Dark tetrad personality traits and counterproductive work behavior among doctors in Pakistan

The purpose of this article is to identify the effects of dark tetrad personality traits (such as narcissism, psychopathy, Machiavellianism and sadism) on counterproductive work behavior with the mediating role of psychological contract breach and the moderating effect of political skills. Previous researches have focused on the direct effect of the dark triad to measure the counterproductive work behavior of individuals. Recently, everyday sadism has been added to the dark triad and become dark tetrad personality traits. Therefore, this study examines the dark tetrad personality traits to study counterproductive work behavior. This study applied structural equation modeling using partial least square to test the hypotheses on a sample of 400 doctors from the health sector of Pakistan. The results of this study reveal that dark tetrad has a positive and significant effect on counterproductive work behavior, and psychological contract breach significantly partially mediates in the relationship between dark tetrad and counterproductive work behavior. Furthermore, findings show that the moderating effect of political skills also positively and significantly strengthening the link between dark tetrad and the psychological contract breach. The conclusion of this study is made an innovative contribution to the Pakistan health sector, researchers and policy makers to designing the relevant practical implications.     

Why is Pakistan vulnerable to COVID-19 associated morbidity and mortality? A scoping review

The scoping review was undertaken to outline the vulnerabilities of Pakistan's public health and healthcare system, which put the population at increased risk of coronavirus disease 2019 (COVID-19) associated morbidity and mortality. The major electronic databases were searched using both “text words” and “thesaurus terms,” focusing on viral infections, COVID-19 and healthcare systems in Pakistan. The content of the selected articles was analyzed by using thematic approach. Out of the total 171 potentially relevant citations, 24 articles were included in the data synthesis. We found that the recent COVID-19 outbreak is a major threat to Pakistan's public health and healthcare system, and the country is not in a position to control spread of disease and provide required standards of care deemed necessary by the World Health Organization. A number of intertwined reasons that expose the Pakistani population at increased risk of COVID-19 associated morbidity and mortality, include public related demurrals, healthcare workforce related demurrals, organizational and regulatory voids, and travel patterns. To cope with the upsurge of COVID-19 in Pakistan, the regulators need to re-examine and recognize deficiencies in the healthcare system, and thereafter reinforce core capacities in workforce and monetary resources, surveillance, laboratory services, and hospital preparedness for isolation and ventilation of patients.     

Determinants of households’ food insecurity with severity dimensions in Pakistan: Varying estimates using partial proportional odds model

This study is conducted to determine the impact of some selected socioeconomic and demographic factors on households’ food insecurity in Pakistan. Data are taken from national‐level survey Household Integrated Income and Consumption Survey 2015–2016. Inclusion of gender dimensions of some important factors and estimation of varying estimates at four severity levels of households’ food insecurity status using partial proportional odds model may be considered unique features of the study. It is concluded that household's income, employment, agricultural income, donations, parental education level and some households’ characteristics are important factors for improving food security in Pakistan. Maternal education, and maternal paid employment compared to paternal education, and paternal paid employment show strong positive effects to improve severe food insecurity. Couple paid employment, livestock ownership and operating agricultural land seem to have the most effective role for improving food security. Social welfare programmes and religious institution of Zakat are helpful to cope with severe food insecurity in Pakistan. Some special efforts or development strategies are recommended to improve food insecurity of rural households and Baluchistan province. Moreover, the observed U‐type quadratic impact of household size and the adverse impact of dependency ratio induce effective policies to control high birth rate in Pakistan. Hence, creation of employment opportunities especially for women, appreciation of couple paid employment, easy access to education for women, steps to raise level of education, growth of agricultural sector, rural development, social welfare and development schemes for Baluchistan, and continuation of Benazir Income Support Program are recommended to overcome severe and moderate level food insecurity in Pakistan. Since socioeconomic conditions and food insecurity issues of developing countries and especially in South Asian countries are homogeneous and therefore, the analysis in this study might be relevant to South Asian region.     

Etiology of acute viral respiratory infections common in Pakistan: A review

Respiratory infections, especially those of the lower respiratory tract, remain a foremost cause of mortality and morbidity of children greater than 5 years in developing countries including Pakistan. Ignoring these acute‐level infections may lead to complications. Particularly in Pakistan, respiratory infections account for 20% to 30% of all deaths of children. Even though these infections are common, insufficiency of accessible data hinders development of a comprehensive summary of the problem. The purpose of this study was to determine the prevalence rate in various regions of Pakistan and also to recognize the existing viral strains responsible for viral respiratory infections through published data. Respiratory viruses are detected more frequently among rural dwellers in Pakistan. Lower tract infections are found to be more lethal. The associated pathogens comprise respiratory syncytial virus (RSV), human metapneumovirus (HMPV), coronavirus, enterovirus/rhinovirus, influenza virus, parainfluenza virus, adenovirus, and human bocavirus. RSV is more dominant and can be subtyped as RSV‐A and RSV‐B (BA‐9, BA‐10, and BA‐13). Influenza A (H1N1, H5N1, H3N2, and H1N1pdm09) and Influenza B are common among the Pakistani population. Generally, these strains are detected in a seasonal pattern with a high incidence during spring and winter time. The data presented include pneumonia, bronchiolitis, and influenza. This paper aims to emphasise the need for standard methods to record the incidence and etiology of associated pathogens in order to provide effective treatment against viral infections of the respiratory tract and to reduce death rates.     

Influence of single‐nucleotide polymorphisms in the IFNG towards susceptibility to tuberculosis in a Pakistani population

Tuberculosis (TB) is a global issue as one‐third of the population worldwide is considered to be infected. TB has become a critical public health problem as a result of increasing drug resistance, which poses a challenge to current control strategies. Similar to environmental factors, genetic makeup of the host equally contributes to disease onset. We performed genotypic analysis to examine the relationship between IFNG and TB onset and drug resistance in a Pakistani population comprising 689 subjects. Notable differences were observed in the IFNG polymorphism (+874T/A) between the case and control groups. The frequency of the wild‐type genotype (TT) in the controls (43.2%) was significantly higher than in the cases (25.3%) (odds ratio [OR] = 0.77, p < 0.0001), while the mutant genotype frequency (AA) (38.57%) in the cases was significantly higher than in the controls (22.6%) (OR = 1.46, p < 0.0001). The heterozygous genotype frequency (TA) did not significantly differ between the control and case groups. Compared with the controls, the variant allele (A) was approximately twice as frequent in the cases. Females and older people have a higher chance of disease development. Finally, the IFNG (+874T/A) polymorphism was not associated with drug sensitivity or resistance. However, a genotypic polymorphism of IFNG (+874T/A) was significantly associated with susceptibility to TB, and the T allele conferred protection against TB. Additional studies involving larger cohorts are needed to further explore this relationship between genetics and disease vulnerability.     

巴氯芬和左莲饮联合治疗顽固性呃逆53例疗效观察

目的：观察巴氯芬和左莲饮中西医结合治疗顽固性呃逆的疗效并进行评价.方法：选择2008-2010年就诊与我院门诊的顽固性呃逆的病人,随机分为联合治疗组和对照组,联合治疗组给与巴氯芬和左莲饮联合用药,对照组仅用巴氯芬,观察两组病人治疗后的临床疗效,并用统计学方法进行评价.结果：巴氯芬和左莲饮联合治疗组53例病人,显效45例（84.9%）,有效8例（15.1%）;对照组48例病人,显效31例（64.6%）,有效5例（10.4%）,联合治疗组效果明显好于对照组,差别有统计学意义,P〈0 05.结论：巴氯芬和左莲饮结合治疗顽固性呃逆具有较好的临床效果.     

Germline Variations of Apurinic/Apyrimidinic Endonuclease 1 (APEX1) Detected in Female Breast Cancer Patients

Apurinic/apyrimidinic endonuclease 1 (APEX1) is a multifunctional protein which plays a central role inthe BER pathway. APEX1 gene being highly polymorphic in cancer patients and has been indicated to havea contributive role in Apurinic/apyrimidinic (AP) site accumulation in DNA and consequently an increasedrisk of cancer development. In this case-control study, all exons of the APEX1 gene and its exon/intronboundaries were amplified in 530 breast cancer patients and 395 matched healthy controls and then analyzedby single-stranded conformational polymorphism followed by sequencing. Sequence analysis revealed fourteenheterozygous mutations, seven 5’UTR, one 3´UTR, two intronic and four missense. Among identified mutationsone 5’UTR (rs41561214), one 3’UTR (rs17112002) and one missense mutation (Ser129Arg, Mahjabeen et al.,2013) had already been reported while the remaining eleven mutations. Six novel mutations (g.20923366T>G,g.20923435G>A, g.20923462G>A, g.20923516G>A, 20923539G>A, g.20923529C>T) were observed in 5’UTRregion, two (g.20923585T>G, g.20923589T>G) in intron1 and three missense (Glu101Lys, Ala121Pro, Ser123Trp)in exon 4. Frequencues of 5’UTR mutations; g.20923366T>G, g.20923435G>A and 3’UTR (rs17112002)werecalculated as 0.13, 0.1 and 0.1 respectively. Whereas, the frequency of missense mutations Glu101Lys,Ser123Trp and Ser129Arg was calculated as 0.05. A significant association was observed between APEX1mutations and increased breast cancer by ~9 fold (OR=8.68, 95%CI=2.64 to 28.5) with g.20923435G>A (5’UTR), ~13 fold (OR= 12.6, 95%CI=3.01 to 53.0) with g.20923539G>A (5’UTR) and~5 fold increase with three missensemutations [Glu101Lys (OR=4.82, 95%CI=1.97 to 11.80), Ser123Trp (OR=4.62, 95%CI=1.7 to 12.19), Ser129Arg(OR=4.86, 95%CI=1.43 to 16.53)]. The incidence of observed mutations was found higher in patients with familyhistory and with early menopause. In conclusion, our study demonstrates a significant association between germline APEX1 mutations and breast cancer patients in the Pakistani population.