Journal of the Pakistan Medical Association最新文献

Objective: To explore the challenges of teenage pregnancy experienced by adolescent girls, and its impact on their social and psychological wellbeing.

Methods: The qualitative study was conducted from August 5 to September 17, 2023, in different villages in northern Sindh after approval from the institutional ethical review board of Shah Abdul Latif University, Khairpur, Pakistan. Data was collected through semi-structured interviews with the subjects who had experienced teenage pregnancy in the preceding 2 years. Data was transcribed verbatim and analysed thematically.

Results: Of the 37 subjects, 20(54%) were aged 19-20 years. The age at the time of marriage was 15-16 years in 22(59%) cases, and 16(43%) had received no formal education. Challenges, impact and outcome of teenage pregnancy were the 3 main themes identified on the basis of the collected data, indicating that it was a challenging experience for adolescent girls resulting in poor health outcomes.

Conclusions: Community-based interventions are needed to promote female education that may put an end to adolescent motherhood.

Objectives: To assess the frequency of workplace gender-based violence and incivility faced by female doctors.

Methods: The analytical, cross-sectional study was conducted from June 10 to August 31, 2023, in Lahore, Pakistan, and comprised female doctors working in 1 public and 1 private medical institution in Lahore. Data was collected using a questionnaire. Workplace incivility and various demographic factors were compared. Data was analysed using SPSS 21.

Results: Of the 200 subjects, 138(69%) were from the private sector and 62(31%) were from the public sector. The majority was aged <30 years 95(47.5%). Some form of workplace violence was faced by 86(43%) doctors; psychological violence by 58(29%), verbal 56(28%), digital harassment 11(5.5%) and physical violence 2(1%). Supervisor incivility was faced by 94(47%) respondents, while 87(43.5%) faced co-worker incivility over the preceding year. Supervisor incivility was significantly higher in private institutions and those having income less than Rs100,000 per month (p<0.05).

Conclusions: Workplace gender-based violence and incivility faced by working female doctors was found to be high. The most common forms faced were psychological and verbal violence. Supervisor incivility faced by female doctors at workplace was significantly higher in private institutions and those having monthly income less than Rs100,000.

Rheumatoid arthritis (RA) causes coronary artery atherosclerosis with a similar risk as diabetes or hypertension. However, coronary artery disease (CAD) is rare in young patients, especially in those presenting as chronic total occlusion (CTO). We report a rare case of aborted sudden cardiac death in a 26-year-old patient with a six-year history of RA. He had no cardiovascular risk factors apart from RA. He was diagnosed with severe ischaemic heart failure (HF) due to recent myocardial ischaemia with CTO, using multimodal evaluation. RA is associated with vulnerable plaque formation and prothrombotic tendencies. Anti-rheumatic drugs are thought to prevent the progression of CAD and reduce cardiovascular risk in patients with RA. However, this patient had severe HF with CTO, despite being on RA medication. This case suggests that RA may be a major risk factor for CAD, including CTO, in young individuals.

Objectives: To investigate the moderating effect of self-compassion on the relationship involving stigma, caregiver burden and expressed emotions among caregivers of males diagnosed with substance use disorder.

Methods: The correlational, quantitative study was conducted from June 1 to September 30, 2021, at the Department of Psychology, University of Central Punjab, Lahore, Pakistan, and comprised caregivers aged 40-55 years living with individuals with substance use disorder and actively performing caregiving duties for at least six months. Data was collected using validated tools. Data was analysed using SPSS 21.

Results: Out of the 300 subjects, 54(18%) were males and 246(82%) were females, with overall mean age 45±7.73 years. The caregiving duration ranged from 6 months to 20 years. Self-compassion significantly moderated stigma, caregiver burden and expressed emotions (p=0.001). The interaction effects of self-compassion with stigma, affect, behaviour, cognition and caregiver burden collectively explained 88% of the variance in expressed emotion. Selfcompassion accounted for a significant change in expressed emotion (p<0.05).

Conclusions: Internalised stigma and caregiver burden predicted expressed emotions in caregivers of males with substance use disorder.

Acute intermittent porphyria (AIP), one of the most severe types of acute hepatic porphyria, is an autosomal dominant inherited disorder of heme biosynthesis. We present a case of a 16-year-old girl who presented with severe abdominal pain, subjected to a laparotomy and later developed seizures and other neurological manifestations. Initial investigations showed hyponatraemia. Magnetic Resonance Imaging of brain showed cerebritis. She underwent several investigations including an ultrasound of abdomen, a computed tomography scan of abdomen and pelvis, cerebrospinal fluid routine examination and culture, and autoimmune investigation which were found to be normal. Later urine porphobilinogen levels were found to be raised. The diagnosis was made based on investigation and clinical symptoms. AIP should be suspected when a patient presents with chronic abdominal pain and neurological symptoms.

Muraqabah is an Islamic form of mindful meditation, prayerful meditation or religious meditation. This is a means of connecting to God, while being mindful of his presence. It also implies seclusion. Muraqabah may be used as means of improving physical and mental health in persons with metabolic diseases such as diabetes and hypertension. In this editorial. We share the need to study and research this potential therapy, we share pragmatic ideas as to how muraqabah can be introduced in clinical practice.

Frailty and malnutrition are two conditions that are frequently present in cardiac failure patients that eventually contribute to hospitalisation and recurrent admissions. Malnutrition and frailty are interrelated and a predictive indicator of hospitalisations and subsequent readmissions that worsen the prognosis of cardiac failure patients. Research does not typically measure both nutritional status and frailty together in cardiac failure patients, and they are not even considered when planning and implementing the interventions. The life quality can be improved by early identification of frailty secondary to malnutrition and timely nutritional interventions. Rehospitalisations after discharge due to these conditions significantly increase the risk of death which can be avoided. The current narrative review was planned to highlight frailty and malnutrition as predictive indicators of hospitalisations and subsequent readmissions. Attempts to reduce the social and economic burden owing to these conditions in cardiac failure patients have emerged as a major public health priority worldwide, particularly in the developing countries.