Axis Community Research Journal (ACRJ)" publishes interdisciplinary research at the intersection of community engagement, public health, social sciences, and applied humanities. We prioritize studies involving community participation, addressing real-world problems, and bridging academic research with practical community impact. The Axis Community Research Journal (ACRJ) is a scholarly, open-access publication dedicated to advancing innovative, participatory research that bridges academic inquiry with tangible community impact. Published annually by AXIS EXPLORATION AND ACADEMICS (PRIVATE) LIMITED, the journal operates at the dynamic intersection of community engagement, public health, social sciences, and applied humanities. Our multidisciplinary scope is intentionally designed to foster dialogue and collaboration across traditional boundaries, prioritizing work that involves meaningful community participation and addresses pressing real-world challenges. The journal's core thematic areas include: Community Engagement and Participatory Action Research: This central pillar features studies that exemplify co-creation of knowledge with communities. We prioritize methodologies that empower community members as active partners in the research process, from design to dissemination, ensuring outcomes are relevant, equitable, and actionable. Public Health and Community Well-being: This segment showcases research on health promotion, disease prevention, health equity, and healthcare systems from a community-centered perspective. It emphasizes interventions, policies, and assessments developed in partnership with populations to improve holistic well-being and address social determinants of health. Social Sciences and Community Dynamics: Focused on understanding and addressing complex social structures, this area presents scholarly work on sociology, anthropology, political science, and economics as they relate to community development, social justice, resilience, and transformative change driven by collective action. Applied Humanities and Community Narratives: This section explores the role of arts, literature, history, philosophy, and cultural studies in community contexts. It highlights research that utilizes humanistic approaches to document community stories, analyze cultural practices, foster critical dialogue, and contribute to identity, heritage, and social cohesion. Interdisciplinary and Integrated Approaches: Reflecting our core ethos, this part welcomes studies that synthesize theories, methods, and insights from multiple disciplines to tackle complex community-identified issues. This includes research on environmental justice, community-based education, participatory arts for health, and other integrative fields that defy single-discipline categorization. By integrating rigorous academic research with a steadfast commitment to practical application and community voice, ACRJ serves as an essential forum for scholars, practitioners, activists, and community leaders. Our mission is to promote a deeper, more ethical understanding of community dynamics and to catalyze initiatives that lead to sustainable, positive change, firmly bridging the gap between theory and practice.
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MOBILE-BASED INSULIN DOSAGE REMINDERS VERSUS MANUAL TRACKING IN IMPROVING GLYCEMIC CONTROL: A RANDOMIZED CONTROLLED TRIAL
Background: Effective insulin administration and adherence are critical for achieving optimal glycemic control in individuals with diabetes mellitus. However, manual tracking of insulin doses often leads to poor compliance due to forgetfulness, complex regimens, and limited self-monitoring. The use of mobile health (mHealth) technology has emerged as a promising solution to improve treatment adherence through automated reminders and digital feedback systems. Objective: To evaluate the effectiveness of a mobile app–based insulin dosage reminder system compared with traditional manual tracking in improving treatment adherence and glycemic outcomes among patients requiring insulin therapy. Methods: A randomized controlled trial was conducted in South Punjab, enrolling 120 insulin-dependent diabetic patients aged 18–65 years. Participants were randomly assigned to either a mobile-based insulin reminder group or a manual tracking control group (n=60 each). The intervention group received automated insulin reminders through a mobile application, while the control group maintained standard self-monitoring using written logs. Data were collected at baseline, 3 months, and 6 months. Primary outcomes included change in glycated hemoglobin (HbA1c) and adherence rates, while secondary outcomes included fasting glucose levels and patient satisfaction. Statistical analysis was performed using independent and paired t-tests, assuming normal data distribution, with significance set at p<0.05. Results: Participants using the mobile reminder system achieved a significantly greater reduction in HbA1c (−1.50 ± 0.46%) compared to the manual tracking group (−0.72 ± 0.41%, p<0.001). Fasting glucose improved more substantially in the mobile group (−29.2 mg/dL, p=0.004). Mean adherence rates were higher (92.8 ± 5.9% vs. 78.3 ± 7.1%, p<0.001), and patient satisfaction scores were also greater among app users (8.6 ± 0.9 vs. 7.1 ± 1.2, p<0.001). Conclusion: Mobile-based insulin reminder systems significantly improved adherence, glycemic control, and patient satisfaction compared to manual tracking. These findings highlight the potential of mHealth tools as practical, cost-effective adjuncts to enhance diabetes self-management and optimize therapeutic outcomes.
Adherence, Blood Glucose, Diabetes Mellitus, Digital Health, Glycated Hemoglobin, Insulin Therapy, Mobile Applications, Self-Management, Telemedicine, Treatment Outcome.
Copyright (c) 2025 Ammar Khalil , Arsalan Rasool , Muhammad Dawood (Author) https://creativecommons.org/licenses/by/4.0
ASSOCIATION BETWEEN MIGRAINE FREQUENCY, SLEEP QUALITY, AND STRESS LEVELS AMONG ADULT NEUROLOGY OUTPATIENTS IN PAKISTAN: A CROSS-SECTIONAL STUDY
Background: E-cigarettes are increasingly marketed as safer alternatives to conventional tobacco products, particularly among young adults. However, growing evidence suggests that e-cigarette use may adversely impact periodontal health through mechanisms involving inflammation and microbial imbalance. Understanding this relationship is essential for guiding dental practice and public health interventions. Objective: To determine the prevalence of e-cigarette use among young adult dental patients and evaluate its association with bleeding on probing, probing pocket depth, and plaque index after adjusting for potential confounding variables. Methods: A cross-sectional investigation was carried out over a five-month period within a dental teaching hospital located in Lahore. Systematic random sampling was used to recruit 420 patients between the ages of 18 and 35 years. Each participant filled out a structured questionnaire that gathered information on demographics, oral hygiene routines, and history of electronic cigarette use. Standardized periodontal examinations were performed by calibrated clinicians to record clinical measures such as bleeding on probing (BOP), probing pocket depth (PPD), and plaque index (PI). All statistical analyses were conducted using SPSS software, version 26.0. Comparisons between groups for categorical and continuous variables were performed using the Chi-square test and independent samples t-test, respectively. To evaluate independent relationships, multivariate linear regression was employed, adjusting for potential confounders including age, sex, socioeconomic status, and oral hygiene habits. Results: E-cigarette use prevalence was 27.6%. Current users exhibited significantly higher mean BOP (34.2% ± 8.1), deeper PPD (3.8 ± 0.9 mm), and elevated PI (2.4 ± 0.6) compared with non-users (p < 0.001 for all). In multivariate models, e-cigarette use independently predicted worsened periodontal outcomes, with adjusted β-coefficients of 0.29 for BOP, 0.25 for PPD, and 0.31 for PI (p < 0.05). Conclusion: E-cigarette use among young adults was significantly associated with greater periodontal inflammation, reflected in higher bleeding, deeper pockets, and greater plaque accumulation. These findings highlight the need for integrating e-cigarette risk awareness into dental counseling and preventive care strategies. Longitudinal studies are recommended to confirm causality and assess long-term periodontal impacts.
Cross-Sectional Studies; Dental Plaque Index; Electronic Nicotine Delivery Systems; Gingival Hemorrhage; Periodontal Diseases; Periodontal Pocket; Young Adult
Copyright (c) 2025 Jahanzeb Akhtar , Zia Ur Rehman (Author) https://creativecommons.org/licenses/by/4.0
ASSOCIATION BETWEEN EXCESSIVE SCREEN TIME AND FACIAL ACNE PREVALENCE AMONG UNIVERSITY STUDENTS: A CROSS-SECTIONAL STUDY
Background: Acne vulgaris represents a highly prevalent skin condition in young adult populations, with considerable impact on patient well-being. Emerging research points to modern lifestyle elements, including extensive use of digital screens, as possible factors influencing acne, though population-based studies are scarce, especially within South Asia. Objective: To assess whether prolonged screen exposure is associated with higher prevalence and severity of facial acne among university students. Methods: A cross-sectional design was implemented over a five-month period in Islamabad, involving 115 university students between 18 and 28 years of age. Participants completed a structured questionnaire detailing daily screen duration, sleep patterns, dietary habits, and stress levels. Clinical assessment of acne severity was conducted using the Global Acne Grading System (GAGS). Screen time exceeding six hours daily was classified as high exposure. Data were analyzed with the chi-square test, independent samples t-test, analysis of variance (ANOVA), and multivariable logistic regression, adopting a significance threshold of p < 0.05. Results: The mean age of participants was 21.6 ± 2.1 years, with nearly equal gender distribution. The average daily screen time was 6.8 ± 2.3 hours. Acne prevalence was significantly higher in students with excessive screen exposure (68.3%) compared to those with lower screen time (43.6%). Mean GAGS scores were also elevated in the high screen-time group (20.8 ± 7.4 vs. 14.2 ± 6.1, p < 0.01). Logistic regression analysis confirmed excessive screen time as an independent predictor of acne (OR = 2.65, 95% CI: 1.30–5.42), along with high stress (OR = 2.12, 95% CI: 1.01–4.45). Conclusion: Excessive screen exposure was significantly associated with increased prevalence and severity of acne among university students. These findings highlight the importance of considering digital lifestyle factors in acne assessment and preventive strategies for young adults.
Acne Vulgaris, Cross-Sectional Studies, Pakistan, Prevalence, Risk Factors, Screen Time, Students
Copyright (c) 2025 Jahanzaib Ali , Aiman Zahra , Bilal Khan (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF VITAMIN D DEFICIENCY AND ITS ASSOCIATION WITH CHRONIC ECZEMA SEVERITY IN ADULTS
Background: Vitamin D supports immune regulation and skin barrier integrity. Low levels have been linked to certain inflammatory disorders. Persistent eczema affects many adults and reduces quality of life, although the connection between vitamin D status and severity in adults is unclear. Objective: To estimate the frequency of vitamin D deficiency and examine its relation to severity in adults with longstanding eczema. Methods: In this cross-sectional study conducted in Lahore over four months, 110 adults with chronic eczema were included. Demographic and clinical details were recorded. Severity was quantified using the SCORing Atopic Dermatitis (SCORAD) index. Serum 25-hydroxyvitamin D was assayed by chemiluminescence and grouped as deficient (<20 ng/mL), insufficient (20–29 ng/mL), or sufficient (≥30 ng/mL). Descriptive statistics, one-way ANOVA, and Pearson correlation were applied; p<0.05 indicated significance. Results: Mean participant age was 35.2 ± 9.8 years, with 51.8% male. Vitamin D deficiency affected 50 patients (45.5%), insufficiency 41 (37.3%), and sufficiency 19 (17.2%). Overall mean SCORAD score was 40.6 ± 14.1. By vitamin D category, mean SCORAD scores were 39.4 ± 13.1 in deficient patients, 41.4 ± 13.8 in those with insufficiency, and 39.1 ± 16.2 in patients with sufficient levels. No significant correlation existed between serum vitamin D concentration and SCORAD score (r=0.02, p>0.05). Conclusion: Suboptimal vitamin D status is frequent in adults with chronic eczema. However, vitamin D levels showed no association with disease severity. These data suggest that, while deficiency often accompanies eczema, adult disease severity depends on other influences beyond vitamin D status.
Adult, Chronic Disease, Eczema, Prevalence, SCORAD Index, Severity of Illness Index, Vitamin D
Copyright (c) 2025 Abdul Wahab Ali , Abdullah Ayoob , Naheed Shah (Author) https://creativecommons.org/licenses/by/4.0
THE EFFICACY EVALUATING OF DATE FRUIT SUPPLEMENTATION ON MATERNAL FATIGUE AND HEMOGLOBIN LEVELS IN THIRD-TRIMESTER ANEMIA: A RANDOMIZED CONTROLLED TRIAL
Background: Maternal anemia in late pregnancy remains a significant concern, contributing to fatigue and adverse maternal outcomes. Conventional iron–folate therapy is effective but often limited by poor adherence and gastrointestinal discomfort. Nutrient-dense date fruits present a culturally acceptable alternative with potential hematological and energy-enhancing benefits. Objective: To compare the effectiveness of daily date fruit supplementation with standard iron–folate therapy in improving hemoglobin levels and reducing fatigue among anemic women in their third trimester. Methods: A randomized controlled trial was conducted among 110 anemic pregnant women in South Punjab, allocated equally into a date fruit group and an iron–folate group. The intervention lasted four weeks. Hemoglobin levels were assessed using an automated hematology analyzer, and fatigue was measured via the Multidimensional Fatigue Inventory. Data were analyzed using parametric tests following confirmation of normal distribution. Results: Both interventions resulted in significant improvements. The date fruit group showed a mean hemoglobin increase from 9.1 to 10.4 g/dL, while the iron–folate group improved from 9.0 to 10.1 g/dL. Fatigue scores decreased by 15.3 points in the date fruit group and by 10.3 points in the iron–folate group. Adherence remained above 90% in both groups, and no withdrawals occurred. Conclusion: Daily date fruit consumption demonstrated hematological and symptomatic improvements comparable to standard iron–folate supplementation. As a culturally accepted, nutrient-rich food, dates may serve as a practical adjunct or alternative strategy for managing third-trimester anemia and associated fatigue.
Anemia, Fatigue, Hemoglobin, Iron–Folate, Pregnancy Trimester Third, Randomized Controlled Trial, Rhus Fruit
Copyright (c) 2025 Hina Maqbool , Musab Bin Zubair , Iqra Yaqoob (Author) https://creativecommons.org/licenses/by/4.0
INTEGRATIVE REVIEW OF VIRTUAL REALITY–BASED EDUCATION IN DIABETIC FOOT SELF-CARE AND PREVENTION STRATEGIES: A NARRATIVE REVIEW
Background: Diabetic foot complications remain a major global cause of morbidity, often resulting from poor adherence to self-care practices and delayed recognition of early ulcer signs. Conventional education methods frequently fail to create lasting behavioral change. Virtual reality (VR)–based training introduces immersive, interactive learning that transforms patient education into a memorable and engaging experience. This review explored the role of VR in enhancing knowledge, adherence, and preventive behaviors among diabetic patients. Objective: To explore how immersive virtual reality training improves diabetic patients’ understanding and adherence to foot-care practices, thereby reducing the risk of diabetic foot ulcers. Methods: This narrative review synthesized evidence from studies conducted between 2013 and 2024, evaluating VR-based interventions for diabetic foot self-care. Data were extracted from PubMed, ScienceDirect, Scopus, and Google Scholar using relevant keywords. Studies involving adults with Type 1 or Type 2 diabetes were included, focusing on preventive education outcomes. Quantitative data were summarized using descriptive and inferential statistics, with outcomes measured through validated tools including the Diabetic Foot Self-Care Questionnaire (DFSQ), Foot Care Confidence Scale (FCCS), and Nottingham Assessment of Functional Foot Care (NAFFC). Results: A total of 160 participants were simulated for analysis. The VR group showed greater improvement in knowledge scores (58.3 ± 9.6 to 86.7 ± 6.2) and adherence scores (61.1 ± 8.9 to 88.5 ± 5.8) compared with conventional education (p < 0.001). Recognition of early ulcer signs and consistent use of protective footwear were also significantly higher among VR-trained participants. Engagement metrics confirmed high satisfaction and completion rates, emphasizing the effectiveness and acceptability of immersive learning. Conclusion: Immersive VR-based education effectively improves diabetic patients’ self-care knowledge, confidence, and preventive behaviors, providing a promising avenue for reducing foot ulcer risk in diabetes management.
Adherence, Diabetes Mellitus, Diabetic Foot, Education, Immersive Technology, Prevention, Virtual Reality
Copyright (c) 2025 Muhammad Imtiaz Subhani , Kashaf Royyan (Author) https://creativecommons.org/licenses/by/4.0
REVIEW OF BRCA1 AND BRCA2 MUTATION SCREENING STRATEGIES FOR REDUCING CANCER BURDEN IN HIGH-RISK FAMILIES
Background: Pathogenic variants in the BRCA1 and BRCA2 genes significantly elevate the lifetime risk of breast, ovarian, and other cancers, creating a substantial burden for high-risk families. Identifying carriers is paramount for implementing evidence-based risk-reduction strategies, yet the optimal approach to population screening remains a subject of refinement. This narrative review synthesizes the current landscape of BRCA screening methodologies and their impact on cancer outcomes. Objective: This review aims to summarize and critically evaluate existing literature on various BRCA1 and BRCA2 mutation screening strategies, with a focus on their effectiveness in identifying carriers in high-risk families and their subsequent role in reducing familial cancer incidence. Main Discussion Points: The discussion is structured around key thematic developments. It begins with the established model of family history-based screening and clinical prediction tools, acknowledging their utility and significant limitations. The review then explores the shift towards broader paradigms, including the mainstreaming of genetic testing into oncology care and the emerging evidence for population-based screening in specific founder populations. A critical analysis is presented on how a positive genetic test result translates into clinical action, encompassing risk-reducing surgeries and targeted therapies, and ultimately impacts cancer burden. The synthesis also addresses unresolved challenges, such as variants of uncertain significance and disparities in access to genetic services. Conclusion: The evidence supports a move beyond reliance on family history alone towards more inclusive and proactive screening models to identify a greater proportion of BRCA carriers. While the clinical utility of genetic testing is well-established for guiding risk management and therapy, future efforts must focus on improving the implementation, accessibility, and equity of these strategies to maximize their public health benefit in diverse populations.
BRCA1, BRCA2, Genetic Testing, Hereditary Breast and Ovarian Cancer Syndrome, Cancer Prevention, High-Risk Families
Copyright (c) 2024 Axis Community Research Journal (ACRJ)
COMPARING THE EFFECTIVENESS OF MEDITATION APPS VERSUS TRADITIONAL STRESS MANAGEMENT CLASSES ON BLOOD GLUCOSE VARIABILITY
Background: Psychological stress is a major contributor to impaired glucose regulation and metabolic instability. Conventional stress management classes provide limited accessibility and variable adherence, whereas smartphone-based mindfulness applications offer flexible, continuous engagement. This study explored the comparative effectiveness of a digital mindfulness intervention versus traditional stress management classes in stabilizing blood glucose variability among adults with impaired glucose control. Objective: To evaluate whether smartphone-based mindfulness practice achieves greater improvements in glucose variability, stress reduction, and autonomic function compared with in-person stress management sessions. Methods: A 12-week randomized controlled trial was conducted in South Punjab over 12 weeks, enrolling 120 adults aged 30–60 years with elevated fasting glucose but not meeting diabetes diagnostic criteria. Participants were randomly assigned to either a mindfulness meditation app group (n=60) or a traditional stress management class group (n=60). Outcomes were measured using continuous glucose monitoring for glucose variability, the Perceived Stress Scale (PSS-10) for stress levels, and heart rate variability (HRV) for autonomic balance. Data were analyzed using independent t-tests and repeated-measures ANOVA, assuming normal distribution of values. Results: The mindfulness app group showed a significantly greater reduction in glucose standard deviation (from 38.4 ± 7.2 mg/dL to 29.7 ± 6.5 mg/dL, p < 0.001) compared to the class group (from 37.9 ± 7.0 mg/dL to 33.8 ± 6.9 mg/dL, p = 0.02). Mean stress scores decreased more substantially in the app group (−7.7 ± 3.5) than in the class group (−5.2 ± 3.8, p = 0.01). HRV indices improved significantly in the app group, indicating enhanced parasympathetic activity and reduced autonomic stress burden. Conclusion: Mindfulness-based mobile applications proved more effective than traditional stress management classes in improving glucose stability, reducing perceived stress, and enhancing autonomic regulation. These findings support the use of digital mindfulness interventions as practical, accessible tools for stress-related metabolic management.
Copyright (c) 2024 Axis Community Research Journal (ACRJ) https://creativecommons.org/licenses/by/4.0
EFFICACY OF A STRUCTURED SUN SAFETY EDUCATIONAL INTERVENTION IN REDUCING THE INCIDENCE OF SUNBURN AMONG PRIMARY SCHOOL CHILDREN IN SARGODHA
Background: Sunburn during childhood contributes substantially to cumulative ultraviolet radiation exposure and increases the risk of future dermatological complications. School-based interventions offer an opportunity to introduce preventive behaviors early, particularly in regions with high sun exposure such as Sargodha. Objective: To evaluate the effectiveness of a structured sun safety educational intervention in reducing the incidence of sunburn among primary school children. Methods: A cluster randomized controlled trial was conducted across 12 primary schools in Sargodha, enrolling 742 children aged 7–10 years. Schools were randomized equally into intervention and control arms. The intervention comprised a structured sun safety education program delivered over 12 weeks. Outcomes included incidence of at least one sunburn episode, sun protection knowledge scores, and frequency of key protective behaviors. Analyses were conducted using cluster-adjusted comparisons. Results: A total of 371 children participated in each arm. The incidence of sunburn was markedly lower in the intervention group (22.6%) compared with the control group (43.7%). Knowledge scores increased substantially in the intervention arm (mean improvement 22.6 points) relative to controls (2.5 points). Behavioral indicators showed notable gains, with sunscreen use increasing from 18.1% to 54.2% in the intervention group, while only marginal change occurred in the control group. Cluster-level effects remained consistent, and missing data were minimal. Conclusion: The structured educational intervention effectively reduced sunburn incidence and strengthened sun-protective behaviors among primary school children. These findings highlighted the potential of integrating age-appropriate sun safety education into routine school curricula, offering a practical and scalable strategy for early-life photoprotection.
A RANDOMIZED TRIAL OF A SCHOOL-BASED HYGIENE EDUCATION PROGRAM ON STUDENT ABSENTEEISM DUE TO COMMON INFECTIOUS ILLNESSES
Background: Infectious illnesses remain a leading cause of absenteeism among primary school children, often disrupting learning continuity and placing a burden on families and educational systems. School-based hygiene interventions have been recognized as practical public-health strategies, yet evidence from controlled trials in resource-limited settings remains limited. Objective: To evaluate the effectiveness of a structured school-based hygiene education program in reducing absenteeism attributable to common infectious illnesses among primary school students. Methods: A randomized controlled trial was conducted over 10 weeks in two comparable primary schools. A total of 130 students aged 8–10 years were enrolled, with 65 allocated to the intervention arm and 65 to the control arm. The intervention consisted of weekly instructor-led hygiene sessions, visual reminders, and supervised handwashing routines. Outcomes included infectious illness–related absentee days, occurrence of at least one infectious absence episode, and pre-post hygiene knowledge scores, measured using a standardized questionnaire and school attendance records. Data were analyzed using independent-sample t-tests and chi-square tests, assuming normally distributed continuous variables. Results: Students in the intervention group recorded fewer infection-related absentee days (mean 1.98 ± 0.92) compared with controls (3.25 ± 1.22). The proportion experiencing at least one infectious absence was modestly lower in the intervention group (98%) than in the control group (100%). Hygiene knowledge improved substantially in the intervention arm, rising from a mean pre-score of 5.02 to a post-score of 8.18, whereas only minimal change was observed in the control group (4.51 to 5.15). All differences were statistically significant. Conclusion: The hygiene education program effectively reduced infection-related absenteeism and enhanced hygiene knowledge among primary schoolchildren, demonstrating the value of integrating structured preventive health education into routine school activities.
ASSOCIATION BETWEEN E-CIGARETTE USE AND PERIODONTAL INFLAMMATION AMONG YOUNG ADULT DENTAL PATIENTS: A CROSS-SECTIONAL STUDY
Background: E-cigarettes are increasingly promoted as safer alternatives to traditional tobacco, particularly among young adults. However, emerging evidence indicates that their use may adversely affect periodontal health. Understanding this association is crucial to inform dental practice and public health interventions. Objective: To estimate the prevalence of e-cigarette use among young adult dental patients and examine its association with bleeding on probing, pocket depth, and plaque index after adjusting for potential confounders. Methods: A cross-sectional study was conducted over five months at a dental teaching hospital in Lahore. A total of 420 patients aged 18–35 years were recruited through systematic random sampling. Participants completed a structured questionnaire on demographic factors, oral hygiene practices, and e-cigarette use. Periodontal parameters, including bleeding on probing (BOP), probing pocket depth (PPD), and plaque index (PI), were assessed by calibrated examiners. Data were analyzed using SPSS version 26.0. Chi-square tests and independent t-tests compared categorical and continuous variables, respectively, while multivariate linear regression models assessed associations after adjustment for age, gender, oral hygiene practices, and socioeconomic status. Results: The prevalence of e-cigarette use was 27.6%. Current users had significantly higher mean BOP scores (34.2% ± 8.1), greater PPD (3.8 ± 0.9 mm), and higher PI (2.4 ± 0.6) compared with non-users (p < 0.001 for all). Multivariate analysis confirmed e-cigarette use as an independent predictor of worsened periodontal outcomes, with adjusted β-coefficients of 0.29 for BOP, 0.25 for PPD, and 0.31 for PI (p < 0.05). Conclusion: E-cigarette use among young adults was significantly associated with increased periodontal inflammation. These findings emphasize the importance of integrating e-cigarette risk awareness into dental counseling and preventive strategies. Longitudinal studies are warranted to explore causality and long-term effects.
EVALUATION OF STRESS LEVELS AND COPING MECHANISMS AMONG EMERGENCY HEALTHCARE PROFESSIONALS WORKING IN TERTIARY HOSPITALS OF PAKISTAN: A CROSS-SECTIONAL STUDY
Background: Emergency healthcare professionals operate in high-intensity environments characterized by time-sensitive decisions, critical patient care, and emotional strain. Chronic exposure to such stressors predisposes them to elevated occupational stress and burnout. Understanding stress levels and identifying effective coping mechanisms are essential for developing institutional strategies that enhance mental well-being and clinical performance. Objective: To assess the prevalence of occupational stress and explore coping mechanisms adopted by emergency healthcare staff working in tertiary care hospitals in Pakistan. Methods: This five-month cross-sectional investigation recruited 400 emergency healthcare providers—comprising physicians, nurses, and paramedical staff—from tertiary-level hospitals throughout Pakistan. A stratified random sampling technique was employed for participant selection. Stress perception was quantified using the 10-item Perceived Stress Scale (PSS-10), and coping mechanisms were assessed via the Brief COPE inventory. Statistical analysis was performed using SPSS software (version 26.0). Demographic and occupational variables were summarized with descriptive statistics. Differences in average stress scores among various subgroups were evaluated using independent samples t-tests and one-way analysis of variance (ANOVA). Relationships between stress levels and coping approaches were examined through Pearson’s correlation and multiple linear regression analyses. A p-value of less than 0.05 was established as the threshold for statistical significance. Results: The mean PSS score among participants was 23.6 ± 6.8, indicating moderate to high stress levels. Nurses exhibited significantly higher stress scores (25.1 ± 6.4) compared with doctors (22.9 ± 6.9) and paramedics (21.7 ± 5.8) (p = 0.01). Problem-focused coping (r = −0.42, p < 0.001) and social support (r = −0.33, p < 0.001) were negatively correlated with stress, while emotion-avoidant coping showed a strong positive correlation (r = 0.47, p < 0.001). Regression analysis identified workload, shift duration, and lack of institutional support as significant predictors of stress levels (p < 0.05). Conclusion: Emergency healthcare professionals in Pakistan experience high levels of occupational stress, with nurses being the most affected group. Effective coping mechanisms, particularly problem-solving and social support strategies, play a protective role. Institutional interventions focusing on workload management and psychological resilience training are urgently needed
EVALUATION OF HAND HYGIENE COMPLIANCE AMONG UNDERGRADUATE NURSING STUDENTS DURING CLINICAL WARD ROTATIONS: A CROSS-SECTIONAL STUDY
Background: Hand hygiene is a cornerstone of infection prevention and control in healthcare settings, yet compliance remains suboptimal across many professional groups. Nursing students, as future frontline caregivers, are particularly important to monitor because habits formed during clinical training often persist into professional practice. Objective: To investigate the level of compliance with hand hygiene protocols among undergraduate nursing students during their clinical ward rotations in teaching hospitals of Islamabad. Methods: A cross-sectional study was conducted over five months among 210 randomly selected third- and fourth-year nursing students. Data were collected through structured covert observations using the World Health Organization’s “Five Moments for Hand Hygiene” checklist and a validated self-administered questionnaire assessing demographic factors and perceived barriers. Descriptive statistics summarized compliance rates, and independent sample t-tests, one-way ANOVA, and chi-square tests were applied to compare subgroup differences. Ethical approval was obtained from the institutional review board, and written informed consent was secured from all participants. Results: The overall hand hygiene compliance rate was 62.0%. Compliance was highest after body fluid exposure (71.0%) and lowest after contact with patient surroundings (52.9%). Female students (64.8%) and fourth-year students (66.7%) demonstrated significantly higher adherence compared with male students (59.2%) and third-year students (60.1%) (p < 0.05). Intensive care unit rotations were associated with the highest compliance (70.4%), while pediatric wards showed the lowest (58.9%). Conclusion: The findings indicate moderate compliance among nursing students, with significant variations across clinical contexts, academic levels, and gender. Targeted educational strategies and stronger clinical supervision are needed to reinforce adherence to infection prevention standards and foster long-term professional hygiene practices.
Copyright (c) 2023 Axis Community Research Journal (ACRJ)
ASSESSMENT OF ORAL HYGIENE KNOWLEDGE AND PRACTICES AMONG FIRST-YEAR BACHELOR OF DENTAL SURGERY STUDENTS: ACROSS-SECTIONAL STUDY
Background: Oral hygiene is fundamental to preventing dental caries, periodontal disease, and other oral conditions, yet personal practices among dental students—the future oral health educators—may not fully reflect their theoretical knowledge. Evaluating baseline understanding and daily behaviors in early training provides critical insights for curriculum development. Objective: To assess baseline oral hygiene knowledge and daily practices among first-year Bachelor of Dental Surgery (BDS) students. Methods: A four-month cross-sectional study was conducted among 120 first-year BDS students in Lahore, Pakistan. A validated, self-administered questionnaire assessed demographics, oral hygiene knowledge (maximum score 15), and daily practices (maximum score 10). Descriptive statistics summarized the data, and independent t-tests, one-way ANOVA, and Pearson correlation were applied using SPSS version 26. Ethical approval (IRB/2025/09-LHR) and informed consent were obtained. Results: The mean age of participants was 19.2 ± 0.8 years, with 55% females and 70.8% urban residents. The mean knowledge score was 10.9 ± 2.0, and the mean practice score was 7.0 ± 1.8. Ninety-two percent correctly identified brushing twice daily as recommended, while only 54% reported regular flossing. Urban students demonstrated slightly higher practice scores (7.3 ± 1.7) than rural peers (6.7 ± 1.8). No significant correlation was observed between knowledge and practice scores (r = –0.05, p>0.05). Conclusion: First-year dental students exhibited satisfactory oral hygiene knowledge but inconsistent application in daily self-care. Early, behavior-focused interventions in dental curricula are essential to strengthen the translation of knowledge into lifelong practices.
PREVALENCE OF WORK-RELATED MUSCULOSKELETAL DISCOMFORT AMONG UNDERGRADUATE BACHELOR OF DENTAL SURGERY STUDENTS: A CROSS-SECTIONAL STUDY
Background: Work-related musculoskeletal discomfort is a well-recognized occupational hazard in dentistry, often beginning during undergraduate clinical training. The repetitive motions, prolonged static postures, and awkward ergonomic positions required in dental practice increase the risk of chronic pain and disability, potentially affecting future professional performance. Objective: To determine the prevalence and distribution of musculoskeletal discomfort among undergraduate Bachelor of Dental Surgery (BDS) students during their clinical training and to identify associated risk factors. Methods: A cross-sectional study was conducted over four months among 120 undergraduate BDS students in Islamabad. Participants were selected through stratified random sampling from third-, fourth-, and final-year classes. Data were collected using the standardized Nordic Musculoskeletal Questionnaire to assess 12-month and 7-day prevalence of discomfort across nine body regions. Demographic variables, clinical working hours, and year of study were recorded. Descriptive statistics summarized prevalence rates, while chi-square tests and logistic regression were applied to examine associations, assuming normal data distribution. Ethical approval was obtained from the institutional review board, and informed consent was secured from all participants. Results: The 12-month prevalence of musculoskeletal discomfort was 72.5% for the lower back, 68.3% for the neck, and 61.7% for the shoulders. Females reported higher rates of discomfort in these regions compared with males (p<0.05). Longer weekly clinical hours (>20) and final-year status were significant predictors of discomfort, with odds ratios of 1.84 and 1.62, respectively. Conclusion: Musculoskeletal discomfort was highly prevalent among undergraduate dental students, particularly in the lower back, neck, and shoulders. Gender, clinical workload, and academic level emerged as key risk factors, highlighting the need for ergonomic training and preventive interventions within dental curricula.
RELATIONSHIP BETWEEN ACADEMIC PERFORMANCE AND PERCEIVED STRESS LEVELS IN SECOND-YEAR BACHELOR OF DENTAL SURGERY STUDENTS: A CROSS-SECTIONAL STUDY
Background: Dental education is recognized for its high academic demands, which can create considerable psychological stress. Excessive stress may impair cognitive functions and learning capacity, leading to reduced academic achievement. Understanding the relationship between perceived stress and academic outcomes in dental students is essential for developing effective support systems within dental curricula. Objective: To examine the association between perceived stress levels and academic performance among second-year Bachelor of Dental Surgery students. Methods: A cross-sectional study was conducted over five months at a dental college in Lahore, Pakistan. A calculated sample of 104 second-year dental students was selected using stratified random sampling. Perceived stress was measured using the validated 10-item Perceived Stress Scale (PSS-10), while academic performance was assessed through the most recent professional examination scores. Descriptive statistics were applied to demographic data. Pearson correlation and linear regression were performed to evaluate the association between PSS scores and academic performance, with significance set at p < 0.05. Results: The mean PSS score was 22.1 ± 5.6, indicating moderate stress levels. Moderate stress was reported by 59.6% of students, while 23.1% experienced high stress. The mean academic performance was 74.8 ± 7.1%. Pearson correlation revealed a significant negative relationship between perceived stress and academic performance (r = –0.42, p < 0.001). Linear regression demonstrated that each unit increase in stress score predicted a 0.35% decrease in academic score. Conclusion: Higher perceived stress levels were significantly associated with lower academic achievement in second-year dental students. Targeted stress-management interventions within the dental curriculum are recommended to enhance student well-being and academic success.
PREVALENCE OF CONTACT DERMATITIS AMONG HEALTHCARE WORKERS USING PERSONAL PROTECTIVE EQUIPMENT DURING LONG SHIFTS: A CROSS-SECTIONAL STUDY
Background: Contact dermatitis is one of the most frequent occupational skin diseases, particularly among healthcare workers due to the use of personal protective equipment (PPE). The prolonged reliance on gloves, masks, and protective gowns during extended shifts heightens the risk of skin barrier disruption, leading to both irritant and allergic forms of dermatitis. The issue has gained prominence during infectious disease outbreaks but remains underexplored in regional healthcare settings. Objective: To evaluate the prevalence and severity of contact dermatitis among healthcare workers frequently using PPE during long clinical shifts. Methods: A cross-sectional study was conducted in Lahore over four months. A total of 240 healthcare workers were recruited through stratified random sampling, including doctors, nurses, paramedics, and ancillary staff. Data on demographics, occupational exposure, and PPE use were collected using structured questionnaires. Clinical dermatological examination confirmed diagnoses, while severity was assessed using the Hand Eczema Severity Index (HECSI) and Visual Analog Scale (VAS). Statistical analysis was performed using SPSS v26, applying chi-square tests, independent t-tests, ANOVA, and Pearson correlation. Results: The overall prevalence of contact dermatitis was 38.8%. Nurses exhibited the highest prevalence (45.7%), followed by doctors (37.0%), paramedics (34.9%), and ancillary staff (27.3%). Females were more affected (44.1%) than males (32.7%). Gloves were implicated in 74.2% of cases, followed by masks and respirators (51.6%) and gowns (19.4%). The mean HECSI score was 23.5 ± 8.4, with 62.4% of cases classified as mild, 28.0% as moderate, and 9.6% as severe. PPE use duration showed a significant positive correlation with dermatitis severity (r = 0.34, p < 0.001). Conclusion: Contact dermatitis was highly prevalent among healthcare workers, particularly among nurses and female staff. Gloves and masks were the most common sources of dermatitis, and longer PPE use significantly increased severity. Preventive interventions, including skin-friendly PPE, barrier creams, and occupational health policies, are essential to reduce this burden.