Medicine and Health Sciences Commons^™

Burnout, Job Dissatisfaction, And Mental Health Outcomes Among Medical Students And Health Care Professionals At A Tertiary Care Hospital In Pakistan: Protocol For A Multi-Center Cross-Sectional Study, Syed Hamza Mufarrih, Aeman Naseer, Nada Qaisar Qureshi, Zohaib Anwar, Nida Zahid, Riaz Hussain Lakdawala, Shahryar Noordin

Department of Biological & Biomedical Sciences

Burnout, a state of vital exhaustion, has frequently been related to work-related stress and job dissatisfaction. Given the emotionally and physically challenging nature of their work, high rates of burnout have been reported among health care professionals. This may put them at a higher risk for of suffering from adverse mental health outcomes, including depression, anxiety and stress. In our study, we aim to assess the prevalence i of and associations among burnout and job dissatisfaction and adverse mental health outcomes in a developing country, where the challenges faced by the health care system are unique. Facilities are over-burdened and …

Mapping Maternal Mortality Rate Via Spatial Zero-Inflated Models For Count Data: A Case Study Of Facility-Based Maternal Deaths From Mozambique, Osvaldo Loquiha, Niel Hens, Leonardo Chavane, Marleen Temmerman, Nafissa Osman, Christel Faes, Marc Aerts

Obstetrics and Gynaecology, East Africa

Maternal mortality remains very high in Mozambique, with estimates from 2015 showing a maternal mortality ratio of 489 deaths per 100,000 live births, even though the rates tend to decrease since 1990. Pregnancy related hemorrhage, gestational hypertension and diseases such as malaria and HIV/AIDS are amongst the leading causes of maternal death in Mozambique, and a significant number of these deaths occur within health facilities. Often, the analysis of data on maternal mortality involves the use of counts of maternal deaths as outcome variable. Previously we showed that a class of hierarchical zero-inflated models were very successful in dealing with …

Barriers And Perceptions Regarding Code Status Discussion With Families Of Critically Ill Patients In A Tertiary Care Hospital Of A Developing Country: A Cross-Sectional Study, Ahsan A. Syed, Aysha Almas, Quratulain Naeem, Umer F. Malik, M. Tariq

Department of Medicine

Background: In Asian societies including Pakistan, a complex background of illiteracy, different familial dynamics, lack of patient’s autonomy, religious beliefs, and financial constraints give new dimensions to code status discussion. Barriers faced by physicians during code status discussion in these societies are largely unknown.
Aim: To determine the barriers and perceptions in discussion of code status by physicians.
Design: Questionnaire-based cross-sectional study.
Setting and participants: This study was conducted in the Department of Medicine of The Aga Khan University Hospital, Karachi, Pakistan. A total of 134 physicians who had discussed at least five code statuses in their lifetime were included. …

Improving Standards Of Care In Obstructed Labour: A Criteria-Based Audit At A Referral Hospital In A Low-Resource Setting In Tanzania, Andrew H. Mgaya, Hussein Kidanto, Lennarth Nystrom, Birgitta Essén

Faculty of Health Sciences, East Africa

Objective In low-resource settings, obstructed labour is strongly associated with severe maternal morbidity and intrapartum asphyxia, and consequently maternal and perinatal deaths. This study evaluated the impact of a criteria-based audit of the diagnosis and management of obstructed labour in a low-resource setting.

Methods A baseline criteria-based audit was conducted from October 2013 to March 2014, followed by a workshop in which stakeholders gave feedback on interventions agreed upon to improve obstetric care. The implemented interventions included but were not limited to introducing standard guidelines for diagnosis and management of obstructed labour, agreeing on mandatory review by specialist for cases …

Motivation And Retention Of Physicians In Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan, Sayed Masoom Shah, Shehla Zaidi, Jamil Ahmed, Shafiq Ur Rehman

Community Health Sciences

BACKGROUND:

Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC) infrastructure, Pakistan's health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan.

METHODS:

An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP) province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental …

‘Essential But Not Always Available When Needed’ – An Interview Study Of Physicians’ Experiences And Views Regarding Use Of Obstetric Ultrasound In Tanzania, Annika Åhman, Hussein Kidanto, Matilda Ngarina, Kristina Edvardsson, Rhonda Small, Ingrid Mogren

Faculty of Health Sciences, East Africa

Background The value of obstetric ultrasound in high-income countries has been extensively explored but evidence is still lacking regarding the role of obstetric ultrasound in low-income countries.

Objective We aimed to explore experiences and views among physicians working in obstetric care in Tanzania, on the role of obstetric ultrasound in relation to clinical management.

Design A qualitative study design was applied. Data were collected in 2015, through 16 individual interviews with physicians practicing in obstetric care at hospitals in an urban setting in Tanzania. Data were analyzed using qualitative content analysis.

Results Use of obstetric ultrasound in the management of …

Successful Management Of Aggressive Fibromatosis Of The Neck Using Wide Surgical Excision: A Case Report., Zain A. Sobani, Montasir Junaid, Mumtaz J Khan

Section of Otolaryngology, Head & Neck Surgery

Introduction:Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck. However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity. Case Presentation: We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck. The mass was excised and histopathological analysis revealed a case of aggressive fibromatosis.

Conclusions:

Due …

Geriatric Patients' Expectations Of Their Physicians: Findings From A Tertiary Care Hospital In Pakistan, Taimur Saleem, Umair Khalid, Waris Qidwai Dr

Department of Family Medicine

Background: Geriatric health is a neglected and under-explored area internationally and in Pakistan. We aimed to ascertain the expectations of the geriatric Patients from their physicians and the factors associated with Patient satisfaction in this particular age bracket.
Methods: A cross-sectional survey was carried out at a tertiary care teaching hospital in Karachi, Pakistan. Data collection was carried out via face-to-face interviews based on structured, pretested questionnaires. All consenting individuals aged 65 years or above were recruited into the study. Convenience sampling was used to draw the sample. The data was analyzed using SPSS version 16. Geriatric Patient's expectations from …

Attitudes Of Developing World Physicians To Where Medical Research Is Performed And Reported, John Page, Richard F. Heller, Scott Kinlay, Lynette Lim, Wang Qian, Zheng Suping, Supornchai Kongpatanakul, Murtaza Akhtar, Salah Khedr, William Macharia

Paediatrics and Child Health, East Africa

Background: Little is known about the influence of the site of research or publication on the impact of the research findings on clinical practice, particularly in developing countries. The International Clinical Epidemiology Network (INCLEN) is dedicated to improving the quality of health research in the Developing World through institutional capacity building for evidence based medicine, and provided the opportunity to examine the likely impact of research location and journal location on physicians' practice in a number of the participating countries.

Methods: Physicians from secondary and tertiary hospitals in six cities located in China, Thailand, India, Egypt and Kenya were enrolled …

Perceptions On Bioethics Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Waris Qidwai, Hafeez Qureshi, Syed Sohail Ali, Mahboob Alam, Syed Lgbal Azam

Department of Family Medicine

Objective: To study the perceptions on bioethics among patients presenting to family physicians at a teaching hospital in Karachi, Pakistan Study design: Questionnaire based cross sectional survey
Settings: The study was carried out at the family practice center, the Aga Khan University Hospital, Karachi Main outcome measures: Perceptions on the broad principles of bioethics
Results: Majority of the respondents were young and well educated and better placed socioeconomically. Respondents reported the moral duties of a physician and their reaction in the event of the death of a close relative due to a doctor`s negligence. The majority agreed …

Patterns Of Use And Non-Use Of The Services Of Hakim Practitioners Among Patients In Karachi, Waris Qidwai

Department of Family Medicine

Objective: To study the pattern of use and non-use of the services of hakim practitioners, among patients visiting the Family Physicians, at a teaching hospital in Karachi.
Design: Cross-sectional survey
Place and Duration of Study: Family practice centre, The Aga Khan University, Karachi, from March to June, 2001.
Methods: A total of 387 patients were surveyed against an estimated sample size of 347. A questionnaire was developed and administered to collect information on the patterns of the use and non-use of the services of hakim practitioners among the respondents.
Results: The majority of the respondents were young, well-educated …