Biological and Clinical Sciences Research Journal

Navigating Parental Knowledge, Experiences, and Challenges Regarding Post-Discharge Care of Preterm Infants

Thu, 31 Jul 2025 00:00:00 +0000

Preterm birth remains a leading cause of neonatal morbidity and mortality globally, with heightened vulnerability persisting after hospital discharge. In resource-limited settings like Pakistan, the caregiving burden shifts predominantly to families, often without adequate preparation or support, leading to adverse outcomes despite advancements in neonatal care. Objective: To explore the knowledge, caregiving experiences, and challenges faced by caregivers of preterm infants after discharge from a tertiary care hospital in Pakistan. Methods: This descriptive, cross-sectional study was conducted in the Neonatology Department of Services Hospital, Lahore, from Nov 2024 to May 2025, following ethical approval (IRB/2025/1530/SIMS). Thirty-six caregivers of preterm infants (born <37 weeks gestation) discharged within the previous six months were recruited through non-probability convenience sampling. Data were collected through structured interviews during follow-up visits using a comprehensive questionnaire covering demographics, infant characteristics, feeding practices, kangaroo mother care practices, hygiene and temperature control, recognition of danger signs, developmental monitoring, emotional well-being, cultural influences, and access to support systems. Descriptive statistics and thematic analysis were used for data interpretation. Results: Most caregivers were mothers (66.7%) with a mean age of 29.94±7.22 years and 44.5% having tertiary level education. Mean infant gestational age was 31.00±2.39 weeks with birth weight 1631.67±429.68g. Primary neonatal diagnoses included respiratory distress syndrome (30.5%), jaundice (22.2%), and sepsis (19.5%). While 83.3% of caregivers knew breastfeeding benefits, only 50% practiced exclusive breastfeeding, with 13.9% incorrectly diluting formula. Hunger cues were confidently recognized by 50% of caregivers. KMC was practiced at home by 44.4% with a mean frequency of 5.1±2.9 hours daily. Despite 83.3% receiving hygiene counseling, only 58.3% consistently practiced good hygiene. Danger sign recognition was limited, with only 27.8% identifying cyanosis, though all caregivers (100%) would seek hospital care when needed. Health concerns were reported in 72.2% of infants, primarily breathing difficulties (27.8%). Developmental concerns were noted by 30.6% of caregivers, while 38.9% reported infants achieving smiling milestones. Follow-up adherence was good (75% attending regular visits), but barriers included scheduling challenges (33.3%), transport issues (11.1%), and financial constraints (5.6%). Traditional practices were used by 47.2% of families. Emotional strain affected 55.5% of caregivers, with stress and fatigue reported by 35.5%. Post-discharge counseling was considered adequate by only 61.1%, while 38.9% received incomplete support. Conclusion: Caregivers of preterm infants face multifaceted challenges after discharge, including significant gaps between knowledge and practice implementation, particularly in exclusive breastfeeding, KMC continuation, and danger sign recognition. Despite relatively high educational levels, practical application of essential neonatal care practices remained suboptimal. Key challenges included feeding difficulties (58.4%), health-related concerns (72.2%), emotional strain (55.5%), and cultural conflicts with medical advice (47.2%). The study reveals urgent needs for structured, culturally-sensitive discharge education extending beyond hospitalization, enhanced psychosocial support addressing maternal mental health, community-based reinforcement mechanisms, and innovative follow-up strategies bridging hospital-to-home care transitions. These findings provide valuable insights for developing targeted interventions to improve neonatal outcomes in similar resource-limited settings.

Comparison of Low-Dose Isotretinoin and Conventional Dosing Regime for the Management of Acne Vulgaris

Usman Ghani, Ansa Bakhtawar, Izma Tariq — Thu, 31 Jul 2025 00:00:00 +0000

Acne vulgaris is a prevalent dermatological condition that significantly affects quality of life. Although isotretinoin is the gold-standard treatment for moderate to severe acne, its conventional dosing is often associated with considerable side effects, prompting investigation into low-dose regimens for comparable efficacy with improved tolerability. Objective: To compare the efficacy and safety of low-dose isotretinoin versus a conventional dosing regimen in patients with moderate to severe acne vulgaris. Methodology: An observational comparative study was conducted with 120 patients aged 14 years or older, equally divided into two treatment groups. Group A received conventional-dose isotretinoin (80 mg/day) while Group B received low-dose isotretinoin (20 mg/day). Acne severity was assessed at baseline using GAGS scores, with moderate acne classified as 19–30 and severe acne as 31–38. Efficacy was evaluated by calculating the percentage reduction in GAGS scores after 12 weeks, categorized as slight (<30%), moderate (30–50%), good (50–80%), or excellent (>80%). An excellent GAGS score was considered adequate. Safety was monitored through clinical assessments of common side effects (e.g., dry skin and dry eyes. Results: The low-dose group exhibited higher efficacy with 70% of patients achieving excellent improvement (>80% GAGS score reduction) compared to 45% in the conventional-dose group. Adverse effects were notably lower in the low-dose group: dry skin (8.3% vs. 16.7%) and dry eyes (10% vs. 20%). Conclusion: Low-dose isotretinoin is an effective and safer alternative to conventional dosing for moderate to severe acne.

Peculiarity of Diabetes in Presentation Characteristics and Outcomes in Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention in Tertiary Care Cardiac Centre

Thu, 31 Jul 2025 00:00:00 +0000

Diabetes mellitus (DM) is a major risk factor for cardiovascular diseases. Atypical and late presentations in people with diabetes pose a danger of delayed diagnosis, treatment, interventions, and, as a result, worse outcomes. In patients with AMI undergoing Primary PCI(PPCI), people with diabetes are prone to high thrombus burden and procedural complications. A registry revealed to have a high thrombus burden, high mortality, and delays in interventions. Studies have shown that patients with type 2 diabetes mellitus (T2DM) combined with AMI are in a high-risk group for no-reflow Phenomena because these patients usually have complex coronary artery diseases. Objective: This study aims to systematically assess the presentation characteristics and outcomes of diabetic patients who presented with AMI Undergoing Primary PCI. Method: A retrospective cohort study was conducted on 422 patients admitted with AMI who underwent PPCI. Patients' data were taken from electronic health records (HMIS)-demographics, presentation, and PPCI data. The Primary outcomes evaluated were in-hospital mortality and PPCI-related complications. Results: Out of 422 patients, 33.6% were diabetic and 66.3% were non-diabetic. Diabetic patients had a higher mean age, longer symptoms to hospital visit duration (9.11 hours vs 8.84 hours), more multivessel disease (28% vs 16.7%), and a higher heavy thrombus burden. Despite presenting later, door-to-balloon times were similar. People with diabetes had lower TIMI-III flow rates (23.4% vs 30.36% in nondiabetics), lower complete revascularization rates, and higher MACE incidence. Conclusion: Diabetic patients with AMI show distinct clinical characteristics and significantly worse outcomes compared to nondiabetics, highlighting the need for heightened clinical suspicion, rapid diagnostics, aggressive early management, and future interventions to improve timely access to care and optimize long-term management for this high-risk population.

Assessment of the Knowledge and Practice of Generic Nursing Students About Cardiopulmonary Resuscitation

Ibrahim Khan, . Karimulhaq, Kousar Perveen, Syeda Tasneem Kausar — Thu, 31 Jul 2025 00:00:00 +0000

Cardiopulmonary resuscitation (CPR) is a fundamental skill required of nursing professionals to improve patient outcomes during cardiac emergencies. Despite global efforts to integrate CPR into nursing education, evidence suggests persistent knowledge and practice gaps among students, particularly in resource-constrained settings like Pakistan. Objective: To assess the knowledge and practice levels regarding CPR among undergraduate nursing students at Superior University, Lahore. Methods: A descriptive cross-sectional study was conducted among 177 Bachelor of Science in Nursing (BSN) students across all four academic years. A structured, pre-validated questionnaire comprising 13 knowledge and nine practice items was administered. Data were collected using simple random sampling and analyzed using SPSS version 23. Descriptive statistics, including frequencies and percentages, were used to summarize the findings. Results: Out of 177 students, 55.4% were female and 50.8% were aged between 21 and 23 years. The majority were second-year students (37.3%). While 80.2% correctly identified the meaning of "BLS", only 47.5% knew how to respond to an unconscious, non-breathing individual. Knowledge about compression locations and AED use was low (30.5% and 31.6%, respectively). In terms of practice, 54.8% identified the adult CPR algorithm correctly, 64.4% knew the correct pulse check site, and only 45.8% identified proper AED pad placement. Awareness of ERC 2015 guidelines stood at 56.5%. Conclusion: The study identified critical gaps in both theoretical knowledge and practical competence of CPR among nursing students. Findings underscore the urgent need for curriculum enhancements, including simulation-based learning, regular refresher training, and inclusion of updated CPR protocols to strengthen emergency response readiness in Pakistani nursing education.