Journal of Pakistan Psychiatric Society

RAMADHAN FASTING (صوم): A TRUE REJUVENATION OF BODY AND MIND.

Muhammad Iqbal Afridi — 2024-03-30

Ramadan, the ninth month of the Islamic calendar, is the holy month of fasting observed by Muslims around the world. It is not just a religious and spiritual journey but also a potential period of physical and mental rejuvenation. Islam, with over two billion followers, is the second-largest religion globally and projected to outnumber Christians by 2050.¹ Abstaining from food and drink from dawn to dusk for a month can bring about significant changes in the body and mind, promoting overall well-being.

Ramadan fasting is a deeply spiritual practice that promotes self-discipline, empathy, and spiritual reflection. It is also a significant cultural and religious tradition that promotes social connection, contributing to mental rejuvenation. It has been associated with improved biochemical parameters and reduced risk of metabolic disorders, such as diabetes and obesity, contributing to physical rejuvenation.²

ASSOCIATION OF PHYSICAL AND NEUROPSYCHIATRIC MORBIDITIES WITH THE SEVERITY AND MORTALITY OF COVID-19 PATIENTS IN PAKISTAN

Beenish Khalid — 2024-03-30

Abstract

Objective: This study aimed to find out the association of co-morbidities; risk factors and complications, with the severity and mortality of Covid-19 patients in our set of population

Methodology:

Covid-19-positive patients (151) ages 18-80, were recruited, (June 2022 to May 2023) from Ziauddin Hospital, after informed consent and approval from Ethics Committee. The questionnaire recorded patients’ demographic variables, laboratory investigations, past medical history, and family history. Follow-up co-morbidities, recovery, death, or LAMA (Leave Against Medical Advice) data was taken from hospital records. Analyses were done using (SPSS) software. P-values of <0.05 were considered significant.

Results:

Out of 151 patients; females were 56 (37%) and males 95 (63%). Among these 82(54.3%) recovered, 52(34.4%) passed away and 17(11.2%) LAMA. Deaths in males 40(26.4%), were higher, compared to females 12(7.9%). Overall 84 (56%), suffered severe infection, 24 (16%) moderate and 43 (28%) mild. The most common risk factors were complications of the heart (hypertension) 35(42.7) followed by diabetes 27 (32.9) (p<0.001). Neuropsychiatric manifestations such as depression 36(23.8), was highest among post covid-19 complications, 14 (17.07%) patients had stroke out of which 9(17.3) could not survive. The most common cause leading to covid 19 severity was Pneumonia 76(80%) then diabetes 63(80%) and hypertension 69(78%) (p<0.001). Majority of patients, 88(58.3%) were above 50 years of age, 35(23.2%) between 25-50 and 28(185%) <25 years.

Conclusion:

The most common risk factor of Covid-19 were complications of the heart and diabetes. Highest post covid-19 complication among survivors was depression. The highest complication leading to death was Pneumonia.

CHARACTERISTICS AND PATTERNS OF PSYCHIATRIC ILLNESS AMONG CHILDREN AND ADOLESCENTS AT A TERTIARY CARE HOSPITAL IN KARACHI PAKISTAN

Fawad Suleman — 2024-03-30

Objective

To assess the patterns of psychiatric illness among children and adolescents presented at psychiatric clinic of a public sector teaching hospital in Karachi, Pakistan.

Study Design

A cross sectional study

Place and Duration of the study

The study was conducted at the Child and Adolescent Psychiatry outpatient clinic of the National Institute of Child Health (NICH) in Karachi, during February 2019 to October 2019.

Methodology

Using consecutive, non-probability sampling, all male and female participants, age less than 18 were recruited from the study setting. Data collection was done using a pre-designed semi-structured proforma. The data was analyzed using descriptive statistics.

Results

A total of 250 pediatric patients visiting the psychiatric clinic were enrolled in this study. These included 161 (64.4%) males and 89 (35.6%) females. Mean age was 9.55 ±3.374 years. 31 (12.4%) patients reported directly to the psychiatry clinic while 160 (64%) patients were referred from pediatric medicine clinics. The remaining 59 (23.6%) patients were referred from adult psychiatry clinics. 126 (50.4%) were diagnosed to have stress and related disorders, 85 (34%) patients were diagnosed with neurodevelopmental disorders. About 5 (2%) patients were diagnosed with psychotic and mood disorders, 34 (13.6%) were diagnosed with other nonspecific disorders.

Conclusion

The study reveals a male predominance among children and adolescents at a public sector hospital, with a high referral rate from pediatricians. The diverse mental health issues include stress, neurodevelopmental, and other diagnoses, highlighting the need for deeper investigation and targeted clinical attention.

ASSOCIATION OF RELIGIOUS ORIENTATION WITH DEPRESSION, ANXIETY AND STRESS AMONG MALE PATIENTS WITH SUBSTANCE USE DISORDER IN PAKISTAN

Muhammad Ali Khan — 2024-03-30

OBJECTIVES

Religion has been discussed in numerous research studies with reference to its significance in mental health outcomes. It has gained its attention of researchers due to its pivotal role in the lives of human kind. Present study aims to investigate the predictive relationship of religious orientation on psychological constructs including depression, anxiety & stress) in male patients with substance use disorder (SUD).

STUDY DESIGN

This study was conducted by using a Cross-sectional study design.

PLACE AND DURATION OF STUDY

Study was carried out from April- July, 2018 in Karachi Pakistan.

PARTICIPANTS AND METHODS

The sample included 200 Muslim male patients with SUD. The age ranges between 18 to 45 years (M =28.14; SD =6.55) were taken from substance use treatment and rehabilitation centers located in Karachi, Pakistan using purposive sampling. Personal Information Form and Urdu translations of the scales including Muslim Attitude towards Religion Scale (MARS) and Depression Anxiety and Stress Scale (DASS-21) were used to conduct this study.

RESULTS

Results revealed a significant association of religious orientation with the variables of psychological distress, i.e., depression (adj R²=.994, F (4, 196) =5424.24, P < .01(, anxiety (adj R²=.97, F (4,196) =1309.5, P < .01(, and stress (adj R²=.991, F (4,196) =3854.2, .00 P < .01(.

CONCLUSION

Religion has significant role in wellbeing of its believers in general, and specifically among patients with SUD. Present findings also show that religious orientation has significant contribution in psychological distress such as, “depression”, “anxiety” and “stress” in male patients with SUD. Substance use treatment practitioners may develop interventions by considering the cultural and religion aspect for better treatment outcome and to improve their wellbeing. Further, religious orientation may serve an important variable to have better treatment outcome, and to address mental health issues which may also improve their wellbeing.

ATTITUDE TOWARD MENTAL ILLNESS; COMMUNITY BASE SURVEY

Uroosa Talib — 2024-03-30

Background: Publics’ attitudes and approach towards mental illness highly influence their behaviors in the way they treat, support, and help a person facing challenges of mental illness.

Objective: the present study envisioned to assess the literate and informally educated community person’s attitude toward mental illness and mentally ill patients in Karachi, Pakistan.

Methods: the descriptive survey research design was adopted for the present study. Data was collected from various areas of Karachi city, using the attitude Scale for Mental Illness (ASMI), which has also been used in several studies worldwide. A total of 189 community-literate and informal educated people were recruited from different areas.

Results: on the Separatism, Restrictiveness, and Stereotyping sub-scales, similar positive results of literate people and informal educated people agreed with the statement. Significant differences were found in the Pessimistic Prediction sub-scale. A higher percentage of informal educated people (72.5%) than literate (51.2%) felt (χ2=8.204, p<0.005). Stigmatization sub-scale: it’s a pleasant response that more than two-thirds of literate (74.1%) and informal educated people (79%) disagree. On the Benevolence sub-scale: almost half of the literate (45.6%) and more than half of informal educated community people (61.3%) also agreed that ‘people are prejudiced towards people with mental illness’ (χ2=8.103, p<0.357).

Conclusion: literate and informal educated people were showing similar positive attitudes on some subscales towards people with a mental illness but on some subscales, both groups were showing negative attitudes toward people with mental illness. There is scope for further research including examining the effects of educational interventions.

PREVALENCE OF PSYCHOACTIVE SUBSTANCE USE AMONG SECURITY GUARDS AT TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY

Ali Burhan Mustafa — 2024-03-30

Abstract

Introduction: Drug addiction is a prevalent problem in Pakistan, and screening tools are available for diagnosis. Seeking guidance from healthcare professionals is important for appropriate treatment. Assessing addiction among security personnel is important for safety and policy formulation
Aims & Objectives: This cross-sectional study aims to investigate drug addiction screening and its correlates among security guards in a tertiary care hospital.
Materials & Methods: This cross-sectional study was conducted at Sheikh Zayed Medical College/Hospital in Rahim Yar Khan, Pakistan. Purposive convenience sampling was used to select a sample size of 184
Results: The study conducted among 184 security guards showed significant associations between gender, marital status, and age categories. A considerable proportion of guards were found to be overweight, had increased blood pressure, and substance use in the form of nicotine-related substances was found to be The study highlights the need for interventions promoting healthy lifestyles and substance use education and prevention efforts among security guards in such settings.
Conclusion: This study revealed a prevalence of substance use among security guards in a tertiary care hospital in Pakistan and identified the need for interventions to promote healthy lifestyles and substance use education/prevention. Seeking guidance from healthcare professionals and implementing public health initiatives to address drug addiction and promote healthy lifestyles among security personnel are crucia
Conflict of Interest: None

PREGNANT WOMEN STRUGGLING WITH HIGH BLOOD PRESSURE AND STRESS IN PREGNANCY AND ROLE OF NITRIC OXIDE SUPPLEMENTS L-ARGININE FOR PROLONG PERIOD

Khalida Soomro — 2024-03-30

INTRODUCTION:

Mental stress can contribute to the exacerbation of hypertension in pregnant women and preeclampsia by the release of stress hormones such as adrenaline and cortisol level. Less nitric oxide (NO)-dependent vasodilation and excess formation of reactive oxygen species could explain poor placenta perfusion already in PIH and Preeclampsia due to impaired endothelial function. Studies have indicated that Nitric oxide supplement L-arginine can lead to beneficial effects on various cardiometabolic markers, including blood pressure and vascular function especially in pregnant mothers.

OBJECTIVE:

The primary objective of this meta-analysis study of placebo-controlled trials was to assess and ascertain the evidence of effectiveness of L-arginine and its use in enhancing nitric oxide synthesis to translate into tangible improvement in Hypertension and preeclampsia management, Nitric oxide supplement L-arginine’s ubiquitous molecule’s role is a subject of debate and research with focus on both systolic and diastolic values, pregnancy outcomes and understanding of its role in Hypertension resistant to currently available therapies.

METHODS:

In this study focused on role of L-arginine on high blood pressure during pregnancy, we did a thorough research, effective communication of information from relevant and up-to-date research articles, studies from reputable sources and great places of academic database like PubMed, Google Scholar, medical journals. Around 16 trials were searched in Pub-Med and Google scholar. A total of six trials were included in this meta-analysis.

RESULTS:

Result of this meta-analysis shows Nitric Oxide L-arginine supplementation showed a mean decrease in diastolic blood pressure and can lead to beneficial effect on blood pressure and vascular function especially in pregnant mothers with stress, mean increase up to 1. 23 weeks (p = 0. 002) for gestation period to delivery but did not showed reduction in systolic blood pressure as compared to placebo.

CONCLUSION:

This meta-analysis study supports the notion that availability of this substrate for NO synthesis prolongs the latency to development of preeclampsia and decrease the hypertension in a high-risk pregnant woman with Hypertension and stress.

EQUITABLE DISTRIBUTION OF FCPS PART 2 (PSYCHIATRY) TRAINEES AMONG ACCREDITED TRAINING INSTITUTES IN SINDH

Inayatullah Awan — 2024-03-30

there is a dire need to take effective steps to ensure equitable distribution of FCPS part 2 (Psychiatry) tarainees among accredited institutes in Sindh.

INVEST IN WOMEN

creative Corner — 2024-03-30

Investing in women can accelerate progress across various sectors, including economic growth, education, healthcare, political participation, technology, and gender equality. Supporting women entrepreneurs stimulates job creation and innovation, while investing in girls' education leads to long-term societal benefits. Improved healthcare access for women enhances maternal and child health outcomes, and promoting women's involvement in politics fosters inclusive decision-making. In STEM fields, investing in women drives innovation, and initiatives for gender equality address issues like discrimination and violence. Ultimately, investing in women is not only a matter of social justice but also a strategic investment for economic and social advancement