Ghurki Journal of Medical and Health Sciences
Ghurki Journal of Medical and Health Sciences (GJMHS) is a biannual, peer-reviewed, open-access journal committed to advancing research and knowledge in medical and health sciences. It publishes original research articles, review articles, current practices, and short communications across diverse disciplines, including clinical medicine, rehabilitation sciences, allied health sciences, and public health. GJMHS follows a rigorous double-blind peer-review process, ensuring academic integrity, transparency, and ethical compliance with COPE and ICMJE guidelines. With a strong editorial framework, open-access model (CC BY 4.0), and DOI-assigned articles, GJMHS aims to enhance global research visibility and facilitate impactful scientific contributions. ISSN: 3106-7360
EVALUATING THE APPREHENSION REGARDING SPEECH INTERVENTIONS FOR VELOPHARYNGEAL DYSFUNCTION AMONG SPEECH AND LANGUAGE PATHOLOGISTS
Background: Velopharyngeal dysfunction (VPD) is a complex speech disorder that poses substantial challenges for speech-language pathologists, particularly in accurate assessment, treatment planning, and interdisciplinary coordination. Despite its reported occurrence in 10–40% of individuals following cleft palate repai, limited attention has been given to the professional confidence and apprehension of clinicians managing this condition. Understanding these factors is essential, as clinician uncertainty may influence decision-making, referral patterns, and overall quality of care for individuals with VPD. Objective: This study aimed to evaluate the level and specific domains of apprehension and perceived competence among speech-language pathologists regarding speech interventions for velopharyngeal dysfunction. Methods: A cross-sectional descriptive survey was conducted among 108 practicing speech-language pathologists working in hospitals, clinics, private practices, and rehabilitation centers in Pakistan. Data were collected using a structured, self-administered questionnaire comprising demographic variables and 17 closed-ended items assessing apprehension and competence across six domains: assessment and treatment planning, articulation therapy, voice and resonance therapy, prosthetic management, surgical collaboration, and compensatory strategies. Responses were recorded on a five-point Likert scale. Descriptive statistical analysis was performed using SPSS version 20. Results: The sample was predominantly female (89.8%), with most participants having 2–5 years of clinical experience (81.5%) and holding a bachelor’s degree (83.1%). Apprehension during VPD assessment was reported at least sometimes by 84.1% of participants, while 75.3% reported similar levels of concern during treatment planning. Concerns regarding intervention effectiveness were reported often or always by 74.1% of respondents, and 73.2% reported feeling overwhelmed by the complexity of VPD. In contrast, strong confidence was observed in articulation therapy, with 43.5% always targeting specific phonemes and 50.0% consistently applying correct placement techniques. Pre- and post-surgical speech assessment was performed often or always by 76.0% of participants. Prosthetic devices were frequently used by 36.1%, while only 61.2% reported consistent confidence in overall VPD intervention knowledge, despite 76.9% believing they could manage case complexity. Conclusion: Speech-language pathologists demonstrated solid technical competence in specific intervention domains but reported substantial uncertainty regarding comprehensive VPD management and treatment outcomes. These findings highlight the need for enhanced training, structured mentorship, and stronger interdisciplinary collaboration to improve clinical confidence and optimize care for individuals with velopharyngeal dysfunction. Keywords: Cleft Palate, Clinical Competence, Professional Practice, Speech Disorders, Speech-Language Pathology, Velopharyngeal Insufficiency, Velopharyngeal Dysfunction
Cleft Palate, Clinical Competence, Professional Practice, Speech Disorders, Speech-Language Pathology, Velopharyngeal Insufficiency, Velopharyngeal Dysfunction
Copyright (c) 2025 Ayesha Rashid , Masooma Rubab, Minahl Rafiq , Madiha Maqsud https://creativecommons.org/licenses/by-nc-nd/4.0
Prevalence and Determinants of Undiagnosed Hypertension in Urban Slum Populations of Lahore Study Design: Community-based cross-sectional study
BACKGROUND: Hypertension is a leading contributor to cardiovascular morbidity and mortality, yet a significant proportion of affected individuals remain undiagnosed, particularly in socioeconomically disadvantaged urban settings. Urban slum populations are exposed to multiple risk factors while facing limited access to preventive healthcare, increasing the likelihood of prolonged undetected disease. OBJECTIVE: To determine the prevalence of undiagnosed hypertension and identify its associated determinants among adults residing in urban slum communities of Lahore, Pakistan. METHODOLOGY: A community-based cross-sectional study was conducted from March to September 2022 in selected urban slum localities of Lahore. A total of 400 adults aged ≥18 years without a prior diagnosis of hypertension were enrolled using multistage random sampling. Data on sociodemographic characteristics and lifestyle factors were collected through interviewer-administered questionnaires. Blood pressure was measured using standardized protocols with a calibrated digital sphygmomanometer. Undiagnosed hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Data were analyzed using descriptive statistics, bivariate analysis, and multivariable logistic regression. RESULTS: Undiagnosed hypertension was identified in 132 participants, yielding a prevalence of 33.0%. The prevalence increased with age, reaching 52.6% among individuals aged ≥60 years. Male gender (AOR=1.68), obesity (AOR=2.41), low physical activity (AOR=1.89), and lack of formal education (AOR=1.76) were independently associated with undiagnosed hypertension. The mean systolic and diastolic blood pressure among undiagnosed individuals were 148.9 ± 11.6 mmHg and 94.3 ± 8.7 mmHg, respectively. CONCLUSION: A substantial proportion of adults in Lahore’s urban slums had undiagnosed hypertension, underscoring missed opportunities for early detection. Community-based screening and targeted preventive interventions are essential to reduce cardiovascular risk in underserved urban populations. KEY TERMS: Community-based study, Determinants, Hypertension, Urban slums, Undiagnosed hypertension
Community-based study, Determinants, Hypertension, Urban slums, Undiagnosed hypertension
Copyright (c) 2025 Dr Malik Jazib Atta , Dr Manal Khan, Khawar Anwar, Muhammad Akmal Khan (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Impact of Structured Nursing Education on Medication Administration Errors in Public Sector Hospitals
BACKGROUND: Medication administration errors remain a major patient safety concern, particularly in public sector hospitals where high workload and limited training opportunities may compromise safe practices. Nurses play a pivotal role in medication delivery, making targeted educational strategies essential for reducing preventable errors and improving healthcare quality. OBJECTIVE: To evaluate the impact of a structured nursing education program on medication administration errors among nurses working in public sector hospitals. METHODOLOGY: A quasi-experimental pre- and post-intervention study was conducted in selected public sector hospitals in Punjab, Pakistan, between February and September 2023. A total of 104 registered nurses completed both baseline and post-intervention assessments. Medication administration errors were measured using a validated assessment tool and observational checklist covering the five rights of medication administration, dose calculation, timing, documentation, and infection control practices. The intervention consisted of a four-week structured education program delivered through interactive sessions and supervised practice. Data were analyzed using paired sample t-tests, with statistical significance set at p < 0.05. RESULTS: The mean overall medication administration error score significantly decreased from 6.74 ± 2.08 at baseline to 5.18 ± 1.86 after the intervention (p < 0.001). Significant reductions were observed across all domains, including five rights violations, dose calculation errors, timing errors, and documentation lapses. Observational findings showed marked improvements in hand hygiene compliance (64.4% to 85.6%) and correct patient identification practices (71.2% to 88.5%). CONCLUSION: Structured nursing education was effective in reducing medication administration errors and improving safe medication practices in public sector hospitals. Incorporating such programs into routine in-service training may enhance patient safety and healthcare quality in resource-limited settings. KEY TERMS: Education, Medication Errors, Nursing Education, Patient Safety, Public Hospitals, Quality Improvement, Pakistan
Education, Medication Errors, Nursing Education, Patient Safety, Public Hospitals, Quality Improvement, Pakistan
Copyright (c) 2025 Safina Youab, Gulsina Joseph , Nagina Joseph (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Effectiveness of Early Physiotherapy-Led Mobilization on Length of Hospital Stay in Post-Abdominal Surgery Patients
BACKGROUND: Prolonged immobilization after abdominal surgery is associated with delayed recovery, increased postoperative complications, and extended hospital stay. Early mobilization has emerged as a key element of enhanced recovery protocols; however, locally generated interventional evidence supporting physiotherapy-led early mobilization remains limited in Pakistan. OBJECTIVE: To evaluate the effectiveness of early physiotherapy-led mobilization on length of hospital stay and functional recovery in patients undergoing abdominal surgery. METHODOLOGY: A randomized controlled trial was conducted in tertiary care hospitals in Punjab, Pakistan, over eight months. A total of 120 adult patients undergoing abdominal surgery were randomly allocated to either an early physiotherapy-led mobilization group or a standard postoperative care group. The intervention group received structured mobilization initiated within 24 hours after surgery, while the control group received routine care. The primary outcome was length of hospital stay. Secondary outcomes included time to first ambulation, functional status assessed using the Modified Barthel Index, postoperative pulmonary complications, and pain intensity. Data were analyzed using independent sample t-tests and chi-square tests, with statistical significance set at p < 0.05. RESULTS: Patients in the early mobilization group demonstrated a significantly shorter mean hospital stay (4.1 ± 1.2 days) compared to the standard care group (6.0 ± 1.6 days; p < 0.001). Time to first ambulation was earlier in the intervention group (1.3 ± 0.4 days vs. 2.6 ± 0.7 days; p < 0.001). Functional independence at discharge was higher in the intervention group, with significantly greater Modified Barthel Index scores (p < 0.001). The incidence of postoperative pulmonary complications was lower in the early mobilization group, while pain levels at discharge were comparable between groups. CONCLUSION: Early physiotherapy-led mobilization significantly improved postoperative recovery by reducing hospital stay and enhancing functional outcomes following abdominal surgery. Integrating structured physiotherapy into routine postoperative care may support enhanced recovery and efficient healthcare delivery in resource-limited settings. KEY TERMS: Abdominal Surgery; Early Mobilization; Hospital Stay; Physiotherapy; Postoperative Care; Rehabilitation; Randomized Controlled Trial
Abdominal Surgery; Early Mobilization; Hospital Stay; Physiotherapy; Postoperative Care; Rehabilitation; Randomized Controlled Trial
Copyright (c) 2025 Dr Maleeha Fuad , Maryam Khan, Dr. Zunaira Mehdi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Clinical and Microbiological Profile of Multidrug-Resistant Urinary Tract Infections in Tertiary Care Hospitals of Punjab
BACKGROUND: Urinary tract infections are among the most common bacterial infections encountered in clinical practice. The increasing emergence of multidrug-resistant uropathogens has complicated management, particularly in tertiary care settings where patients often present with recurrent infections, comorbidities, and prior antibiotic exposure. Local data describing both clinical features and resistance patterns remain essential for guiding effective antimicrobial stewardship. OBJECTIVE: To describe the clinical characteristics and microbiological profile of multidrug-resistant urinary tract infections in tertiary care hospitals of Punjab, Pakistan. METHODOLOGY: A descriptive observational study was conducted across three tertiary care hospitals in Punjab from March to October 2022. Adult patients with culture-confirmed multidrug-resistant urinary tract infections were included. Clinical data were recorded using a structured proforma, while urine samples underwent standard culture, identification, and antimicrobial susceptibility testing according to established laboratory guidelines. Data were analyzed using appropriate descriptive and inferential statistical tests, with significance set at p < 0.05. RESULTS: A total of 385 patients were analyzed, with a mean age of 46.8 ± 15.2 years; 60.3% were female. Prior antibiotic use was documented in 69.4% of cases, and 44.4% had diabetes mellitus. Escherichia coli was the most frequently isolated organism (52.2%), followed by Klebsiella pneumoniae (24.9%) and Pseudomonas aeruginosa (12.2%). High resistance rates were observed for cephalosporins (78.4%) and fluoroquinolones (74.5%), while lower resistance was noted for carbapenems (15.8%) and nitrofurantoin (22.3%). CONCLUSION: Multidrug-resistant urinary tract infections are common in tertiary care hospitals of Punjab and are associated with significant resistance to first-line antibiotics. These findings emphasize the need for routine culture-based diagnosis and locally informed antimicrobial stewardship strategies. KEY TERMS: Antimicrobial Resistance; Carbapenems; Multidrug Resistance; Pakistan; Tertiary Care Hospitals; Urinary Tract Infections; Uropathogens
Antimicrobial Resistance; Carbapenems; Multidrug Resistance; Pakistan; Tertiary Care Hospitals; Urinary Tract Infections; Uropathogens
Copyright (c) 2025 Dr Maryam Shakoor , Hina Shakor, Kashaf Shakoor , Abdullah Ali Khan, Dr Syeda Maimona Tahira, Dr Rubab Vaseer (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Association Between Vitamin D Deficiency and Musculoskeletal Pain Severity Among Female Office Workers in Islamabad
BACKGROUND: Musculoskeletal pain is a frequent occupational health concern among office workers, particularly women engaged in prolonged sedentary work. Vitamin D deficiency is highly prevalent in South Asian populations and has been implicated in musculoskeletal dysfunction and pain. However, evidence exploring this association from an occupational health perspective in Pakistani female office workers remains limited. OBJECTIVE: To determine the association between vitamin D deficiency and musculoskeletal pain severity among female office workers in Islamabad. METHODOLOGY: An analytical cross-sectional study was conducted among 355 female office workers recruited from public and private sector workplaces in Islamabad between March and October 2022. Serum 25-hydroxyvitamin D levels were measured using chemiluminescence immunoassay and categorized as deficient, insufficient, or sufficient. Musculoskeletal pain severity was assessed using the Numeric Pain Rating Scale. Descriptive statistics were used to summarize participant characteristics. Differences in pain severity across vitamin D status groups were analyzed using one-way analysis of variance. Pearson’s correlation and multivariate linear regression analyses were performed to examine the association between vitamin D levels and pain severity while adjusting for relevant covariates. RESULTS: Vitamin D deficiency was identified in 69.6% of participants, with a mean serum level of 17.9 ± 6.8 ng/mL. The overall mean pain score was 5.9 ± 1.8. Participants with vitamin D deficiency reported significantly higher pain scores (6.8 ± 1.4) compared with those with insufficient (5.2 ± 1.3) and sufficient levels (3.6 ± 1.1) (p < 0.001). A significant negative correlation was observed between serum vitamin D levels and pain severity (r = –0.61, p < 0.001). Vitamin D level remained an independent predictor of pain severity after adjustment for confounding variables. CONCLUSION: Vitamin D deficiency was strongly associated with increased musculoskeletal pain severity among female office workers. These findings underscore the importance of incorporating vitamin D assessment into occupational health and rehabilitation strategies for sedentary female populations. KEY TERMS: Ergonomics; Musculoskeletal Pain; Occupational Health; Office Workers; Pain Measurement; Vitamin D Deficiency; Women
Ergonomics; Musculoskeletal Pain; Occupational Health; Office Workers; Pain Measurement; Vitamin D Deficiency; Women
Copyright (c) 2025 Dr Sughra Shakoor , Mohsin Raza , Dr Saqlain Abbass , Fouzia Batool (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
IMPACT OF MUSIC THERAPY IN ENHANCING SPEECH AND LANGUAGE SKILLS IN CHILDREN WITH AUTISM SPECTRUM DISORDER: SLP AND OT PERSPECTIVES
Background: Autism Spectrum Disorder (ASD) is characterized by persistent impairments in social communication, interaction, and adaptive functioning, requiring early and multidisciplinary interventions. Music therapy has emerged as a complementary approach due to its structured, rhythmic, and engaging nature, which may support communication, social participation, cognitive processing, and motor coordination in children with ASD. Despite growing clinical use, limited evidence exists regarding how rehabilitation professionals perceive its effectiveness within routine practice, particularly from speech-language pathology and occupational therapy perspectives. Objective: To examine the perceptions of speech-language pathologists (SLPs) and occupational therapists (OTs) regarding the effects of music therapy on communication, social interaction, cognitive abilities, and motor skills in children with ASD. Methods: A cross-sectional quantitative survey was conducted over six months in rehabilitation settings across Lahore, Pakistan. A total of 155 professionals participated, including 133 SLPs (85.8%) and 22 OTs (14.2). Data were collected using a modified Music Therapy Assessment Tool assessing five domains: communication, musical engagement, cognitive skills, social interaction, and motor abilities. Participants rated observed child responses during music therapy sessions using a frequency-based scale ranging from “never” to “always.” Descriptive statistics were analyzed using SPSS version 20. Results: Positive engagement was reported across multiple domains. Eye contact was observed sometimes by 48.4% of respondents and often by 22.6%. Expression of personal needs occurred sometimes in 51.0%, while direction following was reported sometimes by 53.5%. Musical engagement was notable, with singing in pitch occurring sometimes in 46.5% and often in 27.1%. Melody recall was reported often by 36.8%, and adaptation to volume changes occurred sometimes in 45.2%. Social participation improved, with group engagement reported often in 36.1% and sharing instruments sometimes in 38.1%. Motor participation, including clapping and movement imitation, was frequently observed. Conclusion: Music therapy was perceived as an effective complementary intervention for enhancing social communication, rhythmic engagement, and motor participation in children with ASD. While complex verbal skills remained challenging, the findings supported the integration of music therapy within multidisciplinary rehabilitation programs involving SLPs and OTs. Keywords: Autism Spectrum Disorder, Child Development, Music Therapy, Occupational Therapy, Rehabilitation, Social Communication, Speech-Language Pathology
Autism Spectrum Disorder, Child Development, Music Therapy, Occupational Therapy, Rehabilitation, Social Communication, Speech-Language Pathology
Copyright (c) 2025 Syeda Khushbakht Hashmi, Masooma Rubab, Madiha Maqsud , Emaan Khadim, Maha Ilahi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
ENHANCING KNOWLEDGE TOWARDS INSULIN ADMINISTRATION AND STORAGE THROUGH BROCHURE-BASED LEARNING AMONG DIABETIC PATIENTS IN LAHORE
Background: Insulin is classified as a high-alert medication, and improper administration or storage can result in serious complications such as lipohypertrophy, injection-site pain, hypoglycemia, and poor glycemic control. Evidence from international literature consistently indicates that diabetic patients often possess inadequate knowledge regarding correct insulin handling, injection techniques, and storage conditions. In resource-limited settings, gaps in structured patient education further exacerbate these issues, emphasizing the need for simple, standardized, and accessible educational strategies to improve safe insulin use. Objective: The objective of this study was to assess baseline knowledge of diabetic patients regarding insulin administration and storage and to evaluate the effectiveness of a structured brochure-based educational intervention in improving this knowledge. Methods: A quantitative, one-group quasi-experimental pre-test/post-test study was conducted in diabetic centers and hospital settings in Lahore. Adult patients with type 1 or type 2 diabetes receiving insulin therapy were enrolled using convenience sampling. A pilot-tested, pre-validated questionnaire consisting of 14 items assessed knowledge before and after the intervention. A structured educational brochure covering insulin administration, injection techniques, site rotation, storage, and travel precautions was used. Data from 252 participants (124 insulin pen users and 128 vial–syringe users) were analyzed using SPSS. Non-parametric tests, including Wilcoxon signed-rank, Mann–Whitney U, and Kruskal–Wallis tests, were applied. Results: Post-intervention analysis demonstrated a statistically significant improvement in overall insulin-related knowledge (p < 0.001). Improvement was observed in 233 of 252 participants for general knowledge, 108 of 128 syringe users, and 95 of 124 pen users (p < 0.001 for all). The largest gains were noted in practices related to injection-site preparation and single-use needle replacement. Duration of insulin therapy showed a significant association with general knowledge scores, with patients using insulin for less than one year achieving higher scores (p < 0.05). Conclusion: Brochure-based educational intervention significantly improved patients’ knowledge regarding insulin administration and storage. Incorporating structured, patient-centered educational materials into routine diabetes care may enhance safe insulin practices and support better long-term disease management. Keywords: Diabetes Mellitus, Health Education, Insulin, Medication Adherence, Patient Education, Self-Management, Treatment Outcome
Diabetes Mellitus, Health Education, Insulin, Medication Adherence, Patient Education, Self-Management, Treatment Outcome
Copyright (c) 2025 Javeria Javed, Hajira Durani, Eman Tayyab, Laiba Ali, Javeria Naheed (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
STRUCTURED EDUCATION FOR TYPE 1 DIABETES UNDERSTANDING IN PAKISTAN (SETUP)
Background Type 1 diabetes mellitus is a lifelong condition requiring continuous education, self-management, and psychosocial support to achieve optimal outcomes. In Pakistan, the absence of nationally standardized epidemiological data, limited access to specialist care, and widespread cultural myths contribute to suboptimal disease understanding and management. International structured education programs exist, but they are often poorly aligned with local dietary practices, sociocultural beliefs, and health literacy levels. This gap underscores the need for a locally relevant, evidence-based education framework tailored to the Pakistani context. Objective To develop, implement, and evaluate the feasibility and educational impact of a locally tailored structured education curriculum for people living with type 1 diabetes in Pakistan. Methods A multidisciplinary team developed an evidence-based structured education curriculum, Structured Education for Type 1 Diabetes Understanding in Pakistan (SETUP), adapted from international guidelines and refined through local needs assessment and expert peer review. The curriculum was produced in English and Urdu. Curriculum-based interactive workshops were conducted in Islamabad, Lahore, and Karachi. Individuals with type 1 diabetes were enrolled through community networks. Structured pre- and post-session questionnaires and module-wise feedback forms were used to assess changes in participant knowledge and perceived understanding. Results A total of 180 individuals with type 1 diabetes participated in the workshops, including 64 from Islamabad, 55 from Lahore, and 61 from Karachi. Most participants were accompanied by a parent or sibling, extending education to family members. Post-session feedback demonstrated consistent improvement in participant knowledge across all core domains, including dietary management, basic carbohydrate counting, hypoglycaemia recognition, and sick-day rules with diabetic ketoacidosis awareness. High acceptability and engagement were reported across all sites. Conclusion SETUP proved to be a feasible and well-accepted structured education initiative that effectively improved knowledge among people living with type 1 diabetes in Pakistan. The program offers a scalable, culturally appropriate model for national diabetes education and peer support, with future evaluation planned to assess long-term clinical outcomes. Keywords: Diabetes Education, Diabetes Mellitus Type 1, Pakistan, Peer Support, Quality of Life, Self-Management, Structured Education
Diabetes Education, Diabetes Mellitus Type 1, Pakistan, Peer Support, Quality of Life, Self-Management, Structured Education
Copyright (c) 2025 Dr Atif Munir , Anum Anwer, Dr Sana Ajmal (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
SLEEP QUALITY AND PHYSICAL ACTIVITY AMONG ADULTS WITH HYPERTENSION: A CROSS-SECTIONAL SURVEY
BACKGROUND: Hypertension is a leading global health concern associated with increased risk of cardiovascular morbidity and mortality. Lifestyle factors such as physical activity and sleep quality play an essential role in disease management, yet little evidence exists from the local context of Pakistan. This study aimed to assess sleep quality and physical activity and explore their association among adults with hypertension. OBJECTIVE: to assess sleep quality and physical activity and explore their association among adults with hypertension. METHODOLOGY: A cross-sectional online survey was conducted between January and June 2023 among adults diagnosed with essential hypertension for at least three months. Participants provided electronic informed consent and completed a structured questionnaire, which included demographic information, the International Physical Activity Questionnaire (IPAQ) to assess physical activity levels, and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Descriptive statistics summarized participant characteristics, while chi-square test examined associations between physical activity and sleep quality. A p-value of <0.05 was considered statistically significant. RESULTS: A total of 422 participants were included in the analysis. The mean age was 51.2 ± 8.5 years, and 52.1 % were male. Poor sleep quality (PSQI > 5) was reported by 63.5% of respondents, with a mean PSQI score of 7.2 ± 4.3. Based on IPAQ scoring, 36.7% reported low physical activity, 44.7% moderate, and 19.1% high activity. CONCLUSION: Poor sleep quality was highly prevalent among hypertensive adults and was significantly associated with lower physical activity levels. Promotion of physical activity should be emphasized as a non-pharmacological strategy to improve sleep and overall management of hypertension. KEY TERMS: Hypertension, Sleep Quality, Physical Activity, Cross-Sectional Study
Hypertension, Sleep Quality, Physical Activity, Cross-Sectional Study
Copyright (c) 2025 Farah Niaz Awan, Muhammad Adil , Ali Hamza Arshad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
IMPACT OF ROBOT – ASSISTED GLOVE HAND TRAINING ON FINE AND GROSS MOTOR FUNCTION. RECOVERY AND DAY-TO-DAY FUNCTIONAL TASKS IN POST-MEDIAN NERVE REDIRECTION INDIVIDUALS: A NOVEL RECOVERY THERAPY APPROACH
BACKGROUND: Selective nerve transfers involve rerouting healthy nerves to restore lost motor function, whereas robot-assisted upper-limb therapy provides structured rehabilitation for patients recovering from neurological damage. Robotic systems deliver controlled, accurate movement assistance and interaction, and over the past twenty years have demonstrated rehabilitation results comparable to those achieved through conventional therapy. OBJECTIVE: To evaluate the impact of robotic-glove–assisted hand training on fine and gross motor skills and daily functional performance in patients post median nerve transfer using a quasi-experimental approach. METHODOLOGY: A quasi-experimental study was conducted at Ghurki Trust Teaching Hospital, Lahore, over six months with 36 patients post median nerve transfer. Participants were divided into Group A (Robot Group, n = 18) receiving soft robotic glove therapy and Group B (Control Group, n = 18) undergoing conventional hand exercises. Functional outcomes were assessed using the Soller man Hand Function Test, Jebsen–Taylor Hand Function Test, Pegboard Dexterity Test, and Barthel Index. Propensity Score Matching (PSM) minimized baseline differences, and statistical analyses were performed in SPSS v25, including normality checks via the Shapiro–Wilk test. RESULTS: Both groups showed improvements in hand function and dexterity. The Robot Group improved in the Jebsen–Taylor Test from 85.60±17.02 to 74.53±17.01 (p = 0.000) and in the Sollerman Test from 34.20±7.66 to 45.33±7.73 (p = 0.000). The Control Group also improved, albeit to a lesser extent. Pegboard Dexterity scores increased in the Robot Group from 29.53±4.48 to 40.60±4.34 (p = 0.000) and in the Control Group from 29.20±4.82 to 33.26±4.81 (p = 0.000). CONCLUSION: Combining conventional hand therapy with robotic-glove rehabilitation significantly enhances fine motor performance, hand function, and daily living activities in patients following median nerve transfer. While random assignment was not employed, statistical matching strengthens the validity of results, supporting robot-assisted therapy as an effective post-surgical intervention. KEY WORDS: Hand Rehabilitation, Nerve Transfer Rehabilitation, Robotic Glove, Quasi-Experimental Study.
Hand Rehabilitation, Nerve Transfer Rehabilitation, Robotic Glove, Quasi-Experimental Study.
Copyright (c) 2025 Ayesha Kousar, Sabiha Arshad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
ASSESSING VISUAL PERCEPTION IN CHILDREN WITH DIFFERENT TYPES OF CEREBRAL PALSY
BACKGROUND: Cerebral palsy is a condition of neurodevelopmental disabilities that affects movement and often occurs with deficits in visual perception. This paper explores how children with several types of cerebral palsy—spastic, dyskinetic, and ataxic—were evaluated using the Barry Visual-Motor Integration Test and its three subtests regarding visual perception, motor coordination, and combined visuomotor integration. OBJECTIVE: To determine assessing visual perception in children with several types of cerebral Palsy. METHODOLOGY: The study was cross-sectional in design and conducted over a period of six months among 150 children aged 3 to 15 years at PSRD School and Children's Hospital, Lahore. Structured, purposive sampling ensured a representative cohort for all CP subtypes, including children with varying degrees of motor impairment. RESULTS: The results indicate a variety of visual perception problems across all types of CP. Spastic CP manifested in the loss of depth perception and spatial orientation, seriously impairing the daily abilities. In the case of dyskinetic CP, visuomotor integration was impeded by involuntary movements, while object tracking and spatial awareness were diminished in the case of ataxic CP. The varying degrees of these deficits appear in various VMI indexes: spastic CP was measured at a mean value 80.03, ataxic at 77.23, and dyskinesia at 82.31. Cognitive performance also varied in the study, with individuals having dyskinetic CP showing slightly better results. Therefore, the variability of results indicates the complex interplay of motor, visual, and cognitive impairments in CP. CONCLUSION: It is concluded that visual perception deficits have a significant impact on functional and social outcomes in children with CP. The study recommends the widespread use of individualized rehabilitation plans, improved diagnostic tools such as the Visual Function Classification System (VFCS), and virtual reality-based interventions. Future studies should aim to be more longitudinal, thus allowing them to monitor long-term consequences and address the least understood subtypes like ataxic and dyskinetic CP so that they may better direct treatment modalities for enhancing quality of life of a child with CP. KEY TERMS: Visual Perception, Spastic, Dyskinetic and Ataxic Cerebral Palsy.
Visual Perception, Spastic, Dyskinetic and Ataxic Cerebral Palsy.
Copyright (c) 2025 Muqadas Paracha, Ramma Inam, Maleeha Fuad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
THE RELATIONSHIP BETWEEN BURNOUT AND WORK LIFE BALANCE IN OCCUPATIONAL THERAPISTS AND SPEECH THERAPISTS WORKING WITH PEDIATRIC POPULATION
BACKGROUND: Burnout is a syndrome as hypothesized resulting from chronic workplace stress that has not managed successfully. It is characterized by three extents; emotional exhaustion, depersonalization, reduced personal accomplishment. Work–life balance is essential for health care professionals to prevent burnout, maintain mental and physical health, and deliver high-quality patient care. OBJECTIVE: To find out the relationship between burnout and work life balance in occupational therapists and speech therapists working with pediatric population. METHODOLOGY: It was a Cross-sectional Study. Non-Probability Convenient sampling technique used. The sample size was 70. The duration of the study was 6 months. Maslach Burnout Inventory and Life Balance Inventory were the questionnaires used to assess burnout and work life balance. RESULTS: The total number of participants was 70 in which occupational therapists were 35 (50%) and others were speech therapists (50%) as shown in Table 3. Participant’s gender division showed that there were more females (88.6%) than males (11.4%) as shown in Table 2. The frequency and percentage distribution of burnout levels across three dimensions: emotional exhaustion, depersonalization, and personal achievement. Emotional exhaustion shows the majority (47.1%) experiencing low-level burnout, while high burnout is minimal (11.4%). Depersonalization is highest at the high-level burnout stage (41.4%). Personal achievement exhibits the highest proportion (62.9%) with low-level burnout, indicating a stronger sense of accomplishment among the majority as shown in Table 4, 5&6. There is no significant relationship observed between OTs and STs in relation to burnout and work life balance with X2-value 0.79 because the two groups showed similar rates of burnout. CONCLUSION: Concluded from present study that there is no significant relationship observed between the occupational therapists and speech therapists in relation to burnout and work-life balance. KEY TERMS: Burnout, Occupational therapists, Pediatric population, Speech therapists, Work life balance.
Burnout, Occupational therapists, Pediatric population, Speech therapists, Work life balance.
Copyright (c) 2025 Fahad Farooq, Ramma Inam, Ambreen Sadaf, Kashaf Saleem, Muizz-Ul-Hassan https://creativecommons.org/licenses/by-nc-nd/4.0
PERCEIVED BARRIERS AND FACILITATORS TO PHYSICAL ACTIVITY AMONG POSTGRADUATE MEDICAL TRAINEES
BACKGROUND: Postgraduate medical trainees face unique internal and external challenges affecting physical activity, including time constraints, fatigue, and limited access to facilities. Conversely, factors such as social support, structured opportunities, and incentives can facilitate exercise. Understanding these influences is critical for promoting active lifestyles in this population. OBJECTIVE: To determine perceived barriers and facilitators to physical activity among postgraduate medical trainees in Pakistan. METHODS: A descriptive cross-sectional online survey was conducted from January–March 2024 among postgraduate medical trainees enrolled in accredited programs. Data were collected via a self-administered questionnaire distributed through WhatsApp and Facebook groups. Physical activity levels were assessed using the WHO Global Physical Activity Questionnaire (GPAQ) and categorized into low, moderate, or high activity. The minimum sample size was 267, calculated using a 95% confidence level and 6% margin of error. Descriptive statistics were analyzed using SPSS v23. RESULTS: Of 267 respondents, 44.9% were male and 55.1% female; the majority specialized in medicine (33.7%) and was in Year 1 of training (31.8%). Physical activity levels were low in 44.9%, moderate in 41.2%, and high in 13.9%. Major barriers included lack of time (mean 2.42±0.92), exercise facilities with incompatible schedules (2.44±0.99), and physical fatigue (2.37±0.95). Key facilitators were social encouragement, workplace flexibility, and access to affordable exercise facilities. CONCLUSION: Nearly half of postgraduate medical trainees reported low physical activity, with time constraints and fatigue as primary barriers. Targeted interventions, including flexible scheduling, accessible facilities, and peer support, are essential to foster sustainable physical activity habits in this group. KEYWORDS: Barriers, Facilitators Physical Activity, Lifestyle habits, Medical
Barriers, Facilitators Physical Activity, Lifestyle habits, Medical
Copyright (c) 2024 Ayesha Javed, Muhammad Sohaib Azeem, Nousheen Azam (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
INVESTIGATING THE NUTRITIONAL STATUS OF THE PATIENTS SUFFERING FROM CHRONIC LIVER DISEASE
BACKGROUND: Chronic liver disease (CLD) is a global health issue, contributing significantly to morbidity and mortality, arising from various causes, including viral hepatitis, alcohol misuse, autoimmune disorders, genetic factors, and toxin exposure. OBJECTIVE: This study aimed to evaluate the nutritional status of CLD patients. METHODOLOGY: A cross-sectional design was employed with 208 participants aged 20–45 years at Ghurki Trust Teaching Hospital, Lahore. Simple random sampling was used for participant recruitment, and data were collected using demographic questionnaires, anthropometric measurements (BMI), the International Physical Activity Questionnaire (IPAQ), a Food Frequency Questionnaire (FFQ), the Chronic Liver Disease Questionnaire (CLDQ) for quality of life (QoL), and the Mini Nutritional Assessment (MNA) for malnutrition status. SPSS was used for analysis, with p<0.05 as the significance threshold. RESULTS: The study found that most participants were aged 36–40 years, with an equal gender distribution. Females had poorer Quality of Life (QoL) than males. Physical activity and BMI showed no significant correlation with QoL, and half of the participants had a healthy weight. Dietary habits indicated balanced intake, with daily consumption of dairy, fruits, vegetables, meat, and tea, and cereals and oils consumed 2–3 times daily. The malnutrition indicator score revealed most patients were at risk of malnutrition. Malnutrition status was linked to BMI, QoL, and intake of cereals, dairy, fruits, and red meat, but not vegetables, vegetable oil, or tea. Further research on nutritional interventions is needed. CONCLUSION: The study involved 36-40-year-olds, with equal gender distribution. Females reported poorer Quality of Life compared to males. Most had a healthy weight, and daily consumption of dairy, fruits, vegetables, meat, and tea. Malnutrition was associated with BMI, QoL, cereal intake, dairy, fruits, and meat. Further research on targeted nutritional interventions is recommended to improve QoL in this group. KEY TERMS: Chronic liver disease, CLD, Nutritional status, Quality of Life, QOL, Dietary habits, BMI, Physical activity level.
Chronic liver disease, CLD, Nutritional status, Quality of Life, QOL, Dietary habits, BMI, Physical activity level.
Copyright (c) 2024 Ayesha Shabir , Andleeb Shakoor, Aroosha Saif, Sana Siddique (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
ATTITUDE OF UNDERGRADUATE MEDICAL STUDENTS TOWARDS USING SOCIAL MEDIA FOR LEARNING PURPOSES AT LAHORE MEDICAL & DENTAL COLLEGE, PAKISTAN
BACKGROUND: With the advent of the Internet, particularly Web 2.0 technologies, the learning paradigm shifted from a top-down method centered on academicians and knowledge to a networked one. Social media is a broad word that refers to a number of web-based technologies that allow users to contribute, share, and collaborate. They provide innovative and diverse educational opportunities for learning as well as teaching. To keep the pace with the knowledge and information explosion in constantly evolving medical world, the social media keeps its users abreast OBJECTIVE: To determine the attitude of undergraduate medical students towards using social media for learning purposes. MATERIALS & METHODS: A descriptive cross-sectional study was conducted opting non-probability convenient sampling. 333 students from Lahore medical & dental college, Lahore participated who had an internet enabled devices and profiles on different social media platforms. Statistical package for social sciences (SPSS) software was used for data entering and analysis. And the attitude was assessed by utilizing a standardized self-reported questionnaire. RESULTS: The mean ± SD of age was 21 ± 1.78. The social media platforms with which the students had the best learning experiences were WhatsApp (64.3%), Instagram (45.9%), Facebook (28.8%), YouTube (21.6%), Wikipedia (19.8%) and Twitter (7.2%). Out of 333 participants, 77.7% (n=259) students had positive attitude and 22.2% (n=74) students had negative attitude towards using social media for learning purposes. CONCLUSION: Undergraduate students from all medical disciplines reported to have positive attitudes towards use of social media for learning purposes. They find it convenient for academic purposes. The most popular and preferred social media platforms for academic learning were Facebook, WhatsApp, and YouTube. KEY TERMS: Attitude, Benefits, Learning purposes, Medical students, Social media
Attitude, Benefits, Learning purposes, Medical students, Social media
Copyright (c) 2024 Maryam Zaffar, Ayesha Kousar, Imbisat Abaid (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
ASSOCIATED RISK FACTORS OF VITAMIN D DEFICIENCY IN RURAL COMMUNITIES OF LAHORE, PAKISTAN
Background: Vitamin D deficiency is a global health concern linked to bone disorders, cardiometabolic diseases, autoimmune conditions, and certain cancers. Despite abundant sunlight, South Asian populations, including Pakistan, have high deficiency rates due to limited sun exposure, cultural practices, and dietary insufficiency. This study aimed to determine the prevalence of severe vitamin D deficiency and its associated risk factors among the rural population of Lahore, Pakistan. Methods: An analytical cross-sectional study was conducted from December 2023 to June 2024 in rural areas of Lahore. A total of 800 adults (≥18 years) with confirmed vitamin D deficiency (serum 25(OH)D <20 ng/mL) were recruited from outpatient clinics, primary health units, and laboratory collection sites. Data on demographics, sun exposure, and anthropometric measures were collected. Severe deficiency was defined as <10 ng/mL. Frequencies and percentages summarized participant characteristics, and associations between risk factors and severe deficiency were assessed using chi-square tests and multivariable logistic regression. Results: Of 800 participants, 65.0% were female, and the largest age group was 40–59 years (41.0%). Most (82.0%) were married, and 33.0% worked outside the home. Sun exposure was limited, with 68.6% reporting <1 hour per week; sunscreen use was minimal (3%). Overweight and obesity affected 38.3% and 59.5% respectively. In adjusted analysis, <1 hour of sun exposure per week was associated with more than double the odds of severe deficiency (aOR = 2.38; 95% CI: 1.68–3.38). Obesity (aOR = 1.61; 95% CI: 1.05–2.45) and abdominal obesity in women (aOR = 1.68; 95% CI: 1.10–2.58) were also significant predictors. Conclusion: Severe vitamin D deficiency is highly prevalent among rural residents of Lahore and is strongly associated with low sun exposure, obesity, and abdominal obesity. Public health strategies promoting safe sunlight exposure, culturally appropriate behavioral changes, and targeted supplementation programs are urgently needed to mitigate the health burden in these communities. Keywords: Risk Factors, Rural areas, Vitamin D Deficiency
Risk Factors, Rural areas, Vitamin D Deficiency
Copyright (c) 2024 Dr Syed Muneedb Gillani, Shanawar Hayat , Aiza Ali, Dr Muhammad Arif (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
THE JOURNEY TO PAKISTAN'S FIRST DEDICATED AND LEADING ORTHOPEDIC & SPINE CENTER
"And whoever fears Allah - He will make for him a way out. And will provide for him from where he does not expect. And whoever relies upon Allah - then He is sufficient for him" With this Qur’anic promise as a reminder of faith and reliance on Allah, the journey of Ghurki Trust Teaching Hospital stands as a testament to dedication and service. Laid in 1994 by Abdul Sattar Edhi and formally opened in 2002, the hospital has grown steadily, introducing major developments such as Pakistan’s first Spine and Orthopaedic Center, upgraded Paediatric and Emergency Departments, and modern Modular Theaters. The establishment of the Spine Center reflects years of perseverance, collaboration, and training in advanced spine techniques, supported by international partnerships and the integration of minimally invasive surgery, advanced imaging, and navigation technologies. A multidisciplinary team of surgeons, radiologists, pain specialists, and physiotherapists now provides comprehensive care ranging from conservative treatment to complex procedures and rehabilitation. The center has trained over 200 FCPS orthopedic surgeons and welcomed fellows from 16 countries, contributing to the growth of spine care nationally and internationally. Moving forward, the vision is to strengthen excellence, education, and innovation while ensuring that advanced spinal and orthopaedic care remains accessible to all, in line with the humanitarian values upon which the hospital was founded. Keywords: Clinical Innovation, Healthcare Infrastructure Pakistan, Minimally Invasive Spine Surgery, Orthopedic Surgery, Pain Management, Spine Center
Clinical Innovation, Healthcare Infrastructure Pakistan, Minimally Invasive Spine Surgery, Orthopedic Surgery, Pain Management, Spine Center
Copyright (c) 2024 Prof. Amer Aziz (Author) https://creativecommons.org/licenses/by-nc-nd/4.0