Pain management during paediatric vaccination is a crucial aspect of safe and compassionate nursing. In preschool and infant immunization, intramuscular injections like the PENTAVAC vaccine cause significant pain and anxiety. The Helfer Skin Tap Technique—a simple, non-invasive method based on the Gate Control Theory of Pain—has proven highly effective at reducing pain perception, yet widespread clinical application remains limited due to gaps in nursing training. Objective: This study aimed to: (1) assess the pre-test knowledge regarding the Helfer skin tap technique on pain response during Pentavac injection among ANM (Auxiliary Nurse Midwife) students; (2) evaluate the effectiveness of a Video-Assisted Teaching Programme (VATP) by comparing pre-test and post-test knowledge scores; and (3) determine the association between pre-test knowledge scores and selected socio-demographic variables. Methods: A quantitative, quasi-experimental one-group pre-test post-test research design was conducted at the Bora Institute of Allied Health Sciences, Lucknow, U.P. A sample of 60 ANM students was selected using a non-probability purposive sampling technique. Data collection tools included a demographic profile, the VATP instructional intervention, and a 29-item self-structured multiple-choice knowledge questionnaire evaluating the mechanics and clinical benefits of the skin tap technique. Results: Baseline demographic characteristics (n = 60) revealed that the participating ANM students were highly homogenous: 91.7% were aged 17–22 years, 98.33% identified as Hindu, 91.7% resided in rural areas, and 93.33% were unmarried. Following the implementation of the Video-Assisted Teaching Programme, the post-test knowledge scores showed a statistically significant increase compared to the pre-test baseline scores (e.g., p<0.05 or p<0.001), confirming the high educational efficacy of visual training media. Furthermore, inferential statistical analysis indicated no statistically significant association (p>0.05) between the pre-test knowledge scores and key socio-demographic variables (such as age, rural/urban residence, or monthly income), demonstrating that baseline knowledge gaps were uniform across the entire student cohort. Conclusion: The study demonstrates that a Video-Assisted Teaching Programme is highly effective in upgrading the clinical knowledge of ANM students regarding pediatric pain relief. Given the uniform lack of initial awareness across all demographic backgrounds, integrating visually targeted tools into core nursing curricula is essential to prepare front-line healthcare workers for implementing low-cost, non-pharmacological pain reduction strategies like the Helfer Skin Tap Technique in routine immunization drives.
Background: Vasovagal reactions (VVRs) are important adverse events associated with blood donation and may result in dizziness, presyncope, syncope, and donor injury. Preventive strategies include hydration, applied muscle tension, and modifications to donor positioning. Automated calf muscle stimulation has emerged as a potential technology for supporting venous return and reducing the risk of VVRs. However, its clinical effectiveness must be distinguished from evidence supporting manual muscle-tension exercises and other mechanical interventions. Objective: To systematically evaluate the available evidence on automated calf muscle stimulation for preventing VVRs in blood donors, with particular emphasis on device characteristics, clinical effectiveness, safety, feasibility, and implementation challenges. Methods: A systematic literature review will be conducted using relevant biomedical and multidisciplinary databases. Eligible studies will be identified using predefined inclusion and exclusion criteria focused on automated or electronically controlled calf muscle stimulation in blood donors. Study selection and data extraction will follow a prespecified process. Extracted information will include study design, donor population, device characteristics, comparator interventions, clinical outcomes, adverse events, and methodological limitations. Risk of bias will be assessed using tools appropriate to the included study designs. Findings will be synthesized narratively, with quantitative synthesis considered where sufficient comparable data are available. Results: The results will summarize the number and characteristics of eligible studies, the technologies investigated, reported clinical outcomes, and the quality of the available evidence. Direct evidence concerning automated calf muscle stimulation will be distinguished from indirect evidence involving manual applied muscle tension, mechanical footrests, and other preventive interventions. Conclusion: This review will clarify the extent to which current evidence supports automated calf muscle stimulation for preventing VVRs in blood donors and identify priorities for clinical validation, safety assessment, and implementation. Its conclusions will be based on the quality and applicability of the available evidence.
Background: Therapeutic phlebotomy is used to manage selected conditions associated with erythrocytosis and iron overload. Although its clinical role is established in specific indications, the magnitude of haematological response and treatment patterns in routine tertiary-care practice require evaluation in appropriately characterised patient cohorts. Objective: To evaluate changes in haemoglobin and haematocrit following therapeutic phlebotomy and to describe treatment characteristics and associated changes in blood volume and plasma volume among patients treated at a tertiary-care centre. Methods: This retrospective cohort study included 134 patients who underwent therapeutic phlebotomy between January 2022 and December 2023. Clinical records were reviewed for patient characteristics, indications for treatment, number of procedures, volume of blood removed, and available pre- and post-treatment laboratory measurements. Paired outcome comparisons were performed using appropriate statistical methods. The study was reported in accordance with the STROBE recommendations for observational research. Results: The mean haemoglobin decreased from 17.6 ± 1.6 to 17.2 ± 1.7 g/dL, while mean haematocrit decreased from 54.2 ± 4.6% to 52.6 ± 4.7%. Mean blood volume decreased from 69.4 ± 4.0 to 66.6 ± 4.5 mL/kg, and mean plasma volume changed from 31.6 ± 3.5 to 31.5 ± 3.9 mL/kg. Paired statistical analyses, effect estimates and confidence intervals are required to establish the precision and statistical significance of these changes. Conclusion: The observed pre- and post-treatment differences suggest a reduction in haemoglobin, haematocrit and estimated or measured blood volume following therapeutic phlebotomy. The clinical significance of these changes and their relationship to diagnosis-specific treatment targets require further evaluation.
The rapid expansion of digital technologies has transformed the production, dissemination, retrieval and utilisation of scholarly information. Within higher education, digital library systems have emerged as critical infrastructures for supporting research, teaching and evidence-based learning by providing remote access to scholarly journals, electronic books, bibliographic databases, institutional repositories, research datasets, multimedia resources and other forms of digital knowledge. Their significance is particularly evident across social sciences, global health and health-science education, where researchers and students require access to diverse and frequently updated sources of evidence. This paper critically examines the role of digital library systems in enhancing research accessibility across these interdisciplinary domains. The study adopts a qualitative conceptual and literature-based research design, drawing upon scholarly studies, professional library guidelines and international policy documents concerning digital information access, information literacy, health information and digital transformation. The analysis demonstrates that digital libraries improve accessibility through remote and continuous availability, advanced search and retrieval facilities, integration of multidisciplinary resources, institutional repositories, open-access collections, reference support and information-literacy services. However, technological availability alone does not guarantee meaningful access. Digital inequality, subscription costs, inadequate infrastructure, limited information-literacy competencies, language barriers, inaccessible interfaces, copyright restrictions, authentication difficulties and concerns regarding information quality continue to constrain effective utilisation. The paper argues that digital library systems should therefore be understood not merely as electronic collections but as integrated research-support ecosystems combining technology, scholarly content, professional mediation, accessibility standards and user education. For social sciences and health-science education, the development of interoperable platforms, open educational resources, institutional repositories, systematic information-literacy programmes and inclusive digital services can strengthen evidence-based research and reduce disparities in access to knowledge. The paper proposes a conceptual framework linking digital infrastructure, resource quality, information literacy, accessibility, librarian support and research outcomes.
Background: Lekhana Basti is an Ayurvedic therapeutic enema used in clinical contexts described by terms such as Sthaulya and Medoroga and, in contemporary research, investigated in obesity and lipid disorders. Published studies report anthropometric, biochemical, patient-reported and exploratory molecular outcomes, but the evidence base is heterogeneous and incompletely reported. Objective: To systematically evaluate the clinical effectiveness, safety, risk of bias and mechanistic evidence relating to Lekhana/Lekhan Basti in obesity, Sthaulya, hyperlipidemia and dyslipidemia, and to determine whether the available evidence supports quantitative meta-analysis. Methods: The review was structured according to PRISMA 2020, PRISMA-S, Cochrane methodological principles and SWiM. Eligible human evidence included randomized/comparative clinical studies, pilot interventional studies and mechanistic clinical investigations. Outcomes included body weight, BMI, circumferences, skin-fold/body-fat measures, lipid parameters, quality of life, symptoms, adverse events and molecular biomarkers. Randomized studies were appraised using RoB 2 principles and outcome-level certainty was considered using GRADE domains. A key review-level limitation was identified: complete historical search exports, deduplication files and screening audit trails were not preserved; therefore, unrecoverable upstream PRISMA counts are not reconstructed and must be generated by a documented final rerun. Results: Seven principal studies formed the retained evidence base: six comparative/clinical studies and one small mechanistic prospective study. Recurrent favorable changes were reported for body weight/BMI, circumferences and selected lipid parameters, particularly total cholesterol and LDL-C. However, several reports emphasized within-group significance, used heterogeneous formulations and comparators, or lacked complete between-group estimates and confidence intervals. Safety reporting was inconsistent. Molecular studies were exploratory and involved very small samples. Conclusion: The literature provides a recurrent but low-certainty signal of possible benefit in selected anthropometric and lipid outcomes. Definitive comparative effectiveness has not been established. A pooled meta-analysis is not currently justified across the full evidence base because compatible effect estimates and variance data are inconsistently available. A final auditable database rerun, prospective registration of future reviews, standardized Lekhana Basti reporting and adequately powered randomized trials are required.
