Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

BACKGROUND: Healthcare costs and poverty are significant barriers to achieving universal access to healthcare. Thus, Community-Based Health Insurance Schemes (CBHIS) are regarded as an influential instrument for providing access to healthcare. For this purpose, this study was carried out in order to assess the community’s Willingness to Pay (WTP) for CBHIS and its determinants among the residents of Lahore City.METHODS: A cross-sectional study was adopted during the period of May 2018 to August 2018 to conduct a standardized questionnaire survey among targeted population of Lahore. A total of 250 households from lower, middle and upper-middle-class areas were approached randomly from which 200 participated in the survey, rendering a response rate of 90.9%. Sample size was determined by using single population proportion formula assuming 5% margin of error and 95% Confidence Interval (CI). Moreover, multiple regression analysis, Pearson’s correlation and t-test were employed to determine relationships between different variables affecting WTP.RESULTS: Sixty-four percent of the respondents were willing to pay for CBHIS. Among the remaining thirty-six% of unwilling the community, income level (p< 0.05, CI=0.34 to 1.11) and education level (p< 0.05, CI=0.52-1.37) were significant predictors of WTP. Moreover, strong positive relation (p<0.05) between people’s awareness and WTP for CBHIS was witnessed. The findings further suggested that the larger population of the willing community was not willing to pay more than 5000 Rs annually.CONCLUSION: Henceawareness level of the community regarding the benefits of CBHIS is a major hindrance. The key policy priority is to increase the community’s awareness regarding the benefits of CBHIS and to increase willingness to pay rate among public.&nbsp

Selective lymphadenectomy in endometrial cancer: Retrospective analysis of morbidity and survival data at a tertiary care centre

Objective: To compare perioperative morbidity and survival data between patients with early-stage endometrial cancer who did or did not undergo selective lymphadenectomy.Methods: Retrospective analysis of 180 patients with early-stage endometrial carcinoma treated between 1999 and 2008 was performed in Aga Khan University Hospital, Karachi, Pakistan.Results: Data from 180 patients were analysed. The selective lymphadenectomy group contained 108 women (60%) and the no lymphadenectomy group contained 72 women (40%). The median number of lymph nodes removed was 9. The mean age and extent of disease, as assessed by staging, tumour size, myometrial invasion, and lymphovascular invasion were comparable between groups. Upstaging of the disease to stage 3 and 4 occurred in 11% of patients in the lymphadenectomy group. There were no significant differences in the medical or surgical complications between groups. At a median follow-up of 26 months, both groups had comparable survival (lymphadenectomy versus no lymphadenectomy: 34 versus 32 months). Similar survival was noted for patients who underwent the removal of more or less than 5 pelvic lymph nodes.Conclusion: Selective lymphadenectomy offers the advantage of improved surgical staging but no therapeutic benefit in terms of overall survival

Tabi‘at (Physis) - A Distinction of Unani Medicine

Certain theories lie at the core of Unani (Greco-Arab) system of medicine providing it a solid foundation. Of these, the prominent ones and widely known are temperamental and humoral theories. But, the one that outshines it from other pathies is the concept of Tab‘iat, which believes that every human body carries its real healer within itself and the role of physician is merely of a supporter. Tab‘iat is the supreme controlling power of the body that governs all body functions and for this purpose it requires some medium at different levels of body organization. These media are basically the structure and temperament of the organs concerned. In this paper, it is aimed to present a comprehensive concept about tab‘iat, its function and tools

Condition of Pakistan Wildlife during the COVID-19 Lockdown

Wildlife population helps to maintain the ecological balance of nature. In the past, wildlife population was decline rapidly. During COVID-19 lockdown, human activities are changed on large scale. This lockdown restrict the humans in their houses and these restrictions restored the climate and wildlife to a significant degree. In this situation, we analyzed the conditions of wildlife sector in Pakistan during COVID-19 lockdown. The environmental conditions like quality of air and water are improving and wildlife population also increases in this environment during this lockdown. This study shows some beneficial effects of COVID-19 lockdown on wildlife like enhancement in species diversity in less disrupted areas, reduction of landscape fear, reduction in road killing of wildlife and also reproductive success of raptors birds. Instead of, highlighted few beneficial impacts our study also explain some negative impacts of COVID-19 lockdown on wildlife. From the whole study we conclude that condition of Pakistan Wildlife during the COVID-19 Lockdown was favorable. Reduction in human disruption favorable for exotic species, they can increase their population. However, COVID-19 lockdown also caused interruption in the conservational activities for globally threatened species and also rise in illegal killing wild animals

Willingness to pay for improved drinking water facility in Samsani Khui, Johar Town, Lahore, Pakistan

Quality of drinking water is a universal problem specifically faced by many developing countries. Willingness to pay for improved drinking water facility of the people of a rural settlement, Samsani Khui, Johar Town in Lahore, Pakistan was assessed by questionnaire survey. This article intends to scrutinize the strong relation of these dynamics with willingness to pay by correlating them using chi square and multiple regression. Conferring to results, health status of the people of selected area revealed that 50% adults and 31.9 % children suffered from diarrhea within last 6 months. Education level of 48.6% people is middle school. Income of people lies between 5000-30,000 Rupees per month. People with poor health status held strong association with willingness to pay while low income level and low education level had weak association with willingness to pay. The highest and lowest value calculated are 53.969, -4.83, respectively and the mean ratio of willingness to pay was 1.835. The average willingness to pay calculated was between Rs. 1 to 5. This study depicted that various dynamics including health status, monthly income and education level of the people are the determinants of willingness to pay (WTP) for improved drinking water facility

Consumers' Adoption of Apparel Fashion: The Role of Innovativeness, Involvement, and Social Values

Fashion adoption is concerned with how consumers accept a prevailing style during a particular time. Fashion is accepted by the consumers and influences their behavior in many ways. It is one of the strongest drivers to influence and motivate their intention to buy and adopt new products. Either through advertisement and promotion of brands or through endorsement of celebrities, companies motivate consumers of different socioeconomic backgrounds to follow the new fashion trends and buy their products. The purpose of this study is to investigate the factors that compel consumers to adopt apparel fashion in Pakistan. It has been investigated that, how and why different factors i.e., Fashion innovativeness, Consumer innovativeness, Fashion involvement, Opinion leadership, and Status, influence consumers’ intention to adopt new apparel fashion and how that intention influence their actual fashion adoption. Total 500 questionnaires were distributed among the respondents in different places (i.e., shopping plazas or malls, public places such as bus stops, playgrounds, and inside the educational institutions, in the cities of Islamabad and Lahore, Pakistan. Out of the total, only 332 (66.4%) questionnaires were retrieved. The regression test and the model fit results using Structural Equation Modeling (SEM) analysis revealed that, except fashion innovativeness, and consumer innovativeness, the fashion involvement, opinion leadership and status of consumers positively influence their intention to adopt new fashion. However, Intention to adopt has no significant effect on the consumers’ actual adoption of fashionable clothes. The positive and negative effects are discussed accordingly. In the light of the results and findings, the implications and future research recommendations are also debated at the end.© 2014 The Authors. Copyright for this article is retained by the author(s), with first publication rights granted to the journal. This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).fi=vertaisarvioitu|en=peerReviewed

Morphometric analysis of soldier cast of Odontotermes obesus (Rambur) and Microtermes obesi (Holmgren) (Blattodea: Termitidae; Macrotermitinae) from three localities of Potohar region, Pakistan

A great diversity of termite species is found all over the world, among these 53 species are identified from Pakistan. The knowledge about morphological features in soldier cast of termites is proved to be a technical tool for taxonomy and identification. In the present studies, the morphometric variations of external morphology in soldier caste of Odontotermes obesus (Rambur) and Microtermes obesi (Holmgren) from three different areas i.e. Gujar Khan (A), Rawalpindi (B) and Islamabad (C) were studied. About 36 characters like body, thorax, abdomen, from head to mandible tip, head, pronotum, postmentum, mandible, antenna (scape, pedicle, flagellum), and legs parts were used for morphometric measurements. The data were statistically analyzed for significant differences in their mean, standard deviation, standard error, 95% confidence interval, coefficient of variability and analysis of variance. “Student t-test” was used for the comparison of mean values using Minitab version 16. The results of the present study revealed no significant differences among the population samples collected from various localities. However little variations were observed in a few characters like antennal segments (pedicle, scape) and legs (trochanter, tibia) among the soldier cast which are adaptive in nature to survive in the environment

Polymorphic noncoding region of GNRH1 gene in male patients with impaired fertility

Impaired male fertility is a multifactorial pathological condition and genetic contribution is up to 20%. Gonadotropin Releasing Hormone 1 (GNRH1) is associated with maturation of spermatozoa. We aimed to study genetic sequence of GNRH1 gene in azoospermia males. We collected 50 clinically diagnosed infertile males after the informed consent. DNA was extracted and primers were designed to amplify the exonic and exon/intron boundaries of exon 1 and exon 2 region of GNRH1 gene. The amplicons were sequenced and analyzed using bioninformatic tools. We have identified sequence variations at c.1325-131del.A, c.1325+40 T>G, c.1325+34T>G, c.1325+124 Ins. A, c.1325+126 Ins. A, c.1325+181T>G, c.1325+264 Ins.G and c.1325+269 Ins. A positions. Human Splicing Finder predicted that c.1325-131del.A, c.1325+34T>G, c.1325+124 Ins. A, c.1325+264 Ins.G and c.1325+269 Ins. A have impact on the splicing while c.1325+40 T>G, c.1325+126 Ins. A and c.1325+181T>G have relation with the splicing. The c.1325+40 reported in literature as rs2709608 but has no association with the male infertility. The c.1325+181T>G We could not find other variations in the literature therefore suggested to be novel. Our study suggests that intronic region of GNRH1 gene a highly variable in Pakistani infertile male patients and suggests to explore its correlation with the disease on a large scale

Prevalence of depression, anxiety and Quality of life among North Indian Polycystic ovary syndrome Women: Evidence from a prospective observational study

Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous gynaecological endocrine disorder characterized by clinical features including oligo-amenorrhea/ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. PCOS increases the risk of depression and anxiety which leads to poor quality of life. Aim of the study were to determine the prevalence of anxiety and depression among women suffering from PCOS and to determine the quality of life (QOL) in PCOS women.Methods: The study was prospective, observational, non-interventional and questionnaire-based. 192 women with PCOS voluntarily helped in filling the questionnaires consisting of questions using PHQ-9 for depression, GAD-7 for anxiety, SF-12 for general health and PCOSQ-50 for disease-specific domains. All data were recorded in pre-designed case record forms and analysis of data was done using different statistical methods.Results: Majority of PCOS women were either overweight or obese. Based on PHQ-9 20% of women was suffering with major depression and based on GAD-7, 25% with major anxiety. It is found that psychosocial and emotional domain and coping domain of PCOSQ-50 is significant in patients with major depression and major anxiety. Significant effects were seen on their general health as per SF-12 domain. Lack of physical exercise was found in 83% of women.Conclusions: PCOS is a complex disease which decreases the overall quality of life. Therefore, treatment of PCOS women should include psychological counselling along-with with medication, especially in obese PCOS women. Women should be educated with the benefits of lifestyle modification in PCOS

The Role of Lead Toxicity on Eruption Rate of Hypofunctional Incisors in Albino Wistar Rats

OBJECTIVES This objective of this study was to evaluate the role of a heavy metal- lead acetate in the eruption rate of hypo functional incisors in albino Wistar rats. METHODOLOGY An experimental study was done in animal house of Post Graduate Medical Institute, Lahore since March 2019 to March 2020. 34 adult albino Wistar rats were randomly divided into two groups (n=17 for each group) i.e., control and lead acetate group. Right mandibular incisors were selected for this study. Selected incisors were marked 1mm above the level of gingival papillae. The incisors were cut above this mark to make it hypo-functional. The readings were measured by digital Vernier caliper. This was considered as day 0. Incisors length was measured at day 0, 3, 6, 12 and 15 and eruption was calculated. The data was analyzed using SPSS version 22. RESULTS Eruption rate was similar throughout the study except last follow up. At the end of this study eruption of incisors in albino Wistar rats in control was 03.30±0.72mm, in lead 02.43±1.19mm. At day 15, the difference between control and lead group was statistically significant (p-value 0.033). CONCLUSION These results reveal that besides other causes of delayed tooth eruption excessive lead intoxication are also acausative factor of delayed tooth eruption