Journal of Rehman Medical Institute

Analysis of Measles Vaccination Status in Indoor Measles Patients

2026-03-30T04:45:17+00:00

Abstract:

Introduction: Measles is a highly contagious viral disease causing severe complications and death, especially in children under five. Despite a safe, cost-effective vaccine, measles remains a public health concern in Pakistan.

Objective: To analyze measles vaccination status among indoor patients and its association with demographic factors.

Materials & Methods: A cross-sectional study was conducted on 264 indoor measles patients aged 6 months–12 years. Data were collected using non-purposive sampling and analyzed with SPSS 22. Demographics included age, gender, residence, parental education, and socioeconomic status. Chi-square and chi-square goodness-of-fit tests were applied.

Results: Among 264 patients, 149 (56.4%) were males and 115 (43.6%) females. Most patients (147; 55.7%) were aged 6 months–2 years. Vaccination status was 55 (21%) fully vaccinated, 24 (9%) partially vaccinated, and 185 (70%) unvaccinated, showing a significant difference from expected frequencies (p<0.05). No significant association was observed between vaccination status and gender, residence, parental education, or socioeconomic status (p>0.05). Vaccination coverage varied across D.I.Khan, Bannu, and Peshawar.

Conclusion: Measles predominantly affects unvaccinated children. Strengthened vaccination programs and targeted public health interventions are needed to reduce measles burden.

Keywords: Measles, Vaccination, Children, Cross-sectional Study, Pakistan, Immunization, Public Health

A Rare Case of Common Variable Immunodeficiency Presenting with Recurrent Infections and Lung Abscess in a Young Female.

2026-03-28T06:30:33+00:00

Common Variable Immunodeficiency Syndrome (CVID) is a rare primary immunodeficiency characterized by low immunoglobulin levels, recurrent infections, and an increased risk of pulmonary complications. Early diagnosis is crucial to prevent morbidity and mortality. We report a case of a 21-year-old female presenting with recurrent respiratory infections and a right-sided lung abscess. She had a history of pulmonary tuberculosis (TB) and recurrent sinus infections. CT Chest demonstrated cavitary lung lesions consistent with abscess formation. Laboratory investigations revealed significantly reduced immunoglobulin levels, leading to a diagnosis of CVID. This case highlights the importance of recognizing underlying immune deficiencies in patients with recurrent infections.

Self-medication among Patients for Dental Pain

2026-03-27T07:52:05+00:00

ABSTRACT:

INTRODUCTION: Patients experiencing dental pain often resort to self-medication with analgesics and antibiotics to avoid undergoing dental treatment. Self-medicating for a prolonged time can lead to untreated dental problems, ultimately causing a decline in oral health and tooth loss.

OBJECTIVE(S): To determine the number of patients taking self-medications and the factors leading to self-medication among patients with dental pain.

METHODOLOGY: A descriptive cross-sectional study was conducted in the outpatient department of Peshawar Dental College for three months. A consecutive sampling technique was used. All adult patients were included in the study. Medically compromised patients and patients with no dental pain were excluded. A validated questionnaire was used to evaluate self-medication usage for dental pain. The association between variables was found by using the chi-square test.

RESULTS: Among 320 patients, 165 (51.6%) were male, and 155 (48.4%) were female. Among these, 57.2% were found taking self-medication for their dental pain. Most patients were in the 18-29 age range (44.1%), from urban areas (51.2%), and belonged to the middle 76.3% socioeconomic status. Most patients, 51.9%, used a swallowed type of self-medication, most of which comprised NSAIDS (50%). Self-medication is often driven by a lack of time (39.1%) and an assumption that the ailment is minor and doesn't require a doctor's attention (25%). Association of self-medication usage was found with age p= 0.039 and residence p=0.047; however, no significant association was found with education and socioeconomic status.

CONCLUSION: Age and area of residence affect self-medication usage among patients for their dental pain.

KEYWORDS: Self-medication, Dental Pain, Patients.

Association Between Blood Pressure Control and Cardiovascular Events in Hypertensive Patients A Prospective Cohort Study

2026-03-26T19:46:17+00:00

ABSTRACT

Introduction: Hypertension is one of the most pressing health issues in Pakistan, which is linked to cardiovascular morbidity and mortality. Uncontrolled blood pressure exposes an individual to unfavorable outcomes including heart attack, stroke and heart failure. To maximize the outcomes of antihypertensive treatment and minimize short-term cardiovascular events, it is essential to evaluate the efficacy of antihypertensive treatment in the everyday clinical practice.

Objective: To consider the effectiveness of antihypertensive treatment in the approach to the management of blood pressure and prevention of short-term cardiovascular complications in adult patients with systemic hypertension.

Methods and Materials: This cohort study will be a prospective study carried out at the Department of Medicine, District Head Quarter Hospital, Dera Ismail Khan, Pakistan, from January to August 2025. Consecutive sampling was used in enrolling 100 adults with confirmed systemic hypertension. Background demographic and clinical information such as blood pressure, body mass index and comorbidity were obtained. The patients received prescribed to take individualized antihypertensive therapy such as ACE inhibitors, beta blockers, calcium channel blocker and diuretics. The baseline and post-treatment, as well as 4 and 8-months follow-ups were used to measure blood pressure. Cardiovascular incidents were recorded like myocardial infarction, stroke and hospitalization because of uncontrolled hypertension. The SPSS version 23 was used to analyzed the data.

Results: The average age of the sample was 52.18 ± 11.74 with 58 percent males and 42 percent females. The systolic and diastolic blood pressures were 158.36 ± 14.25 and 96.42 ± 8.73 respectively. After 8 months of antihypertensive treatment, the mean systolic and diastolic pressures were reduced to 132.54 ±11.67 mmHg and 82.19±6.54 mmHg respectively. In 82% of patients, blood pressure was controlled and 18% have uncontrolled. There were 13 participants who had cardiovascular events. Poor blood pressure control showed a significant association with advanced age, smoking, and obesity.

Conclusion: Blood pressure and short-term cardiovascular events were reduced with the use of antihypertensive therapy. To maximize the performance of hypertensive patients, it is important to make a timely diagnosis, follow-up and perform routine monitoring.

Keywords: Hypertension; Antihypertensive Therapy; Blood Pressure Control; Cardiovascular Events; Abbottabad.

Effectiveness of Antihypertensive Therapy on Short Term Cardiovascular Events in Systemic Hypertension: A Prospective Study

2026-03-25T20:24:36+00:00

ABSTRACT

Keywords: Hypertension; Antihypertensive Therapy; Blood Pressure Control; Cardiovascular Events; Abbottabad.

The Factors affecting anti-diabetic medication adherence among type 2 diabetes mellitus patients in Peshawar and Islamabad

2026-03-16T18:58:38+00:00

Abstract

Background: Medication adherence is a major challenge among type 2 diabetes patients. Therefore , the current study was undertaken to determine the factors affecting medication adherence among type 2 diabetes patients In Peshawar and Islamabad.
Objective: To determine the factors affecting medication adherence among type 2 diabetes mellitus patients In Peshawar and Islamabad.
Materials & Methods: A cross-sectional study was conducted over a period of 6 months from February 2024 to July 2024 among type 2 diabetes mellitus patients attending Sugar Hospital, Peshawar and The Diabetic Centre (TDC), Islamabad. A total of 308 patients who had been receiving anti-diabetic treatment for more than one year and provided informed consent were included using convenience sampling. Data were collected using a structured questionnaire comprising socio-demographic variables, the Medication Adherence Report Scale-5 (MARS-5), and binary (yes/no) questions assessing factors influencing adherence. Data were analyzed using SPSS version 21. Descriptive statistics and chi-square tests were applied, with p<0.05 considered statistically significant.
Results: Of the participants, 60.1% were adherent and 39.9% were non-adherent to anti-diabetic medications. Medication adherence was significantly associated with age, educational status, occupation, socio-economic status, type of anti-diabetic therapy and healthcare facility location (p < 0.05), table1, 3-5 and fig-2. Patients receiving insulin therapy demonstrated lower adherence compared to those on oral anti-diabetic medications. No significant association was found between adherence and gender, marital status, duration of diabetes or family history.
Conclusion: Medication non-adherence remains a considerable challenge among patients with type 2 diabetes mellitus. Financial constraints, poor family support and treatment related factors were major contributors to non-adherence, highlighting the need for targeted educational and socio-economic interventions.
Keywords: type 2 diabetes mellitus, medication adherence, associated factors.

original article Prevalence of De Quervain Tenosynovitis Among Students of CECOS University Peshawar

2026-03-12T08:11:19+00:00

Background: DeQuervain’s Tenosynovitis (DQT) is a prevalent work-related musculoskeletal condition affecting the first dorsal compartment of the wrist, affecting the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon represented by radial- sided wrist pain, swelling, tenderness at the styloid process of the radius and it is frequently linked with repeated wrist and thumb motions commonly found in students who are frequently engaged in smartphone use and overwriting.

Objective: To determine the prevalence of De Quervain's tenosynovitis among medical and non-medical students performing laboratory work. To identify the association between laboratory work and the prevalence of DQT.

Methods: Cross sectional study was conducted in which 299 undergraduate students from medical and non-medical department with age range from 18 to 30 participated. Demographic questionnaire, De Quervains Screening Tool (DQST), Numeric Pain Rating Scale (NPRS) and Finkelstein test were used to collect data. SPSS version 27 has been used to interpret data and chi square test was carried out to evaluate the association between prevalence of DQT and laboratory engagement.

Results: Results showed the overall frequency of DQT is 38.8%. with more prevalent among non-medical students (40.9%) than among medical students (34.9%). 64.5% of students reported mild to moderate pain, while 65.2% of participants reported a positive Finkelstein test. 103 out of 116 DQT-positive students reported doing laboratory work frequently, indicating a substantial correlation between frequent laboratory work participation and DQT prevalence (p = 0.004).

Conclusion: DQT is a prevalent issue among both medical and non-medical students. A significant overall prevalence was identified among students with higher prevalence among non-medical students, and a significant association was noted between laboratory work and DQT.

A PATTERN OF ANTIMICROBIAL SENSITIVITY AND RESISTANCE OF SALMONELLA TYPHI AND SALMONELLA PARATYPHI AMONG CHILDREN WITH ENTERIC FEVER IN A TERTIARY CARE HOSPITAL, SWAT, PAKISTAN

2026-03-11T20:08:03+00:00

Objective:

To evaluate the demographic characteristics, antibiotic resistance patterns, and sensitivity profiles of Salmonella infections in children.

Materials and Methods:

A cross-sectional study was conducted on 92 children with culture-confirmed Salmonella infections. Data on demographics, organism type, and antibiotic sensitivity patterns were collected and analyzed. Antibiotic susceptibility was determined using standard laboratory protocols, and resistance rates were documented for commonly used antibiotics.

Results:

The study included 92 children with a mean age of 4.76 ± 1.24 years, of which 37% were male and 63% female. Among the isolates, 96.74% were identified as Salmonella Typhi and 3.26% as Salmonella Paratyphi. Antibiotic resistance was highest for nalidixic acid (95.7%), ampicillin (93.5%), and ceftriaxone (81.5%). Moderate sensitivity was observed for fluoroquinolones, with levofloxacin showing a sensitivity of 44.6%. Meropenem (97.8%) and azithromycin (98.9%) exhibited the highest sensitivity rates, indicating their effectiveness as treatment options.

Conclusion:

The study highlights the alarming resistance rates to commonly used antibiotics, emphasizing the need for stringent antibiotic stewardship programs. Meropenem and azithromycin emerged as the most effective antimicrobials for treating MDR Salmonella infections. The findings underscore the importance of vaccination campaigns and the prudent use of antibiotics to combat resistance.

Determinants of Hypertension Awareness among Adult Outpatients Attending a Tertiary Care Hospital in Karachi, Pakistan

2026-03-11T05:00:49+00:00

Background: Hypertension is a leading cause of cardiovascular morbidity and mortality
worldwide. Awareness of hypertension and its risk factors is critical for prevention, early
detection, and control. In Pakistan, limited awareness contributes to suboptimal management
despite rising prevalence.
Objective: To evaluate hypertension awareness and its associated factors among adult
outpatients attending a tertiary care hospital in Karachi, Pakistan
Methods: A cross-sectional study was conducted at Department of Community Medicine,
Baqai Medical College with data collection performed at Fatima Hospital, Baqai Medical
University, Karachi, from November 2023 to December 2024. A total of 385 adult
outpatients were enrolled using convenience sampling. Interview-based, structured
questionnaire was administered to assess socio-demographic characteristics and awareness.
SPSS (version 20.0) was used for data analysis.
Results: Mean age of the respondents was 34.63±12.45 years; 57.9% were female. Overall,
only 42.6% participants demonstrated adequate awareness regarding hypertension. Education
level (primary AOR=3.64, 95% CI 1.84-7.19, p<0.001; secondary AOR=3.13, 95% CI 1.53-
6.41, p=0.002; intermediate AOR=4.65, 95% CI 1.81-11.90, p=0.001 and graduation or
above AOR=28.00, 95% CI 9.52-82.33, p<0.001), employment status (employed AOR=1.99,
95% CI 1.11-3.56, p=0.019) and diagnosis of hypertension (diagnosed AOR=2.35, 95% CI
1.28-4.30, p=0.006) were found to be significantly associated with awareness level of the
participants.
Conclusions: Study result reveals that awareness of hypertension remains suboptimal, with
less than half respondents demonstrating adequate knowledge. This highlights the need for
integrating targeted health education into routine outpatient care for patients to enhance
awareness of hypertension and to contribute towards its better prevention and effective
control.

The "Microbiome" of the Sink: Are Hospital Faucets the Reservoir for Multidrug-Resistant Pseudomonas in Pediatric Nephrology Wards?

2026-03-09T13:43:12+00:00

Hospital-acquired infections, particularly those caused by multidrug-resistant organisms (MDROs), pose a severe and persistent threat to vulnerable patient populations, including those in pediatric nephrology units. Mounting evidence identifies hospital sink drains and faucets not as passive fixtures, but as complex ecological reservoirs. These environments support biofilm formation and facilitate the horizontal gene transfer of antimicrobial resistance determinants, directly linking environmental persistence to clinical infection. This letter argues that current reactive infection control strategies are insufficient to address this environmental vector. We advocate for a paradigm shift toward proactive environmental containment in ultra-high-risk settings, such as pediatric dialysis and transplant centers. Specifically, the mandatory installation of "self-disinfecting" faucets with integrated UV-C light technology. This targeted engineering control offers continuous, automated disinfection at the source, the faucet interior and aerator to disrupt biofilm formation and interrupt the environmental transmission chain. Adopting such a measure is critical to achieving a "zero-tolerance" goal for infections in our most fragile patients and transforming pediatric nephrology wards into exemplars of preventive innovation by targeting the hidden "microbiome of the sink."

Prevalence and Severity-Stratified Psychosocial and Academic Outcomes of Primary Dysmenorrhea among Healthcare Students: A Cross-sectional Study in Swat

2026-03-06T16:30:10+00:00

Introduction

Primary dysmenorrhea (PD) refers to painful menstrual bleeding in the absence of any pelvic or reproductive pathology.

Objectives

To examine prevalence, severity distribution, symptomology, and psychosocial and academic outcomes among female medical and nursing students.

Materials and Methods

A cross-sectional study was conducted at Saidu Group of Teaching Hospitals, Swat. Data, including sociodemographic, menstruation, menstrual pain, and its outcomes, were collected from 418 participants recruited using a non-probability, convenience sampling technique. Descriptive and inferential statistics were applied using IBM SPSS, with a p-value <0.05 considered statistically significant.

Results

PD was 75.8% prevalent, with the following severity distribution: 24% mild, 41% moderate, and 25% severe. Mood swings (87%) and fatigue (77%) were the most reported associated symptoms; however, the incidence of only dizziness (45%), nausea (50%), vomiting (23%), and diarrhea (40%) increased significantly with pain severity (p <0.05). Similarly, significant associations were indicated with sleep disturbance, appetite changes, poor academic performance, and physical, emotional, and social limitations (p<0.05). Common pain management strategies included taking painkillers (73%) and rest or sleep (89%). A vast majority of participants (59%) perceived menstrual pain as a normal phenomenon, and only 17% consulted with a healthcare professional.

Conclusion

This study demonstrated an alarmingly high prevalence of PD, which exerts profound impacts on students' daily lives and academic performance. Study participants, despite being healthcare students, considered menstrual pain as normal and chose not to seek professional help. Awareness campaigns and accessible management strategies are crucial to mitigate the devastating effects of dysmenorrhea on females' lives.

Trends of Study and Memorization among MBBS Students of Rawalpindi and Islamabad

2026-03-03T05:09:56+00:00

Abstract

Background: Effective study habits are crucial for academic success among university students. This study examines the study practices, memorization techniques, and their association with academic performance.

Objectives: To identify and describe the trends of study habits and memorization techniques among medical students from second year to final year and association with academic performance.

Methodology: Descriptive cross sectional study was conducted during 15th July 2023 to 15^th January 2024 at selected medical colleges of Rawalpindi and Islamabad. The study participants were second to final year students both male and female. Participants were selected through simple random sampling technique. Sample size was 427 calculated using formulas. Data was collected through structured questionnaire. Data was collected on demographics, study habits, memorization techniques, confidence levels, and GPA. Statistical analysis, including odds ratio calculations, was used to identify factors associated with achieving a GPA above 3 out of 4.

Results: The majority of students studied 4-6 hours daily, primarily at night, with group discussions and textbook reading being the most common study methods. Repetition emerged as the predominant memorization technique, perceived as effective by students. Significant factors associated with higher academic performance included reading textbooks (OR=1.8, p=0.003), participating in group discussions (OR=2.0, p=0.003), practicing questions (OR=1.7, p=0.005), and regular review sessions (weekly and monthly). Confidence in recalling information also correlated positively with GPA.

Conclusion: Active learning strategies, consistent revision, and confidence are key determinants of academic success. Educational interventions promoting these practices could enhance student performance. Further research is warranted to explore targeted strategies for improving study habits.

Key Words: Memorization, trends, academic performance