Journal of Gandhara Nursing and Allied Health Sciences

Comparison of Elisa and ICT for the Detection of Hbsag among Blood Donors in Tertiary Care Hospital Peshawar

Imad Ali — 2024-09-30

OBJECTIVES

This study aimed to compare the analytical sensitivity of an ELISA approach with a fast kit in identifying HBV infection in blood donors.

METHODOLOGY

This study used a cross-sectional design. Using the Rapid screening test kit, the ELISA approach was used to re-test 250 blood donor samples that had tested negative. 250 of 250 blood donor samples were analysed that were negative by fast test (ICT) but positive by ELISA method. Each blood sample was tested for HBsAg using both ELISA and ICT techniques. The blood was drawn, processed, and tested according to standard procedures, with serum separated via centrifugation and analyzed using the ICT kit initially, followed by confirmation through ELISA, employing the CMIA principle on the ARCHITECT i1000SR immunoassay analyzer.

RESULTS

The target variables hepatitis B surface antigen (HBsAg) were determined by ELISA. Out of 250 samples, 250 were negative by the ICT method whereas positive by the ELISA method. ELISA demonstrates a higher sensitivity of 95.12% compared to ICT’s sensitivity of 92%. Additionally, ELISA exhibits greater specificity at 99.82% compared to ICT's 97%. The positive predictive value (PPV) for ELISA and ICT is 94% and 93%, respectively, while the negative predictive value (NPV) is 99% for ELISA and 96% for ICT. Overall accuracy is higher for ELISA at 97.6% compared to ICT's 94.6%.

CONCLUSION

ELISA is reliable for detecting HBsAg in blood donors and is better than fast kits in determining hepatitis B virus infection.

A Comparative Study on Work-Life Quality among Nurses at Public and Private Sector Tertiary Care Hospitals of Peshawar

Ayaz Ul Haq — 2024-09-30

OBJECTIVES

The objective of this study was to assess the quality of nurses' work-life in public and private sector hospitals and to compare the quality of nurses' work-life in public and private hospitals.

METHODOLOGY

The research was done at KTH and RMI Peshawar with a cross-sectional study design. From 218 participants pretested and structured Brooks nurse's quality of work-life questionnaire was filled. Data entered in SPSS for categorical variables' frequency and percentages were done while for continuous variables mean and standard deviation were done.

RESULTS

A total of 218 nurses from RMI and KTH Peshawar participated in the research with a mean age of 28.47 and a standard deviation of 6.41. A major portion of the sample i.e. 80.3% have moderate QNWL, 18.8% have high QNWL, while less than 1% of the sample has low QNWL. The mean QNWL score for government hospitals was 160±15.15 while for the private hospital, the mean QNWL score was 172.07±20.57 which shows that private hospital nurses had a high QNWL score than government hospital nurses. The overall mean QNWL score both for public and private hospital nurses was 165.23±18.37 with a minimum score of 67 and a maximum score of 217.

CONCLUSION

The research concluded moderate QNWL among private-sector and public-sector nurses. Furthermore, private-sector nurses were shown to have a higher QNWL than public-sector nurses. Private sector hospitals reported inadequate salaries and poor job security as compared to government sector hospitals.

Nursing Students' Resilience toward the Stereotypical Image of the Nursing Profession

Saad Hassan — 2024-09-30

OBJECTIVES

To assess resilience among nursing students toward the stereotypical image of the nursing profession.

METHODOLOGY

A cross-sectional descriptive design was employed and a convenient sampling technique was used to recruit nursing students from various nursing colleges in Peshawar. The duration for this study was three months. A Conner-Davidson resilience scale (CD-RISK) was used for the sample of 262 BS Nursing students to assess the resilience toward the stereotypical image of the nursing profession.

RESULTS

The study revealed that the mean resilience score was 52.24 out of 72±9.9. On the basis of quartile, low resilience was 0% (equal or lower than 25 percentile), moderate was 51.9% (greater than 25 but lower than 75 percentile), and high resilience was 48.1% (greater than 75 percentile).

CONCLUSION

This study concluded that the resilience among nursing students regarding nursing image was mostly at moderate level. On the basis of result of this study we recommend different strategies to be adopted as to assess and build resilience among nursing students toward the image of the nursing profession.

Role of Contrast-Enhanced Computed Tomography (CECT) in Hepatocellular Carcinoma (HCC) in Adults with Chronic Liver disease (CLD)

Jahanzaib — 2024-09-30

OBJECTIVES

To evaluate the diagnostic accuracy of CECT in identifying HCC in adults with chronic liver disease and compare it with other imaging modalities such as MRI and ultrasonography.

METHODOLOGY

This study involved 200 adult patients diagnosed with CLD. CECT was performed on all patients suspected of HCC. Imaging findings were correlated with histopathological results obtained after biopsy. Sensitivity, specificity, and diagnostic accuracy were calculated. Statistical analysis was performed using SPSS v25.0.

RESULTS

CECT had a sensitivity of 89%, specificity of 94%, and an overall diagnostic accuracy of 92%. The findings were compared with MRI and ultrasonography, where CECT demonstrated superior diagnostic performance in lesion characterization, arterial phase enhancement, and detection of small tumors (<2 cm).

CONCLUSION

CECT plays an integral role in the diagnosis and management of HCC in patients with CLD. Its high diagnostic accuracy, particularly in detecting early-stage tumors, makes it a preferred imaging modality.

Frequency of Chronic Obstructive Pulmonary Disease (COPD) Among Smokers and Non-Smokers at Hayatabad Medical Complex Peshawar

Shah Faisal — 2024-09-30

OBJECTIVES

The study aimed to determine the frequency of COPD, assess the severity of COPD and identify risk factors contributing to COPD development among smokers and non-smokers at Hayatabad Medical Complex.

METHODOLOGY

This cross-sectional study was done at Hayatabad Medical Complex Peshawar from April to December 2023. Data was collected from patients with COPD after obtaining consent, and an opinion poll was used to collect data about their symptoms and medical history. Data analysis was performed using SPSS 25. Chi-square and logistic regression analyses were conducted.

RESULTS

COPD prevalence was found to be significantly higher among smokers (45%) compared to non-smokers (10%) (p<0.001). Smokers exhibited greater severity of symptoms and lung function decline. Comorbid conditions like hypertension were also more frequent in smokers with COPD (30%) versus non-smokers with COPD (5%).

CONCLUSION

The frequency of COPD is more common in males and smokers, specifically those aged 46-60years and working in dirty environments, and most of them were presented with SOB and cough compared to non-smokers in which most of them were female and presented with chest tightness, acute bronchitis, and mucus.

A Call to Action for Nurses in Climate Change and Population Health

kashaf waseem — 2024-09-30

Climate change has a drastic effect on humankind and planet Earth, which is the most significant caution/ threat to human life nowadays.¹ According to the United Nation, climate change can be defined as the long-lasting changes in temperature and weather patterns.² These changes have profound negative impacts on human health, which is posing a question on human survival. For instance, the increment in the respiratory disorders and population growth of climate refugees due to flooding, fires, land sliding, and food shortage, requires an urgent need for immediate action.^3,4 According to a new report by the Intergovernmental Panel on Climate Change, climate change is disrupting human health including both physical and mental health globally.⁵ World Health Organization (WHO) estimates that from the year 2030-2050, climate change can trigger approximately 250,000 more mortalities annually because of heat strain, malaria, diarrhea, and malnutrition.⁶

American Academy of Nursing noted in a 2018 policy report that nurses play an important role in public health and emergency services, as well as in responding to and mitigating the health consequences of climate change.⁷ The International Council of Nurses (ICN) in Position Statement on Nurses, Climate Change and Health, emphasizes that nurses should adopt instantaneous step to shape climate-resilient health systems. Consequently, nurses associations are being asked to develop policy documents on climate change to raise awareness about the potential health effects of climate change. In the United States and globally, health care accounts for 8.5% of carbon emissions.^8,9 With the 28 million nurses, as the only health profession globally, can and should aid decarburize health care, signifying approximately 60% of health specialists and in the United States over its 5 million.^10,11 In the literature, numerous activities of nurses have been highlighted that are environmentally friendly such as shifting to hybrid staff meetings, proper waste disposal, signing off the computers and laptops when not in practice, usage of public transports, making files and preferring electronic documents over papers.^17,18During patient care, nurses guide to throw the garbage in bins and not waste the resources that can pose a threat to the climate.¹⁸ A study conducted in China, it was found that nurses sustainably practiced the habits of recycling the products no longer in use, green travel, using reusable items, producing less garbage, and using degradable products.¹² Nurses should initiate to mitigate climate change causing minor actions that are done unknowingly in promoting climate actions.¹²Nurses use a diversity of products in their daily routine, personal care products, products for nutrition, and pharmaceutics inappropriately.^13,14 In numerous cases, products used regularly are discarded as partially used or perished and a wide range of devices and products are meant for one-time use only. Some items to be used are excessively boxed which leads to a risen carbon footprint on healthcare.¹⁵ Concern, specifically regarding medical waste, which encompasses items like gloves, syringes, and containers, poses environmental pollution and if not disposed appropriately leads to soil and water contamination. On the other hand, caregivers single use of plastics on a daily basis has also contributed to plastic pollution in landfills and oceans with consequent harmful effects on ecosystems and wildlife. Hospitals use lot of energy for lighting, heating, cooling and medical equipments apart from being heavily dependent on fossil fuel sources for power generation. This produces greenhouse gases that contribute to global warming. Nurses also consume fossil-fuel powered vehicles while departing to work or visiting patients generates carbon emissions. Besides handling numerous medications, antibiotics or chemicals are only some examples of the harmful substances that might spill or dispose unsafely thus contaminating soil or water bodies. As far as tests involving toxic chemicals are concerned, they should be handled and treated in an environment friendly way. Health care facilities also emit their own varieties of wastewater laced with chemical residues, pesticides and other pollutants which can affect aquatic ecosystems and water quality.¹⁶

However, nurses must be aware of the climate problems which rising temperatures are causing serious diseases and leading to mortality specifically in heart patients throughout the world. One study showed that mainstream nurses are deficient in knowledge and awareness in terms of changing climate and its linkage with population health impacts.⁴There was a deep connection regarding their level of education and awareness of the negative consequences of climate change on human health. They only linked climate change with flooding, drought, etc.¹⁷To address this gap, nurses should be involved in teams for defining and influencing sustainable product choices and criteria. On top of that, compostable plates and cups should be used instead, along with staff bike schemes. By implementing these moves, healthcare can be made more resilient as well as environmentally friendly which will also result in improved patient care.¹⁶A sustainable approach is necessary within the hospitals and health institutes in Pakistan in correspondence to climate change. Educational training must be given to nurses and lower staff so that the health of the patients can be improved by playing a vital role in mitigating the adverse impacts. Climate change and health topics should be added to nursing courses for ease of living. There is a need to reduce the carbon footprint by advocacy and leadership, so that environmentally sustainable activities can be initiated in health care. Nurses can take personal startup actions as chasing the 5 R’s waste management strategy; refuse, reduce, reuse, repurpose, and recycle. These collective attempts can make the way for healthy survival and a greener future.^14,17,18