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  1. Ullah I, Hassan W, Tahir MJ, Ahmed A
    J Med Virol, 2021 Oct;93(10):5689-5690.
    PMID: 34143897 DOI: 10.1002/jmv.27134
  2. Ullah I, Khan KS, Tahir MJ, Ahmed A, Harapan H
    Vacunas, 2021;22(2):93-97.
    PMID: 33727904 DOI: 10.1016/j.vacun.2021.01.001
    The current coronavirus disease 2019 (COVID-19) pandemic is one of the international crises and researchers are working collaboratively to develop a safe and effective COVID-19 vaccine. The World Health Organization recognizes vaccine hesitancy as the world's top threat to public health safety, particularly in low middle-income countries. Vaccine hesitancy can be due to a lack of knowledge, false religious beliefs, or anti-vaccine misinformation. The current situation regarding anti-vaccine beliefs is pointing towards dreadful outcomes. It raises the concern that will people believe and accept the new COVID-19 vaccines despite all anti-vaccine movements and COVID-19-related myths and conspiracy theories. This review discusses the possible detrimental impacts of myths and conspiracy theories related to COVID-19 and vaccine on COVID-19 vaccine refusals as well as other vaccine programs.
  3. Masood I, Tahir MJ, Naeem A, Shrateh ON, Ahmed A
    Trop Med Health, 2023 Nov 14;51(1):62.
    PMID: 37957782 DOI: 10.1186/s41182-023-00559-z
    Congo virus, or Crimean-Congo hemorrhagic fever (CCHF), is a tick-borne disease caused by a single-stranded RNA virus (genus nairovirus, Bunyaviridae family). It spreads through infected ticks' bites or contact with viremic individuals or livestock. Factors supporting its spread include hot, humid climates, limited pesticide use, poor animal control, inadequate irrigation during monsoons, and vector control deficiencies. Nosocomial transmission in under-resourced hospitals poses a threat to healthcare workers. Decades of CCHF cases persist in Pakistan due to these factors, with six deaths reported by June 2023. To combat the epidemic, Pakistan should raise awareness, improve irrigation, establish surveillance systems, and implement livestock quarantine and vaccination.
  4. Sawal I, Ahmad S, Tariq W, Tahir MJ, Essar MY, Ahmed A
    J Med Virol, 2021 09;93(9):5228-5230.
    PMID: 33942326 DOI: 10.1002/jmv.27031
  5. Tahir MJ, Sawal I, Essar MY, Jabbar A, Ullah I, Ahmed A
    Infect Control Hosp Epidemiol, 2022 Nov;43(11):1758-1759.
    PMID: 34308811 DOI: 10.1017/ice.2021.342
  6. Khan MA, Tahir MJ, Ameer MA, Nawaz RA, Asghar MS, Ahmed A
    Public Health Pract (Oxf), 2022 Dec;4:100298.
    PMID: 36570398 DOI: 10.1016/j.puhip.2022.100298
    This paper focuses on the trends of self-medication practices in treating symptoms that may lead to fatal complications in dengue. As dengue is a viral infection with increasing incidence, decision regarding its treatment is mostly affected by public health believes and practices to self-treat the condition by different home remedies, over-the-counter (OTC) drugs or using outdated prescription drugs that proved beneficial in the past experience. Poverty, lack of education, and poor access to health facilities pave the way for making such decisions. Future complications can be averted by raising awareness, counseling the patients and dispensing of pharmaceuticals with strict monitoring.
  7. Fawzy NA, Tahir MJ, Saeed A, Ghosheh MJ, Alsheikh T, Ahmed A, et al.
    Eur J Radiol Open, 2023 Dec;11:100530.
    PMID: 37920681 DOI: 10.1016/j.ejro.2023.100530
    RATIONALE AND OBJECTIVES: Burnout among physicians has a prevalence rate exceeding 50%. The radiology department is not immune to the burnout epidemic. Understanding and addressing burnout among radiologists has been a subject of recent interest. Thus, our study aims to systematically review studies reporting the prevalence of burnout in physicians in the radiology department while providing an overview of the factors associated with burnout among radiologists.

    MATERIALS AND METHODS: The search was conducted from inception until November 13th, 2022, in PubMed, Embase, Education Resources Information Center, PsycINFO, and psycArticles. Studies reporting the prevalence of burnout or any subdimensions among radiology physicians, including residents, fellows, consultants, and attendings, were included. Data on study characteristics and estimates of burnout syndrome or any of its subdimensions were collected and summarized.

    RESULTS: After screening 6379 studies, 23 studies from seven countries were eligible. The number of participants ranged from 26 to 460 (median, 162; interquartile range, 91-264). In all, 18 studies (78.3%) employed a form of the Maslach Burnout Inventory. In comparison, four studies (17.4%) used the Stanford Professional Fulfillment Index, and one study (4.3%) used a single-item measure derived from the Zero Burnout Program survey. Overall burnout prevalence estimates were reported by 14 studies (60.9%) and varied from 33% to 88%. High burnout prevalence estimates were reported by only five studies (21.7%) and ranged from 5% to 62%. Emotional exhaustion and depersonalization prevalence estimates were reported by 16 studies (69.6%) and ranged from 11%-100% and 4%-97%, respectively. Furthermore, 15 studies (65.2%) reported low personal accomplishment prevalence, ranging from 14.7% to 84%. There were at least seven definitions for overall burnout and high burnout among the included studies, and there was high heterogeneity among the cutoff scores used for the burnout subdimensions.

    CONCLUSION: Burnout in radiology is increasing globally, with prevalence estimates reaching 88% and 62% for overall and high burnout, respectively. A myriad of factors has been identified as contributing to the increased prevalence. Our data demonstrated significant variability in burnout prevalence estimates among radiologists and major disparities in burnout criteria, instrument tools, and study quality.

  8. Tahir MJ, Saqlain M, Tariq W, Waheed S, Tan SHS, Nasir SI, et al.
    BMC Public Health, 2021 09 26;21(1):1759.
    PMID: 34565351 DOI: 10.1186/s12889-021-11814-5
    BACKGROUND: While vaccine development is itself a challenge; ensuring optimal vaccine uptake at population level can present an even more significant challenge. Therefore, this study aimed to assess the Pakistani population's attitude and preferences towards the Coronavirus disease 2019 (COVID-19) vaccine.

    METHOD: A cross-sectional study was carried out through an online self-administered questionnaire from 27 September 2020 to 11 October 2020. A total of 883 people responded to the survey. The questionnaire included the participants' socio-demographic variables, attitudes, beliefs towards the COVID-19 vaccine and acceptance and rejection of vaccination, and reasons for them. Logistic regression analysis was used to analyze the predictors for vaccine acceptance and willingness to pay for the vaccine.

    RESULTS: A majority (70.8%) of respondents will accept the COVID-19vaccine if available, and 66.8% showed a positive attitude towards vaccination. Monthly family income, education level, self-diagnosis of COVID-19 or a friend, family member, or colleague are significant factors influencing the acceptance of COVID-19 vaccination. The dogma of being naturally immune to COVID-19 was a key reason for the refusal of the vaccine. Less than half (48%) of those who refuse will vaccinate themselves if government officials have made it compulsory. A third (33.9%) of participants were willing to pay up to (7 USD) 1000 Pkr (Pakistani Rupees) for the vaccine.

    CONCLUSION: The population's positive attitude should be improved by increasing awareness and eradicating false myths about vaccines through large-scale campaigns.

  9. Jamil H, Din MFU, Tahir MJ, Saqlain M, Hassan Z, Khan MA, et al.
    PLoS Negl Trop Dis, 2022 Dec;16(12):e0010988.
    PMID: 36480553 DOI: 10.1371/journal.pntd.0010988
    BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) continues to pose a serious threat to the fragile healthcare system of Pakistan with a continuous increase of morbidity and mortality. The present study aimed to assess the knowledge, attitudes, and practices regarding CCHF among general people who resided in Pakistan.

    METHODS: An online cross-sectional survey design was applied, and a convenience sampling technique was used to recruit 1039 adult people from Pakistan. Data were collected from September 08 to October 12, 2021. The questionnaire consisted of a total of 32 questions in four parts assessing socio-demographics, as well as knowledge, attitudes, and practices regarding CCHF. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS), and logistic regression analyses were performed to determine the factors associated with good knowledge, positive attitudes, and good practices.

    RESULTS: Alarmingly, 51.5% of participants heard about CCHF infection before administering the survey. Among these, 20.2%, 33.3%, and 48.2% of the study participants had demonstrated good knowledge, positive attitudes, and good practices, respectively. Binary logistic regression analysis revealed that education and income status had a significant impact on knowledge and attitudes (p<0.05). Similarly, the mean attitude scores differed significantly by age, education, and income status (p<0.05).

    CONCLUSIONS: The findings reflected inadequate levels of knowledge, attitudes, and practices regarding CCHF among general people in Pakistan which may regard as lower than expected. As CCHF is a highly contagious disease, it's urgent to initiate a comprehensive approach to handle the situation before it spreads further in Pakistan.

  10. Rehan ST, Khan Z, Abbas S, Imran L, Munir S, Tahir MJ, et al.
    J Dermatol, 2023 Feb;50(2):166-174.
    PMID: 36412248 DOI: 10.1111/1346-8138.16637
    Acne vulgaris is the eighth most common disease worldwide and presents with inflammatory and noninflammatory skin lesions along with other dermal abnormalities. Oral spironolactone is used for treating acne vulgaris due to its antiandrogenic properties and inhibition of sebogenesis. Recent evidence shows that spironolactone in topical form has similar efficacy to its oral form with comparatively fewer adverse events associated with its use. However, to establish an evidence-based understanding, this systematic review aims to investigate the efficacy and safety of topical spironolactone in the treatment of acne vulgaris. PubMed, ClinicalTrials.gov, Cochrane library, and Google Scholar were comprehensively searched from the date of inception till March 18, 2022 All the clinical trials experimenting with the role of topical spironolactone in the treatment of acne were included. Articles examining the effects of oral spironolactone or other topical agents were excluded. The Cochrane risk of bias assessment tool (RoB 2.0, version 2019) was used to assess the risk of bias in each study. The study findings have been reported in line with PRISMA 2020 guidelines. The literature search yielded 600 articles. Five clinical trials with 195 patients were included in this review. Out of the five trials, two showed a high risk of bias while three had overall some concerns. Patients treated with topical spironolactone showed a significant decrease in the number of papules (p = 0.004), closed comedones (p  0.05). Topical spironolactone yields better results than other first-line treatments for acne and displays fewer side effects. However, further large-scale clinical trials are required before spironolactone can be used as the preferred treatment in the clinical management of acne.
  11. Tahir MJ, Zaman M, Saffi J, Asghar MS, Tariq W, Ahmed F, et al.
    Front Public Health, 2023;11:1151936.
    PMID: 37333546 DOI: 10.3389/fpubh.2023.1151936
    Typhoid fever, a common enteric disease in Pakistan, caused by Salmonella typhi, is becoming an extended drug-resistant organism and is preventable through the typhoid conjugate vaccine (TCV). Public adherence to preventive measures is influenced by knowledge and attitude toward the vaccine. This study investigates the knowledge, attitudes, and practices of the general population of Pakistan toward TCV. The differences in mean scores and factors associated with typhoid conjugate vaccine knowledge, attitudes, and practices were investigated. A total of 918 responses were received with a mean age of 25.9 ± 9.6, 51% were women, and 59.6% had graduation-level education. The majority of them responded that vaccines prevent illness (85.3%) and decrease mortality and disability (92.6%), and typhoid could be prevented by vaccination (86.7%). In total, 77.7 and 80.8% considered TCV safe and effective, respectively. Of 389 participants with children, 53.47% had vaccinated children, according to the extended program on immunization (EPI). Higher family income has a higher odds ratio (OR) for willingness toward booster dose of TCV [crude odds ratio (COR) = 4.920, p-value <0.01; adjusted odds ratio (aOR) = 2.853, value of p <0.001], and negative attitude regarding the protective effect of TCV has less willingness toward the booster dose with statistical significance (COR = 0.388, value of p = 0.017; aOR = 0.198, value of p = 0.011). The general population of Pakistan had a good level of knowledge about the benefits of TCV, and attitude and practices are in favor of the usage of TCV. However, a few religious misconceptions are prevalent in public requiring the efforts to overcome them to promote the usage of vaccines to prevent the disease and antibiotic resistance.
  12. Jamil H, Idrees M, Idrees K, Tariq W, Sayyeda Q, Asghar MS, et al.
    PLoS One, 2023;18(8):e0279952.
    PMID: 37561764 DOI: 10.1371/journal.pone.0279952
    BACKGROUND: Monkeypox (mpox), re-emerging zoonotic infectious disease, is striking the world with serious public health concerns, especially in non-endemic countries. The public's knowledge and attitude towards the monkeypox virus (MPXV) influence their adherence to preventive strategies. Therefore, we aimed to assess the public's knowledge, attitudes, and perceptions (KAP) of MPXV in Pakistan.

    METHODS: We collected data for this cross-sectional study from 1040 participants via online self-reported questionnaire from July 5th, 2022, to August 1st, 2022. The questionnaire consisted of a total of 29 items in four sections, assessing socio-demographics, knowledge, attitudes, and practices regarding MPXV. The data were analyzed using IBM SPSS V.25, and factors associated with MPXV knowledge, attitude, and practices were identified by using logistic regression analyses.

    RESULTS: A total of 1040 participants were included. 61.4% were male, and 57.2% had graduation level education. Only 34.4% had good knowledge about MPXV, and 30% knew the effectiveness of the smallpox vaccine against MPXV. 41.7% had a positive attitude, 48.6% agreed that it is a fatal disease, and 44.6% were in favour of banning travel from endemic to non-endemic regions. 57.7% had good practices, and 69.9% would use protective measures if MPXV became an epidemic. Binary logistic regression analysis revealed that gender and education significantly impacted knowledge (p<0.05). While monthly income status had a significant impact on attitudes (p<0.05). The practices were positively correlated with gender and education (p<0.05).

    CONCLUSION: The majority of study participants had inadequate levels of knowledge, and attitudes regarding MPXV. To prevent the emergence and spread of MPXV in Pakistan, a comprehensive strategic framework for public health education must be established and implemented.

  13. Hussain HU, Kumar KA, Rehan ST, Khan Z, Hashmi MR, Khabir Y, et al.
    Ann Med Surg (Lond), 2023 Nov;85(11):5584-5592.
    PMID: 37915701 DOI: 10.1097/MS9.0000000000001242
    BACKGROUND: HIV makes up a large portion of infectious diseases globally. People injecting drugs in prisons are at high risk for contracting HIV infection. Prisons house ~10.2 million people globally, making them a high-risk setting for HIV transmission. This systematic review summarizes the available data on the odds of developing HIV infection among imprisoned people who inject drugs (PWIDs) in Asian regions.

    METHODS: The authors electronically assessed published studies from January, 2000 to December, 2022, including studies that investigated the odds of HIV in imprisoned PWIDs. We extensively searched PubMed, ERIC, and Cochrane Central and Google Scholar with no constraints in language or time. All the observational studies evaluating the chances of HIV in Asian prisoners with an exposure group of PWIDs and a control group of non-injecting-drug users were included in our analysis.

    RESULTS: The databases search yielded 254 potential studies, 10 observational studies of which having a total of 17 333 participants were included. A low or moderate risk of bias was reported in all the studies except one case-control. The pooled analysis showed a significant association between PWIDs and the chances of contracting HIV infection (Odds ratio=6.40; 95% CI=3.89-10.52; P<0.00001; I2=53%).

    CONCLUSION: This study found a vital correlation between injecting-drug usage during imprisonment and HIV transmission speed. The results of this meta-analysis support the need to prevent HIV and conducting treatment programs in high-risk settings like prisons.

  14. Tariq W, Asar MAT, Tahir MJ, Ullah I, Ahmad Q, Raza A, et al.
    Front Public Health, 2022;10:1036800.
    PMID: 36684982 DOI: 10.3389/fpubh.2022.1036800
    BACKGROUND: Telemedicine is the provision of healthcare services through information and communication technology with the potential to mobilize all facets of the health sector to prevent the spread of COVID-19, provide quality healthcare, protect patients, doctors, and the public from exposure to disease, and reduce the burden on the healthcare system. This study aims to identify knowledge, perceptions, willingness to use, and the impact of the COVID-19 pandemic on telemedicine awareness.

    METHODS: A cross-sectional study was conducted from 27 May 2020 to 17 June 2020 using the convenient sampling technique in the general population of Pakistan. Data were collected by designing an online questionnaire consisting of demographic information, knowledge, attitude perceptions, barriers, utilization, and the impact of the COVID-19 pandemic on telemedicine.

    RESULTS: Of the 602 participants included in the study, 70.1% had heard about telemedicine, 54.3% had a good understanding of the definition of "telemedicine," 81.4% had not used telemedicine in the past, 29.9% did not know that telemedicine was available before the COVID-19 pandemic, and 70.4% responded that the COVID-19 pandemic had changed their attitudes toward telemedicine. Gender (p = 0.017) and family income (p = 0.027) had a significant association with the perception of the benefits of telemedicine.

    CONCLUSION: The knowledge and usage of telemedicine are lacking due to inadequate awareness and technology. The need of the hour is to maximize the application of telemedicine to overcome the deficiencies of the healthcare system. Hence, it is essential to increase awareness through various means and develop an appropriate infrastructure to attain maximum benefits from telehealth services.

  15. Jatoi HN, Abbas S, Abbasi MS, Tauni MA, Ghazanfar S, Zafar Malick MD, et al.
    Ann Med Surg (Lond), 2022 Jun;78:103796.
    PMID: 35603097 DOI: 10.1016/j.amsu.2022.103796
    With the emergence of COVID-19 vaccines, individuals with comorbidities and immunosuppression require particular attention and should be prioritized for vaccination. However, the majority of vaccine clinical trials excluded people with comorbidities, resulting in a lack of data regarding vaccine efficacy in this demographic. Along with more inclusivity in clinical trials, reaching a definitive conclusion regarding vaccine efficacy in these patients is also crucial. In our review, we highlight the BNT162b2 vaccine safety and efficacy based on the limited number of clinical trials which included this demographic. We also provide vaccine considerations for individuals with cancer, autoimmune diseases, HIV, obesity, diabetes, organ transplant recipients and those undergoing maintenance haemodialysis to help them govern their decision regarding vaccine administration. In conclusion, further studies are required to alleviate any insecurities in patients with comorbidities regarding vaccination and it is recommended that patients are monitored post-vaccination to make sure sufficient immunity is achieved.
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