Search

Objective: To evaluate the effectiveness, cost-effectiveness and feasibility of internet-based Cognitive Behavioural Therapy (CBT) in the treatment of body dysmorphic disorder., Methods: The systematic review was conducted from August 19 to September 22, 2023, and comprised search on Cochrane Library, Embase, Google Scholar, PubMed, PsycINFO and Web of Science databases using specific key words for studies published in the English language from 2010 onwards. Grey literature and pertinent conference proceedings were also searched to include as many studies as possible that investigated internet-based cognitive behavioural therapy in the treatment of body dysmorphic disorder. Data extraction was done, and the selected studies were subjected to quality assessment, followed by a narrative synthesis of the findings., Results: Out of the 6,837 studies initially identified, 8(0.11%) were analysed in detail. Of the 8 studies, 4(50%) were RCTs, while 5(62.5%) had been conducted in Sweden. Therapist-guided internet-based cognitive behavioural therapy interventions consistently demonstrated efficacy with respect to reducing body dysmorphic disorder symptom severity, improving insight, and enhancing quality of life. Cost-effectiveness analyses highlighted the favourable economic aspect of internet-based cognitive behavioural therapy. Feasibility and acceptability were demonstrated by high participant engagement and satisfaction., Conclusion: Internet-based cognitive behavioural therapy showed promise in addressing the treatment gap in body dysmorphic disorder care, offering accessible, cost-effective and feasible interventions.

With progressive globalisation enabled by technology, there is an increased interest in finding viable solutions to the myriad health problems faced by developing countries. In countries like Pakistan, occasionally the challenge is not a dearth of material resources but rather unavailability of expertise. The current paper was planned to share a model that was successfully implemented in the urban setting of Karachi, Pakistan, from 2012 onwards which significantly improved access to thoracic surgery for underprivileged individuals. Our model focussed on a qualified thoracic surgeon reviving a defunct thoracic surgical unit thereby optimising the use of resources already available in the community. The key to efficient outcomes was direct managerial control by the surgeon who first educated himself in the various processes involved. The model, with its challenges and solutions, has good potential foradaptation in other urban settings in the developing world..

Objective: To evaluate the knowledge, attitude and practice of self-medication in medical undergraduate students., Methods: This cross-sectional questionnaire-based survey was conducted from January to June, 2017, among undergraduate students of Ayub Teaching Hospital, Women Medical College, International Medical College and Frontier Medical College in Abbottabad, Pakistan. The sample comprised students of first, second, third, fourth and fifth professional year. Data was collected using self-generated questionnaire., Results: Of the 400 subjects approached, 300(75%) returned the questionnaire fully completed. Of them, 208 (69.3%) were females and 92(30.66%) were males. The most common age group was 22-25 years 182(60.7%). Self-medication was found to be prevalent among 297(99%) subjects and 139(46.3%) respondents had practised self-medication in the preceding 6 months more than two times. Over-the-counter drugs were commonly used for the self-medication in 295(98.3%) cases. Overall, 285(95%) respondents had a positive attitude towards self-medication. Media was found to be the most common source of information for 93(31%) cases., Conclusions: High prevalence of self-medication was noticed, with over-the-counter drugs being the most commonly used. Proper educational awareness programmes about self-medication can control the issue.

Objective: To find out the association of stress with anxiety and depression during pregnancy and to identify common stressors in women., Methods: This cross-sectional study was conducted at Divisional Headquarters Teaching Hospital, Kohat, Pakistan, from February 2011 to October 2012, and comprised pregnant women. Convenient sampling technique was used. The participants were administered Urdu-translated version of A-Z perceived stress scale and Aga Khan University anxiety and depression scale. Women with a score of >19 on the Aga Khan University scale were labelled as anxious and depressed. Data was collected on a pre-designed proforma. SPSS 17 was used for data analysis., Results: There were 500 participants with an overall mean age of 28.3±6.3 years. The overall mean stress score on A-Z perceived stress scale was 12.93±5.19 and mean Aga Khan University anxiety and depression scale score was 28.58±13.82. Mean A-Z score was 14.18±4.881 in women with anxiety-depression and 9.75±4.58 in non-depressed women (p<0.001). Mean Aga Khan score in women with >10 stressors was significantly higher (32.18±13.79) compared to women with <10 stressors (19.87±9.30) (p<0.01). A-Z stressors score had significant positive correlation with the Aga Khan scale (p<0.001]. The most common stressors were concern about husband's worries and concern about feeling unwell during pregnancy, present in 433(86.6%) patients each, followed by concern about increase in the prices of everyday goods which was present in 364(72.8%) patients., Conclusions: The magnitude of stress was significantly associated with high anxiety and depression during pregnancy.

Objective: To investigate the efficacy and impact of Protection Against Harassment of Women at Workplace Act 2010 in the public health sector in its socio-legal perspective., Methods: This cross-sectional study was conducted from July to December 2014 in Abbottabad, Pakistan, and comprised subjects selected from 53 basic health units managed by the government. SPSS 20 was used for statistical analysis., Results: Of the 450 questionnaires, 430(96.6%) were returned duly filled. Overall, 40% male (120 respondents) and 26% female (34 respondents) knew about the Act. Besides, 39% males (117 respondents) and 63% females (82 respondents) appeared unsatisfied with the complaint mechanism prescribed in the Act; all the respondents established that no case had been registered after the introduction of the Act. Overall, 31% males (93 respondents) and 57% females (74 respondents) thought that without the health governance commitment and social support structure the Act could not work., Conclusions: The Protection Against Harassment of Women at Workplace Act 2010 was considered ineffective by the respondents who were concerned about the lack of social support system for the Act.

Over the past 5 years, 1620 comatosed patients of both sexes aged 1-75 years were screened for cerebral malaria. Of these, 505 (31.2%) were positive for Plasmodium falciparum. During this period frequency of malaria increased from 22.1% in 1991 to 44.4% in 1995. Sixty-four percent cases of cerebral malaria were seen in children and thirty-six percent in adults. Mortality was also higher (41%) in children than in adults (25%). As cerebral malaria is particularly prevalent in Pakistan and is a major community problem, accurate and easier methods of its diagnosis are needed at primary health care level, in all febrile comatose patients, without focal neurological findings.