Papers by Dr Muhammad Sami Bilal
Health Affairs Journal , 2024
Background: Postpartum depression (PPD) is a significant public health concern, particularly in l... more Background: Postpartum depression (PPD) is a significant public health concern, particularly in lowresource settings where access to mental health care is often limited. The condition can adversely affect maternal health, infant development, and family dynamics, necessitating effective identification and management strategies. Aim: The study aimed to investigate the prevalence of postpartum depression and assess the effectiveness of management strategies in low-resource settings. Methods: This prospective observational study was conducted at Civil Hospital Kahuta Rawalpindi from October 2023 to September 2024. A total of 80 postpartum women were recruited using purposive sampling. Participants were screened for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and those with positive findings were assessed further through clinical interviews. Management strategies, including counseling and pharmacotherapy, were implemented based on the severity of symptoms, and outcomes were monitored over a six-months period. Results: The prevalence of postpartum depression in the study population was found to be 45%, with a higher occurrence among women with limited social support and financial constraints. Counseling was provided to all diagnosed cases, while 33% required additional pharmacological intervention. After four weeks of management, 75% of participants reported significant improvement in depressive symptoms, with better outcomes observed in those who adhered to the recommended treatment protocols. Conclusion: Postpartum depression was prevalent in a substantial proportion of women in low-resource settings. Tailored management strategies, combining counseling and pharmacotherapy, proved effective in alleviating symptoms. The findings underscore the need for integrating mental health services into maternal care programs in low-resource settings to ensure early detection and intervention for PPD.
Health Affairs Journal, 2024
Background: This syndrome known as Metabolic syndrome (MetS) including obesity, diabetes, and hyp... more Background: This syndrome known as Metabolic syndrome (MetS) including obesity, diabetes, and hypertension are being increasingly implicated in the causation of several urological disorders such as renal stones, erectile dysfunction (ED), and lower urinary tract symptoms (LUTS). These metabolic disturbances of MetS including insulin resistance and chronic inflammation advanced in this disease may play a key role in the development and progression of these disorders. Aim: The purpose of this present research was twofold: to review and determine the relationship between MetS and urological disorders/ diseases and to examine the possible pathophysiological relationship between MetS components and urological health consequences. Method: A cross sectional study; therefore, the sample of the population included people characterized by their metabolic status. The study also included clinical measurements of MetS and its components such as BMI, fasting blood glucose and blood pressure in addition to diagnostic tests for kidney stones, ED, and LUTS. Correlation and risk factors were done by regression models/statistical tests. Results: MetS was associated with a higher prevalence of kidney stones, ED and LUTS than no MetS. Overweight/obesity was positively related to the prevalence of kidney stone disease and LUTS while diabetes and hypertension had positive association with ED. The results of statistical models showed that the risk of urological diseases with MetS through Insulin resistance and vascular dysfunctions are increased. Conclusion: The finding has captured the significant relationship between MetS and urological disorders hence posturing that if the MetS complications are managed by lifestyle changes and medication, then the above illnesses could be addressed. MetS management should be included as a part of routine urological practice to recommend patient education and cooperation of urologist with metabolic expert.
Health Affairs Journal, 2024
Background: Women who experience recurrent miscarriages often face significant emotional and psyc... more Background: Women who experience recurrent miscarriages often face significant emotional and psychological challenges. Mental health conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) are common in this population. While psychological interventions and support strategies are recommended, their effectiveness in this specific context required further exploration. Aim: The study aimed to assess the mental health status of women with recurrent miscarriages and evaluate the effectiveness of psychological interventions and support strategies in improving their emotional well-being. Method: This retrospective cohort study included 120 women who experienced two or more consecutive miscarriages. Participants underwent a comprehensive mental health assessment using validated psychological scales, including the Beck Depression Inventory (BDI), Generalized Anxiety Disorder Scale (GAD-7), and the Impact of Event Scale-Revised (IES-R). Interventions included cognitive-behavioral therapy (CBT), peer support groups, and mindfulness-based stress reduction (MBSR). Outcomes were measured over a six-month period, and changes in mental health scores were analyzed using paired t-tests and regression analysis. Results: The study found that 78% of participants exhibited moderate to severe levels of anxiety and depression before the intervention. Post-intervention assessments revealed a significant reduction in anxiety (mean GAD-7 score decrease of 4.2, p<0.01) and depression (mean BDI score decrease of 5.6, p<0.01). PTSD symptoms, as measured by IES-R, also showed significant improvement (mean score reduction of 6.3, p<0.05). CBT and MBSR were particularly effective in reducing emotional distress, while peer support groups helped improve coping mechanisms and social connectedness. Conclusion: Psychological interventions, particularly CBT and MBSR, were effective in improving the mental health of women with recurrent miscarriages. Peer support further enhanced emotional resilience by fostering a
Health Affairs Journal, 2024
Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among adolescent g... more Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among adolescent girls, considered by a range of symptoms that can profoundly affect their psychosocial well-being. Despite considerable research on the physical manifestations of PCOS, its psychosocial impact remains less understood, particularly in the adolescent population. Aim: This study aimed to discover psychosocial effects of PCOS in adolescent girls, focusing on their emotional well-being, social interactions, and quality of life. Methods: A mixed-methods study was conducted from December 2022 to December 2024, involving 100 adolescent girls diagnosed with PCOS. Quantitative data were collected using standardized questionnaires measuring depression, anxiety, self-esteem, and quality of life. Qualitative data were obtained through semi-structured interviews, exploring applicants' personal experiences and coping mechanisms. Statistical analysis of the quantitative data was accomplished by means of SPSS software, while thematic analysis was applied to qualitative data to recognize recurrent outlines and themes. Results: Quantitative findings indicated that 65% of the participants experienced moderate to severe levels of depression and anxiety. Low self-esteem was reported by 58% of the girls, and 72% perceived a substantial negative effect on their quality of life. The qualitative analysis revealed four main themes: emotional distress, social isolation, stigma and self-image issues, and adaptive coping strategies. Participants frequently described feelings of frustration and helplessness due to their symptoms, leading to withdrawal from social activities and strained peer relationships. Stigmatization and concerns about body image were common, exacerbating their emotional struggles. Despite these challenges, many girls employed various coping mechanisms, like seeking support from family and friends, engaging in hobbies, and accessing professional counseling.
Health Affairs Journal, 2024
Background: Psychological autopsy has emerged as a valuable tool in suicide investigations, provi... more Background: Psychological autopsy has emerged as a valuable tool in suicide investigations, providing insight into the deceased's mental state, behavior, and life circumstances leading up to their death. This method aids in understanding underlying factors that contribute to suicide, such as mental health disorders, substance abuse, and social stressors, which are not always evident through physical autopsy alone. Aim: The study aimed to evaluate the effectiveness of psychological autopsy in determining the cause of death in suspected suicide cases and to assess its utility in distinguishing between suicide and other causes of death. Methods: This retrospective study involved a detailed psychological autopsy of 50 individuals who died by suspected suicide. Data were collected through interviews with family members, friends, and healthcare professionals, as well as a review of medical, psychiatric, and social records. The information was then analyzed to identify common psychological, social, and environmental factors contributing to the deaths. Results: Psychological autopsies provided critical insights into 85% of the cases, clarifying the deceased's mental state and confirming suicide as the cause of death in 42 cases. In 8 cases, psychological autopsy revealed significant ambiguity, leading to a reevaluation of the initial cause of death. Common factors identified included depression, substance abuse, and interpersonal conflicts, with 70% of individuals having experienced a recent life stressor. Conclusion: Psychological autopsy proved to be an essential tool in suicide investigations, offering a deeper understanding of the deceased's motivations and circumstances. Its application not only clarified the cause of death but also highlighted the importance of mental health interventions in suicide prevention.
Health Affairs Journal, 2024
Background: Breast cancer remains one of the leading causes of morbidity and mortality among wome... more Background: Breast cancer remains one of the leading causes of morbidity and mortality among women globally. Early detection and awareness of associated risk factors are essential to improve prognosis and reduce disease burden, particularly among females of reproductive age. Aim: The study aimed to determine the prevalence, identify the risk factors, and assess the effectiveness of early detection practices for breast cancer among females of reproductive age. Methods: A cross-sectional study was conducted at Allied Hospital Faisalabad. The study population comprised 100 females of reproductive age. Data were collected between February 2024 and January 2025 using structured questionnaires, clinical evaluations, and screening tests including breast selfexamination awareness and clinical breast examinations. Demographic variables, family history, lifestyle factors, and reproductive history were assessed. Results: The prevalence of breast cancer in the study population was found to be 7%. Significant risk factors included a positive family history of breast cancer (p<0.01), early menarche (p=0.03), nulliparity (p=0.04), and obesity (p<0.05). Only 38% of participants reported practicing regular breast selfexamination, and just 25% had ever undergone a clinical breast examination. Lack of awareness and cultural stigma were identified as major barriers to early detection. Conclusion: The study highlighted a notable prevalence of breast cancer among reproductive-age females, with several modifiable and non-modifiable risk factors. The low uptake of early detection methods emphasizes the need for public health strategies focused on awareness, education, and accessible screening programs to promote early diagnosis and better outcomes.
Health Affairs Journal, 2024
Background: Pregnancy-related stress and anxiety can have adverse effects on both maternal and fe... more Background: Pregnancy-related stress and anxiety can have adverse effects on both maternal and fetal health. MBIs, rooted in mindfulness meditation, promote present-moment awareness and non-judgmental acceptance. These practices have shown promise in reducing stress and anxiety across various populations, but their impact on pregnant women remains an area of active research. Aim: This study aims to investigate the effectiveness of Mindfulness-Based Interventions in reducing stress and anxiety in pregnant women. Methodology: The study was conducted in Health Ways Hospital OTS road Kohat. A randomized controlled trial was conducted with a sample of pregnant women in their second and third trimesters. Participants were randomly assigned to either a mindfulness intervention group or a control group. The mindfulness intervention consisted of guided mindfulness exercises tailored to the needs of pregnant women, conducted over a period of eight weeks. The control group received standard prenatal care without mindfulness components. Pre-and post-intervention assessments of stress and anxiety levels were conducted using standardized scales. Results: The results indicated a significant reduction in both stress and anxiety levels among pregnant women who participated in the mindfulness intervention compared to the control group. The mindfulness group exhibited improved emotional well-being and reported enhanced coping mechanisms. These findings suggest that Mindfulness-Based Interventions can be a valuable tool in managing stress and anxiety during pregnancy. Conclusion: This study provides empirical evidence supporting the effectiveness of Mindfulness-Based Interventions in reducing stress and anxiety among pregnant women. Incorporating mindfulness practices into prenatal care holds the potential to enhance the overall well-being of both expectant mothers and their unborn children. Further research could explore the long-term effects of such interventions and their impact on birth outcomes.
Physical Education, Health and Social Sciences , 2025
Teenage pregnancies present significant health and psychological challenges, particularly in unde... more Teenage pregnancies present significant health and psychological challenges, particularly in underdeveloped and populated region like Faisalabad District, Punjab, Pakistan. The study is aimed to evaluate psychological complications through semi structured interviews and observation methods through longitudinal strategy that may arise in fetuses due to maternal stress, inadequate medical care, and socio economic factors associated with adolescent pregnancies. Maternal stress and anxiety during the production period have been linked to altered fetal brain development, increasing the risk of cognitive and emotional disorders in newborns. Additionally, poor nutrition, lack of medical care, and social stigma contribute to developmental delays, low birth weight, and higher incidents of mental health disorders in the later life. This is suggested to tackle the targeted health program urgently, mental health care through psychotherapy, and educational initiatives to mitigate the risk associated with teenage pregnancies in Faisalabad. By addressing these issues, the neonatal health outcome and prolonged psychological burden on both mother and child can be improved by health initiatives and education.
Health Affairs , 2024
OBJECTIVE: A developmental disease called Williams Syndrome is characterized by a varied intellec... more OBJECTIVE: A developmental disease called Williams Syndrome is characterized by a varied intellectual impairment. Williams Syndrome patients need the assistance of numerous educational and medical experts throughout their lifetime. The effects of this handicap, particularly on families, are not well understood, but, in the local context. Knowing the degree of quality of life (QOL)as stated by families with Williams Syndrome (WS) was the goal. METHODS: The kids life Scale was used to examine 33 families that made up the sample. Their young people ranged in age from four to twenty. Emotional health, physical health, material health, personal growth, interpersonal relationships, self-determination, social inclusion, and rights were the eight key quality-of-life areas that were assessed. RESULTS: The data gained showed that a person's quality of life might be affected by a variety of factors to varying degrees, regardless of the severity and existence of an intellectual handicap. No variations in the quality of life were found that were statistically significant, however, there were disparities in reliance levels in the self-determination subarea (p-value <.05). CONCLUSIONS: Based on these findings, we examined how families and their surroundings could be affected socially and emotionally.
Health Affairs ISSN- 0278-2715 Volume 11 CURRENT ISSUE page 1711-1720, 2024
Background: Burnout is a condition where people feel disconnected from themselves, extremely tire... more Background: Burnout is a condition where people feel disconnected from themselves, extremely tired emotionally, and have a feeling of not achieving much. We don't have much information about burnout in doctors who are still in training or how it affects the way they take care of patients. Aim: To investigate the incidence of burnout among medical residents and their association with selfdescribed treatment of patients' practices. Methods: To determine burnout, researchers used a tool called the Maslach Burnout Inventory, which measures the level of burnout experienced by medical professionals. High scores on the depersonalization or emotional exhaustion sections of the inventory indicated burnout. In addition, participants were asked five specific questions about their patient care practices, which could suggest less than optimal care. These questions assessed behaviors such as not fully discussing treatment options or making errors that were unrelated to knowledge or experience. The researchers also evaluated despair and at-danger alcohol usage through exploitation of reliable questionnaires designed for screening these conditions. Results: Out of the 126 residents who responded to the survey (which is about 79% of the total), 92 residents (which is about 72%) showed signs of burnout. When comparing the burned-out residents to those who weren't burned out, it was found that burned-out residents were much more likely to admit that they provided suboptimal patient care at least once a month (55% compared to 22%). This change was substantial (P < 0.005). In analysis that took into account various factors, such as gender, despair, at-risk alcohol use, and burnout, it remained found that burnout was strongly linked to self-reported suboptimal patient care practices happening at least once a month. The odds of reporting such practices were 8.3 times higher for burned-out residents compared to those who were not burned out. The association was not as strong for factors like gender, despair, or at-danger alcohol use. When each aspect of burnout was assessed separately, this was found that only very high score in depersonalization remained linked to self-described suboptimal health care experiences. This relationship followed the dose-retort pattern, meaning that as the level of depersonalization increased, the likelihood of reporting suboptimal patient care practices also increased. Conclusion: Many resident doctors experienced burnout, and this burnout was linked to admitting that they provided suboptimal patient care practices.
Journal for Social Science Archives (JSSA) Volume 2, Number 2, 2024 , 2024
This study explores the role of positive emotions—joy, hope, and empathy—leading people into soci... more This study explores the role of positive emotions—joy, hope, and empathy—leading people into social action and community service. From the psychological theories of emotional motivation and prosocial behavior, the research is interested in how these emotions contribute to immediate and long-term involvement in causes. The survey-based quantitative approach included 300 adults involved in activism or community service. Measuring happiness, hope, and empathies, the Positive and Negative Affect Schedule PANAS was used. A customized Likert scale survey elicited information on participant's motivation to participate in activism. The statistical techniques conducted were correlation, regression, and mediation analysis to observe that positive emotions showed an effect on the engagement towards activism (r = 0.75 for happiness, r = 0.68 for hope, r = 0.80 for empathy, p < 0.01). Empathy mediated between joy/hope and long term activism; regression analysis indicated that empathy was most predictive of long term commitment (β = 0.30). Whereas joy and hope was the prime movers in short-term activism, it is in that aspect in which empathy actually made long-term participation truly stick together. This does empirically provide evidence to require emotional induction where induction of emotion of empathy seems to make a lot with social activism activation/maintenance at work. Implications: This is very important to nonprofit organizations, activists, as well as policymakers who might look to enhance social participation, as well as long-run dedication to social causes.
Pak Armed Forces Med J 2015; 65(5): 714-15 , 2015
Tracheomalaciais one of the complications, which usually results from prolonged compression of tr... more Tracheomalaciais one of the complications, which usually results from prolonged compression of trachea by expanding and longstanding goitre, particularly having an extension in the thoracic inlet. Respiratory embarrassment due to compression of the upper airways by the growing goitre is an indication for surgery, but the residual problem of tracheomalacia which develops after thyroidectomy is a life-threatening postoperative complication1. In rare cases patients develop symptoms preoperatively even without thyroid extension in the thorax. This case report emphasizes the need for extra care and vigilance while sedating and managing the outbursts of aggression in psychiatric and elderly patients especially with compromised airways.
Health Affairs ISSN - 0278-2715 E-ISSN - 1544-5208, 2024
Background: Prophylactic mastectomy (PM) is surgical risk-reduction for women with genetic mutati... more Background: Prophylactic mastectomy (PM) is surgical risk-reduction for women with genetic mutations which include BRCA 1 and BRCA 2 that put them at high risk of breast cancer. Genetic testing plays a crucial role in assessment of emotional and physical conditions and risk-related decision to choose PM or surveillance. Hence, identification of psychosocial consequences of these decisions is crucial for both confident patient-centered treatment and for effective decision-making. Aim: It will also reveal factors that affect the choice of prophylactic mastectomy based on the genetic risk such as BRCA1/BRCA2 mutations among other factors, and the psychosocial implications especially among those who have undergone the surgery or preferred surveillance. Method: The research design that was used in this case was a retrospective cohort analysis which targeted women who had been tested for BRCA1/BRCA2. Participants filled in the questionnaire which included questions concerning decision making factors, gene test results and psychosocial impact of BRCA Gene testing as well as issues related to mental health status that included body image and self-esteem as well as quality of life. Results: In women with reported BRCA1/BRCA2 mutations, 63% underwent PM and mutation carriers of BRCA1 had a higher likelihood of surgery. Consent, medical consultation, family records and genetic consultation helped in making these decisions. PM was associated with cancellation of related anxiety; however, body image and emotional issues were encountered by women who preferred this option and surveillance was associated with constant anxiety regarding the risk of cancer. Conclusion: BRCA1/BRCA2 mutation does play a role in the decisions to proceed with PMM but there are other genetic markers involved and family history as well. PM modifies the sufferers' life on a psychosocial level while surveillance also induces essential psychosocial consequences, making the necessity of individual genetic counselling and long-term psychosocial assistance indisputable. More research should be conducted in the future for increased understanding of the post-acute psychosocial outcomes as well as the novel genetic markers which may be in the future identified.
Prehospital and disaster medicine:, 2007
Vicarious traumatization is now a well-known entity and may have negative influences on those tha... more Vicarious traumatization is now a well-known entity and may have negative influences on those that are involved in rescue efforts in any disaster or traumatic events. Healthcare workers work with trauma survivors and witness an immense array of gruesome and ghastly images. This work has the potential to cause those engaged in rescue efforts to become affected subconsciously. Job-related stress may cause psychological symptoms in care providers who provide support and listen to the survivors’ account of trauma. A therapist working in disaster situations may become a victim of psychological anguish—undermining their physical and mental well-being as well as their profession, adversely affecting their traumatized patients, and leading to a counter-productive therapist-survivor relationship. This significant theme of secondary trauma must be recognized in relief workers at early stages and must be addressed at an individual as well as organizational level. The key may lie in turning to social supports, adapting positive coping mechanisms,and subsequently seeking mental health consultation. Further research is required in this area to determine the best resolution.
Prehospital and Disaster Medicine Journal, 2006
Vicarious traumatization is now a well-known entity and may have negative influences on those tha... more Vicarious traumatization is now a well-known entity and may have negative influences on those that are involved in rescue efforts in any disaster or traumatic events. Healthcare workers work with trauma survivors and witness an immense array of gruesome and ghastly images. This work has the potential to cause those engaged in rescue efforts to become affected subconsciously. Job-related stress may cause psychological symptoms in care providers who provide support and listen to the survivors’ account of trauma. A therapist working in disaster situations may become a victim of psychological anguish—undermining their physical and mental well-being as well as their profession, adversely affecting their traumatized patients, and leading to a counter-productive therapist-survivor relationship.
Counselling Psychology Quarterly, 2011
The primary objective of this article will focus predominantly upon EMDR as an evidence-based tre... more The primary objective of this article will focus predominantly upon EMDR as an evidence-based treatment intervention for psychological trauma. It outlines in particular an EMDR Humanitarian Assistance Training Programme that took place in Abbotabad and Rawalpindi in response to the Pakistan earthquake, 2005, in helping to train teams of mental health workers in EMDR so as to enable them to treat psychological trauma symptoms of earthquake survivors. Results from two preliminary studies will be presented outlining the effectiveness of EMDR with two psychological trauma populations in Pakistan. This article also discusses the rationale for widening the trainings to different parts of Pakistan to include other significant traumas currently affecting some parts of the Pakistani population. Keywords: psychological; trauma; PTSD; EMDR; humanitarian; Pakistan
Review of Applied Management and Social Sciences (RAMSS) Vol. 7, (4) 2024, 791-808, 2024
This study explores positive psychology-based parenting practices and their contributions toward ... more This study explores positive psychology-based parenting practices and their contributions toward children's emotional development, child resilience, and social interactions. Drawing from the principles that guide positive psychology, this article explores how such practices as positive emotional support, empathy, and strength-based approaches impact key developmental outcomes for children. Data gathering involved a quantitative research design, where the responses from parents whose children belonged to the age group between 5 and 12 years were obtained. It was both descriptive and inferential analysis of the association between parenting methods and child outcome variables; this includes Pearson's correlation coefficient as well as multiple regression analysis. The hypotheses include: Hypothesis 1: Positive parenting encourages positive features of children's emotional development. Hypothesis 2: Positive parenting encourages children's resilience. Hypothesis 3: Positive parenting encourages good social relations. The three hypotheses listed below were validated: High positive correlations existed between parenting emotional support and children's emotional intelligence, r =.55, p <.01; between parenting emotional support and resilience, r =.49, p <.01; and between parenting emotional support and social skills, r =.52, p <.01. The findings of this study highlight the importance of emotional encouragement and empathy in a child's life. A contribution to the literature base of positive psychology, this work brings its principles into the terrain of parental practices and thus makes empirical evidence of its feasibility. In short, through this study, some important practical recommendations can be laid out for parents, teachers, and policymakers regarding how best to incorporate techniques based on positive psychology in child rearing. It could also be recommended further research to determine in the long
The Journal of Neurobehavioral Sciences, 2016
ADHD'li çocuklardaki davranış problemlerinin psikososyal yönlerini ve bu özelliklerle bağlantılı ... more ADHD'li çocuklardaki davranış problemlerinin psikososyal yönlerini ve bu özelliklerle bağlantılı cinsiyet farklılıklarını belirlemek amacıyla Pakistan'ın farklı şehirlerinden 150'si erkek, 150'si kız olmak üzere toplam 300 ADHD'li çocuk seçilmiştir. Verilerin toplanması için amaçlı örnekleme tekniği uygulanmıştır. Çok Boyutlu Algılanan Sosyal Destek Ölçeği, WHO Yaşam Kalite Ölçeği ile Güçler ve Güçlükler Anketi kullanılmıştır. Hipotez denemesi için betimleyici istatistikler, Pearson korelasyonu ve bağımsız grup T testine başvurulmuştur. Veri analizi için SSPS (Sosyal Bilimler İstatistik Programı) yazılımının 20. versiyonu kullanılmıştır. Elde edilen sonuçlar, sosyal destek ve yaşam kalitesinin ADHD'li çocuklardaki davranış problemleriyle ters korelasyonlu olduğunu göstermiştir. Cinsiyet farklılıkları, ADHD sorunu olan erkek çocuklardaki davranış problemlerinin sosyal yaşam kalitesi daha iyi olan kız çocuklarına oranla daha yüksek olduğunu ortaya koymuştur. Yapılan bu çalışma, sosyal destek ve yaşam kalitesi ile ADHD'li çocukların sergilediği davranış problemleri arasında negatif ilişki olduğu sonucunu çıkarmıştır. Buna göre, daha iyi bir sosyal destek ve yaşam kalitesi temin edilmesi halinde ADHD'li çocukların zihin sağlığı geliştirilebilir ve yaşadıkları davranış problemleri aza indirgenebilir.
Efficacy of eye movement desensitization and reprocessing (EMDR) for survivors of Hurricane Andrew: A comparative study
102nd Annual Convention of the …, 1994
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Papers by Dr Muhammad Sami Bilal