Contributing and consequential correlates of illicit substance use among students

Background: The world has made tremendous social progress during the past 30 years but opposite has occurred with problems related to drug abuse and addictive disorders. Over the last 30 years, awareness of illicit drugs, access to them and their abuse have dramatically increased. Reports from the United Nations, observations of experts, studies of crime, education, work and health - all show a general agreement that populations at highest risk are those in the age range most needed for productive work i.e., youth, indicating harmful consequences through decreased productivity and thus halting the developmental process of a nation.The aim of this study was to explore the leading and resulting correlates of illicit use of substances (drugs) among college students of ages between 15 to 25 years studying in different institutes of Karachi, Pakistan.Methods: It was a cross sectional study conducted among teens and youth studying in different institutes of Karachi, Pakistan in the year 2015. A questionnaire included multiple-choice and open-ended. The questions were focused on type of substance use, the reason behind, contributing factors, monthly expenditure, dependence upon drug, and effects of illicit substance use. 600 students completed the questionnaire. The data were analysed using IBM SPSS Statistics version 20 and Microsoft excel.Results: The contributing attributes identified included easy accessibility through friends, dealers, and over the counter, Motivation through family members like parents (6%), siblings (8%), cousins/uncles (20%) or friends (50%), The reasons behind were recreational purpose (54%), social pressure (22%) and education stress (24%). The consequential correlates included behavioural, physical and psychological attributes. The results showed that 26% of the students were dependent on the drugs of their choice. Medical problems (physical and mental) identified in sample included 36% withdrawal symptoms (grouchiness, sleeplessness, decreased appetite, anxiety, cravings), 58% experienced mood swings, 40% experienced blackouts, rate15% depression and anxiety, convulsions and impaired memory and others like, hepatitis B & C, Lung infections, and increased heart..This study also shows that substance abuser admitted behavioural changes among themselves as one-third of the students showed negligence to their families, 24% lose their friends and about 38% showed a decline in performance at school, Majority of the respondents were also found to be involved in illegal activities to obtain drugs and more than one-third arrested for the possession of contraband drugs.Conclusions: It was found that majority of the respondents’ friends were involved in drug use and less commonly their cousins and family members. Most of them started drug consumption at age between 15-19 years and were mainly doing it for recreational purposes; other reasons were social pressure or educational stress. The  consequential correlates identified includes, behavioural attributes distorted relationship with family and friends, poor performance in education, and delinquent activities like imprisonment and other unlawful pursuits. Other attributes were medical including physical manifestation of substance abuse like blackouts, hepatitis B & C, increased heart rate, convulsions and lung infections. The psychological manifestations listed depression & anxiety, and impaired memory.

Influence of extroversion and introversion on decision making ability

Background: Decision is defined as a choice that you make about something after thinking about several possibilities. Human decision making and judgment is readily observable in reality. The Personality trait that Influence Decision Making is usually missing from research of decision making. The current study is focused on the characteristics which stimulate the decision making behavior but is not concerned about what makes a decision good or bad.This study aimed to compare the differences in decision making abilities among introverts and extroverts and to analyze which characteristics are favorable for decision making.Methods: A cross sectional study conducted among a sample of 370 participants by nonprobability convenience sampling from Karachi, Pakistan. Questionnaire with close ended and open ended questions had two sections: 1) Personality Analysis; 2) Decision Making characteristics. Eysenck Personality Questionnaire (EPQ) which is the most widely used psychological instrument for measuring the extraversion-introversion with 5-point Likert scale was utilized. The second section regarding decision making included twenty-four open ended and close ended (with a 5-point Likert scale) statements describing how individuals make decisions. The data from the questionnaire was cleaned, coded and entered in Excel (Microsoft, Redmond, WA, USA), exported to SPSS version 21 for windows (SPSS Inc, Chicago, Illinois, USA), for analysis. Descriptive and inferential statistics were used to analyze the data.Results: Exact half (50%) of the extroverts go for snap decisions and quick decisions. Nine out of ten extroverts double-check their information sources before making decisions but more than half (64%) of them hold off important decisions as thinking makes them uneasy. Almost three fourth (68%) of extroverts need someone to steer them in the right direction for decisions. More than three forth (79%) of introverts rely on their intuition, inner feelings and reactions. More than one third (40%) of introverts do not go for impulsive decisions. One third (33%) introverts do not need the assistance of other people while making important decisions.Conclusions: The introverts are better at decision making than extroverts. The introverts rely on their intuition and inner feelings. Majority of them primarily counting on themselves, do not stretch for impulsive decisions while on the other hand extroverts usually go for snap decisions, quick decisions and decide what feels natural at the moment. They prefer to postpone whenever possible as thinking makes extroverts uneasy. Even though extroverts have a good quality of double-checking their information before making decisions but they need someone to steer them in the right direction when they face important decisions. The findings of the present study can-not be generalized due to the limited sample and volunteer bias. Future research is needed for the confirmation of this dimension of personality type and also to find out whether the decisions made by the introverts are good or bad which was beyond the scope of this study

Knowledge, attitude and utilization of sub-dermal birth control implants among married rural women of Pakistan

Background: Pakistan has very high growth rate and only uptake of optimal birth spacing is a way to win this battle. One of modern contraceptive methods is long term hormonal birth control implant. The study was intended to explore the knowledge, attitude and practices of Sub-dermal Birth Control implants among married women in a rural area of Pakistan.Methods: This descriptive cross sectional study was conducted at reproductive health services center at Panoaqil, Sindh, Pakistan. A sample of 120 married women of age 18-45 years, who attended RHS center were included in the study. Data was collected through a standardized questionnaire and analyzed using IBM SPSS version 22 and Microsoft excel.Results: The mean age of sample was 29.48±5.05 years, almost half (44.2%) were illiterate, and 39% were educated up to primary. Three forth (73%) were housewives and 91.7% were poor. Majority (80%) had heard about one method but only one forth (26%) have used one while Implant was used by only 21.9% women. About two third (68%) didn’t know about Implant while 14.2% had good knowledge about Implant. Overall attitude was positive as 85% continued the method but 14.29% quitted due to side effects. Among never users; half (46%) would go for Implant if they would be provided with the insertion services.Conclusions: The current study concludes that knowledge about sub-dermal Implant among women of reproductive age reaching the optimum level. The attitude of women was found positive. The factors which affect the knowledge and the attitude of women are age, parity, family type, level of education, employments status, SE status, previous use of family planning nad source of information

Culture-bound addictions among low income workers of Karachi, Pakistan

Background: The self-efficacy of individuals is influenced by experiences in the community, in the workplace, and in broader civil society, all of which exert a collective influence on attitudes and behaviors. The low-income population is more likely to engage in the use of culture bound addictive substances which include tobacco, gutkha, betel nut/areca nut, alcohol and caffeine. The objective of the study was to identify the type of culture-bound substances used by low-income workers and also to determine the prevalence of substance use among low-income workers, in Karachi, Pakistan.Methods: A cross sectional study was carried out in Karachi, Pakistan. Trained interviewers used a semi-structured questionnaire to interview 707 workers to collect information on socio-demographic characteristics, and addiction history. The data were analyzed using SPSS version 18.Results: Majority (26.4%) of the participants were aged between 26 and 30 years. More than one-third (35.1%) were educated up to secondary level only. Half of the sample (50.8) had 6 to 10 house hold members whereas only one member was employed among 34.8% of the respondents. 39.5% participants reported a household income between Rs11000 and Rs 20000 per month. Half of the sample (50.4%) reported some sort of substance use in their daily routine. A significant number (39.5%) of workers were found to be addicted to tobacco, gutkha or betel nut alone, while another 10.5% were using these substances in combination.Conclusions: Addiction to culture bound substances is prevalent among 50% of the low income workers of Karachi, Pakistan. The common culture bound addiction substances the workers were found to be using were tobacco, ghutka and betel nut. The findings of the present study can­not be generalized due to the limited sample. Still, the study provides evidence of this unhealthy behavior among workers that not only affects their productivity but plays a vicious role in poverty and poor health cycle. Future research should direct attention toward workers' health and working conditions to formulate effective public health interventions to reduce the risky behavior among low income workers. Moreover, there is a need to develop health education programs to create awareness and empowerment among low-income workers to prevent substance use.

Nature and extent of perceived stigma among epileptics in Pakistan

Background: Epilepsy is one of the oldest disorders known to mankind. Often the social stigma (whether a “felt” stigma or an “enacted” stigma) attached to epilepsy is a greater handicap to the person with epilepsy compared to the disability associated with seizures or the side-effects from medications. The aim of this study was to explore the perceived sigma and discrimination among epileptics of Karachi, Pakistan.Methods: A descriptive cross sectional study was conducted in Karachi, Pakistan in the year 2016. A standardized pretested semi-structured questionnaire was completed by 120 epilepsy patients selected through purposive sampling from Department of Neurology, Jinnah Postgraduate Medical Centre. Informed verbal consent was obtained prior to the interview. The data were analysed using IBM SPSS Statistics version 22 and Microsoft excel.Results: The average age of the sample participants was 18-50 years. Almost two third (68%) of the respondents were male. More than half (55%) of the sample was educated up to matriculation. Among them 28.5% were married. Three fifth (60%) of participants were unemployed.  More than half (60%) of the respondents reported discrimination in educational opportunities and three fourth (78.5%) in job opportunities. Results indicated that (75%) participants encountered social problem like being discriminated (30%), or segregated (11%) in performance of daily tasks and were avoided (58.8%) to get marry more often with the belief that people with epilepsy are infectious.Conclusions: The study concludes that there is significant perceived stigma among epileptics living in a big metropolitan city of a developing country. The nature of stigma includes discrimination in education, marriage and job opportunities. There is a need for public awareness programmes to address this ignored facet of epilepsy, since it has both medical as well as social implications

Prevalence of human immunodeficiency virus infection among the diagnosed tuberculosis patients in Karachi, Pakistan

Background: People living with HIV are from 26-31 times more likely to develop TB than persons without HIV. TB is the most common presenting illness among people living with HIV, including among those taking antiretroviral treatment and it is the major cause of HIV-related death. HIV/AIDS has driven TB epidemics in a number of countries including Pakistan where Tuberculosis is endemic and is a major public health challenge. People living with HIV/AIDS continue to be a group at high risk for tuberculosis (TB). National surveillance is important to indicate the magnitude and burden of both diseases. To control the problem, the WHO recommends the establishment of coordinated strategy for both diseases. In this study we aimed to determine the prevalence of HIV/AIDS among diagnosed Tuberculosis (TB) patients in Karachi, Pakistan.Methods: A cross sectional study was conducted, in the year 2015 among the diagnosed TB patients to detect TB/HIV co-infection in the two selected sentinel sites of Karachi, Pakistan. Trained investigators used a standardized multiple-choice and open-ended questionnaire to collect the data regarding demographic profile and collected samples for HIV tests of identified cases. Written informed consent was obtained and questionnaire was completed by respondents selected through simple random sampling. 1257 TB patients underwent the rapid assay for HIV serological testing and subsequent ELISA test was done for confirmation of the HIV. The data were analyzed using IBM SPSS Statistics version 20.0 and Microsoft excel.Results: Among the 1257 patients tested 680 (54%) were men and 577 (46%) women and largest number of patients 56% belonged to the age group 19-40 years. In our study prevalence of HIV among identified Tuberculosis patients was 1.4%.Conclusions: The prevalence of HIV/AIDS among Tuberculosis patients is 1.4%. Future research needs to be directed toward this sensitive issue and social support programs with treatment services should be ensured for HIV positive TB patients to reduce the disparities in provision of health services for this vulnerable stratum of our society.

Assessing knowledge of lady health workers regarding sexually transmitted infections in rural Pakistan

Background: In a conservative culture with limited social mobility like Pakistan, a lady health worker (LHW) provides a valuable opportunity for women with STIs to be diagnosed early, referred for appropriate treatment, and can counsel regarding further prevention. The study was intended to assess LHWs knowledge regarding early assessment and referral of women with STIs in a rural area of Pakistan.Methods: This descriptive cross sectional study was conducted at health centers in a district of interior Sindh, Pakistan called Badin. A sample of 105 lady health workers were recruited using systemic random sampling technique, during six months from September 2015 to March 2016. Data were collected through a semi-structured questionnaire and analyzed using IBM SPSS version 22 and Microsoft excel.Results: Majority (29%) of LHWs were aged between 25 and 29 years. Half sample (51%) of LHWs were educated up to middle school and 6% were intermediate. Eighty-five percent respondents were married. More than half (59%) of LHWs were trained regarding STIs and 21.9% got the special training for it. Among them, 59% of respondents defined STIs correctly. Two thirds (67.6%) of participants knew the meaning of safe sex. One third (37%) of sample was aware of complications due to STIs during pregnancy. Two fifth of LHWs (40%) stated to refer the women with suspected STIs to the hospital for confirmation and further intervention. Near half of LHWs (48%) recommended the use of condom for prevention.Conclusions: The current study concludes that there are gaps in knowledge of LHWs regarding STIs which makes it unsatisfactory. Therefore in service periodical sensitization and advocacy workshops and trainings of these LHWs are recommended to fill information gaps, remove misinformation and provide quality information in a way that is linked to the women’s reproductive health in Pakistan

Exploring nutritional status, physical activity and body mass index of Pakistani teens

Background: Obesity is becoming an increasingly prevalent problem in Pakistan, as it has in other developing countries. Childhood obesity poses high cost to the well-being and negatively affects children’s health, causes chronic disease as children grow older. The aim of this study was to explore nutritional status, physical activity and body mass index (BMI) of school and college going students of mid and late adolescence age (14 to 19 years) studying in multi-ethnic city of Karachi, Pakistan.Methods: A descriptive cross-sectional study was carried out among school and college going students of public and private educational institutes of Karachi, Pakistan. The study sample of 171 students was conveniently selected from these institutes.  The data was collected through a semi-structured questionnaire. In order to calculate BMI, the height and weight of each student were measured after completion of the questionnaire. The data were entered and analysed using IBM SPSS version for Windows 20.0 software.Results: The average age of the respondents was 16.2 years with 68% students belonged to school and 32% to College, and 57.3% were males and 42.7% were females. More than half sample (59.6%) participants belonged to privileged and 40.4% to underprivileged class. The sample was eating a wide variety of junk food in daily routine including chips, packed fruit juices, packed flavoured milk, ice creams/ frozen yogurts both at home and at school/college. The physical activity of the school students was found to be better than the college students. No participant had regular activity or strenuous physical games for more than one hour per day. Around one third (38%) respondents used to watch TV or play computer games for more than two hours a day. Almost half of the students’ BMI was within the normal ranges, but remaining half of the sample was either overweight or underweight.Conclusions: This study indicates that a large proportion of school and college students had physical inactivity, unhealthy dietary habits and they were overweight. All these interrelated factors were independent of their household socioeconomic condition and ethnicity. There is a need to educate and create awareness about healthy lifestyle among the adolescents and the community at large.

COVID-19 vaccine acceptance among pregnant women: a hospital-based cross-sectional study in Sudan

IntroductionPregnancy increases the risk of developing a severe illness due to COVID-19 infection. To the best of our knowledge, no previous study has been conducted on COVID-19 vaccine acceptance among pregnant women in Sudan. Hence, this study aimed to determine COVID-19 vaccination acceptance and its predictors among pregnant women.MethodsA cross-sectional study was conducted among 623 pregnant women attending Gadarif maternity hospital in eastern Sudan through a structured questionnaire. Data were obtained on sociodemographic characteristics, obstetric and health-related characteristics, COVID-19 infection, and vaccination-related information, as well as beliefs about and acceptance of COVID-19 vaccination.ResultsCOVID-19 vaccine acceptance among the pregnant women was 2.7%. The vaccine acceptance was higher if their husband’s education was secondary school or higher [adjusted odds ratio [AOR] 4.30, 95% confidence interval (CI) 1.11–16.65, p = 0.035] and discussion of COVID-19 vaccine with the pregnant women by a health care professional in the hospital (AOR 5.46, 95% CI 1.94–15.35, p < 0.001). The most common reasons for resistance to the vaccine were concerns about the side effects of the vaccine for the mother and her baby.ConclusionAcceptance of the COVID-19 vaccination among the pregnant women was very low. Discussions with pregnant women and their husbands by health care professionals regarding the safety of COVID-19 vaccine for the mother and her baby are highly recommended

Post-COVID-19 fatigue and health-related quality of life in Saudi Arabia: a population-based study

BackgroundDespite substantial literature on symptoms and long-term health implications associated with COVID-19; prevalence and determinants of post-acute COVID-19 fatigue (PCF) remain largely elusive and understudied, with scant research documenting health-related quality of life (HRQoL). Hence, prevalence of PCF and its associated factors, and HRQoL among those who have survived Covid-19 within the general population of Saudi Arabia (KSA) is the subject under examination in this research.MethodsThis cross-sectional study was conducted on 2063 individuals, selected from the KSA’s general population, using a non-probability sampling approach. An online survey was used to employ a self-administered questionnaire to the participants, which included socio-demographic information, the patient’s COVID-19 infection history, 12-item Short Form Health Survey (SF-12) to assess quality of life, and Chalder Fatigue Scale (CFS) (CFQ 11) to evaluate the extent and severity of fatigue. Data were analyzed using SPSS version 26. A p < 0.05 was considered to be strong evidence against the null hypothesis.ResultsThe median age of participants was 34 (IQR = 22) years, with females comprising the majority (66.2%). According to the SF-12 questionnaire, 91.2% of patients experienced physical conditions, and 77% experienced depression. The prevalence of PCF was 52% on CFQ 11 scale. Female gender, higher levels of education, a pre-existing history of chronic disease, as well as the manifestations of shortness of breath and confusion during acute COVID-19 infection, were identified as independent predictors of fatigue.ConclusionTo facilitate timely and effective intervention for post-acute COVID-19 fatigue, it is essential to continuously monitor the individuals who have recovered from acute COVID-19 infection. Also, it is critical to raise health-education among these patients to improve their quality of life. Future research is required to determine whether COVID-19 survivors would experience fatigue for an extended duration and the impact of existing interventions on its prevalence and severity