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.

A national survey to assess breast cancer awareness among the female university students of Pakistan.

The incidence of breast cancer is increasing in Pakistan as well as globally. Awareness of women about breast cancer plays a cornerstone role in its early detection, better management, and prevention. Keeping this in mind, a cross-sectional study was carried out to assess the awareness of female university students about breast cancer's risk factors, signs and symptoms, and breast cancer examination. The data was collected from female university students studying in Pakistan. A total of 774 participants completed the survey and recorded their responses on an online pre-tested self-administered questionnaire. Only 29.8% of the participants have identified breast cancer history in their first-degree relatives as a risk factor. Moreover, 14.1% of the participant considered that the use of oral contraceptives for more than 5 years can increase the risk of developing breast cancer. In addition, inward pulled nipple, wounds around the nipple, and abrupt changes in the breast size were considered as the sign and symptoms of breast cancer by 25.2%, 25.7%, and 31.7% of the participants, respectively. Moreover, only 20.9% of the participants identified the correct year for starting breast cancer examination and 44.4% of the respondents marked that mammography should be initiated after 40 years. Overall, the university female students of Pakistan were poorly aware of breast cancer's risk factors, signs and symptoms, and breast examination. This study has highlighted the need for initiation of aggressive strategies regarding breast cancer awareness in both the literate and illiterate female population of Pakistan.

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.

A Cross-Sectional Study to Assess the Frequency and Risk Factors Associated with Cesarean Section in Southern Punjab, Pakistan.

The increasing frequency of cesarean section (CS) is a major public health issue, and it is on the rise in Pakistan. A cross-sectional study approach was used to assess the frequency of CS and its contributing factors, along with the assessment of knowledge in mothers who had undergone CS in one of the under-developed regions of Pakistan. Data collection was done by using a self-developed study questionnaire. The statistical package for social sciences (SPSS) was utilized for the statistical analysis. During the study period, a total of 173 (69.7%) women have given births by CS; among those, 104 (60.1%) were elective/planned CSs while 69 (39.8%) were emergency CSs. The higher CS frequency was significantly associated with younger age (p = 0.03) and pre-term gestational age (p < 0.001). Pregnancy complications, such as gestational diabetes, hypertension, preeclampsia/eclampsia, and vaginal bleeding, were the significant risk factors for CS (p < 0.001). The highlighted contributing factors to CS in the current study were preterm of gestational age, mothers of a younger age (20-24 years), and mothers that belong to urban populations. These risk factors can be addressed by implementing community-focused educational interventions during the gestational period. The sample size in this study was small; therefore, the results cannot be generalized to the whole population.

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 Barriers Faced by Surgeons While Providing Surgical Care During the COVID-19 Pandemic in Pakistan: An Online Cross-Sectional Study.

BACKGROUND: The COVID-19 pandemic is not only affecting public health, but it is also impairing the specialized surgical care services in the hospitals. The present study aimed to assess the barriers faced by the surgeons while performing surgical procedures during the COVID-19 pandemic. METHODS: A cross-sectional, web-based survey was conducted from September 10 to October 14, 2020. The study population consisted of surgeons practicing in Kpk, Pakistan. Descriptive statistics and binary logistic regression analysis were used to analyze the data. RESULTS: A total of 292, out of 543, surgeons participated in the study (response rate: 59.6%). The younger surgeons (25-30 years) considered the lack of policies and practices regarding exposure to COVID-19 patients as a significant barrier to their practice. The surgeons practicing in private hospitals considered themselves at a higher risk while providing surgical care to the COVID-19 patients. The non-cooperation of the patients was the main barrier in delivering surgical care services. CONCLUSION AND RECOMMENDATION: The current study highlighted the barriers to the surgeons while providing surgical care to patients in the current pandemic. The most pronounced barriers to the surgeons were the lack of policies regarding exposure to COVID-19 and practice and non-cooperation of the patient. To address these barriers, it is recommended that health regulatory agencies of Pakistan should implement strict infection control practices to ensure the safety of surgeons and allied healthcare staff during the COVID-19 pandemic.

The Impact of Treatment Adherence on Quality of Life Among Type 2 Diabetes Mellitus Patients - Findings from a Cross-Sectional Study.

AIM: The current study was conducted to assess the factors contributing to treatment adherence and its impact on the quality of life (QoL) in type 2 diabetes mellitus (T2DM) patients. METHODS: A cross-sectional study was conducted between January 2020 to March 2020 among T2DM patients. The data was collected from T2DM out-patient clinics. The participants were recruited by using a simple random sampling method. To assess the association of demographics with the level of adherence, binary logistics regression analysis was applied. Moreover, the Mann-Whitney U-test was used to evaluate the impact of adherence on QoL. RESULTS: A total of 384 patients participated in this study. Amongst them, 60.2% were male and 39.8% were female. Low adherence was seen in illiterate patients and patients older than 40 years. The results showed that good QoL in T2DM patients was significantly associated with treatment adherence (p= 0.004). CONCLUSION: The finding of the current study showed that the non-adherence prevailed in illiterate strata of the study population and the medication adherence significantly affects the QoL in T2DM patients. These findings suggest that health regulatory agencies should focus on implementing disease-education interventions for improving the adherence to medications in patients with long-term conditions.

Assessment of Undergraduate Pharmacy Students' Attitude Towards Pharmaceutical Care in Pakistan: Practice Implications.

BACKGROUND AND PURPOSE: Over the past few decades, the focus of pharmacy practice has been shifted from the classical role of drug dispenser to pharmacotherapy expert. Pharmacists now are more often involved in the patient care process by addressing the drug-related needs of the patients and this patient-centered approach is known as pharmaceutical care (PC). The present study was conducted to assess the attitude of pharmacy undergraduate students toward PC and various contributing factors that influence their preference towards it. METHOD AND INSTRUMENT: A descriptive cross-sectional study was conducted in 422 undergraduate pharmacy students by using a simple random sampling method. A pre-validated and self-reported Pharmaceutical Care Attitude Scale (PCAS) was used for assessing a student's attitude towards PC. RESULTS: Amongst the 422 undergraduate students, the majority were males (68.2%) and 70.4% were between the age group of 20 and 25 years. The students studying in third, fourth, and fifth year (final year) were 140 (33.2%), 142 (33.6%), and 140 (33.2%), respectively. Overall participant showed a positive attitude toward the PC. Professional year showed significant influence on professional duties (PD) (p<0.001) and age was significantly associated with return on efforts (ROE) (p<0.001) and professional benefits (PB) (p<0.001). CONCLUSION: Most of the participants showed a positive attitude toward PC and showed motivation to practice it. To promote PC practice in Pakistan, the government along with other professional bodies like Pakistan Pharmacists Association (PPA) should work together in collaboration with global health agencies to develop a well-structured advanced healthcare system in which there is a defined role of PC practice.

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.

A national study to assess pharmacists' preparedness against COVID-19 during its rapid rise period in Pakistan.

To evaluate the pharmacist's preparedness against the COVID-19 during its rapid rise period in Pakistan, an online cross-sectional study was carried out from March 30 to May 22, 2020 among the pharmacists using a pre-validated self-administered questionnaire. A total of 1149 participants completed the survey, amongst which 430(37.9%) were working as retail pharmacists, 216 (18.8%) as community pharmacists, and 213(18.5%) as hospital pharmacists. The mean COVID-19 knowledge score of the participants was 6.77±0.5, which indicated that 84% of them had good knowledge about COVID-19. The multiple linear regression model revealed that attitude was significantly associated with gender (p = 0.001), marital status (p<0.0001) and resident (p = 0.013). The mean practice score was 2.85±0.4, showing that 94% of the participants were following adequate preventive practices against this infection. The results from this study suggest that Pharmacists demonstrated good knowledge, positive attitudes, and acceptable practices regarding COVID-19.