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Fulltext A cross-sectional assessment of shared-decision making among patients visiting public healthcare institute of Quetta city, Pakistan

Waheed, Hira, Haider, Sajjad, Iqbal, Qaiser, Khalid, Adnan, Hassali, Mohamed Azmi, Bashaar, Mohammad, et al.

Malaysian Journal of Pharmaceutical Science, 2020;18(1):15-29.
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Shared-decision making (SDM), occasionally called “participatory governance” is the approach in healthcare to ensure that patients have the right to participate effectively in the decision-making (DM) process. The aim of this research was to discuss the external aspect of SDM and put forward applicable solutions to ensure SDM at both patient and physician levels. A standardised validated nine-item SDM questionnaire (patient version SDM-Q-9) was employed. SPSS version 25 was used to perform data analysis. Multiple tests such as Mann-Whitney U and Jonckheere-Terpstra were used. Kendall’s Tau coefficient was used for interpretation of the significant relationship among all items of SDM-Q-9 and education. A total of 465 chronically ill patients took part, where majority (63.4%) of patients was above the age of 47. The cohort was dominated by females (67.5%) with 92% of the sample was married. Majority (86.9%) of the patient reported not involved in any decision. During analysis, considerable association was reported between gender and all items of SDM-Q-9, where more men were involved in SDM when compared with women. Our findings did produce significant association between education and SDM-Q-9, which reveals that increase in education can improve the SDM. SDM should not be limited to chronic or emergency in practice. Specific and tailored shared medical DM programmes must be developed for low literacy population implementation. SDM is to be supported at policy and operation levels.
Uncontrollable medicine prices in Pakistan

Saleem F, Hassali MA, Iqbal Q, Baloch M, Shanker PR

Lancet, 2016 11 26;388(10060):2602.
PMID: 27832869 DOI: 10.1016/S0140-6736(16)32120-1
Crimean-Congo haemorrhagic fever in Pakistan

Haider S, Hassali MA, Iqbal Q, Anwer M, Saleem F

Lancet Infect Dis, 2016 12;16(12):1333.
PMID: 27998597 DOI: 10.1016/S1473-3099(16)30452-2
Fulltext Responsible use of fixed-dose combination antibiotics in India

Shankar PR, Hassali MA, Shahwani NA, Iqbal Q, Anwar M, Saleem F

Lancet Glob Health, 2016 10;4(10):e689.
PMID: 27633429 DOI: 10.1016/S2214-109X(16)30214-5
Frequency and evaluation of the perceptions towards caesarean section among pregnant women attending public hospitals in Pakistan and the implications

Ishaq R, Baloch NS, Iqbal Q, Saleem F, Hassali MA, Iqbal J, et al.

Hosp Pract (1995), 2017 Aug;45(3):104-110.
PMID: 28490205 DOI: 10.1080/21548331.2017.1328250

OBJECTIVES: There is increasing prevalence of caesarean sections (CS) worldwide; however, there are concerns about their rates in some countries, including potential fears among mothers. Consequently, we aimed to determine the frequency of CS, and explore patient's perception towards CS attending public hospitals in Pakistan, to provide future guidance.
METHODS: A two-phased study design (retrospective and cross sectional) was adopted. A retrospective study was conducted to assess the frequency of CS over one year among four public hospitals. A cross sectional study was subsequently conducted to determine patients' perception towards CS attending the four tertiary care public hospitals in Quetta city, Pakistan, which is where most births take place.
RESULTS: Overall prevalence of CS was 13.1% across the four hospitals. 728 patients were approached and 717 responded to the survey. Although 78.8% perceived CS as dangerous, influenced by education (p = 0.004), locality (p = 0.001) and employment status (p = 0.001), 74.5% of patients were in agreement that this is the best approach to save mother's and baby's lives if needed. 62% of respondents reported they would like to avoid CS if they could due to post-operative pain, and 58.9% preferred a normal delivery. There was also a significant association with education (p = 0.001) and locality (p = 0.001) where respondents considered normal vaginal delivery as painful.
CONCLUSION: The overall frequency of CS approximates to WHO recommendations, although there is appreciable variation among the four hospitals. When it comes to perception towards CS, women had limited information. There is a need to provide mothers with education during the antenatal period, especially those with limited education, to accept CS where needed.
Fulltext Frequency and predictors of anxiety and depression among pregnant women attending tertiary healthcare institutes of Quetta City, Pakistan

Ghaffar R, Iqbal Q, Khalid A, Saleem F, Hassali MA, Baloch NS, et al.

BMC Womens Health, 2017 Jul 25;17(1):51.
PMID: 28743261 DOI: 10.1186/s12905-017-0411-1

BACKGROUND: Anxiety and depression (A&D) are commonly reported among pregnant women from all over the world; however, there is a paucity of workable data from the developing countries including Pakistan. The current study, therefore, aims to find out the frequency and predictors of A&D among pregnant women attending a tertiary healthcare institutes in the city of Quetta, in the Balochistan province, Pakistan.
METHODS: A questionnaire based, cross-sectional survey was conducted. The pre-validated Hospital Anxiety and Depression Scale (HADS) were used to assess the frequency of A&D among study respondents. Anxiety and depression scores were calculated via standard scoring procedures while logistic regression was used to identify the predictors of A&D. SPSS v. 20 was used for data analysis and p
Fulltext Knowledge and practice of adolescent females about menstruation and menstruation hygiene visiting a public healthcare institute of Quetta, Pakistan

Michael J, Iqbal Q, Haider S, Khalid A, Haque N, Ishaq R, et al.

BMC Womens Health, 2020 01 06;20(1):4.
PMID: 31906921 DOI: 10.1186/s12905-019-0874-3

BACKGROUND: The current study is aimed to assess menstruation-related knowledge and practices of adolescent females visiting a public health care institute of Quetta city, Pakistan.
METHODS: A questionnaire-based cross-sectional survey was conducted. Nine hundred and twenty three female adolescents attending general out-patient departments of Mohtarma Shaheed Benazir Bhutto Hospital Quetta, Balochistan, was approached for data collection. Based on the objectives of the study, descriptive analysis was conducted and SPSS v. 21.0 was used for the data analysis.
RESULTS: Demographic characteristics revealed that the mean age of the respondents was 15 years. Mothers' (67%) were the main source of menstruation-related information. Majority (77.7%) of our respondents never had a class or session regarding menstruation-related education in their schools. About (44%) knew that menstruation is a physiological phenomenon while 60.2% knew that menstrual blood comes from the vagina. Nearly 40% of our study respondents missed their schools because of menarche. The use of absorbent material was frequent (90%) among the adolescent females and (68.7%) used commercially available sanitary napkins/pads. Although majority of the respondents (58.2%) were not taking baths during menstruation, 80.5% do cleaned their genitalia with water during menstruation.
CONCLUSION: Female adolescents of our study had certain misconception regarding menstruation because of poor access to health-related education. Education can be provided at healthcare facilities, residential area as well as religious centers. Adolescent reproductive health should be included in the school curriculum; this will influence general reproductive health of females.
Fulltext Profile and Predictors of Maternal Quality of Life During Physiological Pregnancy: A Cross-Sectional Analysis

Ishaq R, Shoaib M, Baloch NS, Sadiq A, Raziq A, Huma ZE, et al.

Front Public Health, 2021;9:801035.
PMID: 35111720 DOI: 10.3389/fpubh.2021.801035

Background: Quality of Life (QoL) and its determinants are significant in all stages of life, including pregnancy. The physical and emotional changes during pregnancy affect the QoL of pregnant women, affecting both maternal and infant health. Hence, assessing the QoL of pregnant women is gaining interest in literature. We, therefore, aimed to describe the QoL of pregnant women during physiological pregnancy and to identify its associated predictors in women attending a public healthcare institute of Quetta city, Pakistan.
Methods: A cross-sectional study was conducted at the Obstetrics and Gynecology Department of Sandeman Provincial Hospital Quetta city, Pakistan. The respondents were asked to answer the Urdu (lingua franca of Pakistan) version of the Quality of Life Questionnaire for Physiological Pregnancy. Data were coded and analyzed by SPPS v 21. The Kolmogorov-Smirnov test was used to establish normality of the data and non-parametric tests were used accordingly. Quality of Life was assessed as proposed by the developers. The Chi-square test was used to identify significant associations and linear regression was used to identify the predictors of QoL. For all analyses, p < 0.05 was taken significantly.
Results: Four hundred and three pregnant women participated in the study with a response rate of 98%. The mean QoL score was 19.85 ± 4.89 indicating very good QoL in the current cohort. The Chi-Square analysis reported a significant association between age, education, occupation, income, marital status, and trimester. Education was reported as a positive predictor for QoL (p = 0.006, β = 2.157). On the other hand, trimester was reported as a negative predictor of QoL (p = 0.013, β = -1.123).
Conclusion: Improving the QoL among pregnant women requires better identification of their difficulties and guidance. The current study highlighted educational status and trimester as the predictors of QoL in pregnant women. Health care professionals and policymakers should consider the identified factors while designing therapeutic plans and interventions for pregnant women.