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Objective: To compare the role of the cultural context in determining the use of patient safety by participants from private and public sector hospitals of Karachi, Pakistan. Study Design: Mix method study. Place and Duration of Study: In two tertiary care hospitals (one private and one public sector) of Karachi from Nov 2016 till Nov 2017. Methodology: A sample size of 153 was enrolled by consecutive convenient sampling technique. The role of the cultural context of both hospitals was compared by asking questions from the hospital's staff. Data were collected by the researcher using an open and closed-ended questionnaire. Results: Data of 153 successful and filled questionnaires were analyzed. Out of 153, 78 (51%) cases were for private hospitals and 75 (49%) cases were for public hospitals. The role of the cultural context in determining the use of the patient safety concept was not sufficiently understood by participants of both hospitals, and most of the participants gave vague answers. Conclusion: Cultural context is one of the key factors in patient safety as with collective mindfulness about safety issues, and health care can be delivered safely.

Objective: To study the Peacekeeping Stress syndrome and see its relationship with various demographic variables (age, years of service and marital status). Study Design: Cross sectional study. Place and Duration of Study: Study was carried out on Pakistani Peacekeepers who were deployed in Democratic Republic of Congo in Jun 2019. Methodology: About 536 Pakistani male peacekeepers with mean age of 33 years, deployed in Democratic Republic of Congo were taken as study sample. By group testing method, all participants were assessed through Depression, Anxiety and Stress Scale (DASS-21), Urdu version and demographic form consisted of age, marital status, education, years of service and rank. Results: Results revealed that DASS-21 has good reliability (α=0.71) for the present sample and prevalence of depression, anxiety and stress among Pakistani peacekeepers was low (2.9%, 4% and 4% respectively). Further to it, there was significant negative correlation of depression and stress with the age and years of service whereas relationship of anxiety with these variables (age and years of service) was non-significant. There were significant mean differences between the married and unmarried peacekeepers on Anxiety and Stress and non-significant on depression. Conclusion: Present study provided useful information regarding the mental health of peacekeepers and highlighted the fact that Pakistani peacekeepers are resilient enough to handle the challenges of international environment.

Conclusion: The study recommends introducing professional training program of nurses in communication skills for nurse-patient conflict resolution. [...]the State must provide an environment complete with resources that can be conducive for an efficient health care delivery. [...]the researchers explore: According to the results of this study, the role of a nurse in our society is very important and a nurse can enhance it by gaining more training and education in this field8. [...]studies are important to avoid the rising incidences of unprofessional behaviour by doctors and allied health workers15. [...]there is an increased expectation by the society from the health professionals to provide medical care while maintaining the highest standards of professional behaviour16.

ABSTRACT Objective: To compare cross-cultural followership styles of resident trainees. Study Design: Cross-sectional quantitative study. Place and Duration of Study: Followership styles of trainees in four provinces of Pakistan, from Jun 2019 to Dec 2019. Methodology: The survey of 300 resident trainees was done by direct administration of survey packets in the respective institutes. It included, consent form, demographic survey, return envelope and Kelley's followership survey forms. The participants responded to each question. They were instructed to respond to a question with information that was to the best of their knowledge in the event that they were uncertain of its answer. Results: Total 281 medical trainees participated in the survey. The age ranged from 20 years to 54 years with mean age of 30.62 ± 4.87 years. A total of 139(49.5%) males and 142(50.5%) females participated in the study. One hundred and fifty six(55.5%) from civil hospitals and 125(44.5%) from military hospitals. Most frequent followership style was pragmatist, 62(44.6%) in male and effective, 64(45.0%) in females. Effective followership style was most frequent in Hyderabad 14(50%), Karachi 16(61.5%), Lahore 18(35.2%) and Quetta 19(46.3%). Peshawar had equal effective and pragmatist styles i.e. 29(42.6%) whereas, in Rawalpindi most common style was pragmatist 33(41.7%). Conclusion: This article provides new understandings of the multiple ways in which followership is experienced in the healthcare workplace in different cultural settings. Understanding the follower will have the purpose to educate leaders how to be more effective.

ABSTRACT Objective: To elucidate the frequency of intentional and unintentional non-adherence to medication among patients of different systemic diseases. Study Design: Comparative cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital and Combined Military Hospital Rawalpindi, from Nov 2018 to Jun 2019. Methodology: A total of 80 patients belonging to 4 system specific diseases Asthma, Myocardial infarction(MI), Stroke, Chronic Kidney Disease(CKD) were recruited. Twenty patients in each group were taken for comparison of medication adherence in their respective disease. Diagnostic Adherence Medication Scale(DAMS) was used for the purpose of data collection. Results: Overall there were 24(30%) females and 56(70%) were male patients. Diagnostic adherence medication scale revealed that 40% of the sample was non adherent and 60% were adherent towards their respective medication. Further in non-adherent 23.57% were un-intentionally non-adherent. Non adherence was found more in stroke patients. Chronic kidney disease patients were found most adherent towards medications(70%). Conclusion: The present study highlighted unintentional medication non adherence as a significant barrier for providing complete medical care to the patients of the selected diseases.

Objective: To find out the knowledge and preferences of a rural hypertensive populace. Study Design: A cross-sectional study. Place and Duration of Study: Conducted at the Basic Health Unit (BHU) Mangat Neecha in March, 2018. Material and Methods: Systematic, probability sampling was done. A total of 143 hypertensive patients regardless of age labeled as hypertensive: Visiting from each of the 12 villages under charge of each Lady Health Worker; within the BHU Mangat Neecha bracket were included in the study. Informed consent was taken from all the patients who participated in the study and the data were analyzed using SPSS 20. Results: Eighty-four (58%) patients who did not know of their normal blood pressure, 100 (70%) patients either did not know or were not told of their high BP by their healthcare provider. Sixty four (45%) patients did not consider hypertension a serious life threat. Only 29 (20%) patients could correctly identify the SBP (Systolic Blood Pressure 120 mmHg) number and another 16 (11%) the DBP (Diastolic Blood Pressure), 32 (22.3%) patients agreed having resorted to alternative cures for their illness like homeopathy etc. Eighty four (58%) patients had the perception of hypertension being a normal part of ageing and 60% (n=86) considered it incurable. While 100 (70%) patients agreed the role of medication in BP control and 133 (93%) supported the claim of exercise being of help, only 16 (11%) patients gave weight age to dietary/behavioral changes as an integral part of attaining adequate blood pressure control. Conclusion: Our results suggested existence of inadequate knowledge and awareness about hypertension amongst the hypertensive patients at grass roots level. In general, they fail to recognize hypertension as a very serious health concern owing to lack of percolating public healthcare awareness initiatives. Therefore, extensive patient education and counseling is necessary to improve the adherence of patients to antihypertensive medications as well as better equip them to understand its affects on decreasing their cardiovascular event risk.

Objectives: To determine frequency of adherence to Iron Folic Acid supplementation (IFAS) and to identify determinants of adherence to IFAS in pregnant women of Rawalpindi. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynecology and Obstetrics, Fauji Foundation Hospital, Rawalpindi, Pakistan, from Oct 2021 to Mar 2022. Methodology: Three hundred and ninety-nine pregnant women in their second and third trimesters of pregnancy meeting our inclusion criteria were recruited. A pre-validated, open-access questionnaire, including informed consent, demographic information, and items related to IFAS adherence, including reasons for non-adherence, counselling by healthcare provider, polypharmacy, family support, and whether or not the pregnancy was planned, was administered. Results: Forgetfulness (23.7%), abdominal pain (13.4%), nausea (14.4%), and unpleasant taste (11.3%) were main reasons reported for non-adherence. There was a significant association between education (p=0.001), monthly income (p=0.03), area of residence (p=0.001), planned pregnancy (p=0.001), husband’s support (p< 0.001), counseling by healthcare provider regarding the importance of IFAS (p=0.003), availability (p< 0.001), accessibility (p< 0.001) and affordability (p< 0.001) of IFAS supplements and adherence. Conclusion: The majority of women reported adherence to the prescribed IFAS supplementation. Higher education, planned pregnancy, urban residence, husband’s support, counselling by healthcare provider, affordability, availability and accessibility were associated with adherence. For those who reported non-adherence, forgetfulness and side effects were main reasons reported for non-adherence. Training of healthcare professionals to provide better counseling to women and their husbands during Antenatal care is recommended.

Objective: To identify workplace challenges experienced by women in midlife and beyond and determine the impact of these challenges on their Quality of Life. Study Design: Analytical cross-sectional study. Place and Duration of Study: Islamabad, Pakistan, from March to December 2023. Methodology: This study included working women between the ages of 45 to 65 years, who were invited to participate in an online survey hosted on Google Forms. The survey was a structed and validated questionnaire, comprising demographic details and questions related to time utilization, job satisfaction and facing workplace challenges. Results: The researchers enrolled 282 female participants from Islamabad, Pakistan, majority (160, 56.7%) of whom were between the ages of 45-50 years and reported having full-time employment (162, 57.4%). While most participants felt that they did not face organizational discrimination in their workplace (192, 68.1%), a lot of participants also responded that they had faced employment rejection due to being in midlife (176, 62.4%) and had taken extra efforts to maintain their appearance (149, 52.8%). Statistical tests were applied where p-value ≤0.05 was considered significant. Conclusion: Majority women reported no organizational discrimination at work, experienced no economic challenges and feared no age-related job threats. Participants who reported occasionally taking time off work for themselves and spent time frequently with family and friends felt no need to take early retirement indicating high job satisfaction.

Objectives: To determine the prevalence of Acne Vulgaris, its effects on quality of life of the patient and its associated risk factors. Study Design: Analytical Quantitative cross-sectional study. Place and Duration of Study: University of Rawalpindi/Islamabad Pakistan, from Mar to May 2021. Methodology: Non-probability convenience sampling was used. A total sample of 218 diagnosed cases of acne was included in our study. The data was collected via online Google forms and analyzed using SPSS 25.0. Results: The prevalence of acne vulgaris was 16.8% in university students of Rawalpindi/Islamabad Pakistan. Among 218 acne cases, the overall Dermatology Life Quality Index score showed 36(17%) cases had no effect at all and 182(83%) had some effect on their quality of life. The impaired quality of life was associated with education and family history (p<0.05). Relatively more impaired aspects of life were physical symptoms (67%), one’s own perception of acne (68%) and interference with work/studies (60%). Conclusion: The impact of acne on physical symptoms and self-confidence of people affected their mental health. As a result, these patients found difficulties in studies, work, and their social life. Knowledge about one’s ailment, early access to treatment and improved compliance significantly improves one’s quality of life. Acne is a deeply rooted issue with serious psychological and social implications which need to be addressed.

ABSTRACT The pandemic of COVID-19 corona virus is the most deadly and frightening situation of our times and it is the greatest challenge to which whole world is exposed. We are fighting this pandemic since February 2020 and up till now there is increased surge of cases. Pak Emirates Military Hospital has been declared as corona special hospital, all entitled cases that are corona positive and need surgeries are being operated here. Special protocols and rules have been designed by hospital management and consultants of different specialities to minimize the risk of cross contamination.