Alzheimer’s disease susceptibility in African American elders: a classification and regression tree (CART) analysis approach

Alzheimer's disease (AD) is increasingly prevalent, especially among African American older adults. Despite its widespread nature, accurate and timely diagnosis of AD remains challenging. Addressing the research gap in sociodemographic and cardiovascular risk factor research associated with AD in African American older adults, this study aimed to identify and analyze distinct subgroups within this population that are particularly vulnerable to AD, thereby contributing to the development of targeted interventions and healthcare strategies. This study employs a rigorous methodology utilizing classification and regression tree (CART) analysis to examine data from the 2017 Uniform Data Set (UDS). This approach enables a nuanced analysis of AD susceptibility among African American older adults. The CART analysis revealed significant associations between the studied sociodemographic and cardiovascular risk factors and AD susceptibility among African American older adults. The results indicate the presence of specific subgroups with increased vulnerability to AD, shaped by varying levels of education [relative importance (RI): 100%], antidepressant usage (RI: 83.1%), BMI (RI: 71.2%), use of antipsychotic agents (RI: 35.5%), and age of smoking cessation (RI: 21.5%). These findings underscore the importance of culturally specific research and interventions for addressing AD among African Americans. This study's findings, revealing significant associations between sociodemographic and cardiovascular risk factors and AD susceptibility among African American older adults, underscore the necessity of developing healthcare policies and interventions specifically tailored to address these risks

The economic cost of not practicing optimal breastfeeding: a review

Underfive child mortality is one of the world's most severe public health problems, and the developing world disproportionately bears the brunt of underfive child mortality. It is quite unlikely that developing countries will have sufficient resources, at least in the foreseeable future, to significantly reduce child mortality rates. Fortunately, optimal breastfeeding provides significant protection against child mortality, and it may well be the most practical policy intervention against child mortality in resource-constrained settings. However, the catch lies in the fact that despite the obvious benefits of breastfeeding, optimal breastfeeding is limited across the developing world. I have identified several causal mechanisms that contribute to nonoptimal breastfeeding practices. Additionally, I have drawn upon the literature that has estimated the economic cost of inadequate breastfeeding

A comparison of clinical and patient-reported treatment outcomes in chronic hepatitis C patients treated with direct-acting antivirals with and without cirrhosis: a prospective cohort study

Managing patients with chronic hepatitis C and progressive liver conditions poses significant challenges for healthcare professionals. This research sought to evaluate and compare the clinical outcomes and patient-reported treatment experiences of individuals with chronic hepatitis C, differentiating between those with and without cirrhosis, all of whom were receiving standard direct-acting antiviral (DAA) therapy. This prospective cohort study enrolled outpatients who were diagnosed with hepatitis C virus (HCV) infection and who were recruited from a major public tertiary care hospital. The participants received a standard 12-week antiviral regimen consisting of 400 mg of sofosbuvir (SOF) and 60 mg of daclatasvir (DCV) once daily, with or without ribavirin (RBV) at a dose of 400 mg taken two to three times daily. The primary outcome was the cure rate, which was defined as an undetectable viral load at the end of the 12-week treatment period. The secondary outcomes included patient-reported outcomes (PROs), such as health-related quality of life (HRQoL), which were measured via the EuroQol 5-Dimensions 3-Levels (EQ-5D-3 L) questionnaire, and work productivity loss, which was assessed via the Work Productivity and Activity Impairment (WPAI) questionnaire. A total of 300 participants were assessed, comprising 150 cirrhotic and 150 noncirrhotic patients. Group B (cirrhosis) had a greater proportion of treatment-experienced patients and elevated aspartate aminotransferase (AST) levels (48 ± 22 vs. 131 ± 165, p < 0.001), along with significantly lower platelet counts (p = 0.024). An end-of-treatment response (ETR) was observed in 92.7% of patients without cirrhosis, compared to a significantly lower rate of 52.7% in those with cirrhosis (p < 0.001). A significant increase in HRQoL was noted in both groups across all the EQ-5D-3 L domains (p < 0.001); however, patients with cirrhosis experienced relatively smaller improvements in the areas of pain/discomfort and anxiety/depression. A small subset of noncirrhotic patients showed no improvement in mobility (−0.59 ± 0.62). Regarding work productivity, both groups experienced substantial reductions in overall impairment (43.0% in noncirrhotic patients, 32.3% in cirrhotic patients), absenteeism, and activity limitations (p < 0.001). However, presenteeism increased slightly in both groups, suggesting a return to work with residual functional limitations. The study concluded that SOF-based regimens were highly effective in noncirrhotic patients, who showed greater improvements in virological response, quality of life, and work productivity. In contrast, cirrhotic patients demonstrated lower treatment response rates and smaller gains in patient-reported outcomes despite receiving similar therapies

Three-dimensional printing in medical education: transforming learning and practice!

Three-dimensional (3D) printing is revolutionizing medical education, particularly in surgical training, by transforming digital images into tangible models. These models, derived from patient radiological data, allow for enhanced anatomical understanding and hands-on learning. Studies have shown that 3D-printed models significantly improve medical students’ comprehension of complex anatomical structures and foster interest in specialized fields such as cardiology. Additionally, 3D printing offers cost-effective solutions for creating both normal and pathological models, which is particularly beneficial in resource-limited settings. While challenges remain, including material limitations and ethical considerations, 3D printing holds tremendous potential in advancing medical education globally

Exploring patterns of intimate partner violence during pregnancy through a descriptive lens

Globally, intimate partner violence (IPV) against women is a serious concern, with significant underreporting in Pakistan. This study aimed to explore the patterns of IPV among pregnant women in a Pakistani setting. An exploratory study using nonprobability purposive sampling recruited 363 pregnant women visiting for check-ups at Akbar Niazi Teaching Hospital, Islamabad. Participants were interviewed using a structured questionnaire developed from an extensive literature review and prior research. Data analysis was performed using SPSS, descriptive statistics, bar charts, and chi-square tests, with the significance threshold set at p < 0.05. The demographic analysis revealed that a majority of women (56.75%) were aged 20–29, whereas most husbands fell within the 30–39 age group (68.60%). Educational disparities were significant (p < 0.001), with 48.76% of women lacking formal education versus 34.16% of their husbands having higher secondary education or above. The working status highlighted economic dependency, with 91.74% of women not working. Over 61% of pregnancies were unplanned, with 32.28% of participants reporting contraceptive nonuse due to partner opposition. The most reported controlling behavior was the restriction of medical care access (63.36%). Psychological violence was prevalent (25.07% reported humiliation or intimidation), while physical violence was less common (4.96% experienced object throwing). Sexual violence instances were comparatively rare, with 2.75% reporting nonconsensual sexual relations. This study underscores significant sociodemographic and economic disparities affecting pregnant women's exposure to IPV, with psychological violence emerging as the leading form of IPV experienced during pregnancy. These findings underscore the necessity for targeted interventions to improve healthcare access and support pregnant women's autonomy and well-being amidst IPV challenges

Understanding the value, perceptions, and challenges of research among pharmacy undergraduates in Jamshoro, Sindh

Pharmacy education is evolving worldwide to meet the changing role of pharmacists in providing pharmaceutical care services. Engagement in undergraduate research helps students develop analytical and critical thinking skills that are crucial for their future careers. It is essential to equip pharmacy students with the necessary knowledge, skills, and motivation to engage in research and apply innovative findings to clinical practice. Therefore, this study was conducted to determine the value of research among undergraduate pharmacy students and to understand their perceptions of its importance and challenges. The study was conducted over three months and involved 384 students from two different public sector universities in Jamshoro, Sindh. A convenient sampling technique was used, and data were collected from fourth- and final-year students at the targeted universities. The results of the study revealed that 53.39% of the participants were male and 46.61% were female. A total of 78.65% were between the ages of 21 and 23 years, with 54.69% from urban areas and 39.06% from rural areas. Of the 384 students, 96% considered research valuable, while 85% disagreed with the notion that research is theoretical and has no benefit for the common person. Moreover, 67% of the students considered publishing in a peer-reviewed journal to be a good source of recognition. Regarding the benefits of research, 41% of students strongly agreed that it boosts their professional profile, while 37% strongly agreed that it helps in a pharmacy career. This study revealed that undergraduate students generally possess a good level of knowledge and understanding of research and recognize its future advantages. Moreover, many students expressed a strong interest in participating in undergraduate research projects, although they also identified challenges such as the need for supervision and resources. These findings suggest that there is potential for increased research engagement among students if the research environment is enhanced. Therefore, there is a need for academicians and policymakers to consider ways to support and improve the research opportunities and infrastructure for undergraduate students in universities

Parent-reported health-related quality of life of children with cerebral palsy in Pakistan

Cerebral palsy (CP) affects movement, balance, and posture, leading to activity limitations, motor disability, and musculoskeletal problems. Health-related quality of life (HRQoL) assessment is critical in helping practitioners suggest interventions for children with CP. Therefore, this study was conducted to determine the parent-reported HRQoL among children with CP in Pakistan. Using a purposive sampling technique, 184 parents were interviewed face-to-face with the KIDSCREEN-52 questionnaire to assess their children's subjective health and well-being. The data were analyzed using descriptive statistics, chi-square, and Mann‒Whitney tests. The HRQoL scores for physical activity and health were significantly lower for male children (median = 20.00) than for females (median = 10.00) (p < 0.001), which was also the lowest across all other dimensions of HRQoL. Male children scored higher than females in some domains, such as general mood and bullying, while female children scored higher in domains such as free time and friends, but these differences were not statistically significant (p > 0.05). The overall HRQoL score was low for both male (median = 43.84) and female (median = 42.26) children. However, there was no significant difference in the proportion of children with low and medium HRQoL scores based on gender. This study concluded that physical activities and health were the poorest dimensions of HRQoL. The results help better understand children's lived experiences as perceived by their parents, highlighting various aspects of health that could be optimized to enhance the overall quality of life. Our findings highlight the need for targeted interventions to improve the HRQoL of children with CP, especially regarding physical activity and health

Understanding antibiotic use and resistance: knowledge, attitudes, practices, and training needs of paramedical students

The inappropriate and overuse of antibiotics is considered the main source of antimicrobial resistance (AMR). Therefore, this study aimed to assess the knowledge, attitudes, and practices of antibiotic use and resistance among paramedical students. In addition, the study also assessed the perceptions, knowledge gaps, and educational needs of paramedical students regarding antibiotic use, resistance and related training. This descriptive cross-sectional study was conducted at Khyber Medical University by recruiting 500 students from twelve different paramedic disciplines. The self-administered questionnaire was distributed online through email and WhatsApp, resulting in 364 completed responses and a response rate of 72.8%. The study revealed that 41.21% of paramedic students were using antibiotics without a prescription, 23.63% admitted that they discontinued their prescribed antibiotic course once they felt better, 95.88% recognized the term ‘antibiotics’, and 79.67% acknowledged that inappropriate use contributed to resistance. A sex comparison revealed that male students (81.32%) were significantly more likely to complete their prescribed antibiotic courses than their female counterparts were (67.29%) (p = 0.002). This study identifies gaps in paramedical students' knowledge, attitudes, and practices related to antibiotic use and resistance. Despite a general awareness of key concepts, misconceptions and improper practices were also common. Therefore, there is a dire need to upgrade the curriculum and implement integrated modules on antibiotic stewardship, infection control, and responsible antibiotic use, which could enhance students' knowledge, enable them to make informed decisions, and contribute significantly to combating antibiotic resistance

Maternal awareness and misconceptions about genetic disorders: a cross-sectional study among mothers of affected children at PIMS Hospital, Islamabad

Genetic disorders impose a considerable health burden in low- and middle-income countries, where high consanguinity rates, limited access to services, and low health literacy intensify their impact. This study assessed awareness, knowledge, and misconceptions about genetic disorders among mothers of affected children at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, and examined associated sociodemographic factors. A cross-sectional survey was conducted from April to May 2025 among 100 mothers of children with confirmed genetic disorders via a structured, interviewer-administered questionnaire. The mean participant age was 31.13 ± 6.06 years; 36% were illiterate, and 52% resided in urban areas. While 78% had heard of genetic disorders, only 18% knew of local genetic testing or counseling services, and 24% had received information from healthcare providers. Good awareness was seen in 16% and poor awareness in 78% of the participants; good knowledge was found in 25%, while 66% had poor knowledge. Misconceptions persisted, with 21% attributing genetic disorders to bad luck or punishment and 16% believing they were contagious; 38% demonstrated good understanding, and 46% demonstrated poor understanding. Education and socioeconomic class were significantly associated with awareness (p = 0.011, p = 0.001), knowledge (p < 0.001, p = 0.002), and beliefs (p < 0.001, p < 0.001), whereas age and residence were not significantly associated. The findings highlight a gap between general awareness and functional understanding, emphasizing the need for targeted, literacy-sensitive interventions to improve maternal genetic health literacy and support informed healthcare decision-making

The role of fitness trainers in combating sedentary lifestyles

The role of fitness trainers is crucial in reducing the burden of noncommunicable diseases (NCDs) associated with physical inactivity and sedentary lifestyles. The importance of regular physical activity in improving general health outcomes is widely acknowledged worldwide. Despite this fact, one-third of adults and four-fifths of adolescents still do not adhere to these recommendations. In Pakistan, the role of fitness trainers in disease prevention is highly relevant where NCDs such as diabetes are highly prevalent. Unfortunately, the fitness industry is one of the neglected industries of Pakistan with limited professional growth opportunities, uncertain career paths, low pay employment, and a shortage of certified fitness trainers who can barely meet the community’s healthcare needs in combatting sedentary lifestyles. To maximize the impact of this industry, there is a dire need for stronger partnerships between fitness professionals and healthcare service providers, in addition to the integration of disease management and preventive health training modules into certification programs. Thus, fitness trainers equipped with the required skill sets can play a significant role in improving the public health outcomes of the general population