Displaying publications 1 - 20 of 44 in total

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  1. Chen HWJ, Marzo RR, Sapa NH, Ahmad A, Anuar H, Baobaid MF, et al.
    Healthcare (Basel), 2023 May 17;11(10).
    PMID: 37239741 DOI: 10.3390/healthcare11101455
    BACKGROUND: While social media continues to dominate, social media platforms have become powerful health communication tools for older users. However, fulfilling their social media needs can be both detrimental and beneficial to their quality of life (QoL). This study assessed social media needs as they relate to QoL among older adults in Malaysia.

    METHODS: We conducted a cross-sectional study and adopted convenience sampling to recruit participants. The participants were required to self-report their sociodemographic profile, social media use and needs, and QoL. Social media use and needs were assessed using the Social Networking Sites Uses and Needs (SNSUN) scale, and QoL was assessed using the WHOQOL-BREF questionnaire. Multiple linear regression was performed to identify the predictors of QoL.

    RESULTS: The findings revealed that the fulfilment of social integrative needs was the strongest predictor of higher QoL in all domains. However, those using social media for their affective needs demonstrated lower psychological health quality.

    CONCLUSIONS: Fulfilling social integrative needs is the key to improving the QoL among older adults. The continuous development of age-friendly applications is essential to keep up with constantly changing social media trends and bridge the gap of social media inequalities. More importantly, it would enable older adults to utilize social media to its fullest potential and enjoy a higher QoL through accessible health communication tools.

  2. Pervin MR, Parvin R, Babu MA, Ahmmed MM, Marzo RR
    J Public Health Res, 2021 Nov 08;10(s2).
    PMID: 34751531 DOI: 10.4081/jphr.2021.2271
    BACKGROUND: Bangladesh has been going through the austerity of the unique COVID-19 for more than a year like several other nations in the world in spite of concerted efforts taken by the government along with other concerned authorities who have advocated compulsory guidelines involving social distancing procedures accompanied by lockdown to have control over the pandemic. In this paper, the barriers faced by the government to protect people from the COVID-19 pandemic have been investigated. Also, the number of daily infected people against the number of daily tests has been underlined to comprehend the overall pandemic picture in Bangladesh.

    DESIGN AND METHODS: A descriptive study has been carried out to investigate the obstacles to tackle the COVID-19 pandemic for this country. The intensity of the outbreaks of the pandemic in this country is stated from March 8, 2020, to February 12, 2021. Secondary data have been employed from different sources to serve the goals of the study.

    RESULTS: The poor management in the health sector of Bangladesh has been an issue of major concern during the early stage of COVID-19 which incorporates deficiency of medical equipment, lack of facilities for testing COVID-19, poor patient management, and uncertainty in the medication system. Finally, some recommendations have been proposed for the concerned organizations to tackle the current pandemic and as well in the future.

    CONCLUSIONS: To control this COVID-19 pandemic, it is necessary to find the difficulties and discover the remedies which have been done in this paper for the Bangladesh perspective.

  3. Marzo RR, Bhattacharya S, Ujang NB, Naing TW, Huong Fei AT, Chun CK, et al.
    J Educ Health Promot, 2021;10:160.
    PMID: 34222535 DOI: 10.4103/jehp.jehp_979_20
    BACKGROUND: Patient satisfaction is a comprehensive measurement of patients' happiness with the level of health care delivered to them both inside and outside the physician's office. It is commonly used as an indicator to assess the health-care quality and affects a wide range of components related to the provision of health services such as ease of access, medical malpractice, and clinical outcomes. The study aimed to analyze patients' satisfaction with the quality of health care they received at the outpatient department of Klinik Kesihatan Maharani Muar Healthcare Facility (KMMHF), Johor.

    MATERIALS AND METHODS: This cross-sectional study was conducted between August and December 2019 period. Demographic information and information on patients' feelings about their physicians, treatment, and health facilities provided were collected from 407 consented patients in a simple random sampling survey using a researcher-made, an adapted Medical Interview Satisfaction, questionnaire which was pilot tested before administration to the patients. Data were analyzed with SPSS version 23. Descriptive statistics and correlational and group comparison analyses were utilized.

    RESULTS: Of the 407 patients studied for physician-patient satisfaction, the overall mean of all the respondents responding was 4.089 ± 0.5, which was ranked the highest among the three objectives. The effectiveness of treatment came as the second highest with the overall mean of 4.088 ± 0.5. Finally, the overall health-care facilities had the lowest overall mean of 4.077 ± 0.5 among the three.

    CONCLUSION: Most patients who visited KMMHF were mostly satisfied with the outcomes of physician-patient interaction in the clinic.

  4. Marzo RR, Jun Chen HW, Ahmad A, Thew HZ, Choy JS, Ng CH, et al.
    Arch Public Health, 2024 Mar 06;82(1):28.
    PMID: 38449000 DOI: 10.1186/s13690-023-01222-z
    BACKGROUND: Excessive or inappropriate use of social media has been linked to disruptions in regular work, well-being, mental health, and overall reduction of quality of life. However, a limited number of studies documenting the impact of social media on health-related quality of life (HRQoL) are available globally.

    AIM: This study aimed to explore the perceived social media needs and their impact on the quality of life among the adult population of various selected countries.

    METHODOLOGY: A cross-sectional, quantitative design and analytical study utilized an online survey disseminated from November to December 2021.

    RESULTS: A total of 6689 respondents from ten countries participated in the study. The largest number of respondents was from Malaysia (23.9%), followed by Bangladesh (15.5%), Georgia (14.8%), and Turkey (12.2%). The prevalence of social media users was over 90% in Austria, Georgia, Myanmar, Nigeria, and the Philippines. The majority of social media users were from the 18-24 age group. Multiple regression analysis showed that higher education level was positively correlated with all four domains of WHOQoL. In addition, the psychological health domain of quality of life was positively associated in all countries. Predictors among Social Media Needs, Affective Needs (β = -0.07), and Social Integrative Needs (β = 0.09) were significantly associated with psychological health.

    CONCLUSION: The study illuminates the positive correlation between higher education levels and improved life quality among social media users, highlighting an opportunity for policymakers to craft education-focused initiatives that enhance well-being. The findings call for strategic interventions to safeguard the mental health of the global social media populace, particularly those at educational and health disadvantages.

  5. Masood W, Khan HA, Cheema HA, Shahid A, Bilal W, Kamal MA, et al.
    Inquiry, 2022;59:469580221139366.
    PMID: 36484333 DOI: 10.1177/00469580221139366
    While monkeypox virus (MPXV) remained endemic in central and western African countries, a sudden unusual spike of global cases among non-endemic countries is an enigma for scientists. With 257 cases reported as of 26th May 2021, a multi-country outbreak of monkeypox has been declared in countries including the UK, EU/EEA states, and North America. Even though the likelihood of transmissibility of MPXV is limited compared to COVID-19, yet a coordinated multidisciplinary effort is required to prevent any further global expansion. Few appropriate responsive approaches to contain the infection could be; limiting the contact with potential animal reservoirs, isolation of confirmed cases, using PPEs to prevent human-human transmission, awareness activities, and administration of pre and post prophylactic vaccination. In this review, we have discussed the previous and current outbreaks of MPXV along with the abrupt actions that are needed to address the situation.
  6. King I, Heidler P, Marzo RR
    Vaccines (Basel), 2021 Jul 15;9(7).
    PMID: 34358206 DOI: 10.3390/vaccines9070790
    Acceptance of the COVID-19 vaccine will play a crucial role in combating the current pandemic. Vaccine rollouts have started in most countries. To reach the desirable vaccine coverage and to enhance its uptake, it is imperative to assess vaccine hesitancy.

    METHODS: To assess the current vaccine acceptability in Austria and its influencing factors, an online survey was created and comprised fifteen questions segmented into a sociodemographic part and the acceptance and influencing factors of the approval of the COVID-19 vaccine.

    RESULTS: In total, 70% of the 1350 respondents thought that the COVID-19 vaccine is an effective way to prevent and control the virus, while 13% disagreed and 17% were uncertain. Further, 71% approved the rapid development and rollout of the vaccine, while 55% were willing to accept the vaccine as soon as it became available, 18% did not want to get the vaccine, 17% wanted to delay, and 10% were already vaccinated.

    CONCLUSIONS: The results show a generally positive attitude towards the new COVID-19 vaccine. The doctor's recommendation greatly influences the decision-making process, and tailored vaccine information can support a higher vaccine coverage.

  7. Marzo, Roy Rillera
    MyJurnal
    Medical knowledge, skills, and social requirements for patient care are quickly changing, thus, doctors
    are anticipated to be life-long learners to provide effective care for the patients. This paper addresses
    instructional issues how to prepare medical students to be self-directed learners and how to improve
    medical school and postgraduate training curricula. Now the big question is self-directed learning
    (SDL) an agent in cultivating lifelong learning skills for medical students as claimed by educational
    experts? This will be the focus of my critical reflection on lifelong learning.
  8. Marzo RR, Bhattacharya S, Niranjan V, Shagaran K, Mohd Idris MAB, Clement BJ, et al.
    PMID: 32318611 DOI: 10.4103/jehp.jehp_505_19
    INTRODUCTION: In this era of globalization, urbanization, and rapidly expanding unhygienic food corners across the globe, the incidence of food poisoning is very common nowadays.

    AIM: The aim of our study was to investigate the perceptions and readiness of schoolteachers to accept notifications on food poisoning as a part of education to the students.

    METHODOLOGY: A descriptive cross-sectional study was carried out with the help of a validated questionnaire for data collection. Our research involved schoolteachers from both primary and secondary schools in Muar. The questionnaire was pretested among the eligible trainee teachers and yielded an internal consistency reliability coefficient (c = Cronbach's alpha) of 0.082. This study was conducted from October 29, 2017, to December 14, 2018, in Muar. Our sample size was 259. Ethical consent was obtained from the Institution Ethical Committee.

    RESULTS: A total of 259 schoolteachers from both primary and secondary schools in Muar were included in this study. In our study, 81.1% of the teachers responded that they can easily educate their students about food poisoning. Most of them (93.1%) were ready to receive notifications on food poisoning in any mode, and about 72% of the teachers preferred WhatsApp as their mode of receiving notification. The least (1.2%) preferred mode of notification was LINE (a social app). Teachers' willingness to disseminate the information regarding food poisoning was also higher (98.5%).

    CONCLUSIONS: We concluded that majority of the schoolteachers had a good perception and were ready to receive the notifications on food poisoning through WhatsApp as a part of education to the students.

  9. Marzo RR, Ismail Z, Nu Htay MN, Bahari R, Ismail R, Villanueva EQ, et al.
    PMID: 33619459 DOI: 10.1016/j.cegh.2021.100708
    The COVID-19 pandemics caused an unprecedented mortality, distress, and globally poses a challenge to mental resilience. To our knowledge, this is the first study that aimed to investigate the psychological distress among the adult general population across 13 countries. This cross-sectional study was conducted through online survey by recruiting 7091 respondents. Psychological distress was evaluated with COVID-19 Peritraumatic Distress Index (CPDI). The crude prevalence of psychological distress due to COVID-19 is highest in Vietnam, followed by Egypt, and Bangladesh. Through Multivariate Logistic Regression Analysis, the respondents from Vietnam holds the highest level of distress, while the respondents from Sri Lanka holds the lowest level of distress with reference to Nepal.Female respondents had higher odds of having reported psychological distress, and those with tertiary education were less likely to report psychological distress compared to those with lower level of education. The findings indicate that psychological distress is varies across different countries. Therefore, different countries should continue the surveillance on psychological consequences through the COVID-19 pandemic to monitor the burden and to prepare for the targeted mental health support interventions according to the need. The coping strategies and social support should be provided especially to the lower educational attainment group.
  10. Marzo RR, Ahmad A, Islam MS, Essar MY, Heidler P, King I, et al.
    PLoS Negl Trop Dis, 2022 01;16(1):e0010103.
    PMID: 35089917 DOI: 10.1371/journal.pntd.0010103
    BACKGROUND: Mass vaccination campaigns have significantly reduced the COVID-19 burden. However, vaccine hesitancy has posed significant global concerns. The purpose of this study was to determine the characteristics that influence perceptions of COVID-19 vaccine efficacy, acceptability, hesitancy and decision making to take vaccine among general adult populations in a variety of socioeconomic and cultural contexts.

    METHODS: Using a snowball sampling approach, we conducted an online cross-sectional study in 20 countries across four continents from February to May 2021.

    RESULTS: A total of 10,477 participants were included in the analyses with a mean age of 36±14.3 years. The findings revealed the prevalence of perceptions towards COVID-19 vaccine's effectiveness (78.8%), acceptance (81.8%), hesitancy (47.2%), and drivers of vaccination decision-making (convenience [73.3%], health providers' advice [81.8%], and costs [57.0%]). The county-wise distribution included effectiveness (67.8-95.9%; 67.8% in Egypt to 95.9% in Malaysia), acceptance (64.7-96.0%; 64.7% in Australia to 96.0% in Malaysia), hesitancy (31.5-86.0%; 31.5% in Egypt to 86.0% in Vietnam), convenience (49.7-95.7%; 49.7% in Austria to 95.7% in Malaysia), advice (66.1-97.3%; 66.1% in Austria to 97.3% in Malaysia), and costs (16.0-91.3%; 16.0% in Vietnam to 91.3% in Malaysia). In multivariable regression analysis, several socio-demographic characteristics were identified as associated factors of outcome variables including, i) vaccine effectiveness: younger age, male, urban residence, higher education, and higher income; ii) acceptance: younger age, male, urban residence, higher education, married, and higher income; and iii) hesitancy: male, higher education, employed, unmarried, and lower income. Likewise, the factors associated with vaccination decision-making including i) convenience: younger age, urban residence, higher education, married, and lower income; ii) advice: younger age, urban residence, higher education, unemployed/student, married, and medium income; and iii) costs: younger age, higher education, unemployed/student, and lower income.

    CONCLUSIONS: Most participants believed that vaccination would effectively control and prevent COVID-19, and they would take vaccinations upon availability. Determinant factors found in this study are critical and should be considered as essential elements in developing COVID-19 vaccination campaigns to boost vaccination uptake in the populations.

  11. Hamdana AH, Mohsin H, Habib Tharwani Z, Masood W, Furqana AQ, Sohail A, et al.
    Inquiry, 2023;60:469580231175437.
    PMID: 37190997 DOI: 10.1177/00469580231175437
    Monkeypox (MPX) is a zoonotic disease caused by the MPX virus from the poxviridae family of orthopoxviruses. Typically, endemic in central and west Africa, it has now become a matter of concern since cases have been reported in non-endemic countries around mid-June 2022, especially in the European region, with the transmission not related to travel. The diagnosis is made by PCR testing of the skin lesions. Even though treatment is symptomatic, antiretrovirals, such as tecovirimat, are used in severe cases. Vaccination with second and third generation vaccines is approved for prophylaxis in high risk individuals. Unfortunately, these options of treatment and prevention are only available in high income countries at the moment. This review, through a thorough literature search of articles from 2017 onward, focuses on epidemiology, clinical manifestations, challenges, treatment, prevention and control of MPX virus and how they can be corelated with other viral outbreaks including COVID-19, Acute Hepatitis of unknown origin, Measles and Dengue, to better predict and therefore prevent its transmission. The previous COVID-19 pandemic increased the disease burden on healthcare infrastructure of low-middle income countries, therefore, this recent MPX outbreak calls for a joint effort from healthcare authorities, political figures, and NGOs to combat the disease and prevent its further spread not only in high income but also in middle- and low-income countries.
  12. Qureshi M, Khan S, Bantan RAR, Daniyal M, Elgarhy M, Marzo RR, et al.
    J Clin Med, 2022 Nov 04;11(21).
    PMID: 36362783 DOI: 10.3390/jcm11216555
    BACKGROUND: Monkeypox virus is gaining attention due to its severity and spread among people. This study sheds light on the modeling and forecasting of new monkeypox cases. Knowledge about the future situation of the virus using a more accurate time series and stochastic models is required for future actions and plans to cope with the challenge.

    METHODS: We conduct a side-by-side comparison of the machine learning approach with the traditional time series model. The multilayer perceptron model (MLP), a machine learning technique, and the Box-Jenkins methodology, also known as the ARIMA model, are used for classical modeling. Both methods are applied to the Monkeypox cumulative data set and compared using different model selection criteria such as root mean square error, mean square error, mean absolute error, and mean absolute percentage error.

    RESULTS: With a root mean square error of 150.78, the monkeypox series follows the ARIMA (7,1,7) model among the other potential models. Comparatively, we use the multilayer perceptron (MLP) model, which employs the sigmoid activation function and has a different number of hidden neurons in a single hidden layer. The root mean square error of the MLP model, which uses a single input and ten hidden neurons, is 54.40, significantly lower than that of the ARIMA model. The actual confirmed cases versus estimated or fitted plots also demonstrate that the multilayer perceptron model has a better fit for the monkeypox data than the ARIMA model.

    CONCLUSIONS AND RECOMMENDATION: When it comes to predicting monkeypox, the machine learning method outperforms the traditional time series. A better match can be achieved in future studies by applying the extreme learning machine model (ELM), support vector machine (SVM), and some other methods with various activation functions. It is thus concluded that the selected data provide a real picture of the virus. If the situations remain the same, governments and other stockholders should ensure the follow-up of Standard Operating Procedures (SOPs) among the masses, as the trends will continue rising in the upcoming 10 days. However, governments should take some serious interventions to cope with the virus.

    LIMITATION: In the ARIMA models selected for forecasting, we did not incorporate the effect of covariates such as the effect of net migration of monkeypox virus patients, government interventions, etc.

  13. Marzo RR, Bhattacharya S
    J Family Med Prim Care, 2022 Nov;11(11):6772-6777.
    PMID: 36993001 DOI: 10.4103/jfmpc.jfmpc_271_19
    INTRODUCTION: Globally, mental health today poses a significant hazard to all of us. It is more vital for students, whose survival in a highly competitive atmosphere places them under enormous pressure.

    AIM AND OBJECTIVE: This qualitative study sought to determine how mental health counsellors now address the mental health concerns of their pupils. To achieve this objective, two research questions were developed to direct this study: (1) What are the experiences of counsellors who provide support to students with mental health issues? (2) How might guidance and counselling services and programmes enhance the academic success of students with mental health issues?

    METHODOLOGY: Participants were selected from a university in a northern Malaysian neighbourhood. Several semi-structured, in-depth interviews were conducted with two counsellors to collect data.

    RESULTS: Overall, the counsellors regarded multitasking to be a hindrance to their job performance. Participants felt that their caseloads prevented them from being proactive with each student, resulting in irritation. According to the participants, the job's requirements have changed, but the number of tasks and caseload have not. This has led to feelings of exhaustion and frustration. The study revealed two important research's findings: first, there has been an increase in the number of mental health concerns, particularly anxiety and depression, among students; second, counsellors would be able to effectively support children intellectually and personally if they had appropriate staffing and professional development.

    CONCLUSION: It was concluded that the counselors regarded multitasking was a hindrance to their job performance. Participants reported an increase in the frequency of anxiety and depression exhibited by their students and they felt that additional programming with friends, family, and professors could increase students' social well-being.

  14. Elsayed MEG, El-Abasiri RA, Marzo RR, Dardeer KT, Kamal MA, Abdelaziz H, et al.
    PLoS One, 2023;18(2):e0282264.
    PMID: 36848375 DOI: 10.1371/journal.pone.0282264
    BACKGROUND: Coronavirus disease-19 emerged in December 2019. Healthcare workers were exposed to this highly infectious virus during the pandemic and suffered several social and psychological consequences, such as anxiety, psychological distress, and burnout.

    OBJECTIVES: To assess the psychological distress, anxiety, depression, coping strategies, risk perception, and attitude toward interprofessional teamwork among Egyptian healthcare workers during the COVID-19 pandemic.

    METHODS: We conducted a cross-sectional online survey which consisted of five sections. The primary outcomes were anxiety (GAD-7), depression (PHQ-9), risk perception towards COVID-19, interprofessional teamwork attitude, and coping strategies during the Coronavirus disease-19 pandemic. The web-based questionnaire was distributed to Egyptian healthcare workers from the 20th of April 2020 to the 20th of May 2020. A snowball sampling method was used. Regression analysis was conducted to test the relationship between the socioeconomic characteristics and the previously mentioned outcomes.

    RESULTS: A total of 403 participants responded to the online questionnaire. The majority were females (70.5%) and within the age group of 26-40 years (77.7%), with 2-5 years of work experience (43.2%). Most participants were pharmacists (33%) and physicians (22.1%). Eighty-two participants (21%) reported moderate to severe anxiety, and 79 participants reported (19.4%) moderate to severe depressive symptoms. In the univariate model, the marital status was associated with depression (OR 0.47, 95% CI 0.28-0.78), anxiety (OR 0.52, 95% CI 0.32-0.85), and an attitude toward interprofessional teamwork (β = -1.96 95% CI -2.72 to -1.2). Providing direct care to the patients was associated with lower anxiety symptoms (AOR 0.256, 95% CI 0.094-0.697). More severe anxiety and depressive symptoms were associated with difficulties in everyday life and the professional work environment (AOR 4.246 and 3.3, P = 0.003 and 0.01, respectively). Availability of mental health facilities at the workplace was associated with a lower risk perception towards COVID-19 (β = -0.79, 95% CI -1.24 to -0.34) and a more positive attitude towards teamwork (β = 2.77 95% CI 1.38-4.15).

    CONCLUSIONS: According to our results, the COVID-19 pandemic was associated with mild anxiety and depression among healthcare workers in Egypt, especially pharmacists and physicians. We recommend more research targeting the mental health of healthcare workers in Egypt. If proven cost-effective and needed, wide-scale mental health screening and public health campaigns can facilitate effective prevention and treatment strategies. In addition, the availability of mental health facilities at the workplace could alleviate some of the risk perception associated with health emergencies and improve interprofessional teamwork.

  15. Bhattacharya S, Heidler P, Saleem SM, Marzo RR
    Front Public Health, 2022;10:945082.
    PMID: 36033797 DOI: 10.3389/fpubh.2022.945082
    INTRODUCTION: Digital eye strain, which is often ignored by the public, has emerged as a "Shadow Pandemic" in the era of the COVID-19 pandemic.

    AIM: The current paper is aimed at discussing the ill effect of digital screens on eyes in the wake of the COVID-19 pandemic.

    METHODOLOGY: A literature search was done using "PubMed," "Google scholar", and "Scopus" using key terms like "Digital Eye Strain," "Eyestrain," or "Computer Vision Syndrome." Relevant articles were identified and included to support the argument for this narrative review.

    RESULTS: Studies conducted in the UK reported that 68% of children extensively use computers, while 54% undertake online activities after the age of 3. Similar studies estimated 4 h and 45 min per day of screen exposure time among adults in the UK. Indian studies reveal that the prevalence of DES is 69% in adults and 50% in children respectively. Indian ophthalmologists found that computer-using and specialized ophthalmologists were more informed of symptoms and diagnostic signs but were misinformed about treatment modalities. The use of social media and multitasking is particularly prominent among younger adults, with 87% of individuals aged 20-29 years reporting the use of two or more digital devices simultaneously. It has been observed that the use of computer glasses corrects refractive errors and helps in the reduction of symptoms, while precision spectral filters help in reducing symptoms of micro-fluctuation of accommodation.

    CONCLUSION: We concluded that DES is emerging globally as a "Shadow Pandemic" and it is high time to respond. Community ophthalmologists, public health authorities, and educational sectors especially should be involved to prevent this.

  16. Eltewacy NK, Nabil S, Sweedy R, Marzo RR, Hamza N, EARG Group
    Front Public Health, 2022;10:1018757.
    PMID: 36324469 DOI: 10.3389/fpubh.2022.1018757
    INTRODUCTION: During the COVID-19 lockdown, people's lifestyles have changed including their habits and physical activities. There has been an increase in anabolic hormones and nutritional supplement use among people who regularly do exercise in the MENA region. This study aims to assess knowledge, practice, and attitude toward the use of anabolic hormones and nutritional supplements among people who regularly exercise in the Middle East and North Africa (MENA) region and to compare their exercise habits and hormones and supplements usage between before and during COVID-19 lockdown.

    METHODS: A self-administrated online Google form survey was carried out between February 2021 and April 2021. Five thousand eight hundred forty-five participants who regularly exercise and aged ≥18 years responded to the questionnaire. The questionnaire was distributed through social media platforms and included five sections: demographic, training characters, knowledge, practice, and attitude.

    RESULTS: The participants mean age was 27.4 ± 8.6 years. Males represented 58.2 % of participants. 75.3% of the study participants had not used either hormones or supplements, and about 19% used supplements only. The mean percent score for knowledge, practice, and attitude were 39.3 ± 30.5, 1.1 ± 9.5, and 21.3 ± 23.8, respectively. Level of knowledge was higher among participants who worked in the medical field or as sports coaches. The practice was higher among male participants. The most commonly used anabolic hormones and nutritional supplements were steroids and proteins with bodybuilding being the most common purpose. Internet was the main source of information and pharmacy was the main source for procuring these substances. There was a significant decrease in proteins, carbohydrates, and sports drinks used during the COVID-19 lockdown compared to before the COVID-19 lockdown, while a statistically significant increase in vitamins used during the COVID-19 lockdown compared to before COVID-19 lockdown.

    DISCUSSION: In the MENA region, there has been an increase in the use of anabolic hormones and nutritional supplements. Most of the population has low knowledge of the harmful effect of uncontrolled, uninformed and unmonitored use of these substances Therefore, increasing the awareness level of participants and sports coaches should be a priority to limit the unsupervised use of hormones and supplements.

  17. Inusah AW, Alhassan NA, Charadan AMS, Marzo RR, Ziblim SD
    Int J MCH AIDS, 2023;12(2):e639.
    PMID: 38312497 DOI: 10.21106/ijma.639
    BACKGROUND AND OBJECTIVES: Even though Ghana has recorded an appreciable level of facility delivery compared to other countries in sub-Saharan Africa, the country still has a lot of regional and community variations in facility delivery where professional maternal health care is guaranteed. This study assessed the main factors associated with facility delivery in the Sagnarigu Municipal Assembly of the Northern Region of Ghana.

    METHODS: Using a simple random sampling method, a retrospective community-based cross-sectional study was conducted from July 12, 2021 to October 17, 2021, among 306 postnatal women within 15 to 49 years who had delivered within the last six months. We conducted descriptive analyses, and the Pearson chi-square test of association between the sociodemographic factors and obstetrics history with the outcome variable, choice of place of birth. Lastly, significant variables in the chi-square test were entered into adjusted multivariate logistics regression to determine their association with the place of delivery. Data analysis was performed using the Statistical Package for Social Sciences version-25, with statistical significance set at a p-value of 0.05.

    RESULTS: The study reported a facility delivery rate of 82%, which is slightly higher than the national target (80%). We observed that age group [AOR 2.34 (1.07-5.14)], marital status [AOR 0.31 (0.12-0.81)], ethnicity [AOR 3.78 (1.18-12.13)], and couple's occupation [AOR 24.74 (2.51-243.91)] were the significant sociodemographic factors influencing facility delivery. The number of antenatal care (ANC) attendance [AOR 8.73 (3.41 - 22.2)] and previous pregnancy complications [AOR 2.4 (1.11 - 5.7)] were the significant obstetrics factors influencing facility delivery.

    CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: We found that specific sociodemographic and obstetric factors significantly influence the choice of place of delivery in the study area. To address this, the study recommends targeted interventions that focus on providing support and resources for women from different age groups, marital statuses, ethnicities, and occupational backgrounds to access facility delivery services. Additionally, improving ANC attendance and effectively managing pregnancy complications were highlighted as important measures to encourage facility-based deliveries.

  18. Tharwani ZH, Bilal W, Khan HA, Kumar P, Butt MS, Hamdana AH, et al.
    Inquiry, 2023;60:469580231167024.
    PMID: 37085986 DOI: 10.1177/00469580231167024
    Over the years, several developing countries have been suffering from high infant and child mortality rates, however, according to the recent statistics, Pakistan falls high on the list. Our narrative review of copious research on this topic highlights that several factors, such as complications associated with premature births, high prevalence of birth defects, lack of vaccination, unsafe deliveries, poor breastfeeding practices, complications during delivery, sudden infant death syndrome (SIDS), poor socioeconomic conditions, and a struggling healthcare system, have influenced these rates. Bearing in mind the urgency of addressing the increased infant and child mortality rate in Pakistan, multiple steps must be taken in order to prevent unnecessary deaths. An effective initiative could be spreading awareness and education among women, as a lack of education among women has been indirectly linked to increased child mortality in Pakistan across many researches conducted on the issue. Furthermore, the government should invest in healthcare by hiring more physicians and providing better supplies and improving infrastructure, especially in underdeveloped areas, to decrease child mortality due to lack of clean water and poor hygiene. Lastly, telemedicine should be made common in order to provide easy access to women who cannot visit the hospital.
  19. Bhattacharya S, Singh A, Semwal J, Marzo RR, Sharma N, Goyal M, et al.
    PMID: 32154300 DOI: 10.4103/jehp.jehp_423_19
    INTRODUCTION: Disaster can occur at any time any place. Disaster preparedness plays an important role to reduce the loss of a community/country. The aim of this interventional study was to ascertain the impact of a video-based educational intervention program on improvement in knowledge and attitude of paramedical students in a hospital.

    MATERIALS AND METHODS: A pre-post study (interventional study design) was conducted on paramedic students. Our study period was 6 months which was divided into Phases I, II, and III. For administrative purpose, we included all paramedical students, and our sample size was 119. The baseline assessment of knowledge and attitude of paramedic students was done by a pretested questionnaire (Observation 1) with having a baseline scoring. After that, intervention Phase 1 was implemented, and later, end line observation (Observation 2) was made. Changes in knowledge and attitude were observed by the score difference (Observation 2-Observation 1). Descriptive statistics were calculated, and the mean of cumulative score was compared using the Wilcoxon signed-rank test. We applied Mann-Whitney U-test for finding associations between dependent variables with an independent variable using SPSS version 22 (IBM, Chicago, USA) software.

    RESULTS: Our baseline results showed that most of our participants had average knowledge (54.6%), followed by poor knowledge (24.4%). Approximately one-fifth (21.0%) of the participants had good knowledge regarding disaster preparedness. A significant improvement was observed in cumulative score (P < 0.005). A significant difference was observed in knowledge and attitude with respect to age and courses (P < 0.05). Forty percent of the students responded that they would like to get trained by that mock drill, and 26.1% were interested in disaster preparedness workshops in the future.

    CONCLUSION: Our present study results indicate that the overall knowledge and attitude level of the students was average and required improvement. A similar result was reported in some studies conducted globally for the same purpose. All of our students perceived that training for disaster preparedness is necessary for all health facilities, and it is important to have an emergency plan and disaster management committee. Regarding training methods, most of our students liked our interactive audiovisual method. However, their preferred methods were mock drill and workshops. It can be arranged in the future for them.

  20. Kamberi F, Sinaj E, Jaho J, Subashi B, Sinanaj G, Jaupaj K, et al.
    PMID: 34751254 DOI: 10.1016/j.cegh.2021.100824
    BACKGROUND: The COVID-19 pandemic impacted health care workers in many ways including mental health. This impact is usually underestimated in particular in developing countries.

    OBJECTIVES: The study aims to assess the level of anxiety, depression, risk perception, and coping strategies of Albanian healthcare workers during the COVID-19 pandemic and to identify associated factors.

    METHODS: A cross-sectional online study was conducted from April to May 2020 by recruiting health care personnel through the snowballing method. Data collection was carried out through social media using the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9) by Google forms. Participants were recruited from all health care sectors including doctors, nurses, etc. working in both the public and private sectors.

    RESULTS: 410 questionnaires were included in the analysis. Most participants were nurses (59.3%), female (78.5%), and belonged to the age group 26-40 years (46.3%). Mild levels of anxiety were expressed in 26.9% of participants while 7.2% of them expressed moderate levels. 23.1% and 12.1% of participants expressed respectively mild and moderate depression levels. High levels of risk perception were found. A statistical association was found between occupation (p = 0.011), gender (p = 0.031), providing care for COVID-19 patients (p = 0.011), and the availably of mental health support in the workplace. Poor coping strategies were reported among participants.

    CONCLUSIONS: Mental health support should be a priority of the healthcare system in particular for young health care workers caring for COVID-19 patients. It can improve the mental health status of health care workers and their family members, impacting the quality of care provided.

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