Pakistan BioMedical Journal

A Qualitative Exploration of Awareness, Perceptions, and Help-Seeking Behaviors among Parents of Post-Partum Depression in Islamabad, Pakistan

Tehmina Sultan — 2025-07-31

Postpartum depression (PPD) profoundly impacts mothers' and fathers' mental health but remains underdiagnosed and stigmatized in the majority of low-resource settings. Cultural role expectations and gender roles further accentuate awareness and help-seeking in Pakistan. This research investigated parental awareness, perceptions, and help-seeking behavior towards PPD within Islamabad. Objectives: To investigate parental knowledge of PPD, determine barriers and facilitators to seeking help, evaluate the awareness and utilization of available resources and support systems for PPD. Methods: A two-stage qualitative design was employed, utilizing a non-probability purposive sampling technique. In Phase 1, EPDS was used to screen parents for symptoms of depression. During Phase 2, 12 mothers and 8 fathers who screened positive had in-depth interviews. Thematic analysis was applied to examine socio-cultural, emotional, and system factors that shape PPD experiences. Results: Findings identified a few parents with awareness of PPD, and strong stigma was present among both parents. Mothers outlined emotional exhaustion, pressure to be in control and happy, and insufficient time for seeking care. Fathers also reported emotional repression, cultural expectations, and concerns about being judged. Stigma, time, limited mental health service availability, and gender roles were identified as shared barriers. Spouses' and peers' casual support was a primary facilitator of seeking help. Conclusions: The study concluded that limited awareness, cultural stigma, and gendered expectations hinder help-seeking for postpartum depression among parents.

Correlation Between Menopausal Symptoms and Quality of Life in Post-Menopausal Women

Dania Sijjil — 2025-07-31

Lack of public awareness calls for this research, as women’s post-menopausal health and quality of life are neglected in Pakistan. Objective: To find the relation between Quality of Life (QoL) and Menopausal Symptoms in postmenopausal women. Methods: A cross-sectional study was conducted for six months. Post-menopausal women were considered based on non-probability convenience sampling, and 267 of them were recruited. In this study, the age range was 45 to 85 years. Outcome measure tools included are the Menopausal Rating Scale (MRS) and Short Form 36 (SF-36). The data collected were entered into SPSS version 23.0 for analysis. Results: This study used Pearson’s Test because the data were parametric, based on a p-value more than 0.05, according to the Kolmogorov-Smirnov test. The majority of the women, i.e. 165 (61.8%), were working. Results showed that the QoL diminishes as the severity of post-menopausal symptoms increases. Key findings included that out of all nine domains of Short-Form-36, Physical Functioning was vastly affected, with a percentage mean of 69.42% altogether. Conclusions: A negative relation came into view between the QoL and post-menopausal symptoms. It entails that with increasing severity of post-menopausal symptoms, QoL deteriorates.

Association of Dry Eye, Sleep Quality, Anxiety and Depression among Young Pakistani Adults: A Cross- Sectional Study

Maryam Jabbar — 2025-07-31

Tear film instability is a hallmark of dry eye disease, a multifactorial disorder which is affected by several variables such as sleep quality, depression and anxiety. Objectives: To examine the connections between anxiety, depression, dry eye and sleep quality. Methods: A cross-sectional study was carried out at Madinah Teaching Hospital, Faisalabad. Prerequisites for inclusion were being between the ages of 20-35 years and not having any clinically significant eye disorders or reported sleep disorders. Patients who were taking medication or who had undergone surgery in the six months prior were not included. Descriptive statistics, Pearson correlation and multiple linear regression were used to assess the results of the HADS, OSDI and PSQI, which were used to measure symptoms of anxiety and depression, dry eye and sleep quality, respectively. Results: Multiple linear regression revealed a significant (p<0.001) relationship between the OSDI and PSQI subscales (sleep latency, sleep disturbances and use of sleep medications). Other indicators that did not show statistically significant relationships with the regression model included subjective sleep quality, sleep duration, habitual sleep efficiency, and dysfunction during the day (p>0.001). Multiple linear regression analysis revealed that the OSDI and the other variables HADS-A, HADS-D and PSQI total score were related to the following values: p=0.29, p=0.001and p<0.001, respectively. Conclusions: Dry eye was closely associated with depression and disturbed sleep, although it did not significantly correlate with anxiety. The OSDI scores and the PSQI subscale showed significant associations, suggesting a link between dry eye and sleep quality.

Code Ready? Evaluating Basic Life Support Awareness in Nursing Students

Lal Khan Keerio — 2025-07-31

Basic Life Support (BLS) is a critical skill for nurses, yet gaps remain in both awareness and technical proficiency among nursing students in low and middle-income countries. In Pakistan, limited simulation-based training may impact confidence and competence in cardiopulmonary resuscitation (CPR). Objectives: To assess BLS awareness, self-perceived competence, and associated demographic factors among post-RN BScN students in Sindh, Pakistan. Methods: A descriptive cross-sectional study was conducted between May and November 2022 across five nursing institutes, a structured questionnaire collected data on BLS awareness, CPR technique knowledge, attitudes, and self-perceived competence. A total of 378 students were recruited via convenience sampling. Descriptive statistics were calculated, and chi-square tests were used to examine associations between demographic variables and perceived BLS competence. Results: Most participants (86.2%) had heard of BLS and supported its inclusion in curricula (81%). However, correct responses on technical CPR skills such as the CAB sequence (51.9%), compression depth (56.3%), and 30:2 ratio (43.9%) were suboptimal. Statistically significant associations were found between self-perceived competence and gender, age, clinical experience, and academic year (p<0.05), with males and experienced students rating themselves more highly. Conclusions: The study found high BLS awareness but gaps in technical skills. Integrating simulation-based training, refresher sessions, and addressing gender confidence gaps is essential to improve patient care.

Comparison of Upper Limb Weakness among Drivers and Non-Drivers

Fatima Mazhar — 2025-07-31

The strength of the upper limbs is crucial for performing daily activities, and prolonged working hours, such as driving, can lead to muscle weakness. Muscle activity may be impacted by repetitive movements of the upper limb, posture, and vibrations to which the drivers are exposed. The evaluation of upper limb weakness in groups of drivers and non-drivers can be used to gain insight into the occupational effects of this condition and possible preventive measures. Objective: To compare upper limb weakness among drivers and non-drivers. Methods: This comparative cross-sectional study was conducted on 54 male respondents (27 drivers and 27 non-drivers) who were recruited by a convenience sampling method. MMT was applied to evaluate the upper limb strength. SPSS version 27.0 was used to analyze data. Results: A total of 54 participants were included, evenly divided between drivers (n=27) and non-drivers (n=27). The majority were middle-aged, with the largest proportion aged 46–55 years (29.6%), and most participants were right-handed (79.6%). There were no statistically significant differences in upper limb muscle strength between drivers and non-drivers across shoulder, elbow, and wrist movements (p>0.05). However, shoulder adduction showed a notable trend, with 48.1% of non-drivers exhibiting normal strength (Grade 5) compared to only 14.8% of drivers (p=0.054). Elbow flexion also favoured non-drivers (40.7% vs. 29.6% with Grade 5 strength), though the difference was not significant (p=0.378). Most strength grades across all movements fell within Grade 4 (against some resistance) for both groups. Conclusion: It was concluded that there were significant differences in upper limb strength between drivers and non-drivers.

Prevalence and Molecular Docking-Based Drug Evaluation of Thyroiditis in Hyderabad, Pakistan

Beenish Khanzada — 2025-07-31

Thyroiditis, an inflammation of the thyroid gland, is a globally significant health issue, with a prevalence of 5–10% worldwide. In Pakistan, the prevalence of clinical and subclinical hypothyroidism is estimated at 4–5%. Objectives: To determine the prevalence, clinical features, and risk factors of thyroiditis in Hyderabad, Pakistan, and to evaluate the drug-protein interactions of commonly used thyroid medications (levothyroxine, methimazole, and propranolol) with thyroid-stimulating hormone (TSH) using molecular docking analysis. Methods: This prospective, observational, cross-sectional study included 72 patients aged 18 to 65 years from Hyderabad. Demographic and clinical data were collected through structured questionnaires. Blood samples were analyzed using ELISA to assess biochemical markers (T3, T4, TSH). Molecular docking was performed using the PyRx virtual screening tool to evaluate drug interactions with TSH. Statistical analysis was conducted using SPSS version 26.0. Results: The majority of patients (68.05%) were between 21–40 years of age, with a predominance of females (81.9%) and rural residents (54.1%). Hypothyroidism was the most prevalent condition (47.2%). Significant risk factors included smoking and autoimmune disorders (P=0.045), whereas family history and iodized salt consumption were not significantly associated (P>0.05). Molecular docking revealed that propranolol had the highest binding affinity to TSH (Kd=-6.3), followed by levothyroxine (Kd=-5.3), while methimazole showed the lowest affinity (Kd=-3.7). Conclusions: The study concluded a high prevalence of thyroiditis (52.78%; 95% CI: 41.3%–64.3%) in females aged 21–40 from rural areas of Hyderabad. Propranolol exhibited the strongest interaction with TSH, suggesting potential therapeutic implications.

Factors Affecting Job Satisfaction among Healthcare Professionals at Public and Private Tertiary Care Hospitals in Pakistan

Behram Ahmad — 2025-07-31

Job satisfaction plays a critical role in the performance, motivation, and retention of healthcare professionals. In Pakistan, contrasting work environments between public and private hospitals may affect satisfaction levels, yet limited comparative data are available. Objectives: To assess job satisfaction among healthcare professionals in public and private tertiary care hospitals in Pakistan and identify key demographic and institutional factors associated with satisfaction. Methods: A descriptive cross-sectional study was conducted from 1^st July 2023 to 26^th February 2024 among 400 healthcare professionals in four tertiary care hospitals. Data were collected using a structured, self-administered questionnaire comprising demographic items and 30 Likert-scale job satisfaction statements. Descriptive statistics and Chi-square tests were applied using SPSS version 26.0. A p-value<0.05 was considered statistically significant. Results: Among the 400 participants, 57% reported being satisfied with their jobs. Job satisfaction was significantly higher among those working ≤12 hours/day (98.1%) compared to >12 hours/day (86.8%) (p<0.001). Satisfaction was also greater among professionals with >5 years of experience (p<0.001), permanent employment status (p=0.021), higher income brackets (p=0.026), and those working in the private sector (p=0.003). No significant associations were found with gender, marital status, or socioeconomic background. Conclusions: Job satisfaction is significantly influenced by institutional and structural factors. Policymakers and healthcare administrators should focus on strategies that ensure optimal working conditions, equitable compensation, and job security to foster a satisfied and stable healthcare workforce in Pakistan.

Stillbirths: The Neglected Epidemic of Silent Loss

Anna Maria Lavezzi — 2025-07-31

Each year, an estimated 2.6 million third-trimester stillbirths occur globally, 98% in low- and middle-income countries, yet this profound loss remains absent from major global health priorities. Stillbirths are not included in the Global Burden of Disease, disability-adjusted life years, or most international development goals [1]. In public health discourse, they are largely invisible. For affected families, the consequences extend beyond grief. In many regions, the loss of a stillborn child is compounded by social stigma, blame, and isolation. Rituals of mourning are often denied. Babies are not named or held, and their deaths are attributed to fate, sin, or spiritual causes. This erasure leaves women unsupported and silenced [2].

Despite perceptions of inevitability, many stillbirths are preventable. Over 1 million intrapartum stillbirths occur annually, often in settings where basic emergency obstetric care, infection screening, and nutrition programs could save lives. Evidence supports the impact of periconceptional folic acid supplementation, malaria prevention, syphilis treatment, and improved antenatal monitoring. In 68 priority countries, broad implementation of these interventions could reduce stillbirths by up to 45% [3]. However, progress is slow. Stillbirth reduction is not consistently included in national health strategies, and data remain scarce. In many countries, less than 5% of stillbirths are officially registered [4]. Without consistent classification and recording, intervention efforts are poorly targeted and their impact under measured.

Every Newborn Action Plan targets 12 or fewer stillbirths per 1,000 births by 2030, but at least 56 countries will need to more than double their current rate of progress. Achieving this goal requires political will, investment, and integration of stillbirth prevention into broader maternal and neonatal care frameworks [5].

We must insist on recognition, registration, and research. Governments must be held accountable for counting and reporting stillbirths. Interventions must be expanded, and community beliefs must be addressed with empathy and evidence. Every stillbirth is a human tragedy—and a signal of systemic failure. More than 7,000 families each day experience the reality of stillbirth. These losses must no longer be met with silence. Acknowledging the scale and causes of stillbirth is the first step toward prevention, justice, and healing.

The Effectiveness of Myofascial Release in Managing Pain, Improving Mental Health and Quality of Life in Fibromyalgia Patients: A Narrative Review

Gulzar Ahmad — 2025-07-31

Fibromyalgia is a chronic condition characterized by widespread pain, mental health issues, and reduced quality of life. Myofascial release (MFR) has emerged as a potential treatment, targeting fascia to release tension and promote relaxation. This narrative review explores the impact of MFR on fibromyalgia symptoms, evaluating its efficacy, long-term effects, and comparative effectiveness. A comprehensive review of 14 studies published between 2021 and 2025 was conducted, including randomized controlled trials, quasi-experimental studies, systematic reviews, and case series. The results demonstrated that MFR significantly reduced pain intensity, improved mental health, and enhanced quality of life in patients with fibromyalgia. Specifically, MFR was associated with reduced pain, improved sleep quality, and better functional ability. The benefits of MFR were observed in various study designs, providing a promising approach for managing fibromyalgia symptoms. While MFR is a valuable addition to multidirectional treatment plans for fibromyalgia, further research is needed to establish standardized protocols. This review provides insights into MFR benefits and limitations, guiding clinical practice and future research. The findings suggest that MFR can be an effective treatment option for managing fibromyalgia symptoms, improving patient outcomes and quality of life. However, additional high-quality research is necessary to confirm the long-term efficacy and optimal application of MFR in clinical practice. By informing clinical practice and guiding future research, this review aims to contribute to the development of effective treatment strategies for fibromyalgia management. Overall, MFR shows promise in alleviating fibromyalgia symptoms and improving patient outcomes.