ObjectiveTo produce a strategic roadmap for supporting the development of dementia research in Pakistan.BackgroundWhile global research strategies for dementia research already exist, none is tailored to the specific needs and challenges of low- and middle-income countries (LMIC) like Pakistan.MethodsWe undertook an iterative consensus process with lay and professional experts to develop a Theory of Change-based strategy for dementia research in Pakistan. This included Expert Reference Groups (ERGs), strategic planning techniques, a “research question” priority survey, and consultations with Key Opinion Leaders.ResultsWe agreed on ten principles to guide dementia research in Pakistan, emphasizing pragmatic, resource sparing, real-world approaches to support people with dementia, both locally and internationally. Goals included capacity/capability building. Priority research topics included raising awareness and understanding of dementia, and improving quality of life.ConclusionThis roadmap may be a model for other LMIC health ecosystems with emerging dementia research cultures.
Introduction: Deaths-related to medications errors are common in Pakistan but these are not accurately reported. Recently, the death of a 9 months old baby due to abrupt administration of 15% potassium chloride injection sparked the issue of high alert medications (HAMs) related errors in the country. Since drug administration is the prime responsibility of the nurses, it is pivotal that they possess good knowledge of HAMs. Since there is no published data regarding the knowledge of HAMs among Pakistani nurses, we aimed to assess knowledge of HAMs among registered nurses of Pakistan. Methods: A cross-sectional study was conducted among registered nurses, recruited using a convenient sampling technique, from 29 hospitals all over the Punjab Province. Data were collected using a validated self-administered instrument. All data were entered and analyzed using SPSS version 22. Results: The study sample was comprised of 2,363 registered nurses (staff nurses = 94.8%, head nurses = 5.2%). Around 63% were working in tertiary hospitals whereas almost 25 and 12% were from district headquarter hospitals and tehsil headquarter hospitals, respectively. Around 84% of the study participants achieved scores <70%, indicating majority of Pakistani nurses having poor knowledge of HAMs administration as well as regulation. There was no significant difference of overall knowledge among age, hospitals, departments, training, designations, qualification, and experience categories. Major obstacles encountered during HAMs administration were "getting uncertain answers from colleagues" (72.9%), "unavailability of suitable person to consult" (61.1%) and "receiving verbal orders" (55.6%). Conclusion: Our study revealed the serious inadequacies in HAMs knowledge among Pakistani nurses which may lead to adverse patient outcomes. Nurses should receive
Background: Iron deficiency anemia afflicts masses of all ages, worldwide. The disease tends to be prominent in the adolescence, students being more vulnerable due to their dynamic lifestyle, dietary habits and demanding growth spurt. Use of iron supplements can greatly reduce the burden of disease and associated morbidity. The objective of this study was to estimate the prevalence of anemia and use of iron supplements in MBBS students of CMH Medical College, Lahore. Methods: A cross sectional study was conducted in CMH Medical College, Lahore. A predesigned questionnaire was used to obtain information regarding use of iron supplements. Afterwards, hemoglobin level was measured using conventional Sahli’s method. The collected data was analyzed with SPSS 25 software. Results with p value < 0.05 were taken as significant. Results: Mean hemoglobin level was found to be 14.3±1.3 g/dL in males and 11.6±1.4 g/dL in females. Prevalence of anemia was found to be 38.7%. Anemia was found to be more prevalent in female students (57.8%) as compared to the male students (14.9%). Difference between prevalence of anemia in hostellites and day scholars was not found to be statistically significant (p = 0.17). Frequency of anemia was observed to be significantly higher in students who did not use oral iron supplements (p=0.03). Conclusion: Iron deficiency anemia is more common in female students than male students, of CMH Medical College Lahore. Majority of the anemic students do not take oral iron supplements. There is no difference in the prevalence of anemia among hostellites and day scholars. MeSH words: anemia, hemoglobin, iron supplements
Violence against physicians has been considered a significant issue in Pakistan. Objective: This study was conducted to explore the need for specific policy-related responses to patient-physician violence in the hospitals of Pakistan. Methods: A qualitative study was conducted in the hospitals of Pakistan, by using in-depth interviews. A total of 40 participants were selected out of which ten were in-depth interviews with patients, ten in-depth interviews with their families, ten in-depth interviews with physicians, and ten in-depth interviews with the administrative staff. In-depth interviews were recorded and then transcribed. The responses of the participants were coded with the help of thematic analysis. Results: The results of the study revealed that three main themes were derived through thematic analysis. The cause is multi-factorial. The employees of the health sector were asked to build revenue without taking care of patients' needs. In the east, no training is provided to physicians regarding how to prevent violence. Patient-physician violence leads to various disputes as a result of which verbal and physical abuse is observed towards physicians. Conclusion: The financial stress at hospitals to increase revenue has ruined the patient-physician relationship leading to violence. Certain policies should be developed for the security of physicians. The low literacy rate among patients is also one of the major contributing factors. Communicating strategies should be developed to prevent patient-physician violence.
BACKGROUND AND AIM Stroke is currently the second leading cause of death and third main cause of disability throughout the world. Around 75% of stroke survivors suffered from upper limb dysfunction with limited functional activities whereas distal parts of upper extremity such as hand and forearm are mostly affected by stroke. Therefore, this study aims to determine the benefits of TENS along with conventional Occupational therapy in the rehabilitation of stroke patients to ascertain the optimal recovery of hand function. METHODOLOGY A Single-blind Randomized Controlled Trial was conducted on 76 individuals with acute phase or one-year history post-stroke. Group-A (n=38) received Low Frequency Transcutaneous Electrical Nerve Stimulation on elbow and wrist extensors (3 Hz, 400 μs)along with conventional Occupational therapy while Group-B (n=38) received conventional Occupational therapy only. Both the groups received intervention for 5 days/week of duration 45 minutes till 3 weeks. RESULTS Group-A showed significant improvement in means scores of FMA-UE and ARAT (p<0.05) in comparison to Group-B which showed moderate improvements in sensorimotor and activity capacity of hand function. CONCLUSION Conventional therapy along with TENS significantly improved the hand function in acute stroke patients as compared to the conventional therapy.
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