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Hepatitis C virus (HCV) transmission remains a significant public health concern. It is well documented globally, however, Nowshera district, Pakistan, is lacking such profile. This study aims to explore the relationship between HCV infection and several risk factors, including socio-demographic, clinical and personal life-style factors. This study using a cross-sectional design, examined 606 randomly selected individuals visiting the Pathology department at Qazi Hussain Medical Complex and District Headquarter (DHQ) Hospital Nowshera between May 1, 2022 and Jun 30, 2023. This research investigation employed a methodical approach involving formal interviews in conjunction with structured questionnaires to gather comprehensive information related to socio-demographic characteristics, clinical history, and personal hygiene practices. We collected 10 ml of blood samples and tested the separated serum to identify markers using the Immuno-Chromatographic Test (ICT) and the Enzyme-Linked Immunosorbent Assay (ELISA). IBM SPSS Statistics version 27 was used for data analysis. To measure the association between dependent variable and independent variables, a chi-square and risk analysis was carried out; multiple logistic regression was employed for modeling the risk factors associated with independent variable. A statistical significance level was established at a P-value of less than 0.05. In present study, which included 606 participants, 12% were found to be infected with HCV. Importantly it revealed that facial shave at barber (adjusted odds ratio, aOR = 40.65, p = 0.000) represents the most prevalent mode of HCV transmission. Additionally, a strong association was observed between HCV infection and history of past surgery (RR = 2.98, p = 0.001), HCV infected family member (aOR = 4.28, p = 0.001), workplace injuries (aOR = 6.68, p = 0.000), history of hospital admission (RR = 2.09), practicing ear and nose piercing (aOR = 5.01, p = 0.001), dental treatment (RR = 2.31) and the frequency of injections (aOR = 8.607, p = 0.000). These findings underscore the pressing need for targeted interventions. This study highlights the paramount importance of understanding the modes of HCV transmission and their associated risk factors. The results emphasize the need for educational initiatives, both within the healthcare sector and among the general public, to combat HCV transmission effectively. By implementing sterilization procedures and increasing awareness, we can make significant strides in reducing the burden of HCV infection. Moreover, proactive measures within families can help contain the spread of the virus, ultimately contributing to improved public health., (© 2024. The Author(s).)

Background/objective: Adults with asthma who experience difficulties in emotion regulation are prone to developing psychopathological symptoms that may affect their self-management activities and symptom control. The current research investigated the role of psychological flexibility and cognitive emotion regulation strategies in relation to mental health outcomes (psychological distress and quality of life) among patients with asthma in Pakistan., Method: A sample of 200 adults, diagnosed with asthma (32% men, 68% women; M age = 42.32, SD age = 16.99), completed the acceptance and action questionnaire (AAQ-II) cognitive emotion regulation questionnaire (CERQ), depression, anxiety, stress scale-21 (DASS-21), asthma-related quality of life questionnaire (AQLQ) and a self-structured demographic sheet., Results: Results of Pearson product moment correlation showed that most of the adaptive cognitive emotion regulation strategies (positive refocusing, refocus on planning, and positive reappraisal) were positively correlated with psychological flexibility and quality of life, whereas negatively correlated with psychological distress. All the maladaptive strategies of cognitive emotion regulation had a significant inverse relationship with psychological flexibility and quality of life, while positively correlated with psychological distress. Results of serial mediation analysis through PROCESS MACRO showed that catastrophising and anxiety fully mediated the relationship between psychological flexibility and asthma-related quality of life., Conclusion: Evidence-based interventions should focus on developing psychological flexibility and identifying maladaptive patterns of cognitive emotion regulation strategies for improved mental health and quality of life outcomes for adults with asthma., Competing Interests: The authors declare that they have no competing interests., (© 2023 Hussain et al.)

Background: In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus., Methods: The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory., Results: Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates., Conclusion: This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time., Competing Interests: Declaration of competing interest All authors declare there are no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

In the current digital environment, satisfying sexual needs via Internet pornography use has the potential to develop into a problem that affects one's psychological health and daily functioning. The aim of this study was to examine potential cognitive and affective factors that could help explain the maintenance and exacerbation of self-defined problematic internet pornography use., Methods: 280 Pakistani men and women (mean age = 25.40; SD = 5.271, range 18-50) who were current pornography users were recruited through social networking sites (Facebook, Instagram, LinkedIn, WhatsApp groups) to participate in an online study about pathways to problematic pornography use (PPU). Structural equation modeling was used to estimate path analysis coefficients extending from predisposing variables (depression, anxiety, self-esteem, and loneliness) to PPU via the mediating variables of craving, dysfunctional sexual coping, and stimulus-specific inhibitory control., Results: Craving mediated the relationship between three predisposing variables (depression, anxiety, and self-esteem) and PPU, though not the fourth, namely loneliness. Indirect effects of depression, anxiety, and self-esteem were significantly linked to PPU through two serial mediation pathways: (a) craving and stimulus-specific inhibitory control, and (b) craving and dysfunctional sexual coping., Conclusion: These findings demonstrate that craving, stimulus-specific inhibitory control, and dysfunctional coping serve as important mediators in maintaining and exacerbating the cycle between negative predisposing variables and PPU. These results are interpreted within the general framework of therapeutic interventions that can help develop positive coping skills in individuals seeking to alter self-perceived bothersome or unwanted habits related to pornography use.

Background: Child sexual abuse is one of the most pervasive threats to children's wellbeing worldwide. Globally, around 7% to 19% of children have been estimated to be a victim of child sexual abuse. In Pakistan, around 18 thousand instances of child sexual abuse were reported in the last five years., Aims: Current study aimed to evaluate the preliminary effect, acceptability and feasibility of a sexual abuse prevention program for children with intellectual disabilities, in a rural public school of Pakistan., Method: A non-randomized (pre-post) evaluation of the acceptability, feasibility and impact of the adapted sexual abuse prevention program on a range of knowledge and skills-based outcomes of 15 female children with mild intellectual disability was undertaken. Participants were exposed to a 5-session based program incorporating common sexual abuse prevention concepts, e.g. knowledge of private body parts, body ownership, discriminating between safe and threatening situations, refusing to sexual lures, escaping the situation and reporting the potential offender. Structured assessments were conducted with children before and after intervention delivery., Results: The school-based sexual abuse prevention program was shown to be acceptable, feasible and efficacious in improving sexual abuse prevention knowledge and skills of female children with a mild intellectual disability enrolled in a public school of rural Pakistan., Conclusions: The program offers a promising framework for school-based sexual abuse prevention in Pakistan., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To compare the physiological and biochemical markers in healthy and periodontitis subjects, and to relate these markers with the periodontal health condition., Method: The case-control study was conducted at the Dow University of Health Sciences, Karachi, from April 2017 to March 2018, and comprised systematically healthy controls and periodontitis cases. Periodontal probing depth, clinical attachment loss, oral hygiene indices, educational status and body mass index were recorded for all the subjects. Serum levels of biochemical markers, including calcium, phosphate and interleukin-6, were also measured. Data was analysed using SPSS 16., Results: Of the 150 subjects, 75(50%) each were in the case and control groups. The overall mean age was 31.23±3.7 years (range: 22-42 years). The cases had relatively poor oral hygiene indices and educational status compared to the controls (p<0.05). Serum calcium level was lower, whereas mean body mass index was higher in the cases compared to the controls (p<0.05). No significant difference was found in interleukin-6 and phosphate levels (p>0.05). Clinical attachment loss showed significant correlation (p<0.05)., Conclusions: Low serum calcium and educational levels, higher body mass index and poor oral hygiene were found to be the risk factors for the progression of periodontitis.

Background: Social anxiety is common among adolescents in Pakistan and is associated with low self-esteem. Among the recommended treatments, cognitive behavioural therapy (CBT) is effective, and self-help approaches are encouraged., Aim: To determine the effectiveness of culturally adapted CBT-based guided self-help (CACBT-GSH) intervention, using a manual 'Khushi aur Khatoon', for treating social anxiety when added to treatment as usual (TAU) compared with TAU only., Method: A total of 76 adolescents with social anxiety aged 13-16 years from six schools in Multan, Pakistan were recruited into this randomized controlled trial. Participants were divided into intervention and control groups in a 1:1 ratio. Social anxiety, self-esteem and fear of negative evaluation were assessed through the Liebowtiz Social Anxiety Scale for children and adolescents, the Rosenberg Self-Esteem Scale and the Brief Fear of Negative Evaluation, respectively, at baseline and at the end of the study. Guided self-help using culturally adapted CBT (CACBT)-based self-help manual (eight sessions, one session per week) was provided to the intervention group. The effect of the CACBT-GSH intervention was analysed with ANCOVA., Results: There was a statistically significant difference between the intervention and the control groups in favour of intervention. Participants in the intervention group showed reduced symptoms of social anxiety (p < .001), fear of negative evaluation (p < .001) and enhanced self-esteem (p < .001)., Conclusion: The study demonstrated the effectiveness of CACBT-based guided self-help intervention in treating social anxiety and addressing the symptoms associated with it.

Recently, probiotic yeasts have become an interesting topic of research all over the world. Saccharomyces cerevisiae is well proven probiotic yeast against several gastrointestinal diseases. Current study aimed to explore the probiotic potential and antibacterial properties of Saccharomyces strains isolated from fresh lychee fruits available in local markets of Karachi, Pakistan. Probiotic potential and antibacterial activity of locally isolated probiotic yeast strains (named as S. cerevisiae BEL 1 and S. cerevisiae BEL 9) was studied against gastrointestinal pathogens using standard in vitro screening methods. Comparative analysis was also carried out with commercially available S. boulardii probiotic preparations. Furthermore, for probiotic potential, all the studied yeast strains were exposed to various stress conditions inherent of gastrointestinal tract i.e., thermo tolerance, pH tolerance, bile salts survivability and osmo-tolerance. Isolated strains (BEL 1 and BEL 9) were able to tolerate at the temperatures (40oC and 45oC), moreover survived in the presence of gastric juices, extreme bile salt concentrations (range 0.5%-2%) and different osmotic stress conditions (1M and 1.5 M NaCl). Optimal growth was observed at 37oC. Similar growth pattern and viability of BEL 1 and 9 was found for most of the stress conditions, when compared with the commercially available strains of S. boulardii. Therefore, isolated yeast strains BEL 1 and 9 will be considered as a potential bio-therapeutic agent because of the promising probiotic potential.

Background: Not much is known about glycaemic-control trajectories in childhood-onset type 2 diabetes (T2D). We investigated characteristics of children and young people (CYP) with T2D and inequalities in glycemic control., Methods: We studied 747 CYP with T2D, <19 years of age in 2009-2016 (from the total population-based National Pediatric Diabetes Audit [>95% diabetes cases in England/Wales]). Linear mixed-effects modeling was used to assess socioeconomic and ethnic differences in longitudinal glycated hemoglobin (HbA 1c ) trajectories during 4 years post-diagnosis (3326 HbA 1c data points, mean 4.5 data points/subject). Self-identified ethnicity was grouped into six categories. Index of Multiple Deprivation (a small geographical area-level deprivation measure) was grouped into SES quintiles for analysis., Results: Fifty-eight percent were non-White, 66% were female, and 41% were in the most disadvantaged SES quintile. Mean age and HbA 1c at diagnosis were 13.4 years and 68 mmol/mol, respectively. Following an initial decrease between diagnosis and end of year 1 (-15.2 mmol/mol 95%CI, -19.2, -11.2), HbA 1c trajectories increased between years 1 and 3 (10 mmol/mol, 7.6, 12.4), followed by slight gradual decrease subsequently (-1.6 mmol/mol, -2, -1.1). Compared to White CYP, Pakistani children had higher HbA 1c at diagnosis (13.2 mmol/mol, 5.6-20.9). During follow-up, mixed-ethnicity and Pakistani CYP had poorer glycemic control. Compared to children in the most disadvantaged quintile, those in the most advantaged had lower HbA 1c at diagnosis (-6.3 mmol, -12.6, -0.1). Differences by SES remained during follow-up. Mutual adjustment for SES and ethnicity did not substantially alter the above estimates., Conclusions: About two-thirds of children with childhood-onset T2D were non-White, female adolescents, just under half of whom live in the most disadvantaged areas of England and Wales. Additionally, there are substantial socioeconomic and ethnic inequalities in diabetes control., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To identify the pattern and causes of making contraceptive choices among females attending family planning centre in Peshawar, Pakistan., Methods: The simple observational study based on convenient sampling was conducted at the family planning centre of Hayatabad Medical Complex, Peshawar, from October to December, 2010. Included were 104 females who were asked about their contraceptive use and the reason for their decisions. The variable used for contraceptive choices, included effectiveness (against preventing pregnancy), easy availability, side effects of the method, general health issues, cost factor and permanence of the method., Results: It was found that 49 (46.7%) females were currently using injectables; 18 (17.1%) pills; 18 (17.1%) IUDs; 19 (10.5%) tubal ligation; and 9 (8.6%) condoms. The major causes for making the choices were effectiveness (n = 32; 30.5%); easy availability (n = 19; 18.1%); side effects (n = 11; 10.5%); reproductive tract infections (n = 3; 2.9%); and cost factor (n = 2; 1.9%). Respondents who choose more than one reason were 23.8% (n = 25). It was observed that 60% (n = 63) of respondents were first-time users, while the rest gave history of using some method in the past. Out of this proportion, pills and barrier method were used in most patients. Among the illiterate group of 35 (55.2%) respondents, 18 (28.6%) chose injectables; 6 (9.5%) chose IUCDs; and 6 (9.5%) tubal ligation. Similarly, 13 (20%) respondents from poor socio-economic group and 15 (22.9%) respondents from the middle group chose injectables., Conclusions: When given choices and balanced information about contraceptives, more women are likely to continue the method. Respondents from the lower socioeconomic and illiterate group chose injectables in high proportion due to their effectiveness and easy availability. Side effects of the method and health concerns were less considered, while the cost factor was the least considered.