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> en-US <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> (Editor in Chief) (Managing Editor) Sat, 01 Dec 2018 09:57:35 +0000 OJS 60 Knowledge and awareness of osteoporosis and its related risk factors among the undergraduate students of doctor of physical therapy in Karachi, Pakistan <p style="text-align: justify;"><strong>Background:&nbsp;</strong>Osteoporosis (OP) is a chronic progressive skeletal muscle disorder, which leads to an increased risk of fracture due to low mineral density. It is one of the major global health problems and most people are unaware of it. Education of OP was one of the key factors to reduce the risk from the society.</p> <p style="text-align: justify;"><strong>Methodology:&nbsp;</strong>This observational cross-sectional survey was conducted from October 2017 to March 2018. A sample size of 252 was calculated through Open Source Epidemiologic Statistics for Public Health (Open EPI) version 3.0 with a hypothesized frequency of 79.4% confident limit of 5%, design effect of 1% and confidence level of 95%. Undergraduate students of DPT i.e. 3rd to 5th-year students were research participants &amp; those who already had some knowledge regarding OP via any kind of workshop and conference were excluded. Non-probability purposive sampling technique was used for sampling purpose. OP was evaluated through OKAT scale. Statistical Package of Social Sciences (SPSS) version 20 was selected for data entry and analysis.</p> <p style="text-align: justify;"><strong>Result:&nbsp;</strong>Out of 252 participants, 81.3% of students were female while only 18.7% were males. According to our results, 20.6% students were found having poor knowledge regarding OP, 77% participants had satisfactory knowledge and only 2.4% students were having good knowledge regarding the awareness of OP and its related risk factors.</p> <p style="text-align: justify;"><strong>Conclusion:&nbsp;</strong>OP is a crucial health problem which is significantly rising in many countries, so the awareness regarding this progressive disorder is essential. Interventional programmes and campaigns should be held across the globe to increase awareness in society.</p> Varisha Tariq, Zainab Khalid Khan, Hafsa Paracha ##submission.copyrightStatement## Sat, 01 Dec 2018 00:00:00 +0000 Computed tomogram image encoding for internet of things based systems <p><strong>Background:&nbsp;</strong>In recent times, transmission of information over a wireless channel is increasing at an exponential rate. Applications based on IOT will exceed all form of data available over the internet, it can be in the form of data based on videos and images which alone size up to 70% of the global traffic.</p> <p><strong>Methodology:&nbsp;</strong>In this paper, an encoding technique based on discrete cosine transform (DCT) have been utilized to reduce information of a CT image that is unwanted or a human eye is unable to perceive. For medical images, preserving maximum information in order to properly diagnose any disease is important and for such application, the amount of quantization needed to gain an image with minimum error is to observe the Correlation index (CI).</p> <p><strong>Results:&nbsp;</strong>CI at 50% Quality Quantization Table (QQT) for image 1 was found to be 0.9981 and its size reduced to 0.403 MB, it means that the compressed image is 99.8% similar to the original image. But its similarity reduces with the increase in QQT, its size will also decrease by at this point quality will degrade too.</p> <p><strong>Conclusion:&nbsp;</strong>In order to store images on the drive, it is imperative to apply a compression technique. In this paper, a compression technique is proposed utilizing a DCT algorithm to reduce an image size with different QQT provided for quality assessment. Each image has a different set of information and to cater their differences this QQT can be manipulated for best possible quality with acceptable size on disk.</p> Ali Akbar Siddique, M. Tahir Qadri, Zia Mohy-Ud-din ##submission.copyrightStatement## Sat, 01 Dec 2018 09:34:32 +0000 Identifying relationship of lipid profile with hypertension among diabetic patients <p style="text-align: justify;"><strong>Background:&nbsp;</strong>Relevant literature suggests that hypertension (HTN) is commonly linked with lipid abnormalities among diabetics so management of dyslipidaemia may reduce the cardiovascular complications significantly. The study was aimed to evaluate whether dyslipidaemia was associated with HTN among type 2 diabetics.</p> <p style="text-align: justify;"><strong>Methodology:&nbsp;</strong>This hospital-based, observational, retrospective and comparative study was carried out from January 2018 to June 2018 in the medical outdoor department of Bahawal Victoria Hospital (BVH), Bahawalpur. The study sample was comprised of 50 normotensive diabetic patients as control (group A) and 50 diabetic subjects with HTN were labeled as group B. Comparative values of lipids were primarily observed between the two groups. Quantitative demographic data, blood pressure (BP) recordings, laboratory values of lipid and serum sugar levels were presented as percentage, mean and standard deviation accordingly. To determine statistical assessment, Statistical Package for the Social Sciences (SPSS) version 15 was used and Student t-test was applied to compare the means of two groups for lipoproteins with significance level at 5%.</p> <p style="text-align: justify;"><strong>Results:&nbsp;</strong>Analytic results of this study showed that hypertensive subjects (group B) had hyperlipidemia along with uncontrolled hyperglycemia as well. Among them, high-density lipoprotein cholesterol (HDL- C) was 32.73±4.47mg/dl while in normotensive control (group A) it was 39±2.94 mg/dl. Same with the total cholesterol (TC) and triglycerides (TG), both lipoproteins were observed in greater concentrations among hypertensive patients as 194.68±31.75mg/dl and 196.05±78.45mg/dl respectively, compared to control (179.07±38.61mg/dl and165.75±48.80mg/dl respectively). Hyperlipidaemia was defined according to guidelines for diabetic patients provided by the National Cholesterol Education Program /American Diabetes Association (NCEP/ADA).</p> <p style="text-align: justify;"><strong>Conclusion:&nbsp;</strong>It can be concluded from the study results that diabetics having HTN have more susceptibility towards hyperlipidemia when compared to the normotensive diabetic.</p> Muhammad Ahmad Alamgir, Irum Alamgir, Shafique Aqil, Masroor Ali Qazi, Ali Imran, Javeria Aslam, Humanyun Hassan ##submission.copyrightStatement## Sat, 01 Dec 2018 09:39:22 +0000 Response of Sofosbuvir and Daclatasvir combination in Chronic Hepatitis C with Hemodialysis Pakistani Patients: A Single Centre Study <p style="text-align: justify;"><strong>Background: </strong>Globally, Hepatitis C is the primary causes of acute and chronic hepatitis in end-stage renal disease patients and highly prevalent in hemodialysis patients. In Asia, Hepatitis C Virus (HCV) infection has become a serious public health problem, whereas, in Pakistan, 26.02% hemodialysis patients are infected with HCV infection. The advent of direct-acting antivirals (DAAs) has brought HCV treatment into a revolutionized era. Among the approved DAAs, sofosbuvir (SOF) is the only one that has a significant renal elimination whereas daclatasvir (DAC) is not eliminated by the kidneys. The aims of the study were to assess the effectiveness and safety of SOF and DAC combination in HCV infected patients on Hemodialysis (HD) in the local population as per routine Pakistani practice.</p> <p style="text-align: justify;"><strong>Methodology:&nbsp;</strong>An observational, prospective, single-centre study was conducted from December 2017 till September 2018 at the Nawaz Sharif Kidney Hospital, Swat, Pakistan. Total 27 HCV- HD subjects on SOF/DAC regime for 12 weeks, were enrolled in the study. The study was conducted as per the ICH-GCP Guidelines. The collected data was analyzed using SPSS Software version 19 and p-value &lt; 0.05 was considered significant. &nbsp;</p> <p style="text-align: justify;"><strong>Results:&nbsp;</strong>As per the results of 27 subjects’, (n= female 12, 44.5% and n = male 15, 55.5 %), 21 subjects were naive and 6 belonged to treatment experienced group with a mean age of 35.5±9.6 years. On SOF/DAC treatment for 12 weeks, the sustained virological response rate was 100% (27 of 27) at 12 weeks. 95% confidence interval, (95 to 100). No patients had a virologic failure during treatment. The reported adverse events (AE’s) were mainly nausea, headache and fatigue, no serious AE reported. Moreover, no treatment discontinuation due to side effects was observed.</p> <p style="text-align: justify;"><strong>Conclusions:&nbsp;</strong>The regime of full dose SOF and DAC therapy is well tolerated, safe and with a high rate of Sustained Viral Response (SVR) in both naive and treatment experienced group of HD Pakistani patients with HCV.</p> Rahmat Ali Khan, Anwar Ali, Ali Yasir Khan ##submission.copyrightStatement## Sat, 01 Dec 2018 09:44:44 +0000 Toxic shock and mortality in a dialysis patient <p style="text-align: justify;"><strong>Background:&nbsp;</strong>Staphylococcus and Streptococcal infections are a matter of serious concern in the dialysis population especially those having tunnel catheter access. Importance of these organisms is their virulent nature, higher incidence and prevalence in tunnel catheters resulting in significant morbidity and mortality. Staphylococcal toxic shock syndrome (STSS) is an uncommon but potentially fatal disease with multisystem involvement. This is a case of toxin-producing methicillin sensitive staph aureus (MSSA) which is known to have high mortality. A high degree of clinical suspicion and prompt management is necessary to avoid fatality. The aim of the study was to get the idea for the management of the toxic shock in terms of reducing the morbidity and mortality rate.</p> <p style="text-align: justify;"><strong>Case presentation: </strong>This case progressed to state of shock within few hours of presentation to emergency room and admission, attributed to be toxic shock with multi-organ failure.</p> <p style="text-align: justify;"><strong>Management and Results:&nbsp;</strong>In the management of the patient at the very beginning, the infected catheter was removed further aggressive resuscitation and empirical antibiotics&nbsp;were administered but this case resulted into a fatality.</p> <p style="text-align: justify;"><strong>Conclusion:&nbsp;</strong>The early action for source removal of the infection, appropriate antibiotic therapy and adjuvant therapy including clindamycin and immunoglobulin can effectively treat the toxic shock and its related complications.<strong><br> </strong></p> Akbar Mahmood, Muhammad Imran, Abdullah Balkhair ##submission.copyrightStatement## Sat, 01 Dec 2018 09:50:41 +0000 Prefabricated direct composite veneer: with and without teeth preparation <p style="text-align: justify;"><strong>Background:&nbsp;</strong>Componeer (prefabricated direct composite veneer) is a nano-hybrid composite enamel veneer that combines the advantages of both, placing a direct composite resin and those of a prefabricated laminate veneer manufactured in a laboratory. Any structural defects or anomalies in the anterior teeth or ‘esthetic zone’ create a problem for the patient. Hence, composite laminate veneers focus on targeting such abnormalities where the dentist is in complete control of the outcome, despite the pre-existing color, shape, structure, contours or morphology of the tooth. The aim of the study was to determine the success rate of using prefabricated direct composite veneers for cases with minimal preparation and ‘prep-less’ technique and compare both outcomes for establishing a better and long-lasting restoration.</p> <p style="text-align: justify;"><strong>Case presentation: </strong>The study presented two case reports, the first case was of a 46-year-old female with major complaints regarding spaces between upper teeth along with yellow discoloration. While the second i.e. Case 2 was of a 23 years old female with generalized spacing in her teeth due to microdontia and her chief complaint was the diastema present in between her upper front teeth.&nbsp;</p> <p style="text-align: justify;"><strong>Management and Results:&nbsp;</strong>A minimal preparation technique for composite veneering was used in Case 1 to combat the problem of yellow discoloration along with generalized spacing whereas a ‘prep-less’ technique was used for Case 2. Both cases depict different methods of composite veneering and restorations for both minimally prepared or ‘prep-less’ technique showed no differences at the follow-up visit (after 6-month).</p> <p style="text-align: justify;"><strong>Conclusion:&nbsp;</strong>Composite veneers have shown excellent results for restoring anterior defects while preserving tooth structure and surrounding tissues. It has proven to be the most time-efficient way of restorations meeting the high demands of superior esthetics and cost-effectiveness.</p> Azam Muhammad Aliuddin, Jabeen Zafar Ali, Abubakar Shiekh, Saqib Rashid ##submission.copyrightStatement## Sat, 01 Dec 2018 09:53:38 +0000 Beginning of meta-analysis in medical literature and its progression <p><strong>Background:&nbsp;</strong>Meta-analysis is an epidemiological, recognized, quantifiable study design that helps in systematical evaluation of earlier research studies to originate conclusions indicative of the body of research. This paper provides an overview to meta-analysis and to highlight its rationales and also over-all considerations related to meta-analysis. This article emphasizes on methods that are used in order to produce a demanding meta-analysis including various facets of staging and understandings of meta-analysis are deliberated.</p> <p><strong>Methodology:&nbsp;</strong>A Systematic literature was conducted from 1990 till 31<sup>st</sup> December 2017, utilizing PubMed, Web of science, Scopus and Embase using a single keyword "meta-analysis in medicine". We made 5 groups on the basis of years and the variation in the number of articles (meta-analyses) published.</p> <p><strong>Results:&nbsp;</strong>One of the critical outcomes of the meta-analysis study result is its heterogeneity or variability examination. Our results showed that the number of meta-analysis published in the recent years has excelled rapidly in comparison to the previous rate i.e. 3294 meta-analyses were published back in 1990-1995, which increased to 7863 in 1996-2000, 18044 for the year 2002-2007, 44965 articles in 2008-2013 and 76135 in 2014-2017.</p> <p><strong>Conclusion:&nbsp;</strong>Meta-analysis results in the detailed and accurate assessment of the consequences of various treatments, different risk factors for any particular or specific diseases or some other outcomes, other than individual research contributing to joint analysis. Thoroughly conducted meta-analyses can be a useful tool in evidence-based medicine. The needs of integrating outcomes from several studies confirm that meta-analytic research is necessary and the vast literature based on newly generated researches contribute highly in conduct of this research achievable.</p> Saima Khan, Guangming Dai, Sadaf Ahmed, Shamoon Noushad ##submission.copyrightStatement## Sat, 01 Dec 2018 09:56:57 +0000