Assessing the knowledge, attitude, and practice measures against tuberculosis in patients in ambulatory department facilities in Pakistan: a cross-sectional analysis.

Tuberculosis (TB), at present, is the leading infectious etiology of death globally. In Pakistan, there are approximately 510,000 new cases annually, with more than 15,000 of them developing into drug-resistant TB, making the nation the fifth-leading country in TB prevalence in the world. Due to the ongoing COVID-19 pandemic, the focus has drifted away from TB screening, diagnostic and health awareness campaigns, and therapeutic measures endangering knowledge, attitude, and practices (KAP) towards TB in our population. We conducted a cross-sectional descriptive study in Pakistan to assess the KAP of Pakistani residents attending the adult outpatient departments of public hospitals for any health-related concerns. Our sample size was 856 participants, with a median age of 22 years. Occupation-wise, those who were employed had better knowledge of TB than those who were unemployed [odds ratio (OR): 1.011; 95% confidence interval (CI): 1.005-1.8005]. No differences were observed in TB knowledge between those adherents to common preventive practices versus those not adherent (OR: 0.875; 95% CI: 0.757-1.403). More than 90% of participants agreed that TB is dangerous for the community, and the majority opted against stigmatizing TB patients (79.1%). People who could read and write were 3.5 times more likely to have a good attitude towards TB compared to those who could not (OR: 3.596; 95% CI: 1.821-70.230; p=0.037). Similarly, employed subjects had better attitudes compared to unemployed ones (OR: 1.125; 95% CI: 0.498-1.852; p=0.024) and those with better knowledge of TB had a better attitude grade (OR: 1.749; 95% CI: 0.832-12.350; p=0.020). Age, occupation, and educational status were statistically significant among the two groups (p=0.038, p=0.023, p=0.000). Literate subjects had three times better practice towards TB than illiterate subjects (OR: 3.081; 95% CI: 1.869-4.164; p=0.000). Future education and awareness programs should target specific groups, such as the unemployed and illiterate, with practice-focused approaches. Our study outcomes can enable the concerned officials and authorities to take appropriate evidence-based steps to direct the efforts efficiently to curtail the burden of TB in Pakistan and to limit its progression, which could potentially lead our nation to become a multi drug-resistant TB endemic territory.

The Cholera outbreak in Karachi, Pakistan: Challenges, efforts and recommendations.

Sindh Health Authorities have declared a new outbreak of cholera in Karachi, Pakistan after 129 lab-confirmed cases were reported from the Central, East, and South districts. With COVID-19 already having wreaked havoc on the country's health condition in the past years, any neglect in early preventative measures against this cholera outbreak implies progression to a perilous situation with millions of individuals at stake of acquiring the disease. Factors contributing to the occurrence of cholera outbreak include poor hygiene practices, overpopulation, increasing poverty and climate change. Appropriate responsive approaches by health authorities in cooperation with the World Health Organization (WHO) must be implemented to address the situation accordingly.

Assessment of COVID-19 related preventive measures in medical students across a lower-middle-income country: A cross-sectional study from Pakistan.

Objectives: This study aims to identify the effect of having COVID-19 positive close contact on practices and evaluate practices regarding COVID-19 prevention among medical students and the differences among clinical and preclinical students. Study design: The cross-sectional study included medical students from the Micro-fest++ event held on 30th May 2020. Methods: Participants filled a questionnaire of 15 questions regarding COVID preventive measures practices having satisfactory reliability (Cronbach's alpha = 0.715) and validity. The Statistical Package for Social Sciences (IBM SPSS) 26.0 was used for data analysis. Out of 1342 medical students, the majority were female (N = 881, 65.6%). Greater proportion (47%) of students had good practices (>85.7%) (p < 0.05). Results: Having COVID-19 positive relatives resulted in higher positive responses for practices with 11.86 ± 1.94 (out of 14) compared to 11.78 ± 2.38 for the COVID-19 negative group. Clinical year students compared to preclinical students responded positively to all questions, except one, and had a better score of 11.90 ± 2.28 (out of 14) compared to 11.61 ± 2.37 (p < 0.05). A significant difference was noted for "Information on preventive measures" (p < 0.01), "Avoiding crowds and staying home" (p < 0.05), "Social distancing (maintain 3 feet)" (p < 0.01), and "Practices of disinfection after going outside" (p < 0.05). Conclusions: Overall, medical students showed good practices, but a lack of knowledge in certain areas requires addressing infection during clinical rotations. A greater proportion of clinical students and those having a COVID-19 positive relative showed better adherence to practices.

Burnout in health care workers during the fourth wave of COVID-19: A cross sectional study from Pakistan.

Objective: To assess the burnout among the healthcare workers during the fourth wave of COVID-19. Methods: In this cross-sectional study, burn out was measured in health care professionals using the MBI scale inventory during the fourth wave of COVID-19. Age, gender, marital status, having children, hospital, job type, experience, and workload, as well as the severity of burnout in each subscale, were all measured. We used the chi-square test to detect the difference between the level of burnout and other demographic variables, and a multiple logistic regression test was used to define the predicted correlation between the high level of burnout and the risk factors. Odds ratios and corresponding 95% confidence intervals (CI) were reported. A p-value of less than 0.05 indicated a statistically significant outcome. Results: Out of 776 healthcare workers who participated in our study, 468 (63.2%), 161 (21.7%) and 112 (15.1%) participants experienced low, moderate and high levels of emotional exhaustion, respectively. For the depersonalization subscale, 358 (48.3%), 188 (25.4%) and 195 (26.3%) people suffered from low, moderate, and high levels of depersonalization, respectively while 649 (87.6%), 40 (5.4%) and 52 (7.0%) respondents had low, moderate and high levels in the personal accomplishment subscale, respectively. Conclusion: During the fourth wave of COVID-19, the healthcare workers reported increased level of burnout overall possibly due to the long term physical and mental impacts that the pandemic has had over the time. Moreover, healthcare workers in Pakistan were more prone to burnout as compared to other countries.

An assessment of publishing practices and barriers faced by medical students to conduct research: A cross-sectional study from Pakistan.

Background: Pakistan being a low- and middle-income country, its institutes are substantially deficient in scientific and technological aspects and share limited research contributions to the world repositories. Therefore, there is a rising concern to reflect on the history and status of publishing attitudes among medical students in Pakistan and to highlight and address the barriers that they are facing. Methods: A study was conducted aiming to determine the experience, motivation, and attitude of medical students in regarding publishing practices throughout Pakistan in several medical colleges. A multivariable logistic regression model was used to find the independent predictors of students publishing a research article. Forward selection was used to arrive at the final stepwise logistic regression. Odds ratio (OR) and 95% confidence interval (CI) were calculated. p < 0.05 was considered significant for all statistical tests. Results: From a sample size of 1225 participants, only 6.6% of students had published an article in our study. Of these, 59% were males and 31.3% were in final year. Males were more likely to publish articles than females (OR = 2.69, 95% CI: 1.37-5.26) and final-year students were more likely to publish articles than first-year students (OR = 7.48, 95% CI: 1.34-41.81). Students that had the knowledge that performing research is the way through which they will be judged for jobs had significantly higher odds of getting an article published (OR = 16.21, 95% CI: 3.65-71.88). Additionally, students who had been taught how to write a paper and those who knew the process of submitting an article were more likely to get published than the others. Conclusion: Our study has successfully highlighted the status of publishing among medical students in Pakistan. Our findings serve as an eye opener and call to action for authorities to address the grievances of students in terms of barriers, lack of mentorship, and lack of research teaching. We hope our findings can guide a strong policy change to facilitate the next generation of passionate researchers.

Rampant Increase in Cases of Mucormycosis in India and Pakistan: A Serious Cause for Concern during the Ongoing COVID-19 Pandemic.

COVID-19 is a global health crisis that continues to pose new challenges all around the world. Amidst the growing pandemic, a spike in the number of mucormycosis cases in India and Pakistan has been reported in COVID-19 patients and in those who have recovered from COVID-19. This increase in cases may be related to the overuse of steroids and zinc, the use of industrial oxygen, unsterilized medical equipment, frequent intubation, a weakened immune system, and pre-existing comorbidities such as diabetes. As a result, it is critical to take steps to handle the current increase in mucormycosis cases. Therefore, this article aims to highlight the existence of mucormycosis amidst the COVID-19 pandemic in India and Pakistan, focusing on possible causes and implications, and suggests important plans of action to be taken during this pandemic.