Young medical doctors’ perspectives on professionalism: a qualitative study conducted in public hospitals in Pakistan

Background: Professionalism is amongst the major dimensions determining the competence of medical doctors. Poor professionalism affects the overall outcome of healthcare services. This study explores the perspectives of young medical doctors on professionalism in Pakistan. Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors, aged less than 40 years, who had studied medicine in Pakistani universities, were Pakistani nationals, and were employed at various hierarchical levels, from house officer to consultant specialist, in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Qualitative thematic analysis was applied to analyse the data. Results: The data analysis revealed that rigidity of opinions, unacceptability of contrasting perspectives, false pride, and perceived superiority over other professions and patients were major components of poor medical professionalism. Most of the young doctors believed that there is no need to include professionalism and humanity course modules in the medical curriculum, because topics related to social sciences are deemed irrelevant to medicine and judged to be common sense. The doctors recognised good professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues and paramedics. Other factors contributing to poor medical professionalism included the use of social media applications during duty hours, ridiculing patients, substance use such as smoking cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays, lack of cooperation from paramedical staff, and inadequate role models. Conclusions: Poor medical professionalism among young doctors needs to be addressed by policymakers. There is a need to revisit the medical curriculum to strengthen professionalism. It is essential to develop the qualities of tolerance, teachability, and acceptance in doctors in order to facilitate interprofessional collaborations and avoid medical errors

Some Interval Neutrosophic Dombi Power Bonferroni Mean Operators and Their Application in Multi–Attribute Decision–Making

The power Bonferroni mean (PBM) operator is a hybrid structure and can take the advantage of a power average (PA) operator, which can reduce the impact of inappropriate data given by the prejudiced decision makers (DMs) and Bonferroni mean (BM) operator, which can take into account the correlation between two attributes

Anxiety amongst physicians during COVID-19: cross-sectional study in Pakistan

Background: Ensuring safety and wellbeing of healthcare providers is crucial, particularly during times of a pandemic. In this study, we aim to identify the determinants of anxiety in physicians on duty in coronavirus wards or quarantine centers. Methods. We conducted a cross-sectional quantitative survey with an additional qualitative item. Five constructs of workload, exhaustion, family strain, feeling of protection, and anxiety were measured using items from two validated tools. Modifications were made for regional relevance. Factor analysis was performed showing satisfactory Cronbach alpha results. Overall, 103 physicians completed the questionnaire. Results. T-test results revealed significant associations between gender and anxiety. Structural equation modeling identified that high workload contributed to greater exhaustion (beta =0.41, R-2=0.17, p=0.47, R-2=0.22, p=0.17, p=0.34, p=-0.30, p<0.001) significantly explained anxiety (R-2=0.28). Qualitative findings further identified specific needs of physicians with regard to protective equipment, compensation, quarantine management, resource allocation, security and public support, governance improvement, and health sector development. Conclusions: It is imperative to improve governmental and social support for physicians and other healthcare providers during the corona pandemic. Immediate attention is needed to reduce anxiety, workload, and family strain in frontline practitioners treating coronavirus patients, and to improve their (perceptions of) protection. This is a precondition for patient safety

Iono- and chronotropic effects of aqueous extract of berberis lycium royle root bark and berberine on in situ frog-heart preparation

Berberis lycium Royle is used in folk medicines for treating various ailments however it has not been investigated in cardiac problems at pharmacological level. Here, iono- and chronotropic effects of B. lycium root bark’s aqueous extract and berberine were studied on frog-heart. Present data showed that aqueous extracts of B. lycium and berberine exhibited dose-dependent negative chronotropic and ionotropic effects and at higher doses both caused a heart block. Berberine also displayed a positive ionotropic effect but at very low doses. Diltiazem did not antagonize positive ionotropic effect of berberine indicating that this activity is independent of L-type calcium channels, while propranolol antagonized the positive ionotropic effect, suggesting involvement of β1 - adrenoceptors. It is concluded that ionotropic and chronotropic effects exerted by aqueous extract of B. lycium may be due to berberine while its negative ionotropic actions and heart block may attribute to other active principle(s) present in the extract.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Effect of Pretreatment and Substrate Ratios in Biorefinery Employing Co-digestion of Plant Biomass and Poultry Waste

The current study investigated the optimization of biogas generation during co-digestion of various plant biomasses with poultry waste at different ratios and pretreatment of plant biomass. The biochemical tests were executed at 35°C in a thermostat. Water hyacinth was found as the suitable substrate for mono and co-digestion due to high volatile solids (VS) and total soluble contents. However, poultry waste was appropriate only if it was co-digested with other biomasses. The experiments evaluating biogas generation at different ratios of plant biomasses and poultry waste demonstrated that water hyacinth and poultry (50:50) produced 262 mL g−1VS, giant reed and poultry (80:20) produced 235 mL g−1VSwhile maize and poultry (60:40) generated 193 mL g−1VS. However, the pretreating the plant biomass with either Fenton's or Fenton's plus ultrasonic had no effect on biogas generation. The volumes of biogas generated after various pretreatment were low as compared to condition without pretreatment. The codigestion can be classified as WH:P (50:50 &gt; GR:P (80:20) &gt; M:P (60:40). So, these ratios can be applied at decentralized scale for better waste management and biogas generation due to balanced C:N ratio of plant biomass and poultry manure. Co-digestion can also be applied at large scale with optimized ratio in Pakistan and other developing countries for biogas generation and waste management and reduce the methane emission through landfills

Manifestation of Mobile Phone Assisted Personal Agency among University Students: Evidence from Lahore

The study was carried out to explore the manifestation of mobile phone assisted personal agency among university students. Personal Agency of Mobile Phone Users Scale was adapted to measure the practice of personal agency. The questionnaire was administered to a sample of 401 university students in Lahore. Findings of the study indicated three constituents of personal agency among youth; contactability, organizability and derestriction. Furthermore, duration of the possession of mobile phone was found significantly correlated with the practice of mobile phone assisted personal agency. Respondents reported that mobile phone has conferred upon them a sense of individual freedom and social connectedness. It has helped them to organize their daily activities. According to them, this electronic gadget has enabling effect and it enlivened their lives through its beeps and bells. The findings of the study are aligned with the results of D&rsquo;Souza (2010) who did the pioneering study in exploring personal agency through mobile phone use. However, further research is required to explore the impact of mobile phone use on the lives of youth who have not been enrolled in the universities.&nbsp

Natural Treatment Systems as Sustainable Ecotechnologies for the Developing Countries

The purpose of natural treatment systems is the re-establishment of disturbed ecosystems and their sustainability for benefits to human and nature. The working of natural treatment systems on ecological principles and their sustainability in terms of low cost, low energy consumption, and low mechanical technology is highly desirable. The current review presents pros and cons of the natural treatment systems, their performance, and recent developments to use them in the treatment of various types of wastewaters. Fast population growth and economic pressure in some developing countries compel the implementation of principles of natural treatment to protect natural environment. The employment of these principles for waste treatment not only helps in environmental cleanup but also conserves biological communities. The systems particularly suit developing countries of the world. We reviewed information on constructed wetlands, vermicomposting, role of mangroves, land treatment systems, soil-aquifer treatment, and finally aquatic systems for waste treatment. Economic cost and energy requirements to operate various kinds of natural treatment systems were also reviewed

Role of positive mental health in reducing fears related to COVID-19 and general anxiety disorder in Khyber Pakhtunkhwa, Pakistan

Background: The outbreak of the novel coronavirus disease (COVID-19) has posed multiple challenges to healthcare systems. Evidence suggests that mental well-being is badly affected due to compliance with preventative measures in containing the COVID-19 pandemic. This study aims to explore the role of positive mental health (subjective sense of wellbeing) to cope with fears related to COVID-19 and general anxiety disorder in the Pashtun community in Pakistan. Methods: A cross-sectional survey was conducted among 501 respondents from Khyber Pakhtunkhwa participating in an online-based study. We performed correlational analysis, hierarchical linear regression and structural equational modeling (SEM) to analyze the role of mental health in reducing fears and general anxiety disorder. Results: The results of the SEM show that positive mental health has direct effects in reducing the fear related to COVID-19 (beta = - 0.244, p < 0.001) and general anxiety (beta = - 0.210, p < 0.001). Fears of COVID-19 has a direct effect on increasing general anxiety (beta = 0.480). In addition, positive mental health also has an indirect effect (beta = - 0.117, p < 0.001) on general anxiety (R-2 = 0.32, p < 0.001) through reducing fear of coronavirus. Conclusion: Based on these findings, there is a need to develop community health policies emphasizing on promotive and preventive mental health strategies for people practicing social/physical distancing

Water quality assessment of River Kabul at Peshawar, Pakistan: industrial and urban wastewater impacts

Untreated wastewater discharges may have significant short term and long term effects on the quality of a river system. Present study was undertaken to assess the present status of the water quality of River Kabul near Peshawar in Pakistan. Seven sites were sampled upstream and downstream in River Kabul in 2009. Samples were also taken from waste water channel (Budni Drain) that carries wastewater of Peshawar Industrial Estate as well as the domestic sewers to assess the pollution contribution of these sources to River Kabul. Physico-chemical and microbiological parameters of the samples were analyzed during the study, as well as possible sources of contamination were investigated. The study showed that the pollution level in river is rising from upstream (at city entrance) to downstream (at city exit) due to discharge of domestic waste water effluents, agricultural activities, and solid waste dumping directly into the river