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Pervez A, Bukhari MM, Chhapra R, Baig MI, Martins RS, Pirzada S, Rizvi NA, Aamdani SS, Ayub B, Rehman AA, Mustafa MA, Nadeem S, Asad N, Haider AH, Nadeem T. Adolopment of clinical practice guidelines and creation of referral pathways for psychiatric conditions in Pakistan. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 23:100387. [PMID: 38486880 PMCID: PMC10938165 DOI: 10.1016/j.lansea.2024.100387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/07/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024]
Abstract
Psychiatric disorders are highly prevalent in Pakistan and burdens the scarce number of psychiatrists present in the country. The establishment of evidence-based clinical practice guidelines (EBCPGs) and primary-care referral pathways within the local context is imperative to make the process efficient. In this Health Policy, we aimed to develop EBCPGs and primary-care referral pathways that are specific to Pakistan's primary-care setting, with the aim of facilitating the management of psychiatric conditions. Ten EBCPGs were created through the GRADE-ADOLOPMENT process; two recommendations were adopted with minor changes, 43 were excluded, and all others were adopted without any changes. Ten primary-care referral pathways for managing ten psychiatric disorders were created and 23 recommendations were added which will help to bridge the gap in care provision. These psychiatric referral pathways and EBCPGs will bring Pakistan's healthcare system a step closer to achieving optimal health outcomes for patients.
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Affiliation(s)
- Alina Pervez
- Center for Clinical Best Practices, Clinical and Translational Research Incubator, Aga Khan University, Karachi, Pakistan
| | | | | | | | - Russell Seth Martins
- Center for Clinical Best Practices, Clinical and Translational Research Incubator, Aga Khan University, Karachi, Pakistan
| | - Sonia Pirzada
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Nashia Ali Rizvi
- Center for Clinical Best Practices, Clinical and Translational Research Incubator, Aga Khan University, Karachi, Pakistan
| | | | - Bushra Ayub
- Learning Research Centre, Patel Hospital, Karachi, Pakistan
| | - Alina Abdul Rehman
- Center for Clinical Best Practices, Clinical and Translational Research Incubator, Aga Khan University, Karachi, Pakistan
| | - Mohsin Ali Mustafa
- Center for Clinical Best Practices, Clinical and Translational Research Incubator, Aga Khan University, Karachi, Pakistan
| | - Sarah Nadeem
- Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | | | - Tania Nadeem
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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Stott J, Coleman E, Hamilton A, Blackwell J, Ball HL. Exploring the Longitudinal Relationship Between Short Sleep Duration, Temperament and Attention Deficit Hyperactivity Disorder Symptoms in a Biethnic Population of Children Aged Between 6 and 61 Months: A Born in Bradford Study. J Atten Disord 2023:10870547231168433. [PMID: 37154203 DOI: 10.1177/10870547231168433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Examine the association between sleep duration, temperament and symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in a biethnic child-population from The Born in Bradford cohort. METHOD Parent-report sleep duration categorized children as: early short, late short, consistently short or consistently normal sleepers between 6 and 36 months. Temperament was measured using the Infant Characteristics Questionnaire at 6 months. The Strengths and Difficulties Questionnaire assessed symptoms of ADHD at 37, 54, and 61 months. RESULTS Normal sleepers before 18 months had significantly fewer ADHD symptoms at 37 months compared with consistently short sleepers. Fussiness at 6 months was significantly positively associated with ADHD symptoms at 37 and 54 months; but does not appear to mediate the relationship between sleep duration and ADHD symptoms. CONCLUSION Awareness of the relationship between short sleep duration and fussiness in infancy and later ADHD symptomatology may support earlier identification of arising difficulties in children.
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Affiliation(s)
- Jonathan Stott
- Leeds and York Partnership NHS Foundation Trust, UK
- Tees, Esk and Wear Valleys NHS Foundation Trust, UK
- Hull York Medical School, UK
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Shoaib M, Iqbal M, Waqas UJ, Ahmed SM, Sangeet F, Raza FA, Shahab A, Fatima K, Siddiqui M, Nadeem A. Concurrent Obsessive-Compulsive Symptoms in Patients With Schizophrenia: A Retrospective Study From a Tertiary Care Centre in Sindh, Pakistan. Cureus 2023; 15:e37583. [PMID: 37197122 PMCID: PMC10184718 DOI: 10.7759/cureus.37583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION The present study aimed to evaluate the proportion of concurrent symptoms of obsessive-compulsive symptoms (OCSs) among patients with schizophrenia. METHODS A retrospective study was undertaken at the Department of Psychiatry, Jinnah Postgraduate Medical Center, Sindh, Pakistan between 1st March 2019 and 1st April 2020. All cases with diagnosed schizophrenia irrespective of gender, age, or ethnicity were eligible for the study. We excluded patients with acute psychosis due to isolated substance use disorder or any organic brain disease. The medical records for each patient were retrieved from the departmental database. Sociodemographic factors including age, gender, ethnicity, and presence of OCSs and other psychiatric comorbidities were recorded in a predefined pro forma. The presence of OCSs was noted by the attending psychiatrist during history taking as positive or negative. RESULTS A total of 139 patients were included. A predominance of the male gender was noted. There were 63 (45.3%) patients with concurrent OCSs. Out of the total patients, 42 (66.67%) males and 21 (33.33%) females had OCSs. A total of 28 (44.44%) patients between 31 and 45 years of age had OCSs. Out of the 63 patients with OCSs, 36 (57.14%) had a history of substance abuse (p = 0.471). In the study, 17 (26.98%) Balochi and 19 (30.16%) Pashtuns had OCSs. However, the difference was statistically insignificant. CONCLUSION In conclusion, OCSs were frequent in patients with schizophrenia, according to the current study. We discovered that males, individuals between the ages of 18 and 30 years, Balochis, Pashtuns, and those with a history of substance abuse were more likely to have OCSs. However, the difference was not statistically significant.
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Affiliation(s)
- Marium Shoaib
- Department of Acute Medicine, Blackpool Victoria Hospital, Lancashire, GBR
| | - Maria Iqbal
- Department of Surgery, Blackpool Victoria Hospital, Lancashire, GBR
| | - Uzma J Waqas
- Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Sheikh M Ahmed
- Department of Medicine, Liaquat National Hospital, Karachi, PAK
| | - Fnu Sangeet
- Department of Psychiatry, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Fatima A Raza
- Department of Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Azka Shahab
- Department of Medicine, Pakistan Navy Station Shifa Hospital, Karachi, PAK
| | - Kiran Fatima
- Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Maham Siddiqui
- Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Ammar Nadeem
- Department of Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Mohammed F, Geda B, Assebe Yadeta T, Dessie Y. Exploring the trend of Schizophrenia at Hiwot Fana specialized university referral hospital, Eastern, Ethiopia (2016-2020): A 5-year retrospective analysis. SAGE Open Med 2022; 10:20503121221132160. [PMID: 36277442 PMCID: PMC9583212 DOI: 10.1177/20503121221132160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Schizophrenia is one of the most troublesome psychiatric problems requiring
long-term antipsychotic treatments. There is a scarcity of data regarding its
overtime trend in Ethiopia.
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Affiliation(s)
- Fethia Mohammed
- Department of Psychiatry, School of
Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University,
Harar, Ethiopia,Fethia Mohammed, Department of Psychiatry,
School of Nursing and Midwifery, College of Health and Medical Sciences,
Haramaya University, Harer 235, Ethiopia.
| | - Biftu Geda
- Department of Nursing, School of Health
Sciences, Madda Walabu University, Harar, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery,
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Neurological manifestations of COVID-19: A perspective from Pakistani medical students. Ann Med Surg (Lond) 2022; 79:104035. [PMID: 35757270 PMCID: PMC9212922 DOI: 10.1016/j.amsu.2022.104035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022] Open
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Yousef N, Abdullahi KO, Perveen K, Khan S. IMPACT OF EDUCATIONAL TRAINING ON NEUROLOGICAL ASSESSMENT SKILLS OF FEMALE NURSES IN EVALUATING TRAUMATIC BRAIN INJURY PATIENTS THROUGH GLASGOW COMA SCALE IN LAHORE GENERAL HOSPITAL, LAHORE, PAKISTAN. GOMAL JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.46903/gjms/19.03.971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Background: Traumatic Brain Injury (TBI) is a leading cause of death and disability worldwide. The objective of this study was to determine the impact of educational training on neurological assessment skill of female nurses in evaluating traumatic brain injury patients through Glasgow Coma Scale in Lahore General Hospital, Lahore, Pakistan.Material Methods: This quasi-experimental one group pre-posttest design study was conducted at Lahore School of Nursing, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan from April 3, 2021 to May 15, 2021. Pre-test neurological assessment skill of 70 nurses was noted by an observer, two weeks educational training was given and four weeks later on, post-test score was noted. For neurological assessment skill, a 20 items observatory checklist was used. Age groups, marital status, job experience, work experience in recent department and work place were four demographic, while neurological assessment skill score was one research variable. Paired sample t test was used for hypothesis testing.Results: Out 70 nurses, 26 (37.1%) were in age group 25-30 years, 18 (25.7%) in 31-35, 16 (22.9%) in 36-40, six (8.6%) in 41-45 and four (5.7%) in 46-50 years. Marital status was; 36 (51.4%) single, 27 (38.6%) married, three (4.3%) divorced and four (5.7%) widow. Job experience was; eight (11.4%) had 2 years, 33 (47.1%) 2-5 years, 25 (35.7%) 6-10 years and four (5.7%) had 10 years. Work experience in recent department was; 16 (22.9%) had 1 year, 39 (55.7%) 1-3 years, 13 (18.6%) 4-5 years and two (2.9%) had 5 years. Work place was Trauma Unit in 12 (17.1%), neurosurgery ICUs in 38 (54.3%) and surgical units in 20 (28.6%) cases. Mean 16.89±2.52 posttest skills score was significantly higher than mean 12.56±2.67 pretest skills score (p=.0001).Conclusion: Our study confirmed that the effect of educational training was significant in improving neurological assessment skills of nurses in evaluating traumatic brain injury patients through Glasgow Coma Scale in Lahore General Hospital, Lahore, Pakistan. Further studies are suggested with increased sample size and multiple research settings.
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Hayat K, Mustafa ZU, Godman B, Arshed M, Zhang J, Khan FU, Saleem F, Lambojon K, Li P, Feng Z, Fang Y. Perceptions, Expectations, and Experience of Physicians About Pharmacists and Pharmaceutical Care Services in Pakistan: Findings and Implications. Front Pharmacol 2021; 12:650137. [PMID: 34054528 PMCID: PMC8160509 DOI: 10.3389/fphar.2021.650137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Optimal collaboration between pharmacists and other healthcare professionals such as physicians is integral in implementing pharmaceutical care. However, there are concerns regarding the role of pharmacists, especially among low- and middle-income countries. This study explored the perceptions, expectations, and experience of physicians working in various hospital settings of Punjab, Pakistan, about pharmacists and their roles. Methods: A self-administered questionnaire consisting of four sections was administered from October to December 2020. Descriptive and inferential statistics such as Kruskal-Wallis and Mann-Whitney tests were used for data analysis using SPSS. Results: Six hundred and seventy-eight physicians participated in this study with a response rate of 77.9%. Most of the physicians reported minimal to no interaction with pharmacists (n = 521, 76.8%). However, more than three-quarters of physicians (n = 660, 97.3%) accepted pharmacists as evidence-based sources of drug information. In addition, many physicians (n = 574, 84.7%) strongly agreed that pharmacists should attend patient care rounds to respond promptly to questions related to patient medication. A limited number of physicians (n = 124, 18.3%) assumed that pharmacists were advising their patients regarding the judicial use of their drugs. Median expectation and experience score had a significant association with age, experience, and education of physicians (P < 0.05). Conclusions: The perception of physicians was positive toward certain roles of pharmacists, coupled with high expectations. However, their experience was low, with most of the activities of pharmacists due to inadequate interprofessional coordination.
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Affiliation(s)
- Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Centre for Health Reform and Development Research, Xi'an, China.,Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Zia Ul Mustafa
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital Pakpattan, Pakpattan, Pakistan
| | - Brain Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Muhammad Arshed
- Department of Emergency Medicine, Lifeline Hospital, Lahore, Pakistan.,Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Selangor Darul Ehsan, Malaysia
| | - Jiaxing Zhang
- Department of Pharmacy, Guizhou Provincial People's Hospital, Guiyang, China
| | - Faiz Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Centre for Health Reform and Development Research, Xi'an, China
| | - Fahad Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Krizzia Lambojon
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Centre for Health Reform and Development Research, Xi'an, China
| | - Pengchao Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Centre for Health Reform and Development Research, Xi'an, China
| | - Zhitong Feng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Centre for Health Reform and Development Research, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Centre for Health Reform and Development Research, Xi'an, China
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