Journal of Bashir Institute of Health Sciences

Cross-Sectional Study on the Prevalence of Asthenopic Symptoms Among Digital Screen Users

Kulsoom — 2025-08-19

This cross-sectional study aimed to assess the prevalence of asthenopic symptoms among digital screen users in Muzaffargarh, Pakistan. A total of 97 participants were surveyed, with 66% reporting at least one symptom of digital eye strain. The most commonly reported symptoms were eye discomfort (52%), blurred vision (45%), dry eyes (38%), and headaches (42%). A significant positive correlation was observed between daily screen time and asthenopic symptoms (p < 0.001), with those using screens for more than six hours per day experiencing higher symptom rates. Additionally, environmental and behavioral factors, including poor lighting conditions (p = 0.017), improper screen positioning (p = 0.01), and the use of blue light filters (p = 0.004), were found to affect symptom prevalence significantly. Furthermore, reduced blinking (p = 0.009), multitasking (p = 0.003), and high caffeine consumption (p = 0.012) were associated with increased visual discomfort. Gender differences were noted, with females reporting more frequent headaches and dry eyes than males, though the overall difference in symptom prevalence was not statistically significant (p = 0.09). These findings highlight the multifactorial nature of asthenopia, suggesting that both environmental and behavioral modifications could reduce the prevalence and severity of digital eye strain among screen users.

Prevalence of Groin Strain and Its Impact on Quality of Life among Field Hockey Players of Islamabad: Cross-Sectional Study

Hina Javed — 2025-08-19

Background: Groin strain is a condition in which the inner thigh muscles, the adductors, are overstretched, causing pain. This is a common injury among athletes in many sports, especially those involving sudden twisting or rapid changes of direction. Groin strains are highly prevalent in field hockey due to sport-specific biomechanics; however, data on prevalence and quality-of-life (QoL) impact in Pakistani athletes is limited. Hence, understanding the prevalence and impact of groin strains can help identify common risk factors in developing prevention and treatment strategies to reduce injury rates. This study aims to determine groin strain prevalence and its association with QoL using HAGOS in Islamabad field hockey players. Methods: A cross-sectional study of 134 male field hockey players (20–51 years) from Islamabad Sports Complex assessed groin strain prevalence using the Copenhagen Hip and Groin Outcome Score (HAGOS). Groin strain was defined as HAGOS ≤70. Descriptive statistics characterized demographics; ANOVA with effect sizes (η²) compared HAGOS domains between impaired/non-impaired groups; and multiple regression identified quality-of-life (QoL) predictors. Results: The study identified a 31.3% prevalence (n=42) of clinically significant groin strain (HAGOS ≤70) among male field hockey players in Islamabad. Athletes with groin strain exhibited severe functional deficits across all HAGOS domains (p<0.001), with the largest impairments in Pain (Δ=31.4, η²=0.626) and Symptoms (Δ=30.4, η²=0.567). Paradoxically, Physical Activity participation was preserved despite symptoms (lowest η²=0.119), reflecting cultural norms prioritizing athletic persistence over symptom reporting. Regression analysis revealed Pain (β=0.3479, p=0.003), Daily Function (β=0.2484, p=0.018), and Symptoms (β=0.2112, p=0.024) as key predictors of diminished Quality of Life (QoL), collectively explaining 52.7% of variance. Conversely, Sports Function showed no QoL association (β=-0.0008, p=0.992), highlighting a critical disconnect between athletic performance and holistic wellbeing. Conclusion: Groin strain prevalence in Pakistani hockey players reflects region-specific risks, with pain—not mechanical dysfunction—driving severe disability. Athletes prioritize sport participation over wellbeing, decoupling performance from holistic health. Culturally adapted interventions must target pain neuroscience education, load management on natural turf, and institutional QoL monitoring to reconcile athletic resilience with sustainable health.

Efficacy of Amblyopic Patching Therapy in Children with Down Syndrome: A Study on Refractive Errors and Visual Acuity Outcomes

Farwa Gul — 2025-08-19

Background: Down syndrome (DS), caused by trisomy 21, is associated with developmental delays and a high prevalence of ocular conditions, including refractive errors and amblyopia. To identify the types of refractive errors in children with Down syndrome and to assess the efficacy of amblyopic patching therapy on visual acuity outcomes. Methods: This prospective longitudinal study was conducted at the Strabismus Unit of Layton Rahmatulla Benevolent Trust (LRBT), Lahore, from September 2022 to May 2023. Thirty children with Down syndrome aged 8 to 18 years diagnosed with amblyopia were enrolled. The non-amblyopic eye was patched for four hours daily for three months. Visual acuity was assessed using the LogMAR chart, and refractive errors were determined through objective and subjective refraction. Data was analyzed using SPSS version 22.0. Descriptive statistics were used for demographic variables. Repeated Measures ANOVA was applied to compare baseline, one-month, and three-month follow-up measurements. A p-value of < 0.05 was considered statistically significant. Results: A total of thirty Down syndrome patients (mean age 14.19 ± 1.04 years; 50% male, 50% female) were enrolled. Hypermetropia was found in 66.7% (n=20) and myopia in 33.3% (n=10) of participants. Visual acuity improved significantly from a baseline mean of 0.55 ± 0.27 to 0.54 ± 0.27 at one month, and 0.41 ± 0.258 at three months (p = 0.041). Pairwise comparison showed maximum improvement at the three-month follow-up (p = 0.001). Mean glasses prescription improved from 2.13 ± 2.13 at baseline to 2.11 ± 1.40 at one month and 1.71 ± 1.32 in three months (p = 0.047), with a significant difference observed at the three-month mark (p = 0.001). These findings indicate the effectiveness of patching therapy in improving both visual acuity and refractive correction over time. Compliance was generally good across the cohort. Conclusion: Amblyopic patching therapy was effective in improving visual acuity in children with Down syndrome, with the greatest benefit observed after three months of consistent treatment.

Evaluating the Role of Colored Filters (Red, Green) in Improving Color Vision Deficiency

Ayesha Rahman Qazi — 2025-08-19

Background: Color Vision Deficiency (CVD) is defined as the inability to make discriminations based on the wavelength composition of the light, independent of its intensity. This is due to the abnormalities found in the cone cells of the retina. Some professional activities become so difficult that effective tools like colored filters are needed. These filters do not treat the condition overall, but they improve the perception of color and, therefore, the quality of life for all CVD patients. Methods: This study used an observational cross-sectional study design. 500 patients were screened for Color Vision Deficiency (CVD) for two months using the Ishihara test, visiting the Eye OPD of PIMS hospital. Patients who have CVD were then subjected to red and green filters to assess any improvement in the discrimination of colors. The data were then analyzed to find out whether these filters made any improvement in colour discrimination in CVD patients. Results: From these 500 people who were examined, 30 of them (6%) had Color Vision Deficiency (CVD). From these diagnosed patients, 73.3% were males,90% were red-deficient (Protanopia/Protanomaly), and the remaining 10% were green-deficient (Deuteranopia/Deuteranomaly). Red filters were effective for all patients when subjected to the Ishihara plate tests. Whereas green filters did not show any effect on CVD. These findings show the practical use of red filters for the enhancement of color vision for those with CVD. Conclusion: Red filters enhanced the color perceptions in patients with Color Vision Deficiency (CVD), especially in red-green deficient patients. This study confirms red filters can be used as an effective management device for CVD.

Knowledge-Practice Gaps in Medical Ethics: A Cross-Sectional Study of Healthcare Professionals at a Pakistani Tertiary Hospital

Sundus Khan — 2025-08-19

Background: Quality healthcare relies on medical ethics, which helps professionals to make complicated decisions based on patient autonomy, beneficence, non-maleficence, and justice. This study evaluated the knowledge, attitudes, and practices (KAP) of HCWs in Pakistan Institute of Medical Sciences (PIMS) to determine the gaps and provide a basis on which to design specific educational interventions. Methods: A cross-sectional study was done at PIMS, where 264 healthcare professionals (consultants, registrars, house officers, medical students, and postgraduate trainees) were involved. They used a structured questionnaire to collect the information that consisted of demographics, self-reported medical ethics/laws knowledge, sources of training, the frequency of ethical issues, attitude toward the main principles (e.g., informed consent, patient rights), and ethical decision-making practices. SPSS 22 was used to analyze descriptive statistics (frequencies/percentages). Results: The participants of the study were males (60.61%), aged 21-30 (48.48%), and with more than five years of working experience (39.4%). Major gaps in knowledge were found: 21.2% of them knew about the Nuremberg Code, 24.2% about the Helsinki Declaration, and 36.4% about the PMDC Code. Although 69.7 % of them considered the knowledge of ethics as very important, 30.3 % had average knowledge of the laws that were relevant, and 18.2% did not know the relevant laws. The first source of knowledge was training (ethics: 42.4%; laws: 45.5%). In terms of practices and attitudes, 57.6 % of them sometimes got informed consent in the local language, and 24.2 % of them never gave copies of consent to patients. Just 27.3 % indicated that an active ethics committee (IEC) existed in their institution, and 63.6 % were uncertain. The attitudes indicated contradictions: 39.4 % of the respondents indicated that ethical conduct was mainly to prevent legal action, whereas 45.5 % of the respondents indicated that written consent was a requirement in clinical trials. Lastly, 24.24 % of them experienced ethical/legal problems daily, but 39.39 % did not experience any such problems. Conclusion: The HCWs at PIMS have identified the value of medical ethics, yet they have a high level of knowledge gaps in the basic codes of ethics, laws, and the roles of IECs. Variability in informed consent and low IEC involvement identify systemic gaps. A special, ongoing education that combines formal ethics training, hands-on workshops, and IEC reinforcement is urgently required to improve ethical competency and patient care quality within the healthcare system of Pakistan.

Challenges in Provision of Essential Dental Care Services by Dentists during the Covid-19 Pandemic in Public and Private Healthcare Facilities in Islamabad, Pakistan

Maham Zulfiqar — 2025-08-19

Background: The COVID-19 pandemic has been a burden to all healthcare professionals, including dentists. The close contact and exposure to aerosols create a serious health hazard for the dental professionals; it’s impossible to halt the clinical practice completely, as it not only is economically challenging, but also creates an ethical dilemma by depriving patients of care who are in need. This study aimed to explore various challenges faced by dental professionals in providing essential dental care services during the COVID-19 pandemic in public and private healthcare facilities of Islamabad and assessed their knowledge and attitude regarding updated guidelines, PPE protocols, and their implementation. Methods: It was a descriptive cross-sectional study that used a comprehensive questionnaire to collect data about various variables related to challenges faced by dental professionals practicing during the COVID-19 pandemic. The questionnaire consisted of eight sections, including socio-demographic, patient attitude, trends of practice, medical resources, COVID-19 SOPs, PPE, financial burden, anxiety, and depression. A sample of 70 dental professionals, with the majority dentists (93%), participated in the study. About 43% practiced in private clinics, 30% in private hospitals, and 26% in public hospitals. The data were collected using Google Forms, and then the statistical analyses using the chi-square test at p<0.05 were conducted using SPSS software version 25. Results: Majority of the participants (70%) agreed that the practice changed during COVID-19, about 68% performed non-emergency procedures due to various underlying reasons. The type of workplace was also significantly associated with a decrease in income, use of another source of income, taking a COVID-19 test for patients, and belief that the latest guidelines of dental settings during COVID-19 are useful. The field of practice of dental practitioners was significantly associated with the belief that the phone is effective in resolving patients’ dental problems, the types of dental services provided, and belief in possible changes in guidelines toward dental practice during COVID-19 in the future. Conclusion: The study revealed that even though the knowledge of dental practitioners regarding the latest guidelines seemed up to date, they faced financial, psychological, and other challenges regarding resources in their practices owing to this pandemic. Thus, the government and policymakers must pay attention to these factors while designing future guidelines and ensure the availability of the required material and equipment.

Prevalence of Anxiety, Depression, Sleep Quality and Suicide Ideation among Medical Students in Islamabad, Pakistan

Maira Manzoor Kiani — 2025-08-19

Background: Medical education is stressful and challenging, as it usually exposes students to multiple academic pressure, working long hours, and emotional stressors. The medical students are prone to developing mental health problems that may have a severe effect on their general well-being and academic performance. The purpose of the research study is to examine the prevalence of anxiety, depression, sleep quality, and suicide ideation among medical students. Methods: The research study was cross-sectional, and the data were collected among medical students studying in different medical colleges and universities in Islamabad, Pakistan. The stratified random sampling was employed to represent various years of study and institutions. Data were collected using validated self-report questionnaires, such as the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Beck Scale for Suicide Ideation. The administration of the data collection was based on a structured online survey, which guaranteed the confidentiality and anonymity of the participants. The data was analyzed using statistical analysis such as descriptive statistics, chi-square tests, t-tests, and multivariate analysis. Results: The data of 200 people were analyzed, and the proportion of males and females was equal. A significant number of people recognized the presence of stressors, with 39% of men and 27% of women reporting the existence of stressors. The use of benzodiazepines in sleep was on the lower side [12% in males and 8% in females]. A few participants (a small percentage) indicated that they had substance abuse. Most of them practiced exercise, although regular exercise was less common. The level of anxiety was different, and mild anxiety was the most frequent. The degree of depression was not very high, and the participants described different levels of sleep disturbances. A minor proportion was administered the Beck Scale of Suicide Ideation, and some of them had positive outcomes. Conclusion: This study provides insights into the prevalence of anxiety, depression, sleep quality, and suicide ideation among medical students in Pakistan. The findings suggest that medical students face significant mental health challenges, including high rates of anxiety, depression, and sleep disturbances. These results emphasize the importance of addressing the mental well-being of medical students and implementing targeted interventions and support systems to promote their resilience and overall well-being.

Prevalence of Computer Vision Syndrome among Staff Working at the Radiology Department in Healthcare Settings of Islamabad, Pakistan

Maria Waris — 2025-08-19

Background: Computer Vision Syndrome (CVS) is a severe occupational health issue in the field of radiology because of the widespread application of digital displays (e.g., PACS) to interpret images. Although the risks of CVS are well known globally due to their visual strain, headaches, and decreased productivity, little research has been conducted on radiology personnel in low-resource countries. This paper explored the prevalence of CVS, risk factors, and symptom profile in radiology workers in Islamabad, Pakistan, where the use of digital healthcare is rapidly growing without the corresponding protective strategies. Methods: A cross-sectional survey was done in 161 radiology employees (radiologists, technologists, nurses) of both government and privately owned hospitals in Islamabad. The participants were recruited through consecutive sampling and were evaluated with the help of the validated CVS-QT questionnaire that evaluated socio-demographics, screen exposure, ocular symptoms, and preventive practices. CVS was categorized as a symptom score of 6 or more, mild (6-19), moderate (10-14), or severe (15-18). The analysis of data was done in SPSS v 28, with descriptive statistics and chi-square tests used to determine risk-symptom relationships (significance: p < 0.05). Results: The prevalence of Computer Vision Syndrome among the radiology staff under investigation was 49.1%, with the severity of symptoms being mild (22.4%), moderate (15.5%), and severe (9.3%). The most common symptoms were headache, tearing eyes, and itching eyes, with 70.9%, 50.3%, and 47.9% of the participants reporting them, respectively. The top modifiable risk factors that were significantly linked to CVS were exposure to screen time all day long, more than five hours (45.3% of staff), poor workstation ergonomics where monitors are placed below eye level (47.2%), and lack of preventive measures (54.7%). It is worth noting that younger staff (20-29 years) and female workers had disproportionately increased rates of severe symptoms. There was a significant lack of protective measures, with only 31.7% taking regular breaks and only 5.0% using eye drops lubricating despite evidence-based recommendations. Conclusion: CVS is highly prevalent among Pakistani radiology staff, driven by modifiable occupational hazards: prolonged screen time, poor ergonomics, and inadequate eye protection. The disproportionate burden on younger professionals and women underscores the need for institutional interventions, including mandatory break protocols, ergonomic workstation redesigns, and accessible ocular health resources. Prioritizing these measures is essential to safeguard workforce well-being and diagnostic efficiency in radiology.

Molecular Insights into Hypertriglyceridemia-Associated Cardiovascular Disease and Pancreatitis in Pakistan: A Systematic Review

Quratul Ain — 2025-08-19

Background: Hypertriglyceridemia (HTG), defined as fasting triglyceride levels above 150 mg/dL, is a complex lipid disorder that significantly contributes to the burden of cardiovascular disease (CVD) and acute pancreatitis worldwide. While lifestyle factors, such as poor diet, obesity, and diabetes, play a major role in its development, genetics also have a profound impact on when and how the condition manifests, as well as how patients respond to treatment. In Pakistan, where consanguineous marriages are common and dyslipidemia is on the rise, the genetic landscape of HTG offers unique insights but remains largely unexplored. This review summarizes published research on the genetics of HTG in Pakistan. Methods: We systematically searched PubMed and Google Scholar up to June 2025 for studies on Pakistani individuals reporting genetic data related to triglyceride metabolism, using combinations of HTG-related terms and MeSH headings. Eligible designs included case reports, case–control studies, and family studies. Data were extracted on study characteristics, genetic variants, and clinical associations. Results: Five studies met the inclusion criteria. Variants in APOA5, LPL, GPIHBP1, and CETP were associated with severe or moderate HTG, therapeutic responses, and CVD risk. No studies examined the genetic basis of HTG-associated pancreatitis in Pakistan. Limitations included small sample sizes, restricted gene coverage, and the absence of longitudinal follow-up. Conclusion: Limited evidence links both rare, high-impact and common triglyceride-related variants to HTG and CVD risk in Pakistani populations. There is an urgent need for large-scale genomic studies, especially on pancreatitis genetics, to enable precision-based interventions.