Blunt thoracic trauma--an analysis of 264 patients in Rawalpindi, Pakistan.

OBJECTIVE: To analyse the outcome in terms of morbidity and mortality in blunt thoracic trauma patients in tertiary care hospitals, Rawalpindi. METHODS: The prospective study was conducted from March 2008 to February 2012 in surgical wards of public and private sector hospitals in Rawalpindi. A total of 221 patients were included from the Combined Military Hospital during 2008-10, and 43 patients from the Heart's International during 2011-12. The patients reported to emergency department within 48 hours of trauma. All patients were subjected to detailed history and respiratory system examination to ascertain fracture of ribs, flail segment and haemopneumothorax. The diagnosis of chest wall injuries, parenchymal pulmonary injuries and pleural involvement were made on the basis of chest radiographs and computed tomography scan of the chest. The lung contusion was assessed by the number of lobes involved. SPSS 19 was used for statistical analysis. RESULTS: Of the 264 patients in the study, 211 (80%) were males and 54 (20%) females. The overall mean age was 44.8 +/- 17.1 years. Over all morbidity was 222 (84.2%); morbidity (minor) was 128 (48.5%), and morbidity (major) was 94 (35.7%). Mortality was 26 (9.8%) and 16 (6%) cases had normal outcome. CONCLUSION: Early identification and aggressive management of blunt thoracic trauma is essential to reducing significant rates of morbidity and mortality.

Assessment of stress among physiotherapy students at Riphah Centre of Rehabilitation Sciences.

OBJECTIVE: To assess stress and psychological morbidity in undergraduate students of physiotherapy at Riphah Centre of Rehabilitation Sciences (RCRS). METHODS: A cross-sectional study was conducted from 2008 to 2010 at RCRS. Two hundred and thirty one students from first semester to fourth semester were included in the study. The data was collected through a semi-structured proforma and the Student Life Stress Inventory (SLSI) scale. Data was analysed by applying t-test and ANOVA with SPSS version 17. RESULTS: Two hundred and three respondents (88%) reported feeling stressed: 97(42%) students were mildly stressed, 92(40%) were moderately stressed, and 14 (6%) were severely stressed. Significant gender differences were found on the total score of stress, stressors and reactions. The findings revealed that females face more stressors especially pressures (p<0.001), physiological, emotional (p<0.01) and behavioural (p<0.05). An analysis of variance on SLSI is significant, F = 3.747 (p<.05). Mean difference indicates that prevalence of stress is higher in 4th semester RCRS students. CONCLUSION: The findings reveal the higher level of stress in undergraduate physiotherapy students. The high psychological morbidity necessitates the need for interventions like counseling and psychological support to improve the quality of life for these allied health care professionals.

Promoting healthy workplaces--health pledges initiative at North Kirklees Primary Care Trust, NHS, England.

OBJECTIVE: To evaluate the effectiveness of health promotion activities targeting physical activity, healthy eating, smoking and stress management as a part of healthy workplace initiative at North Kirklees Primary Care Trust, England. METHODS: The quasi-experimental interventional study was conducted from April 2005 to March 2006 and involved all the employees of the North Kirklees Primary Care Trust, England, who were willing to participate. Main interventions were; lunch-time walk, motivational interviews, counselling and support sessions from qualified dieticians, physical activity and smoking cessation advisors. Free occupational therapy sessions were provided at the workplace. Incentives like discounted vouchers for sports club and the gymnasium were also given. Pre- and post-intervention data was collected and analysed using SPSS version 17. RESULTS: Of the total, 57 (42%) pledged to undertake physical activity; 50 (37%) healthy eating; 20 (15%) mental and emotional well-being; and 8 (6%) to quit smoking. Statistically significant associations were found between different health promotion activities like physical activity (p = 0.004), healthy eating (p = 0.003), stress management and stop smoking (p = 0.001) at the workplace. CONCLUSION: Workplace is a potentially valuable setting for health promotional activities for primary prevention and may facilitate lifestyle modification.