <p align="justify"><strong>Results:</strong> 44 out of 50 patients were evaluable for response rate and toxicity. Immediate response was 90% CR. After 24 months of followup CR, PR, SD, and PD were seen in 26 (59%), 6 (13%), 7 (15%) and 6 (13%) patients respectively. Grade III mucositis and dysphagia were observed in 19 (43%) and 8 (18%) patients respectively, grade III skin rash in 14 (30%) patients, grade-II peripheral neuropathy was seen in 3 (6%) patients.</p> <p align="justify"><strong>Conclusion:</strong> The study showed that vinorelbine as a radiosensitizer in advanced HNC is a feasible option with acceptable toxicities. A large study is required to define its definite role.</p> Rana Atique Anwer Khan Ahmed Ijaz Masood Sadaqat Ali Gorchani Muhammad Junaid Ali Yasir Khan ##submission.copyrightStatement## 2019-09-01 2019-09-01 7 3 116 123 10.29052/IJEHSR.v7.i3.2019.116-123 The study of immunity dysfunction and high susceptibility of infections in patients with diabetes and pre-diabetes: A prescription based study <p align="justify"><strong>Background:</strong> Diabetes, being the most prevalent co-morbidity associated with various metabolic complaints and is considered as the principal emerging health issue of 21st century. As along with conformist complications, the disease due to having immuno-deficiency characteristics that leads to low functioning of T-cells and neutrophils consequently becomes highly accountable for frequent infections. The present study was conducted to analyze the co-morbidity of infections with diabetes and to describe and control the foremost complications of infectious diseases and their management allied with this metabolic disorder.</p> <p align="justify"><strong>Methodology:</strong> A cross sectional prospective study was conducted in the diabetic clinics of public and private sector hospitals of Karachi. 170 diabetic patients were included in the study, 26 were tested to be pre-diabetic and while the remaining 144 were not only diabetic also on antibiotics. The data was analyzed using the SPSS version 17.</p> <p align="justify"><strong>Results:</strong> The data of study reveals that the frequency of infection was found utmost in diabetic patients, as the antibiotics prescription rate and antiseptic utilization for treating various infections was increased among these cases. As among 144 diabetic patients 50% were found to have frequent infection as were often prescribe antibiotics.</p> <p align="justify"><strong>Conclusion:</strong> We concluded, severe hyperglycemia can drastically alter body immune response against pathogens, that strongly favors the deprived outcomes and severe complications. Health care professionals are required to encourage the patients to follow the recommendations and guidelines to reduce the morbidity of diabetes along with infection and prescribe drugs of choice for the management of pathogenic bacteria at early phase to avoid the severity of pathogenicity and recommendation of supplements and medicine that enhances the immunity must be enforced.</p> Kiran Rafiq Shagufta Nesar Sobia Iftikhar Zafar Saied Saify Aleeza Raza Alisha Hassan Alina Rizvi ##submission.copyrightStatement## 2019-09-01 2019-09-01 7 3 124 130 10.29052/IJEHSR.v7.i3.2019.124-130 Conceptual approach of shared decision making in physical therapy: An approach for betterment of patients? <p align="justify"><strong>Background:</strong> Shared decision making (SDM) depicts the work that patients and clinicians do together to consider the relative benefits of accessible administration choices and choose an arrangement that fits the patient objectives, inclinations and setting. SDM decreases the authoritative control between the patient and physical therapist. SDM allows a balanced relationship between a clinician and patient. The practical application of evidence-based practice in health care is always been a challenge for clinician. The objective of this study was to explore the use of shared decision making among physical therapists in Karachi.</p> <p align="justify"><strong>Methodology:</strong> A cross-sectional study was conducted at the Institute of physical medicine and rehabilitation (IPM&amp;R) department of Dow University of Health Sciences from 3 August 2017 till 13 April 2018. A total of 232 physiotherapists from different hospital and rehabilitation centers of Karachi participated in the study. SDM Q-Doc 9 (a physician version) questionnaire and questions regarding barriers were used to collect data. Those participants who fulfilled the inclusion criteria i.e. graduate physiotherapists and postgraduates and completed the entire survey were included in this study. Following participants were excluded undergraduate physical therapist (PT’s), house officers, internees, technicians, and academic staff of physiotherapy, non- practicing PT’s and other healthcare professionals. Data was analyzed by using SPSS version 20.00. Categorical variables were reported as frequency/percentage, while numerical data was presented as Mean±SD. Descriptive statistics test were applied.</p> <p align="justify"><strong>Results:</strong> The result showed that use of SDM was moderate (70.3%) among physiotherapists and the barriers included were: physician’s instructions (67.7%), lack of time (53.6%) and misconception of patient about disease or treatment (65.9%) which resisted in utilization of SDM.</p> <p align="justify"><strong>Conclusion:</strong> In conclusion we can state that the institutional physical therapists would prefer to use SDM moderately and it could be due to a relatively new concept.&nbsp;</p> Hamna Syed Kanwal Zubaria Anum Qayyum Tanoli Saif Ullah Khalid ##submission.copyrightStatement## 2019-09-01 2019-09-01 7 3 131 139 10.29052/IJEHSR.v7.i3.2019.131-139 Frequency of neck pain and its associated factors among Post CABG patients <p align="justify"><strong>Background:</strong> Chronic postoperative pain (CPOP) is a well-recognized problem in Post-Coronary artery bypass grafting (CABG) patients. Post CABG upper extremity pain is found to be common among these patients effecting quality of life and hinders with the routine activities. The aim of this study was to identify the frequency of neck pain and its associated factors among post-operative CABG patients.</p> <p align="justify"><strong>Methodology:</strong> A cross-sectional study was conducted in Dow University of Health Science, Karachi between April 2018 to November 2018. The sample size 78 was calculated by open epi calculator. Both male and female Postoperative CABG patients with a one-year follow-up were selected with or without neck pain aged between 30-75 years from Outpatient Department. Patients below &lt;30 years of age and those with any other surgeries before or any malignant disease were excluded from the study sample. A questionnaire was given to grade their overall experience of pain on Visual Analogue Scale (VAS) and to fill out Neck Disability Index (NDI) for their neck pain. The data was analysed using SPSS version 21 and Chi square T-test was applied to evaluate the significance.</p> <p align="justify"><strong>Results:</strong> Out of 78 patients there were 32 (41%) females and 46 (58%) males with a mean age range between 30-75 years. 51.3% had neck pain presented within 12 hours of onset of symptoms while 48% had no complaint of neck pain. After CABG, 40 (51.2%) patients developed pain in their neck within 1 year of follow up. The mean VAS score was 5.32 out of 10 points on the basis of which 38 patients didn’t experienced any &nbsp;pain while 20 suffered from moderate pain, 12 from severe pain and 8 patients from mild pain.</p> <p align="justify"><strong>Conclusion:</strong> Patients following CABG surgery develop neck pain within one-year follow-up associated with restricted neck and shoulder range of motion. They also experienced muscle tenderness in their trapezius and sternocleidomastoid muscles followed by frequent headaches.&nbsp;</p> Ambreen Shahzad Saba Aijaz Ali Samreen Yasmeen Sidra-tul- Muntaha Tajammul Hussain Madiha Rehaman ##submission.copyrightStatement## 2019-09-01 2019-09-01 7 3 140 146 10.29052/IJEHSR.v7.i3.2019.140-146 Assessment of anxiety, stress and depression in primary dysmenorrhic females <p align="justify"><strong>Background:</strong> Dysmenorrhea is the most common gynecological complaint, adversely affects the quality life and work productivity in females of reproductive age. Risk factors for primary dysmenorrhea include age, early menarche, low body mass index (BMI), menorrhagia, family history, smoking, nulliparity, depression and stress. This study was carried to find out the pattern of dysmenorrhea in young Pakistani females, and to determine its association with stress, depression and anxiety.</p> <p align="justify"><strong>Methodology:</strong> This was a cross sectional questionnaire based study conducted on 300 female participants of age 20-30 years studying at the local university. Healthy, nulliparous females with the occurrence of dysmenorrhea were included in the study whereas those females who had gynecological, psychological or other medical problems were excluded from the study. Students were asked to provide the information about their socioeconomic status, dysmenorrheal symptoms, mental health status, their habits and other medical characteristics. To evaluate the effect of stress, depression and anxiety, Depression, Anxiety Stress Scale (DASS) was used. All statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 16.</p> <p align="justify"><strong>Results:</strong> Of the total dysmenorrhic females 31% were married, 57% had positive family history of dysmenorrhea, 18% of the subjects had BMI&lt;18Kg/m<sup>2</sup> while 39% reported high waist hip ratio (WHR). The incidence of menstrual irregularity and menorrhagia was identified in 67% and71%, respectively while passing of clots were found to be in 71% subjects. Significant differences were observed in terms of anxiety (p=0.025) and stress (p=0.028) between the two groups but there was no statistical difference in the levels of depression (p=0.11). It was found that depression is a common complaint irrespective of presence or absence of dysmenorrhea during periods.</p> <p align="justify"><strong>Conclusion:</strong> This study shows that high stress level and anxiety were positively associated with primary dysmenorrhea in young adolescent females. Therefore, mental health promotion and counselling measures should be taken to lessen the severity of dysmenorrhea.</p> Uzma Firdous Noaima Fatima Ghazala Yasmeen ##submission.copyrightStatement## 2019-09-01 2019-09-01 7 3 147 153 10.29052/IJEHSR.v7.i3.2019.147-153 Frequency of Smart Phone Usage in Medical Students and its Association with Academic Performance <p align="justify"><strong>Background:</strong> Smart phone use is becoming a severe mental health problem as it is becoming dominant with<br>the passage of time leading to dependency and diverting individual’s concentration. The addiction is not only<br>confined to youth, it can be observed among individual of all ages. Through this study our aim was to observe<br>the smart phone usage frequency and its association with academic performance among university students.</p> <p align="justify"><strong>Methodology:</strong> A cross sectional study was conducted on a total of 400 students of Dow university of health<br>sciences between January 2016 – January 2017. The problematic mobile phone usage scale (PUMP) was used<br>to evaluate the smart phone addiction level and grade point average (GPA) of previously attended semester<br>was analyzed to evaluate its association with academic performance.</p> <p align="justify"><strong>Results:</strong> It was observed that 134 out of 400 participants were spending 1-2 hrs. daily on mobile phone usage.<br>A strong association was observed between frequency of smart phone usage and academic performance.<br>Moreover, control loss and dependence were also affecting the academics among the study participants. In this<br>study we observed that female students with frequent smart phone use had greater chances of having poor<br>academic performance as compared to males.</p> <p align="justify"><strong>Conclusion:</strong> It can be concluded form the study results that excessive smart phone usage affects academic<br>performance and hence results in increased dependence leading to lack of concentration, decreased confidence, reduced public dealings and face-to-face interactions. Furthermore, the use must be restricted as in long term it is leading to several health issues especially among youth.</p> Hatim Haider Ali Muhammad Imran Yahya Noori ##submission.copyrightStatement## 2019-09-01 2019-09-01 7 3 154 160 10.29052/IJEHSR.v7.i3.2019.154-160