Refusal to autopsy: a societal practice in Pakistan context

Autopsies or post-mortem examinations have become a common practice in Western medicine for verifying the cause of death, and to obtain additional scientific information on certain diseases. In monotheistic religions autopsies present several ethical questions even though the advantages attributed to post-mortems in the West are well acknowledged by people living in this modern world. In Islamic Republic of Pakistan where Islam is the prevailing religion followed by the Muslims, Pakistani society have diverse perception, assumptions and hypothesis on the concept of autopsy. This presumption is due to presence of diverse objections raised in religious and sociocultural context. In our context, death ritual and practices are surrounded by religious and cultural beliefs and has a major influence on post mortem examination. Religious objections face a debate where the oppositions are in conflict with the laws. A definite and clear-cut answer is not possible based on Islamic beliefs nonetheless, for the advancement of medical science and betterment of humanity autopsies seems to be accepted

Impact of divorce on students’ life

Tensions and anxiety is the common phenomena among the students of modern generation. These students go through stress due to personal, psychosocial, familial and academic matters. Some of the common ones which substantially impact their lives like family disputes, academic challenges, parental conflicts, financial concerns, social isolation and interpersonal matters, parental separation and divorce, separation from family and reduced support system. Untiring conflicts between the parents weakens the lifelong marriage contract to the verge of break down where both the life partners determines to go for the option of divorce. This creates traumatic and nerve wracking atmosphere at home and the children are mostly affected by this decision and are torn between the parents. They undergo through persistent mental pressure which can have substantial physical, psychological, psychosocial impact on the student’s wellbeing as well as on their academic performance graph

Academic incivility in modern generation of nursing students

Incivility in nursing academia and workplace is one of the emerging and complex issues in recent years, and can have substantial consequences on the organizational benchmark as well as on the teaching and learning milieu of the institution. Growth of academic incivility among the modern and diversified generation of students can have a profound destructive impact on their academic life and professional career. Impolite and discourteous attitude and behavior in a classroom atmosphere can originate from the learners as well the teachers, which can significantly impact the critical thinking and learning outcomes of the learner. This matter needs to be addressed based on the institutional policy and standards so that professional leaders for tomorrow can be extracted from the current and upcoming generation

Verbal violence at workplace: A reality from Pakistani context.

Work place violence is the most distressing subject globally, and has been a concern for many decades affecting home and work environment.This cancer has even invaded health care sector worldwide. Nursing professionals whether they are at hospital or at academics institutions are subjected to violence. Although, it has been a burning issue, among nursing health care workers it has often gone unchecked, and people tend to accept it as the part of the system. In this paper I would be discussing and deliberating that work place violence particularly verbal abuse is a serious matter and it can have negative consequences not only on person’s health but also on the productivity of the employee. This will be followed by some strategies to promote healthy work environment and how can we combat violence at individual, organizational and country level

Comparative assessment of health care delivery systems of developing countries: Pakistan versus Cuba

The health of a nation can be measured by its health care system and it strongly depends upon country’s health policy and strategical planning. Globally health care industry is undergoing a rapid change and is confronting the challenges of shift in demographics and emergence of chronic diseases which is resulting in higher cost of health care delivery. Countries worldwide are scrutinizing their current operational performance of health system, and struggling to adjust to recent growing demands. The health care system of developing countries are immersed in the complex issues of governance and financing of health care, human resource inequity and lack of access to quality health services, which are significantly impacting on the delivery of health services to the consumers. This paper will highlight on of health care system of Pakistan and Cuba under the spheres of their health care delivery system, organizational structure, authority and power structure, decision making process, future challenges and their resolutions

Organizational analysis of private nursing educational institution in Karachi,Pakistan

I would like to begin with the words of Nelson Mandela, “Education is the most powerful weapon which you can use to change the world”. I strongly believe that in order to transform the coming up generation, the vision, mission and philosophy of an educational organization significantly reflects in the standards teaching and learning culture provided to their learners. In the health sector, nursing profession have undergone through a significant process of diversification from the time of Florence Nightingale. It is extremely crucial that in order to generate quality and professional nurses, educational institutions should focus on coaching the learners based on the growing burden of diseases, and equipping them with future coming up challenges

Exploring the experiences of the older adults who are brought to live in shelter homes in Karachi, Pakistan: A qualitative study

Background: The traditional joint family system in a culturally diverse Pakistani society shows great respect and care for older population by the families and their generations. However, in the recent years the phenomenon of population ageing in Pakistan is rapidly increasing due to demographic shift influencing life expectancy, along with changes in socio-cultural values. This transition has resulted in institutionalization of the elderly as an emerging shelter alternative. The aim of this study was to explore the experiences of the elderly people and to identify the reason which compelled them to reside in these shelter homes.Method: A qualitative methodology, with a descriptive exploratory design, was adopted for the study. A purposive sample of 14 elderly males and females were selected, from two different shelter homes in Karachi, Pakistan. Semi-structured interviews were audio recorded and transcribed. Content analysis was done to extract the themes and comprehend the data.Results: Content analysis revealed five major themes: the circumstances of leaving home, experiences, and challenges to wellbeing before entering the care facility, coping with challenges, and decision to live in a shelter home. The analysis discovered that the elderly were experiencing lack of physical, psychological, emotional, and financial support from their family and children. It also indicated that migration of children for better career and employment opportunities, entrance of women into the workforce, and insensitive behaviour of children, left the senior citizens neglected and helpless. The findings also uncovered the challenges of unemployment and family disputes that the elderly had to face made them dependent, distressed, helpless, and lonely resulting in both their apparently willing and forceful decision to reside in shelter homes.Conclusion: The findings point to need for further investigation of the identified areas in this study through qualitative and quantitative researches. There is a dire need for increasing public awareness through the social, electronic, and print media, and providing capacity building training to HCPs for the care of the elderly. The lobbying group can act as a catalyst in persuading the government officials for the execution of a policy on retirement, day care and subsidized provision of health services for the betterment of the elderly

Assessing health-related quality of life, morbidity, and survival status for individuals with down syndrome in Pakistan (DS-Pak): Protocol for a web-based collaborative registry

Background: Down syndrome is the most common chromosomal disorder, with a global incidence of 1 in 700 live births. However, the true prevalence, associated morbidities, and health-related quality of life (HRQOL) of these individuals and their families are not well documented, especially in low- and middle-income countries such as Pakistan. Disease-specific documentation in the form of a collaborative registry is required to better understand this condition and the associated health outcomes. This protocol paper describes the aims and processes for developing the first comprehensive, web-based collaborative registry for Down syndrome in a Pakistani cohort.Objective: This study aims to assess the HRQOL, long-term survival, and morbidity of individuals with Down syndrome by using a web-based collaborative registry.Methods: The registry data collection will be conducted at the Aga Khan University Hospital and at the Karachi Down Syndrome Program. Data will be collected by in-person interviews or virtually via telephone or video interviews. Participants of any age and sex with Down syndrome (trisomy 21) will be recruited. After receiving informed consent and assent, a series of tablet-based questionnaires will be administered. The questionnaires aim to assess the sociodemographic background, clinical status, and HRQOL of the participants and their families. Data will be uploaded to a secure cloud server to allow for real-time access to participant responses by the clinicians to plan prompt interventions. Patient safety and confidentiality will be maintained by using multilayer encryption and unique coded patient identifiers. The collected data will be analyzed using IBM SPSS Statistics for Windows, Version 22.0 (IBM Corporation), with the mean and SD of continuous variables being reported. Categorical variables will be analyzed with their percentages being reported and with a P value cutoff of .05. Multivariate regression analysis will be conducted to identify predictors related to the HRQOL in patients with Down syndrome. Survival analysis will be reported using the Kaplan-Meier survival curves.Results: The web-based questionnaire is currently being finalized before the commencement of pilot testing. This project has not received funding at the moment (ethical review committee approval reference ID: 2020-3582-11145).Conclusions: This registry will allow for a comprehensive understanding of Down syndrome in low- and middle-income countries. This can provide the opportunity for data-informed interventions, which are tailored to the specific needs of this patient population and their families. Although this web-based registry is a proof of concept, it has the potential to be expanded to national, regional, and international levels.International registered report identifier (irrid): PRR1-10.2196/24901

My teaching and learning philosophy

The teaching learning journey is a dynamic, continuous and challenging process. It is beyond the boundaries to what we learn in schools in our initial years of life. We learn from our environment, positive and negative past experiences, and from the people with whom we interact. It is the teacher who brings an enormous impact on shaping the personality of the learners. Every classroom presents a unique community of learners that vary not only in abilities, but also in learning styles. It is the teacher who provides students with the necessary tools to develop their knowledge and skills and facilitates them to think critically. In addition, when the positive learning atmosphere is coupled with innovative teaching and learning strategies, creates environment conducive for critical and lifelong learning. This paper will highlight on my teaching philosophy under diverse spheres of student, teachers, teaching and learning cycle and the learning environment, and how combined phenomena can foster lifelong learning among learners

Elderly depression in Pakistan: An emerging public health challenge

Depression in elderly is a growing and a major public health problem in both the developing countries and developed world. It is anticipated to touch second place of DALYs (Disability Adjusted Life Years) by 2020 and single leading cause by 2030 (World Federation for Mental Health, 2012). It is also interesting to note that elderly populations above 55 years with depression have four times higher death rate than those without depression (WHO Report, 2001). Elderly living in Pakistan experience significant level of physical, social and psychological health problems, leading to increased burden of chronic diseases, disabilities, and psychiatric illnesses. In Pakistan, depression is the most common psychiatric disorder among elderly population that cannot be neglected (Bhamani, Karim& Khan, 2013). The magnitude of the problem is much greater than what is being reported. In United States, the rate of prevalence of depression is high as 40% where as in Pakistan it is as high as 66% among elderly (Javed& Mustafa, 2013). This paper will provide an in depth analysis on the major determinants of depression among elderly in Pakistani context. These determinants are the root cause of the issue among elderly and it includes genetic/biological factors, physical factors, and economic factors, sociocultural and political/organizational factors. Timely identification of these determinants and prospective workup and recommendations will be a rationale attempt towards improvement of physical and psychological wellbeing of geriatric population