Search

Objective: To evaluate the impact of enhanced healthcare provider counseling and practical demonstrations of correct breastfeeding techniques on improving exclusive breastfeeding practices. Study Design: Prospective follow-up study. Place and Duration of Study: This study was conducted at Alkhidmat-Raazi Hospital, Rawalpindi, Pakistan, from 17 September 2022 to 7 April 2023. Materials and Methods: A total of 309 mothers were enrolled in the study based on specific inclusion and exclusion criteria. A structured counseling intervention was implemented for postnatal care, incorporating bedside guidance during hospital stays and follow-up sessions conducted monthly over six months. Breastfeeding compliance was assessed through in-person and telephonic interviews documented in standardized data sheets. Data were analyzed using SPSS version 24. Descriptive statistics summarized the demographic characteristics and breastfeeding practices of participants. Chi-square tests were applied for categorical variables to assess the impact of the intervention. A p value ≤ 0.05 was considered statistically significant. Results: The response rate for follow-up visits was 76%. Early breastfeeding initiation (within one hour of birth) was observed in 52.8% of mothers, and exclusive breastfeeding at six months increased to 65.4%. Conclusion: Systematic postnatal counseling and hands-on guidance significantly improved breastfeeding practices. Continued support over six months facilitated better adherence to the exclusive breastfeeding code, emphasizing the importance of healthcare provider engagement in promoting optimal breastfeeding practices.

Background: Stroke ranked third in terms related to mortality and impairment worldwide and second common reason of death (11.6%). It greatly affects people quality of life and mobility. For faster recovery different rehabilitation approaches used like Transcranial Direct Current Stimulation (tDCS) device, a small intensity of electrical current is produced that can stimulate specific areas of the brain which are affected due to stroke. The tDCS device can be effective in improving motor skills and aiding in the recovery process after a stroke. Physical exercise is also crucial for stroke rehabilitation. But when we used these approaches together in rehabilitation of stroke patients it enhance recovery effectively. Objective: The objective of this systematic review is to evaluate the effects of non-invasive transcranial direct current stimulation (tDCS) and physical exercises on the rehabilitation outcomes of stroke patients. Methodology: This systematic review followed the guidelines of PRISMA. Used several online search engine known as PubMed, Cochrane Library, Google scholar to search eligible data availability. PICO framework used as screening criteria tool. Data relevant to study was extracted using self-developed data table based on previous literature. The Studies on stroke patients from subacute to chronic conditions with age limit 20 to 80 years, using tDCS device as an intervention and physical exercises were included in this review. Studies before 2019, Grey or unreported, not using tDCS device and non-English studies were excluded. Studies on stroke used tDCS and physical exercises were included in this review. Studies which conducted before the year 2019 and Non-English studies were excluded. Results: In this systematic review 35 studies were included with 1242 subjects after fulfill the requirements. In which 30 studies revealed significant improvement in stroke patients used noninvasive electrical stimulation tDCS and physical exercises with p value

This article discusses religious coping behaviors in relation to Islamic spiritual care practices. Islamic spiritual care is an established practice, integrated in many European countries’ health and welfare services, and an emerging field of research. I have 17 years of experience as a Muslim chaplain in Danish hospitals and a prison, working with counseling, educating staff, and policymaking in the field of Muslim chaplaincy. In this article, I use psychological theory to analyze positive and negative religious coping, first demonstrating that spiritual care is a practice in Islam that is embedded in its theological and psychological (re)sources. Then, based on two case examples, I analyze negative religious coping among Muslims, which is a topic that has received little scholarly attention. The article contributes to the emerging field of Islamic practical theology and the interdisciplinary relationship between practical theology and psychology of religion.

At present, there is limited theoretical clarity on the nature of Islamic spiritual care, which is a developing discipline around the world. How it is defined will be instrumental for spiritual care institutions, professionals and recipients of spiritual care in the years to come. This article wishes to understand and explore the idea and vision behind Islamic spiritual care and why this line of investigation may be of importance to care providers with different faith backgrounds.

Abstract Background Many interventions to motivate community health workers to perform better rely on financial incentives, even though it is not clear that monetary gain is the main motivational driver. In Pakistan, Lady Health Workers (LHW) are responsible for delivering community level primary healthcare, focusing on rural and urban slum populations. There is interest in introducing large-scale interventions to motivate LHW to be more actively involved in improving tuberculosis case-finding, which is low in Pakistan. Methods Our study investigated how to most effectively motivate LHW to engage more actively in tuberculosis case-finding. The study was embedded within a pilot intervention that provided financial and other incentives to LHW who refer the highest number of tuberculosis cases in three districts in Sindh province. We conducted semi-structured interviews with 20 LHW and 12 health programme managers and analysed these using a framework categorising internal and external sources of motivation. Results Internal drivers of motivation, such as religious rewards and social recognition, were salient in our study setting. While monetary gain was identified as a motivator by all interviewees, programme managers expressed concerns about financial sustainability, and LHW indicated that financial incentives were less important than other sources of motivation. LHW emphasised that they typically used financial incentives provided to cover patient transport costs to health facilities, and therefore financial incentives were usually not perceived as rewards for their performance. Conclusions This study indicated that interventions in addition to, or instead of, financial incentives could be used to increase LHW engagement in tuberculosis case-finding. Our finding about the strong role of internal motivation (intrinsic, religious) in Pakistan suggests that developing context-specific strategies that tap into internal motivation could allow infectious disease control programmes to improve engagement of community health workers without being dependent on funding for financial incentives.

Rationale: Cross-sectional studies demonstrate an association between metabolic syndrome and impaired lung function.Objectives: To define if metabolic syndrome biomarkers are risk factors for loss of lung function after irritant exposure.Methods: A nested case-control study of Fire Department of New York personnel with normal pre-September 11th FEV(1) and who presented for subspecialty pulmonary evaluation before March 10, 2008. We correlated metabolic syndrome biomarkers obtained within 6 months of World Trade Center dust exposure with subsequent FEV(1). FEV(1) at subspecialty pulmonary evaluation within 6.5 years defined disease status; cases had FEV(1) less than lower limit of normal, whereas control subjects had FEV(1) greater than or equal to lower limit of normal.Measurements and Main Results: Clinical data and serum sampled at the first monitoring examination within 6 months of September 11, 2001, assessed body mass index, heart rate, serum glucose, triglycerides and high-density lipoprotein (HDL), leptin, pancreatic polypeptide, and amylin. Cases and control subjects had significant differences in HDL less than 40 mg/dl with triglycerides greater than or equal to 150 mg/dl, heart rate greater than or equal to 66 bpm, and leptin greater than or equal to 10,300 pg/ml. Each increased the odds of abnormal FEV(1) at pulmonary evaluation by more than twofold, whereas amylin greater than or equal to 116 pg/ml decreased the odds by 84%, in a multibiomarker model adjusting for age, race, body mass index, and World Trade Center arrival time. This model had a sensitivity of 41%, a specificity of 86%, and a receiver operating characteristic area under the curve of 0.77.Conclusions: Abnormal triglycerides and HDL and elevated heart rate and leptin are independent risk factors of greater susceptibility to lung function impairment after September 11, 2001, whereas elevated amylin is protective. Metabolic biomarkers are predictors of lung disease, and may be useful for assessing risk of impaired lung function in response to particulate inhalation. [ABSTRACT FROM AUTHOR]

Osteoarthritis is one of the most common degenerative conditions affecting knee joint. As our understanding in the disease pathogenesis is evolving, so do the treatment modalities. One of the postulated mechanisms suggests the production of inflammatory cytokines secondary to repeated micro trauma than in turn lead to cartilage damage overtime. Cartilage being avascular structure has limited potential for repair. Based on this, recent studies have been focusing on stimulating cartilage-healing process by growth factors. This is where platelet-rich plasma comes in to light. Literature is showing promising results of platelet-rich plasma in treating knee osteoarthritis. In this review we have discussed the preparation, composition, classification, uses of platelet-rich plasma as well as evidence for its efficacy and complications.

Summary: Despite the efforts of the international community diarrheal diseases still pose a major threat to children in children less than five years of age. Bacterial diarrhea has also emerged as a public health concern due to the proliferation of drug resistant species in many parts of the world. There is a paucity of population-based data about the incidence of shigellosis and Campylobacter infections in Pakistan. We report country specific results for Shigella diarrhea that were derived from a multicenter study conducted in six Asian countries. Disease surveillance was conducted over a 24 month period in urban slums of Karachi, Pakistan, a city with a population of 59,584. Cases were detected through passive detection in study treatment centers. Stool specimens or rectal swabs were collected from all consenting patients. Between January 2002 and December 2003 10,540 enteric infection cases were detected. The incidence rate of treated diarrhea in children under 5 was 488/1000/year. In children, 5 years and older, the diarrhea rate was 22/1000/year. 576 (7%) Campylobacter isolates were detected. The pre-dominant Campylobacter species was C. jenuni with an increase of 29/1000 year in children under 5 years. Shigella species were isolated from 394 of 8032 children under 5 years of age. Shigella flexneri was the dominant species (10/1000/year in children under 5 years) followed by Shigella sonnei (3.9/1000/year), Shigella boydii (2.0/1000/year) and Shigella dysenteriae (1.3/1000/year). Shigellosis and Campylobacter infection rates peaked during the second year of life. The incidence rate of shigellosis increased in old age but such a trend was not observed in Campylobacter infections. Of 394 shigellosis patients 123 (31%) presented with dysentery in contrast to only 54 (9%) of 576 patients with Campylobacter infections (p

Introduction. Nutritional deficiencies are rarely reported in developed countries. We report a child of Pakistani origin brought up in Dubai who developed skeletal manifestations of scurvy due to peculiar dietary habits. Case Presentation. A 4.5 year old boy presented with pain and swelling of multiple joints for three months and inability to walk for two months. Dietary history was significant for exclusive meat intake for the preceding two years. On examination the child’s height and weight were below the 5th percentile for his age. He was pale and tachycardic. There was significant swelling and tenderness over the wrist, knee and ankle joints, along with painful restriction of motion. Basic blood workup was unremarkable except for anemia. However, X-rays showed delayed bone age, severe osteopenia of the long bones, epiphyseal separation, cortical thinning and dense zone of provisional calcification, suggesting a radiological diagnosis of scurvy. The child was started on vitamin C replacement therapy. Over the following two months, the pain and swelling substantially reduced and the child became able to walk. Repeat X-rays showed improvement in the bony abnormalities. Conclusion. Although scurvy is not a very commonly encountered entity in the modern era, inappropriate dietary intake can lead to skeletal abnormalities which may be confused with rickets. A high index of suspicion is thus required for prompt diagnosis of scurvy in patients with bone and joint symptoms.

: PurposeTo determine the duration of action of ketotifen 0.025% eye drops vs placebo taken as single or multiple doses in an allergen challenge model.: DesignTwo randomized, multicenter, double-masked, contralateral placebo-controlled studies, one a single-dose and one a multiple-dose study.: MethodsTwo conjunctival provocation tests (CPTs) were initially conducted to confirm reproducibility of subject responses in both studies. Subjects in study 1 (n = 87) received single doses of ketotifen in one eye and placebo in the other 15 minutes, 6 hours, and 8 hours before CPT. Subjects in study 2 (n = 85) received ketotifen or placebo once 8 hours before CPT. Single-dose efficacy results were used to further qualify a subject as a responder. Responders were re-randomized to a 4-week twice daily dosing regimen with a CPT 8 hours after the final dose. In both studies, ocular symptoms were assessed at three time points 3 to 15 minutes after challenge. There were no significant differences in adverse events between groups.: ResultsFor both studies, ocular itching and vascular injection were significantly reduced (P < .003) at all time points after instillation of ketotifen, with a maximum reduction at 7 minutes postchallenge. In study 2, chemosis, tearing, and lid swelling were also assessed and were significantly reduced (P < .008) after instillation of ketotifen.: ConclusionsKetotifen 0.025% eye drops were safe and statistically effective in preventing ocular itching, injection, and other signs and symptoms of allergic conjunctivitis at 15 minutes, 6 hours, and 8 hours after a single dose and at 8 hours after the final dose of a 4-week twice daily regimen. [Copyright &y& Elsevier]