Journal of Liaquat University of Medical & Health Sciences

Determinants of Maternal Characteristics Associated with Labor Complications

Ika Fitria Elmeida, Nurlaila Nurlaila, Nurchairina Nurchairina — Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To determine which questions are most appropriate for describing the complications of childbirth experienced in research.

METHODOLOGY: An instrument was formed for a quantitative questionnaire for data collection with a cross-sectional study design of 300 respondents. The study was conducted at Abdoel Moeloek Regional Hospital, A. Dadi Tjokrodipo Regional Hospital and Kotaarang Community Health Center in January-June 2024. Inclusion criteria were women giving birth in the hospital obstetrics room with a diagnosis of postpartum hemorrhage, pre-eclampsia or eclampsia, Dystocia caused by uterine atony, uterine abnormalities, and mothers giving birth normally. The exclusion criteria were plans to move domicile from Lampung Province during the research and home addresses that were difficult to reach. Logistic regression was used to determine the most predictive questions regarding complications and each question item's accuracy, sensitivity, and specificity values ??. We use SPSS software to analyze data.

RESULTS: The study showed that this questionnaire could be used for survey research that asks about the accuracy of mothers' answers about complications of pre-eclampsia, bleeding, and Dystocia, with the highest accuracy value of 0.93, se. 90.7% and sp.98.2% on the questionnaire for pre-eclampsia; accuracy: 0.84, se.73.3%, and sp. 99.1% for the bleeding questionnaire, and accuracy values of 0.96, se.97.3%, sp. 98.7% for the dystocia questionnaire.

CONCLUSION: The questionnaire for the three groups of labor complications had a high accuracy value (> 70%). The survey times at the hospital and the mother's home were equally good.

Associated Factors with the Implementation of Patient Safety Culture in Hospital

Heri Juanda, Teuku Tahlil, Said Usman — Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To identify factors associated (i.e., organizational culture, patient safety regulation, patient safety management quality) with implementing a patient safety culture in hospitals.

METHODOLOGY: Quantitative research was used with a cross-sectional approach. All 219 nurses working in inpatient wards of a hospital in Banda Aceh were conveniently included in this study using a non-probability convenience sampling technique with some inclusion and exclusion sample criteria. Data were collected from 18 to 28 April 2024 using the Organizational Culture Assessment Instrument (OCAI), the Karen-personnel instrument for managing the QPSM, the Hospital Survey on Patient Safety for assessing patient safety culture, and a questionnaire comprising questions based on existing literature for evaluating patient safety regulations. Data analysis involved Pearson correlation and multiple linear regression by SPSS 26 for Windows.

RESULTS: There was a relationship between organizational culture (p < .0001, r² = 0.659), patient safety regulation (p < .0001, r² = 0.423), and quality management of patient safety (p < .0001, r² = 0.442) and patient safety culture. The results of the multiple linear regression analysis indicated that higher levels of organizational (p < .0001) and regulatory culture (p < .0001) were associated with a higher patient safety culture among nurses in the hospital's nursing wards.

CONCLUSION: Implementing a hospital patient safety culture is associated with the organizational and regulatory culture levels. Organizational and Regulatory Culture Hospitals are encouraged to foster a positive organizational culture ensuring a comfortable and secure working environment and providing training opportunities for nurses to enhance patient safety practices.

Micro-Organisms Isolated from Open Fractures of Extremities

Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To determine the frequency of micro-organisms from culture reports of open fractures of extremities.

METHODOLOGY: In this descriptive cross-sectional study carried out in the orthopedic surgery department of Lady Reading Hospital in Peshawar, 173 patients with open fractures lasting more than five days were included. The trial lasted for six months. Consecutive non-probability sampling was used. Swabs were collected from the fracture wounds. Swabs were inoculated on Blood agar, MacConkey agar and chocolate agar. Different biochemical tests were used to identify the Micro-organisms.

RESULTS: Analysis of 173 patients' ages revealed that the patients were 18-67 years old, with a mean age of 28.6±3. Analysis of the gender-wise distribution of the 173 patients showed that 92(53.2%) were men and 81(46.8%) were women. Analysis of the distribution of micro-organisms among 173 patients revealed that 45(26%) and 36(20.8%) of them were staphylococcus aureus and Streptococcus. Staphylococcus epidermidis were 32 (18.5%). Pseudomonas aeruginosa were 34(19.7%) and E Coli were 26 (15.02%). The Gustilo classification was used to examine the distribution of fractures among 173 patients. Grade 1 consisted of 31, Grade II consisted of 48, Grade III consisted of 80, Grade IIIB consisted of 8, and Grade IIIC consisted of 6.

CONCLUSION: This study concludes that both staphylococcus aureus were the frequent micro-organisms involved in open fracture infections.

Comparative Effects of Instrument-Assisted Soft Tissue Mobilization (Iastm) and Muscle Energy Technique (Met) on Post-Operative Elbow Stiffness

Nayab Gohar, Sidra Majeed, Zarnab Seher, Areej Azeem, Fatima Nadir, Tooba Asif — Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: This study aimed to compare the effectiveness of Muscle Energy Technique (MET) and Instrument-Assisted Soft Tissue Mobilization (IASTM) in reducing pain, improving range of motion (ROM), and enhancing function in individuals with post-operative elbow stiffness.

METHODOLOGY: A registered randomized clinical trial with NCT06575855 was conducted with 28 participants aged 30 to 50 with post-operative elbow stiffness from proximal radius-ulna or distal humerus fractures. Participants were randomly assigned to receive either MET or IASTM interventions. Pain levels were measured using the Visual Analog Scale (VAS), functional status was assessed via the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and ROM was evaluated. Statistical analyses included the Wilcoxon Signed Rank Test, Mann-Whitney U-test, and paired and unpaired t-tests.

RESULTS: MET and IASTM significantly reduced pain and improved ROM and function (p < 0.05). The IASTM group showed more significant pain reduction at rest and during activity (p-values of 0.050 and 0.039, respectively). No significant differences were found between the groups for improvements in ROM (elbow flexion/extension and forearm supination/pronation) and DASH scores, indicating similar effectiveness in these areas.

CONCLUSION: MET and IASTM effectively manage post-operative elbow stiffness, with IASTM demonstrating superior pain reduction. These findings suggest that IASTM may be more beneficial for pain management in post-operative elbow stiffness, while both techniques offer comparable benefits for ROM and functional improvement.

Sleeve Gastrectomy and Pancreatic Omentoplasty improve B-cell status in Rats by increasing VEGF, PDX1, islet of Langerhans area, and B-cell count

Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To analyze the effect of sleeve gastrectomy and pancreatic omentoplasty on pancreatic B-cell status by evaluating the levels of PDX1 and VEGF.

METHODOLOGY: This experimental animal research was done with a post-test-only control design. This research was conducted at the Laboratory of Integrated Research and Development, Universitas Gadjah Mada, Yogyakarta, Indonesia, from April to June 2022. The subjects consist of obese and T2DM rats, divided into sleeve gastrectomy (K1), sleeve gastrectomy with pancreatic omentoplasty (K2), positive control (K3), and normal rats in negative control (K4). On the 10th day post-surgery, VEGF and PDX1 were measured using polymerase chain reaction, with histologic examination of the Langerhans islet area and pancreatic ?-cell count.

RESULTS: Significant differences in Langerhans islet area and pancreatic ?-cell count were found between K1 and K2, and K2 and K3 (p < 0.01). PDX1 expression was highest in K4, followed by K2, K1, and K3, with significant differences between K4 and K3, K2 and K3, and K1 and K3 (p < 0.01). VEGF expression in K2 was significantly higher than in K1 (p = 0.006), K3 (p = 0.004), and K4 (p = 0.001).

CONCLUSION: Sleeve gastrectomy and pancreatic omentoplasty improve pancreatic B-cells status by increasing VEGF, PDX1, Langerhans islet area, and pancreatic ?-cell count compared to sleeve gastrectomy alone.

Network Pharmacological Study of Papaver Somniferum to Explore the Potential Compounds to Treat Epilepsy

Thu, 27 Mar 2025 00:00:00 +0500

Objective: This study aims to discover potential compounds of Papaver somniferum for epilepsy treatment using network pharmacology and molecular docking tools.

Methodology: Papaver somniferum compounds were obtained from KNApSAcK and the IMPPAT database. Potential epilepsy targets were obtained from DisGeNET and GeneCards. After identifying common targets using a Venn diagram, DAVID analysis was performed. STRING database was used for protein-protein interactions, and Cytoscape was used for visualization and construction of target-compound-pathway network. Molecular docking was performed to identify potential active ingredients against epilepsy.

Results: Fifteen active ingredients and 343 therapeutic targets were obtained from Papaver somniferum, and 7784 and 1215 epilepsy disease genes resulted in 79 common targets. Hub genes were identified using topological analysis. Molecular docking studies demonstrated that 15 active compounds possess the potential to bind the epilepsy targets.

Conclusion: Network pharmacology and molecular docking identified potential multitargeting compounds such as salutaridine, scoulerine, gamma-isomorphine, morphine, Codeine, Codeinone, (S)-Scoulerine and (-)-Codeinone for Epilepsy treatment.

Effect of Stuttering Modification Technique on Social Emotional Functioning and Communication Skills in Stutterers

Rooma Imtiaz, Anum Ashraf, Amna Rashid, Fazaila Ehsan, Talala Usman — Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To look into how the stuttering modification technique affects a person's ability to communicate and their social-emotional functioning.

METHODOLOGY: This quasi-experimental study was conducted at Sehat Medical Complex Hospital from January to July 2023. Data were gathered from patients who had been experiencing stuttering. A non-probability convenient sampling strategy was selected for this study; data was collected from 30 individuals with moderate to severe stutters at Sehat Medical Complex Hospital. Individuals without comorbid speech impairments or psychological/neurodevelopmental disorders between the ages of 6 and 18 were included, regardless of gender. The CALMS rating scale was used to assess the cognitive, affective, linguistic, motor, and social components of stuttering, while the Stuttering severity instrument SSI 4 was utilized to determine the severity level.

RESULTS: According to the results of this study, the paired t-test was used for the pre and post-reading analysis. The results indicate significant t-values ranging from 11.584 to 22.954 and a p-value of 0.000, which suggests a substantial impact of stuttering modification techniques on cognitive, affective, linguistic, motor, social, and overall severity.

CONCLUSION: The result stated that significant improvements in cognitive, affective, linguistic, motor, social, and overall severity were observed in 30 individuals with moderate to severe stuttering to mild to moderate severity who used stuttering modification approaches. The results bolster the effectiveness of this therapy, which prioritizes desensitization and modification techniques in improving stutterers' social-emotional health and communicative abilities.

Effects of Neuromuscular Training with and Without Kinesio-Tape on Pain, Range of Motion, Balance and Function in Footballer with Ankle Sprain

Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To determine the effects of neuromuscular training with and without kinesio-tape on pain, range of motion, balance, and function in footballers with ankle sprain.

METHODOLOGY: The randomized control trial was conducted at the Pakistan Sports Board, Lahore, from March to August 2023. The Squeeze and Talar Tilt Test purposefully identified thirty male football players who sustained grade I and II ankle sprains. Assigned to group A randomly, neuromuscular training alone (control n=15) and group B neuromuscular training with kinesio-tape (experimental n=15). Both groups performed neuromuscular training for 15–20 min for 4 weeks (three times per week), and after each session, Kinesio-tape was applied to the experimental group. Pain Intensity was evaluated with the Numerical pain rating scale (NPRS), range of motion (ROM) was measured by goniometer, dynamic balance status was assessed with the Star excursion balance test (SEBT), and ankle function was assessed with functional ankle ability measure (FAAM-Sports Subscale).

RESULTS: After 4 weeks of intervention, both groups significantly improved all outcome measures. However, there was significant improvement (p<0.001) in intragroup analysis in all outcome measures after treatment in both groups with p< 0.001. Additionally, the between-group analysis revealed significantly more significant improvements in pain reduction, ROM, balance, and sports function in Group B compared to Group A.

CONCLUSION: Both treatments significantly improved pain, range of motion (ROM), balance, and functional outcomes. However, the group receiving neuromuscular training supplemented with Kinesio Tape exhibited greater effectiveness in ankle sprain.

Concurrent Validity and Intra-Rater Reliability of Smartphone Application Angle Meter for Shoulder Range of Motion

Thu, 27 Mar 2025 00:00:00 +0500

Objective: To evaluate concurrent validity and intra-rater reliability of smartphone application angle meter for shoulder range of motion.

MethodOLOGY: An observational cross-sectional study was performed using a non-probability convenient sampling technique to collect data. Data from 37 healthy volunteers was recruited from Riphah Rehabilitation Center Lahore in April-September 2022. Participants aged 18 to 35 who could actively move the Shoulder's dominant side were included in the study. The universal goniometer and the angle meter application measured the active shoulder range of motion. Each movement was performed three times and assessed one by one with a universal goniometer and angle meter application to limit exertion. There was a resting period of 1 day after each movement. Collected data was analyzed with SPSS 20.0.

Results: An angle meter app could be a feasible alternative to the goniometer instrument for healthcare practitioners to evaluate active shoulder range of motion. The Cronbach's alpha value was 0.933 for Shoulder Flexion, 0.986 for Shoulder Abduction, 0.994 for Shoulder Internal Rotation, and 0.980 for Shoulder External Rotation. Overall, Cronbach's alpha value portrayed excellent reliability for the Smartphone Angle Meter. Based on the results, it can be stated that the Smartphone Angle Meter app has a high strength to robust positive correlation for the Shoulder range value of <0.001, confirming the statistical significance of the positive relationship.

Conclusion: According to this study's findings, the Angle meter app was a valid and reliable alternative goniometer tool for assessing active shoulder range of motion in healthy adults.

Unlocking the Nootropic Effect of Trachyspermum ammi Seeds against Scopolamine-induced Memory Deficits in Rodents

Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To evaluate the potential of TASE in improving memory and cognitive function using animal models.

METHODOLOGY: These experimental trials were conducted in the Pharmacology Laboratory, University of Karachi, from January - November 2021. Thirty-five male Wistar Rats and thirty-five male mice weighing 200-230g and 20-40g, respectively, were used for Morris water maze (MWM) and passive avoidance response (PAR) tests. The subjects were distributed equally into five groups. Group 1 (control) received 2% gum tragacanth, Groups 2, 3, and 4 received TASE at 50, 100, and 250mg/kg, respectively, and Group 5 received Piracetam at 200mg/kg. Scopolamine at 0.4mg/kg was administered intraperitoneally to induce amnesia in rodents.

RESULTS: In the MWM test, TASE at 250 and 100mg/kg significantly decreased the escape latency in rats compared to the control group. Similarly, in the PAR test, TASE at 250 and 100mg/kg significantly delayed the compartment change time in mice compared to the control group. The outcomes of both experiments were comparable to the reference drug Piracetam, indicating that TASE improves cognition and has substantial potential as an anti-amnesic agent. This potential may be due to the presence of significant phytochemicals in TASE, such as Thymol, saponins, flavonoids, ?- and ?-pinene, and ?-terpinene, which improve cholinergic neurotransmission and exert antioxidant effects.

CONCLUSION: TASE improves memory and cognitive function, likely due to its significant phytochemical content. Identifying these nutritional elements is crucial for researching and developing innovative and potent medications.

Ethics and Communication in Providing Health Education in Midwifery Services

Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: The aim was to analyze the differences in providing modules and assistance from a certified senior midwife in applying ethics and communication in providing health education in midwifery services.

METHODOLOGY: This quantitative research used cluster sampling and was conducted in Makassar, Maros, Pangkep, and Barru cities between January and April 2024. Slovin formula and cluster sampling were used. Each region was divided into 30 samples, with a total sample size of 120. The midwife group was split into a control group that was given a health ethics and communication module (This module is developed based on the curriculum and combined with existing regulations from the Ministry of Health). The intervention group was provided with assistance from a certified senior midwife. Eight midwives from the control and intervention groups were randomly assigned to four cities, and an independent t-test was conducted to compare the control and intervention groups. SPSS was used for analytical tools.

RESULTS: The findings show that age, education, and employment are all related to ethics and communication, with a p-value of <0.005 in both the control and intervention groups. The control and intervention groups showed significant differences in ethics and communication, with a p-value of 0.000 for both.

CONCLUSION: Communication and ethics differences exist between the control and intervention groups. The findings emphasize how crucial it is to implement assistance from a certified senior midwife to enhance the quality of ethics and communication among these groups.

Clinical, Laboratory and Risk Factors for COVID-19 Mortality in the Elderly Population of Iran: A Three-year Cross-sectional Study

Thu, 27 Mar 2025 00:00:00 +0500

OBJECTIVE: To investigate the clinical characteristics, laboratory findings, and risk factors associated with COVID-19 mortality among elderly patients in Khoy, West Azerbaijan, Iran.

METHODOLOGY: This retrospective cross-sectional study analyzed data from 447 confirmed COVID-19 patients over 60 years old hospitalized in Khoy's referral hospital between March 2020 and December 2022. The diagnosis was confirmed via RT-qPCR based on Iran's national protocol. Demographic, clinical, and laboratory data were extracted from hospital records and the city health centre using a standardized checklist.

RESULTS: Significant risk factors for mortality included patient gender, hospital admission route, and the presence of severe clinical symptoms such as dyspnea, hypoxia, myalgia, altered consciousness, and high fever. Among comorbidities and lifestyle factors, diabetes, neurological disorders, smoking, and lung diseases were significantly associated with increased mortality risk. Except for platelet count and alanine aminotransferase (ALT) levels, all other laboratory parameters demonstrated significant differences between recovered and deceased patients.

CONCLUSION: This study highlights the importance of considering age, gender, clinical presentation, and pre-existing conditions when managing elderly COVID-19 patients to mitigate complications and reduce mortality. Targeted interventions and enhanced monitoring strategies for high-risk individuals are essential to improve outcomes in this vulnerable population.

Effect of Hyperbaric Oxygen Therapy Dose on Post-Replantation of the Distal Phalanx of Digiti II Manus Sinistra

Titut Harnanik, Made Kanya Emeralda Pradnyapramesti, Nyoman Sayang Jayarta — Thu, 27 Mar 2025 00:00:00 +0500

Finger replantation in adults requires a more extended healing period and is at risk of failure. Giving hyperbaric oxygen therapy (HBOT) at the correct dose can speed healing, reducing the risk of failure. A case involved a 32-year-old woman after replantation of the distal phalanx of digiti II manus sinistra of the patient who experienced cyanosis and necrosis. This report analyzes the relationship between HBOT dose and accelerated stimulation of growth factors that can improve the wound healing process.

Replantation refers to the reconnection of an amputated body part to its anatomical structure to restore the function of the injured part. The outcome depends on the dose of HBOT, the patient's intrinsic factors, and the nature of the injury. Giving HBOT once a day, in this case, was not effective because the patient's fingertips became more cyanotic, and necrosis increased. Providing the correct dose of HBOT twice a day accelerates overcoming hypoxia. It helps successfully heal wounds through angiogenesis, collagen formation, and epithelialization, so new tissue growth is expected to accelerate.

Ileocolic Intussusception Secondary to Cecal Diverticulum Containing Heterotopic Gastric Mucosa in a 4 Month Old Boy: A Case Report

Hammad Manzoor, Mushtaq Ahmad, Usama Rehman, Asif Shah — Thu, 27 Mar 2025 00:00:00 +0500

A case report of a 04-month-old boy is reported, who presented to the Pediatric Surgical Emergency Department of Sheikh Zayed Hospital, Rahim Yar Khan, with a history of abdominal distension, vomiting, reluctance to feed, and per rectal bleeding for two days. He was provisionally diagnosed as Intussusception with the typical symptoms' triad (i.e. abdominal pain, palpable mass and currant jelly stools). There was no associated history of fever, sore throat or constipation. On examination, he had abdominal distention, visible peristalsis, and a right upper quadrant palpable mass. Abdominal X-rays and ultrasonography supported the provisional diagnosis of Intussusception. Laparotomy findings showed an ileocolic intussusception secondary to the cecal diverticulum. Intussusception was manually reduced, followed by right limited hemicolectomy and ileocolic anastomosis, as some parts of the gut (intussusceptum) were not viable. Postoperatively, there were no active complaints, and the patient was made oral-free following the third postoperative day and was sent home on the 5^th day following surgery. On the follow-up visit (10th post-op day), the infant was all right and playful, with no active complaints.

The objective of this case report is to present a rare case of ileocolic Intussusception secondary to a cecal diverticulum containing heterotopic gastric mucosa in a 4-month-old boy, highlighting the clinical presentation, diagnostic challenges, surgical management, and the importance of recognizing uncommon etiologies in pediatric intussusception cases.

The Effect of Immune Cell Abnormalities in the Pathogenesis of Chronic Prostatitis / Chronic Pelvic Pain Syndrome

Yang Xuan, Yue Duan — Thu, 27 Mar 2025 00:00:00 +0500

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological condition with high incidence, complicated etiology, and unsatisfactory treatment. It seriously affects the quality of life of patients, and the pathogenesis of the disease is still not clear. This paper reviews the recent progress of research on the effect of immune cell abnormalities in CP/CPPS.