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Applications of nanotechnology in allergy and asthma
No full textThe increasing incidence of allergic diseases requires effective curative strategies for their alleviation. Allergen-specific immunotherapy (AIT) is a causal treatment technique instead of a symptomatic treatment technique for allergies. At present, AIT is being offered utilizing immunization response modifiers (IRMs) or adjuvants. The adjuvant helps in vigorous inaugral as well as long-term IR (immune response), thus enhancing the efficacy of AIT. The successful development of novel additives requires complete knowledge regarding the underdevelopment of novel and conservative additives. Hence, this review describes the applications of nanotechnology in allergic disorders, namely, allergies and asthma. The development of vaccines based on nanoparticles (NPs) is an important strategy for AIT because of their innate physicochemical characteristics, production ease and capacity to incite inherent immunity
Exploring patterns of intimate partner violence during pregnancy through a descriptive lens
No full textGlobally, intimate partner violence (IPV) against women is a serious concern, with significant underreporting in Pakistan. This study aimed to explore the patterns of IPV among pregnant women in a Pakistani setting. An exploratory study using nonprobability purposive sampling recruited 363 pregnant women visiting for check-ups at Akbar Niazi Teaching Hospital, Islamabad. Participants were interviewed using a structured questionnaire developed from an extensive literature review and prior research. Data analysis was performed using SPSS, descriptive statistics, bar charts, and chi-square tests, with the significance threshold set at p < 0.05. The demographic analysis revealed that a majority of women (56.75%) were aged 20–29, whereas most husbands fell within the 30–39 age group (68.60%). Educational disparities were significant (p < 0.001), with 48.76% of women lacking formal education versus 34.16% of their husbands having higher secondary education or above. The working status highlighted economic dependency, with 91.74% of women not working. Over 61% of pregnancies were unplanned, with 32.28% of participants reporting contraceptive nonuse due to partner opposition. The most reported controlling behavior was the restriction of medical care access (63.36%). Psychological violence was prevalent (25.07% reported humiliation or intimidation), while physical violence was less common (4.96% experienced object throwing). Sexual violence instances were comparatively rare, with 2.75% reporting nonconsensual sexual relations. This study underscores significant sociodemographic and economic disparities affecting pregnant women's exposure to IPV, with psychological violence emerging as the leading form of IPV experienced during pregnancy. These findings underscore the necessity for targeted interventions to improve healthcare access and support pregnant women's autonomy and well-being amidst IPV challenges
Nutritional status and postoperative outcomes in patients undergoing major resection for gastrointestinal cancer: a prospective cohort study
No full textMalnutrition is highly prevalent among patients with gastrointestinal (GI) cancers and has a significant effect on surgical outcomes. Despite the growing recognition of this relationship, standardized nutritional assessment and intervention protocols remain inconsistent across healthcare settings. A prospective cohort study was carried out over a one-year period (June 2023–June 2024) to determine the associations between preoperative nutritional status and postoperative outcomes in patients undergoing major resection for GI malignancies. Consecutive patients who underwent elective major GI cancer resection were enrolled. The study utilized validated tools to assess nutritional status, including serum albumin (ALB), body mass index (BMI), and the Patient-Generated Subjective Global Assessment (PG-SGA). The principal outcomes were major postoperative complications (Clavien–Dindo grade ≥3), length of hospital stay, and thirty-day mortality. Among 294 patients, 128 (43.5%) were identified as nutritionally at risk preoperatively. Patients classified as malnourished experienced significantly higher 30-day mortality, with a rate of 12.5% versus 4.2% in well-nourished patients (p = 0.008). They also had a greater incidence of major postoperative complications, occurring in 35.9% of cases versus 18.1% among their well-nourished counterparts (p < 0.001). In addition, the median length of hospital stay was notably longer in malnourished individuals (14 days) than in those with adequate nutritional status (9 days; p < 0.001). Multivariate analysis revealed severe malnutrition as an independent risk factor for adverse postoperative outcomes, with an odds ratio (OR) of 2.84, a 95% confidence interval (CI) ranging from 1.52 – 5.31, and a p value of 0.001. These findings demonstrate that preoperative malnutrition significantly increases perioperative morbidity and mortality among patients undergoing GI cancer surgery. These findings advocate the integration of routine nutritional screening and tailored interventions into the perioperative care pathway
Comparison of teledentistry and on-site clinical diagnosis using the International Caries Detection and Assessment System (ICDAS) in Rawalpindi and Islamabad: a validation study
No full textDental caries significantly impact global health, particularly in Pakistan, where the prevalence is notably high. This study assessed the diagnostic accuracy of mobile teledentistry in Islamabad and Rawalpindi by employing the International Caries Detection and Assessment System (ICDAS) as a benchmark. This cross-sectional validation study was conducted from July to September 2022 in nine private dental clinics involving 460 participants proficient in basic Android smartphone functions. The diagnostic procedure comprised initial in-person evaluations by dentists, subsequent remote assessments using images captured by smartphones based on verbal instructions, and validations by a third independent dentist. Statistical analyses were performed using sensitivity, specificity, Matthew’s correlation coefficient, and receiver operating characteristic (ROC) curves. Teledentistry achieved a specificity of 89% and a sensitivity of 70%. The positive and negative predictive values were 74.6% and 86%, respectively. The ROC curve analysis, with an area under the curve greater than 0.7, confirmed the high diagnostic efficacy of the method. The Cohen’s kappa statistic reached 0.814, demonstrating substantial interrater reliability, while the diagnostic odds ratio was 18, indicating strong discriminative power. This study confirmed that teledentistry, enabled by the use of smartphone cameras, serves as a reliable method for detecting dental caries, with efficacy comparable to that of conventional clinical examination methods. It significantly extends dental care accessibility, particularly in geographically remote or economically underserved regions, effectively mitigating the logistical challenges associated with traditional dental visits. The findings support the broader implementation of teledentistry, highlighting its potential to enhance mass screening efforts, improve oral health outcomes, and alleviate pressures on healthcare systems across diverse demographic landscapes
Assessing the effectiveness of digital media platforms on birth preparedness and complication readiness knowledge among healthcare professionals
No full textThe integration of modern technology in healthcare education, mainly through digital media platforms, is pivotal for enhancing healthcare professionals' proficiency in birth preparedness and complication readiness (BP/CR). This study aimed to assess the effectiveness of digital media interventions on BP/CR knowledge among healthcare providers, reflecting on broader implications for global healthcare delivery and patient education. In this quasi-experimental study, 70 healthcare professionals were recruited using a nonprobability convenience sampling method. The training protocol was developed after an in-depth literature review, while the evaluation questionnaire incorporated provider-level index indicators aligned with Johns Hopkins University's BP/CR guidelines to ensure a comprehensive assessment framework. The intervention utilized widely accessible digital platforms, i.e., WhatsApp and email, aimed to deliver educational content, with its effectiveness gauged through pre- and postintervention assessments analyzed using SPSS 25.00. The study findings demonstrated significant improvements in BP/CR knowledge postintervention across various care domains. The results showed significant increases in BP/CR knowledge postintervention: focused antenatal care knowledge improved from 34.00% to 69.00% (p < 0.001), and knowledge of third-stage labor management increased from 21.00% to 56.00% (p < 0.001). Furthermore, significant improvements were also observed in neonatal care and emergency obstetric and neonatal care management knowledge (p < 0.001). These results affirm the role of digital media in improving healthcare education, suggesting its integration into healthcare policies to reduce maternal mortality and support professionals in resource-limited settings
Association between premenstrual syndrome severity and academic performance among adolescent girls in Bara Kahu, Islamabad
No full textPremenstrual syndrome (PMS) affects many adolescent girls in terms of physique, behavior, and psychology. However, evidence regarding the association between PMS severity and academic performance among adolescents in peri-urban areas of Pakistan remains limited. This cross-sectional analytical study was conducted from May to September 2024 among 270 adolescent girls enrolled in secondary and higher secondary schools in Bara Kahu, Islamabad, using multistage cluster sampling. This study determined the frequency and severity of PMS and examined its association with academic performance. Overall, 85.93% of the participants reported PMS symptoms, with 35.19% experiencing mild, 30.00% moderate, 12.59% severe, and 8.15% very severe symptoms. For inferential analysis, PMS severity was categorized into mild, moderate, and severe levels. A statistically significant association was observed between PMS severity and academic performance (χ² = 34.565; p < 0.001). Spearman’s rank correlation further demonstrated a significant negative correlation between PMS severity and academic performance (ρ = −0.356, p < 0.01), indicating poorer academic performance with increasing symptom severity. These findings suggest that greater PMS severity is associated with reduced academic performance among adolescent girls in peri-urban Islamabad. While causality cannot be inferred because of the cross-sectional design, the results highlight the relevance of menstrual health in educational contexts during adolescence
Rising incidence of chikungunya in Pakistan: surveillance gaps, diagnostic limitations, and the need for integrated vector control
No full textChikungunya virus disease (CHIKVD) is a re-evolving public health threat worldwide, including in Pakistan, since 2024 new cases of infection have been reported in the country, with spikes in infection observed in Karachi. Technically limited as well as decentralized diagnostic capacity and clinical overlap of infection with dengue contribute to underdiagnosis and delayed treatment among patients. The reappearance of the infection highlights structural gaps in the surveillance integration, laboratory infrastructure, and vector control strategies of Pakistan. Strengthening provincial diagnostic facilities, enhancing routine arboviral surveillance, integrating CHIKVD into national vector-borne disease programs, and promoting coordinated community-based mosquito control are essential for preventing endemic diseases nationwide. Without timely and effective system-level interventions, CHIKVD may accelerate from sporadic outbreaks to sustained urban transmission, posing recurrent strain on Pakistan’s healthcare system
Assessment of academic performance, preparedness, and career orientation among Doctor of Pharmacy students: a cross-sectional study from Sargodha, Pakistan
No full textPharmacy students face critical decisions about their career paths as they approach graduation. However, in Pakistan, data are limited on how academic performance, job preparedness, and career orientation are interrelated among pharmacy undergraduates. This study aimed to assess academic performance, job-seeking preparedness, and career orientation among fourth- and fifth-year Doctors of Pharmacy (Pharm.D.) students and to evaluate the availability and utilization of institutional career counseling services. A descriptive cross-sectional study involving 183 fourth- and fifth-year Pharm.D. was conducted at the College of Pharmacy, University of Sargodha. students. Data were collected via a self-structured, expert-validated questionnaire covering academic performance, job preparedness, and career orientation. The data were analyzed via SPSS and RStudio, which employ descriptive statistics, independent samples t tests, and Pearson correlation analysis. Most participants were female (65.57%), urban residents (72.68%), and unmarried (95.08%), with 69.95% having one to three siblings with a university education. A CGPA ≥ 3.5 was reported by 60.66% of the students, whereas only 20.77% had research experience. Workshop and conference participation was high (85.25% and 83.06%, respectively), but institutional support was limited—only 19.67% received help from the student affairs department, and 29.51% received guidance from a student society or organization. Although 89.62% could make a CV and 71.58% could independently apply for jobs, only 46.45% could write a cover letter, and 42.08% felt prepared for interviews. The awareness of private-sector pharmaceutical roles (15.85%) exceeded that of public-sector roles (13.11%), and the knowledge of community (70.49%) and clinical (64.48%) pharmacies was greater than that of industrial (8.20%) or hospital (38.25%) positions. Career orientation toward nonpharmaceutical sectors was relatively stronger in the public (49.73%) and private (45.90%) domains. Gender (p = 0.030) and year of study (p = 0.047) were significantly associated with preparedness, favoring male and 5th-year students. A moderate correlation existed between academic performance and preparedness (r = 0.38), whereas correlations between academic performance and career orientation (r = –0.02) and between preparedness and career orientation (r = 0.09) were weak or negligible. Pharmacy undergraduates in their fourth and fifth professional years were academically sound but demonstrated deficiencies in job-seeking readiness and awareness of nontraditional career paths. However, exposure of students to career counseling by institutions has remained limited; findings highlight the need for career guidance services in a structured manner, intense research engagement, and vast exposure of students as well as fresh graduates to diverse professional pathways beyond traditional pharmacy roles
Standard treatment guidelines and clinical decision-making in type 2 diabetes mellitus: insights from tertiary care healthcare providers in Islamabad
No full textDiabetes mellitus (DM) is an illness caused by either a relative or absolute loss of insulin; it is highly prevalent worldwide. The role of standard treatment guidelines (STGs) is fundamental to ensure positive treatment outcomes for type 2 diabetes mellitus (T2DM), as they promote rationality in prescriptions. This descriptive cross-sectional study aimed to determine healthcare providers’ perceptions of STGs for T2DM management, perceived barriers to T2DM management, and perceptions of the effectiveness of oral antidiabetics. Furthermore, the study also examined the associations of knowledge with the dose of antidiabetic agent, sector of employment and clinical experience. This study included 150 healthcare providers working in public and private tertiary care facilities in Islamabad. A relevant expert-verified questionnaire was employed in the study, and data were gathered via a convenient sampling technique. The results of the study revealed that 38.67% of the providers were from the public sector and that 61.33% of the providers were from the private sector. A total of 87.33% of the providers agreed that current antidiabetic drugs are effective, and 77.33% supported combination therapy; 64.00% reported that STGs are cost effective, and 94.67% underlined the importance of educational program treatment outcomes; 88.67% of the providers highlighted patient-related barriers, 80.67% highlighted limited guideline availability, and 80.00% highlighted a lack of prescriber awareness as major barriers in the implementation of STGs. Glimepiride by 82.00% of providers and metformin by 73.33% of providers were rated as most effective, whereas glibenclamide was the least preferred agent by 61.33% of providers. The level of knowledge varied, with sector showing a significant association (p = 0.001), whereas experience had no significant impact (p = 0.503). The study concluded that healthcare providers support the effectiveness of oral antidiabetics and the use of combination therapy, and the role of treatment guidelines in T2DM management, patient-related barriers, limited access to STGs, and discrepancies in knowledge across sectors remain major challenges in T2DM management
Cost analysis of malaria prescriptions by prescriber type in healthcare facilities in Lahore
No full textMalaria is a significant public health problem in developing countries, including Pakistan, with an annual mortality rate of 50,000 2.6 million cases in 2018. Pakistan continues to be among the top four countries with the highest number of anticipated malaria cases in the region. This descriptive cross-sectional study determined the unit cost of antimalarial prescriptions, compared average treatment costs, and assessed any differences in cost across prescriber types and medication categories. Using purposive sampling, 300 prescriptions of uncomplicated malaria were collected from physicians and consultants practicing at two public tertiary care hospitals in Lahore. The cost of drugs was calculated on the basis of the standard retail price set by the pharmaceutical company. The data were analyzed via SPSS version 25, frequencies were calculated, and two-way ANOVA was performed. The results highlighted that the unit cost of antimalarials prescribed by physicians ranged from Pakistani rupees (PKR) 21-30, whereas the majority of combination therapies for physicians cost up to PKR 50. In comparison, antimalarials prescribed by consultants had unit costs between PKR 31 and 40, with combination therapies falling into either a low-cost band (PKR 1–50) or a higher-cost band (PKR 201–300). Two-way ANOVA revealed a statistically significant interaction between prescriber type and medication category in relation to treatment cost (p = 0.002). The study concluded that physicians prescribe lower-cost unit doses and combinations of antimalarial medications than consultants do, and there are significant differences in treatment costs on the basis of prescriber type and the category of medication prescribed. Future research should explore qualitative determinants of prescriber behavior to guide national malaria control and health policy