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From concept to curriculum: pediatric dermatology training in Pakistan
No full textPediatric dermatology in Pakistan emerged as a level IV specialty in 2022 under the College of Physicians and Surgeons Pakistan (CPSP). Previously, it was integrated into the general dermatology residency program without any structured pathway. With the increasing need for dermatological care among the pediatric population, senior dermatologists recognize the need to establish a separate training program for this specialty. This perspective highlights the history and evolution of this specialty over time, advocacy efforts, and the development of teaching units across Pakistan
A comparative study of life satisfaction and psychological stress levels among male and female allied health college students
No full textGender differences in psychological disorders have distinct gender profiles, with males more susceptible to aggressive behavior, hypertension, and substance abuse and females more prone to depression and anxiety. Likewise, stress responses among both genders vary physiologically and psychologically, which could lead to complications in many ways. Therefore, this study aimed to determine gender differences in life satisfaction and psychological stress levels among allied health college students. Using a purposive sampling technique, a comparative cross-sectional study recruited 190 male and 190 female students. The self-administered questionnaire included questions related to sociodemographics and two validated scales, the Perceived Stress Scale (PSS-10) and the Satisfaction With Life Scale (SWLS). Descriptive statistics were calculated for the study variables, and the students' locality was compared by gender using the chi-square test. Moreover, other sociodemographics, PSS, and SWLS scores were compared by gender using the Mann‒Whitney U test, and the chi-square test was used to determine gender differences in the outcomes of SWLS. The study results showed that the PSS and SWLS scores were higher among female students than their male counterparts, which were statistically significant (p < 0.05). Furthermore, female students were more satisfied with their life than male students, which was also statistically significant (p < 0.05). Our study highlights that female first-year allied health students are more likely to encounter psychological stress, despite being more satisfied with their lives than male students. Therefore, establishing a student support committee within the allied health faculty or university is recommended to provide counseling and guidance in healthy ways to cope with psychological stress for both male and female students
Evaluating the pharmacokinetic parameters of a single dose of oral disintegrating tablets in elderly patients with hypertension and hyperlipidemia
No full textCardiovascular diseases (CVDs) are the leading cause of death worldwide, particularly in underprivileged areas such as Pakistan. Hypertension and hyperlipidemia are major risk factors for CVDs and often require medication for effective management. This study aimed to develop and validate a high-performance liquid chromatography (HPLC) method to assess the bioavailability of orally disintegrating tablets (ODTs) of atenolol and atorvastatin in elderly volunteers with high blood pressure and cholesterol levels by comparing the pharmacokinetic parameters of these ODTs with those of conventional tablet formulations. The study was conducted in Sargodha, Punjab Province, Pakistan, by recruiting 30 male and female elderly volunteers aged 45-65 years and weighing 60-90 kilograms. Each participant was administered a single dose of atenolol (25 mg), atorvastatin (10 mg), or an ODT containing both drugs. Blood samples were collected at specific intervals up to 48 hours postadministration. The concentrations of atenolol, atorvastatin, and the ODTs were measured using HPLC, and various pharmacokinetic parameters, including the area under the curve (AUC), maximum plasma concentration (Cmax), and elimination half-life (t½), were analyzed. The maximum concentration (Cmax) of 10 mg atorvastatin occurred at 4 hours (9.50 ng/mL), while for 25 mg atenolol, it peaked at 4 hours (150.00 ng/mL). The ODTs showed comparable pharmacokinetic profiles, with the Cmax values for atorvastatin and atenolol at 4 hours being 4.00 ng/mL and 165.00 ng/mL, respectively. The elimination half-life (t½) for the ODTs was 4.62 hours for atorvastatin and 4.95 hours for atenolol. The pharmacokinetic analysis indicated that the AUC and Cmax of the ODTs met the bioequivalence criteria, demonstrating absorption and elimination properties similar to those of conventional tablet formulations. The study concluded that the pharmacokinetic parameters of the ODT formulations atenolol and atorvastatin are comparable to those of conventional tablets. ODTs offer a viable and effective alternative for delivering these medications, particularly for patients who have difficulty swallowing pills, thereby potentially improving patient compliance
Psychological distress among parents of children with obstetric brachial plexus injury visiting pediatric departments
No full textObstetrical brachial plexus injury (OBPI) is a severe nerve injury that is destructive with expected lifelong repercussions among affected children. A child with morbidity can affect a family in several ways, encompassing social, relational, financial, and emotional states. However, such effects on households remain mostly unrecognized, where the focus remains solely on the child’s health or his/her treatment endeavors, with little attention given to the parent's emotional state. Therefore, this study aimed to measure psychological distress among parents of children with OBPI. This descriptive cross-sectional study recruited 100 parents with children aged between 18 months and 16 years under treatment for OBPI who visited different healthcare facilities using a purposive sampling technique. Data were collected by conducting face-to-face interviews. The study used the General Health Questionnaire-12 (GHQ-12) to assess parents’ psychological distress. The positive items were assigned scores from 0 to 3 (i.e., always to never), and the negative items were assigned scores from 3 to 0 (i.e., always to never). The outcome score ranged between 0 and 36, with higher scores indicating a greater likelihood of general psychological distress. Descriptive statistics were calculated to achieve the study objectives. Most children suffering from OBPI were male (64%) rather than female (36%). All positive items of the GHQ-12 questionnaire had an average low score, indicating parents were not feeling reasonably happy, less able to concentrate on their routine work, somewhat incapable of making decisions, and unable to enjoy day-to-day activities. In contrast, negative items had an average high score, indicating that parents constantly felt under strain, could not overcome difficulties, felt unhappy and depressed, and lost confidence. The average GHQ-12 score was 23.47 ± 2.54, depicting a high level of psychological distress among parents of children with OBPI. Our study concluded that parents of children with OBPI are at potential risk of various psychological problems. Therefore, health personnel should be aware of these parents’ psychological adjustment and refer them for psychological support when necessary
Pharmaceutical industry and academia linkage in Pakistan: a prevalent challenge
No full textThe pharmaceutical industry and academia together play a pivotal role in addressing drug-associated issues, formulation, and processing errors. Therefore, the waste of expensive therapeutic moieties and problems such as batch failure during pharmaceutical dosage form production processes can easily be overcome. This partnership can also reduce the economic burden at the patient’s end. Understanding that trust is a prime factor in establishing strong linkages between the pharmaceutical industry and academia is pertinent. However, before making such commitments, organizations must revisit their capacities. Academia should focus on updating and improving the existing curriculum by including subjects with practical significance, such as biotechnology, rheology, particle processing, formulation technologies, and material sciences, to promote problem-based learning among students
Understanding antibiotic use and resistance: knowledge, attitudes, practices, and training needs of paramedical students
No full textThe inappropriate and overuse of antibiotics is considered the main source of antimicrobial resistance (AMR). Therefore, this study aimed to assess the knowledge, attitudes, and practices of antibiotic use and resistance among paramedical students. In addition, the study also assessed the perceptions, knowledge gaps, and educational needs of paramedical students regarding antibiotic use, resistance and related training. This descriptive cross-sectional study was conducted at Khyber Medical University by recruiting 500 students from twelve different paramedic disciplines. The self-administered questionnaire was distributed online through email and WhatsApp, resulting in 364 completed responses and a response rate of 72.8%. The study revealed that 41.21% of paramedic students were using antibiotics without a prescription, 23.63% admitted that they discontinued their prescribed antibiotic course once they felt better, 95.88% recognized the term ‘antibiotics’, and 79.67% acknowledged that inappropriate use contributed to resistance. A sex comparison revealed that male students (81.32%) were significantly more likely to complete their prescribed antibiotic courses than their female counterparts were (67.29%) (p = 0.002). This study identifies gaps in paramedical students' knowledge, attitudes, and practices related to antibiotic use and resistance. Despite a general awareness of key concepts, misconceptions and improper practices were also common. Therefore, there is a dire need to upgrade the curriculum and implement integrated modules on antibiotic stewardship, infection control, and responsible antibiotic use, which could enhance students' knowledge, enable them to make informed decisions, and contribute significantly to combating antibiotic resistance
Surgical fixation versus conservative management for rib fractures caused by blunt chest trauma: a comparative study
No full textRib fractures are a frequent consequence of blunt chest trauma and are associated with significant morbidity and mortality, particularly in cases of flail chest or multiple displaced fractures. While conservative management remains the traditional approach, surgical stabilization of rib fractures (SSRFs) has gained increasing attention for its potential to improve outcomes. This prospective comparative cohort study, conducted between April 2018 and August 2023, compared the effectiveness of SSRF with that of nonoperative management. A total of 114 patients with respiratory compromise from unstable rib fractures were enrolled, 57 of whom underwent SSRF via custom-made titanium plates and screws (Group A) and 57 of whom received conservative treatment (Group B). Baseline demographics and associated injuries were comparable between the groups, although flail chest was more common in the surgical cohort (40.4% vs. 19.3%, p = 0.012). By discharge, patients in the SSRF group reported significantly lower pain scores (3.6 vs. 7.5, p < 0.001) and demonstrated superior pulmonary function at follow-up (FEV₁ at 3 months: 2.84 ± 0.40 L vs. 2.06 ± 0.36 L, p < 0.001). Oxygen dependence was shorter in the surgical group (2.5 ± 0.7 vs. 5.1 ± 0.8 days, p < 0.001), and fewer patients required ventilatory support (12.3% vs. 29.8%, p = 0.022). Among ventilated patients, 50% in the SSRF group were weaned within 3 days, whereas none were weaned in the conservative group (p < 0.001). The length of hospital stay was nearly halved with surgery (4.4 ± 1.5 vs. 9.4 ± 2.3 days, p < 0.001). Mortality was lower in the surgical group (5.3% vs. 15.8%), although this difference was not statistically significant (p = 0.062). Importantly, return-to-work rates at one month were markedly higher following SSRF (62.96% vs. 12.50%, p < 0.001). Compared with conservative management, SSRF offers significant benefits in terms of pain control, respiratory recovery, and functional outcomes. These findings support broader adoption of SSRF, particularly in patients with flail chest or multiple displaced rib fractures, and highlight the feasibility of custom-made implants in resource-limited settings
Gender-based analysis of antibiotic prescribing trends for pediatric patients with respiratory tract infections admitted to a tertiary care hospital in Lahore
No full textRespiratory tract infections (RTIs), caused by microorganisms such as bacteria and viruses, are a leading cause of morbidity and mortality in children worldwide. Antibiotic resistance is a serious concern, and proper prescribing practices are necessary to avoid life-threatening situations. Thus, this study aims to conduct a gender-based analysis and compare antibiotic prescribing patterns for pediatric patients with respiratory tract infections admitted to a tertiary care hospital in Lahore. This comparative cross-sectional study was conducted at Children’s Hospital in Lahore, Pakistan, for three months and enrolled 250 pediatric patients who met the inclusion criteria, including 155 males and 95 females. Data were collected through face-to-face interviews and reviewing hospital records. The results of the study showed that the average number of drugs per prescription was 3.06 ± 1.29 (male) and 3.12 ± 1.5 (female), while the average number of antibiotics per prescription was 2.25 ± 0.60 (male) and 2.17 ± 0.58 (female). The most prevalent medical conditions were bronchopneumonia (53.55% males and 58.95% females), followed by respiratory distress (20.00% males) and pneumonia (16.13% males and 16.84% females). The most commonly prescribed drugs were J01DD04: Ceftriaxone (78.71% males and 71.58% females), J01CR02: Amoxicillin/Clavulanate (59.35% males and 56.84% females), and J01GB06: Amikacin (41.29% males and 45.26% females). A low percentage of prescriptions had major drug‒drug interactions (8.39% males and 10.53% females), while most prescriptions had no drug‒drug interactions (81.94% males and 84.21% females). There was no significant difference between male and female patients for caregiver, indications for antibiotic prescriptions, the class of active agent prescribed, and drug interactions. Our study findings indicate that most male and female patients admitted to the hospital with lower respiratory tract infections were prescribed antibiotics alongside analgesics and antipyretics. Furthermore, our analysis revealed minimal drug interactions among the prescribed medications. Importantly, we observed a similar antibiotic prescribing trend among male and female pediatric patients, highlighting the consistency in treatment approaches
Knowledge, attitudes, and practices of pelvic floor muscle exercises among pregnant women visiting public hospitals
No full textMany countries are focusing on antenatal programs and developing strategies to ensure the availability of basic needs to pregnant women and prevent complications concerning childbirth. During the antenatal period, pelvic floor muscle exercises (PFMEs) reduce complications during labor or puerperium, benefiting the mother and the child. Therefore, the current study was designed to identify the gaps in knowledge, attitudes, and practices of PFMEs among pregnant women. This descriptive cross-sectional study recruited 385 pregnant women using a purposive sampling technique aged 18 to 40 who visited major tertiary care public hospitals in their second and third trimesters. Face-to-face interviews were conducted using a semistructured questionnaire consisting of four sections: sociodemographics, knowledge, attitude, and practices. The overall knowledge of the pregnant women was determined using the modified Bloom's cutoff point. Descriptive statistics were calculated for the collected data. Pregnant women's education levels varied widely, ranging from no formal education to graduate. Most of them belonged to low socioeconomic status families (84.16%), i.e., below Pakistani rupees (PKR) 15,000. Nearly half of the pregnant women were familiar with PFMEs (51.69%). They had relatively better knowledge about PFMEs regarding preventing urine leaks (43.38%), reducing back pain (40.00%), preventing excessive weight gain (46.49%), preventing swelling of extremities (47.01%), and increasing energy and stamina during pregnancy (40.52%). Moreover, 50.39% of pregnant women believed childcare activities barred them from performing PFMEs. However, a meager number of pregnant women (6.75%) were performing PFMEs. The overall knowledge of PFMEs among most pregnant women was poor (64.16%). The study observed various deficiencies in PFME-related knowledge among pregnant women and some difficulties performing these exercises. Only a meager number of the recruited sample reported the regular practice of PFMEs, indicating a dire need to increase the awareness and adherence of women in the local community
Beyond transmission: exploring the knowledge of risk factors and myths of Hepatitis B and C among undergraduate medical students
No full textHepatitis B virus (HBV) and hepatitis C virus (HCV) have significant impacts on global public health, necessitating a deep understanding of their transmission dynamics and risk factors. Given the high prevalence in Pakistan and the critical role of healthcare education, this study aimed to assess medical students’ knowledge of transmission risk factors and common myths and misconceptions about HBV and HCV. An exploratory study was conducted in May 2022 at Rai Medical College, Sargodha, Pakistan. A total of 376 undergraduate medical students were recruited using a convenient sampling technique. Participants completed self-administered questionnaires to assess their knowledge of HBV and HCV transmission risk factors and associated myths and misconceptions. The data were analyzed for frequencies and percentages with SPSS version 25.00. The majority of students accurately identified traditional transmission pathways for HBV, with 78.72% recognizing transmission during pregnancy and 73.14% during delivery. However, knowledge about nontraditional transmission routes and household practices was less robust, with only 60.64% acknowledging the risks of sharing nail cutters. For HCV, knowledge was generally lower, with 62.77% recognizing the risk associated with tattooing. Misconceptions were also prevalent; for instance, 53.99% of students mistakenly believed that HBV could be transmitted through the home care of patients. This study highlights significant knowledge gaps and pervasive misconceptions among medical students regarding HBV and HCV transmission. Despite a good grasp of traditional risk factors, the widespread misunderstanding of nonbloodborne transmission routes underscores the urgent need for enhanced educational interventions. The findings suggest that targeted improvements in curriculum design could better equip future healthcare providers to combat hepatitis effectively