Lived experiences of COVID-19 patients admitted in isolation wards of healthcare centers in Peshawar, Pakistan: A phenomenological perspective.

The emergence of COVID-19 caused a significant global threat, affecting populations worldwide. Its impact extended beyond just physical health, as it inflicted severe damage and challenges to individuals' well-being, leading to a deterioration in mental health. The lived experiences of patients hold a paramount position to explore and understand their perception of care which can ultimately strengthen the health system's delivery domain. This study explores the lived experiences of patients in the isolation ward, their recovery, and the quality of care being provided in the hospital and its effects on their mental health. Study design: A phenomenological qualitative study using in-depth interviews. Methods: We conducted 11 in-depth interviews of COVID-19 patients admitted to the isolation ward of the public hospitals of Peshawar, Pakistan. Participants who stayed for a minimum of 10 days in an isolation ward were included in this study. Interviews were transcribed and analyzed using NVivo 12 software and generated five themes through inductive analysis. Results: Five themes emerged from the participants' lived experiences: Heading towards the hospital, Health Care Quality, Impact on Mental Health, Recovering from COVID-19 and Back on one's feet. These included all the positive and negative lived experiences. Socio-environmental factors along with their experiences of the disease itself and with the healthcare providers guided their reaction which was important conciliators in their experiences during the pandemic. Conclusion: Based on the findings, the environment of isolation had a major influence on the mental well-being of the individuals involved. Considering the important role of the ward environment in shaping patient experiences and outcomes prompts a reevaluation of healthcare practices and policies. By addressing these factors healthcare systems can strive for greater effectiveness, resilience, and compassion in managing the pandemic's impact on patient care.

Patient Satisfaction and Utilization of Ambulance Services in Prehospital Services at a Tertiary Care Hospital: A Cross-Sectional Study in Peshawar, Khyber Pakhtunkhwa, Pakistan.

OBJECTIVE: Patients reporting to emergency departments frequently use different ambulance services; therefore, the measurement of patient satisfaction is relevant to encouraging those services to meet patient expectations. The aim of this study was to determine the patients' satisfaction and utilization of different ambulance services at a tertiary health care hospital in Peshawar relating to prehospital services. METHODS: This cross-sectional study was conducted at Lady Reading Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan, from July 2019 to January 2020 using a consecutive sampling technique with a total sample size of 378. The patients reporting to the emergency department using any ambulance service were included in this study. Different types of ambulance services were used as an outcome variable. Proportions were compared for the categoric variables using the chi-square test, whereas the 1-way analysis of variance test was used to determine the mean response time and age. Results were considered significant at a P value ≤ .050. All analyses were completed using SPSS version 20 (IBM Corp, Armonk, NY). RESULTS: Of the total 378 study participants, approximately 166 (43.9%) used Rescue 1122 services, 99 (26.2%) used private ambulance services, and 44 (11.6%) used public ambulance services. Road traffic accidents were the most common complaint by 98 (25.9%, P < .003) participants. The mean response time for Rescue 1122 was 13.2 ± 18 minutes followed by the Chippa Foundation (private) at 17.8 ± 20 minutes (P < .005). Males (n = 254) were the predominant users of all services. Participants from the urban region (n = 112) used Rescue 1122, whereas the public ambulance service was used only by 31 patients (P < .005). Among all the ambulance services, 19 (61.3%) participants were not satisfied with the Chippa service regarding vehicle cleanliness, whereas participants were highly satisfied with Rescue 1122. CONCLUSION: Overall, the patients were more satisfied with the services provided by the Rescue 1122 ambulances compared with all other ambulance services.

Linkages between poverty and food insecurity in Pakistan: Evidence from urban and rural households in Peshawar.

Objective: To assess household poverty, sanitation and hygiene practices, and food security in both urban and rural settlements of district Peshawar. Methods: We conducted this cross-sectional study from March 2019 to October 2019 in the urban and rural households of Peshawar, KPK. Using stratified random sampling, 554 households (HH) having children and young adolescents of age 5-19 years, adult men > 19 - 62 years, and adult women >19 - 62 years were included in this study. Data was collected using comprehensive tool comprised of all validated questionnaires and was analyzed using SPSS Version 24.0. Result: Within the urban clusters, the maximum number of households (n=29) were from Gari Baloch and the minimum number of households (n=7) were from Gulberg. In the rural clusters, the maximum number of households surveyed (n=41) were from Lamara, minimum(n=21) was from Chargula. The average age of household heads was 44.5 ±12.5 with mean age slightly higher in urban areas (45.1 ±11.8) compared to 44.0 ±13.2 in rural areas. The mean poverty score was 56.8 (±11.6) with 72.1% non-poor households, and 94.2% households being food secure. Handwashing practices were highly prevalent among all the HH, however, handwashing practices before eating were comparatively lower in all HH (45.2%), lowest (37.8%) among rural households. Conclusion: The findings of the study revealed both non-poor and food secure households with satisfactory water, hygiene and sanitation practices.

Perception of Master of Public Health Students regarding E-Learning in Covid-19 Era: A New Normal in Lower- and Middle-Income Countries.

Objectives: To explore the perception of postgraduate public health students regarding e-learning in context to Covid-19 pandemic and its effect on their academic performances. Methods: This cross-sectional study was conducted at Sarhad Institute of Health Science, SUIT Peshawar from 3rd October 2020 to 4th February 2021. The Census method was incorporated for sample selection. Participation in the study was subjected to consent by participants. A self-administered questionnaire was used for data collection. Data was analyzed using SPSS Version-26. Results: Out of 95 participants, 72 (75.8%) were males and 23 (24.2%) were females. The mean grade point average (GPA) of previous semester-1 and semester-2, when they were having a conventional education system on campus before the pandemic was 2.741±0.499 and 2.643±.498 respectively. The current mean GPA of semesters 1, 2, and 3 who had online classes during this pandemic was 2.41±0.66, 3.06±0.51, and 2.80±0.47 respectively. Fifty-one (53.7%) students preferred to use mobile for e-learning. Convenience to the use-learning management system (LMS) was 67.4% and 72.6% responded that their academic performance was positively affected by e-learning. Logistic regression revealed that source of learning (p 0.99), uninterrupted internet (p 0.87), convenience with LMS (p 0.17), stress (p 0.505), convenient communication with faculty (p 0.69), and compatibility with professional routine (p 0.21) were not significantly associated with good academic performance, however, students of semester 2 (p 0.001) and those using laptops (p 0.02) were more likely to get a GPA of 3.0 or above. Conclusions: Students in this study had a positive perception regarding e-learning however, there is a definite need to amalgamate both online and on-campus learning modalities for post-graduate students especially during the uncertain situations.

Unconventional Uses of Laser Hair Removal: A Review.

Laser hair removal since its availability has been primarily used for aesthetic purposes. Over the years, it has emerged as an important therapeutic modality in various dermatological and surgical disorders, both as an adjuvant and as a monotherapy. Depending on the skin type, all laser hair removal systems have been used with good results and minimal complications. We hereby review the diverse range of unconventional indications of laser hair removal.

How Effective is Autologous Serum Therapy in Chronic Autoimmune Urticaria.

BACKGROUND: Chronic autoimmune urticaria (CAU) is one of the most challenging therapeutic problems faced by a dermatologist. Recently, weekly autologous serum injections have been shown to induce a prolonged remission in this disease. AIM: To evaluate the efficacy of repeated autologous serum injections in patients with CAU. MATERIALS AND METHODS: Seventy patients of CAU were prospectively analyzed for the efficacy of nine consecutive weekly autologous serum injections with a post-intervention follow-up of 12 weeks. Total urticaria severity score (TSS) was monitored at the baseline, at the end of treatment and lastly at the end of 12 weeks of follow up. Response to treatment was judged by the percentage reduction in baseline TSS at the end of treatment and again at the end of 12 weeks-follow-up. RESULTS: Out of the 70 patients enrolled, 11 dropped out of the injection treatment after one or the first few doses only. Among the rest of 59 patients, only 7 patients (12%) went into a partial or complete remission and remained so over the follow-up period of 12 weeks. Forty patients (68%) did not demonstrate any significant reduction in TSS at the end of the treatment period. Rest of the 12 patients showed either a good or excellent response while on weekly injection treatment, but all of them relapsed over the follow-up period of 12 weeks. CONCLUSION: Autologous serum therapy does not seem to lead to any prolonged remission in patients of CAU.