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BACKGROUND: Although physicians are highly regarded members of society, patients are not always satisfied with their care, suggesting a mismatch between the public's expectations and reality. Thus, the aim of this study was to determine the public's expectations regarding roles and responsibilities of a physician, to assess patient experiences, and to evaluate factors associated with the two outcomes. METHODS: A cross-sectional study was conducted via face-to-face structured interviews from July 14th to August 2nd, 2023, in Karachi, Pakistan. The study sample comprised 424 consenting adults enrolled by visiting public spaces (malls, parks, hospitals, and residential areas). A modified version of 'Exceptionally Good Doctor Likert scale', and 'Patient Picker-15' (PPE-15) questionnaires was used. The Likert and PPE-15 sections were scored through pre-decided criteria for expectations and experience, respectively, and categorized using a median cut-off into high and low expectations and negative and positive experiences, respectively for simple and multivariable logistic regression. RESULTS: A median score of 30.5/ 34 (IQR = 3.3) was found for expectations and 4/ 14 (IQR = 4) for experiences. Significant factors associated with expectations were older age groups (OR = 4.54 [1.18-17.50]) and higher monthly household incomes (0.40 [0.20-0.79]), while the odds of negative experiences were lower after visits to emergency departments (0.38 [0.18-0.84]) and private health care centers (0.31 [0.13-0.70]). CONCLUSION: These results suggest that the public has high expectations from physicians, however their experiences are not always positive. Initiatives to develop a patient-centric ethos are needed for which we outline recommendations to both the public and physicians, respectively.
Assuntos
Motivação , Médicos , Adulto , Humanos , Idoso , Estudos Transversais , Paquistão , Inquéritos e Questionários , Hospitais PúblicosRESUMO
Pumpkin is a well-known vegetable, among the members of Cucurbitaceae family, due to its importance as pharma food. Keeping in view the antidiabetic and plasma lipids lowering potential of pumpkin, the present study was conducted to investigate that, which part of pumpkin (peel, flesh, and seeds), possess more bioactive compounds, exhibiting antihyperglycemic and antihyperlipidemic potential. Albino rats with 190-210 g body weight were divided into 11 groups. Five rats were included in each group; group A was negative control, group B was positive control, and groups C to K were diabetic rats fed with pumpkin peel, flesh, and seed powders. Diabetes was induced in rats with the help of alloxan monohydrate. During 28 days of experimental period, blood glucose level of different rat's groups was checked with the help of glucometer, at every 7 days interval and at the end of 28 days study, plasma lipids were checked with the help of commercial kits. A significant decrease in blood glucose level (128.33 ± 1.67 mg/dl), TC (88.43 ± 0.66 mg/dl), TG (69.79 ± 0.49 mg/dl), and LDL-C (21.45 ± 0.08 mg/dl) was recorded in rat groups fed with 15 g pumpkin seed powder, at the end of study. After pumpkin seeds, second significant antihyperglycemic and antihyperlipidemic effect was recorded in rat's groups fed with 15 g pumpkin peel powder. Pumpkin flesh powder effect in lowering blood glucose level and plasma lipids was less significant as compared to seeds and peel powder. As the dose of the pumpkin powders was increased from 5 to 10 and then 15 g, the blood glucose-lowering and plasma lipid-lowering effect became more significant. Similarly, as the experimental duration was expanded from first week to 28 days, this antihyperglycemic and antihyperlipidemic effect became more significant. These results were sufficient to conclude that pumpkin has high potential to be used in human diet to cope with noncommunicable diseases like diabetes and hypercholesterolemia.
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Progression of today's world has been given setback due to the adversity of a novel, viral and deadly outbreak COVID 19, which raised the concerns of the scientists, researchers and health related officials about the inherent and adaptive immune system of the living body and its relation with healthy diet balanced with pharma foods. Choice of right food can help to build and boost adaptive immunity and pumpkin due to excellent profile of functional and nutraceutical constituents must be the part of both infected and non-infected person's daily diet. Vitamins, minerals, phenolic acids, essential oils, peptides, carotenoids and polysaccharides present in pumpkin could accommodate the prevailing deficiencies in the body to fought against the pathogens. Pumpkins are well equipped with nutraceuticals and functional ingredients therefore, consumption and processing of this remarkable fruit must be encouraged as pharma food due to its antihyperlipidemic, antiviral, anti-inflammatory, antihyperglycemic, immunomodulatory, antihypertensive, antimicrobial and antioxidant potential, and these pharmacological properties of pumpkin are directly or indirectly related to the COVID 19 outbreak. Utilization of pumpkin has a domain in the form of powders, extracts, isolates, and pumpkin incorporated food products. A wide range of healthy, nutritious and functional food products has been developed from pumpkin, which includes juice, soup, porridge, chips, biscuits, bread, cake, bar and noodles. In recent times some innovative and novel technologies have been applied to process and preserve pumpkin for its enhanced shelf life and bioaccessibility of nutrients. Need of healthy eating in current post COVID 19 period is very crucial for healthy population, and medicinal foods like pumpkin, and bioactive compounds present in this functional food could play a vital role in developing a healthy community around the globe.