Volume 1
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2022
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Volume 1

Viewpoint

Rafi Amir-ud-Din
Published online: 21 December 2022
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Underfive 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.

Original Articles

Rooha Tamimi
Published online: 26 December 2022
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Knee osteoarthritis (OA) is a highly prevalent disease among the elderly population that results in joint degeneration, leading to reduced mobility and challenging daily living. Patients can choose from various treatment options depending on the stage of joint degeneration. In developing countries such as Pakistan, it is crucial to comprehend the financial burden borne by patients and their families due to this condition's high prevalence. Therefore, this exploratory study aimed to assess the financial burden of knee OA patients seeking healthcare services by analyzing the healthcare costs and expenses incurred by them. A purposive sampling technique was employed to recruit 112 knee OA patients undergoing any treatment modality from public and private hospitals in Lahore. A semistructured questionnaire collected patients' sociodemographic information and overall out-of-pocket health expenditures. Descriptive statistics and the Mann‒Whitney U test were utilized for data analysis. The patients' mean age was 53.69 ± 11.73 years, with 10.26 ± 4.83 years of education. Stage III knee OA was the most common diagnosis (30.36%), followed by stage IV (28.57%), stage II (22.32%), and stage I (18.75%). The direct medical cost was significantly higher [United States dollars (USD) 2,590.97] among patients who underwent surgery than among those who opted for alternative treatment procedures (USD 192.10) (p = 0.001). Similarly, the indirect medical cost was significantly higher (USD 371.75) among patients who underwent surgery than among those who chose other treatment options (USD 23.66) (p = 0.001). The overall cost of illness was 6.02 times higher among patients who had surgery (USD 3,050.93) than among those who opted for other treatment modalities (USD 507.19) (p = 0.001). The study’s findings provide insights into the financial burden borne by knee OA patients' families, emphasizing the need for policymakers to intervene. By understanding the costs of illness borne by patients and their families, policymakers can develop targeted interventions to alleviate the financial burden and improve access to healthcare services for knee OA patients.

Syeda Shazmina Fayyaz
Published online: 29 December 2022
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Smartphones are increasingly being used by health sciences students as a popular and effective learning tool, globally replacing traditional learning methods with advanced e-learning techniques. This study aimed to explore students' perception of smartphones as a new modality to enhance health science knowledge and whether this technology could assist them in accomplishing their educational goals. This descriptive cross-sectional study recruited 222 undergraduate health sciences students using a convenience sampling technique and used Delone and Mclean's information systems (IS) success model to develop variables for five IS success constructs. The study results showed that most participants were females (70.27%), and students used smartphones for multiple purposes, with accessing learning content (weighted average = 4.58), text messaging services (weighted average = 4.48), and internet-based text messaging services (weighted average = 4.36) being the most reported reasons. Students' perceptions regarding most smartphone usage for education included educational purposes and understanding lectures/revising concepts. Using smartphones as an educational aid influenced students' perceptions of system quality, information quality, system importance, usefulness, and satisfaction. Our study highlights the significant role of smartphones in the daily lives of health sciences students and their positive attitudes toward using them as a tool for enhancing their knowledge. Students use smartphones to access learning content and other online resources, and our findings suggest that educators should incorporate them into the educational curriculum. Notably, our study found that students' average daily smartphone usage varied widely. These findings have significant implications for the educational system, as smartphones have become an essential part of the educational experience for health sciences students. However, future studies could investigate the potential negative effects of smartphone usage on academic performance and explore the correlation between smartphone usage and academic outcomes to better understand the impact of smartphones on education.

Hira Ashraf
Published online: 29 December 2022
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Gender differences in psychological disorders have distinct gender profiles, with males more susceptible to aggressive behavior, hypertension, and substance abuse and females more prone to depression and anxiety. Likewise, stress responses among both genders vary physiologically and psychologically, which could lead to complications in many ways. Therefore, this study aimed to determine gender differences in life satisfaction and psychological stress levels among allied health college students. Using a purposive sampling technique, a comparative cross-sectional study recruited 190 male and 190 female students. The self-administered questionnaire included questions related to sociodemographics and two validated scales, the Perceived Stress Scale (PSS-10) and the Satisfaction With Life Scale (SWLS). Descriptive statistics were calculated for the study variables, and the students' locality was compared by gender using the chi-square test. Moreover, other sociodemographics, PSS, and SWLS scores were compared by gender using the Mann‒Whitney U test, and the chi-square test was used to determine gender differences in the outcomes of SWLS. The study results showed that the PSS and SWLS scores were higher among female students than their male counterparts, which were statistically significant (p < 0.05). Furthermore, female students were more satisfied with their life than male students, which was also statistically significant (p < 0.05). Our study highlights that female first-year allied health students are more likely to encounter psychological stress, despite being more satisfied with their lives than male students. Therefore, establishing a student support committee within the allied health faculty or university is recommended to provide counseling and guidance in healthy ways to cope with psychological stress for both male and female students.

Khalid Masood Gondal
Published online: 31 December 2022
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Breast cancer is a significant health concern for women in Pakistan, with one in nine women facing a high lifetime risk of being diagnosed with the disease. Accessing timely and appropriate healthcare services for breast cancer patients can be challenging in Pakistan, and understanding the role of different health practitioners is essential to understand the functioning of the informal referral system. Therefore, this study aimed to explore the different aspects of patients' consultations with various health practitioners for diagnosing breast cancer symptoms. Data were collected from 168 breast cancer patients who had consulted local health practitioners before being diagnosed with breast cancer. Descriptive statistics, the Kruskal‒Wallis H test, and post hoc tests were used to analyze the data. The study found that most patients consulted general practitioners (59.52%) and pir (56.55%) for their health-related concerns. Consultants referred most patients to diagnostic centers, while pir and hakim referred no patients. Patients visited pir and general practitioners the most, but the average number of visits to pir and hakim was higher than that to other health practitioners (p < 0.05). Moreover, pir (130 days) and hakim (120 days) had longer treatment periods than other health practitioners, with hakim charging the highest consultation fees [i.e., Pakistani rupees (PKR) 18,000] and patients incurring the highest travel expenses to visit pir (p < 0.05). Our study highlights the challenges faced by breast cancer patients in seeking timely and effective healthcare services. The absence of a formal referral system resulted in prolonged diagnosis times, extensive travel, and financial burdens on the patients. The findings suggest the need to improve general public awareness regarding breast cancer symptoms and establish an active cancer referral system to achieve early diagnosis, timely treatment, and improved quality of life for breast cancer patients, especially those with a lower socioeconomic status.

Misrat Masuma Parvez
Published online: 31 December 2022
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Tobacco use and related exposure in Pakistan are responsible for approximately 110,000 deaths. While previous studies have reported improved knowledge about the health risks of cigarette smoking among the general population due to ongoing tobacco control programs, fewer studies have investigated such knowledge in young adults. Thus, we conducted a comparative cross-sectional study of 220 young adult students aged 22 years (interquartile range (IQR) = 2) enrolled at a public university to assess their knowledge of the health risks of cigarette smoking and to compare this knowledge between smokers and nonsmokers. The self-administered semistructured questionnaire collected sociodemographic data, cigarette smoking status, and knowledge about the health risks of cigarette smoking. Data were analyzed using descriptive statistics, the chi-square test, and the Mann‒Whitney U test. Overall, most young adults were nonsmokers (69.09%), and the remaining 30.91% of smokers smoked an average of 5.31 ± 2.40 cigarettes daily for 3.80 ± 1.33 years, primarily in rural areas (p < 0.05). Nearly half of the young adults showed good knowledge of the health risks of cigarette smoking, irrespective of smoking status (smokers = 54.41%, nonsmokers = 53.29%). Conversely, few young adults demonstrated poor knowledge (smokers = 10.29%, nonsmokers = 6.58%) about the health hazards of cigarette smoking. Our findings showed that smoking rates were higher among young adults in rural settings than in urban areas. In addition, knowledge of gender-specific health risks associated with cigarette smoking, such as pregnancy-related complications in female smokers and male impotence in male smokers, was low. Nonetheless, almost half of the young adults displayed good knowledge of most of the potential health risks of cigarette smoking, regardless of their smoking status.