A Systematic Review of the Economic Burden of Diabetes in Eastern Mediterranean Region Countries.

Diabetes Mellitus (DM) is a highly prevalent non-communicable disease with high mortality and morbidity, which imposes a significant financial impact on individuals and the healthcare system. The identification of various cost components through cost of illness analysis could be helpful in health-care policymaking. The current systematic review aims to summarize the economic burden of DM in the Eastern Mediterranean Region (EMR) countries. The original studies published in the English language between January 2010 and June 2023 reported the cost of DM was identified by searching four different databases (Google Scholar, PubMed, Science Direct, and Cochrane Central). Two reviewers independently screened the search results and extracted the data according to a predefined format, whereas the third reviewer's opinion was sought to resolve any discrepancies. The costs of DM reported in the included studies were converted to USD dates reported in the studies. After the systematic search and screening process, only 10 articles from EMR countries met the eligibility criteria to be included in the study. There are substantial variations in the reported costs of DM and the methodologies used in the included studies. The mean annual cost per patient of DM (both direct and indirect cost) ranged from 555.20 USD to 1707.40 USD. The average annual direct cost ranged from 155.8 USD to 5200 USD and indirect cost ranged from 93.65 USD to 864.8 USD per patient. The studies included in the review obtained a median score of 8.65 (6.5 ─ 11.5) on the quality assessment tool based on Alison's checklist for evaluation of cost of illness studies. There is a significant economic burden associated with DM, which directly affects the patients and healthcare system. Future research should focus on refining cost estimation methodologies, improving the understanding of study findings, and making it easier to compare studies.

COVID-19 Vaccine Booster Hesitancy (VBH) among Healthcare Professionals of Pakistan, a Nationwide Survey.

Background: The waning vaccine immunity and emergence of new variants of SARS-CoV-2 led health authorities across the globe to administer booster doses (BDs) of the COVID-19 vaccine. Hence, the current study aimed to assess the COVID-19 vaccine booster hesitancy (VBH) amongst Pakistani healthcare professionals (HCPs). Methods: A nationwide survey-based study was carried out from April 2022 to May 2022. The online self-administered questionnaire was utilized to collect data regarding demographics (age, gender, marital status, profession, residential area, and province), COVID-19 infection history (infection history, onset, and clinical severity of disease), previous COVID-19 vaccination (type of vaccination and the number of doses), attitudes towards BDs (acceptance, rejection, and hesitancy), and psychological drivers of VBH (perceived effectiveness, vaccine safety, risk/benefit ratio, and vaccine type preference). We assessed the association between the dependent variable attitudes of study participants, regarding BDs and independent variables (demographics, COVID-19 infection history, previous COVID-19 vaccination, and psychological drivers of VBH), by using the Chi-square test/Fisher exact test. Results: Among the 1164 study participants, 51.4% were male, and 80.4% were medical professionals. The half of study participants (52.1%) agreed to take the COVID-19 vaccine BD or had already taken it, while the rest of them refused (34.7%) or hesitated (24.2%) to take it. These attitudes of the participants were significantly associated (p < 0.001) with psychological divers about the COVID-19 vaccine BD. Conclusion: This study revealed that Pakistani HCPs hesitant to take the COVID-19 vaccine BD had concerns about the safety, efficacy, and risk/benefits ratio of the vaccine's BD. To eliminate the hesitancy, regarding BD in HCPs, certain educational strategies should be implemented by health authorities to address the concerns of HCPs.

Assessing the Frequency and Risk Factors Associated with Gastroesophageal Reflux Disease (GERD) in Southern Punjab, Pakistan.

PURPOSE: Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder with modifiable risk factors and it is associated with considerable health and economic burden. The current study was conducted to assess the frequency and risk factors related to GERD in the previously unstudied population of Southern Punjab, Pakistan. METHODS: A cross-sectional study was conducted for assessing the frequency and risk factors of GERD by using a self-administered questionnaire. The gastroesophageal reflux disease questionnaire (GerdQ) was utilized to detect the presence of the disease. RESULTS: The study included 308 participants; among them, 55.2% were female and 44.8% were male. The participants diagnosed with GERD (GerdQ score ≥8) were 26.6%. The various risk factors like higher BMI, past disease and smoking history, frequent use of NSAIDs, soft drinks, pickles, and spicy foods were significantly associated with GERD. CONCLUSION: The present study showed that GERD is prevalent in Southern Punjab and is associated with various modifiable risk factors. The ascendance of GERD can be prevented by public health education and awareness campaigns.

A National Survey to Assess the COVID-19 Vaccine-Related Conspiracy Beliefs, Acceptability, Preference, and Willingness to Pay among the General Population of Pakistan.

The current study aims to assess the beliefs of the general public in Pakistan towards conspiracy theories, acceptance, willingness to pay, and preference for the COVID-19 vaccine. A cross-sectional study was conducted through an online self-administered questionnaire during January 2021. The Chi-square test or Fisher exact test was utilized for statistical data analysis. A total of 2158 respondents completed the questionnaire, among them 1192 (55.2%) were male with 23.87 (SD: ±6.23) years as mean age. The conspiracy beliefs circulating regarding the COVID-19 vaccine were believed by 9.3% to 28.4% of the study participants. Among them, 1040 (48.2%) agreed to vaccinate on its availability while 934 (43.3%) reported the Chinese vaccine as their preference. The conspiracy beliefs of the participants were significantly associated with acceptance of the COVID-19 vaccine. The existence of conspiracy beliefs and low vaccine acceptance among the general population is a serious threat to successful COVID-19 vaccination.

Cross-sectional study to assess the healthcare professionals' knowledge, attitude and practices about probiotics use in Pakistan.

OBJECTIVES: The study aimed to assess the knowledge, attitude and practices (KAP) of HCPs regarding the use of probiotics in different health conditions and to identify various barriers that are associated with their use. METHODS: A cross-sectional study was conducted on 405 HCPs by using a validated self- administered questionnaire for assessing their KAP towards probiotic use. The study data were analysed using descriptive statistics, χ2 test and binary logistic regression (BLR). RESULTS: Among the 405 participants, only 15.1 % of HCPs had good knowledge, while 15.6% had acceptable practices and 89.1% had a positive attitude towards probiotics. The professional position of HCPs was significantly associated with knowledge (p=0.001) and practice (p=0.001). Among all the HCPs, the pharmacists showed a significant association with good knowledge (p=0.016) and good practices (p=0.024) by using BLR. The lack of knowledge about probiotics was a major barrier to the utilisation of probiotics. CONCLUSIONS: The poor knowledge and practices regarding the use of probiotics have been seen in the current study. While the participants showed a positive attitude towards the utilisation of probiotics. To transform HCPs' positive attitude to their practices and to create awareness regarding probiotic use focused training programmes should be initiated by professional health organisations.

Assessing the Impact of COVID-19 on the Mental Health of Healthcare Workers in Three Metropolitan Cities of Pakistan.

PURPOSE: The COVID-19 (coronavirus disease-2019) has been associated with psychological distress during its rapid rise period in Pakistan. The present study aimed to assess the mental health of healthcare workers (HCWs) in the three metropolitan cities of Pakistan. METHODS: A cross-sectional, web-based study was conducted in 276 HCWs from April 10, 2020, to June 5, 2020. Depression, anxiety, and stress scale (DASS-21) were used for the mental health assessment of the HCWs. Multivariable logistic regression analysis (MLRA) was performed to measure the association between the demographics and the occurrence of depression, anxiety, and stress (DAS). RESULTS: The frequency of DAS in the HCWs was 10.1%, 25.4%, and 7.3%, respectively. The MLRA showed that the depression in HCWs was significantly associated with the profession (P<0.001). The anxiety in HCWs was significantly associated with their age (P=0.005), profession (P<0.05), and residence (P<0.05). The stress in HCWs was significantly associated with their age (P<0.05). LIMITATION: This study was conducted in the early phase of the COVID-19 pandemic, when the number of COVID-19 cases was on the rise in Pakistan and it only represents a definite period (April to June 2020). CONCLUSION: The symptoms of DAS are present in the HCWs of Pakistan and to manage the psychological health of HCWs, there is a need for the initiation of psychological well-being programs.