Biological and Clinical Sciences Research Journal

Assessment of Knowledge Regarding Neutropenic Patients Among Oncology Nurses

2026-03-01T17:12:05+00:00

Neutropenia is a frequent and potentially life-threatening complication among oncology patients, particularly those receiving chemotherapy. Early identification of infection risk and implementation of evidence-based preventive strategies are essential to reduce morbidity and mortality. Oncology nurses play a pivotal role in monitoring neutropenic patients and implementing infection-control measures. However, variability in nurses’ knowledge may compromise patient safety. This study assessed oncology nurses' knowledge of neutropenic patients in tertiary care hospitals in Lahore, Pakistan. Objective: To assess the level of knowledge regarding neutropenic patients among oncology nurses in selected public and private tertiary care hospitals. Methods: A descriptive cross-sectional study was conducted from March to August 2025 in oncology departments of selected tertiary care hospitals in Lahore. A purposive sample of 150 registered oncology nurses directly involved in patient care was recruited. Data were collected using an adopted structured questionnaire comprising 30 true/false knowledge-based items covering definition, causes, clinical manifestations, infection control measures, environmental precautions, dietary considerations, oral care, and nursing management of neutropenic patients. Descriptive statistics were computed using SPSS version 25. Knowledge scores were categorized into low, average, and high levels based on predetermined criteria. Results: Among 150 participants, 56.0% were aged 21–30 years, and 91.3% were female. Regarding qualification, 39.3% held BSN/Post RN degrees, 35.3% had diplomas, and 25.3% had specialization training. High correct response rates were observed for daily skin and mucosa assessment (94.0%), stomatitis as a common complication (92.7%), use of personal protective equipment (90.0%), patient and family education (90.7%), and requirement of private rooms (88.7%). Lower correct response rates were noted for room cleaning sequence (48.7%), glycosuria as a sign of infection (50.0%), oral care with sodium bicarbonate (54.7%), and identification of infection signs (56.0%). Overall knowledge classification revealed that 40.0% of nurses had low knowledge, 26.0% had average knowledge, and 34.0% demonstrated high knowledge regarding the management of neutropenic patients. Conclusion: A substantial proportion of oncology nurses demonstrated low to average knowledge regarding neutropenic patient management. Although awareness of core infection-control measures was generally adequate, notable gaps persisted in specific clinical and preventive domains. Targeted continuing education programs and structured competency-based training may help strengthen oncology nursing practice and improve patient safety outcomes.

Does Suturing Technique Affect Outcomes of TIP Urethroplasty? A Comparative Study of Distal Penile Hypospadias in a Tertiary Care Hospital

2026-02-24T20:21:27+00:00

Hypospadias is one of the most common congenital anomalies in male children. Distal penile hypospadias is commonly corrected using tubularized incised plate (TIP) urethroplasty (Snodgrass procedure). The optimal suturing technique for urethral tubularization, interrupted versus continuous, remains uncertain. Objective: To compare postoperative complication rates between interrupted and continuous suturing techniques in TIP urethroplasty for distal penile hypospadias. Methods: This retrospective study was conducted from September 2024 to October 2025 at the Department of Pediatric Surgery, The Children’s Hospital and Institute of Child Health, Multan. Eighty-eight patients who met the inclusion criteria were enrolled and randomly assigned to two groups. Group A underwent TIP urethroplasty using an interrupted suturing technique, while Group B underwent repair using a continuous suturing technique. Patients were followed up at one week post-discharge and subsequently at 1, 2, and 3 months postoperatively. The primary outcome measure was the occurrence of postoperative complications. Results: Postoperative complications occurred in 13 patients (29.1%) in Group A and 17 patients (39.1%) in Group B. The difference between the two groups was not statistically significant (p > 0.05). Urethrocutaneous fistula was the most frequently observed complication in both groups. Conclusion: The suturing technique—interrupted or continuous—does not significantly affect the rate of postoperative complications following Snodgrass repair for distal penile hypospadias.

Management of Migraine and Associated Factors among Nurses of DHQ Hospital Jhelum

2026-03-07T19:23:31+00:00

Migraine is a common and disabling neurological disorder that disproportionately affects nursing professionals due to high occupational stress, shift work, and sleep disturbance. In Pakistan, limited evidence exists regarding migraine-related stressors and coping practices among nurses working in public sector hospitals. Objective: To assess workplace stressors, migraine-related physical and psychological responses, and coping strategies among nurses working at DHQ Hospital, Jhelum. Methods: A descriptive cross-sectional study was conducted among 155 registered nurses at DHQ Hospital Jhelum during 2022–2023. Participants were selected through non-probability convenience sampling. Data were collected using a structured, self-administered questionnaire covering demographic characteristics, workplace stressors, migraine-related symptoms, and coping strategies. Responses were recorded on a five-point Likert scale. Data were analyzed using SPSS version 20, and results were presented as frequencies and percentages. Results: The majority of participants were female (94.2%), with the largest age group being 31–40 years (36.8%). Most nurses held a Diploma in General Nursing (52.3%) and had 6–10 years of professional experience (43.2%). Supervisor pressure was reported as “always” by 43.9% of nurses, while health problems were reported “very often” by 62.6%. Sleep disturbance was the most frequent physical response, reported “very often” by 48.4% of participants. Headaches, gastrointestinal symptoms, backache, mood swings, forgetfulness (45.2% “sometimes”), and poor concentration (41.3% “sometimes”) were common. Sleeping was the most frequently used coping strategy (62.6% “always” or “very often”), followed by prayer (45.2% “frequently”). Non-pharmacological approaches such as exercise, walking, music therapy, and social interaction were widely practiced. Conclusion: Nurses at DHQ Hospital Jhelum experience substantial occupational stress associated with frequent migraine-related physical and psychological symptoms. Coping strategies are largely self-directed and non-pharmacological. These findings suggest the need for structured occupational health interventions, stress-reduction programs, and institutional support systems tailored to the context of Pakistani public hospitals to mitigate the migraine burden and enhance workforce well-being.

The Assessment of Different Positions and Attachment Adopted by Mothers During Breastfeeding

2026-03-01T11:02:27+00:00

Appropriate breastfeeding positioning and attachment are essential determinants of successful lactation, adequate milk transfer, and prevention of nipple trauma. Despite global recommendations supporting exclusive breastfeeding for the first six months, technical challenges related to positioning and latch remain common among mothers. Objective: To assess the different breastfeeding positions and attachment practices adopted by mothers attending a tertiary care hospital in Lahore. Methods: A hospital-based descriptive cross-sectional study was conducted over six months (January–June 2025) in the gynecology inpatient ward, Expanded Programme on Immunization (EPI) clinic, and pediatric outpatient department of Ittefaq Hospital, Lahore. A total of 171 breastfeeding mothers were recruited using non-probability convenience sampling. Data were collected using an adopted structured questionnaire comprising demographic variables and assessment of breastfeeding positions (cradle, cross-cradle, football/rugby, and side-lying) and attachment indicators (wide mouth opening, chin-to-breast contact, alignment, switching breasts, seeking professional help, and pain/discomfort). Responses were recorded on a five-point Likert scale. Data were analyzed using SPSS, and results were summarized as frequencies and percentages. Overall practices were categorized as poor, moderate, or good based on cumulative scores. Results: Most mothers were aged 26–35 years (67.3%) and had matric/intermediate education (42.7%). Cradle hold was the most frequently practiced position (57.3% “always”), whereas football/rugby hold was rarely used (71.9% “never”). The side-lying position showed moderate utilization. Regarding attachment indicators, 68.4% always ensured a wide mouth opening before latching, 60.8% ensured nose and chin contact with the breast, and 69.6% maintained proper alignment with the baby facing the mother. However, 53.8% never sought professional help for breastfeeding positioning. Overall evaluation revealed that 45.0% of mothers demonstrated poor positioning and attachment practices, 22.8% moderate, and 32.2% good practices. Conclusion: Although commonly recommended breastfeeding positions were widely practiced, comprehensive positioning and attachment techniques were not consistently achieved. Structured antenatal and postnatal counseling, practical demonstrations, and routine assessment in clinical settings may improve breastfeeding technique and maternal comfort.

Insomnia and Academic Performance: A Correlational Study of Undergraduate Students in District Okara, Pakistan

2025-11-27T06:42:06+00:00

Insomnia is common in university students and may adversely affect learning, concentration, and academic outcomes. District-level evidence from Pakistan, including Okara, remains limited. Objective: To determine the prevalence of insomnia and examine its association with academic performance among undergraduate students in District Okara, Pakistan. Methods: A cross-sectional study was conducted from December 2024 to March 2025 among 632 undergraduate students from academic institutions in Okara. Data were collected using a structured questionnaire including demographic variables, self-reported CGPA, and the Insomnia Severity Index (ISI). Descriptive statistics were used to estimate the prevalence of insomnia. Chi-square tests assessed associations between insomnia severity and participant characteristics. Spearman's correlation was used to examine the relationship between ISI score and CGPA. Statistical significance was set at p < 0.05. Results: Overall, 60.3% of students reported insomnia symptoms (mild to severe), while 39.7% reported no clinical insomnia. Insomnia severity was distributed as mild (37.8%), moderate (19.9%), and severe (2.5%), and it was significantly associated with gender (p = 0.008) and academic discipline (p = 0.008), but not with age, residence, marital status, family income, or CGPA category. Spearman's correlation showed a weak negative association between insomnia severity and academic performance (r = -0.100, p = 0.012). Conclusion: Insomnia symptoms were highly prevalent among undergraduates in Okara and were weakly but significantly associated with lower academic performance. Universities should consider sleep health promotion, early screening, and student support interventions to reduce the burden of insomnia and improve academic functioning.

Acute Antimicrobial Resistance Patterns of Pseudomonas aeruginosa and E. coli Clinical Isolates

2026-03-17T12:31:05+00:00

Antimicrobial resistance among Gram-negative bacteria is a growing global health concern, particularly in hospital settings, where opportunistic pathogens contribute to severe infections. Pseudomonas aeruginosa and Escherichia coli are common causes of healthcare-associated infections and frequently demonstrate multidrug resistance, limiting therapeutic options. Objective: To determine the antimicrobial resistance patterns and prevalence of multidrug-resistant strains of Pseudomonas aeruginosa and Escherichia coli isolated from clinical specimens in a tertiary care hospital. Methods: A retrospective observational study was conducted at the University of Veterinary and Animal Sciences, Lahore, Pakistan, from June 2025 to December 2025. A total of 60 clinical isolates (30 Pseudomonas aeruginosa and 30 Escherichia coli) obtained from various specimens, including urine, sputum, blood, pus, wound swabs, and catheter tips, were analyzed. Bacterial identification was performed using standard microbiological techniques. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method in accordance with established clinical laboratory standards. Antibiotics tested for Pseudomonas aeruginosa included ceftazidime, piperacillin-tazobactam, ciprofloxacin, gentamicin, amikacin, imipenem, and colistin, whereas Escherichia coli isolates were tested against ampicillin, ceftriaxone, ciprofloxacin, gentamicin, amikacin, meropenem, and nitrofurantoin. Multidrug resistance was defined as resistance to three or more antimicrobial classes. Data were analyzed using SPSS, with descriptive statistics used for frequencies and percentages, and chi-square and independent t-tests applied for comparisons, with p < 0.05 considered statistically significant. Results: A total of 60 bacterial isolates were analyzed. The mean age of patients associated with Pseudomonas aeruginosa isolates was 48.97 ± 16.32 years, while for Escherichia coli it was 49.53 ± 15.06 years; there was no significant difference between groups (p = 0.889). Pseudomonas aeruginosa demonstrated the highest resistance to ciprofloxacin (56.7%), gentamicin (53.3%), and ceftazidime (50.0%), while the lowest resistance was observed for colistin (13.3%). Escherichia coli showed the highest resistance to ampicillin (70.0%) and ceftriaxone (63.3%), with lower resistance to meropenem and nitrofurantoin (20.0%). Overall, 56.7% of isolates were identified as multidrug resistant. No statistically significant difference in the prevalence of multidrug resistance was observed between the two organisms. Conclusion: A high prevalence of antimicrobial resistance and multidrug-resistant strains was observed among Pseudomonas aeruginosa and Escherichia coli isolates, highlighting the urgent need for continuous antimicrobial surveillance, rational antibiotic prescribing, and strengthened antimicrobial stewardship programs to control the spread of resistant pathogens in healthcare settings.