International Journal of Endorsing Health Science Research (IJEHSR) <p><strong>International journal of endorsing health science research (IJEHSR)</strong>&nbsp;aims to&nbsp;improve health care by providing the most recent research results&nbsp;leading to advancement in health science.</p> <p><strong>IJEHSR</strong>&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;<strong>IJEHSR</strong>&nbsp;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 the Eastern Mediterranean Region.&nbsp;<strong>IJEHSR</strong>&nbsp;editorial board members are working in diverse fields of health care in countries like&nbsp;<strong>Pakistan, Canada, Australia, United States of America, China, India, Oman,&nbsp;Saudi&nbsp;Arabia,&nbsp;</strong>and<strong>&nbsp;Ethiopia.</strong></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> Are countries preparing for a responsible lockdown exit strategy? <p>Maybe, or truly, in barely some weeks, leaders across the world should start making decisions about lifting lockdown policies, with considerable social, economic and political consequences. We aim to propose a strategy for what could even be arguably the foremost challenging health challenge that governments globally have faced since the beginning of this century: a responsible lockdown exit strategy. Several Asian countries are successfully combating their COVID-19 pandemics through a mix of assorted measures like large-scale testing, isolation and quarantine, in parallel with moderate countries like Asian countries or much stronger China social-distancing measures. They have also relied on a rapid upscaling of testing capacity and up hailed by mobilization of thousands of physicians recruited to perform measures.</p> Tracy Jane Syed A. Aziz ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 109 111 10.29052/IJEHSR.v8.i3.2020.109-111 Hysterectomy in the Mentally Disabled Female: An Ethical Dilemma <p>The establishment of menstrual hygiene, specifically among the mentally disabled females, is one of the most critical concerns posing challenges for the individual, family and caretaker. Although the performance of hysterectomy among females with intellectual disabilities (ID) is now trending, but it has given rise to many ethical questions. Therefore, the study aimed to address the ethical dilemmas associated with hysterectomy among ID females, taking reference from a case of 19-year-old female, unable to practice menstrual hygiene.</p> Anna Rana ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 112 116 10.29052/IJEHSR.v8.i3.2020.112-116 Post Viral Acute Cerebellar Ataxia following Chickenpox (Varicella) in a toddler <p><strong>Background: </strong>Varicella-zoster virus (VZV) is one of the most common infections of childhood causing chickenpox, which in a majority of cases is self-limiting without any complicating consequences. However, in a meagre 0.01-0.03% cases, chickenpox may lead to serious neurological complications. Among them is acute cerebellar ataxia, which presents with the characteristic sign of broad-based gait abnormality, progressing gradually over the course of days, the mechanism of which is still debated upon. As a treatment option, the use of antiviral remains controversial, and some recommend it for better prognosis while others do not base on its autoimmune pathogenesis. This case is being communicated due to its rarity.</p> <p><strong>Case Presentation: </strong>A case of a two-year-old female with a recent history of chickenpox eruption presented with the complaint of progressive loss of normal gait and difficulty in talking followed by generalized to-and-fro movements of her body leading to a diagnosis of post-viral acute cerebellar ataxia. There was no significant history of any past illnesses. Bacille Calmette Guerin (BCG) vaccine was given at birth, later followed by a single dose of pentavalent (Penta) vaccine.</p> <p><strong>Management: </strong>Central nervous system (CNS) examination showed ataxic gait, pupils bilaterally equally reflective to light (BERL), nystagmus, dysmetria, and decreased muscle tone. Laboratory investigations were within the normal range. Imaging modalities that were all normal excluded other causes, including metabolic, tumors, and toxins. The patient was empirically treated with IV acyclovir BD for one week.</p> <p><strong>Conclusion: </strong>As the rash of chickenpox resolves spontaneously in most cases, it is important that children infected with VZV should be closely observed for any neurological symptoms for timely and effective intervention.</p> Sarrah Ali Asghar Faryal Tahir Zainab Majid Laila Tul Qadar Syed Muhammad Hussain Zaidi ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 117 122 10.29052/IJEHSR.v8.i3.2020.117-122 Assessment of antibacterial potential of Natural and Commercial Honey samples against Wound Isolates <p><strong>Background: </strong>Antibiotic resistance has surged the development and exploration of new, improved and effective natural products from plants and other sources like Honey has been rediscovered as a therapy for wounds, both in-vitro studies and in clinical trials. It has been observed to exert bacteriostatic and bactericidal potentials against pathogenic bacteria, including drug-resistant strains. The following study aimed to isolate and identify bacteria from wound infections and to investigate the antibacterial activity of honey samples; natural and commercial honey, against common clinical wound Pathogens.</p> <p><strong>Methodology: </strong>Bacteria from wound samples of patients with injured legs were isolated using differential and selective agars, while the antibacterial activity of natural and commercial honey samples was determined by agar well diffusion method and minimum inhibitory concentrations (MIC).</p> <p><strong>Results: </strong>The results indicated that natural honey has more potential to exert antibacterial activity with an 18-30mm zone of inhibition, which was significantly higher as compared to commercial honey with a 13-23mm zone of inhibition. MIC of natural honey was visible in most of the test organisms at25µg/ml as compared to commercial honey with only <em>Bacillus sp and Staphylococcus sp2 </em>at 50 µg/ml while<em> Staphylococcus sp1 </em>at 25µg/ml.</p> <p><strong>Conclusion: </strong>The results propose due to a significant difference in the antibacterial activity of natural and commercial honey, these findings would help experts from the health sciences in the selection of the type of honey as an apitherapy for wound care and management.</p> Zareen Fatima Sidra Zafar Tuba Batool ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 123 128 10.29052/JEHSR.v8.i3.2020.123-128 Assessment of different Enzymatic Virulence Traits contributing to pathogenicity of Candida Albicans <p><strong>Background: </strong>Candidiasis is regarded as one of the frequently occurring fungal infections of humans elicited by yeast that belongs to the genus <em>Candida.</em> Among the different species of <em>Candida</em>, <em>Candida albicans</em> is the most pathogenic specie. The pathogenicity of this specie depends on various virulence factors. This study was designed to determine the activity of some important enzymatic virulence factors such as phospholipase, proteinase and hemolysin produced by <em>Candida albicans </em>strains.</p> <p><strong>Methodology: </strong>A total of 300 clinical isolates of <em>C. albicans</em> were obtained and identified by conventional standard diagnostic criteria. For the evaluation of phospholipase production, the egg yolk agar medium was employed. The minimum agar medium was used for proteinase activity and for hemolysin production, blood plate assay was used. The results were statistically analyzed by SPSS 16.0 version software.</p> <p><strong>Results: </strong>Of a total of 300 isolates reviewed, the majority of the isolates were recovered from females, i.e. 234 (78%); however, the number of isolates obtained from males were 66 (22%). Amongst all the strains of <em>C. albicans</em>, phospholipase and hemolysin enzymes were produced primarily by 89.3% of the total <em>C. albicans </em>strains. While proteinase enzyme was produced by 86% of the total <em>C. albicans </em>isolates. A p-value &lt; 0.05 was measured as statistically significant.</p> <p><strong>Conclusion: </strong>From the existing study, it can be determined that these enzymes are produced by most of the pathogenic strains of <em>C. albicans</em>. The detection of these virulence enzymes is tremendously significant in designing of drugs to combat these opportunistic infections in future.</p> Sadia Nazeer Sehar Afshan Naz Arif Zubair Maryam Shafique Shaheen sharafat Samina Baig Gul Jabeen ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 129 138 10.29052/IJEHSR.v8.i3.2020.129-138 Vitamin D deficiency in the population of Karachi, Pakistan; A cross-sectional study <p><strong>Background: </strong>Vitamin D deficiency affects over one billion people globally, which results in the progression of severe health consequences and chronic diseases. Literature indicates high rates of vitamin D deficiency in the Pakistani population. Thereby, this current study was aimed to determine the status of vitamin D deficiency in the population of Karachi.</p> <p><strong>Methodology: </strong>This descriptive cross-sectional study was conducted during January to December 2017 at the Dadabhoy Institute of Higher Education (DIHE). A total of 1159 healthy individuals aged between 18-72 years were selected for the study. Data was collected through a questionnaire seeking the demographics of the participants. For the quantitative colorimetric immune-enzymatic determination of 25(OH) vitamin D concentrations in the human plasma level, venous blood was collected and was analyzed using a vitamin D Enzyme-Linked Immunosorbent Assay (ELISA) kit. Statistical analysis was carried out using SPSS version 20.0.</p> <p><strong>Results: </strong>A total of 1159 participants were included in the study with the mean age of 40.1±15.2 years. It was observed that 59.1% of participants had deficient vitamin D levels, while 22.6% of participants had sufficient vitamin D levels. There was a significant association between gender and vitamin D status (p &lt; 0.05), as the majority of females (68.5%) were vitamin D deficient as compared to males (31.5%). In contrast, no significant association was found between age and vitamin D levels, with the most deficient age group being 18 to 28 years.</p> <p><strong>Conclusion: </strong>It is concluded from the study results that vitamin D deficiency was prevalent in the studied population, despite increased exposure to sunlight. The initial screening for early detection and correction of the condition must be considered as an essential component of the national health strategy, as there is a need to detect and combat the burden of vitamin D deficiency in the country.&nbsp;</p> S. Ali Danish Kazmi Ali Asghar Mustansir Mareeha Sheikh Saad Ahmad Khan ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 139 144 10.29052/IJEHSR.v8.i3.2020.139-144 Association of Grip Strength with obesity & cortisol; Possible indicators of biological ageing <p><strong>Background:&nbsp;</strong>Cortisol has a positive correlation with Obesity, which indicates a relation between obesity and cortisol. Furthermore, there are increased chances of demolished muscle strength up to two times with elevated levels of cortisol. Thus, the aim of the study was to assess the impact of increased cortisol levels on the grip strength&nbsp;and to determine that the grip strength is a possible indicator for accelerated biological ageing.</p> <p><strong>Methodology:&nbsp;</strong>This cross-sectional, purposive sampling study was conducted in Karachi, Pakistan. Overall 412 were recruited to participate in the study, the data for age, gender, BMI, grip strength, and cortisol was collected from the participants.&nbsp;The age-wise correlates of hand grip strength were assessed using Multiple linear regression analysis and the mean decline in the grip strength with advancing age is displayed.</p> <p><strong>Results:&nbsp;</strong>The mean Grip strength of the overall population was 30.75±14.35.&nbsp;It was observed that there was a negative significant correlation between the age and the grip strength (F = 3.57; r= -0.27; p=0.007) i.e. with increasing age a gradual decrease in the grip strength was observed. BMI (Obesity) was also significantly associated with grip strength (p=0.000). Moreover, females were more likely to have weak muscle strength as compared to males (p=0.000).&nbsp;However, no significant association was observed among the grip strength, socioeconomic status &amp; longevity in any of the studied age groups (p&gt;0.05). While&nbsp;a significant correlation was found between Grip strength and Obesity as well as between Obesity and Cortisol.</p> <p><strong>Conclusion:&nbsp;</strong>Thus it can be concluded that obese individuals had increased chances of accelerated biological ageing due to an increase in cortisol, and a weakened grip strength is an indicator of it.</p> Faizan Mirza Amaila Fazal Khadija Shabbir Hafsa Farooq Sadaf Ahmed ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 145 152 10.29052/IJEHSR.v8.i3.2020.145-152 Early and Late complications associated with Open Modified Janeway Gastrostomy, Under Local Anesthesia in patients with Head & Neck Tumors <p><strong>Background:</strong> Percutaneous Endoscopic Gastrostomy (PEG) is the primary modality for patients requiring long-term enteric feeding and stomach decompression, it has the potential for complications. Therefore, an open surgical gastrostomy presents as an appropriate alternative for patients not viable for an endoscopic approach. The purpose of the study was to assess the complications associated with Open Modified Janeway Gastrostomy (OMJG) in patients with head &amp; neck tumors and determine their post-operative pain and satisfaction scores.</p> <p><strong>Methodology:</strong> A cross-sectional study was conducted at Ziauddin Hospital, North Nazimabad Campus, Karachi, from May 2015 and November 2019. Patients undergoing Open Modified Janeway Gastrostomy were included in this study. Patients with over 18 years of age and who had feeding needs extending beyond 30 days were included in this study. Outcomes measured included length of stay, operating time, complications, surgical satisfaction and post-operative pain. Chi-square test, with a 95% confidence interval, was used to evaluate any association of complications with patient demography and post-treatment parameters.</p> <p><strong>Results:</strong> A total of 27 patients participated in this study with the mean age of 56 ± 11.9 years. Complications were not significantly associated with gender, age, mortality or cancer stage. 24 (88.9%) had no post-operative complications, 2 presented with early complications (&lt;14 days post-surgery) and 1 with late complications (&gt;14 days post-surgery). No significant changes were found in activities, sleep or mood. On average, patients reported low pain scores (3.78 ± 1.22), and patient satisfaction was high after opting for OMJG (8.44 ± 0.89).</p> <p><strong>Conclusion:</strong> OMJG was found an effective procedure for the insertion of a feeding tube when endoscopic procedures are not feasible, with minimal complications and post-operative pain. It provides more cumulative benefits than other available methods.</p> Fatima Zehra Khan Mir Arsalan Ali Shafiq Ur Rehman Syed Mustafa Ali Shah Maheen Nisar Zohaib Jawed Abubaker ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 153 158 10.29052/IJEHSR.v8.i3.2020.153-158 Past and current Coronavirus outbreaks; Focusing on Coronavirus Disease 2019 in comparison with Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome <p><strong>Background: </strong>Coronavirus Disease 2019 (COVID-19) is currently the most significant public health concern globally, having affected more than 22 million patients and caused an excess of 0.78 million deaths since its emergence in December 2019 in the city of Wuhan, China.&nbsp; There have been similar Coronavirus outbreaks in the past, namely Severe Acute Respiratory Syndrome Coronavirus-1 (SARS-CoV-1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). In this review article, we discussed the epidemiology, virology, clinical presentation, diagnostic approaches, and effective treatment modalities for COVID-19 in light of existing literature.</p> <p><strong>Methodology: </strong>The aim of conducting this systematic review was to compare the three human coronavirus outbreaks: Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and Corona Virus Disease 2019 (COVID-19). Multiple search engines were used and PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines was referenced.&nbsp;</p> <p><strong>Results: </strong>The findings suggest that COVID-19 shares substantial characteristics with both SARS and MERS, SARS being more closely related to COVID-19 in terms of epidemiological characters, particularly their viral reservoirs. SARS-CoV-1 and SARS-CoV-2 use the same receptor to gain access to the host cells, while MERS-CoV uses a different entry point. The radiological manifestations of SARS, MERS and COVID-19 are similar as well.</p> <p><strong>Conclusion: </strong>The recurrent appearance of coronaviruses in the human population makes it crucial to study them in great details. Furthermore, owing to its similarity to previous coronavirus outbreaks, the lasting effects of COVID-19 on pulmonary tissue must be investigated. Moreover, at the time of writing this paper, no vaccines are available against Covid-19.</p> Izna Najam Syed Nazia Shamim Syed Muhammad Hussain Zaidi ##submission.copyrightStatement## 2020-09-01 2020-09-01 8 3 159 170 10.29052/IJEHSR.v8.i3.2020.159-170