Biological and Clinical Sciences Research Journal

Exploring the Link Between Biofilm Formation and Multidrug Resistance in Escherichia coli Isolated from Urinary Tract Infections in Sialkot, Pakistan

2025-08-30T13:17:35+00:00

Escherichia coli strains are among the key contributors to urinary tract infections (UTIs) around the world, presenting a significant health challenge globally. Objectives: This cross-sectional study aims to isolate multidrug-resistant (MDR) Escherichia coli strains from UTI patients in Sialkot, Pakistan, and to investigate their biofilm-forming ability, exploring the possible association between biofilm formation and antibiotic resistance. Methods: A total of 131 E. coli isolates were isolated and identified. Their ability to form biofilms was confirmed using the tube method, and their antibiotic susceptibility patterns were evaluated using the disc diffusion method. Fisher's exact test was applied to investigate the association between biofilm production and antibiotic resistance. Results: The findings revealed that 65.6% isolates (n = 88) were biofilm producers, while 34.4% (n = 43) were non-biofilm producers. Antibiotic sensitivity testing indicated high levels of resistance among isolates to several antibiotics, notably ceftriaxone (91.6%), cefoperazone (86.3%), ciprofloxacin (85.5%), cefotaxime (82.4%), and cefixime (81.7%). A significant association was observed between biofilm formation and resistance to most antibiotics, including nitrofurantoin, amoxicillin-clavulanate, amikacin, piperacillin-tazobactam, and sulfamethoxazole-trimethoprim, among others. Conclusion: These findings suggest that E. coli isolates resistant to these certain antibiotics are more likely to form biofilms. This research highlights the critical need to explore biofilm formation, along with antibiotic susceptibility patterns of isolates, to help select appropriate antibiotics and facilitate effective treatment approaches.

Barriers to Effective Pain Management in Postoperative Patients: Perspectives of Nurses in Pakistan

2025-08-28T17:55:19+00:00

Effective pain management is a cornerstone of quality postoperative care. However, in Pakistan, nurses face multiple barriers, including staffing shortages, lack of resources, inadequate training, and cultural influences that hinder optimal patient outcomes. Understanding these barriers is essential for developing targeted interventions. Objective: To identify and analyze the barriers perceived by nurses in providing effective postoperative pain management in a tertiary care hospital in Pakistan. Methods: This descriptive cross-sectional study was conducted from July to December 2024 in a tertiary care hospital. A total of 99 registered nurses working in surgical and postoperative wards were recruited through purposive sampling. Data were collected using a structured, pre-validated questionnaire consisting of demographic details and a 5-point Likert scale assessing institutional, professional, and patient-related barriers. Descriptive statistics were used for demographic variables, and Chi-square tests assessed associations between demographics and perceived barriers. A p-value of <0.05 was considered statistically significant. Results: The majority of participants were female (83.8%), with a mean age of 29.7 ± 5.6 years. Most nurses held a diploma in nursing (59.6%) and had 1–5 years of experience (53.5%). The most frequently reported barriers included time constraints/work overload (48.5%), inadequate staffing (46.5%), lack of pain assessment tools (42.4%), and poor communication with physicians (41.4%). Nurses with less than five years of experience perceived inadequate staffing (p = 0.043) and limited pharmacological knowledge (p = 0.009) as significantly greater barriers compared to more experienced nurses. Conclusion: Nurses in Pakistan encounter multiple barriers in managing postoperative pain, primarily related to staffing, workload, inadequate tools, and limited pharmacological knowledge. Tailored educational programs, supportive institutional policies, and improved inter-professional collaboration are vital to enhance pain management and improve patient recovery outcomes.

Frequency of Primary Infertility with PCOS among Women Aged 25 to 30 Years in Tertiary Care Hospitals Quetta

2025-09-08T15:18:25+00:00

A significant worldwide health issue, infertility has detrimental psychological and societal effects. With 3.5% of cases being primary infertility, Pakistan has one of the highest rates of infertility in South Asia. Anovulatory infertility is primarily caused by polycystic ovarian syndrome (PCOS), the most common endocrine condition affecting women of reproductive age. Nevertheless, there is still a lack of information about infertility in Balochistan linked to PCOS. Objective: to ascertain the prevalence of PCOS-related primary infertility in women between the ages of 25 and 30 who visit Quetta's tertiary care facilities. Methods: This cross-sectional descriptive study was carried out in Quetta's tertiary care hospitals' obstetrics and gynecology departments. Through non-probability convenience sampling, 200 married women between the ages of 25 and 30 who met the Rotterdam criteria for PCOS and main infertility were included. A standardized, pre-tested questionnaire that covered socio demographic information, menstrual and reproductive history, PCOS clinical symptoms, ultrasound findings, and psychosocial impact was used to gather data. SPSS version 26 was used for data analysis. While chi-square and independent t-tests were used to evaluate relationships, descriptive statistics were computed. Results: On ultrasonography, polycystic ovaries were seen in nearly half of the individuals (49.5%), and irregular menstruation was very common (oligomenorrhea in 28% and amenorrhea in 25%). Of those with clinical signs, 46% had acne, and 42.5% had a family history of PCOS or infertility. 48% cited marital or family strain, and nearly half (47.5%) reported a lower quality of life. There was no statistically significant correlation (p = 0.209) between the length of infertility and BMI. Conclusion: According to the study, PCOS significantly contributes to primary infertility in Quetta among women between the ages of 25 and 30. The burden of PCOS-related reproductive difficulties in this population is highlighted by the high prevalence of sonographic and clinical characteristics. Improving fertility and quality of life requires early diagnosis, lifestyle changes, and effective management techniques.

Parents’ Perception Regarding Their Infants’ Pain Experience in the NICU

2025-09-04T17:48:10+00:00

Neonates admitted to the Neonatal Intensive Care Unit (NICU) often undergo multiple painful procedures, yet their inability to verbally communicate can lead to underestimation and inadequate management of pain. Parental involvement in pain assessment and management is crucial for improving neonatal outcomes; however, limited knowledge and confidence among parents may hinder their effective participation. Objective: To assess parents' perceptions regarding their infants' pain experiences in the NICU of a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted among 200 parents of infants admitted to the NICU using non-probability convenience sampling. Data were collected through a structured questionnaire that comprised demographic details and six perception items, rated on a Likert scale. Perception scores were categorized as positive (≥50%) or negative (<50%). Data were analyzed using SPSS version 21, with descriptive statistics applied to summarize the responses. Results: Most parents (71.5%) demonstrated a negative perception regarding their infant's pain experiences. A majority (68.5%) strongly disagreed that they could identify when their baby was in pain, and 78.0% disagreed that they could reduce their baby's pain. Confidence in performing kangaroo care was low, with only 31.0% agreeing they felt capable. Some parents expressed confidence in calming their infant, as 40.5% agreed they could soothe them to sleep during pain. However, fewer parents recognized the effectiveness of holding (38.0% agreed) or pacifiers (33.0% agreed) in stopping infant crying. Conclusion: The findings highlight significant gaps in parental confidence and awareness regarding infant pain recognition and management in the NICU. Targeted educational interventions are necessary to improve parental self-efficacy, foster active participation in pain management, and enhance neonatal care outcomes, particularly in resource-limited settings like Pakistan.

Evaluation of the Role of Nurses in Maternal Health Education Programs on Reducing Obstetric Complications in Resource-Limited Settings

2025-08-31T08:12:48+00:00

Maternal health education is a crucial strategy for reducing obstetric complications, particularly in resource-limited settings. Nurses play a central role in delivering structured education to enhance maternal knowledge, promote health-seeking behavior, and improve outcomes. Objective: To evaluate the effectiveness of a nurse-led Maternal Health Education Program (MHEP) in improving antenatal care (ANC) attendance, knowledge of obstetric danger signs, and reducing maternal complications in a Pakistani tertiary care hospital. Methods: A prospective, controlled evaluation was conducted from July to December 2024, involving 99 pregnant women (49 with MHEP, 50 controls). Participants in the intervention group received structured one-to-one and follow-up educational sessions based on WHO/UNICEF guidelines, adapted for local literacy and language needs. The primary outcome was a composite of maternal complications (hypertensive disorders, postpartum hemorrhage, maternal sepsis, prolonged/obstructed labor). Secondary outcomes included ANC process indicators, knowledge scores, and neonatal outcomes. Results: The MHEP group demonstrated significantly higher attendance at≥4 ANC visits (73.5% vs 46.0%, p = 0.005), improved iron–folate adherence (69.4% vs 38.0%, p = 0.0017), and greater birth preparedness (65.3% vs 34.0%, p = 0.0018). Mean knowledge scores on obstetric danger signs were markedly higher (14.2 ± 3.1 vs 10.7 ± 3.4, p<0.001). Composite maternal complications were reduced in the MHEP group (24.5% vs 44.0%; RR 0.56, p=0.041; NNT=5.1). A dose–response relationship was observed, indicating fewer complications with greater session attendance (p = 0.023). Multivariable analysis confirmed an independent reduction in the odds of complications associated with MHEP participation (adjusted OR, 0.41; p = 0.045). Conclusion: Nurse-led maternal health education significantly improved ANC utilization, maternal knowledge, and reduced maternal complications in a resource-limited setting. The observed dose–response effect highlights the importance of sustained, repeated educational engagement. Scaling such interventions could be an effective strategy to improve maternal health outcomes in similar contexts.

Effect of Meat Type on the Compositional and Functional Characteristics of Meat Sauce During Refrigerated Storage for Shelf-Life Evaluation

2025-08-30T12:41:18+00:00

Meat sauce is a very practical food that makes preparing wholesome meals quick and simple. It eliminates the need for intricate cooking procedures by combining premium protein with deep flavors. It improves the flavor and variety of pasta, rice, and other foods while saving time for time-pressed customers. It can be readily reheated or used immediately. It is the perfect choice for contemporary lifestyles due to its long shelf life and versatility. Objective: This study focuses on the development, physicochemical, and functional properties, and storage stability of meat sauces made from different types of meats. Methods: A laboratory-based experimental study was conducted from March to July 2025. Three treatment formulations were prepared: T₁ (minced chicken), T₂ (minced beef), and T₃ (minced mutton). Meat sauces were formulated using a modified protocol from Prayitno et al. (2021). Analyses were conducted on 0, 15 and 30 days to measure variations in moisture content, ash levels, fat content, protein content, and color analysis by using a handheld spectrocolorimeter (Lovibond, LC-400) and the CIE L a*b* scale. To assess shelf life, bacterial and mold counts were regularly monitored throughout the storage period. Additionally, pH, water-holding capacity, emulsifying capacity, and antioxidant activity were also determined during the storage period. Sensory evaluations were carried out by a panel of judges using a 9-point hedonic scale to assess the meat sauce’s taste, aroma, texture, and overall acceptability. The data collected from these evaluations were analyzed using Statistix 8.1 software, with a statistical significance set at p < 0.05. Results: Over a 30-day refrigerated storage period, all meat sauce samples exhibited a progressive decrease in moisture and protein content, accompanied by corresponding increases in ash and fat concentrations, likely due to moisture loss and concentration effects. Among the formulations, the T₃ sample containing minced mutton demonstrated the highest free fatty acid (FFA) content and pH values, suggesting a greater degree of lipid hydrolysis and microbial activity compared to the other variants. In contrast, the T₁ sample prepared with minced chicken showed superior emulsifying and water-holding capacities, reflecting better functional protein properties that enhance texture and stability. Sensory evaluation revealed that while T₁ was generally well-accepted by the panelists, T₂ (minced beef) achieved the highest overall acceptability scores, indicating favorable flavor and appearance attributes. Conclusion: The study investigates the nutritional advantages, sustainability and ease of access to consumers of using meat sauce in a variety of dishes. The sauce offers a blend of nutrients when it is incorporated into different dishes. This creative strategy promotes economic stability by sourcing meat from local shops. In addition, it fulfils the consumer demand for fresh and organic convenience meals, making it a viable choice for health-conscious individuals.

Assessing the Acceptability and Knowledge of Nurses Regarding Artificial Intelligence in Healthcare

2025-08-26T20:21:11+00:00

The integration of artificial intelligence (AI) into healthcare offers opportunities to improve clinical efficiency and patient outcomes. However, successful adoption depends on nurses' knowledge, attitudes, and readiness to use AI tools. Objective: To assess the acceptability and knowledge of nurses regarding AI in healthcare and identify factors influencing its adoption. Methods: An analytical cross-sectional survey was conducted among 99 registered nurses in a tertiary care hospital in Pakistan from July to December. Participants were selected using stratified random sampling and completed a validated, self-administered questionnaire that covered socio-demographics, AI knowledge (a 15-item test), and attitudes (a 17-item Likert scale). Data were analyzed using descriptive statistics, bivariate analysis, and multivariable logistic regression to identify predictors of high AI acceptability. Results: The mean knowledge score was 8.7 ± 3.1, with 32.3% demonstrating good knowledge (≥11/15). Perceived usefulness (mean 3.7 ± 0.7) and intention to use (3.6 ± 0.8) scored highest among attitude domains, while job-displacement concern averaged 3.1 ± 0.9. High acceptability (composite score > 3.5) was observed in 54.5% of the nurses. Multivariable analysis identified good knowledge (AOR = 2.85, p = 0.020), prior AI training (AOR = 3.41, p = 0.038), and high computer literacy (AOR = 2.23, p = 0.047) as significant predictors, while job-displacement concerns were inversely associated (AOR = 0.71, p = 0.037). The most reported barriers were lack of training (71.7%) and inadequate infrastructure (57.6%), whereas key facilitators included hands-on workshops (68.7%) and managerial support (55.6%). Conclusion: Nurses in this study showed moderate AI knowledge and cautious optimism toward adoption. Targeted training, infrastructure investment, and addressing job security concerns are crucial to enhancing the acceptability of AI in nursing practice, particularly in resource-limited healthcare settings such as Pakistan.

Role of Nurses in Public Health Education Programs on Glycaemic Control Among Type 2 Diabetic Patients in Urban and Rural Settings

2025-09-10T18:20:18+00:00

Type 2 diabetes mellitus (T2DM) poses a significant public health burden in Pakistan, with urban and rural populations facing distinct challenges in management. Nurse-led education programs have shown potential in improving glycaemic control and self-care behaviors, but comparative evidence between these settings remains limited. Objective: To evaluate the effectiveness of structured nurse-led public health education programs on glycaemic control and lifestyle adherence among T2DM patients in urban and rural Pakistan. Methods: A quasi-experimental study was conducted from July to December at a tertiary care hospital in Pakistan, enrolling 99 patients with type 2 diabetes mellitus (T2DM) (54 urban, 45 rural) aged 35–70 years with HbA1c levels of≥7.5%. The intervention consisted of six months of structured, nurse-led education on dietary modification, physical activity, medication adherence, and self-monitoring of blood glucose levels. HbA1c and fasting blood glucose (FBG) were measured at baseline and after six months using standardized methods. Lifestyle adherence was assessed using validated questionnaires. Data were analyzed using paired and independent t-tests as well as chi-square tests, with p < 0.05 considered statistically significant. Results: Both urban and rural groups showed significant reductions in HbA1c (urban: 9.4% to 7.8%; rural: 9.8% to 8.3%), with a greater improvement in the urban group (p = 0.04). FBG decreased significantly in both groups, with a more pronounced reduction in urban participants (p = 0.03). Lifestyle adherence improved in both settings, with significant differences in regular self-monitoring of blood glucose favoring the urban group (68.5% vs. 48.9%, p = 0.04). Conclusion: Nurse-led education significantly improves glycemic control and lifestyle adherence in patients with type 2 diabetes mellitus (T2DM) in both urban and rural settings. Urban patients experienced greater benefits, underscoring the need for tailored strategies to overcome rural healthcare barriers. Integrating such programs into national diabetes management plans could enhance long-term outcomes.

Impact of Hempseed Incorporation on the Quality Characteristics of Granola: Nutritional and Sensory Evaluation

2025-09-06T09:26:19+00:00

Health-conscious consumers are increasingly seeking functional foods enriched with natural ingredients to promote wellness. Hemp seeds, a nutrient-dense byproduct of commercial fiber production, offer potential for incorporation into food products to enhance both nutritional and sensory attributes. Objective: This study aimed to develop hempseed-incorporated granola using two different processing techniques and to evaluate its nutritional composition, functional properties, and sensory acceptability. Methods: A comparative experimental study was conducted to prepare hempseed-based granola using oven-baked and roasted methods. Proximate composition (moisture, ash, fat, fiber, protein, carbohydrate), functional properties (bulk density, oil-holding capacity, water-holding capacity, swelling index), and sensory evaluation (taste, color, aroma, texture, mouthfeel, overall acceptability) were assessed. Data were analyzed using standard statistical procedures to determine significant differences between treatments (p<0.05). Results: The oven-baked granola demonstrated significantly higher ash (2.68%), fat (22.47%), fiber (5.52%), and protein (16.45%) contents, whereas roasted granola contained higher moisture (4.30%) and carbohydrate (56.17%) levels. Functional characteristics were improved in the oven-baked product, including bulk density (1.00), oil-holding capacity (2.85), water-holding capacity (2.19), and swelling index (3.60). Sensory scores indicated superior consumer acceptance for the oven-baked granola in terms of taste, color, aroma, texture, mouthfeel, and overall acceptability compared with roasted granola. Conclusion: Incorporating hempseed enhances the nutritional, functional, and sensory qualities of granola, particularly when processed using oven-baking methods. This product provides a sustainable and health-promoting snack alternative for individuals pursuing nutritious and natural dietary options.

Assessment of Parents’ Knowledge of Their Infants’ Pain Experience in the NICU

2025-09-04T17:16:52+00:00

Parental involvement in the assessment and management of neonatal pain in the Neonatal Intensive Care Unit (NICU) is essential for improving infant comfort and outcomes. However, gaps persist in parental knowledge, use of pain assessment tools, and engagement in clinical decision-making. Limited evidence exists from the Pakistani context, where resource constraints may further impact parental participation. Objective: To assess the knowledge and involvement of parents in evaluating their infants' pain experiences in the NICU of a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted from July 2024 to March 2025 at a tertiary care hospital NICU in Lahore. Using non-probability convenience sampling, 153 parents of neonates aged less than one month were recruited. Data were collected through a structured, validated questionnaire that covered demographic characteristics, parental knowledge of pain assessment, and their involvement in the assessment process. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS version 21. Results: More than half of the infants (52.9%) were aged 0–7 days, with a slight female predominance (52.3%). Preterm births accounted for 32.7% of cases, and 64.7% of infants had a birthweight below 2500 grams. Most deliveries were by cesarean section (60.1%). The leading causes for NICU admission were shortness of breath (34.0%) and jaundice (24.8%). Regarding parental involvement, 56.2% reported that their expertise was considered in pain assessments; however, only 41.8% were informed about pain scales, and 26.8% were asked to use standardized tools. Nearly half (49.0%) could identify the type of pain, but many parents were uncertain about assessing its duration and location. Conclusion: While over half of the parents felt included in their infants' pain assessment, significant knowledge gaps remain, particularly in understanding and applying standardized pain assessment tools. These findings highlight the need for targeted educational interventions to improve parental engagement in neonatal pain management.