Journal of Gandhara Nursing and Allied Health Sciences

Diagnostic Performance of Xpert® MTB/XDR for Drug-Resistant Pulmonary Tuberculosis

Muhammad Kashif Munir — 2025-01-27

ABSTRACT

OBJECTIVES

The study aimed to determine the diagnostic accuracy of Xpert^® MTB/XDR assay for drug-resistant pulmonary tuberculosis by taking conventional drug susceptibility testing (DST) as standard.

METHODOLOGY

In the cross-sectional analytical study, 1789 pulmonary TB suspects were tested for Xpert^® MTB/RIF assay from November 2022 to April 2023. Of these 604 were Mycobacterium tuberculosis (MTB) positive and 57 rifampicin-resistant (RR). Two first-morning sputum specimens were collected from all RR cases. One specimen was processed for Xpert^® MTB/XDR, and the other for Lowenstein Jensen (LJ) culture and conventional DST.

RESULTS

Overall mean age was 36.6±16.6 years, and gender distribution was comparable (49.1% vs. 50.9%). RR was 100.0% on Xpert^® and 78.9% on DST, MDR 77.2% on Xpert^® and 66.7% on DST, pre-XDR 26.3% on Xpert^® and 31.6% on DST, and XDR 0.0% on Xpert^® and 5.3% on DST. Compared to conventional DST, the accuracy of Xpert^® was 79.0% for RR, 75.0% for MDR, 81.0% for pre-XDR, and 95.0% for XDR-TB.

CONCLUSION

The Xpert^® MTB/XDR assay demonstrated greater accuracy for drug-resistant pulmonary tuberculosis, especially XDR-TB. However, more studies are needed to validate the diagnostic performance of this new modality.

Determining Patient Satisfaction with Nursing Care at Khalifa Gulnawaz and District Headquarter Hospital Bannu Pakistan

Saira — 2025-01-27

ABSTRACT

OBJECTIVES

The objective of this study was to determine the level of patient satisfaction with nursing care at Khalifa Gul Nawaz and District Head Quarter Hospitals in Bannu, Pakistan, and identify factors influencing satisfaction, such as communication, professionalism, and care environment. Additionally, the study aimed to compare patient satisfaction levels between the two hospitals to highlight areas for improvement in nursing care.

METHODOLOGY

A cross-sectional study was conducted using a structured questionnaire to collect data from 300 patients. The questionnaire included Likert scale items to evaluate various aspects of nursing care, including communication, patient education, and respect for privacy. Data were analyzed using descriptive statistics and inferential tests to compare satisfaction levels.

RESULTS

The results indicated a moderate level of satisfaction overall. KGN Hospital had slightly higher satisfaction levels compared to District Head Quarter Hospital. Key factors influencing satisfaction included nursing staff communication, attentiveness, and professionalism. Patients at Khalifa Gul Nawaz rated these factors more positively. However, both hospitals showed areas for improvement, particularly in patient education and responsiveness to patient needs.

CONCLUSION

Patient satisfaction with nursing care at Khalifa Gul Nawaz and District Headquarter Hospitals in Bannu is moderate, with notable differences between the two institutions. Improving communication, staff training, and patient education could enhance satisfaction levels. Continuous monitoring and quality improvement initiatives are recommended to address these issues and improve patient care outcomes.

Factors Associated with Traumatic Brain Injury in Patients Presenting to Intensive Care Unit of Hayatabad Medical Complex Peshawar, Pakistan

Zabih Ullah — 2025-01-27

OBJECTIVES

This study aimed to investigate the correlation between falls, motor vehicle accidents, and sports-related injuries with occurrences of traumatic brain injury. Additionally, the research aimed to examine the relationships among age, gender, and occupational factors in traumatic brain injury.

METHODOLOGY

A cross-sectional study was conducted in the intensive care unit of Hayatabad Medical Complex in Peshawar. A purposive sampling technique, accompanied by a structured questionnaire, was employed to collect data. The Chi-square test was applied with the type of group (CT scan findings of TBI) as the outcome variable, while all other independent variables were considered. Data analysis was performed using SPSS version 22.

RESULTS

Most patients with extradural hematoma were male (29, 24.6%, p-value 0.59), primarily aged 15-29, with 16 (33.3%, p-value 0.09) identified as students. Notably, road traffic accidents affected 21 patients (30.4%, p-value 0.03), mainly in the frontal brain area. Vital signs showed 21 patients (28.0%, p-value 0.88) with low blood pressure and 25 (36.8%, p-value 0.08) with low respiratory rates. Most had a GCS score below 8 (25 patients, 30.9%, p-value 0.20), with many (44 patients, 32.6%, p-value 0.007) having reactive pupils and no prior alcohol use. Additionally, 45 patients (27.3%, p-value 0.02) were not wearing protective gear, 40 (31.3%, p-value 0.17) reported headaches and dizziness, 27 patients (42.9%, p-value 0.10) took over 90 minutes to seek care, and 33 patients with multiple findings (35.9%, p-value 0.009) required invasive ventilation.

CONCLUSION

TBI was common in males who had a history of road traffic accidents and their CT scan finding shows most of the patients had extradural Hematoma with severe traumatic brain injury.

Knowledge, Attitudes, and Practices Regarding Exclusive Breastfeeding among Mothers of Childbearing Age in Mallah Village, Hyderabad

Yasmeen Sikandar Ali Mugheri — 2025-01-27

ABSTRACT

OBJECTIVES

To assess the knowledge, attitudes, and practices regarding exclusive breastfeeding among mothers of childbearing age in Mallah Village, Hyderabad.

METHODOLOGY

Convenience sampling was used for selecting 75 mothers for this cross-sectional study, which was carried out between July and September 2024. Data was collected using structured questionnaires, and IBM SPSS software version 23 was utilized for analysis. Descriptive statistical techniques were employed to examine the demographic information and the primary research variables.

RESULTS

According to the results of the study, most mothers (90.7%) had a good level of knowledge about exclusive breastfeeding, with healthcare facilities being the primary source of information (76%). However, there was a knowledge-practice gap, as many mothers did not exclusively breastfeed for the recommended six months. Although 93.3% reported practicing exclusive breastfeeding, only 42.7% initiated breastfeeding immediately after delivery. Positive attitudes were noted, with 72% of participants finding exclusive breastfeeding easier than formula feeding. However, 70.7% perceived exclusive breastfeeding as more demanding.

CONCLUSION

Study concluded that mothers in Mallah Village have adequate knowledge and positive attitude towards exclusive breastfeeding. However, gaps between knowledge and practice still exist because of challenges including delayed initiation of and perceived barriers to exclusive breastfeeding. The analysis emphasizes the necessity of focused educational initiatives and community-based interventions to bridge this gap and advance breastfeeding practices in this region.

Bacteriological and Physico-Chemical Analysis of Drinking Water from Underground Source in Domel District Bannu KPK Pakistan.

Noor Zada khan — 2025-01-27

Objective: Clean drinking water is a prime important issue for protecting health of humans in all over the globe. Drinking water quality are not being managed appropriately both in the rural and urban areas of Pakistan.

Material and Methods: Bacteriological and Physico-Chemical and analysis of drinking water from underground source (pressure pumps) were investigated in forty selected areas of Tehsil Domel District Bannu.

Results: A total of 40 samples of drinking water were analyzed for Elemental analysis and BOD, COD, Total coliform, Fecal coliform, E.coli, Total Plate Count, Electrical conductivity, Salinity, Total suspended solids(TSS), Total dissolved solids(TDS) and pH. Research showed that samples of drinking water of some villages i.e. Bezan khel, Bodin khel, Bara Chashmi and Masti khel were found bacterial contaminated. They have large amount of bacterial colonies i.e. 398 colonies/ml, 561colonies/ml, 470 colonies/ml and 566 colonies/ml respectively. E.coli was also detected in the above mentioned highly polluted sites. These bacterial concentrations are beyond the permissible range of WHO. BOD, COD, TDS and TSS values were also above the standard values in some selected villages of this research study. Cu and Zn were found bellow the permissible ranges of WHO while some research sites showed higher values of Pb and Cd than WHO approved ranges.

Conclusion: It was determined from the current research study that drinking water from pressure pump source in Tehsil Domel District Bannu KPK is contaminated and is not suitable for drinking purposes. It needs necessary management before consumption to avoid waterborne and other carcinogenic diseases in Tehsil Domel District Bannu.

Knowledge, Attitude, and Practices of Undergraduate Nursing Students Related to Disaster Management: A Descriptive Cross-Sectional Study in MMC Mardan

Shaista — 2025-01-27

OBJECTIVES

The objective of this study was assess the knowledge, attitudes, and practices of undergraduate nursing students on disaster management.

METHODOLOGY

A quantitative cross-sectional study was done at Mardan Medical Complex, Mardan, using a modified questionnaire administered among 145 nursing students to assess the knowledge, attitude, and practice regarding disaster management.
RESULTS
While 35.2% of students had enough knowledge of disaster management, 42.8% were aware of preparedness strategies. Most viewed disaster response as a shared responsibility, with 83.3% desiring more education. Regarding practices, 73.3% were willing to join response teams, and 70% felt confident assessing victims, though 51% had not participated in disaster drills.
CONCLUSION
Nursing students showed adequate knowledge and positive attitudes toward disaster management but would benefit from more practical training.

A Perspective on Platelet-Derived Products for Regenerative Medicine

Muhammad Rizwan Alam — 2024-01-27

In modern health sciences, cell-based therapies have emerged as one of the most transformative approaches for treating a variety of diseases. In this regard, autologous platelets and their products have garnered significant attention in regenerative medicine. With a pivotal contribution in hemostasis, platelets are rich in cytokines, growth factors and numerous bioactive molecules with tremendous potential in tissue repair and regeneration.¹ The generation of extracellular vesicles including microvesicles and exosomes from activated platelets have also been demonstrated to participate in intercellular transport of different types of biomolecules including protein, nucleic acids and small molecules, that has strong therapeutic potential.² The clinical use of platelet-rich plasma and its derivatives including platelet-rich fibrin, platelet releasate/secretome and extracellular vesicles have evolved into promising avenues for treating a wide range of medical conditions.^1,3 Platelet-rich plasma (PRP) is one of the most widely used platelet-derived products in regenerative medicine with its applications in, but not limited to, sports medicine, dermatology, cosmetology, ophthalmology and orthopedics. Its low cost and ease of preparation from a relatively small volume of blood makes it a promising therapeutic strategy for treating several acute and chronic injuries. The concentrated platelets in PRP release growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), and epidermal growth factor (EGF), all of which contribute to several cellular processes including tissue repair, angiogenesis, collagen synthesis, and inflammation modulation. PRP has shown potential in the treatment of musculoskeletal injuries, bone fractures, wound repair, and hair regeneration by promoting healing and reducing recovery time, though outcomes can vary depending on preparation protocols, injury type, and patient factors.^3,4 Platelet-rich fibrin (PRF) is a second-generation platelet-rich product that also contains leukocytes, circulating stems cells and cytokines in a fibrin matrix. As compared to PRP, which has short term effects, PRF therapy at the injury site is associated with a prolonged bioavailability due to slow release of cells and biomolecules from the fibrin network. By providing sustained release of growth factors, PRF accelerates tissue repair, enhances healing, reduces inflammation, and promotes regeneration It has broad spectrum clinical applications with a more common use in oral and maxillofacial surgery, orthopedics, wound healing and hair restoration.^1,5 Beyond PRP and PRF, platelet-derived growth factors (PDGFs) and extracellular vesicles (EVs) are emerging as novel therapeutic modalities. PDGFs, which are present in high concentrations in platelets, regulate cellular processes such as migration, proliferation, and angiogenesis. These growth factors are essential for wound healing and tissue regeneration. EVs, including exosomes, are released by platelets that carry bioactive molecules, including proteins, lipids, and RNA, which impacts cellular behavior. EVs have been shown to promote tissue repair, enhance angiogenesis, and modulate immune responses, making them an attractive tool for regenerative applications. The application of platelet-derived EVs is in the research phase, but their potential to deliver targeted therapeutic effects makes them a promising approach for future regenerative therapies.^2,3

The use of platelet-derived products particularly PRP has significantly increased in regenerative medicine worldwide including Pakistan.⁶ However, the regulatory framework for the use of these products in Pakistan is still developing. Although, the PRP is an autologous biological product that often falls outside the scope of traditional pharmaceutical regulation, there is still a need to develop specific guidelines and regulations by ensuring standardized protocols and devices for safe and effective patient care.