International Journal of Endorsing Health Science Research (IJEHSR)

Assessment of Carpal Tunnel Syndrome Symptoms and Functional Status among Medical Students: A Cross-Sectional Survey in Lahore, Pakistan.

Thu, 18 May 2023 10:37:50 +0000

Background: Medical students may be at a higher risk for developing CTS due to the repetitive nature of their work and prolonged use of computers. This survey investigated the severity of CTS symptoms and functional status among medical students.

Methodology: Among medical students, a quantitative observational cross-sectional survey was carried out in Lahore, Pakistan. A total of 112 students of both gender, aged between 19 to 27 years, participated in this study. A demographic questionnaire and a Boston carpel tunnel syndrome questionnaire were used, and questions related to moderate and strenuous exercise were included in the survey.

Results: The functional status of a medical student is categorized as 22.3% in the asymptomatic category, 40.2% in the mild category, 19.6% in the moderate category, and 17.9% fall in the severe category. An association was found between symptom severity and prolonged hand use & functional status. The study results provide insights into the risk factors and potential preventive measures for CTS in this population.

Conclusion: The study has collected data on the prevalence of CTS among medical students, the severity of their symptoms, the impact of CTS on their academic performance, and the factors associated with the development and severity of CTS among medical students. Our survey results show that medical students of the study site have not been classified as high-risk.

Candidemia in Pediatric Patients: Changing Pattern of Isolated Candida Species and Risk Factors in Eastern India.

Tue, 28 Mar 2023 10:28:56 +0000

Background: Candidemia is a life-threatening bloodstream infection caused by Candida species and is a major concern in pediatric patients, particularly in developing countries like India. Therefore, the goals of the current study are to isolate and identify several Candida species from blood samples, link various risk factors with candidemia, and ascertain the antifungal sensitivity pattern of each species.

Methodology: This study is an observational, cross-sectional study conducted to determine the prevalence, distribution, and antifungal susceptibility of Candida species among pediatric patients with candidemia. The current study collected blood samples in BACT/ALERT 3D Pediatric bottles for fungal blood culture. After positive growth was obtained from Blood agar and Sabouraud's dextrose agar (SDA), a range of biochemical reactions, including Gram staining, Germ tube test, CHROM agar Candida Medium, and Sugar fermentation, were carried out. The Kirby-Bauer disc diffusion method was used for conducting the antifungal susceptibility test.

Results: Among the total of 156 different species of Candida, the maximum isolates were Candida albicans (CA) (42.9%), followed by Candida tropicalis (23.1%) and Candida parapsilosis (14.7%). The Pediatric Intensive Care Unit (PICU) had the most Candida isolates, and catheterization was a leading risk factor. Susceptibility to Amphotericin B, Caspofungin, and Voriconazole was 84.6%, 81.4%, and 76.9%, respectively. Our study observed that the azole group of antifungals revealed pretty high resistance to Non-Candida albicans (NCA).

Conclusion: The prevalence of candidemia was higher in the pediatric ICU and neonatal ICU, and the incidence rate was highest among neonates and infants. The study concludes that NCA species are gradually replacing C. albicans as an important pathogen, and clinicians need to be aware of the antifungal resistance patterns of the different Candida species.

A cross-sectional survey on hand hygiene among nursing students working in an eastern Indian hospital.

Tue, 28 Mar 2023 10:41:12 +0000

Background: Proper hand hygiene practices by healthcare providers are critical to prevent healthcare-associated infections (HCAIs). This study aimed to assess the hand hygiene knowledge and practices of nursing students in various departments and operation theatres of a tertiary care hospital in Eastern India.

Methodology: A cross-sectional survey based on WHO questions was conducted in March-April 2022 to evaluate the hand hygiene knowledge and practices of 105 nursing students. The study included nursing students from different departments, including medicine, surgery, pediatrics, obstetrics and gynecology, eye, different ICUs (adult, NICU, and PICU), and different OTs. The collected data were analyzed according to the STROBE guidelines.

Results: Of the 105 nursing students, 42.86% had no training in hand hygiene practices, highlighting the need for additional training. However, due to the COVID-19 pandemic, most students (86%) were familiar with using alcohol-based hand rubs. Most students preferred hand rubbing before giving an injection (65.74%), while hand washing was preferred after vacating a bedpan (91.42%) or being exposed to blood (89.52%). Comparing the pre-and post-workshop questionnaires showed a significant improvement in hand hygiene knowledge. However, more training is required to understand the importance of infection spread from the infected hands of HCWs. Additionally, gloves are not a substitute for hand hygiene practices, and wearing jewelry and artificial nails should be avoided. Regular training and workshops can increase awareness among nursing students.

Conclusion: The findings indicate a need for ongoing training to improve hand hygiene practices among nursing students. Regular training and workshops can increase awareness and knowledge, leading to decreased incidence of HCAIs.

Diagnostic accuracy of Lateral X-Ray of Cervical Spine in detection of fracture in hospitalized patients.

Tue, 30 May 2023 10:13:22 +0000

Background: Lateral X-ray of the cervical spine (LCSX) is a common diagnostic tool to detect fractures in hospitalized patients. Its non-invasive nature and cost-effectiveness make it a preferred imaging technique for rapid identification of cervical spine fractures. However, its diagnostic accuracy is still a subject of debate and further research is needed to establish its reliability and validity. This study aimed to determine the diagnostic accuracy of LCSX in detecting fractures in hospitalized patients, using multi-detector computed tomography (MDCT) as the gold standard.

Methodology: This cross-sectional retrospective study was conducted at a tertiary care hospital in Karachi. The study included 431 male and female patients aged between 18 to 60 years referred by the primary medical team to the Radiology Department for both LCSX and MDCT to detect cervical spine fractures. Patients with known cases of cervical spine fractures determined by history, examination, and previous radiological modalities like LCSX, MDCT, or MRI at the time of imaging were included.

Results: LCSX identified 63 cases (14.6%) as having cervical spine fractures, while 368 cases (85.3%) were reported as not having cervical spine fractures. However, on MDCT, 116 cases (26.9%) out of the 431 cases were found to have cervical spine fractures, while 315 cases (73.08%) were reported as not having cervical spine fractures. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of LCSX were calculated. The sensitivity of LCSX was found to be 58.35%, specificity was 100%, positive predictive value was 100%, negative predictive value was 85.59%, and diagnostic accuracy was 87.70%.

Conclusion: LCSX has low sensitivity as a diagnostic tool in detecting cervical spine fractures in trauma patients, resulting in missed diagnoses of critical cervical spine fractures and compromised patient care, which can lead to increased morbidity and mortality.

Uterocutaneous fistula managed medically: A case report.

Tue, 28 Mar 2023 11:24:20 +0000

Background: The uterocutaneous fistula is an abnormal connection or passageway between the uterus and the skin. The most common causes include infections, trauma, or surgery, a severe medical condition requiring prompt medical attention and treatment.

Case Presentation: Here, we describe the case of a 36-year-old female who developed a uterocutaneous fistula after cesarean delivery. Her post-cesarean recovery was complicated by wound infection, and after healing the wound, she presented with cyclical bloody discharge from a pinpoint opening in the healed wound scar.

Management: On ultrasound and MRI, she was diagnosed as having a uterocutaneous fistula. She opted for non-surgical management and underwent successful medical management with GnRH agonists. She remained symptom-free after the resumption of her menstrual cycle.

Conclusion: In younger populations hoping to avoid surgery, pharmacological care with GnRH agonist therapy can be a reasonable alternative to surgical resection of the fistulous tract. Healthcare professionals should have a high index of suspicion to diagnose this condition.

Role of the Advanced Practitioner in Leading Change in Primary Care.

Qaiser Shahzad Chishty, Shashikant Bhasme — Mon, 24 Apr 2023 13:15:33 +0000

The role and recognition of advanced clinical practitioners (ACPs) have been subject to debate in various healthcare settings. Therefore, this review aims to critically analyze the role of ACPs in leading change within primary care services. By referring to current clinical research, the review aims to evaluate the efficacy of this role in creating a sustainable future for the National Health Service (NHS) by reducing the gap between primary and secondary care, as highlighted in the NHS Five Year Forward View. From the authors' perspective, the role of ACPs in leading change in primary care settings has never been more crucial than it is today. Understanding the changes that ACPs can introduce is essential to accelerate progress and achieve the most optimistic scenario for the future. However, the emergence of the ACP role faces three challenges: defining their domain, their training package, and determining the necessary adjustments in NHS organizations.