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Mexico’s failure to address the true toll of the COVID-19 pandemic
No full textThis study retrospectively analyzes the organizational handling of the COVID-19 pandemic by Mexico’s health authorities, from its outbreak in February 2020 to the final phase of the pandemic. The analysis begins with the undercounting of infected persons and deaths, which led to distorted figures and an abnormally high case fatality rate. The underestimation is examined separately for infections, deaths, and case fatality rates. The number of infected persons was affected by insufficient COVID-19 testing and restrictions on hospitalization. Death figures were evaluated by comparing mortality trends observed during the five years preceding the outbreak with the postpandemic data disaggregated by cause of death. These data were first collected by health authorities, reviewed by the Interinstitutional Group for the Estimation of Excess Mortality (GIEM, in Spanish), and later consolidated by the National Institute of Statistics and Geography (INEGI, in Spanish). The case fatality rate was calculated as the relationship between both variables on the basis of the original figures published by health authorities. After different calculation methods were explored, a more plausible estimate of the real COVID-19 death toll was established. Despite the need to correct the initial figures, the official database has not been updated. This lack of correction misinforms the public about the real impact of COVID-19 and risks leading the health system to repeat the statistical and organizational failures observed during the pandemic, potentially underestimating future health emergencies
Delays in the referral, diagnosis, and treatment of tuberculosis patients in a community pharmacy network in Pakistan
No full textTimely diagnosis and treatment delays among tuberculosis (TB) patients remain among the major challenges for controlling and eradicating the disease globally. Delayed health-seeking behavior among TB patients may either contribute to undetected and untreated TB cases or lead to poor treatment outcomes when patients are eventually diagnosed. Managing these delayed TB consultations becomes even more challenging in lower-middle-income countries (such as Pakistan), where TB incidence and transmission rates are high, but limited evidence is available on patient and health system delays in seeking and initiating TB treatment. This study aimed to assess the time delays of patients attending pharmacies managed by TB referral initiatives in Pakistan. A case detection approach utilizing a public‒private-mix (PPM) partnership was developed and fully protocolized for use; this approach involved participation in pharmacies to assess and provide a formal written referral to patients presenting with symptoms indicative of TB. Ranges of pharmacy referral implementation delay as well as diagnostic and treatment delay of TB patients were defined. Among the 500 pharmacies trained in PPM partnerships, 427 (85%) were active in providing referrals. The median pharmacy referral implementation delay was found to be 46 days. Among the 547 TB cases identified through the community pharmacy-referral network, the median diagnostic delay and treatment delay were found to be 4 days and 1 day, respectively. Time delays among TB patients diagnosed through the community pharmacy referral network in Pakistan were relatively low for diagnosis and treatment; however, delays related to the implementation of pharmacy referrals were at times longer than those reported in local, regional, and global settings
Three-dimensional printing in medical education: transforming learning and practice!
No full textThree-dimensional (3D) printing is revolutionizing medical education, particularly in surgical training, by transforming digital images into tangible models. These models, derived from patient radiological data, allow for enhanced anatomical understanding and hands-on learning. Studies have shown that 3D-printed models significantly improve medical students’ comprehension of complex anatomical structures and foster interest in specialized fields such as cardiology. Additionally, 3D printing offers cost-effective solutions for creating both normal and pathological models, which is particularly beneficial in resource-limited settings. While challenges remain, including material limitations and ethical considerations, 3D printing holds tremendous potential in advancing medical education globally
Predictors of evidence-based pressure ulcer prevention behaviors among recently graduated nurses in tertiary care hospitals in Lahore
No full textPressure ulcers (PUs) remain a critical and preventable challenge in hospital care, especially in resource-constrained settings. Despite formal training, early-career nurses often experience gaps in applying evidence-based PU prevention practices. This study identified the behavioral and contextual predictors of evidence-based PU prevention behaviors among recently graduated nurses in tertiary care hospitals in Lahore, Pakistan, by assessing their level of knowledge, attitudes, and self-efficacy, as well as the impact of clinical exposure, internship training, and perceived barriers to preventive practices. An exploratory design involving 135 BSN graduates who had completed their clinical internships within the past six months were recruited for the study using a purposive sampling method. Data were collected via a structured, self-administered questionnaire composed of validated tools, including the Pressure Ulcer Knowledge Assessment Tool 2.0, the Attitude toward Pressure Ulcer Prevention (APuP) scale, and constructs derived from the Theory of Planned Behavior framework. Descriptive statistics, Spearman correlations, and multiple linear regression were used for analysis. While participants showed moderately positive attitudes and self-efficacy, only knowledge of PU prevention emerged as a statistically significant predictor of evidence-based behavior (p = 0.003). Other factors, such as attitudes, perceived barriers, and clinical decision-making ability, did not significantly influence behavior. Despite high exposure to PU cases, most participants reported limited workshop participation and demonstrated low decision-making accuracy. This study highlights that factual knowledge, rather than attitudinal or perceptual factors, plays a pivotal role in shaping evidence-based PU prevention behavior among newly graduated nurses. This finding emphasizes the need for knowledge-intensive interventions and scenario-based training in early clinical practice. Further longitudinal studies are recommended to evaluate the impact of mentorship and institutional support on sustained preventive behaviors
The economic cost of not practicing optimal breastfeeding: a review
No full textUnderfive child mortality is one of the world's most severe public health problems, and the developing world disproportionately bears the brunt of underfive child mortality. It is quite unlikely that developing countries will have sufficient resources, at least in the foreseeable future, to significantly reduce child mortality rates. Fortunately, optimal breastfeeding provides significant protection against child mortality, and it may well be the most practical policy intervention against child mortality in resource-constrained settings. However, the catch lies in the fact that despite the obvious benefits of breastfeeding, optimal breastfeeding is limited across the developing world. I have identified several causal mechanisms that contribute to nonoptimal breastfeeding practices. Additionally, I have drawn upon the literature that has estimated the economic cost of inadequate breastfeeding
Comparative analysis of depression, anxiety, stress, and eating disorders among working and nonworking women visiting community pharmacies in Lahore, Pakistan
No full textAnxiety and depression are common worldwide and often occur together. Anxiety can alter appetite, causing women to consume more food than usual, leading to changes in eating behavior and obesity. This comparative cross-sectional study compared the severity of depression, anxiety, stress, and eating disorders among working and nonworking women visiting community pharmacies. Data were collected through face-to-face interviews with 244 working women and 267 nonworking women. The data were analyzed using descriptive statistics, and a chi-square test was conducted to evaluate differences in the severity of depression, anxiety, stress, and eating disorders between the two groups of participants. Most participants were literate; approximately half of the working (50.82%) and nonworking women (55.06%) had a normal body mass index. There were significant differences between the working and nonworking women in terms of their education and physical activity levels (p < 0.05). Both groups were identified as being at risk of developing bulimia, but their ability to control eating habits differed significantly (p = 0.008). Most participants reported never using laxatives, diet pills, or diuretics to control their weight. Moreover, they reported that they had never received treatment for eating disorders or experienced thoughts of suicide. The study found no significant difference in depression (p = 0.085) and anxiety levels (p = 0.207) between working and nonworking women. However, a significant difference was found in stress levels between working and nonworking women (p = 0.001). Our study highlights a significant prevalence of psychological issues among working and nonworking women in Pakistan, impacting their eating habits and contributing to developing eating disorders and obesity. Interestingly, working women display higher physical activity levels, while nonworking women demonstrate better oral control to prevent eating disorders. To improve women's mental and physical well-being, we recommend prioritizing mental health interventions for all women, promoting healthy eating habits, supporting physical activity, and investigating underlying factors influencing psychological well-being
Prevalence of internet addiction and its associated factors among adolescents in private education institutes in Sargodha, Pakistan
No full textAs digital connectivity has become an integral part of daily life, internet addiction has emerged as a significant concern, particularly among adolescents. Therefore, this study aims to estimate the prevalence of internet addiction among adolescents, assess its severity, investigate the associations between sociodemographic factors and internet addiction levels, and examine the correlation between adolescents' age and the severity of internet addiction. This descriptive cross-sectional study involved 200 adolescents from private education institutes in Sargodha, Pakistan. A structured questionnaire was developed to collect data on sociodemographic indicators, and the validated Internet Addiction Test (IAT) questionnaire was adopted to assess the occurrence and severity of internet addiction. The data were analyzed using IBM® SPSS® software. The results revealed that among the 200 participants, 42% were male and 58% female, with nearly half (47.5%) being aged 13–15 years. Most (57.00%) owned a personal mobile device, whereas 47.5% had a laptop. Furthermore, 39.5% of the participants used the internet for one hour or less per day, whereas 30% reported using it for 2–4 hours daily. Only 8 participants stated that they did not use any social media applications. The study highlights significant internet addiction patterns. Many participants stayed online longer than intended (12.5% always, 16.5% often), whereas 34.5% neglected household chores. Internet dependency was evident, with 14.5% preferring online excitement over intimacy and 26.0% receiving complaints about excessive internet use. Sleep disturbances affected 25.0% of the study participants, whereas academic impacts were reported by 14.5% of the participants. The IAT results revealed that 8.5% of the participants had full control, 54.0% had mild, 36.0% had moderate, and 1.5% had severe addiction. Chi-square analysis revealed no significant associations between addiction severity and sex, age, or device ownership (p > 0.05), but the duration of internet use per day was significantly associated with addiction severity (p = 0.030). Age was weakly but significantly correlated with internet addiction (p = 0.04). The study concluded that a significant proportion of adolescents experienced moderate to severe internet addiction. These findings highlight the urgent need to implement measures to promote healthy digital practices among adolescents