Search

Objective: To identify the determinants of health-seeking behaviour among incidentally diagnosed cases of HIV and to explore the patterns of care seeking behaviour among these HIV infected persons. Method: The qualitative study based on the grounded theory was conducted from February to September 2019 at the Armed Forces Institute of Transfusion, Rawalpindi, Pakistan, and comprised incidentally diagnosed new cases of human immunodeficiency virus. Data was collected using in-depth interviews to understand how local environments and settings impact healthcare-seeking behaviour. Data was analysed using the constant comparison method. Results: Of the 12 patients, 10(83.3%) were male, 1(8.3%) female and 1(8.3%) transgender. The mean age of the sample was 31+5 years. Of the total, 10(83.3%) patients were receiving free antiretroviral treatment from government hospitals in Rawalpindi/Islamabad, while 2 (16.7%) opted for some alternative form of healthcare. Ten (80%) were married and were carrying the diagnosis for >6 months. Processing of human immunodeficiency virus status, value placed in one’s own health, experiences with healthcare provider and medication-related factors were the main themes that emerged from the data. Better counselling services, free-of-cost medication, positive patient-provider relationship and social support were the key players, while non-disclosure due to fear of stigma and beliefs about the disease were the main stumbling blocks. Conclusion: Value placed in one’s own healthcare and thus the need for healthcare services, regardless of social norms, cultural reservations and personal beliefs, was the most important factor affecting the healthcare-seeking behaviour of human immunodeficiency virus patients. Key Words: Grounded theory, Health-seeking behaviour, Human immunodeficiency virus, HIV.

Objective: To assess the psychosocial impact of acne and to evaluate the quality of life in relation to severity of symptoms among young adults. Study Design: Cross-sectional – analytical study. Place and Duration of Study: Outpatient Department, Pak Emirates Military Hospital, Rawalpindi, from Sep 2018 to Feb 2019. Methodology: We included 300 individuals visiting the hospital and their quality of life was assessed using Acne quality of life Index questionnaire. Data was analyzed using SPSS-23. Results: Total scores were calculated for three domains of Quality of life in patients with Acne i.e. Self-perception, Emotional well-being and Social life. Out of these three domains, Social Life was most affected by acne (mean score 15.61 ± 7.37out of a total of 30) and Self-Perception was seen to be least affected (mean score 16.90 ± 8.20). There was a strong positive co-relation between the increasing severity of symptoms and impact on Self Perception (r=-0.58, p

Abstract Objective: To measure incidence of COVID-19 vaccine breakthrough infections among health care workers vaccinated with both doses of Sinopharm Vaccine. Study Design: Prospective cohort study. Place and Duration of Study: All Military Institutes of Pakistan, from Feb to Jun 2021. Methodology: Detailed surveillance mechanism was developed before the start of Health Care Workers vaccination in Pakistan Military to report any PCR positive COVID-19 infection post vaccination. Among 39512 health care workers vaccineted with both doses of COVID-19 vaccine; those who developed COVID-19 infection ≥14 days post 2nd dose were included in the study. Total 124 participants till 30 Jun 2021 fulfilled the criteria of COVID-19 vaccine breakthrough infection and were analyzed. Results: Mean age of the participants was 38.8 ± 11 years. Males were 69.4% while females were 30.6%. Median duration from 2nd dose to development of COVID-19 vaccine breakthrough infection was 36.5 days (IQR, 26-62). Asymptomatic/mild infections were reported among 94.4% and only 5.6% had moderate disease. No severe/critical disease requiring oxygen supplementation or ventilator support was observed. Recovery rate was 100% with no mortality. There was no significant statistical association of age, gender, job category with COVID-19 vaccine breakthrough infection (p>0.05). Conclusion: Vaccines remain an important weapon in the battle against COVID-19. No vaccine is 100% effective against all strains of COVID-19; however among the completely vaccinated health care workers less severe disease was observed. There was no mortality.

Objective: To determine the health care seeking behaviour and its association with socio-demographic factors among newly diagnosed Human Immunodeficiency virus infection patients. Study Design: Cross sectional analytical study. Place and Duration of Study: The study was conducted in a regional blood centre and an Institute of Pathology affiliated with National University of Medical Sciences (NUMS) in Rawalpindi, from Feb 2019 to Oct 2019. Methodology: A pretested structured questionnaire was used to collect data from thirty newly diagnosed (within last one year) Human Immunodeficiency Virus Infection (HIV) patients, using consecutive sampling. Age, education, socioeconomic score (SES), family size, income and months living with HIV were divided into groups for analysis. Chi square test was applied to determine association between these variables and health care seeking behaviour. Data was analysed using SPSS version 22. A p-value of 0.05) was found between these independent variables and overall health care seeking behaviour. Conclusions: Health care seeking behaviour of newly diagnosed Human Immunodeficiency Virus infected patients was moderately appropriate and no significant association was found between sociodemographic variables and health care seeking behaviour.

Objective: To assess the gastroprotective effect of montelukast on aspirin induced gastric mucosal ulceration in rabbits. Study Design: Laboratory based quasi experimental study. Place and Duration of Study: National Institute of Health Islamabad and department of Pharmacology and Therapeutics in collaboration with Histopathology department at Army Medical College Rawalpindi from March to May 2018. Methodology: Twenty eight New Zealand white rabbits were randomly divided into four groups as follows: Group 1 was normal control group, group 2 received aspirin as a single dose of 300mg/kg orally on day 6 of the study, group 3 and 4 received omeprazole and montelukast respectively on a similar dosing schedule: where a total of 10mg/kg/day of each respective drug was administered orally for 6 consecutive days followed by a single oral dose of 300 mg/kg of aspirin after 1 hour of the last dose. All animals were sacrificed 5 hours after aspirin administration. The abdomens were dissected and the gastric tissues were excised for macroscopic, ulcer index and pH evaluation and were sent for histopathology for microscopic assessment. Results: Moderate to severe gastric mucosal damage (grade II-III) was seen in the aspirin treated toxic group, with considerable increase in ulcer index and decrease in pH (p

Objective: To assess the gap in knowledge and practices regarding the nosocomial infections among nursing staff of Military Hospitals of Rawalpindi. Study Design: Cross-sectional analytical study. Place and Duration of Study: A 2500 bedded Military Hospital affiliated with National University of Medical Sciences and study duration was one year, from Jan 2018 to Dec 2018. Methodology: A structured pre-tested questionnaire was given to 377 participants which consisted of nursing staff and nursing assistants. Study was started after getting approval from the ethical committee. Data was analyzed using SPSS version 25. Results: Study participants consisted of 66.8% males and 33.2% females. The mean age of study participants was 26.99 ± 5.79 years. Median work experience of our study population was 4 years ranging from 1 to 33 years. The mean knowledge score of our study population was 79.94 ± 20.67 with male participants having better knowledge than their female counterparts (p-value=0.011). The practices of our study population were poor with mean score of 59.31 ± 16.5. Female participants (62.24 ± 17.68) though had better practices then male participants (57.86 ± 15.72) with statistically significant difference (p-value=0.015). Conclusion: Healthcare workers were found to have adequate knowledge regarding hospital acquired infections, but their prevention practices were not in line with their knowledge and not satisfactory.

Abstract Background: Use of the World Health Organization’s (WHO) Safe Childbirth Checklist (SCC) has been associated with a significant reduction of maternal mortality. Method: A descriptive cross-sectional survey conducted at a tertiary care hospital of Rawalpindi in labour room and postnatal ward from February 2018 to July 2018. A sample size of 359 was estimated using WHO sample size calculator and were enrolled using purposive sampling technique. A close ended WHO standardized questionnaire covering the 22 elements of WHO SCC was used. Frequencies and percentages were documented of variables and data was analysed using SPSS version 23. Results: Mean age of participants was 27 ± 4.25 years. On admission, it was observed that being centre of excellence and referral, there was 100% availability of gloves and supplies to clean hands before and after each vaginal examination. Just before pushing or caesarean, it was found that in 342 (95.3%) patients, assistant was identified to help at time of birth. Immediately after one hour of birth, it was noted that 79 (22%) patients were bleeding abnormally and were immediately addressed. We also found out that only 79 (22%) of the mothers were counselled regarding family planning. Almost half of the participant mothers 182 (50.7%) or their companions were counselled regarding danger signs and to seek care immediately which should have been 100%. Conclusion: Excellent adoption of some of the element up to 100% was observed while some of the elements of checklist were poorly adopted; noticeable was counselling regarding family planning options immediate postpartum.

Background and Objectives: Clinicians need to build an astute doctor-patient relationship. The term clinical empathy is the ability of doctor to cognitively appreciate a patient's perspective, experiences, and deliver such an understanding back to patient. Studies associate high physician empathy with improved patient trust and clinical outcomes. In Pakistan, there is paucity of research data on this relationship. This study assessed the empathy and its relation to fatigue levels among physicians and surgeons., Methods: This was a cross-sectional analytical study involving 262 Physicians and Surgeons (1:1) chosen by convenience sampling method. Physicians and Surgeons were included from three hospitals in Rawalpindi from September 2017 to February 2018 and RAO soft sample calculator was used. The Jefferson Scale for Physician empathy (JSPE) (score range 20-140) and Multidimensional Fatigue Inventory (MFI-20) (score range 20-100) were used as data collection tools. The data was analyzed using SPSS version 23. Statistical tests including T-test and Pearson Correlation were used., Results: Overall, mean score of empathy was found to be 98.8±21.9 (range; 46-138). The empathy in Physicians (106.8±18.3) was found to be greater than Surgeons (89.4±22.1) and the difference was statistically significant (p value <0.01). Mean score of fatigue was 50.6±16.0. The fatigue level in Surgeons was greater than Physicians and the difference was found to be statistically significant (p value < 0.01). Strong negative correlation was observed between empathy and fatigue (r= -0.5, p=<0.01) using Pearson correlation., Conclusion: Overall, physicians had better empathy than surgeons, while fatigue scores were higher among surgeons. Fatigue is associated with empathy decay. This research provides an understanding of empathy deterioration and other factors responsible for it., (Copyright: © Pakistan Journal of Medical Sciences.)