Following the announcement of Traditional and Complementary Medicine Act 2013, Muslim faith healers are slowly gaining grounds to make their practice mainstream. One of the major characteristics of Muslim faith healers is the strong inclination to attribute mental illnesses to Jinn possession (demonic possession). Unlike other traditional healers, Muslim faith healers’ primary mode of treatment is Ruqyah, an incantation or generally considered as ‘Du’a or prayers. This article is a sharing by a psychiatrist who has been actively engaging with faith healers in order to understand the world of faith healing including the attitude and knowledge of both the healers and clients while attempting to educate them on modern psychiatry based on bio-psycho-socio-spiritual paradigm. The methodology: 1) Involvement in symposium, seminar and focused group discussion, either as participant or as speaker. 2) Collaborating with local spiritual leader to conduct workshop on mental illness in mosques. 3) Writing articles in scientific and popular publications with and without faith healers as the collaborators. 4) Appearing in radio advocating and discussing about the dilemma of mental illness issue from the religious perspectives, and 5) Participate in workshop conducted by Muslim faith healers. As a result, several issues come to the author’s attention. The divisions of Muslim faith healers are rather complicated, for example Malay traditional healers or bomoh should not be categorized in the same group as Muslim faith healers. The oft-quoted ‘Islamic Medicine’ is problematic in view that it is laced with elements of local cultural value and practice which are not necessarily authentically Islamic. Since Malays make up the biggest community in Malaysia, one has to differentiate between Islam and Muslim. Majority of Muslims misunderstood the term Ruqyah as a form of healing exclusively done by the Muslim faith healers. In conclusion, psychiatrists should engage more proactively with faith and spiritual healers in order to curb stigmatization and delay in seeking psychiatric care and treatment.
The current study aims to explore the knowledge, attitude, and perception of hospital pharmacists towards HIV/AIDS and patients living with HIV/AIDS (PLWHA) in the state of Kedah, Malaysia.
Use of non-prescription antibiotics can portend danger and predispose the populace to changes in bacterial resistance pattern. The aims of this study were to (a) evaluate the knowledge and attitudes of residents of Al-Ahsa community, Saudi Arabia on the use of non-prescribed antibiotics. (b) To identify possible predictors (if any) for self-medication within the community. A cross-sectional survey study, using self-administered questionnaire was conducted in two sections; demographics and self-medication attitude (in form of self-antibiotic use). Questions contained the following outcomes; for demographics; gender, age, education level and common disease within the community. Whereas the second part evaluated sources of information, knowledge of antibiotics, frequency/duration of use, underlined illness in which drug use was employed, names of antibiotics used and awareness of adverse effects of antibiotics. Results revealed that the adult population in the 18-40 year age range constituted about 82.5% of the respondents. Also 18-29 age group made of 60.5% of the respondents and that 56.8% the respondents are university graduates. Cold (18.8%) and sore throat (13.0%) were the diseases commonly found among the community that drove them to using non-prescribed antibiotics. About 337 (72.8%) of the respondent mention the use of antibiotics to treat the illness, and 21 (4.5%) were aiming to prevent the illness. While, 19.4% of the respondents admitted to taking non-prescribed antibiotics for both prevention and treatment of illness. 43.6% of the respondents disclosed that they are not aware of the dangers of using non-prescribed antibiotics. In conclusion the use of non-prescribed antibiotics in this community is evident, as a significant number use them from previous experience for prevention and treatment of illness. Therefore introduction of rational use of drugs will help in limiting the attendant development of bacterial resistance.
OBJECTIVE: The aim of this study was to assess the patients' knowledge and awareness of sexually transmitted infections (STIs).
SUBJECTS AND METHODS: A face-to-face interview was conducted among the patients visiting the Venereal Diseases Outpatient Department of the General Hospital of Pulau Pinang (Malaysia). A 19-item questionnaire was used. A total of 116 patients participated in the study and 107 patients had valid responses. The reliability and internal consistency of the questionnaire tool was estimated on the basis of Cronbach's alpha (= 0.81). The Statistical Package for Social Sciences (SPSS 13.0(R)) was used for data analysis. Student's t test and analysis of variance were used to analyse the knowledge differences among the groups.
RESULTS: Of the 107 patients, 82 (76.6%) were diagnosed with syphilis; AIDS was the most commonly known STI among the patients. Of the 107 patients, 35 were sexually active and of these 23 (65.7%) had more than 1 sexual partner. The most popular source of knowledge was newspapers (51 patients, 47.7%), with hospitals (3 patients, 2.8%) being the least popular one. Overall mean score on knowledge questions was 12.21 out of the maximum of 33 points. Knowledge about causative organisms, risk groups, transmission, symptoms, prevention and treatment of STIs was inadequate. The knowledge level was significantly related to gender (p = 0.03), religion (p = 0.005), educational level (p = 0.000), marital status (p = 0.000) and income level (p = 0.036).
CONCLUSION: This study demonstrated evidence of poor knowledge of STIs amongst the patients attending an STI service in the General Hospital of Pulau Pinang (Malaysia). Hence there is an immediate need for efforts towards improving patient knowledge of STIs.
Study site: Venereal Diseases Outpatient Department, General Hospital Pulau Pinang, Malaysia
Background. The aim of the present study was to evaluate the knowledge and perception of depression among students of University Sains Malaysia (USM), in Penang, Peninsular Malaysia.
Method. Face-to-face interviews were conducted using a pre-validated 21-item questionnaire among students at USM.
Results. A total of 500 respondents participated in the survey comprising 24.6% (n=123) males and 75.4% (n=377) females. Half (50.0%, n=250) were Malays, followed by Chinese (44.0%, n=220) and Indians (6.0%, n=30). Whilst exploring the respondents' knowledge of the symptoms of depression, it was found that Chinese females had a comparatively better knowledge (P=0.058) of the symptoms of depression in comparison with Malays and Indians. Overall, social issues were attributed as the possible cause of depression. A cursory knowledge level was observed regarding medication for depression. Female students were more inclined towards the use of alternative and traditional medicines. However, with regard to seeking professional help, consultation with a psychiatrist was preferred by the majority.
Conclusion. Overall, a moderate level of knowledge about the symptoms of depression and a cursory knowledge of its therapy were observed. Those with personal experience of depression had better knowledge of the symptoms and therapy. Alternative treatments and traditional medicines were also favoured. There is a risk that this may affect the ability of Malaysian youths to seek evidence-based mental health care.
Constructing efficient structured materials for artificial photosynthesis of CO2 is a promising strategy to produce renewable fuels in addition of mitigating greenhouse effect. In this work, 2D porous g-C3N4 (PCN) coupled exfoliated 3D Ti3C2TA MXene (TiC) nanosheets with TiO2 NPs in-situ growth was constructed in a single step through HF treatment approach. The different exfoliated TiC structures were successfully synthesized for adjusting HF etching time (24 h, 48 h and 96 h). With growing etchant time from 24 to 96 h, the amount of TiO2 produced was increased, but it has adverse effects on CO and CH4 production rate. The maximum production rates for CO and CH4 of 317.4 and 78.55 µmol g-1 h-1 were attained when the 10TiC-48/PCN was employed than using TiC-24/PCN, TiC-96/PCN and PCN composite samples, respectively. The performance of 10TiC-48/PCN composite for CO and CH4 evolution were 9.9 and 6.7 folds higher than using pristine PCN sample, respectively. The possible mechanism is assigned to porous structure with intimate contact enabling efficient charge carrier separation with the role of TiO2 NPs to work as a bridge to transport electrons towards MXene surface. Among the reducing agents, water was favorable for CO evolution, whereas, methanol-water system promoted CH4 production. All these findings confirm that heterojunction formation facilitates charges separation and can be further used in solar energy relating application.
The increasing degradation of fossil fuels has motivated the globe to turn to green energy solutions such as biofuel in order to minimize the entire reliance on fossil fuels. Green renewable resources have grown in popularity in recent years as a result of the advancement of environmental technology solutions. Kapok fiber is a sort of cellulosic fiber derived from kapok tree seeds (Ceiba pentandra). Kapok Fiber, as a bio-template, offers the best alternatives to provide clean and renewable energy sources. The unique structure, good conductivity, and excellent physical properties exhibited by kapok fiber nominate it as a highly favored cocatalyst for deriving solar energy processes. This review will explore the role and recent developments of KF in energy production, including hydrogen and CO2 reduction. Moreover, this work summarized the potential of kapok fiber in environmental applications, including adsorption and degradation. The future contribution and concerns are highlighted in order to provide perspective on the future advancement of kapok fiber.
BACKGROUND: Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes.
METHODS: Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form.
RESULTS: Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 +/- 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022).
CONCLUSIONS: It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.
BACKGROUND: Smoking is a risk factor not only for the development of cancer and coronary heart disease but also for tuberculosis (TB). The aim of this study was to determine the prevalence of smoking in patients with TB, identify demographic and clinical characteristics associated with smoking and to evaluate TB treatment outcomes in the smokers.
METHOD: A retrospective cohort study of patients with TB was conducted at Khyber Teaching Hospital, Peshawar, Pakistan. All patients with pulmonary and extrapulmonary TB and those coinfected with HIV, hepatitis or diabetes mellitus were included in the study. The patients were categorized into smokers and nonsmokers. Treatment outcomes were evaluated by smear testing at the end of the treatment.
RESULTS: Of 472 enrolled subjects, 68 (14.4%) were smokers. The prevalence of smoking among male and female patients with TB was 11.8% and 2.5%, respectively. Univariate analysis indicated that the gender, age group and marital status of patients with TB were associated with smoking. The results indicated that patient gender (P = 0.05), age: 15 to 24 years (P = 0.05) and age >55 years (P = 0.004) were risk factors associated with smoking among TB patients. Of the 68 smokers with TB, the treatment outcomes among 54 patients (79.4%) were unsuccessful. The treatment outcomes was statistically significantly associated with smoking (odds ratio: 2.58, P = 0.004).
CONCLUSIONS: Findings from the current study proved smoking to be one of the main factors associated with the occurrence of TB and significantly reducing the outcomes of TB therapy.
The Kalasha are a religious, ethnic, and linguistic minority community in Pakistan. They are indigenous people living in remote valleys of the Hindu Kush Mountains in northern Pakistan, neighboring Afghanistan. The Kalasha are pastoral, as well as agricultural people to some extent, although they are increasingly facing pressures from globalization and social change, which may be influencing youth and community development. Their traditional world view dichotomizes and emphasizes on the division of the pure (Onjeshta) and the impure (Pragata). There remains a scarcity of literature on mental health and resilience of indigenous communities in South Asia and Pakistan generally, and the polytheistic Kalasha community specifically. Thus, the current study was conducted with the aim to explore the cultural protective factors (resilience) of the Kalasha youth (adolescents and emerging adults) and to explore their perceived etiological understandings and preferred interventions for mental health support systems. The theoretical framework of Bronfenbrenner's (1, 2) ecological systems model was used. Interpretative Phenomenological Analysis (IPA) was conducted, considering the advantage of its idiographic approach and the "double hermeneutic" analytic process. This methodology was consistent with the aim to understand and make sense of mental health and resilience from the Kalasha indigenous perspective. A total of 12 in-depth interviews were conducted with adolescents and emerging adults (5 males, 7 females), along with ethnographic observations. The analysis revealed 3 superordinate themes of mental health perceptions and interventions, each with more specific emergent themes: (1) Psychological Resilience/Cultural Protective Factors Buffering Against Mental Health Problems (Intra-Communal Bonding & Sharing; Kalasha Festivals & Traditions; Purity Concept; Behavioral Practice of Happiness and Cognitive Patterns); (2) Perceived Causes of Mental Health Issues (Biological & Psychosocial; Supernatural & Spiritual; Environmental); and (3) Preferred Interventions [Shamanic Treatment; Ta'awiz (Amulets); Communal Sharing & Problem Solving; Medical Treatment; Herbal Methods]. The overall findings point to the need for developing culturally-sensitive and indigenous measures and therapeutic interventions. The findings highlighted the Kalasha cultural practices which may promote resilience. The findings also call for indigenous sources of knowledge to be considered when collaboratively designing public health programs.
Influenza vaccination is strongly recommended by World Health Organisation on a yearly basis. The rate of immunization in Pakistan is suboptimal. High cost, traditional norms, customs and low levels of education in Pakistan are preventing people from getting vaccinated. It is timely to include influenza vaccination in the expanded programme on immunization (EPI), which is a disease prevention programme aiming to eradicate preventable diseases through subsidized or free immunization. The Ministry of National Health Services, Regulation and Coordination, Government of Pakistan should launch a national influenza vaccine policy in view of this current situation and oversee its implementation. Healthcare professionals should promote influenza vaccination and focus on high risk groups such as the elderly, pregnant women and children. Convincing and educating family members regarding immunization of pregnant women and follow-up with parents regarding a second influenza shot for their children will further improve vaccination rates in Pakistan.
BACKGROUND: Adverse Drug Reactions (ADRs) are a major public health problem. Prompt reporting of suspected ADRs is fundamental in the post-marketing surveillance of medicines and helps in ensuring medicine safety. However, fewer ADRs are reported in general and in particular by community pharmacists. There is limited knowledge about the factors which are preventing community pharmacists in the UK from reporting an ADR.
OBJECTIVES: To identify the barriers to ADR reporting among community pharmacists practicing in the UK.
METHODS: A cross sectional study using a 25-items questionnaire (both online and paper based) including 10 barriers to ADR reporting was conducted from 1st April 2012 to September 2012. Community pharmacists practicing in the West Midlands, UK, were approached for the participation in this study. Chi-Square and regression were applied to identify covariates for the barriers to ADR reporting. A significant value of 0.05 was assigned for analysis.
RESULTS: Of the 230 invited community pharmacists, 138 pharmacists responded (response rate 60%). The median age of respondents was 31 years. All pharmacists reported that they would report both serious and mild ADRs from drugs with black triangle among children as well as adults. About 95% (n=131) of the pharmacists were familiar with the paper based ADR reporting system. Store-based pharmacists were more likely to be more confident about which ADRs to report [0.680, 95% Confidence Interval 0.43-3.59]. Lack of time 46.4% (n=64), and pharmacists perception that ADR is not serious enough to report (65.2%; n=90) were identified as barriers to ADR reporting. Majority 63.0% (n=87) of the pharmacists identified training and information about what to report and access to Information Technology (IT) (For example access to internet connection) 61.6% (n=85) as facilitators to ADR reporting process.
CONCLUSION: Lack of time and ADRs considered not serious enough by pharmacists to report were barriers to ADR reporting. Further training and education about the types of ADRs to be reported can help to improve the reporting of ADRs.
The purpose of this study is to explore the behavior and lifestyle of individuals in response to the coronavirus that the safety behavior of people in the coronavirus disease of 2019 pandemic. Hence, the study integrates the theory of planned behavior and the health belief model to understand the behavioral change in response to the coronavirus pandemic. The current study is qualitative therefore, a survey-based online questionnaire was used for data collection from university students and staff (faculty and nonfaculty) residing in top-tier cities of Pakistan, nonprobability convenient sampling was used to approach the audience. A two-stage approach was used to test the model using partial least square (variance-based structural equation modeling). The reliability and validity of the measurement model indicate that the data is reliable and valid. Outcomes prove all the relationships as proposed by the study, except for the impact of perceived barriers on intention and individual safety behavior. Perceived barriers act as obstacles that abstain individuals from following the standard operating procedures. The research agenda provides new insights into the fields of marketing, health care, consumer behavior, and behavioral studies. It contributes to the existing literature in the field of social marketing by studying the behavior and changes in the behavior of people in the global pandemic.
Objective. This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.
Methods. A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.
Results. The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.
Conclusion. This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.