Mader-e-Milat International Journal of Nursing and Allied Sciences

Relationship of Resilience and Self-Efficacy with Work Engagement Among Cardiac Nurses in Public Sector Hospitals of Karachi

2025-10-15T08:52:38+00:00

Nurses make up a significant portion of the health care workforce and directly interact with patients daily, which inherently makes them important players in achieving quality care and positive patient outcomes. The purpose of the present study was to understand the relationship between self-efficacy, resilience, and work engagement among nurses working in cardiac units of two public sector hospitals of Karachi by using a cross-sectional study design (n= 162). Work engagement was assessed through standardized Utrecht Work Engagement Scale (UWES), while general efficacy is analyzed through the General Self-Efficacy Scale (GSE), and Resilience is determined through the Connor-Davidson Resilience Scale (CD-RISC). The Study analysis was done using Pearson's correlation and multiple regression in RStudio Software. The result of the study shown a significant positive correlation between resilience and work engagement (r = 0.53, p < 0.001), and between self-efficacy and work engagement (r = 0.56, p < 0.001) and multiple regression analysis also confirmed that both resilience and self-efficacy are significant predictors of work engagement, together accounting for 34% of the variance (R2=0.34). These findings suggest that both traits are crucial for enhancing and sustaining work engagement, allowing nurses to proactively address challenges and remain actively involved in their work.

HLA-DQ2 Heterozygosity in Symptomatic Adults from Balochistan: A Case Series Supporting Coeliac Disease Diagnosis

2025-10-28T07:04:56+00:00

Background: Coeliac disease (CD) is an immune-mediated enteropathy triggered by gluten ingestion in genetically susceptible individuals. The presence of HLA-DQ2 and/or HLA-DQ8 haplotypes is a major genetic predisposing factor, with HLA-DQ2.5 showing the strongest association. In Pakistan, particularly in resource-limited regions such as Balochistan, CD remains underdiagnosed due to limited access to genetic testing and awareness of its clinical spectrum.

Objective: This case series aims to describe the clinical and genetic findings of three adult patients from Balochistan presenting with symptoms suggestive of coeliac disease, confirmed by the presence of HLA-DQ2 heterozygosity through whole blood genotyping.

Methods: Whole blood samples were collected from three symptomatic adults with chronic gastrointestinal complaints and malabsorptive features. HLA-DQA1 and HLA-DQB1 alleles were analyzed using standard genotyping techniques to determine the presence of HLA-DQ2 and HLA-DQ8 haplotypes. The allelic combinations were assessed to identify high-risk variants, particularly the DQ2.5 heterodimer.

Results: All three patients demonstrated heterozygous HLA-DQ2 haplotypes. One individual was identified as carrying the high-risk DQ2.5 combination (DQA105 and DQB102 alleles). Clinical features—including chronic diarrhea, weight loss, anemia, and fatigue—were consistent with coeliac disease in all cases. Symptomatic improvement was noted following the initiation of a gluten-free diet, further supporting the diagnosis.

Conclusion: This case series provides molecular evidence of HLA-DQ2 heterozygosity among symptomatic adults in Balochistan and reinforces the diagnostic relevance of HLA genotyping in suspected coeliac disease. Expanding access to genetic testing and increasing clinical awareness can enhance early detection and management of CD in underserved populations. Early identification of genetically at-risk individuals may significantly improve patient outcomes through timely dietary interventions and prevention of long-term complications.

A Strategic Review of the Role and Effectiveness of Public Health Communication Campaigns During Epidemics and Their Impact on Public Behavior

2025-10-31T16:04:09+00:00

Background and Purpose: Vaccination programs have played a transformative role in improving global health outcomes by reducing morbidity, mortality, and healthcare costs associated with infectious diseases. Despite their immediate success, there is a need for a comprehensive evaluation of their long-term health and economic impacts on national and global public health systems. This study aims to assess how vaccination initiatives contribute to sustained health improvements, cost-effectiveness, and healthcare system resilience across diverse socioeconomic contexts.

Methods: A quantitative research design was employed, utilizing secondary data from global health databases such as WHO, UNICEF, and World Bank covering the period from 1990 to 2024. Statistical analyses, including trend analysis, multiple regression, and cost-benefit modeling, were conducted to measure correlations between vaccination coverage rates, disease reduction, healthcare expenditure, and economic productivity. Data were stratified by income level and region to ensure cross-national comparability.

Key Findings: Results revealed a significant positive association between high vaccination coverage and reductions in mortality and morbidity rates from vaccine-preventable diseases (p < 0.01). Econometric models indicated that every 1% increase in national immunization coverage corresponded to a 0.5% reduction in healthcare spending on communicable diseases. Long-term analysis demonstrated that vaccination programs generated a substantial return on investment (ROI), averaging 18:1 globally, through reduced treatment costs and increased workforce productivity. Moreover, countries with sustained immunization policies showed improved pandemic preparedness and reduced strain on healthcare infrastructure.

Conclusion: The findings confirm that vaccination programs yield enduring health and economic benefits, reinforcing their role as one of the most cost-effective public health interventions. Strengthening vaccine delivery systems, ensuring equitable access, and maintaining long-term funding commitments are critical to maximizing global health security and economic stability.

A Cross-National Analysis of Public Health Preparedness Plans and Emergency Response Strategies for Combating Emerging Infectious Disease Outbreaks

2025-11-19T14:04:10+00:00

Background and Purpose: Emerging infectious diseases continue to challenge global health systems, revealing significant differences in how countries prepare for and respond to public health emergencies. This study aims to conduct a cross-national qualitative analysis of public health preparedness plans and emergency response strategies, focusing on how varying governance structures, surveillance capacities, and community-level mechanisms influence outbreak management.

Methods: A qualitative comparative approach was adopted, analysing national preparedness documents, policy frameworks, and emergency response guidelines from multiple countries representing high-, middle-, and low-income settings. Data were examined using thematic content analysis to identify common strategies, contextual differences, and gaps in national planning and implementation.

Key Findings: The analysis reveals substantial variation in surveillance systems, risk communication protocols, and resource mobilisation capacities. High-income countries demonstrated stronger integration of digital surveillance and multisectoral coordination, while many low- and middle-income countries relied more on community health networks and international assistance. Common strengths across nations included early warning systems and public communication platforms, but gaps were observed in cross-border coordination, equitable resource distribution, and sustainability of preparedness investments. The study also highlights the importance of adaptive governance, decentralised decision-making, and culturally appropriate communication strategies in improving outbreak response effectiveness.

Conclusion: Public health preparedness and emergency response strategies vary considerably across national contexts, yet key elements such as coordinated governance, rapid surveillance, and community engagement remain universally essential. Strengthening cross-national collaboration, investing in resilient health systems, and ensuring inclusive planning can significantly enhance global readiness for future infectious disease outbreaks.

Evaluating the Influence of Age and Gender on Hemoglobin Variation and Red Cell Characteristics in Anemic Patients of Dera Ismail Khan

2025-11-04T07:26:22+00:00

Anemia remains a major public health concern in Pakistan, particularly affecting vulnerable groups. This study aimed to assess demographic variations in hemoglobin (Hb) levels and red blood cell (RBC) indices Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), and Mean Corpuscular Hemoglobin Concentration (MCHC) among different population groups in Dera Ismail Khan, a rural district of Pakistan. A retrospective cross-sectional analysis was conducted using 210 anonymized complete blood count (CBC) reports obtained from local clinical laboratories in Dera Ismail Khan. Participants were categorized by gender (male, female, and pregnant female) and age (1–17 years, 18–39 years, and ≥40 years). Outliers were excluded using the interquartile range (IQR) method. Descriptive statistics (mean ± SD) were computed, and one-way analysis of variance (ANOVA) was applied to compare means across groups, with statistical significance set at p < 0.05.Pregnant females exhibited the lowest Hb (7.81 ± 1.42 g/dL) and MCV (58.52 ± 8.35 fL), indicating severe microcytic anemia, while males had the highest Hb (9.80 ± 1.47 g/dL). Children aged 1–17 years demonstrated significantly lower MCV (63.63 ± 7.92 fL) and MCH (18.80 ± 2.92 pg) than adults aged ≥40 years (MCV: 78.47 ± 10.33 fL; MCH: 26.05 ± 3.51 pg). ANOVA revealed statistically significant differences across gender and age groups for Hb, MCV, and MCH (p < 0.001). The findings highlight a higher prevalence and severity of anemia among pregnant women and children in rural Pakistan. Incorporating RBC indices alongside Hb measurements in routine screenings can improve anemia classification and support targeted interventions, such as iron supplementation and nutrition programs for high-risk groups.

Hypoglycorrhachia and Raised Total Protein Level in CSF, as Predictive Marker for Bacterial Meningitis

2025-12-19T17:29:43+00:00

Meningitis is an inflammatory condition in which protective layer of brain and spinal cord called meninges get inflamed. Among infectious meningitis, bacterial meningitis has higher morbidity and mortality rate, the aim of current study is to evaluate predictive marker of bacterial meningitis to initiate antibiotic therapy. Current study was conducted at department of central pathology, Allama Iqbal Teaching Hospital, Dera ghazi khan. The research was carried out on total of 188 CSF samples received from different wards of above mention hospital from September 2024 to September 2025. For the measurement of CSF glucose and total protein, Cobas pure 6000 fully automation biochemistry analyzer was used. For bacterial cultivation, samples were sent to Pak city diagnostic center located in Dera ghazi khan. Among these 188 specimens, 25(13.29%) samples met exclusion criteria. From remaining 163 samples, 91(55.8%) were diagnosed with meningitis against previously set criteria of cerebrospinal fluid cell count >5/uL. Biochemical analysis reveals that out of 91 sample, 32(35.16%) were diagnosed with hypoglycorrhachia (CSF glucose level <45mg/dl) and significantly raised CSF total protein level. The mean glucose level in these thirty-two specimens was 33 mg/dL and mean total protein level was recorded 218 mg/dL. Considering these abnormal parameters as an indication of bacterial meningitis, the sample with hypoglycorrhachia and elevated protein level were sent to microbiological laboratory for bacterial culture. Among these 32 samples, 26(81.25%) cultures were found positive for bacterial growth. Significantly reduction in CSF glucose level and elevation of CSF total protein are predictive marker for bacterial meningitis and antibiotic therapy can be initiated on the basis of these parameters.

Co Comparing the Effect of Intensive Care Unit Nurses as Teachers of Central Line-Associated Bloodstream Infection Prevention in Bahawal Victoria Hospital, Bahawalpur Punjab Pakistan

2025-12-19T17:39:50+00:00

Background: CLABSIs have been a primary source of morbidity and mortality in hospitals, especially in resource-constrained environments. Infection prevention is an essential task which nurses have, and therefore their knowledge and practices are critical to the reduction of CLABSI.

Purpose of the study: It was a study that determined the role of ICU nurses in preventing CLABSIs at Bahawal Victoria Hospital (BVH), in Bahawalpur, in terms of their knowledge, practices, and perceived barriers.

Methods: This study was a descriptive cross -sectional study carried out on 100 ICU nurses. The information was gathered using the structured questionnaires, semi-structured interviews and direct observations. The SPSS (version 25) was used to analyze the quantitative data, whereas the qualitative data were subjected to thematic analysis.

Findings: The majority of the respondents were knowledgeable about the definition of CLABSI (80 percent), insertion of catheters (75 percent), and hand washing (70 percent). Infection preventive practices, including the use of sterile barriers, hand hygiene, and dressing procedures, had a 90-95-percent compliance. Nonetheless, factors such as lack of training (50%), staff short (40%), workload (35%), and resource limitation (30%) were a setback based on total compliance.

Conclusion: The overall awareness and practice of ICU nurses in BVH are high, and on the whole, good regarding CLABSI prevention. However, institutional issues, especially the lack of training options and insufficiency of resources hamper long-term compliance. Improving continuous professional education, making resources available, and imposing supervision systems are necessary measures in achieving the rates of CLABSI reduction in critical care units.