Journal of Health and Rehabilitation Research

Adolescent Migraine in Klang Valley, Malaysia: Identifying Prevalence and Common Triggers Through a Cross-Sectional Approach

Kiruthika Selvakumar — 2025-02-28

Background Migraine is a prevalent neurological disorder affecting adolescents, yet its prevalence and triggers remain underexplored in Malaysia. Identifying modifiable risk factors is crucial for early intervention and prevention strategies. Objective: This study aimed to determine the prevalence of adolescent migraine in Klang Valley, Malaysia, and assess common trigger factors, particularly their associations with gender and academic grade. Methods: A cross-sectional study was conducted among adolescents aged 14–18 years (n = 393) using convenience sampling. Participants completed an online survey, including the validated Migraine Screen Questionnaire (MS-Q) for migraine prevalence and a trigger factor assessment adapted from prior studies. Data were analyzed using SPSS v27, applying descriptive statistics, Pearson’s correlation, and significance testing (p < 0.05). Ethical approval was granted by the UTAR Scientific and Ethical Review Committee (U/SERC/224/2022), ensuring compliance with the Helsinki Declaration. Results: The prevalence of suspected migraine was 6.9%, with sensitivity to light/noise (64.1%) and restricted physical/intellectual activity (78.4%) being the most reported symptoms. Significant correlations were found between migraine triggers and gender, particularly electronic device use (r = 0.284, p = 0.001), lack of sleep (r = 0.270, p = 0.002), and emotional stress (r = 0.204, p = 0.011). Academic stress was significantly associated with migraine (p = 0.009), but study hours showed no significant correlation (p = 0.412). Conclusion: Academic stress, sleep disturbances, electronic device use, and dehydration were significant migraine triggers among adolescents. Findings highlight the need for school-based stress management, sleep hygiene education, and digital screen regulation to mitigate migraine risk. Future research should explore longitudinal patterns and targeted interventions for adolescent migraine prevention.

Prevalence of Coronaphobia Among Healthcare Workers in Tertiary Care Hospitals of Peshawar

Aqib Javid — 2025-02-28

Background: The COVID-19 pandemic has significantly impacted healthcare professionals' mental well-being, with fear and anxiety leading to a phenomenon termed "coronaphobia." Limited data exist on the prevalence of coronaphobia among healthcare workers (HCWs) in Peshawar, Pakistan, highlighting the need for this study. Objective: To determine the prevalence of coronaphobia among HCWs in tertiary care hospitals of Peshawar and assess its severity across different demographic categories, including gender and age. Methods: A descriptive cross-sectional study was conducted in three public tertiary care hospitals of Peshawar (HMC, LRH, and KTH) with a sample size of 378 HCWs, including doctors and nurses. Participants diagnosed with COVID-19 or psychological disorders were excluded. Data were collected using the COVID-19 Phobia Scale (C19P-SE), a validated instrument comprising psychological, psychosomatic, economic, and social domains. Ethical approval was obtained from the Institutional Review Board. Data were analyzed using SPSS version 22, with descriptive and inferential statistics applied. Results: Among 378 participants, 68.8% exhibited moderate coronaphobia, while 25.1% experienced severe coronaphobia. Males showed a higher prevalence than females (P = 0.326, statistically not significant). The most affected age group was 26-35 years (P = 0.482). No statistically significant associations were found between coronaphobia and demographic variables. Conclusion: A significant proportion of HCWs in Peshawar experienced moderate to severe coronaphobia, which may impact their psychological resilience and work efficiency. Mental health interventions and workplace support programs are necessary to mitigate fear and stress among frontline healthcare workers.

Self-Concept and Its Impact on Academic Performance Among High School Students

Asmara Rubab — 2025-02-28

Background: Academic self-concept is a critical determinant of student performance, yet its influence on academic achievement remains underexplored in developing educational contexts. Prior research highlights a strong association between self-concept and academic success, but gender-based differences and predictive relationships remain inconclusive. Objective: This study aims to examine the relationship between academic self-concept and academic performance among high school students while analyzing gender-based differences in self-concept, confidence, and effort as predictors of academic achievement. Methods: A cross-sectional observational study was conducted among 250 public high school students (115 boys, 135 girls) aged 13–19 years in Rawalpindi, Pakistan. Participants were selected through convenient non-probability sampling. Academic self-concept was assessed using the Revised Academic Self-Concept Scale, and academic performance was measured using the Academic Self-Description Questionnaire. Ethical approval was obtained from Fatima Jinnah Women University IRB (following the Helsinki Declaration. Statistical analysis, including Pearson correlation, independent t-tests, and multiple regression, was conducted using SPSS v20. Results: Academic self-concept showed a strong positive correlation with academic performance (r = .658, p < 0.05), with academic confidence (β = 0.42, p < 0.001) and effort (β = 0.28, p = 0.00) emerging as significant predictors. Boys demonstrated higher academic self-concept (M = 90.35, SD = 7.42) and confidence (M = 29.31, SD = 7.03), whereas girls exhibited greater academic effort (M = 45.89, SD = 6.42, p = 0.001). Conclusion: Academic self-concept significantly predicts academic performance, emphasizing the need for interventions fostering self-confidence and effort-based learning. Addressing gender disparities in self-perception can enhance student outcomes and inform educational policy improvements.

A Qualitative Study on the Effects of Homesickness on Mental Health and Sleep Among Newly Admitted Students Residing in Hostels in Public Universities of Punjab, Pakistan

Syed Gufran Sadiq Zaidi — 2025-02-28

Background: Homesickness is a significant psychological challenge for newly admitted university students living in hostels, affecting their mental health and sleep patterns. Despite its prevalence, limited qualitative research has explored homesickness in the specific socio-cultural context of Punjab, Pakistan. Objective: This study aims to examine the impact of homesickness on mental health and sleep disturbances among newly admitted hostel students in public universities of Punjab, Pakistan, identifying emotional, behavioral, and academic consequences alongside coping strategies. Methods: A qualitative phenomenological study was conducted using semi-structured interviews with n = 10 newly admitted university students meeting predefined inclusion criteria. Data was analyzed thematically to identify key patterns in students’ experiences. This study was conducted in accordance with ethical research principles, including obtaining informed consent from participants, ensuring confidentiality, minimizing harm, and maintaining scientific integrity, in line with the Helsinki Declaration. Results: Thematic analysis revealed that homesickness led to heightened stress, loneliness, and depressive symptoms, often manifesting as sleep disturbances, academic disengagement, and physical exhaustion. Social support deficits and unfamiliar hostel environments exacerbated distress. However, students adopting coping mechanisms such as social networking, extracurricular activities, and physical exercise reported improved emotional adaptation. Conclusion: Homesickness significantly disrupts mental well-being and sleep in university students. Institutional interventions, such as structured peer support and recreational activities, could mitigate its effects, enhancing student well-being and academic success.

Age-Related Effects of Donor on Corneal Transplantation and Clinical Study of Causal Allograft Rejection in Pakistan

Muhammad Junaid — 2025-02-28

Background: Corneal transplantation is a widely performed surgical procedure for treating corneal blindness. Donor-related factors, particularly age, are known to influence graft survival and rejection rates. While younger donor corneas exhibit higher endothelial cell density, their potential for increased immunogenicity remains a concern. This study evaluates the impact of donor age on corneal transplantation outcomes in Pakistan. Objective: To assess the influence of donor age on graft clarity, visual acuity, and allograft rejection rates following corneal transplantation. Methods: A retrospective observational study was conducted from February 2013 to June 2016 in collaboration with the Rawalpindi Eye Donor Organization, The Shifa Eye Trust, and Saba Deseret Eye Hospital. A total of 300 patients underwent corneal transplantation, categorized by donor age: <40 years (n=105), 40–60 years (n=120), and >60 years (n=75). Surgical techniques included Penetrating Keratoplasty (PK) (70%), Descemet’s Stripping Endothelial Keratoplasty (DSEK) (20%), and Descemet Membrane Endothelial Keratoplasty (DMEK) (10%). Postoperative outcomes were assessed at 12 months. Data were analyzed using SPSS v25, with chi-square tests for categorical variables and logistic regression for predictors of rejection. Results: At 12 months, 80% (n=240) of grafts remained clear, while 20% (n=60) developed opacity. Visual acuity improved to 20/40 or better in 85% (n=255) of patients. The overall rejection rate was 15% (n=45), highest in young donor grafts (21%), followed by middle-aged (13%) and older donor grafts (8%) (p=0.046). Patients undergoing DSEK and DMEK had significantly lower rejection rates than PK (p<0.01). Conclusion: Donor age did not significantly affect graft clarity or visual acuity but influenced rejection rates, with younger donor grafts exhibiting a higher risk. Advanced surgical techniques and postoperative steroid management improved outcomes. Future research should focus on optimizing donor selection criteria and long-term graft survival strategies.

Effectiveness of Prehospital Use of Advanced Airway Management in Traumatic Brain Injury Patients: A Systematic Review

Abdullah Alsamahri — 2025-02-28

Background: Traumatic brain injury (TBI) is a leading cause of trauma-related mortality and disability, necessitating rapid and effective airway management to prevent secondary brain injury. Establishing a definitive airway before hospital admission is often performed in the prehospital setting; however, its impact on patient outcomes remains debated. Objective: This study aimed to assess the effectiveness of prehospital advanced airway management in TBI patients by comparing mortality and morbidity outcomes between prehospital and in-hospital intubation. Methods: A systematic review was conducted following PRISMA guidelines. Five electronic databases were searched, and data extraction was performed using Endnote. Inclusion criteria encompassed observational studies, cohort studies, and randomized controlled trials (RCTs) evaluating prehospital intubation. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias, and statistical analysis was performed to evaluate mortality and morbidity trends. Results: Despite considerable heterogeneity, no statistically significant difference in mortality was observed between prehospital and in-hospital intubation (OR = 1.08, 95% CI: 0.89–1.27, p = 0.32). However, sensitivity analysis suggested a 12% reduction in morbidity with prehospital intubation (RR = 0.88, 95% CI: 0.79–0.96), particularly when performed by trained professionals following standardized protocols. Studies incorporating rapid sequence intubation (RSI) and capnography monitoring reported improved neurological outcomes, with a 15–20% increase in favorable Glasgow Outcome Scale (GOS) scores compared to non-RSI approaches. Variability in intervention techniques, prolonged on-scene times, and inconsistent ventilation management contributed to conflicting findings, underscoring the necessity of cautious interpretation due to data variability. Conclusion: While prehospital intubation remains a critical intervention in TBI management, its superiority over in-hospital intubation remains uncertain. Standardized protocols, RSI implementation, provider training, and further high-quality RCTs are essential to establish its clinical efficacy and optimize patient outcomes.

Clinical Researchers vs. Research Clinicians: Impact on Healthcare Research in Pakistan

Bilal Umar — 2025-03-01