International Journal of Endorsing Health Science Research (IJEHSR) <p>IJEHSR is quarterly, open access, peer-reviewed&nbsp;journal keen to endorse the need for finest healthcare globally mainly&nbsp;focusing on origins &amp; hazards of ailment and complete array of significant psycho-social and healthcare problems and barriers. This academic journal endeavors to encourage both basic and clinical health science scholars to publish the manuscripts for a better understanding of the molecular mechanisms, healthiness concerns, current challenges, disease treatment, and prevention. IJEHSR invites all these domains endorsing concerns of individual or populations as impacted by age, race, ethnicity, religion, nationality and geographical region, mental and physical health impacts, educational capability in healthcare surroundings, general health, screening plans and disease impediment, practices and guidelines, public health policies etc.</p> Advance Educational Institut 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> Emergence of Enhanced Quality Expectations in Pharmaceuticals <p>Commercial viability of any drug product may often bring pain for patients who otherwise wait for their drug to improve their quality of life and breath. Dryness of drug products like thyroxin, warfarin, phenobarbitone, salbutamol inhalers, morphine etc. from the market leave patient on the mercy of nature. The heart wrenching healthcare professional burst out when lifesaving drugs are not available due to any reason. Voice of civil society rises in community where care of others is felt as a moral responsibility beside capitalism and/or socialism. It is also observed and quite possible that quality defects may create similar situations of drug shortage. Manufacturing facility or its control may go out unwittingly due to knowledge limitation. A quality defect that impacts delivery and performance of drug and/or carries harmful potential has always been a matter of top priority. In both cases, ability to detect, report and assess defines presence and thickness of protection wall for the public. Power to predict uncertainty and taking measures well in time is a challenge for industry and regulators to maintain uninterrupted supply of quality drugs.</p> Roohi Bano Obaid Obaid Ali ##submission.copyrightStatement## 2018-09-01 2018-09-01 6 3 01 05 10.29052/IJEHSR.v6.i3.2018.01-05 Outcome and safety of Arbeitsgemeinschaft für Osteosynthesefragen external fixator in the management of open tibial fractures by firearm injuries: A study at Liaquat University Jamshoro <p><strong>Background:</strong> Tibial fractures are considered as the most common long bone fracture but their treatment and management remains controversial and challenging. The tibia fractures due to firearm injuries, increases the treatment complexity with higher morbidity and mortality rate. In the developing countries, Open tibial fractures are commonly treated by Arbeitsgemeinschaft für Osteosynthesefragen external fixator (AOEF). The aim of the study was to evaluate the results and the consequences by the use of AOEF in the management of open fracture of the tibia caused by firearm injuries and to determine the complications in the routine practice.</p> <p><strong>Methodology:</strong> An observational, prospective study was conducted at the Department of Orthopedic Surgery and Traumatology (DOST), Liaquat University Jamshoro, Pakistan during the period of 1 year (2017 to 2018). As per study inclusion/exclusion criteria, 38 patients with Gunshot injury of diaphysis tibia with Gustillo type IIIa and IIIb, age range from 12 to 60 years of either gender were recruited for the study.</p> <p><strong>Results:</strong> All 38 fractured cases were treated by AOEF. Of them 32 (84.0%) patients were male while 6 (16.0%) were females, with the mean age of 29.1 + 9.27 years. The mean time duration for the treatment with AOEF was observed as 19.1 + 2.72 weeks. Out of all 38, 3 (8.0%) cases with surgical wounds became infected during the study while 2(5.2%) patients went in infective non-union. Knee stiffness was observed in 5(13.0%) patients and 3(8.0%) patients were observed with ankle stiffness.</p> <p><strong>Conclusion:</strong> It can be concluded from the study results that AOEF is simple, cost-effective, and minimally invasive, requires less operating time and is safe to apply. It gives good access to soft tissue and excellent results in type GIII-A&amp;B open tibial fractures by firearm injuries.</p> Muhammad Asif Aziz Tahirani Irshad Ahmed Bhutto Faheem Ahmed Memon Muhammad Ayoub Laghari Ali Yasir ##submission.copyrightStatement## 2018-09-01 2018-09-01 6 3 06 15 10.29052/IJEHSR.v6.i3.2018.06-15 Uropathogens and their antibiotic sensitivity pattern among poorly controlled diabetic Pakistani patients with Asymptomatic Bacteriuria <p><strong>Background:</strong> Urinary tract infections (UTIs) are common among diabetic patients, 60% of the patients with diabetes mellitus (DM) have risk of UTI and two third of them develop symptomatic or asymptomatic UTIs. The uropathogens may vary in their susceptibility to antimicrobials from place to place and time to time, therefore susceptibility pattern of predominant organisms against antimicrobials is essential. The aim of the study was to investigate the incidence of asymptomatic bacteriuria (ASB) and UTIs in clinically diagnosed diabetic patients and to determine the uropathogens responsible for ASB and UTIs as well as their antimicrobial susceptibility pattern.</p> <p><strong>Methodology:</strong> An observational, prospective study was conducted at the Islamabad Social Security Hospital, Pakistan. Total 269 patients were recruited as per the study inclusion/exclusion criteria. Fasting blood glucose (FBG), blood sedimentation rate (BSR), urine routine examination (RE), abdominal ultrasound and hemoglobin-A1c (HbA1c) were examined in all patients to exclude other causes of urosepsis.</p> <p><strong>Results:</strong> According to the study results 106 urine cultures were positive in the absence of urinary symptoms. Majority of the study subjects were around 50 years of age with an average glycosylated hemoglobin level of 8.98 g/dl. Urine culture and sensitivity test showed that E coli - Extended-spectrum beta-lactamases (ESBL) isolated in 39.63% was the most common organism sensitive to Tazobactam and Tiegecycline. E coli isolated in 32% was observed sensitive to levofloxacin, cefotaxime and tazobactam. Klebsiella (ESBL) isolated in 5.6% and found sensitive to tazobactum and amikacin. Klebsiella saprophyticus isolated in 3.77% with greater sensitivity to Tazobactum and cefixime while Enterococcus isolated in 5.6% mainly sensitive to minocycline and vancomycin. Majority of the isolated organisms were poorly sensitive or resistant to cefixime, quinolones and amoxiclav.</p> <p><strong>Conclusion:</strong> Asymptomatic bactriuria is common in type 2 diabetic patients. The growth and sensitivity of microorganism reveal resistance and poor sensitivity to commonly used oral antibiotics therefore it is mandatory to treat UTI only after isolation of microorganisms according to culture and sensitivity to prevent resistant strains.</p> Nadeem Islam Sheikh Ambreen Zahoor Sajid Naseem Ali Yasir ##submission.copyrightStatement## 2018-09-01 2018-09-01 6 3 16 24 10.29052/IJEHSR.v6.i3.2018.16-24 The association of maternal age, body mass index, physical activity with Gestational Diabetes Mellitus <p><strong>Background:</strong> Gestational diabetes mellitus (GDM) represents the state of carbohydrate intolerance during gestation. GDM is found as a risk factor for adverse outcomes of gestation concerning maternal and fetal health conditions. Increasing maternal age is found associated with GDM and also other obstetric complications. High maternal weight is reported to be linked to elevated risk of GDM. Relation of increased maternal age and elevated body mass index (BMI) state with GDM suggests a need of effective measures for improving the maternal and fetal health conditions and alienate the GDM associated obstetric concerns. Previous studies have found possible role of physical activity and exercise in reducing the risk of GDM development. This study aimed to explore GDM prevalence among participants and to perform comparative analysis of maternal age and BMI between participants without GDM and participants with GDM.</p> <p><strong>Methodology:</strong> This cross-sectional study was conducted from March 2014 to September 2014, participants (n=133) filled in a questionnaire which aimed to assess parameters like age, BMI and physical activity for the study. Women in gestation were randomly invited to participate in study, and informed signed consent was obtained from each participant prior participation. Participants were categorized in two groups, participants without GDM and with GDM. For each participant, maternal age, BMI and involvement in physical activities were recorded. Data were analysed using IBM SPSS Statistics 24.</p> <p><strong>Results:</strong> Mean values of maternal age and BMI were found to be lower for participants without GDM as compared to that of participants with GDM. Participants without GDM reported to be involved in household activities, occupational activities and exercise whereas participants with GDM were found to be only involved in household activities.</p> <p><strong>Conclusion:</strong> In conclusion, this study may suggest possible influence of maternal age in GDM. Moreover, in view of findings which indicated higher mean value of maternal BM of participants with GDM compared to that of participants without GDM, and in view of physical activity state, weight measurement and healthy lifestyle may be encouraged.</p> Hina Hazrat Sadaf Ahmed Shamoon Noushad ##submission.copyrightStatement## 2018-09-01 2018-09-01 6 3 25 33 10.29052/IJEHSR.v6.i3.2018.25-33 To compare the effectiveness of taping technique and hydrotherapy in treatment of primary dysmenorrhea <p><strong>Background:</strong> Dysmenorrhea is one of the common complaints in women. Globally, the reported prevalence rate is 90%. Sometimes the pain intensity is so severe that it may depict labour contractions. Hence, it greatly affects the productivity of women and causes socioeconomic lose. To subside such pain, over the counter medications are widely used, regardless of its systemic side effects. This study was conducted to estimate the extent to which women are affected with dysmenorrhea and to compare the effectiveness of Taping and Hydrotherapy for the treatment of primary dysmenorrhea.</p> <p><strong>Methodology:</strong> A survey-based quasi experimental single blinded, two- stage study with pre-test and post-test design was conducted. Fifty menstruating women suffering from primary dysmenorrhea of grade 2 or 3 between the age group of 15 to 25 years were recruited and divided into two groups with 25 females in each group. Females with any severe co-morbidity, abdominal surgery within past 2 years, intrauterine contraceptive devices, any skin lesions (scar, cyst or erosions) or who have recently conceived were excluded from the study sample. Females in taping group received treatment 2 days prior to menstruation which then continued till the first day of cycle. The hydrotherapy group was treated with 30 minutes session for 2 days a week, during non-menstruating phase. Data was collected using a Menstrual Symptom Questionnaire (MSQ) and Verbal Multidimensional Scoring System (VMSS) to estimate the frequency of dysmenorrhea, specifically primary dysmenorrhea in our society. To assess the effectiveness of the intervention, Short-form McGill Pain Questionnaire (SF-MPQ) was completed before and after the intervention. The collected data was analyzed using SPSS ver. 22.0.</p> <p><strong>Results:</strong> The survey revealed 92.4% of women were suffering from dysmenorrhea out of which 64% were primary dysmenorrheic. A significant decline was observed in Pain Rating Index (PRI) before and after intervention i.e. the mean PRI prior to the intervention was 29.53±2.53 for the taping group and 29.4±3.18 for the hydrotherapy group while after intervention it decreased up to 4.33±0.61 in taping and 4.26±0.7 in hydrotherapy group. Whereas, the Visual Analogue Scale (VAS) means before intervention were 8.53±1.06 and 8.73±1.03 for taping and hydrotherapy group respectively. Which then decreased to 3.93±1.03 and 5.2±1.52 for the two groups. The mean Present Pain Intensity (PPI) scores were 4.33±0.61 in taping and 4.26±0.7 in hydrotherapy group and reduced to 1.66±0.81 and 2.26±1.57.</p> <p><strong>Conclusion:</strong> The study findings proclaimed that taping technique was found more effective in decreasing the painful cramps in women with primary dysmenorrhea as compared to the hydrotherapy.</p> Sonya Arshad Muhammad Faisal Qureshi Farah Deeba Samreen Sarshad Sehrish Shiraz Sidra Farooq Sidra Abdul Majeed Sheeraz Ahmed Shafaq Malik ##submission.copyrightStatement## 2018-09-01 2018-09-01 6 3 34 42 10.29052/IJEHSR.v6.i3.2018.34-42 Methodologies of Verbal autopsy and Social autopsy tools, adopted by VASA studies in exploring under-five mortality determinants <p><strong>Background:</strong> Verbal Autopsy/Social Autopsy (VASA) tools should be based on a well-holistic conceptual framework, allowing them to record and organize a wide range of determinants and contributors of child mortality in developing countries. This paper aims to review how successfully VASA studies have been able to record and organize biological and social determinants of child mortality, in pursuit of World Health Organization’s (WHO) guidelines for verbal autopsy (VA) and Kalter’s recommendations for social autopsy (SA).</p> <p><strong>Methodology:</strong> A systematic search of literature from January 1995 to January 2018 was conducted on primary studies which attempted VA and SA on deceased cases of under-5 child mortalities using VA and SA questionnaires. A thorough search revealed 16 directly relevant papers.</p> <p><strong>Results:</strong> Sixteen relevant studies from 14 countries revealed the two most common conceptual frameworks which were utilized for VASA studies. VA component of three studies followed W.H.O.’s guidelines, while the SA component of the other three studies followed Kalter’s recommendations. The most robust VA tools identified were INDEPTH Network VA tool, INCLEN VA tool, and WHO VA tool; while CHERG SA tool and BASICS SA tool were found as the most robust SA tools.</p> <p><strong>Conclusion:</strong> Due to the fact that only separate recommendations for VA, and conceptual frameworks for SA exists and no evidence on integrated conceptual framework exists, we suggest that there is a great need for developing a conceptual framework, based on which an integrated VASA tool can be developed and utilized in VASA based child mortality investigations in developing countries.</p> Muhammad Bilal Siddiqui Chiu Wan Ng Wah Yun Low ##submission.copyrightStatement## 2018-09-01 2018-09-01 6 3 43 55 10.29052/IJEHSR.v6.i3.2018.43-55