Objective: To explore the impact of HIV/AIDS on the quality of life (QoL) of women living with HIV/AIDS in Balochistan-Pakistan, with specific focus on gender-related stigma, family dynamics, and regional disparities. Methods: This convergent parallel mixed-methods study was conducted at provincial HIV/AIDS Control Centre, Bolan Medical College Hospital Quetta, Balochistan, between January and April 2025. Ethical approval was obtained from Institutional Review Board of Bolan University of Medical and Health Sciences, (Ref: 1067/BUMHS/25). Registered women aged >= 18 years with confirmed HIV infection were eligible. Quantitative data were collected from 150 participants using a structured questionnaire developed with reference to established HIV-specific QoL frameworks, including WHOQOL-HIV. Descriptive statistics and Chi-square tests were applied using SPSS version-27. Qualitative data were obtained through semi-structured in-depth interviews with 15 participants and analyzed using inductive thematic analysis. Results: Among 150 participants, 60.0% were unaware of HIV/AIDS before diagnosis and 78.1% had disclosed their diagnosis to family members. Increased family support after disclosure was reported by 42.0%. More than half (52.3%) reported no discrimination in public spaces, while 40.6% felt comfortable discussing their diagnosis. Significant associations were observed between awareness and knowledge of transmission routes (p<0.001), diagnosis disclosure and family behavior (p<0.001), comfort discussing diagnosis and anxiety/stress levels (p=0.010), and region and perceived sufficiency of resources (p=0.010). Qualitative analysis identified six major themes reflecting stigma, psychological distress, and social challenges. Conclusion: Women livingwith HIV/AIDS experience considerable psychosocial challenges. Strengthening awareness, reducing stigma, and improving psychosocial and family-centered support are essential to improve their lived experiences.
Objective: To investigate the clinical and epidemiological characteristics of multiple sclerosis (MS) in the Aran region of Azerbaijan. Methods: This prospective, single-center longitudinal study was conducted at Neurology Center under the Ministry of Health of Azerbaijan from January 2013 to December 2022. Patients from the Aran region were evaluated using standardized national diagnostic protocols based on the 2010 McDonald criteria. Of 267 individuals assessed, 241 with confirmed MS were included. Data on demographic characteristics, clinical features, and epidemiological indicators were collected. Incidence and prevalence rates per 100,000 population were calculated and age-standardized using World, European, and national reference populations. Statistical analysis was performed using SPSS version-27. Results: Of the 241 patients, 150 (62.2%) were women and 91 (37.8%) were men. Mean age at diagnosis was 35.91 +/- 8.16 years, higher in men than women (p<0.05). The mean diagnostic delay was 5.90 +/- 5.27 years and was longer in rural residents (p=0.009). Relapsing-remitting MS was the predominant clinical subtype, observed in 190 patients (78.8%). The 10-year average incidence rate was 1.13 +/- 0.26 per 100,000 population, with no significant differences by gender or residence. By the end of 2022, the overall prevalence was 13.49 +/- 0.88 per 100,000 population (95% CI: 11.75-15.22), higher in women and urban populations (p<0.001). The highest prevalence was recorded in Central Aran Economic Region (16.20 +/- 1.50 per 100,000 population). Conclusion: MS in Aran region shows moderate prevalence with female predominance, relapsing-remitting dominance, and diagnostic delays, particularly in rural populations. Findings highlight the disparities and need for improved access to neurological services and earlier referral.
Objectives: To examine the relationship between intolerance of uncertainty (IU), including its components inhibitory IU and prospective IU, and cyberchondria, and to compare IU and cyberchondria across demographics such as gender, work status, education, and family system. Methods: This cross-sectional study was conducted from April to August 2023 at National Institute of Psychology, Quaid-i-Azam University, Islamabad, after ethical approval. A purposive sample of 302 young adults aged 18-29 years who used the internet for health-related searches was included. Participants completed the Cyberchondria Severity Scale (CSS-12), the Intolerance of Uncertainty Scale (IUS-12), and a demographic questionnaire. The data were analyzed using SPSSversion 25. Results: The sample comprised 177females (58.6%) and 125 males (41.4%). IU showed a significant positive correlation with cyberchondria (rs=0.59, p<0.01). Inhibitory IU demonstrated a stronger positive association with cyberchondria (rs=0.64, p<0.01) compared with prospective IU (rs=0.38, p<0.01). Hours spent on the internet daily for health-related searches (rs=0.26, p<0.01) and age (rs=0.28, p<0.01) were also positively correlated with cyberchondria, whereas family monthly income (FMI) was negatively correlated with cyberchondria (rs=-0.41, p<0.01). Cyberchondria scores were significantly higher among males, working individuals, participants with PhD-level education, and those living in nuclear family systems. Conclusion: Intolerance of uncertainty, particularly inhibitory IU, is strongly associated with cyberchondria among young adults. Demographic factors also influence these psychological tendencies. Interventions targeting uncertainty management and responsible online health information use may help reduce cyberchondria.
The adoption of Single Best Answer (SBA) and Multiple True or False (MTF) questions in the assessment of medical students within an Outcome-Based Education (OBE) framework continues to evolve toward competency-based training. This necessitated an urgent effort to evaluate the effectiveness of various assessment methods in fostering clinical reasoning, knowledge application, and decision-making skills. The current viewpoint highlights the strengths and limitations of both SBA and MTF formats, emphasizing their suitability in different stages of medical education. While MTF questions offer broad content coverage and efficiency in assessing foundational knowledge in preclinical years, SBA questions are better suited for higher-order cognitive skills and real-world clinical decision-making in the later clinical years. The discussion underscores the necessity of a strategic combination of these formats to align with OBE principles, ensuring that medical graduates are well-equipped for professional practice. This viewpoint is an attempt to provide insights for medical educators, curriculum designers, and policymakers seeking to refine assessment strategies in undergraduate medical training. By advocating for a balanced approach to assessment, the article contributes to ongoing efforts to enhance the validity, reliability, and effectiveness of medical examinations. This topic aligns well with the journal's focus on medical education innovation and curriculum development, making it atimely and relevant addition toyour publication.
Objective: To investigate the comparative effects of Bruegger's exercise and Egoscue exercise on anterior pelvic tilt in individuals with lower crossed syndrome (LCS). Methods: This single-center, parallel-group randomized clinical trial (NCT06303388) was conducted at Pakistan Railway General Hospital, Rawalpindi. A total of 34 participants (aged 20-50 years) with LCS were randomly allocated into two groups. Group A received Bruegger's exercise, while Group B received Egoscue exercise, alongside standardized conventional physiotherapy (hot packs and muscle stretching). The intervention comprised 12 sessions over four weeks. Anterior pelvic tilt was measured pre- and post-intervention using a pelvic inclinometer. Data were analyzed using the Wilcoxon signed-rank test for within-group comparisons and the Mann-Whitney U test for between-group differences. Results: The mean age of participants was 26.45 +/- 4.41 years, with 85.3% females. Both groups demonstrated significant reductions in anterior pelvic tilt after four weeks (Bruegger's: median 12 to 9, p <0.001; Egoscue: median 12 to 9, p <0.001). Within-group effect sizes were large (Bruegger's r = 0.63; Egoscue r = 0.64). However, no statistically significant difference was observed between groups at baseline (p = 0.327) or post-intervention (p = 0.793), with a negligible between-group effect size (r = 0.04). Conclusion: Both Bruegger's and Egoscue exercises significantly improve anterior pelvic tilt in individuals with LCS, with no evidence of superiority of one intervention over the other. However, given its simplicity and ease of execution, Bruegger's exercise may offer a more practical and feasible option in clinical settings. Clinical Trial Registration Number: NCT06303388
