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                        <title>Latest Health News and Articles - Express News</title>
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                        <description>Health News</description>
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			<title>Could insight from cats lead to breast cancer cures?</title>
			<link>https://tribune.com.pk/story/2593622/could-insight-from-cats-lead-to-breast-cancer-cures</link>
			<comments>https://tribune.com.pk/story/2593622/could-insight-from-cats-lead-to-breast-cancer-cures#comments</comments>
			<pubDate>Fri, 20 Feb 26 08:45:53 +0500</pubDate>
			<dc:creator>
				<![CDATA[AFP]]>
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			<category><![CDATA[Technology]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2593622</guid>
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				<![CDATA[Study finds feline cancers mirror human disease, offering clues for new treatments]]>
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				<![CDATA[Owning a cat offers many health benefits, including reduced stress and emotional support, and new research suggests our feline friends might also offer clues to better treat certain cancers.

That&#39;s according to a new study published Thursday in the journal Science, which investigated cancers in cats and found significant parallels with how the disease plays out in humans.

Previous studies had highlighted similar links between dogs and humans, but little research focused on cats, said co-author Louise van der Weyden, a scientist at the British Wellcome Sanger Institute.

Cats, just like dogs, provide &quot;a great model for us,&quot; she told AFP, because they share an environment with humans that includes similar pollution, such as second-hand smoke.

&quot;They develop other illnesses that we do when you get cancer,&quot; Van der Weyden told AFP, explaining that cancer can be accompanied by ailments like diabetes or heart disease. Not infrequently, she said, the &quot;animals will have that too.&quot;

With this principle as their guide, the international research team analysed cancerous tumour samples from nearly 500 domestic cats across five countries. They covered 13 types of cancer, including brain, breast, lung and skin.

Read: Meta&#39;s Zuckerberg denies at LA trial that Instagram targets kids

Since cancers develop from genetic mutations, researchers probed the DNA of cat tumour cells for markers already known in human medicine.

Several similarities emerged, especially when it comes to breast cancer.

In more than half of the feline mammary tumours analysed, the gene FBXW7, which has already been identified in humans, was found to have mutated.

This type of mutation is not common in women with breast cancer, but when it does occur, it&#39;s particularly aggressive, Van der Weyden said.

It&#39;s similarly aggressive in cats. &quot;It&#39;s a really good model for what you see in humans, in terms of the biology of it,&quot; said Van der Weyden.

The researcher said that for women who are impacted by this type of mutation, the discovery is &quot;great&quot; because it could pave the way for new treatments.

Carrying out human clinical trials is difficult, given the small number of affected patients.

But because so many cats suffer this mutation, targeted treatments could be more broadly tested on them in veterinary clinics.

Read More: Indian PM Modi&#39;s AI unity pose turns awkward for OpenAI&#39;s Altman and Anthropic&#39;s Amodei

Van der Weyden added with a smile that she personally would be more inclined to &quot;take a drug based on it working in cats&quot; rather than in mice.

Encouraged by this parallel, Swiss researchers conducted additional experiments on these samples and discovered that two chemotherapy treatments appeared very effective against tumours with this particular mutation.

The results must be confirmed with further research. But they could quickly have benefits for both women and cats, as these drugs are already approved for human and veterinary use, Van der Weyden said.

Professor Harikrishna Nakshatri, who studies breast cancer at Indiana University, called the results &quot;fascinating&quot; and said the data could help scientists gain a better understanding of how cancer develops.

Specifically, Nakshatri told AFP, the results could benefit our understanding of how genes interact with environmental factors, which are often considered prime suspects of triggering the disease.

For Van der Weyden, the findings could result in a &quot;win-win&quot; for humans and our beloved pets.

&quot;We&#39;re genomically so similar, the tumours we develop are so similar,&quot; she said. &quot;What you learn in one species can be used to help the other.&quot;]]>
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			<title>Dangerous chemicals detected in hair extensions, study warns</title>
			<link>https://tribune.com.pk/story/2592857/dangerous-chemicals-detected-in-hair-extensions-study-warns</link>
			<comments>https://tribune.com.pk/story/2592857/dangerous-chemicals-detected-in-hair-extensions-study-warns#comments</comments>
			<pubDate>Mon, 16 Feb 26 07:45:35 +0500</pubDate>
			<dc:creator>
				<![CDATA[Web Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2592857</guid>
			<description>
				<![CDATA[Out of 169 identified chemicals, many were associated with risks of cancer, developmental issues, reproductive health]]>
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				<![CDATA[According to a study published in Environment &amp; Health on February 11, this was &ldquo;the most comprehensive testing of hair extensions publicly reported.&rdquo; The concern arose 11 from testing 44 hair samples and detecting dangerous chemicals, including flame retardants, phthalates, and pesticides. Additionally, out of the 169 identified chemicals, many were associated with risks of cancer, developmental issues, and reproductive health.

Dr Elissia T. Franklin, lead researcher of the paper, shared her concerns that each identified chemical poses its own risks and that extended exposure to these substances accumulates over time.

The study&rsquo;s importance is heightened by the rise of the wig and hair extension industry, which is projected to surpass $14 billion by 2028, while regulation and chemical characterisation remain subpar.

&ldquo;Hair extension product packaging and websites rarely disclose chemical composition. Extensions may be made of human hair, other natural fibres, or synthetic fibres and may be treated with dyes, flame retardants, waterproofing agents, pesticides/antimicrobials, and other conditioning agents,&rdquo; Franklin et al. state.

Black women are disproportionately affected because over 70% of them wear extensions at least once a year, compared to under 10% of white women. &ldquo;Little is known about how chemical exposure differs among different races/ethnicities,&rdquo; the study adds.

The research indicates the potential harms of hair extensions. Prolonged exposure to the chemicals through skin contact, inhalation, and even ingestion can accumulate over time.

Given the lack of research on these substances and their long-term exposure, the study encourages further research, greater corporate transparency, and stronger regulation within the growing industry.]]>
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			<title>Hamdard Pakistan celebrates 3rd Shaheed Hakim Mohammed Said Awards 2025 with a 'Wellness Redefined' theme</title>
			<link>https://tribune.com.pk/story/2591087/hamdard-pakistan-celebrates-3rd-shaheed-hakim-mohammed-said-awards</link>
			<comments>https://tribune.com.pk/story/2591087/hamdard-pakistan-celebrates-3rd-shaheed-hakim-mohammed-said-awards#comments</comments>
			<pubDate>Fri, 06 Feb 26 12:55:56 +0500</pubDate>
			<dc:creator>
				<![CDATA[Sponsored Content]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2591087</guid>
			<description>
				<![CDATA[The event reaffirmed Hamdard Pakistan’s pledge to drive national social growth, holistic health, and future prosperity]]>
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				<![CDATA[With more than 800 guests in attendance, Hamdard Pakistan recently hosted the 3rd Shaheed Hakim Mohammed Said Awards at the Governor&rsquo;s House, Lahore.

Centred on the theme &quot;Wellness Redefined,&quot; the event celebrated visionary leaders who are actively shaping a brighter future for Pakistan through their contributions to health, education, and community development.

For the very first time, the awards were held in Lahore, reflecting Hamdard Pakistan&#39;s expanding national footprint and its commitment to spotlighting excellence nationwide.

The evening was graced by His Excellency, the Governor of Punjab, Sardar Saleem Haider Khan as Chief Guest. In his address, the Governor highlighted the importance of celebrating those dedicated to knowledge, health, and community uplift, noting that Pakistan can only progress when the nation actively encourages and supports exceptional contributions.

Mrs Sadia Rashid, Chairperson, Hamdard Pakistan Group, in her remarks, connected the ceremony to the founding vision of Shaheed Hakim Mohammed Said. She explained how Hamdard was founded to be self-sustaining, funneling its earnings back into social welfare, education, and healthcare. By celebrating exceptional Pakistanis, she noted that the organisation is upholding its 70-year legacy of integrity and selfless service.

Ms Fatema Munir Ahmed, Managing Director &amp; CEO, Hamdard Pakistan, shared key elements of Hamdard Pakistan&rsquo;s ongoing transformation.

Her remarks focused on the organisation&#39;s upgraded manufacturing infrastructure, its diversification from health, medicaments, and Rooh Afza drink syrup to beverages, foods and spices, including syrups, herbal drinks, cereals, dessert mixes, condiments and recipe mixes, as well as an enhanced retail presence and export readiness.

Ms Ahmed highlighted that Hamdard Pakistan continues to evolve under the theme &quot;Wellness Redefined,&quot; focusing on expanding the reach of premium wellbeing solutions to a broader audience on both a local and global scale.

Closing the formal addresses, Mr Faisal Nadeem Mangroria, COO, Hamdard Pakistan, thanked guests, dignitaries, media partners, and honourees, reiterating that Hamdard Pakistan&#39;s mission will continue to expand through innovation and social impact.


Applauding excellence across all sectors

The awards began by spotlighting Education Excellence. Prof. Dr Muhammad Iqbal Choudhary was recognised for his pioneering contributions to biochemical research that have earned Pakistan international recognition. Dr Mariam Chughtai was also honoured for her leadership in modern education and academic reform.

In Sports Excellence, international sports champion Mr Arslan Ash received recognition for placing Pakistan on the global competitive gaming map. Squash Champions Ms Mahnoor, Ms Mehwish, and Ms Sehrish Ali were all honoured for their sporting achievements and for championing women&rsquo;s participation in competitive sport.

Acknowledging the evolving landscape of modern influence, the Digital Influencer Awards were granted to Irfan Junejo and Muhammad Shiraz. Both creators were celebrated for their genuine storytelling and creative impact, which have helped foster more meaningful and positive engagement within the digital space.




Honouring exceptional valor, the Bravery Award was given to Mr Muhammad Ali Swati and Ms Syeda Shehrbano Naqvi&mdash;two individuals who redefined courage under fire for all Pakistanis.

In Health Excellence, Hakim Abdul Hannan was honoured for preserving Tibb-e-Unani and strengthening its relevance in contemporary healthcare. Dr Faisal Sultan received recognition for his leadership in modern medicine and national healthcare, particularly during periods of heightened medical need.

In the Leaders &amp; Social Change Makers category, the 2025 Awards celebrated two pioneers of societal progress:


	Ms Roshaneh Zafar was recognised for her transformative work in economic empowerment and expanding financial inclusion for women.
	Mr Aslam Khaliq was honoured for his visionary leadership in embedding social responsibility within corporate structures; his daughter, Ms Shaista Khaliq, accepted the distinction in his stead.



In the realm of Journalism Excellence, the 3rd Shaheed Hakim Mohammed Said Awards celebrated Mr Mazhar Abbas for his steadfast adherence to ethical reporting. A posthumous honour was also granted to the visionary Mr Arshad Zuberi for his transformative role in nation-building, with the award being accepted by Mr Shahab Zuberi of the Business Recorder.

The Literature Award paid tribute to two giants of the craft: Ms Ghazi Salahuddin, who shared a moving message with the guests, and Ms Zehra Nigah, celebrated as a cornerstone of modern Urdu poetry.

Likewise, the Arts &amp;Culture Excellence Award was given to Mr Tauqeer Nasir for his performance career and to Ms Samina Peerzada for her contributions both as a mentor and as an artist legend.

As the evening reached its emotional zenith, the Lifetime Achievement Awards were presented to Ms Seema Aziz for her work in education and social development, and to the late Mr Talat Hussain for his contributions to culture. The award was accepted on his behalf by his daughter, Ms Tazeen Hussain.



Official media partners Hum TV, Tamasha, MyCo, and Mera FM 107 helped extend the event&#39;s reach. The ceremony concluded with a musical performance by Mr Shafqat Amanat Ali Khan, followed by dinner for award recipients and guests.

The Shaheed Hakim Mohammed Said Awards 2025 reaffirmed Hamdard Pakistan&rsquo;s role as an organisation that channels commercial success into public wellbeing. With the theme &ldquo;Wellness Redefined,&rdquo; the evening hailed individuals redefining excellence and emphasised Hamdard&rsquo;s continued commitment to Pakistan&rsquo;s wellbeing, growth and future.]]>
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			<title>When access decides ability</title>
			<link>https://tribune.com.pk/story/2582049/when-access-decides-ability</link>
			<comments>https://tribune.com.pk/story/2582049/when-access-decides-ability#comments</comments>
			<pubDate>Sat, 13 Dec 25 22:23:47 +0500</pubDate>
			<dc:creator>
				<![CDATA[Nabil Tahir]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2582049</guid>
			<description>
				<![CDATA[How lived experience, corporate shifts and design failures shape opportunity for persons with disabilities in Pakistan]]>
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				<![CDATA[Disability in Pakistan is rarely invisible. It appears in classrooms where ramps are missing, in buses that cannot be boarded, in job interviews that quietly end after a single glance. Yet it is also rarely discussed in any sustained way. For most people, it remains something to be acknowledged briefly, often with sympathy, and then moved past. What is missing from the national conversation is not awareness, but attention to how deeply everyday systems are stacked against persons with disabilities, long before questions of talent or ambition even arise.

Access to schools is uncertain, public transport is unreliable, and expectations are set low from the start. Children are steered towards &ldquo;special&rdquo; spaces, not because they lack ability, but because mainstream ones are unwilling to adapt. By the time they reach working age, many persons with disabilities have already navigated years of exclusion. Employment, is often framed as charity, rather than contribution. The loss is not only personal, but economic and collective, and people who could otherwise be shaping classrooms, offices, factories, and businesses across the country, are sidelined.

Disability is not a niche issue. It cuts across class, geography, gender, and profession. It shapes childhoods, limits education pathways, and narrows employment options long before individuals enter the workforce. By the time many persons with disabilities reach working age, their barriers are not because of lack of ability, but because of a system that was never built to accommodate differences.

Against this backdrop, recent conversations around inclusion have, slowly but noticeably, begun to shift from charity to structure and from empathy to systems. For instance, the launch of the second edition of the Overseas Investors Chamber of Commerce and Industry&rsquo;s (OICCI) Diversity and Inclusion Handbook, developed in partnership with the NOWPDP. The discussions it sparked in the corporate event were deeply human, aimed at confronting gaps instead of drifting off to celebrate progress.

Rather than positioning inclusion as a moral obligation alone, the conversation framed it as a question of redesign. What happens when workplaces are built with accessibility in mind? What changes when hiring processes account for different abilities? And what is lost when millions are excluded from meaningful participation in the economy?

&ldquo;Corporate Pakistan must move from empathy to structural action,&rdquo; says OICCI Secretary General M. Abdul Aleem, as he captured the shift. &ldquo;Persons with disabilities are not looking for favours, they deserve equity, opportunity, and accessible systems. When companies invest in inclusion, productivity rises, retention improves, and workplaces become more innovative.&rdquo; His remarks moved the discussion away from goodwill and toward accountability. Inclusion, he suggested, is not about compensation, it is about correcting systems that have excluded capable people for decades.

Yet the strongest case for inclusion did not come from policy arguments or business metrics, but from lived experience.

The story of Abdul Qadeer, Co-Founder and COO of Deaf Tawk, reflected the quiet resilience many persons with disabilities develop early in life. &ldquo;I am the first in my family who suffered from this eye disease, which made my eyesight very poor when I was around 6 or 7 years old,&rdquo; he says. &ldquo;My parents were very sad as they didn&rsquo;t know what happened, as no one had previously suffered from this eye disease.&rdquo;

There was no treatment available then, and as Qadeer points out, there still isn&rsquo;t. But the medical diagnosis was only one part of the challenge. &ldquo;In Pakistan there are a lot of barriers that persons with disabilities have to face and they also have to deal with society&rsquo;s behaviour towards them. They don&rsquo;t have good opportunities for education,&rdquo; he explains.



Despite these obstacles, Qadeer adapted. &ldquo;When I started my education, there wasn&rsquo;t much technology for the blind, but I understood how I could take help from technology,&rdquo; he says.

The learning curve was steep, resources limited, and support systems scarce, yet persistence led to achievement. His success was earned in spite of the system, not because of it. &ldquo;Alhamdulillah I received a gold medal in my master&rsquo;s degree,&rdquo; shares Qadeer, acknowledging the role of innovation. &ldquo;Technology makes life easy for people with disabilities. A lot of blind people are now getting good education, and many work at a high levels in the corporate sector,&rdquo;

Farhat Rasheed, Director at Dalda Foods and Westbury Group of Companies, discussed how exclusion often begins long before employment. &ldquo;I strongly believe that all the differently-abled have some unique qualities,&rdquo; she says. &ldquo;Even I had difficulties in getting admission in schools without resources or finance. The mindset in Pakistan is that special children should go to special schools, and no one is ready to see their talent. Segregation is often mistaken for support. All they need is basic necessities, wheelchair access, a little support, guidance and some extra time. If these children are not educated, how will they contribute to society in the future?&rdquo;

Even academic excellence did not guarantee Rasheed equal opportunity. &ldquo;I got a gold medal in my degree and was also a high GPA holder, but where my friends had 30 or 40 options to apply, I only had a couple,&rdquo; she explains. &ldquo;It was a stark reminder that achievement does not erase bias. For many persons with disabilities, success exists alongside restriction, not freedom.&rdquo;

The corporate sector, often criticised for its slow response to inclusion, has begun to recognise that exclusion is not just unjust, it is inefficient. Some organisations have moved beyond symbolic gestures and experimented with structured programmes that integrate persons with disabilities into mainstream roles.

Faysal Bank&rsquo;s Qabil programme is one such example. Habiba Salman, EVP and Head of Learning and DEI, explained that the initiative began before inclusion became a regulatory conversation. &ldquo;We launched our programme in 2021, with just a pilot group of 10 people in the call centre,&rdquo; she shares. &ldquo;What followed challenged long-held assumptions. It was such a huge business case, because in four years, there has not been a single complaint by any customer for those 10 sales officers, who have shown high levels of productivity.&rdquo;

The results reframed inclusion not as a risk, but as an advantage. &ldquo;We launched this programme to give them training in the mainstream employment sector so they can get trained and find opportunities &mdash; some with us, some outside,&rdquo; she said while adding that in this model, inclusion was not confined to corporate social responsibility, but embedded into talent development.

&ldquo;If you want people with disabilities to be part of the workforce, you have to have accessible workplaces,&rdquo; says Sana Rauf, Talent Acquisition and EVP Manager at Nestl&eacute; Pakistan. &ldquo;We have been having regular audits and from the findings we make sure that we work on the areas of improvement, so all our offices are accessible.&rdquo;

These interventions point to a broader shift: inclusion is not a one-time initiative, but a continuous process of evaluation and redesign.

Entrepreneurship is also an area where persons with disabilities remain underrepresented. Ali Tareen, Founder and CEO of Khaas Foods Kitchen, outlined the gaps that prevent PWD-led businesses from scaling. &ldquo;Regarding the challenges of entrepreneurs with disabilities, we need three approaches,&rdquo; he explains. &ldquo;First, capacity building of persons with disabilities. We have to equip institutes and people to produce more entrepreneurs. Second, we need to make the system easier for them through reform. We need to move towards financial access or equity-free models. And finally, through visibility. By promoting their success stories of how they can excel and helps organisations gain awareness.&rdquo;

Inclusion cannot succeed in isolation. It requires alignment across education, finance, infrastructure, and culture.

PepsiCo Pakistan offered a view of what systemic inclusion can look like when embedded across an organisation. &ldquo;Our focus has been to shift disability inclusion from isolated initiatives into structured and sustainable system design,&rdquo; explains Sarah Hassan, Senior Director HR. &ldquo;Through programmes such as Roshan Kal, Beyond Side, and Kaabil, and partnerships with organisations like ConnectHear and NOWPDP, the company has attempted to integrate inclusion into its operational fabric. When inclusion is embedded, the outcome is stronger not just for the individual or the community but for the businesses overall. We are approaching inclusion in a way that is both ambitious and operationally grounded.&rdquo;

Now if we come back to the OICCI Diversity and Inclusion Handbook, it was clear that the document was responding to a much larger problem than corporate policy alone. The handbook draws on data, case studies, and organisational experience, but its relevance lies in how closely it reflects realities shared. It urges companies to look beyond hiring targets and ask more difficult questions, such as, are workplaces accessible in practice? Are managers trained to support diverse teams? Are career paths designed with flexibility, or with assumptions about what productivity looks like?

What emerged most strongly was that inclusion cannot function as a standalone initiative. It is shaped by the education system that precedes employment, the transport that enables mobility, the technology that makes work possible, and the attitudes that define who is considered capable. When any one of these fails, the burden shifts back onto the individual. And when several fail at once, talent is quietly filtered out, not through policy, but through design.

One side of Pakistan&rsquo;s reality is defined by barriers that remain firmly in place. On the other side are individuals who continue to adapt, learn, and perform, often with little structural support. Closing that distance will not happen through statements or handbooks alone. It will require a willingness to redesign systems so that access is built in rather than added later. Only then can ability, rather than assumption, begin to shape how opportunity is distributed.]]>
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			<title>Punjab orders province-wide mental health screening for police personnel</title>
			<link>https://tribune.com.pk/story/2579966/punjab-orders-province-wide-mental-health-screening-for-police-personnel</link>
			<comments>https://tribune.com.pk/story/2579966/punjab-orders-province-wide-mental-health-screening-for-police-personnel#comments</comments>
			<pubDate>Mon, 01 Dec 25 06:00:23 +0500</pubDate>
			<dc:creator>
				<![CDATA[Saleh Mughal]]>
			</dc:creator>
			<category><![CDATA[Health]]></category><category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2579966</guid>
			<description>
				<![CDATA[Stresses that mandate is for addressing stress-related concerns]]>
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				<![CDATA[Punjab Police has announced a mandatory mental and physical health screening programme for all ranks amid rising concerns over stress-related conditions within the force.

According to an official circular issued by the Deputy Inspector General (DIG) Establishment Punjab-I titled &quot;Psychological Profiling for All Cadres,&quot; police officers and frontline personnel are increasingly exposed to high-pressure environments, including long duty hours and frequent encounters with criminal elements.

The letter states that additional administrative, social, economic and political factors place further strain on officers, leaving them vulnerable to a range of mental and physical health problems.

It warns that continuous exposure to such conditions may increase the risk of schizophrenia, depression, bipolar disorder and other mental-health disorders. In response, the police department has announced a structured screening campaign that will cover all ranks, from constables to senior officers.

Under the new policy, screening will be mandatory across all districts and units. Senior officers will supervise assessments for Inspectors, Sub-Inspectors, Deputy Superintendents of Police, Superintendents of Police, DIGs and other higher cadres.

Unit heads have been instructed to conduct individual interviews with their personnel and document any signs of mental-health concern.

Cases requiring further examination will be referred to psychiatrists at district hospitals. District police heads have been directed to coordinate with the Medical Superintendents of District Headquarters Hospitals to ensure timely evaluation and clinical follow-up.

The circular stresses that all screening reports will be kept strictly confidential and used solely for professional development and organisational improvement. Comprehensive reports from across Punjab are required to be submitted to the Central Police Office by December 15.]]>
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			<title>How obesity is driving Pakistan’s diabetes epidemic</title>
			<link>https://tribune.com.pk/story/2577404/how-obesity-is-driving-pakistans-diabetes-epidemic</link>
			<comments>https://tribune.com.pk/story/2577404/how-obesity-is-driving-pakistans-diabetes-epidemic#comments</comments>
			<pubDate>Fri, 14 Nov 25 07:06:08 +0500</pubDate>
			<dc:creator>
				<![CDATA[Daniyal Khuhro]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2577404</guid>
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				<![CDATA[Around 34m adults in country lived with diabetes as of 2024 yet insufficient lifestyle interventions persist]]>
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				<![CDATA[Pakistan&rsquo;s diabetes crisis is now among the worst in the world, but health experts warn that only half the battle is being fought. Obesity, a critical driver of Type 2 diabetes, remains largely overlooked for the main reason that people in Pakistan see it as a lifestyle failure, not a disease.

The International Diabetes Federation (IDF) estimates that more than 34 million adults in the country live with diabetes as of 2024, giving Pakistan one of the highest diabetes prevalences in the world and the fourth highest number of adults with the disease.

Read: How a mother&rsquo;s stress can decide when her baby arrives

Speaking at an event for World Diabetes Day, Vice Chancellor of Health Services Academy Islamabad, Dr Shahzad Ali Khan, said, &quot;Pakistan has the lowest glycemic [diabetes] control among the countries of the world. 1/4 people don&#39;t even know about diabetes, and even though the rest know of diabetes, they have no knowledge of how to manage it.&quot;

Recent analyses describe Pakistan as facing a &ldquo;double burden&rdquo; of non-communicable diseases (NCDs), with diabetes, cardiovascular disease and obesity all rising. A national policy brief led by Aga Khan University and partners warns that NCDs now account for 58% of annual deaths, and that mortality from diabetes and related conditions is climbing.

Professor of Diabetes and Endocrinology at the University of Birmingham, Dr Waseem Hanif, is reported to have said, &ldquo;In Pakistan, over 100 million people are obese... Obesity is a disease, and its main symptom is hunger.&rdquo;

He framed obesity not as a moral failing but as &ldquo;a normal response to an abnormal environment,&quot; one in which highly processed food, inactivity and urban stress are built into daily life.

Obesity is a disease, not a lifestyle failure

&quot;Obesity is not a disease, rather a complex culmination of lifestyle failures,&quot; said former health minister Dr Zafar Mirza.&nbsp; However, global medical thinking has shifted decisively toward recognising obesity as a chronic, relapsing disease. &quot;We need to define obesity as a chronic metabolic disease with behavioural, environmental and genetic drivers,&quot; added Dr Khan.&nbsp;

Novo Nordisk Pakistan, a multinational pharmaceutical company working in the diabetes and obesity space in Pakistan, states that &ldquo;obesity is a complex chronic disease, and losing weight is not just a question of eating less and moving more&rdquo;. They add it is driven by genetics, physiology, environment and brain biology.

They further say, &quot;Understanding these factors is critical, because obesity is associated with other diseases, including type 2 diabetes, heart disease and certain &nbsp;types of cancer&quot;.

But with the right care and support of healthcare professionals, people with obesity can make a difference to their health.

Read more: Brain and Mind: Experts push for multi-layered mental health solutions, not just tertiary care

The NCD policy analysis found that &ldquo;strong political action to improve the dietary environment and address the growing burden of NCDs&hellip; is largely lacking&rdquo;, with no major &ldquo;best buy&rdquo; interventions fully implemented. &ldquo;We have a double burden of malnutrition in Pakistan, but we are dealing with deficiencies only. We are not dealing with obesity, hypertension, etc., because of a lack of attention and finances.&rdquo;

Underdiagnosed diabetes, undertreated obesity

IDF figures and analyses done by independents such as Health Policy Watch &mdash; a platform reporting on global health &mdash;suggest tens of millions of Pakistanis have diabetes or pre-diabetes, with many unaware of their condition until complications emerge.

Obesity is also rarely treated systematically in primary care. According to research done by Aga Khan University, risk factors show high levels of overweight and obesity in both urban and rural populations, yet routine screening and structured weight management remain sparse.

The result is a vicious circle: people live for years with untreated obesity, then present with advanced type 2 diabetes, cardiovascular disease or kidney failure at far higher cost to both families and the state.

Combating obesity

When asked about what to do to combat obesity, Dr Mirza said that &quot;instead of treating obesity, we have to deal with lifestyle behaviours with lifestyle interventions.&quot; Dr Shahzad echoed this, &quot;Combating obesity reduces type 2 diabetes. Even modest weight loss (up to 10%) can dramatically improve insulin sensitivity.&quot;

&quot;Lifestyle interventions like the Diabetes Prevention Program reduce diabetes onset by 58%, outperforming early medications...Bariatric surgery has reversed type-2 diabetes in a large percentage of patients... proving how tightly gut hormones and adiposity [fat levels] are intertwined,&quot; he added.

Additionally, GLP-1&ndash;based therapies (drugs that mimic the body&#39;s natural hormones, which regulate things like hunger and blood sugar levels) have redefined how clinicians manage obesity and diabetes risk. These drugs mimic gut hormones that regulate appetite, insulin and digestion, helping patients both lower blood sugar and lose significant weight.

In Pakistan, this science is beginning to translate into practice. A study from Aga Khan University reported that semaglutide, a drug used to treat obesity and type 2 diabetes, was effective in reducing body weight in Pakistani patients with Type 2 diabetes, with &ldquo;measurable tolerability and patient satisfaction.&rdquo;]]>
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			<title>Pakistan built a world-class Polio system. Then 40,000 Karachi families said no</title>
			<link>https://tribune.com.pk/story/2578465/pakistan-built-a-world-class-polio-system-then-40000-karachi-families-said-no</link>
			<comments>https://tribune.com.pk/story/2578465/pakistan-built-a-world-class-polio-system-then-40000-karachi-families-said-no#comments</comments>
			<pubDate>Fri, 21 Nov 25 09:27:57 +0500</pubDate>
			<dc:creator>
				<![CDATA[Daniyal Khuhro]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2578465</guid>
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				<![CDATA[Global experts meet to ask how we go polio-free in 3 years]]>
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				<![CDATA[Forty thousand Karachi families refused polio vaccines this year. In a city where the virus circulates through every district, those refusals represent the gap between Pakistan&#39;s impressive polio infrastructure and its inability to close the final mile of eradication.

Pakistan has cut polio cases by more than 99.6% since 1994&mdash;from 20,000 annual cases to just 30 this year. It has built one of the world&#39;s most extensive surveillance systems: 127 environmental sampling sites, 12,500 reporting locations, and campaigns that reach 45 million children. Two of three global poliovirus strains have been eliminated.

But Pakistan and Afghanistan remain the only countries where polio still circulates. And in 2024, the WPV1 strain resurged across 90 districts, forcing authorities to overhaul their approach with a &quot;2-4-6 roadmap&quot; under the National Emergency Action Plan.

&quot;The last mile is actually very difficult to achieve,&quot; said Dr Azra Pechuho, Sindh&#39;s Minister of Health and Population Welfare, speaking at Aga Khan University on Friday. &quot;It&#39;s the small pockets we&#39;re missing as the number of infected children is reducing.&quot; A two-hour event brought together the top names in Polio from the WHO, Sindh government, federal government and AKU.

Environmental samples confirm what health officials already know: the virus persists in underserved communities that vaccination campaigns struggle to reach. Every district in Sindh shows ongoing transmission.

The 42,000 vaccine refusals across Sindh&mdash;40,000 of them in Karachi&mdash;reflect what Dr Azra calls &quot;vaccination fatigue.&quot; But Dr Sebastian Taylor from the Technical Advisory Group for Polio Eradication cautioned against assuming families refuse because of too many vaccines. Many refusals stem from lack of knowledge rather than vaccine overload, he said.

The WHO reports that authorities have narrowed the gap, reducing missed children from 1.48 million to 1.13 million. But low routine immunization coverage, vaccine hesitancy, and population movement continue leaving spaces where the virus survives.

South Khyber Pakhtunkhwa presents the most urgent challenge. &quot;That&#39;s where we need to do something really fast and really hard,&quot; said Prof. Shahnaz Ibrahim, chair of the National Certification Committee, which annually determines whether Pakistan qualifies as polio-free.

The certification process requires three consecutive years with no cases and no environmental detection of the virus&mdash;and Pakistan cannot achieve it alone. &quot;It has to be both Pakistan and Afghanistan as a unit,&quot; Prof. Ibrahim explained.

The Prime Minister&#39;s Focal Person for Polio Eradication, Ayesha Farooq, noted that WPV1&#39;s genetic diversity is &quot;increasingly squeezed,&quot; meaning fewer chances of new strains emerging. Dr Azra said eradication remains achievable if Pakistan maintains focus during the upcoming low-transmission season.

&quot;To the students today, you don&#39;t have to study smallpox. It&#39;s history,&quot; said Aziz Memon, National Chair of Pakistan&#39;s PolioPlus Committee. &quot;Let us put polio in the books of history.&quot;]]>
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			<title>Rise of vapes, e-cigarettes fuels new nicotine risks for Pakistan’s youth</title>
			<link>https://tribune.com.pk/story/2577392/rise-of-vapes-e-cigarettes-fuels-new-nicotine-risks-for-pakistans-youth</link>
			<comments>https://tribune.com.pk/story/2577392/rise-of-vapes-e-cigarettes-fuels-new-nicotine-risks-for-pakistans-youth#comments</comments>
			<pubDate>Fri, 14 Nov 25 05:20:40 +0500</pubDate>
			<dc:creator>
				<![CDATA[Wisal Yousafzai]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2577392</guid>
			<description>
				<![CDATA[Accessibility for Pakistani youth raises concerns over addiction, weak regulation]]>
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				<![CDATA[Pakistan has witnessed a dangerous shift in the way young people are being targeted by the tobacco industry. Once dominated by conventional cigarettes and smokeless forms like naswar and gutka, the market has expanded to include e-cigarettes and vapes among other new nicotine products.

These products, often disguised in colourful packaging and sweet flavours, are marketed as &ldquo;safer alternatives&rdquo; &ndash; a narrative that resonates dangerously with impressionable youth seeking novelty and acceptance. Walk through the streets of major urban centres like Islamabad, Lahore, or Peshawar, and it is easy to spot small kiosks selling vapes in fruit, candy, or mint flavours.

These products are cheap enough to fit into a teenager&rsquo;s pocket money, and easily accessible due to weak enforcement of age restrictions. The lack of awareness among parents and school authorities allows the problem to spread silently, making it harder to detect until addiction has already taken root.

&ldquo;The industry is creating a false sense of safety by marketing e-cigarettes as less harmful,&rdquo; said Qamar Naseem, a civil society activist working on tobacco control in Khyber Pakhtunkhwa. &ldquo;In reality, nicotine remains addictive and harmful, especially for young brains that are still developing. These tactics are designed to trap youth into lifelong addiction,&rdquo; he said.

Read: Tobacco sector: potential &amp; illicit trade challenges

The tobacco industry&rsquo;s strategy is clear; by presenting vaping and e-cigarettes as &ldquo;modern&rdquo; or &ldquo;cool,&rdquo; it exploits the curiosity and social insecurities of young people. Flavoured products are designed to mask the harshness of nicotine, creating an illusion of harmless fun while establishing patterns of dependence.

Once addicted, young consumers are more likely to transition to other tobacco products, ensuring a long-term customer base for the industry.

Evidence from Pakistan paints a worrying picture. A 2019 Global Youth Tobacco Survey revealed that over 10% of teenagers aged 13&ndash;15 use some form of tobacco. More recent observations from civil society groups suggest that this figure may have increased with the rise of vapes and e-cigarettes.

The lack of regulation means that companies and importers can continue marketing these products without clear restrictions, often bypassing advertising bans by relying on social media platforms.

&ldquo;Every week, I see teenagers as young as 14 buying flavoured vapes from shops near schools,&rdquo; said Alvina Javed, a youth rights activist in Peshawar. &ldquo;The easy access and the appealing flavours make it almost impossible for young people to resist. Unless the government steps in, we are heading toward a new epidemic of nicotine addiction among the youth,&rdquo; she warned.

Nicotine is highly addictive and harmful to the developing brain. Research has linked early use to long-term cognitive and behavioural issues, including difficulties with attention, impulse control, and learning.

Read More: Tobacco exports likely to fetch $150m this year

Moreover, e-cigarettes are not risk-free; they expose users to harmful chemicals that can cause lung injury and other health complications.

Pakistan has taken steps toward tobacco control through frameworks like the ongoing National Tobacco Control Strategy launched in 2022, and provincial roadmaps; however, these efforts remain focused on traditional tobacco products. Without urgent policy action, new nicotine products will continue to slip through the cracks, undermining efforts to reduce tobacco use.

The future of Pakistan&rsquo;s youth should not be sacrificed at the altar of profit. By acting now to regulate and restrict new nicotine products, policymakers may safeguard young generations from a lifetime of addiction and ill health.]]>
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			<title>I went to Valika hospital to find out if children got HIV there</title>
			<link>https://tribune.com.pk/story/2577236/i-went-to-valika-hospital-to-find-out-if-children-got-hiv-there</link>
			<comments>https://tribune.com.pk/story/2577236/i-went-to-valika-hospital-to-find-out-if-children-got-hiv-there#comments</comments>
			<pubDate>Thu, 13 Nov 25 06:26:12 +0500</pubDate>
			<dc:creator>
				<![CDATA[Qaisar Kamran]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Sindh]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2577236</guid>
			<description>
				<![CDATA[Hospital reported cases to Sindh's HIV program in October, asked for screening]]>
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				<![CDATA[The information surfaced on a reporter WhatsApp group: Eight small children had been infected with HIV, supposedly at Kulsum Bai Valika hospital in Karachi and two were dead. Every reporter was busy calling their Sindh government contacts to get confirmation and details. Since I am new to Health reporting, I decided to go to the area&rsquo;s Pathan Colony to see if I could find any parents who might know how this happened? Was there any connection with Kulsum Bai Valika Hospital as people were claiming?

It took me a while to reach Valika hospital in SITE, which sits to the top left of Karachi&#39;s map. This is where all our big soft drink factories are located, next to textile mills. Pathan Colony is a katchi abadi with tall skinny buildings right across the hospital, accessed through a hole in the wall at the petrol pump.

When I went to Valika on a Tuesday afternoon, the government hospital was really quiet, which seemed strange to me because it offers free treatment to registered factory workers and their families.

I went upstairs to meet the person who runs the hospital, Medical Superintendent Mumtaz Shaikh. I mentioned the rumours about at least 18 HIV-positive children. &quot;We don&#39;t read all the news,&quot; he said to me. &quot;And we don&#39;t believe all the news.&quot; Of course, I thought. How stupid. He wasn&rsquo;t going to be open with me.

Interviewing the hospital chief

The MS does go on to say, however, that first, there were two children, one from Banaras and one from Pathan Colony. Both positive. They were immediately sent to Indus and Civil hospitals.

Valika alerted the Sindh HIV program on October 22, which all hospitals have standing orders to do with epidemic-causing diseases. Within 24 hours, screening teams came to SITE. According to the MS, 35 people sitting in the OPD that day were tested and emerged negative.



The hospital had to also tell its watchdog authority, the Sindh Healthcare Commission, and ask it to send officers to shut down small clinics run by fake doctors and barbershops in the area.

But wait. I stop the MS because he had just shown me the letter. It says six to eight children tested positive, I say to him. Not 2.

Shaikh snapped the file shut. &quot;They were not admitted patients,&rdquo; he retorted. &ldquo;They were people from outside the hospital, from the area.&quot;

Translation: Eight children have HIV. Two are perhaps dead. Six might still be out there, somewhere, with HIV.

The Sindh HIV program is part of the Communicable Disease Control or CDC. I meet a young CDC staffer in the MS&#39;s office but he also refuses to share any information. &quot;It would spread panic. People will be ostracised,&quot; he said.

I try to tell him I don&#39;t want names. Just numbers. Just confirmation.

&quot;All I can tell you is that the CDC place is here,&rdquo; he says, handing me a pamphlet with an address. &ldquo;You go here, but they won&#39;t tell you anything.&quot;

Neighbourhood watch

Rather deflated, I go outside to the parking lot to think about what to do next. Luckily, I notice a man talking to the CDC staffer and hang back till he is alone. He introduces himself as Irshad Khan, the local elected representative for Pathan Colony&rsquo;s Union Council 1. He also happens to be the chairman of the SITE Town health committee. He has a fat file of papers.

Irshad Khan has been hounding the authorities since August, when the first diagnosis surfaced. &quot;We are asking Valika for the list, but they are not giving it,&quot; he said. They told the hospital that the committee could help by gathering the other people in the area for testing.

Irshad has done something pretty commendable. He has gotten the grassroots political party workers to form a committee to work on the issue. There is someone from the ANP, PTI, Jamaat-e-Islami and PPP.

The town representatives asked Valika to hold a seminar where hospital staff, people from Pathan Colony and grassroots organizations spoke about HIV. People learned it doesn&#39;t spread through touch.

Dr Arman, the paediatrician everyone knew, was there. Now he&#39;s been transferred to Landhi, I am told.

In the absence of real information, rumors have been circulating in the colony. I have shared videos of hospital waste being carried out in dustbins. The neighbourhood committee has started collecting its own data. They count ten cases.

Akhtar Ali, a political worker, says, &quot;These people are rude, the hospital staff. If this hospital were on MQM turf, they would have set this hospital on fire. We have really controlled the people of the area. No one wants to come here.&quot;



Usman Ahmed, the president of Pathan Colony&#39;s Jamaat-e-Islami chapter, rejects the explanation that small clinics are to blame. &quot;These people put it on the quacks,&quot; he says, naming a news channel that came to give coverage. &quot;But when we go to the clinics, we buy our own injections from outside. There are quacks across Pakistan, not just here. So why is it happening to children who came to Valika?&quot;

The good news, I am told, is that since the cases surfaced, Valika&#39;s medicine and syringe shortages have ended. Bad news: Staff shortages persist. There still aren&#39;t enough beds for the children.

The real cost

The political workers take me deep into the neighbourhood, where I am introduced to a young man who says his niece died of HIV. He has just given an interview to a vlogger. He offers to introduce me to the other family whose child had also died.

But when I met the family and asked the mother about what happened, they did not have any test results to show me that HIV had indeed been detected. A maulvi sahib told them the child had HIV. And I wonder why these families don&rsquo;t have any way of really knowing what happened.

One of the mothers, a factory worker&#39;s wife, had to go to Indus hospital herself as her husband could not miss daily wage work. She went alone with her sick child. She later told the neighbourhood committee that the travel alone cost her Rs 12,000.

I hear of Sahil&#39;s niece: 14 months old, admitted to Valika with a fever that wouldn&#39;t break. She had it for three, four days. Two children in her ward tested HIV-positive. One was in the same bed as his niece.

Sahil didn&#39;t trust Valika&#39;s lab, so he had the whole family tested at Dow. They were all negative, thank God, he said.

What about the child who shared the bed with his niece, I ask. She was sent to Patel hospital.

Akhtar Ali&#39;s niece was born at Valika and was always treated there because her father, a factory worker, was registered with the Benazir Mazdoor Card that makes him eligible for free treatment at a SESSI hospital. The baby was one year old when she developed a persistent fever in April. She was treated for five months and her weight kept dropping. By September 11, she tested HIV-positive.

Her mother claims she saw hospital staff using the same syringe on multiple children.

The baby was tested at a Ziauddin hospital lab and now she is receiving ART treatment at Civil hospital and has gained 2.5kg. Her parents and siblings tested negative.



This has happened before

After the Ratodero outbreak, since 2019, HIV testing has expanded across Sindh and there are over 30 ART centers, almost one per district.

When hospitals find positive cases, they file &quot;zero reports&quot; to the government. These patients then go to the government-run ART centers because treatment is expensive. The government provides it free through the National AIDS Control Program.

The government tests the patients again according to a WHO protocol.

But in Pathan Colony, I am told by the committee&rsquo;s men that some HIV-positive children were just taken home and are not getting treatment. If true, this is alarming. But I have no way of corroborating.

&quot;Because this is a chronic illness, people think that it happens only sexually,&quot; says Prof. Fatima Mir, the paediatric HIV expert at Aga Khan University. &quot;So parents think that, &#39;We have not done anything like this, so how did this happen to my child?&#39;&quot;

What some officials later tell me

I managed to get through to Dr. Zulfiqar Ali Dharejo, the Deputy Director-General of the CDC, but he did not share any confirmed numbers. &quot;We are screening,&rdquo; is all he could say. &ldquo;Whatever cases are surfacing are being shifted to ART centres and being treated.&quot; Cases from Valika are being registered at Indus hospital.

Dr Ahsan of the Sindh Health Care Commission added that, &quot;People think quacks when you say HIV.&quot; But quacks are just one reason. The commission keeps shutting them down; they pop up elsewhere. Another risk is infected blood. Families ask relatives to donate rather than paying for screened blood, he says. The donor could have hepatitis or HIV.

He provides another clue: &quot;When a child is infected, it shows at least six months later.&quot; So that could mean that the children allegedly testing positive at Valika hospital and only being treated there because it was on their father&rsquo;s panel, were infected months earlier.

I learn that the SHCC met Keamari Deputy Commissioner Tariq Chandio and they will team up with the SSP Keamari and DHO to inspect public and private hospitals in a district-wide crackdown against unqualified practitioners.

Meanwhile, the neighbourhood committee says that people are scared and want to get more information. They&#39;re gathering their own data because no one else will but proper clinical testing and assessments can only be done by the government.]]>
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			<title>Brain and Mind: Experts push for multi-layered mental health solutions, not just tertiary care</title>
			<link>https://tribune.com.pk/story/2575973/brain-and-mind-experts-push-for-multi-layered-mental-health-solutions-not-just-tertiary-care</link>
			<comments>https://tribune.com.pk/story/2575973/brain-and-mind-experts-push-for-multi-layered-mental-health-solutions-not-just-tertiary-care#comments</comments>
			<pubDate>Wed, 05 Nov 25 13:18:52 +0500</pubDate>
			<dc:creator>
				<![CDATA[Daniyal Khuhro]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2575973</guid>
			<description>
				<![CDATA[Can't dismiss income inequality, climate change when dispensing mental healthcare, say doctors at AKUH conference]]>
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				<![CDATA[Mental health is a multifaceted issue that needs to be addressed at every echelon of society and across all walks of professional and communal life, underscored experts at Aga Khan University Hospital&#39;s (AKUH) Brain and Mind conference on Wednesday.

The two-day conference featured discussions on a variety of subjects, from the effects of climate change on mental health and suicidality to the ways mental health practices can be integrated into policy and primary health care. Around 74 moderators, panellists and local and international speakers from Kenya, America, the United Kingdom and more shared their insights.

Panellists covered topics regarding the brain-gut connection, non-communicable diseases, the mental health journeys of young migrants, digital mental health, suicide prevention, climate change and mental health, brain ageing and dementia, and the importance of contextualising mental health outcomes.

On Wednesday, Founding Director of the Brain and Mind Institute (BMI) Dr Zul Merali invited participants and audience members to &quot;bring not just our expertise, but our humanity,&quot; emphasising the need to treat mental health as a multifaceted problem.

Former state minister of health Dr Zafar Mirza spoke about the realities of implementing a mental health plan, explaining that it is impossible to separate economic hardships from psychological suffering. &quot;The issue of our country is wealth inequality, and 78 years of such inequality...Inequity in healthcare haunts us,&quot; he said, referring to the vast number of Pakistanis living on the poverty line. Most of the money in healthcare goes to tertiary care, not primary care, which benefits the poor the most, he noted.

Read: Pakistan&rsquo;s poverty rate rises to 44.7% under new World Bank thresholds

He emphasised the need for implementing robust healthcare models. &quot;We already have essential packages of services, but nobody has implemented them.&quot; He argued that before we can talk about mental health in our healthcare systems, we must first provide basic healthcare needs for all and integrate mental health into those essential services.

Earlier, National Adviser on Mental Health Dr Asma Humayun opened the conference today underscoring the challenges and opportunities when prioritising mental healthcare in Pakistan. She spoke on the current status of the Mental Health and Psychosocial Support (MHPSS) model she had been working on, detailing the journey of its formation and implementation in different phases from 2021 to 2025. &quot;Pakistan is one of the few countries able to incorporate mental health into the agenda.&quot;

She said that a robust MHPSS model needs to be multi-layered and implemented as such, as single-tier implementations of mental healthcare solutions (only addressing one facet of policy or society) do not work. &quot;This is a comprehensive model; we think that this will help us build the system that is missing both at the level of communities and primary care.&quot;

CEO of Tech4Life Enterprises Dr Shariq Khoja spoke about empowering primary mental health workers with digital tools, explaining that most people in Pakistan possess smartphones, which would allow them to utilise digital apps and AI-powered tools to assist in providing mental health services quickly.

Professor of Child Psychiatry at the University of Liverpool Dr Atif Rahman explained that this would also streamline the process of teaching and co-producing mental health interventions with community health workers for the specific contexts they work in.

Meanwhile, UK Lead of Climate Cares Centre and Mental Health Dr Emma Lawrance opened the session on climate change and its effects on mental health, detailing the cycle of climate disasters leading to worsening mental health outcomes. She said that there is a need for a multidisciplinary approach that brings together climate and mental health workers (especially those in natural-disaster-affected areas) to provide improved care, which she said can assist in reducing suicidality.

Read more: &#39;One in three Pakistanis suffer from psychological disorders&#39;

Professor at the Department of Epidemiology and Prevention at Wake Forest University, Dr Michelle Mielke, and Professor of Medicine, University of Wisconsin-Madison, Dr Ozioma Okonkwo, spoke about Alzheimer&#39;s Disease. Dr Michelle explained the current state of using biological markers in the blood to identify Alzheimer&#39;s, pointing out that it must be treated with caution, as other factors, such as Chronic Kidney Disease, can lead to misdiagnoses.

Dr Ozioma showed his team&#39;s work, in which he called attention to methods that one could take to stave off the risk of Alzheimer&#39;s. He said the &quot;best thing&quot; that one could possibly do is be physically active (specifically with cardiovascular exercises), and that there was no limit to when you could start.

A presentation on suicide prevention by Senior Scientist at BMI, Dr Murad Moosa Khan, outlined a research strategy for suicide prevention in Pakistan. He went over the problem areas and current limitations, stating that the main problem with suicide statistics is the lack of a suicide surveillance system, as he said, we have no actual suicide statistics in the country, only projections from the WHO. &quot;I believe these numbers [from the WHO] are underestimates,&quot; he added.

Last but not least, there were film screenings on both days, featuring &quot;Darya ke iss paar,&quot; a film by Nighat Akbar Shah, and episodes from &quot;Voices from the Roof of the World,&quot; a documentary series about the impact of climate change and the crises affecting different areas.]]>
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			<title>No food for thought</title>
			<link>https://tribune.com.pk/story/2575407/no-food-for-thought</link>
			<comments>https://tribune.com.pk/story/2575407/no-food-for-thought#comments</comments>
			<pubDate>Sun, 02 Nov 25 01:13:46 +0500</pubDate>
			<dc:creator>
				<![CDATA[Tufail Ahmed]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category><category><![CDATA[Magazine]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2575407</guid>
			<description>
				<![CDATA[Across various life stages, gender discrimination in nutrition &amp; patriarchal prejudices hinder physical development]]>
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				<![CDATA[While poverty is often seen as the primary predictor of malnourishment, it fails to account for the gender-specific disparities in access to nutrition that have steadily led to the development of chronic nutritional deficiencies among women and girls in the country.

According to Dr Basmaa Ali, Clinical Instructor in Internal Medicine at the Harvard Medical School, malnourishment, particularly iron-deficiency anaemia is a huge problem in Pakistan since it causes the national IQ score among girls to drop by three to five points, which is 5 per cent of our GDP.

&ldquo;Growing up if you have anaemia, your brain does not develop since haemoglobin is needed to supply oxygen. Hence, the affected women and girls are unable to develop the intellectual prowess needed to excel in the public sphere,&rdquo; revealed Dr Ali.

On the other hand, Dr Nighat Khan, General Secretary at the Women Care Foundation of Pakistan highlighted the fact that nutritional deficiencies not only impacted the development of female adolescents but also had dire consequences for their future children.

&ldquo;Girls who suffer from severe malnutrition face various medical complications during pregnancy. Even when they give birth successfully, the child born is underweight and is susceptible to acquiring various diseases,&rdquo; claimed Dr Khan.



&ldquo;Approximately 50 per cent of women in urban areas and 75 per cent of women in rural areas are suffering from some nutritional deficiency especially of iron and calcium,&rdquo; explained Professor Dr Jahan Ara Hassan, Professor of Gynaecology at the Dow University of Health Sciences.

Whilst acknowledging the hazards of malnourishment, Dr Ali felt that genotypic variations among different populations could partially explain the staggering figures highlighting anaemia in Pakistan.

&ldquo;We rely on Western medical guidelines, which label women with a haemoglobin level of 11g/dL as anaemic, even though these levels are perhaps normal in our local female population. The average haemoglobin levels among women in our country are genetically lower,&rdquo; noted Dr Ali.

While it could be said that the figures on malnourishment might be exaggerated, the interplay of various gendered social factors hindering access to nutrition for women and girls perpetuates a vicious cycle of malnourishment, which hampers the quality of life of females across socio-economic backgrounds.



Taste of discrimination

In a male-dominated society where women are stereotypically relegated a lower status, gender discrimination is a harsh reality withholding half the population from equally accessing education, healthcare, employment and even nutrition.

Since sex determination through a sonography is allowed in Pakistan, gender discrimination in nutrition often begins even before a girl child is born. Families that have knowledge of the gender of the child convey their bias through the quality of care given to the expectant mother.

Nazia*, a 21-year-old first time mother was over the moon when she was told by her doctor that she was carrying a boy. However, her days of happiness were short-lived since a couple of months later she delivered a baby girl.

&ldquo;Although my husband was happy, my mother-in-law was distraught since she worried for her poor son who now had the burden of a daughter on his shoulders. To express her resentment, she did not even announce the birth of my daughter in the family,&rdquo; recalled Nazia.

Nazia&rsquo;s heart-breaking experiences were corroborated by healthcare providers during a study undertaken by the Population Council to study son preference in Karachi. According to the respondents, pregnant women carrying male children reported being treated better by their families, who would take special care of their nutrition and rest.



In Nazia&rsquo;s case, her mother-in-law, who would feed her nuts and milk during pregnancy, stopped caring for her nutritional needs after the birth of her daughter. &ldquo;Whenever I would nurse my daughter, she would order me to do some household chore. I was forced to stop breastfeeding my daughter so that I could conceive a boy soon after. This treatment continued until I had my son two years later,&rdquo; recalled Nazia, whose daughter suffers from stunting.

Published by the Quarterly Journal of Economics, a study exploring breastfeeding practices in India revealed that a negative covariance was found between the duration of breastfeeding and parents&rsquo; plans for subsequent births. Since breastfeeding physiologically lowered a woman&rsquo;s fertility, after the birth of a girl, parents were more likely to limit breastfeeding in order to try for a boy.

Regrettably, such discriminatory practices only worsen as the girl grows older. Dr Basmaa Ali, Resident Scientist at the Lahore University of Management Science (LUMS) informed that in many areas across the country, iron-rich foods were still considered premium foods reserved for boys.

&ldquo;Eggs, chicken and red meat are first given to boys and then to girls hence the latter have no iron supplementation. Plant-based iron must be consumed in large amounts for efficacy. Three cups of cooked spinach are required most days of the week to fulfil the body&rsquo;s iron requirement. However, a lot of times this is not feasible,&rdquo; claimed Dr Ali.

&ldquo;One in seven women in Pakistan is undernourished, while nearly half of the female population suffers from iron deficiency anaemia, which is a major factor contributing to miscarriages among pregnant women. Furthermore, the deficiency of vitamins A and D is also quite common among women and adolescent girls in the region,&rdquo; noted Dr Bushra Khalil, Head of Nutrition at the Lady Reading Hospital in Peshawar.



Starved by standards

Upon reaching puberty, the nutritional requirements of female adolescents increase sharply to compensate for the monthly loss of blood. Unfortunately, however, this is the exact same time when societal pressure to fit the conventional standards of beauty encourages young women to zip their mouths shut.

Alina*, a 16-year-old student struggled with obesity since childhood. However, the unease that she felt within her own body hit a whole new level once she entered her teenage years. While her favourite online influencers could pull off any outfit grabbed at the mall, she had to spend hours finding the correct fit. Tired of the constant body shaming and desperate to lose the extra pounds, she decided to turn to YouTube for help.

&ldquo;I came across this juice detox diet, which guaranteed significant weight loss within two weeks. All I had to do was only drink juice the whole day. What could possibly go wrong?&rdquo; shrugged Alina, who whilst suffering from heavy menstrual bleeding was unaware of the repercussions of her highly restrictive diet.

Soon after, Alina started fainting in school on a daily basis and eventually required multiple blood transfusions to correct her severe anaemia. &ldquo;I wish society was not as unforgiving for young girls. Children should never be body shamed since adolescence is a time when their bodies are still developing. Unfortunately, our constant exposure to the perfect physiques of influencers only further ruins our self-esteem,&rdquo; said Alina, who has consistently struggled with anorexia.

According to the Cureus Journal of Medical Science, adolescent&rsquo;s exposure to ideal body types on social media has significantly increased their susceptibility to following fad diets and developing eating disorders over the past few years.



Explaining Alina&rsquo;s case, Dr Ali revealed that in girls, iron was not stored as fastidiously as in boys hence it must be restored through food. &ldquo;Heavy menstruation is quite common, especially during the initial few years of menarche. When this blood loss is not corrected through food it leads to anaemia,&rdquo; highlighted Dr Ali.

In order to correct anaemia, it must first be diagnosed. In Pakistan however, taboos surrounding menstruation prevent young girls from discussing issues like heavy bleeding with female caregivers while the stigma associated with taking an unmarried girl to a gynaecologist prevents many mothers from seriously addressing their daughters&rsquo; concerns.

&ldquo;Women&rsquo;s reproductive health, including menstruation, is all taboo in our country. When I was a medical student in Pakistan, every time we would take the menstrual history of a female patient, the male professor would have a sly smile on his face while all the male students at the back would invariably smirk. Later, when I went to the US for my residency, I was presenting a woman&rsquo;s medical history to my male supervisor in a class of nearly all male students and not a single one of them acted weird,&rdquo; recalled Dr Ali.

Dr Ali further opined that in order to destigmatize women&rsquo;s reproductive health, it was necessary to raise awareness about the topic in the local languages. &ldquo;The reproductive system is just like any other part of the body. Talking about this subject in English allows us to distance ourselves from it. Therefore, we should talk about it in Urdu and the other vernacular languages to reduce the stigma. That&rsquo;s the only way to make it normal because as long as it is considered a matter of shame, people will not talk about it,&rdquo; noted Dr Ali.



Hunger for heir 

&ldquo;It&rsquo;s a girl.&rdquo; Till date, the following revelation is received by families in two extreme ways. An open exhibition of outright shock or a well mastered display of feigned exuberance. In both the scenarios, the new parents are tacitly consoled by the clich&eacute;d declaration that daughters are a blessing from God and that having a healthy baby is all that matters. However, in discreet words the mother is told that her nine-month long journey of patience was fruitless since it ended with the disappointing birth of a sour fruit.

Not much different was the plight of Hajra Bibi, a 25-year-old mother hailing from the Momand Agency, whose failure to produce a son landed her in an endless cycle of consecutive pregnancies. &ldquo;The doctors advised me against conceiving another child because of my severe anaemia. I tried explaining this to my husband but he insisted on having a son despite my health struggles,&rdquo; bemoaned Hajra, who is pregnant once again.

Hajra&rsquo;s case is a classic example of son-biased fertility stopping behaviour, under which the desire to have one son or a desired number of sons leads couples to continue having more and more daughters, significantly deteriorating the mother&rsquo;s health.

Dr Muhammad Rizwan Safdar, Assistant Professor of Sociology at the Institute of Social and Cultural Studies (ISCS), University of Punjab highlighted the fact that the prevailing cultural mind-set in the country actively encouraged couples to continue having children until a son was born. &ldquo;Son-biased fertility stopping behaviour often leads to malnutrition in mothers,&rdquo; said Dr Safdar.

However, the gendered consequences of son-biased fertility stopping behaviour extend beyond the health of the mother, entailing much deeper repercussions for the ill-fated cohort of girls, who are seen as little more than the pitiful outcomes of repeated failed attempts at having a boy. Given the limited economic means of the average household, the nutrition, education and life outcomes of these girls are all significantly impacted, with their futures obscured by the darkness of both malnutrition and child marriage.

According to the National Nutrition Survey 2018, over half of adolescent girls in Pakistan suffer from anaemia, with rural areas hit the hardest. While the prevalence of anaemia among girls in urban areas stands at 54.2 per cent, a staggering 58.1 per cent of adolescents hailing from poverty-ridden areas are affected.

Research by the Future Business Journal confirmed that children with a large number of siblings were more likely to suffer from malnutrition while a study published by BMC Women&rsquo;s Health revealed that girl&rsquo;s belonging to large families with more than five members were at an increased risk of child marriage. Therefore, it is seen that son-biased fertility stopping behaviour leads to the birth of more girls than the family can afford to feed therefore, the easiest way out of a financial crisis is to lend their frail hands in marriage.

Moreover, the results of a study exploring the link between female early marriage and son preference in Pakistan published by the Journal of Development Studies concluded that girls who were married before the age of 18 not only expressed a greater desire for having male children but were also less likely to stop reproduction until or unless they gave birth to a boy. Hence, the cycle of son preference and malnutrition survives through generations, silently bedeviling the health of millions of women and girls in the country.



Breaking the cycle 

Whether women want to improve bone strength to manage daily tasks or flaunt flawless skin, hair and nails at a wedding, the billion-rupee vitamin and minerals market claims to offer a myriad of benefits. Beguiled by the tactful marketing strategies, very few consumers stop to ponder how effective these supplements really are?

&ldquo;From an evolutionary standpoint, our food is much older than humanity, which has actually co-evolved with its food. The body recognizes nutrients in the matrix of food. Therefore, when you take calcium or iron in a pill form, the body is unable to recognize them as nutrients. For iron the studies are not as good, but for calcium we know that 10 times more calcium is absorbed through food than from tablet form,&rdquo; emphasized Dr Ali, whose medical practice integrates the principles of Ayurveda with those of western medicine.

Hence, Dr Ali stressed the importance of supplementation through food. &ldquo;In order to prevent and correct anaemia, women and girls should eat red meat, liver, and eggs regularly alongside incorporating a good number of green vegetables especially spinach, into their diet. Iron-rich foods should be taken alongside foods that are high in vitamin C since the micronutrient is needed for iron&rsquo;s absorption,&rdquo; explained Dr Ali.

Since female adolescents spend a large part of their day at school or college, Dr Ali believed that educational institutions could play a part in improving nutritional outcomes among women. &ldquo;Unfortunately, however, high carb junk foods dominate the menu at nearly all educational institutions. On the contrary, in countries like Japan, a nutrition profile is made for foods to highlight the exact quantity of protein, carbs and fresh vegetables necessary for students across all ages. Nutritious foods, however, require proper storage. Therefore, our government should issue general guidelines and invest in developing a system for nutrition in schools,&rdquo; implored Dr Ali.

In Punjab, the Chief Minister&rsquo;s School Nutrition Program, which was launched with great fanfare in selected districts, has now completely disappeared into the background. Despite attempts to contact the Education Department for clarification, no information could be obtained about the program&#39;s current status.

Commenting on the female malnutrition, former Provincial Health Minister Dr Javed Akram claimed that the government had launched the Punjab Human Capital Investment Project, which would provide medical check-ups, vaccinations, and financial assistance to women in 13 districts.

Conversely, Dr Fazal Majeed, Director of the Nutrition Health Department of K-P claimed that the government had launched the Micro-Nutrient Universal Program in 12 districts, where women will receive essential vitamins, including folic acid supplements, free of cost.]]>
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			<title>Built from the battle</title>
			<link>https://tribune.com.pk/story/2574271/built-from-the-battle</link>
			<comments>https://tribune.com.pk/story/2574271/built-from-the-battle#comments</comments>
			<pubDate>Sun, 26 Oct 25 01:14:50 +0500</pubDate>
			<dc:creator>
				<![CDATA[Nabil Tahir]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2574271</guid>
			<description>
				<![CDATA[At 24, Jovita’s world changed with three words, breast cancer. What followed was the fight that rebuilt her life.]]>
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				<![CDATA[The music of her life used to be the sound of gloves hitting the bag, sneakers gripping the mat, and laughter echoing through the gym after another exhausting round. Fitness wasn&rsquo;t something Jovita did, it was who she was. &ldquo;Before cancer, fitness was just part of who I was,&rdquo; she says, smiling softly at the memory. &ldquo;I loved being athletic. It made me feel confident and strong. Back then, I focused more on aesthetics and performance than on health itself. I didn&rsquo;t realize how much it would later become my lifeline.&rdquo;

In those days, she was training to become an athlete, moving through life with rhythm and drive. &ldquo;Honestly, it just felt natural,&rdquo; she says. &ldquo;I was always drawn to movement, running, training, and pushing limits. There wasn&rsquo;t one big moment, but more a series of small ones where I realized this is where I feel most alive. Competing, sweating, challenging myself, that&rsquo;s when I knew this wasn&rsquo;t just a hobby, it was who I am.&rdquo;

At twenty-four, Jovita carried the kind of energy that filled a room before she even spoke. &ldquo;I was full of energy and dreams, a confident, fun-loving person but also focused on my goals, and living life fast,&rdquo; she recalls. &ldquo;I thought I had everything figured out, not knowing life was about to test me in ways I couldn&rsquo;t imagine.&rdquo;

And then, suddenly, everything changed. The body she had spent years training, the one that had never failed her, started sending silent signals she couldn&rsquo;t ignore. A small lump. A few medical visits. And words that no one is ever ready to hear. In a single moment, the girl who had once fought for medals found herself preparing for a different kind of battle, one for her life.



The discovery

It began as a dull ache she could not quite explain. &ldquo;I first noticed a small lump, and it would slightly hurt whenever I threw a punch or a jab during training,&rdquo; Jovita recalls. &ldquo;At first, I brushed it off, but deep down I knew something felt off. I wanted to be okay because I had a tournament I wanted to participate in.&rdquo;

That mix of denial and instinct became her first real opponent. She remembers crying one night, unsure of what was happening to her body. &ldquo;I felt scared,&rdquo; she says quietly. &ldquo;I didn&rsquo;t know what this meant. I just wanted things to go back to normal.&rdquo;

When she finally visited the doctors, the verdict was almost comforting. They told her the lump was likely benign, something harmless. &ldquo;I felt confused and uneasy,&rdquo; she says. &ldquo;A part of me wanted to believe them, but another part just knew something wasn&rsquo;t right. It was frustrating, like my instincts were being ignored.&rdquo;

The months that followed were marked by uncertainty and delays. The world outside was locked down due to COVID, and so were her medical options. She waited, hoping the discomfort would fade, that it really was nothing. But when clinics reopened, she pushed for another checkup. This time, the news would change everything.



&ldquo;I remember the doctor saying, &lsquo;It&rsquo;s Stage 3 Triple-Negative Breast Cancer,&rsquo;&rdquo; she recalls, her voice tightening. &ldquo;The words hit me like a shockwave, but there was no time to even process them. Every step after that happened so urgently, appointments, scans, treatment plans, it all moved at lightning speed. I didn&rsquo;t have a moment to breathe or truly absorb what was happening.&rdquo;

Her biggest fear was not just the disease, but what it would take away from her. &ldquo;Getting the final diagnosis was absolutely terrifying,&rdquo; she says. &ldquo;The thought of chemotherapy was overwhelming. I knew I would lose my hair, and as someone who had always cared about my appearance, that scared me more than anything. Suddenly, my life felt completely shattered because I wasn&rsquo;t ready to accept myself the way I was.&rdquo;

Her family&rsquo;s reaction mirrored her own shock. &ldquo;They were scared and overwhelmed, just like I was,&rdquo; she says. &ldquo;I could see the fear in their eyes. No one could believe it because cancer doesn&rsquo;t run in our family.&rdquo;

Still, they stood beside her, even when words fell short. &ldquo;They tried to stay strong for me. Emotionally, I felt completely torn. I had always been healthy, fit, and careful with my body. Part of me wanted to break down, scream, and cry endlessly, but part of me knew I had to hold it together for them too.&rdquo;

Those first few weeks became a blur of emotion, fear, anger, sadness, confusion, yet somewhere in that chaos, she began to find her footing again. &ldquo;It was a rollercoaster,&rdquo; she says, &ldquo;but also filled with moments of love and support that reminded me I wasn&rsquo;t alone in this fight.&rdquo;



The battle phase

The months that followed became a blur of hospital rooms, medication, and exhaustion. &ldquo;The sixteen rounds of chemotherapy were some of the hardest days of my life,&rdquo; Jovita says. &ldquo;I was dealing with so much at once, losing my hair, going through a mastectomy, and trying to recover from both the physical pain and the emotional loss. I couldn&rsquo;t even recognize the person staring back at me.&rdquo;

She remembers brushing her teeth or washing her face but avoiding the mirror. &ldquo;I didn&rsquo;t feel like me anymore,&rdquo; she says. &ldquo;There were days when I&rsquo;d put on a brave face, smile, and act happy in front of my family because I didn&rsquo;t want them to worry. But every night, when I was alone, I would cry myself to sleep. It was painful, lonely, and heavy, but deep down, I kept telling myself that I had to survive this. I had to find my strength again, no matter how broken I felt.&rdquo;

At Shaukat Khanum Hospital in Lahore, the care she found became one of her biggest sources of comfort. &ldquo;The support there was incredible,&rdquo; she says. &ldquo;From the doctors to the nurses to the staff, everyone went above and beyond to make sure I felt cared for not just physically, but emotionally too. They were patient with my fears, answered all my questions, and reminded me that I wasn&rsquo;t just a patient, I was a person fighting for her life.&rdquo;

She recalls how their compassion gave her hope on days when she felt completely lost. &ldquo;Their professionalism combined with genuine empathy made a huge difference,&rdquo; she says. &ldquo;Knowing that I was in capable hands helped me keep going, even on the hardest days.&rdquo;

Still, there were moments when her spirit almost gave way. &ldquo;Yes, there were times I felt like giving up,&rdquo; she admits. &ldquo;The pain, the exhaustion, and the constant changes in my body sometimes felt unbearable. I questioned why this was happening to me and whether I could really survive it all.&rdquo;



But each time, something pulled her back. &ldquo;It was a mix of love and determination, my family who stood by me, my friends who never let me feel alone, and a deep inner voice that reminded me of who I was,&rdquo; she says. &ldquo;I also used to see small kids in the hospital fighting for their lives, and I thought about the life I still wanted to live and the person I still wanted to become. That thought, of fighting for my own future, kept me moving forward even when every part of me wanted to stop.&rdquo;

Cancer had stripped away much of what she once took pride in, her strength, her appearance, her sense of control. &ldquo;Physically, I had to face scars, the loss of my breast, hair falling out, and weakness that left me struggling to do even simple things I once took for granted,&rdquo; she explains. &ldquo;Mentally, it was shattering. I didn&rsquo;t recognize myself in the mirror anymore. I felt like a stranger in my own skin.&rdquo;

There were days when she hated her reflection, cried over what she had lost, and wondered if she would ever feel whole again. But over time, her perspective began to shift. &ldquo;Slowly, I began to see my body differently,&rdquo; she says. &ldquo;Not for how it looked, but for what it had endured. It had survived something I never thought I could survive, and that realization, painful as it was, became the foundation of a new kind of strength and self-love.&rdquo;

Her identity as an athlete became her anchor. &ldquo;Even though my body felt weak and unfamiliar, the discipline, resilience, and mental toughness I had built through years of training stayed with me,&rdquo; she says. &ldquo;I approached chemotherapy like I would a tough workout, one rep at a time, focusing on small victories, pushing through pain, and never giving up.&rdquo;



The turning point

When the words finally came, &ldquo;You&rsquo;re cancer-free,&rdquo; Jovita could barely process them. After months of hospital corridors, restless nights, and silent prayers, she found herself caught between disbelief and relief. &ldquo;It was like a weight I didn&rsquo;t even fully realize I was carrying had finally been lifted,&rdquo; she says. &ldquo;After months of fear, pain, and uncertainty, it was as if I had been given a second chance at life.&rdquo;

There were no grand celebrations, just quiet tears and gratitude. &ldquo;I cried, not just for the end of the treatment, but for everything I had endured, the fear, the loneliness, the nights of crying myself to sleep, and the journey of learning to accept and love my body again.&rdquo;

But survival was only half the battle. &ldquo;Rebuilding my strength after cancer was one of the hardest journeys of my life,&rdquo; she says. &ldquo;Even lifting a two-kilogram dumbbell felt the heaviest, and I remember crying in the gym because I kept comparing my old self to the fit person I used to be.&rdquo;



She rebuilt herself one step at a time. &ldquo;Every day was a reminder that progress, no matter how small, mattered,&rdquo; she says. &ldquo;I found grounding in gratitude, which made my faith in God even stronger and made me appreciate my life, my body, and the people who supported me.&rdquo;

Before cancer, Jovita had studied interior design. After it, that world no longer spoke to her. &ldquo;I realized how much I wanted to focus on health, strength, and helping others rather than just aesthetics,&rdquo; she says. &ldquo;Surviving cancer gave fitness a deeper meaning.&rdquo;

She began coaching people not just for appearance, but for confidence and healing. &ldquo;It wasn&rsquo;t just about coaching anymore,&rdquo; she says. &ldquo;It was about guiding people to feel strong, confident, and capable in their own skin. It was a way of giving purpose to my pain, and finally, a way to heal and help others heal.&rdquo;

Many of her clients were fighting their own battles, arthritis, diabetes, depression, or post-surgery recovery. &ldquo;It was proof that my pain and experiences weren&rsquo;t just my own,&rdquo; she says. &ldquo;They could be a source of hope and strength for others.&rdquo;



Reinvention and purpose

Jovita&rsquo;s story today is no longer about illness; it&rsquo;s about strength. &ldquo;Please, don&rsquo;t ignore your body,&rdquo; she says. &ldquo;Listen to it. Pay attention to changes, no matter how small they seem. I was young, healthy, and fit, and I never imagined something like cancer could happen to me. But it did, and early detection could save your life.&rdquo;

She urges women to act before it&rsquo;s too late. &ldquo;Do your self-examinations regularly, go for checkups, and don&rsquo;t let fear or denial hold you back,&rdquo; she says. &ldquo;If my story can make even one woman stop and check herself, then everything I went through has meaning.&rdquo;



The illness changed her perspective on everything. &ldquo;I used to chase perfection,&rdquo; she says. &ldquo;How I looked, what people thought of me, the idea of always being &lsquo;put together.&rsquo; But when you come face to face with something that threatens your life, you realize none of that truly matters.&rdquo;

Now, she values peace and presence. &ldquo;Small things like a morning coffee, a good workout, laughter with family, they feel like blessings,&rdquo; she says. &ldquo;What matters to me now is living a life that feels meaningful, one where I can inspire others, love deeply, and be grateful for the second chance I&rsquo;ve been given.&rdquo;

Every year, she celebrates her cancer-free anniversary like a birthday. &ldquo;I cut a cake, reflect on how far I&rsquo;ve come, and spend the whole day doing things that make me happy,&rdquo; she says with a smile. &ldquo;It&rsquo;s a celebration of my new body, my second chance, and the strength that carried me through everything.&rdquo;



Light through the cracks

Looking back, Jovita no longer calls cancer her downfall. &ldquo;At first, I thought cancer broke me,&rdquo; she admits. &ldquo;It stripped away everything I knew about myself, my body, my confidence, my identity. I felt lost, fragile, and shattered.&rdquo;

But time brought clarity. &ldquo;With time, I realized it didn&rsquo;t just break me, it rebuilt me. It tore me down only to make space for a stronger, wiser, and more grounded version of myself,&rdquo; she says. &ldquo;Cancer taught me strength I never knew I had. It showed me what truly matters in life and helped me reconnect with who I really am. So yes, it broke parts of me, but those same cracks became where the light came in.&rdquo;



When asked what her younger self would say if she could see her now, Jovita smiles. &ldquo;If my 24-year-old self could meet me today, I think she would just stare in disbelief for a moment, and then probably cry,&rdquo; she says. &ldquo;She&rsquo;d see the scars, the strength, and the calm in my eyes, and she&rsquo;d realize how much pain and growth it took to get here. She&rsquo;d tell me she&rsquo;s proud. that even after everything that tried to break me, I never gave up.&rdquo;

She pauses before adding softly, &ldquo;She&rsquo;d probably say, &lsquo;I can&rsquo;t believe you made it through that,&rsquo; and I&rsquo;d tell her, &lsquo;I can&rsquo;t believe it either, but we did.&rsquo;&rdquo;

For Jovita, survival is no longer just about defeating cancer, it&rsquo;s about rediscovering herself. &ldquo;She&rsquo;d see that I turned my pain into purpose,&rdquo; she says. &ldquo;That I built a life around strength, healing, and helping others. And I think she&rsquo;d finally understand. that everything she feared, everything she lost, led her to become exactly who she was meant to be.&rdquo;

For her, cancer didn&rsquo;t just change her life. It rewrote the meaning of it.]]>
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			<title>What to look out for at Health Asia 2025 happening at Karachi Expo Centre</title>
			<link>https://tribune.com.pk/story/2573842/what-to-look-out-for-at-health-asia-2025-happening-at-karachi-expo-centre</link>
			<comments>https://tribune.com.pk/story/2573842/what-to-look-out-for-at-health-asia-2025-happening-at-karachi-expo-centre#comments</comments>
			<pubDate>Thu, 23 Oct 25 13:10:17 +0500</pubDate>
			<dc:creator>
				<![CDATA[Daniyal Khuhro]]>
			</dc:creator>
			<category><![CDATA[Technology]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2573842</guid>
			<description>
				<![CDATA[From AI diagnostics to digital hospitals, global healthcare innovation is on display.]]>
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				<![CDATA[Health Asia Exhibition is being held at the Karachi Expo Centre from the 23rd to the 25th of October, and is the largest health sector exhibition held in Pakistan with over 200 exhibitors this year and more than 24 countries participating, including Iran, China and Russia.

&quot;The destination you have chosen - the right place to be is here,&quot; said Federal Health Minister Syed Mustafa Kamal, addressing representatives from foreign companies. &quot;Our country&#39;s population is growing bigger and bigger. It&#39;s a big market...The economy is of scale here&quot;

Below are some exhibitors who stood out at the event.

All-in-one x-ray machine &mdash; Rays Medical World

A Pakistani company specialises in manufacturing and supplying imaging equipment, such as MRI machines, CT scans, and X-ray technology. They are currently innovating with a new kind of all-in-one X-ray machine that can do both full-body imagery as well as targeted X-rays.

Director of Rays Medical World Muhammad Rafiq said that the firm has produced basic X-ray machines that are installed in several hospitals across Pakistan, and that compared to imported models, which can cost up to Rs15 million, these models cost only Rs4 million.

Read: First locally made advanced X-ray machine unveiled

Heartbeat monitoring patch &mdash; Aman Ventures

Aman Ventures has a digital health platform dubbed AViCA, which enables streamlined healthcare for patients and providers. They have released the AViCardia: a waterproof, reusable patch that provides up to 7 days of Holter Monitoring &mdash; monitoring one&#39;s heartbeat for any irregularities &mdash; which allows patients and medical professionals to quickly check in on the patient&#39;s heart health (a portable electrocardiogram).

&quot;This device is the first of its kind in Pakistan,&quot; a product manager for Aman Ventures claimed, adding that it is currently deployed at the two hospitals in Karachi. Unfortunately, their products aren&#39;t available for consumer retail, but their product manager said that there are plans to bring this to consumers in the future. You can visit them to try and find out what their timelines are.

Customised ambulances &mdash; Al-Bashir Custom Fabrication

Specialising in custom-made automotives, they focus on the manufacture and supply of vehicles across Pakistan. Most of the vehicles they provide are made locally, and they supply hospitals with custom-made ambulances fitted to each service provider&#39;s needs, as well as custom-made automobiles for individual and police use.

They have supplied to organisations such as the World Health Organisation, Capital Development Authority Islamabad, NADRA and more, but if you want to modify a luxury vehicle for personal use, these are the people to talk to.

Recording patient information &mdash; Boston Health AI

Integrating AI with healthcare, this company shows the &quot;world&#39;s first AI-powered physician&#39;s assistant where you talk to the AI&quot; to help in patient care. According to them, Hami the AI-assistant, can take patient histories and use technologies such as Ambient Scribe, which are AI-driven systems designed to passively listen to clinician-patient interactions, transcribe conversations, and automatically generate structured clinical notes and documentation, to provide treatment and prescription recommendations.

They add that Hami is meant to streamline the process of seeing a patient, so less time is taken with history taking and more time is spent discussing the treatment or diagnosis, and they have currently deployed the AI assistant at Aga Khan University Hospital. If you want to experience Hami for yourself, you can find out more at their booth and even request a technical demonstration.

Healthcare charity &mdash; Hammad Foundation 

A Non-Profit organisation that provides charitable services such as roti banks that provide Rs10 rotis in Karachi, water plants across Balochistan and Tharparkar. They also have a medical complex in Karachi, which provides many services for only Rs50 to Rs100. Talking to the spokesperson there, we learned that these services are open to all.

We highly recommend checking out their booth and learning more about the foundation, as they have merchandise, and all money made from that goes right back as investments for their many projects.

Digital hospital &mdash; Novacare Hospital

Pakistan&#39;s first international venture, Novacare Hospital, is slated to open its doors in Islamabad in October of 2026. They intend to follow the standards of the British National Health Service and will have international auditors come in to ensure quality control.

According to a spokesperson, the hospital will attempt to operate completely digitally as to eliminate paper usage and streamline administrative duties, and will also look to open institutions in Lahore and Karachi. Additionally, they stated that the hospital will expand to offer diverse services over time, and you can visit their booth to find out more about these services.

Cell and gene therapy &mdash; Taskin Bioregeneration

A biotechnology company based in Iran that specialises in cell and gene therapies, their DestroCell technology can be used to provide cell therapy for children with Autism by reducing inflammation in the brain, supporting brain repair and communication pathways and helping improve their social behaviour.

Their other products assist with cellular repair of wounds, both shallow and deep, and they &quot;hope they can provide these services to Pakistan soon,&quot; as per their spokesperson, and are interested in speaking to people who can assist them with expanding their operations. Currently, they operate in Iran and offer services to healthcare providers and educational institutions.

Infertility treatments &mdash; Behrad Royesh Royan 

Another company based in Iran they are known as the &quot;largest manufacturer of consumer medical equipment in the field of gynaecology and infertility treatment&quot;. They have already been imported to Russia, Lebanon and Iraq, and they work closely with around 100 centres in Iran for in-vitro fertilisation (IVF).

Speaking with their representative, I learned that there have been more instances of IVFs over the past 3 years, and they believe that this will only increase. This is one of the reasons why they are interested in bringing their operations to Pakistan.

Iranian orthopaedic supplies &mdash;  Mobtakeran Parsian Darman (BoneTech Co. Ltd)

Founded in Iran in 2008, this company started working in the field of designing and producing a complete basket of orthopaedic products, including bone screws, plates, maxillofacial and spinal implants. The company reportedly exports to around 55 to 60 countries and is looking to work closely with local hospitals.]]>
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			<title>Pioneer of epidural services in Pakistan, Dr Ursula Chohan, passes away</title>
			<link>https://tribune.com.pk/story/2573628/pioneer-of-epidural-services-in-pakistan-dr-ursula-chohan-passes-away</link>
			<comments>https://tribune.com.pk/story/2573628/pioneer-of-epidural-services-in-pakistan-dr-ursula-chohan-passes-away#comments</comments>
			<pubDate>Wed, 22 Oct 25 09:02:12 +0500</pubDate>
			<dc:creator>
				<![CDATA[Web Desk]]>
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			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category>
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			<description>
				<![CDATA[She performed country’s first epidural in 1986, founded Pakistan’s first formal obstetric epidural service]]>
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				<![CDATA[One of the foundational pillars of the Department of Anaesthesiologists at Agha Khan University (AKU) and a pioneer of epidural services in Pakistan, Dr Ursula Chohan has passed away.

Dr Chohan has built a career contributing to education, clinical advancement and helped introduce anaesthesia training in the country.

She performed the country&rsquo;s first epidural for painless childbirth in 1986 and later founded Pakistan&rsquo;s first formal obstetric epidural service at AKU in 1994 &mdash; a milestone that revolutionised maternal healthcare across the nation.

An epidural is the most effective pain relief during labour. A local anaesthetic is injected into the lower back to block pain from the uterus and birth canal without causing drowsiness or slowing labour.

Dr Chohan was known for co-founding the Journal of Anaesthesia and Critical Care. She also received Lifetime Achievement Awards from AKU in 2018 and the Pakistan Society of Anaesthesiologists in 2019.

She graduated from Dow Medical College. Dr Chohan began her medical journey in Obstetrics and Gynaecology, obtaining the DRCOG (Diploma from the Royal College of Obstetricians and Gynaecologists) in 1970.

Recognising the growing need for qualified anaesthesiologists, she transitioned to anaesthesia, earning her DA (Diploma in Anaesthesia) in 1972 and later the FFARCS (Fellowship of the Faculty of Anaesthetists, Royal College of Surgeons, London) in 1982.

In 1986, she returned to Pakistan and joined AKU as an Assistant Professor, where her clinical excellence and professionalism helped define the culture and standards that continue to guide the Department today.]]>
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			<title>Hyderabad’s psychiatrists learn from Jamshoro anthropologists</title>
			<link>https://tribune.com.pk/story/2573398/hyderabads-psychiatrists-learn-from-jamshoro-anthropologists</link>
			<comments>https://tribune.com.pk/story/2573398/hyderabads-psychiatrists-learn-from-jamshoro-anthropologists#comments</comments>
			<pubDate>Tue, 21 Oct 25 04:50:52 +0500</pubDate>
			<dc:creator>
				<![CDATA[PRESS RELEASE  ]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2573398</guid>
			<description>
				<![CDATA[Blending anthropology with psychiatry can foster culturally informed, compassionate mental health care.]]>
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				<![CDATA[Anthropology and psychiatry can collaborate to lead to a deeper understanding of mental health challenges and culturally appropriate care, said speakers at a seminar at the Sir Cowasjee Jehangir&nbsp;Institute of Psychiatry &amp; Behavioral Sciences in Hyderabad on Saturday.

Medical Superintendent Dr. Nisar Ahmed Sohoo had asked Dr. Abdul Razaque Channa, the chairman of the Department of Anthropology and Archaeology of the University of Sindh, Jamshoro, and Dr. Rafique Ahmed Wassan to speak. They discussed the significance of anthropology in enriching psychiatric education, practice, and research.

Dr. Channa outlined four major subfields which help us comprehend complex human behavior. He stressed the importance of culture as the central focus of anthropological inquiry.

Dr. Wassan introduced the concept of Psychological Anthropology, focusing on the work of Ruth Benedict, a pioneering American anthropologist of the 1930s and 1940s. He discussed the Culture and Personality school of thought, illustrating its significance for psychiatry and mental health education and research. Dr. Wassan elaborated on Benedict&rsquo;s concepts of cultural-psychological types and national character, demonstrating their continued relevance in understanding the cultural dimensions of mental health.]]>
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			<title>From scapegoat to centre of care: MoltyFoam’s new TVC champions mothers after childbirth</title>
			<link>https://tribune.com.pk/story/2570582/from-scapegoat-to-centre-of-care-moltyfoams-new-tvc-champions-mothers-after-childbirth</link>
			<comments>https://tribune.com.pk/story/2570582/from-scapegoat-to-centre-of-care-moltyfoams-new-tvc-champions-mothers-after-childbirth#comments</comments>
			<pubDate>Sat, 04 Oct 25 11:40:54 +0500</pubDate>
			<dc:creator>
				<![CDATA[Sponsored Content]]>
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			<category><![CDATA[Life &amp; Style]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2570582</guid>
			<description>
				<![CDATA[The TVC silently captures a new mother's struggle and offers a hopeful vision of a family choosing care over conflict]]>
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				<![CDATA[In Pakistani households, the birth of a child is always a time of celebration.

Families gather, sweets are shared, and prayers are offered for the newborn&rsquo;s future. The baby instantly becomes the centre of attention, as they should. But in the glow of this joy, the mother, who has endured the struggles of pregnancy and the pain of childbirth, often fades into the background.

For generations, new mothers have been unfairly cast as scapegoats. If the baby cries, it&rsquo;s her fault. If she seems tired, she&rsquo;s called weak. If she asks for help, she&rsquo;s judged as incapable. Instead of becoming the most cared-for member of the family, she is often left isolated, expected to manage it all.

MoltyFoam&rsquo;s new TVC boldly challenges this narrative. With a tender and thought-provoking story, it shifts the spotlight back onto the mother, reminding us that her comfort, healing, and emotional well-being are just as important as the newborn&rsquo;s care.



Breaking stereotypes inside the household

Cultural depictions have long fueled the image of the &ldquo;difficult&rdquo; mother-in-law or the rivalrous sister-in-law. Sadly, these stereotypes often play out in real homes, where after birth women find themselves navigating not only recovery but also household tensions.

MoltyFoam&rsquo;s TVC turns this story on its head. Instead of friction, it shows love. Instead of rivalry, it portrays unity. The mother-in-law steps in with compassion, the sister-in-law becomes a friend, and the husband takes on an active role in his wife&rsquo;s recovery.

This is not just advertising, it&rsquo;s a cultural reset. By portraying empathy where we often expect judgment, MoltyFoam is pushing society to reimagine family roles after childbirth.



Why the mother deserves equal care

Every baby deserves to be nurtured. But so does the mother. Recovery from child birth is a deeply challenging time, both physically and emotionally. New mothers struggle with exhaustion, fluctuating hormones, and the pressure to care for the baby without faltering.

When families focus only on the newborn, the mother becomes invisible. Yet research and lived experience show that a well-supported mother is better able to bond with and care for her child. Caring for the mother is not a luxury, it&#39;s essential.

MoltyFoam&rsquo;s TVC captures this truth beautifully. It reminds viewers that while there are many willing hands for the baby, the mother too needs comfort, understanding, and support.



A symbolic gesture: MoltyFoam&rsquo;s mother&rsquo;s range

One of the most powerful moments in the TVC is when the husband brings home MoltyFoam&rsquo;s Mom and Baby Range for his wife. It&rsquo;s more than a gift; it&rsquo;s a statement. It says, &ldquo;Your healing matters. Your comfort matters. You matter.&rdquo;

MoltyFoam&rsquo;s Mom and Baby Range has been designed with childbirth needs in mind, from easing backaches to providing restful sleep. It represents a new kind of care, one that acknowledges the physical and emotional journey of mothers after childbirth.

By highlighting this in its campaign, MoltyFoam, best mattress brand in Pakistan, isn&rsquo;t just showcasing a product. It&rsquo;s underscoring a shift in priorities, putting the mother back at the centre of family care.



A shared responsibility

The TVC also emphasises that caring for a new mother is not one person&rsquo;s job. It&rsquo;s a collective responsibility. Husbands, mothers-in-law, sisters-in-law, and even extended family members all have a role to play.

Husbands can step up as active partners, not passive observers.

Mothers-in-law can offer guidance with empathy rather than criticism.

Sisters-in-law can bridge the gap with companionship and support.


When everyone contributes with love, the household becomes a place of healing rather than pressure.



More than a campaign, a call for change

What makes MoltyFoam&rsquo;s TVC stand out is its authenticity. It doesn&rsquo;t shy away from showing the quiet struggles of new mothers, nor does it sensationalise them. Instead, it offers a hopeful vision, a family that chooses care over conflict and compassion over criticism.

This message resonates far beyond Pakistan. Around the world, mothers share the experience of being sidelined after childbirth. By championing mothers, MoltyFoam is sparking a conversation that every culture needs to have: the mother matters too.

For too long, mothers have silently carried the weight of being blamed, judged, and overlooked after childbirth. But MoltyFoam&rsquo;s new TVC is rewriting this story. It replaces the image of the scapegoated mother with one of dignity, love, and comfort.

By showing families united in supporting her, and by offering products designed to ease her recovery, MoltyFoam has gone beyond selling mattresses. It has become an advocate for empathy.


Because when a mother is cared for, the whole family flourishes.]]>
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			<title>Pakistan’s beacon of cardiac excellence: Tabba Heart Institute secures fifth consecutive American College of Cardiology Platinum Award</title>
			<link>https://tribune.com.pk/story/2569841/pakistans-beacon-of-cardiac-excellence-tabba-heart-</link>
			<comments>https://tribune.com.pk/story/2569841/pakistans-beacon-of-cardiac-excellence-tabba-heart-#comments</comments>
			<pubDate>Tue, 30 Sep 25 15:03:21 +0500</pubDate>
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				<![CDATA[Sponsored Content]]>
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			<category><![CDATA[Health]]></category>
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			<description>
				<![CDATA[Their campaign 'Dil Hai Toh Zindagi Hai' urges Pakistanis to undergo regular health screenings before problems arise]]>
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				<![CDATA[Ahead of World Heart Day 2025, one of Pakistan&rsquo;s premier cardiac care facilities has once again earned global recognition.

Tabba Heart Institute (THI) has become the first and only hospital in Pakistan to secure the prestigious American College of Cardiology (ACC) Platinum Performance Achievement Award for five consecutive years, with the latest recognition awarded earlier this year.

This international distinction honours hospitals that consistently deliver evidence-based, guideline-driven emergency cardiac care, particularly for patients suffering acute heart attacks in emergency rooms and catheterization labs.



A Benchmark for Pakistan

Reflecting on the achievement, Dr Bashir Hanif, Executive Director and Consultant Cardiologist at Tabba Heart Institute, remarked:


Maintaining this award five years in a row is a testament to Pakistan&rsquo;s potential to meet and even exceed global standards in emergency cardiac care. Our team&rsquo;s commitment to saving precious minutes and lives remains unwavering.



According to the American College of Cardiology, only a select group of hospitals worldwide reach this level of compliance with stringent performance metrics, including:

● Door-to-balloon time (the speed at which treatment begins)

● Use of guideline-directed medications

● Improved patient outcomes

● Accurate and transparent data reporting

THI&#39;s five-year winning streak demonstrates a culture of continuous quality improvement and further strengthens its standing as the best cardiac hospital in Pakistan and a trusted center for world-class treatment.


Beyond Emergency Care: A National Call for Prevention

While celebrating this global recognition, Dr Hanif emphasised that although catheterisation labs and emergency procedures remain vital, prevention remains the ultimate goal.

He commented:


Every award we win is a reminder that no matter how advanced our emergency care is, the best heart attack is the one that never happens. 

We need Pakistanis &mdash; young and old &mdash; to know their numbers, manage their risk factors, and undergo regular heart health screening in Pakistan before problems arise.


This preventive focus resonates strongly with the World Heart Day 2025 theme, &ldquo;Don&rsquo;t Miss a Beat,&rdquo; and Tabba Heart Institute&rsquo;s campaign slogan, &ldquo;Dil Hai Toh Zindagi Hai.&rdquo;



Making Screening Accessible and Affordable

To encourage more people to take preventive action, Tabba Heart Institute is offering special heart health screening packages at discounts of up to 35% during its World Heart Day campaign from September 26 to October 25, 2025.

These comprehensive packages include risk-assessment tests designed to detect early signs of cardiovascular disease.

Dr Hanif explained:


Accessibility matters. By reducing the cost barrier, we are encouraging families to view heart checks as a regular habit, not just a response to crisis.


&nbsp;

Leadership in Cardiac Care

Recognized internationally for its excellence in interventional cardiology in Pakistan, THI combines world-class emergency services with a growing national leadership role in preventive health.

Public-health experts note that Tabba Heart Institute&rsquo;s recognition is more than just another accolade. It demonstrates that Pakistani institutions can deliver timely, evidence-based care, while also leading the national conversation on early detection, preventive screening, and lifestyle change.

As Dr Hanif concluded:


Quality emergency care saves lives today. Preventive care saves lives tomorrow. At Tabba Heart Institute, our mission is to deliver both and to show that it can be achieved right here in Pakistan.]]>
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			<title>How Trump’s claim on painkillers and autism sent Karachi mothers searching for answers</title>
			<link>https://tribune.com.pk/story/2569793/how-trumps-claim-on-painkillers-and-autism-sent-karachi-mothers-searching-for-answers</link>
			<comments>https://tribune.com.pk/story/2569793/how-trumps-claim-on-painkillers-and-autism-sent-karachi-mothers-searching-for-answers#comments</comments>
			<pubDate>Tue, 30 Sep 25 08:54:54 +0500</pubDate>
			<dc:creator>
				<![CDATA[Mehak Nadeem]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2569793</guid>
			<description>
				<![CDATA[Fear and guilt after Tylenol remarks, but Pakistan paediatricians say the science hasn’t changed]]>
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				<![CDATA[When the president of the United States stands on a podium and proclaims that Tylenol&mdash;locally known as Panadol&mdash;causes autism in children, parents listen. His statements unleashed a wave of fear, anxiety and anguish at least in Karachi, where we report from.

An autism expert at Aga Khan University was &ldquo;flooded&rdquo; with calls and emails from anxious mothers over the weekend after Trump&rsquo;s briefing.

&ldquo;Many mothers feel guilty, thinking their child&rsquo;s autism might be linked to medications taken during pregnancy,&rdquo; said Associate Professor Dr Sidra Kaleem, one of Pakistan&rsquo;s few developmental paediatricians, and the director of the Child Development and Rehabilitation Centre at Aga Khan University Hospital.

&ldquo;It&rsquo;s important to understand the difference between causation and association,&rdquo; she stressed. Some studies have observed children developing autism after their mothers took Panadol during pregnancy, others did not. &ldquo;This proves that taking Panadol does not guarantee a child will develop autism,&rdquo; she said.

Autism is largely a condition, with genetic and environmental factors contributing. &ldquo;Vaccines do not cause autism,&rdquo; she added by way of comparison. &ldquo;We&rsquo;ve seen children with autism from areas where vaccination programs do not exist.&rdquo;

Autism manifests as social communication difficulties, repetitive behaviors, and challenges in understanding societal norms, especially when these signs appear in early childhood.

&ldquo;Tylenol remains one of the safest painkillers for pregnant women, and using it when necessary is not a risk factor for autism,&rdquo; Dr Sidra said.

Read: Stakeholders push reforms to curb unethical medical practices in Pakistan

What did Trump say?
Panadol, widely prescribed to pregnant women for fevers and minor pain, is considered one of the &ldquo;safest&rdquo; options during pregnancy. Acetaminophen&mdash;known globally as &lsquo;Tylenol&rsquo; or &lsquo;Panadol&rsquo;&mdash;is the same medication used to treat pain and fever.

Speaking at a White House briefing on autism research, President Donald Trump said the Food and Drug Administration would notify physicians that the prenatal use of acetaminophen &ldquo;can be associated with a very increased risk of autism&rdquo;.

Scientists react to Trump
A major US-based non-profit organization focused on autism, Autism Speaks, issued this statement, &ldquo;We urge the Administration&rsquo;s resources be dedicated toward advancing new and innovative areas of research, so the community benefits from fresh insights, rather than revisiting questions that have been well studied, including vaccines and autism.&rdquo;

The WHO and European regulators have also weighed in. &ldquo;Neither acetaminophen (Tylenol/Panadol) nor vaccines have been shown to cause autism,&rdquo; WHO spokesperson&nbsp;Tarik Jasarevic said, noting that some observational studies suggested a possible association but that evidence remains inconsistent.

Medical experts and Tylenol&rsquo;s parent company, Kenvue, dismissed Trump&rsquo;s claims. &ldquo;Independent science clearly shows acetaminophen does not cause autism,&rdquo; a spokesperson told PEOPLE magazine.

Dr. Karam Radwan, the director of the UChicago Medicine Neurodevelopmental Clinic, added, &ldquo;Tylenol has been safely used for decades and remains one of the safest options for treating fever and pain during pregnancy.&rdquo;

The UK&rsquo;s Medicines and Healthcare products Regulatory Agency (MHRA) echoed this reassurance, stating, &ldquo;Patient safety is our top priority. There is no evidence that taking paracetamol during pregnancy causes autism in children.&rdquo;

WHO and MHRA further clarified that autism occurs even in areas without vaccination programs, reinforcing that vaccines do not cause the condition &mdash; and similarly, there is no evidence that Panadol (acetaminophen) taken during pregnancy causes autism.

&lsquo;We cannot draw sweeping conclusions&rsquo;

The head of the Sindh Institute of Child Health &amp; Neonatology, Professor Dr. Syed Jamal Raza, told The Express Tribune, it is difficult to establish a clear linkage between the painkiller and Autism.

&ldquo;If we particularly talk about Panadol, we must ask why mothers are taking it during pregnancy in the first place. Often, it&rsquo;s due to an underlying viral infection or body pain. So, indirectly, there was already another factor present. You cannot isolate the effect. We call this a confounding effect &mdash; when two effects appear together.&rdquo;

He stressed that when all factors are considered, there is still no evidence to suggest Panadol causes autism. &ldquo;Other factors, such as environmental influences or excessive screen time, can also play a role. We cannot draw sweeping conclusions the way Trump did. In pregnancy, even the slightest risk can cause complications, which is why we generally avoid medicines altogether. So yes, it&rsquo;s better to avoid taking Panadol unnecessarily for something minor like a sneeze or headache.&rdquo;

When asked what actually causes autism, Dr Raza said there is no single reason. &ldquo;Autism is a multi-factor disorder. There is no one gene directly linked to it. What we know is that there can be a genetic predisposition, which is then triggered by environmental factors.&rdquo;

Clarifying further, he added that autism has a very high heritability rate, and around 5&ndash;10% of cases result from single-gene disorders. Abnormalities in brain development also play a role, alongside environmental influences.

Read More: Sindh extends HPV vaccination drive to October 1

Drawing a comparison with Type 1 diabetes, he added, &ldquo;The gene may be present, but it only gets activated later in life.&rdquo;

Dr Raza explained that autism develops over a period of time, and early detection signs vary case to case, such as difficulty in maintaining eye contact. &ldquo;Autism is not a single, uniform disorder. It exists on a wide spectrum, which is why we call it &lsquo;ASD&rsquo; (Autism Spectrum Disorder). It can range from mild to severe.&rdquo;

Summing up, Dr Raza emphasized that current scientific evidence strongly rejects a causal link between Panadol and autism.

At most, there is a very slim possibility. The main takeaway, he said, is that while it remains &#39;safe when necessary&#39;, Panadol&mdash;like all medicines&mdash;should not be taken unnecessarily during pregnancy.

Parents react
Some parents sought urgent consultations, while others dismissed the claims.

One mother told The Express Tribune, &ldquo;I don&rsquo;t think it will happen because of taking Tylenol (Panadol) during pregnancy. Yes, it&rsquo;s possible if we take it excessively or routinely, but I don&rsquo;t think so.&rdquo;

She added, &ldquo;I feel that excessive mobile use and exposure to harmful rays can also contribute to autism, as far as I know.&rdquo;

With additional reporting by Noor ul Huda Bhurgri.]]>
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			<title>The shot they fear: HPV vaccine &amp; the uphill battle</title>
			<link>https://tribune.com.pk/story/2569407/the-shot-they-fear-hpv-vaccine-the-uphill-battle</link>
			<comments>https://tribune.com.pk/story/2569407/the-shot-they-fear-hpv-vaccine-the-uphill-battle#comments</comments>
			<pubDate>Sun, 28 Sep 25 07:28:06 +0500</pubDate>
			<dc:creator>
				<![CDATA[Rizwana Naqvi]]>
			</dc:creator>
			<category><![CDATA[T-Magazine]]></category><category><![CDATA[Magazine]]></category><category><![CDATA[Health]]></category><category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2569407</guid>
			<description>
				<![CDATA[In a country where every new vaccine sparks rumours of infertility, the HPV shot faces the same mistrust]]>
			</description>
			<content:encoded>
				<![CDATA[As the campaign for immunisation against HPV began, a lot of objections to the vaccine came to the fore, raising doubts in the minds of even those optimistic people who usually see the bright side of things. The most common objection is why a girl as young as nine years old needs to be vaccinated against a disease that, in her opinion, usually affects older women.&nbsp;

For those who question the logic behind early vaccination and its efficacy and need, let me present some facts regarding the vaccine and why it is important.



HPV vaccine prevents cervical cancer, which, though is preventable and treatable if diagnosed at an early stage, silently claims thousands of lives each year. Globally, cervical cancer is the fourth most common cancer in women, accounting for around 660,000 new cases in 2022. In the same year, about 94 percent of the 350,000 deaths caused by cervical cancer occurred in low- and middle-income countries.&nbsp;

Cervical cancer is the third most prevalent cancer among women in Pakistan. With a female population of 73.8 million aged 15 years and older at risk, over 5,000 women are diagnosed annually, many at advanced stages when treatment options are limited and outcomes are poor. &nbsp;Almost 3,200 of them (64%) die from the disease. The mortality rate, one of the highest in South Asia, is primarily attributed to delayed diagnoses and limited access to screening programmes. Despite this, Pakistan remains dangerously behind in protecting its girls and women, though globally there are examples of success in reducing cervical cancer occurrence due to timely vaccination and treatment when detected early.



Cervical cancer is mostly caused by a common virus called human papillomavirus (HPV) that is primarily transmitted through sexual contact. HPV infection is widespread and while many strains of HPV are harmless, high-risk types, particularly HPV 16 and 18, are responsible for nearly all cases of cervical cancer. In most people, the virus does not cause any problems and goes away on its own; however, in some cases it can cause changes in the cells that may lead to cancer.

While cervical cancer is caused by the virus there are several factors that increase the risk of developing cancer. &ldquo;When the immune system is compromised, a high risk HPV infection is more likely to persist and lead to abnormal cervical cell changes. Multiple pregnancies as hormonal changes during pregnancy may make a woman more susceptible to HPV virus, early sexual activity, and poor diet,&rdquo; Samrina Hashmi, Consultant Obstetrician and Gynaecologist and Fertility specialist, Noor Hospital and Concept Fertility, Karachi, explained the risk factors.

Whether someone not sexually active can have cervical cancer, Dr Hashmi said, &ldquo;Because nearly all cases of cervical cancer result from an individual having a high risk strain of HPV, it is highly unlikely for someone to develop cervical cancer if they have never had sex. But in medicine we never say never.&rdquo;



While cervical cancer remains the most recognised HPV-related malignancy, the virus is also linked to cancers of other sexual organs, mouth and throat.

Since cervical cancer can be cured if diagnosed and treated at an early stage, recognising symptoms and seeking medical advice is crucial. Initially, there might not be any symptoms but as it grows, it might cause symptoms such as menstrual bleeding that is heavier and lasts longer than usual; bleeding between periods, after menopause, or after intercourse; watery, bloody vaginal discharge that may be heavy and have a foul odour; persistent pain in the back, legs, or pelvis; weight loss, fatigue and loss of appetite; vaginal discomfort; swelling in the legs.&nbsp;

However, the good news is that it is possible to reduce your risk of cervical cancer and the best way is to receive HPV vaccine.&nbsp;

HPV vaccine is recommended for everyone through age 26. It is recommended that HPV vaccines should be given to all girls between ages nine and 14 years, before exposure to the virus or, to say, before having the first sexual contact because younger people respond better to the vaccine than older people do. Two doses are sufficient for most children in this age group, while three are recommended for those with compromised immunity or for individuals above 15 years of age. The doses are given at least five months apart. Individuals who begin the vaccine series at ages 15 through 26 should get three doses of the vaccine.&nbsp;



&ldquo;Many people in this older age group have already been exposed to the virus, diminishing the vaccine&rsquo;s benefit,&rdquo; says Dr Hashmi. Also, &ldquo;It should be kept in mind that HPV vaccine prevents new HPV infection but does not treat existing HPV infections or diseases. It works best when given at a younger age before any exposure to HPV. Once someone has been infected with HPV, the vaccine might not work as well or at all. If given before someone has HPV infection, the vaccine can prevent most cervical cancers,&rdquo; says Dr Hashmi.

The current HPV vaccines target the main high-risk virus types but cannot cover all cancer-causing strains, or treat existing infections. In addition, though in rare cases, cervical cancer can also be caused without HPV infection, women aged 25 to 64 are advised to have cervical screening every five years, even after vaccination.
Also because there are no symptoms in the early stage of cervical it is important to have regular screening tests. Women ages 21 to 29 who have not been vaccinated should have a Pap ( Papanicolaou , named after Greek physician) test that can find changes in the cervix that might lead to cancer, every three years&nbsp;



To protect millions of adolescent girls, i.e. its future generation, the Pakistan government has introduced the HPV vaccine in partnership with UNICEF, GAVI the vaccine alliance, and the World Health Organisation. The first HPV vaccination campaign that ran from September 15&ndash;27 aimed to cover 15 million girls aged 9-14; the campaign was conducted at fixed centres, outreach sites and schools, and through mobile/special vaccination teams. Later, the vaccine would be available at government facilities and will be incorporated in the routine immunisation schedule.&nbsp;

Despite the fact that it is a very timely intervention and is being promoted through media in a very efficient manner, as in the past with polio vaccine and Covid-19 vaccine, a number of myths have arisen regarding the HPV vaccine that have sown seeds of doubt among parents. Myths vary from vaccines causing infertility, to children being sexually inactive so why vaccinate them against something that does not concern them at this age, to HPV vaccines being new and hence no safety and efficacy data available on the long-tern side effects.&nbsp;



These myths, that been thoroughly debunked by science, are driven by stigma and misinformation and are barriers to HPV vaccine acceptance in Pakistan. &nbsp;
It is being said that the vaccine is new and there&rsquo;s no safety and efficacy data on long term side effects. The fact is that the HPV vaccine which protects against the high-risk HPV types 16 and 18, and have shown to be safe and effective in preventing HPV infection and cervical cancer, was developed in the early 2000s. The World Health Organisation (WHO), the US Centres for Disease Control and Prevention (CDC), and numerous global studies have confirmed the vaccine&rsquo;s safety and effectiveness. Millions of doses have been administered worldwide.

Its widespread introduction into national programmes began in mid-to-late 2000s, and by 2023, its access expanded to 150 countries. The World Health Organisation has set a target of fully vaccinating 90 percent of girls by age 15 by 2030. At present, only about 48 percent of girls worldwide are fully vaccinated.

The efficacy of the vaccine is evident in the fact that the countries that introduced the HPV vaccine have seen dramatic declines in infection rates and prevalence of cervical cancer. For example, Australia is on track to eliminate cervical cancer within a decade, while Rwanda, a low-income country, has achieved over 90 percent coverage.&nbsp;



&nbsp;

Regarding the doubt that the vaccine causes infertility, Dr Hashmi gave two examples of studies that prove otherwise: &ldquo;An evaluation in 2018 of nearly 20,000 women aged 11&ndash;34 years found no connection between adolescent vaccination and ovarian failure. Recent data from Denmark also showed no association between HPV and primary ovarian insufficiency among 950,000 Danish women and girls.&rdquo;

Another objection is that children are not sexually active so why vaccinate them against something that does not concern them at this age. &ldquo;Adolescents vaccinated under the age of 15 years showed much higher HPV antibody than older peers,&rdquo; Dr Hashmi explains. &ldquo;They had a higher immune response. This together with the results of clinical trials showing persistent high antibody titres after receiving two doses of HPV vaccination at younger age led to the recommendation of two doses in adolescents under the ages of 15 years.&rdquo;

To address religious and cultural concerns and promote greater acceptance, a multifaceted approach is essential. It is important to present the HPV vaccine as &lsquo;a protective measure against cervical cancer&rsquo; which affects thousands of women annually and not as a means of protection against a sexually transmitted infection. Religious scholars in several Muslim countries have reviewed and approved the HPV vaccine. For instance, in Malaysia, a Muslim-majority nation, the vaccine was successfully integrated into the national immunisation programme; for greater acceptance it was presented as a cancer prevention measure, which definitely helped.&nbsp;

The same approach can be adopted in Pakistan for greater acceptance. Public health messaging should carefully avoid sexual references, as these can alienate certain segments of the population.

To address these misconceptions and enhance acceptance, it is important to engage trusted members of the community such as religious leaders, teachers, health workers and influencers. As people trust them they can use their influence to cultivate confidence among the people and work to dismantle the myths surrounding the vaccine and encourage people to have their children vaccinated.

HPV vaccine: myths &amp; facts

The human papillomavirus (HPV) vaccine has been around for more than a decade! The vaccine is safe, effective, and protects against many strains of HPV, which is the most common sexually transmitted infection and a cause of several cancers. Despite numerous benefits, several misconceptions about the vaccine still persist.&nbsp;

1. MYTH: HPV vaccination is not safe.

FACT:&nbsp;The HPV vaccine is safe and doesn&rsquo;t contribute to any serious health issues. Like any vaccine or medicine, the vaccine may cause mild reactions. The most common are pain or redness in the arm where the shot is given. Other typical side effects include low-grade fever, headache or feeling tired, nausea, or muscle or joint pain &ndash; all of which are temporary. Rarely, an allergic reaction can occur, and individuals should not get the vaccine if they are allergic to any of the components.

The vaccine itself has been researched for many years (including at least 10 years of research before it could even be used in humans) and is highly monitored by the Food and Drug Administration. Vaccinations in the U.S. have never been safer because of the stringent standards the FDA uses.

2. MYTH: HPV vaccination can lead to infertility.

FACT:&nbsp;Claims of HPV vaccine-induced infertility due to premature ovarian failure are anecdotal and not backed by research or clinical trials. A recent study of over 200,000 women found no association between the HPV vaccine and premature ovarian failure.1&nbsp;In fact, the HPV vaccine can actually help protect fertility by preventing gynecological problems related to the treatment of cervical cancer. It&rsquo;s possible that the treatment of cervical cancer could leave a woman unable to have children. It&rsquo;s also possible that treatment for cervical pre-cancer could put a woman at risk for problems with her cervix, which could cause preterm delivery or other complications.

3. MYTH: HPV vaccination is not effective at preventing cervical cancer.

FACT:&nbsp;In the studies that led to the approval of HPV vaccines, the vaccines provided nearly 100% protection against persistent cervical infections with HPV types 16 and 18, plus the pre-cancers that those persistent infections can cause. In addition, a clinical trial of HPV vaccines in men indicated that they can prevent anal cell changes caused by persistent infection and genital warts.2&nbsp;HPV-associated cancers can take decades to develop, so it will be a few more years before we will be able to have studies comparing cancer rates. Advanced pre-cancers have long been universally accepted markers for cancer.

4. MYTH: Only girls need to get the HPV vaccine, men and boys don&rsquo;t need it.

FACT:&nbsp;HPV affects both men and women. It can cause genital warts, penile, anal, and oral cancer in men. It can also be easily transmitted to a sex partner without either of the partners knowing.

5. MYTH: Getting the HPV vaccine will encourage adolescents to be more sexually promiscuous.

FACT:&nbsp;No research links the HPV vaccine to increases in sexual activity. No evidence giving the HPV vaccine is linked with higher sexual activity. In fact, a recent article reviewing studies of over 500,000 individuals revealed that there was no increase in sexual activity after HPV vaccination.3&nbsp;In fact, vaccinated participants actually engaged in safer sexual practices than unvaccinated participants! Also, adolescents who get the vaccine don&rsquo;t have more partners after they become sexually active.4

6. MYTH: The HPV vaccine doesn&rsquo;t protect against enough strains of human papillomavirus to be worth getting.

FACT:&nbsp;The current HPV vaccination protects against nine types of HPV. These nine have been linked to more than 90 percent of genital warts cases, 90 percent of cervical cancers, and 70 percent of anal cancer diagnoses. This vaccination is highly protective to prevent this very common viral infection and to help prevent genital warts and cancers.

7. MYTH: HPV is uncommon, and it&rsquo;s unlikely I&rsquo;ll be infected, so there&rsquo;s no need to get the HPV vaccine.

FACT:&nbsp;The genital HPV infection is the most common sexually transmitted infection and there are over 14 million new infections each year in the United States. It&rsquo;s so common that nearly every male and female will be infected with at least one type of HPV at least once in their lifetime. Currently, over 80 million Americans are infected.

Rizwana Naqvi is a freelance journalist and tweets @naqviriz; she can be reached at naqvi59rizwana@gmail.com
All facts and information is the sole responsibility of the writer]]>
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			<title>Rabies, rage &amp; rights</title>
			<link>https://tribune.com.pk/story/2565347/rabies-rage-rights</link>
			<comments>https://tribune.com.pk/story/2565347/rabies-rage-rights#comments</comments>
			<pubDate>Sat, 06 Sep 25 07:30:27 +0500</pubDate>
			<dc:creator>
				<![CDATA[Nabil Tahir]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2565347</guid>
			<description>
				<![CDATA[As stray dog bites rise, Pakistan faces a tense battle between public safety &amp; animal rights. Can both be protected?]]>
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				<![CDATA[Over the past few years, Pakistan&rsquo;s relationship with dogs has visibly evolved. In gated communities and urban enclaves, pet ownership has risen sharply. Social media is full of Labradors on patios, Huskies on driveways, and beagles in shopping carts.

On the other hand, public spaces in low- and middle-income areas continue to be shaped by another, more unpredictable reality: the growing presence of stray dogs. Some are watched over by local shopkeepers and households who feed them leftovers or treat them like community guardians.

Caught between these extremes is a growing debate that has become both polarising and deeply personal. Animal rights activists have long opposed the culling of stray dogs, arguing instead for humane sterilisation and vaccination drives. Yet in many neighbourhoods, especially those without security gates or private clinics, residents say they are left to deal with sudden and, at times, deadly attacks, often without any support or empathy.

For K*, a quiet Sunday in May turned into the kind of nightmare he never imagined would unfold within the walls of his own home.

&ldquo;My family and I lived through a deeply traumatic experience,&rdquo; he recalled, still shaken by the memory. It was a routine day, with all four family members gathered in the drawing room. His wife stepped outside with their two-and-a-half-year-old son to attend to a small chore in the garage. Within moments, everything changed.

Heart-wrenching screams pierced the air. &ldquo;I froze for a split second,&rdquo; K* said, &ldquo;unable to grasp what was unfolding.&rdquo; He rushed outside and was confronted with a scene he describes as every husband and father&rsquo;s worst fear. His wife lying on the ground, injured and in shock, while their toddler stood motionless beside her.

A stray dog, described by residents as mad and aggressive, had entered their home unprovoked. According to K*, the same dog had earlier bitten a goat and attacked at least five people in a nearby society that day. &ldquo;It went for her shoulders, abdomen and legs,&rdquo; he said. His wife, in a moment of instinct and unimaginable courage, managed to protect their child from harm.

Turned away by multiple private hospitals, K* feared the worst as headlines about rabies deaths flashed in his mind. Eventually, they made it to Jinnah Hospital, where his wife received emergency treatment, including anti-rabies shots and wound care.

The dog was later put down by people in the area, but the episode was far from over. What followed was a wave of online abuse and backlash from animal rights groups. K* said the criticism felt unfair and disconnected from the daily realities faced by people like him. &ldquo;Those who judged us weren&rsquo;t there when we carried her bleeding into the car, or when our son kept waking up crying in the middle of the night,&rdquo; he said.

His story offers a glimpse into a larger, more uncomfortable question. In a country battling thousands of dog bite cases annually, how do we protect human lives while still respecting animal rights?

A preventable but deadly crisis

Health experts estimate that Pakistan sees over a million dog bite cases annually. However, these incidents play out quietly in emergency rooms and fatalities are under-reported fatalities every year.

Rabies, which is transmitted through the saliva of infected animals, remains endemic in the country. While the disease is entirely preventable, delays in treatment can turn a bite into a death sentence.

&ldquo;If a human is bitten by a rabid dog and treatment is delayed, the consequences can be extremely serious and often fatal,&rdquo; said Dr Wajiha Ahmed, a clinical research scientist based at New York University. She explained that the rabies virus typically enters through a wound and travels slowly through the nervous system. Early signs can include fever and pain at the site of the bite, but once the virus reaches the brain, the symptoms turn severe and irreversible. Confusion, agitation, hallucinations, even a crippling fear of water, are all severe symptoms.

&ldquo;By the time those neurological signs appear, there is no cure,&rdquo; Dr Wajiha said. &ldquo;Treatment becomes supportive at that point, not curative.&rdquo;

The danger lies not just in the bite, but in the window of response that follows. According to Dr Wajiha, timely care involves thoroughly washing the wound and immediately beginning post-exposure prophylaxis (PEP), a course of rabies vaccines and, in some cases, rabies immunoglobulin. Yet in many parts of the country, especially away from urban centres, that care remains out of reach or is poorly understood by the public.

Efforts to tackle rabies, she noted, cannot be limited to hospitals alone. Dr Wajiha emphasised the need for a multi-layered approach. Mass vaccination of dogs, management of stray populations through Catch-Neuter-Vaccinate-Return (CNVR) programs, and sustained public awareness.

&ldquo;People need to know not just how to react after a bite, but how to avoid one,&rdquo; she said, pointing to the importance of pet vaccination, early reporting, and reducing contact with unmonitored street dogs.

The science is clear. Rabies is one of the few deadly diseases that remains entirely preventable, yet it continues to thrive in the shadows of policy neglect and misinformation.

Despite the clear medical urgency, the solutions being applied on the ground often lean toward reactionary measures. In many cities, that has meant mass culling of stray dogs, a practice that remains both controversial and widely debated. While some view it as a necessary step to make streets safer, others argue it is neither effective nor ethical. The divide has grown sharper in recent years, raising questions about whether Pakistan is addressing the root of the problem, or simply shifting it further out of sight.

Culling controversy &ndash; A flawed fix?

In many parts of Pakistan, local authorities continue to respond to rising stray dog populations by resorting to mass culling. It is a method that dates back decades and is often seen as the fastest way to reduce numbers and calm public concern. Mass culling is often carried out quietly using harmful methods, but critics say it fails to address the root of the problem.

Yet around the world, including in countries with far greater resources and stronger veterinary systems, this approach has largely failed.

Dr Amir Khalil, who serves as Animal Welfare and Rescue Senior Advisor at FOUR PAWS International, has seen the effects of culling firsthand across multiple regions. &ldquo;In several countries, they have been killing dogs for decades and the stray population still hasn&rsquo;t gone down,&rdquo; he said. &ldquo;I was born in Egypt. They have been killing dogs for over 40 years and the problem remains.&rdquo;

To him, the issue goes beyond data. &ldquo;Killing is never a solution,&rdquo; he said. &ldquo;Even when you kill the dogs of a city, the dogs from another city will come and take over the empty place. It&rsquo;s like an empty apartment. Other dogs will come and move in.&rdquo;

This movement of animals from one area to another is what experts call the vacuum effect. But beyond its ineffectiveness, Dr Khalil also points to the cost of the practice. &ldquo;Normally, killing a dog is more expensive than castrating or neutering one,&rdquo; he noted. And while stray dogs can create challenges, he said the real issue is not their existence, but their uncontrolled numbers.

It is this distinction that often gets lost in the broader debate. The sight of dogs roaming the streets triggers fear and frustration, but the absence of coordinated systems, public education, and long-term planning makes those fears harder to resolve.

Humane alternatives. What works globally?

While culling continues to be the go-to response in many parts of Pakistan, international experience points toward a different path, one that prioritises long-term safety without compromising the dignity of animals. The Catch-Neuter-Vaccinate-Return (CNVR) model has gained traction in several countries, particularly in regions that once struggled with aggressive stray dog populations and rabies outbreaks.

Dr Khalil has been involved in animal welfare operations across multiple countries, including post-conflict and disaster zones. From his experience, the shift away from killing dogs toward humane management has delivered not just ethical benefits but measurable results. He added that they&rsquo;ve seen long-term impact in countries like Romania, Moldova, and Ukraine.

The logic behind CNVR is simple but requires coordination. Dogs are caught, neutered to prevent breeding, vaccinated against rabies, and then released back into their environment. When done consistently and across entire urban zones, the method reduces population growth and eliminates the threat of disease without provoking the vacuum effect that often follows culling.

Dr Khalil also pointed to broader global consensus. &ldquo;The World Health Organization, the World Food Programme, and other international health organisations recommend CNVR,&rdquo; he said. &ldquo;If you vaccinate 70 percent of the dog population in a city, that area becomes free of rabies. This is very important, especially for human safety.&rdquo;

But success in countries like Romania or Moldova did not come through veterinary departments alone. It required collective action. &ldquo;It should not be only a veterinary authority,&rdquo; he stressed. &ldquo;It should be a group from the Ministry of Health, the Ministry of Agriculture, and the Veterinary Authority. They have to work together.&rdquo;

That spirit of collaboration, however, remains largely missing in Pakistan. According to Dr Khalil, while individual animal welfare groups are trying their best, many work in isolation. &ldquo;They are working alone without teamwork to support and raise awareness between the people. This will not solve the problem,&rdquo; he said.

The science exists. The models exist. What remains uncertain is whether there is enough political will, policy alignment, and public engagement to implement these solutions at scale. But even the most humane systems face difficult questions, especially when safety is already compromised. What should be done when a dog becomes aggressive or shows signs of rabies? And how do we balance compassion with public health in those critical moments? The answers are rarely simple, but they lie at the heart of the ethical debate surrounding this crisis.

Ethics in rabies management

Even the most humane frameworks for managing stray dog populations must contend with moments of immediate threat. A dog showing signs of rabies is not simply unpredictable, it is lethal. For residents on the ground, the time between warning and attack is often measured in seconds, not policy papers.

For K*, the question of whether the dog should have been put down doesn&rsquo;t come with philosophical uncertainty. To him, the answer was made clear by the injuries, the panic, and the five other victims already reported by the time his wife was taken to hospital. &ldquo;Will you wait for the sixth, seventh victim?&rdquo; he asked. &ldquo;Again, I am nobody to decide, when the religious guidelines are there.&rdquo;

But even as his family tried to recover from the trauma, a new kind of attack began&mdash;this time online. Within hours of sharing a blog post about the incident, K* began receiving messages of support from colleagues and well-wishers. But soon, that shifted. Some people, particularly from the entertainment and activist community, began criticising him for what they saw as complicity in the dog&rsquo;s death. &ldquo;They didn&rsquo;t even ask how my wife or son were doing,&rdquo; he said. &ldquo;They started arguing about dog rights like nothing else mattered.&rdquo;

The criticism quickly escalated into something darker. He received abusive WhatsApp messages from unknown numbers and threatening voice notes on Facebook Messenger. &ldquo;One woman, sounding elderly, told me: &lsquo;Your wife and 2.5-year-old child are not more important than that dog. Be ready to get them killed. I will make sure.&rsquo;&rdquo;

The toll was immense. &ldquo;It felt like I had invited the dog to attack my wife just to get attention,&rdquo; he said, &ldquo;as if I had done it all for some gain.&rdquo; K* consulted his mosque&rsquo;s imam, who provided a fatwa permitting the killing of a rabid dog. He shared it with his critics, but many dismissed it.

Eventually, he contacted cybercrime experts for advice. &ldquo;One of them told me to forgive them, block the numbers, and move on,&rdquo; he said.. For days, he remained indoors with his wife and children, unable to make sense of the outrage. What stayed with him most, he said, was the silence from those who had once called themselves close friends.

His frustration lies not just in the moral debate, but in the absence of functioning systems. &ldquo;We are living in a country where people die daily due to the unavailability of ordinary medicines, anti-rabies vaccines, safety measures, hygienic living, and rescue services,&rdquo; he said. In a rare moment of composure within an otherwise emotional account, he added, &ldquo;If we can create, manage, and run a department to stop a ready-to-attack mad dog from biting its victim and take that dog away peacefully, that would be gold.&rdquo;

K* is also critical of those who oppose action under all circumstances. &ldquo;No matter what?&rdquo; he repeated, visibly frustrated. &ldquo;Under the name of unconditional love for a dog, should we just stand by and watch our loved ones be attacked, bitten, and risk dying from rabies? I don&rsquo;t understand the mindset of those who defend this, especially when human lives are at stake. It feels like some of these people are completely disconnected from the ground reality.&rdquo;

Dr Khalil believes that responding to rabid animals requires both urgency and ethical responsibility. &ldquo;If a dog shows signs of rabies, the dog must be caught and quarantined,&rdquo; he said. &ldquo;It&rsquo;s a 100 percent fatal disease, but also a 100 percent preventable one.&rdquo; He stressed the importance of following international standards that begin with large-scale vaccination efforts, so fewer dogs ever reach that critical point.

Still, the tension remains. On one side are those like K*, who feel abandoned by the system and act out of fear and necessity. On the other are those who caution against panic-driven decisions, calling instead for protocols rooted in science, not emotion. It is not a matter of choosing between people and animals, as both sides quietly imply. It is about whether the state can be trusted to protect both.

What needs to change?

For all the debate between activists, residents, and medical experts, the way forward ultimately depends on the ability of institutions to work together. Pakistan has experimented with piecemeal efforts, but experts say what is missing is a coordinated national plan that can last long enough to make an impact.

Dr Khalil believes the foundation of such a plan lies in human capacity. &ldquo;I think what we miss in Pakistan is to train the catcher and train the trainer,&rdquo; he said. He recalled the organisation&rsquo;s work in Myanmar, where despite difficult conditions they managed to vaccinate more than 350,000 dogs in a year. &ldquo;It is really important to apply international standards, but the resources we need most are human resources, people trained in a humane and constructive way to catch the dog, to vaccinate the dog, and to work with national and international organisations to castrate many dogs, especially males.&rdquo;

He added that Pakistan has shown the ability to resolve complex animal welfare issues in the past. &ldquo;Pakistan can solve this with a coordinated three-to-five-year national plan, just like other countries have done,&rdquo; he said.

Beyond vaccination and training, Dr. Khalil believes the root cause of many stray dog attacks is often overlooked. &ldquo;We say all the time, animal protection is human protection. It is the first line of defence,&rdquo; he said. &ldquo;If we are able to protect this animal, it will be easy to protect this human.&rdquo;

He explained that stray dogs are often drawn to humans not out of aggression, but dependence. &ldquo;They come to attack in some regions because they are depending on humans for food. As much as there is rubbish and garbage in the street, this becomes their food source.&rdquo; For him, even basic municipal planning could help ease the problem. &ldquo;If the municipality has a good plan to get rid of the rubbish in rural or urban areas, the dogs will eventually disappear because there is no source of food.&rdquo;

The challenge, then, is not one of knowledge but of commitment. The methods exist, the international support is available, and the urgency is clear. What remains uncertain is whether Pakistan will choose to treat the stray dog crisis as a matter of humane policy and public health rather than a cycle of fear and reaction.

&nbsp;

*Name has been changed to protect source&rsquo;s identity]]>
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			<title>When hospitals become HIV vectors</title>
			<link>https://tribune.com.pk/story/2564278/when-hospitals-become-hiv-vectors</link>
			<comments>https://tribune.com.pk/story/2564278/when-hospitals-become-hiv-vectors#comments</comments>
			<pubDate>Sun, 31 Aug 25 10:05:16 +0500</pubDate>
			<dc:creator>
				<![CDATA[Tufail Ahmed]]>
			</dc:creator>
			<category><![CDATA[Health]]></category><category><![CDATA[Magazine]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2564278</guid>
			<description>
				<![CDATA[Lack of adherence to infection control SOPs has turned healthcare facilities into hubs of deadly outbreaks]]>
			</description>
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				<![CDATA[Whether for a minor injury or a life-saving procedure, hospitals are where sick people rush to in the hopes of getting better. However, when proper infection control protocols are not followed, a patient walking in for a simple blood test might leave the hospital unknowingly carrying HIV-AIDS.

According to the Better Health Channel, basic infection control protocols for HIV-AIDS at hospitals involve the disposal of single-use syringes in approved sharps containers, decontamination and sterilization of reusable medical devices after each use, disposal of single use medical devices, provision of personal protective equipment (PPE) gowns, gloves and eyewear for healthcare workers, and cleaning of spilled body fluids and laundry as per strict guidelines.

Although hospital officials in Pakistan assure the presence of infection control departments at government hospitals, in reality, these bodies remain non-functional and adherence to standard operating procedures (SOPs) is highly unsatisfactory. The human immunodeficiency virus (HIV) living in the bloodstream is easily transmitted through contact with an infected person&rsquo;s bodily fluids, which could be present on unsterilized medical apparatus and work surfaces. Pakistan&rsquo;s lack of an effective strategy to prevent diseases is one reason why the number of HIV-AIDS patients, currently around 290,000, continues to grow.



A patient&rsquo;s family at the Civil Hospital&rsquo;s Infection Unit revealed that their brother, diagnosed with HIV in 2020, fled the hospital due to unhygienic conditions. After persuasion, the family got him re-registered at the Lyari General Hospital, where he now receives monthly medication. &ldquo;The appalling condition of hygiene at public hospitals worsens the patient&rsquo;s mental and physical health, burdening their families. Medical neglect and lack of sanitation are major contributors to the spread of infections in these healthcare facilities,&rdquo; claimed the family.

Similarly, Asghar, whose elder brother acquired HIV-AIDS during the 2023 outbreak, recounted his family&rsquo;s tough journey. &ldquo;My completely healthy brother used to work as a lab technician at a large private hospital in Karachi. Suddenly, his health started deteriorating and it was revealed that he had contracted HIV. Once his treatment started, my brother had to quit his job,&rdquo; shared Asghar.

Dr Pir Ghulam Nabi Shah Jilani, Deputy Director at the Karachi Health Department, claimed that infection prevention committees were functional in government hospitals. &ldquo;These committees, comprising qualified doctors and pathologists, are tasked with ensuring sterilization and proper disposal of medical waste. However, their effectiveness remains questionable,&rdquo; noted Dr Jilani, while speaking of Sindh, where HIV transmission has increased by 139.6 per cent over the past five years, with 1,438 cases reported in 2020 and 3,446 cases recorded in 2024.

Professor Dr Faisal Mahmood, an infectious disease specialist at the Aga Khan University Hospital, emphasized the urgent need to implement infection control protocols at hospitals and clinics. &ldquo;Patients can be carriers, and hospitals must treat every patient as potentially infectious,&rdquo; said Dr Mahmood, while mentioning medical protocols, which were clearly ignored in Punjab, where healthcare facilities&rsquo; lamentable adherence to infection control dragged multiple patients towards sickness and death.



In October 2024, over 24 nephrology patients acquired the HIV virus at the Nishtar Hospital in Multan, which is the largest facility offering dialysis to over 200 registered patients from South Punjab. During the investigation, it was revealed that a patient with HIV was dialyzed without proper sterilization protocols, which led to the spread of the virus to other patients due to the negligence of hospital staff.

Sources revealed that inspections of other government hospitals also found similar lapses in infection control protocols for HIV. Health Minister Salman Rafiq handed the matter over to the Punjab Healthcare Commission for further investigation. However, doctors at the Nishtar Hospital did not cooperate, and when summoned to the Lahore office, they presented excuses and resisted.

When contacted, the Punjab Healthcare Commission declined to provide further details on the grounds that it was investigating the matter and monitoring adherence to infection control SOPs. Dr Zahid Ansari, former Head of the Sindh Blood Transfusion Authority, clarified the difference between HIV-positive individuals and AIDS patients.

&ldquo;HIV-positive individuals should not donate blood, and their used medical tools like syringes or razors must not be reused. The virus can be identified through specific blood tests and viral load analysis. Four key diseases &mdash; HIV, Hepatitis B, Hepatitis C, and malaria &mdash; must be screened in blood tests before transfusions,&rdquo; emphasized Dr Ansari.

In the Nishtar Hospital incident, it was clear that screening procedures were completely ignored. Despite the gravity of the situation, the issue has once again disappeared into the background in Punjab, where more than 7,000 HIV cases were reported last year.

Shehzad, a 60-year-old dialysis patient at the Jinnah Hospital in Lahore, conveyed his worries after the Multan hospital outbreak. &ldquo;After hearing about what happened at the Nishtar Hospital, I live in fear. Even routine procedures now feel dangerous. Patients are constantly worried that they may contract a serious illness at any time due to medical negligence,&rdquo; revealed Shehzad.

Similar concerns have mounted over the poor performance of the Infection Prevention Committee and the Healthcare Commission in Khyber-Pakhtunkhwa, which has observed an 888.1 per cent increase in the incidence of HIV-AIDS over the past three years, with 816 cases reported in 2022, 5,543 cases reported in 2023, and an alarming 8,063 cases recorded in 2024.

Major medical teaching institutions (MTIs) in Peshawar, including the Lady Reading Hospital, Khyber Teaching Hospital, and Hayatabad Medical Complex, along with district-level Tehsil Headquarter Hospitals (THQs) are failing to maintain effective infection control and sterilization systems. Instead of preventing diseases, these hospitals are allegedly turning into hotbeds of infectious outbreaks.

A technician at the Hayatabad Medical Complex, speaking on the condition of anonymity, revealed that standard operating procedures (SOPs) for infection control were not being followed at all. &ldquo;We have repeatedly requested the administration to provide basic supplies for infection control. However, now we do not even have spirit or syringes available, let alone anything else for infection prevention,&rdquo; informed the technician.

Dr Amir Taj, an infection control expert, told The Express Tribune that it was unfortunate that both the Infection Control Committee and the Healthcare Commission, which were created for the very purpose of controlling the spread of transmissible infections, were failing to do their job.

&ldquo;Instead of controlling infections, the Healthcare Commission seems more focused on collecting hospital fees and registration charges. Infections like HIV, Hepatitis, and others are rapidly spreading, costing the government billions of rupees each year. If proper infection control systems were in place at hospitals, patients would recover faster, and the national treasury would also benefit,&rdquo; opined Dr Taj.

On the other hand, Dr Tariq Hayat, Director of the HIV Control Programme, stated that SOPs for infection control were strictly followed at HIV and Hepatitis control centers operating within hospitals. However, he also acknowledged the fact that awareness sessions on infection control were urgently needed at both public and private hospitals.

Dr Muhammad Naeem, former Director of the Sindh AIDS Control Program, recalled that Larkana faced major HIV outbreaks in 2019 and 2023. &ldquo;After the Rato Dero outbreak, the Sindh Health Department screened 37,272 people in Larkana. HIV-AIDS was confirmed in 1,811 cases. Contributing factors included reused syringes, abundance of unqualified healthcare providers and unregulated blood transfusion practices,&rdquo; revealed Dr Naeem.

Speaking to the Express Tribune on the matter, Azam Rehman, spokesperson for the Healthcare Commission, claimed that the commission strictly enforced SOPs for infection control, fining both private and public hospitals found violating the guidelines.

Despite official claims, the current poor adherence to infection control protocols at hospitals across the country demands urgent government intervention, including strict regulation of medical practices, enforcement of hygiene protocols, and establishment of a trace-and-track system for HIV-positive patients. Without swift action, the spread of HIV-AIDS may spiral out of control.]]>
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			<title>Antibiotic resistance: a plague of our own making</title>
			<link>https://tribune.com.pk/story/2561718/antibiotic-resistance-a-plague-of-our-own-making</link>
			<comments>https://tribune.com.pk/story/2561718/antibiotic-resistance-a-plague-of-our-own-making#comments</comments>
			<pubDate>Sun, 17 Aug 25 08:15:16 +0500</pubDate>
			<dc:creator>
				<![CDATA[Abdur Razzaq]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2561718</guid>
			<description>
				<![CDATA[Despite mounting warnings, antibiotics in Pakistan are dispensed like everyday painkillers]]>
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				<![CDATA[Muhammad Sufian, 8, admitted to Benazir Children Hospital Mardan (BCHM) with a high-grade fever, has taken different antibiotics for almost 24 days.

&ldquo;Before admission to BCHM,&rdquo; shares Sufian&rsquo;s father Aziz Ur Rehman. &ldquo;My son was treated by local medical practitioners in clinics situated in Lundkhawar area of Mardan district, and then by doctors at nearby hospitals. They all used a variety of antibiotics.&rdquo;

Sufian&rsquo;s medical history shows that the antibiotics administered to him include Cefixime and Augmentin that were given orally, while Ceftriaxone, Azithromycin, Grasil, and Mycacine were administered as injections. None of these could not develop positive response.

According to Dr Abbas Ali Khan, a pediatrician at BCHM, a sample had been sent to the lab for a culture test, but since the result would take seven days, Meropenem injections were administered in the meantime which showed a positive response against the infection. Finally, Sufian&rsquo;s temperature began to drop.

&ldquo;Based on previous culture test observations and clinical criteria, Cefoperazone &ndash; Sulbactam, Tanzo, and Meropenem injectable antibiotics are the remaining three weapons against infections in such resistant cases,&rdquo; he says.

Heath experts said that despite growing concerns over antimicrobial resistance (AMR), antibiotics are being offered to children without proper investigations and diagnosis in small clinics, and other medical facilities across Pakistan, and the situation is worsening day by day.

According to the report of the American Society for Microbiology, Pakistan ranks 176th out of 204 nations in AMR-related mortality per 100,000 people.

In 2019, the Global Research on Antimicrobial Resistance Project reported 59,200 deaths in Pakistan directly attributable to AMR, with an additional 221,300 deaths listed as being AMR-associated. AMR was therefore the third-leading cause of death for Pakistanis in 2019, behind cardiovascular disease and maternal/neonatal disorders.

&ldquo;In the misuse and inappropriate use of antibiotics, parents, quacks, and even doctors are involved,&rdquo; explains Dr Abbas Ali Khan. &ldquo;Parents know the names of some common antibiotics and without a qualified doctor&rsquo;s examination, get them from medical stores and without knowing the accurate strength and duration give them to their children who are sick. Quacks and non-qualified doctors, who run clinics in rural areas, also administer antibiotics without proper dosage to small children, and this is how antimicrobial resistance (AMR) develops among children.&rdquo;

He mentioned that qualified doctors follow all protocols during the treatment of children, which usually takes 3 to 4 days. However, for immediate recovery in high grade fever, parents often rush their children to other medical facilities, where antibiotics are prescribed unnecessarily due to their pressure, he added.

&ldquo;We mostly receive children aged 5 to 10 years with high temperature, who have already been treated with antibiotics by parents, quacks, or doctors in peripheral hospitals, where there is no concept of culture testing,&rdquo; shares Dr Khan. &ldquo;Culture tests conducted in the facility show that almost 90 percent children have developed resistance to various antibiotics, as the medicines were not administered to them properly.&rdquo;

According to health experts, antibiotics are given to children even for viral infections such as sore throats, colds, coughs, fever, flu, and condition of mild diarrhea, where antibiotics do not provide any benefit.

They shared that nowadays the resistance to different antibiotics is observed in enteric fever, tuberculosis, urinary tract infections, and gastroenteritis.

Recent findings by Aga Khan University, in Karachi, show that Pakistan has witnessed one of the world&rsquo;s largest outbreaks of extensively drug-resistant (XDR) typhoid, which began in Hyderabad in 2016.

By 2018, over 5,000 confirmed XDR Salmonella Typhi cases had been reported, nearly 70 percent of them in Karachi.

&ldquo;In Pakistan, this silent epidemic is taking a firm grip, especially among children who are our youngest and most vulnerable,&rdquo; says Dr Imran Nasir, Associate Professor at Aga Khan University, Karachi. &ldquo;Hospitals across the country are seeing an alarming surge in antibiotic resistance, much of it stemming from the widespread and often reckless use of antibiotics.&rdquo;

He explained that due to weak diagnostic capacity, with many clinics lacking access to timely lab tests, doctors often prescribe antibiotics with a &ldquo;just in case,&rdquo; approach, rather than based on confirmed diagnosis of bacterial infections. Another contributing factor, he added, is poor antibiotic stewardship.

&ldquo;According to a multi-centre study, most Pakistani hospitals lack clear guidelines on rational antibiotic use, and few have formal stewardship programs in place,&rdquo; explains Dr Nasir. &ldquo;There are prevailing misconceptions even among some in the physician community, who believe antibiotics are effective against viral infections or fear losing patients&rsquo; trust if they don&rsquo;t prescribe something strong. The unnecessary use of antibiotics may offer short-term relief but carries long-term consequences.&rdquo;

He added that overexposure to antibiotics disrupts the gut microbiome, which plays a critical role in immune development.

&ldquo;This leaves children more vulnerable to future infections, allergies, and even obesity,&rdquo;says Dr Nasir. &ldquo;Moreover, it increases the risk that bacteria in a child&rsquo;s body will become resistant, turning minor infections into life-threatening ones,&rdquo; he explains.

He said that in Pakistan stronger stewardship, tighter regulations, better diagnostics and public awareness are urgently needed. Until then, antibiotics will continue to be handed out like candy, and the bacteria will keep getting stronger and smarter, he warned.

To combat antimicrobial resistance, under the AMR National Action Plan 2.0, the Khyber Pakhtunkhwa (KP) government has established an AMR secretariat and has notified a provincial surveillance committee, and a technical working group, shared Dr Musawir Manzoor, a surveillance officer at Integrated Disease Surveillance and Response System (IDSRS), KP health department.

He added that for the awareness among local community the department has conducted awareness activities across the province during the AMR week last year in November.

Dr Shafa Haidar, Director of Registration at the KP Health Care Commission (KPHCC), shared that besides licensing health facilities, regulating pharmacies and rising public awareness, the commission is also combating against quackery, a major contributor to AMR.

She added that the KPHCC conducted raids and took legal action against quacks and illegal healthcare facilities to dismantle practices that contribute to antimicrobial resistance.

The Global Research on Antimicrobial Resistance (GRAM) project suggests that bacterial antimicrobial resistance will cause 39 million deaths between 2025 and 2050 globally &ndash; equating to three deaths every minute.

The study forecasts a 67.5 percent increase in annual deaths directly attributed to bacterial AMR, rising from 1.14 million in 2021 to an estimated 1.91 million in 2050. Deaths associated with AMR are also expected to increase by 74.5 percent, from 4.71 million in 2021, to 8.22 million deaths in 2050.

From rural clinics to urban hospitals, antimicrobial resistance is eroding treatment options, turning routine infections into life-or-death battles. If left unchecked, Pakistan&rsquo;s overreliance on antibiotics will continue to shrink the arsenal of drugs that can save lives, leaving doctors with fewer &mdash; and often more toxic &mdash; options. The battle against antimicrobial resistance is not only a medical challenge but also a social one, demanding stricter regulations, better diagnostics, and a cultural shift in how we perceive antibiotics. Every unnecessary prescription, every self-medicated dose, is another step towards a future where common childhood infections become untreatable. Protecting our children means acting now &mdash; before the medicines we trust become relics of the past.

&nbsp;

Abdur Razzaq is a Peshawar-based multimedia journalist. He tweets @TheAbdurRazzaq

All facts and information are the sole responsibility of the writer]]>
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			<title>When the body turns on itself</title>
			<link>https://tribune.com.pk/story/2560620/when-the-body-turns-on-itself</link>
			<comments>https://tribune.com.pk/story/2560620/when-the-body-turns-on-itself#comments</comments>
			<pubDate>Sun, 10 Aug 25 09:43:29 +0500</pubDate>
			<dc:creator>
				<![CDATA[YUSRA SALIM]]>
			</dc:creator>
			<category><![CDATA[Health]]></category><category><![CDATA[Magazine]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2560620</guid>
			<description>
				<![CDATA[Autoimmune diseases in Pakistan are frequently sidelined in diagnosis &amp; in public health conversations]]>
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				<![CDATA[When 28-year-old Sana began to lose clumps of hair and to wake up with stiff, painful joints in her right hand, she told herself it was nothing but stress. Six months later, a rash across her cheeks flared and she developed breathlessness. Multiple doctors offered inhalers, creams, or reassurance that it would go away. It was only after a referral to a tertiary hospital that blood tests and specialist review produced a diagnosis. She had systemic lupus erythematosus (SLE), an autoimmune disease in which the body&rsquo;s own immune system attacks skin, joints, kidneys, and other organs.

Sana&rsquo;s story is far from unique. In Pakistan, a growing body of clinical research, hospital case series, and on-the-ground testimony from physicians and patients points to two linked truths that autoimmune diseases are not rare, and they are frequently missed, misdiagnosed, or diagnosed late, often with high financial and health costs for patients and families.

Unlike Sana, many children are born with eczema and other skin diseases, and the cure is nowhere to be found. &ldquo;When my baby was born, he had no problem, but within a few weeks, he developed several allergies and acne on his face, which kept spreading all over his body,&rdquo; shared Azra Ramsha, adding that after a few weeks of discomfort, she decided to consult a dermatologist because the rashes were not getting any better. Ramsha faced the same issue with both of her daughters and today lives a lifestyle that requires shampoos, face wash, lotions, and many other expensive creams to prevent the rash from flaring up and causing pain to her 5 and 7-year-old daughters.



Designed by: Ibrahim

What are autoimmune diseases?

Autoimmune diseases occur when the immune system, whose primary function is to defend the body against diseases, mistakenly targets healthy tissues. The spectrum is wide for it, as some are organ-specific, for example, type 1 diabetes targets insulin-producing pancreatic cells, while others are systemic, for example, rheumatoid arthritis RA and lupus, and can affect multiple organs. Globally, estimates suggest 5&ndash;10% of the population may be affected by one of the 80&ndash;100 recognised autoimmune conditions; women are disproportionately affected, making up roughly 4 of every 5 cases for some diseases.

While some autoimmune disorders are chronic but stable with treatment but others, left untreated, cause irreversible organ damage, disability, or life-threatening complications. Early recognition, specialist referral, and access to appropriate immunomodulatory therapy can substantially change outcomes. Delayed diagnosis often increases the risk of permanent damage.



Designed by: Ibrahim

The Pakistani dilemma

Pakistan lacks a single national registry for autoimmune disease, and comprehensive population studies are few. Nonetheless, hospital-based studies, specialist surveys, and international reports that include Pakistani cohorts paint a worrying picture. Rheumatoid arthritis (RA) prevalence in Pakistan is estimated at around 0.5% of the population in some studies, comparable to or slightly lower than global figures, but still representing hundreds of thousands of people. On the other hand, Type 1 diabetes and other autoimmune issues are increasingly reported in the younger generation. Screening studies in Pakistani diabetes clinics have found significant rates of additional autoimmune disorders in people with type 1 diabetes.

Autoimmune liver diseases and autoimmune hepatitis have been diagnosed in tertiary hospitals in Pakistan. While uncommon, they require specialised testing and early immunosuppression to avoid progression to cirrhosis. Perhaps the most shocking statistic comes from workforce data, published international reporting, and Pakistan-focused pieces which estimate that there are only a few dozen trained rheumatologists in the country. One article cited roughly 24 practitioners, an alarming, inadequate number given Pakistan&rsquo;s population and the burden of rheumatic and autoimmune disease. That imbalance compounds diagnostic delay and limits ongoing specialist care.



Designed by: Ibrahim

Sana, a primary school teacher from Lahore, first noticed hair loss and fatigue. Her family doctor treated it as chronic stress and prescribed vitamins. When a facial rash appeared and she began to have joint pain, she visited multiple clinics. Blood tests at a public hospital finally revealed positive ANA and anti-dsDNA antibodies; a nephrology workup then showed early kidney involvement. &ldquo;By the time I reached a rheumatologist, I had already lost good weeks of treatment,&rdquo; she said, adding that early immunosuppression led to further kidney damage, but the delay increased anxiety, medical costs, and the issue of time away from work.

Farzana, in her early twenties, developed persistent joint swelling and morning stiffness. Family members advised time, rest, and local remedies. Tests ordered only after the pain became disabling showed elevated inflammatory markers and anti-CCP antibodies. A Pakistani study looking at diagnostic delay in RA patients reported median delays measured in months to years; practitioners point to cultural attitudes that normalise pain and to lack of specialist access as major causes. With early DMARD (disease-modifying antirheumatic drugs) therapy, Farzana&rsquo;s disease was controlled, but many patients in less fortunate circumstances continue to deteriorate.

Bilal was diagnosed with type 1 diabetes at age 12. Routine screening later revealed hypothyroidism due to autoimmune thyroiditis, a familiar pattern in pediatric diabetes clinics in Pakistan. &ldquo;No one realised until I fainted in school one day, because having diabetes as young as 12 is something no one can accept in my family,&rdquo; Bilal shared, adding that he and his family had a history of diabetes, but even then, no one bothered to get it checked earlier.



Designed by: Ibrahim

Structural and cultural causes

Several overlapping factors explain why autoimmune diseases are under-recognised in Pakistan, such as a limited specialist workforce and diagnostic capacity. With very few rheumatologists and constrained laboratory services in many districts, patients are often managed for months or years by general practitioners without specialist tests (e.g., autoantibody panels). Studies documenting diagnostic delays and reports from clinicians confirm this bottleneck.

Many autoimmune disorders begin with fatigue, body aches, or intermittent rash symptoms commonly attributed to stress, ageing, or infection. &ldquo;Cultural tendencies to downplay pain or to seek traditional remedies can delay biomedical evaluation,&rdquo; shared Shahmeer Ahsan, practicing dermatologist, adding that most of the time patients come to them is after wasting years in general physician clinics.

Infectious diseases, maternal health, and non-communicable disease programmes (diabetes, cardiovascular disease) receive the bulk of public health attention, but autoimmune conditions sit between specialties and lack targeted national programmes or surveillance.



Designed by: Ibrahim

&ldquo;Testing for autoantibodies, imaging, and specialist visits are expensive for many families. Travel to tertiary centres concentrates care in large cities, leaving rural populations underserved,&rdquo; Ahsan shares. A cross-sectional study of diabetic patients in Rawalpindi highlighted financial strain and treatment compliance challenges that echo across chronic disease care.

Diagnosing autoimmune disease requires a combination of clinical and targeted testing. Careful history and examination to detect patterns (e.g., inflammatory joint pain, photosensitive rash, sicca symptoms of dryness). &ldquo;Not everything is an infection and not every rash is eczema, it has types and kinds,&rdquo; Ahsan explained, adding that patients take everything as the same and mostly follow the layman&rsquo;s word and not believe the doctors.

Multiple studies in Pakistani hospitals highlight that delays at each step from GP visit to specialist referral to confirmatory testing are common. One Pakistan study of rheumatology clinic patients found that only about a fifth are presented to a rheumatologist within 12 weeks of symptom onset; such delays can close the window of opportunity for optimal response to therapy in conditions like early RA.



Designed by: Ibrahim

Manageable, not curable 

For most autoimmune diseases, there is no cure; the goal of therapy is to control immune activity, prevent organ damage, and maintain quality of life. Therapeutic tools include symptomatic agents such as NSAIDs, analgesics, and short courses of corticosteroids for flares. Conventional DMARDs and immunosuppressants for severe disease, biologic agents, and targeted therapies are also highly effective in many cases but costly and often unavailable in public hospitals.

In Pakistan, clinicians say the cost and supply of biologics and long-term immunosuppressants remain serious barriers for many patients. Even when drugs exist in the market, affordability and monitoring for infection risk, blood counts, and liver function add complexity.

&ldquo;We have a huge mismatch between burden and workforce,&rdquo; says a rheumatologist involved in training programmes that are slowly expanding rheumatology capacity. A profile of rheumatology in Pakistan noted fewer than three dozen trained specialists caring for millions of people, a situation that extends waiting lists and delays care.

Clinicians in tertiary hospitals report that late presentations, for example, patients coming with already advanced lupus nephritis or erosive RA, are common and that psychosocial consequences job loss, family stress, and depression, are underappreciated. A Pakistani study showed depression was overlooked in nearly half of RA patients in some tertiary settings, arguing for integrated mental-health screening in chronic autoimmune care.

The rheumatologist also calls for education of general practitioners, scaled-up diagnostics in district hospitals, and the establishment of referral pathways so patients are seen by rheumatology, endocrinology, hepatology, or neurology teams when appropriate.

Exact national economic figures for autoimmune disease in Pakistan do not yet exist, but international analyses show chronic autoimmune conditions carry high lifetime costs due to medications, hospitalisations, lost productivity, and disability. In low and middle-income settings, out-of-pocket costs and the absence of social safety nets often push families into financial distress. Local cross-sectional research among diabetic patients demonstrates how treatment costs and compliance challenges interact in a pattern likely mirrored across autoimmune care.

Experts and clinicians interviewed suggested scaling up training and the workforce, expanding rheumatology, clinical immunology, and allied specialty training programmes, leveraging telemedicine, and visiting specialist clinics for rural districts. &ldquo;Developing short symptom-recognition toolkits for family physicians and medical officers, and creating clear referral pathways to specialists, can help in coping with the menace,&rdquo; Ahsan suggests. He also suggested that we subsidise core autoantibody testing and inflammatory markers at district hospitals, and develop regional labs to reduce travel and delay can help.

Other than that he also proposed that public awareness campaigns, symptom checklists, when to seek care and establish patient support organisations in major cities to reduce stigma and improve self-management. While creating a national registry for autoimmune diseases and standardising case reporting across tertiary hospitals to inform policy and resource allocation.

Where early recognition and coordinated care exist, outcomes improve. In tertiary centres across Pakistan, multidisciplinary clinics that combine rheumatology, nephrology, and dermatology have demonstrated better monitoring and faster initiation of disease-modifying therapy for conditions like lupus. Specialist training programmes often run with international partners are producing the next generation of clinicians. But scaling these pilots into nationwide systems will require political will, financing, and public engagement.



Designed by: Ibrahim

Bringing it out of the shadows

Autoimmune diseases are not exotic rarities; they are chronic, often disabling conditions that affect tens or hundreds of thousands of Pakistanis. Yet the current system too often allows these disorders to fester undetected until organ damage or functional loss becomes evident.

What Sana, Farzana, and Bilal&rsquo;s lives experienced makes clear is that early recognition makes a difference, it saves function, reduces long-term cost, and preserves quality of life. To achieve that in Pakistan will take better data, wider public understanding, stronger primary care, more specialists, and fairer access to diagnostics and medicines.

This is a public-health and human-rights issue as much as a clinical one. As clinicians and patient advocates here say, it&rsquo;s time to move autoimmune diseases from the clinic&rsquo;s margins into mainstream health planning before the next set of patients lose precious months or years to diagnostic delay.]]>
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			<title>The missed diagnosis</title>
			<link>https://tribune.com.pk/story/2559371/the-missed-diagnosis</link>
			<comments>https://tribune.com.pk/story/2559371/the-missed-diagnosis#comments</comments>
			<pubDate>Sun, 03 Aug 25 04:40:09 +0500</pubDate>
			<dc:creator>
				<![CDATA[Nabil Tahir]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2559371</guid>
			<description>
				<![CDATA[Without reliable diagnostics, even the best treatment plans in Pakistan often start with guesswork.]]>
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				<![CDATA[In a country where patients often arrive at hospitals only when their condition turns critical, where public health infrastructure remains chronically underfunded, and where even routine illnesses can become life-threatening due to delays, the cracks in Pakistan&rsquo;s healthcare system are no secret. But while treatment gaps and medicine shortages dominate headlines, a quieter crisis continues to erode outcomes: the failure to diagnose early, or accurately.

Diagnostics are the starting point of any effective treatment journey. They help identify diseases before symptoms become severe, guide doctors toward the right course of action, and save lives through timely intervention. But in Pakistan, diagnostics have long remained on the periphery of healthcare planning.

Dr. Suleman Alvi, Country Head of Martin Dow Specialities Private Limited, believes the problem is structural, rooted in slower policy reforms, systemic inefficiencies, and a lack of prioritisation. &ldquo;We do not have enough functional labs, especially in the rural belt and even in urban setups,&rdquo; he says. &ldquo;You&rsquo;ll often find a good hospital but not a good diagnostics department attached to it. That&rsquo;s a huge gap.&rdquo;

He further adds that the issue is not that we don&#39;t have enough people or even labs. &ldquo;The problem is the infrastructure, the availability of proper devices, quality control, trained manpower, and policy priority.&rdquo;

Pakistan ranks 130 out of 195 countries in laboratory systems, according to the Global Health Security Index, lower than all its South Asian neighbors. Despite the increasing burden of non-communicable diseases like diabetes, hypertension, and cancer, and the persistence of infectious diseases such as hepatitis, TB, dengue, and even polio, the role of diagnostics in shaping healthcare outcomes is yet to be fully recognised.

Professor Dr. Naila Tariq, a senior pathologist and head of laboratories at both JPMC and JSMU, has seen the cost of this neglect play out for decades. &ldquo;Diagnostics are central to the treatment because without diagnostics, we cannot reach to any conclusive diagnosis and then the treatment would be random and erratic,&rdquo; she says.

In her view, it&rsquo;s not just one issue, it&rsquo;s a matrix of challenges. &ldquo;Is it accessible? Yes, in Pakistan, it is nearly everywhere. Is it affordable? No, it&#39;s not affordable. Do you think people have got awareness about it? I think no, they don&#39;t have the awareness. And the problem is that we have sprawling laboratories. We don&#39;t know which is the right one, what they are doing, how they are doing.&rdquo;

She added that even the consultants are not aware of exactly what test needs to be done and in what order. &ldquo;These are very important issues. Access is there, but they&#39;re extremely expensive. And now, the running of a business is only gauged through the laboratory and the diagnostics. It&#39;s not giving the answer which we should have exactly for diagnostics.&rdquo;

The invisible crisis

In healthcare, what isn&rsquo;t seen often becomes what&rsquo;s ignored. That&rsquo;s especially true for diagnostics. Their role is foundational, yet, unlike a hospital bed shortage or a medicine stockout, the damage caused by unreliable or absent testing unfolds quietly.

&ldquo;Unfortunately, we don&rsquo;t treat diagnostics as a priority in policymaking,&rdquo; says Dr. Alvi. &ldquo;They&rsquo;re usually an afterthought when planning facilities, budgeting for healthcare, or even when setting up hospitals. But in reality, diagnostics should be the starting point, they&rsquo;re the eyes of the healthcare system.&rdquo;

The impact of this neglect can be devastating. Missed or late diagnoses mean diseases like TB, hepatitis, diabetes, and cancer are often caught when the patient&rsquo;s condition is already deteriorating. What could&rsquo;ve been addressed with preventive care turns into long-term treatment and lifelong financial strain.

&ldquo;It&rsquo;s not just about having labs, it&rsquo;s about having the right tools and trained staff to deliver accurate results,&rdquo; Dr. Alvi explains. &ldquo;You&rsquo;ll find places calling themselves diagnostic centers, but the equipment is outdated, the staff undertrained, and there&rsquo;s no standardised procedure.&rdquo;

And while patients suffer the consequences, the system often fails to even recognise the root cause. &ldquo;In many cases, wrong treatment is blamed on the doctor or the medicine. But the problem started before that, with diagnostics. If the test was flawed, the treatment never stood a chance,&rdquo; he adds.

Dr. Naila echoes the concern from a lab practitioner&rsquo;s perspective. &ldquo;The market is flooded with kits of varying quality, there&rsquo;s no reliable check on what&rsquo;s being used where. So precision, specificity, accuracy, all become challengeable.&rdquo;

Without accountability, even the most basic tests can lose clinical value. And without early, affordable, and reliable diagnosis, the entire healthcare chain, from doctors to patients, is flying blind.

Systemic barriers

Pakistan&rsquo;s diagnostic sector is tangled in more than just weak infrastructure, it&rsquo;s burdened by outdated procurement rules, unnecessary red tape, and a regulatory environment that, rather than facilitating improvement, often adds friction.

Among the many structural challenges, Dr. Alvi also acknowledges some recent efforts that signal progress. &ldquo;Credit where it&rsquo;s due, DRAP has taken steps in the right direction,&rdquo; he says. &ldquo;Their digitalisation initiative for regulatory approvals is a welcome move. It has made some processes more transparent and efficient. This is the kind of policymaking we need more of, responsive, technology-driven, and focused on reducing friction.&rdquo;

While much of the sector remains bogged down in inefficiencies, Dr. Alvi believes that some policymakers have shown willingness to reform. &ldquo;It&rsquo;s important to acknowledge that not all is stagnant,&rdquo; he says. &ldquo;There are individuals and departments trying to push things forward, despite systemic constraints. But they need more support, autonomy, and continuity of policy to truly make a difference.&rdquo;

Still, Dr Alvi believes, &ldquo;The biggest challenge is the import process. It&rsquo;s a long, complex procedure, you need to go through various departments, and approvals are delayed. Even when you&#39;re importing something as basic as reagents, it takes months. If you&#39;re trying to bring in new technology, the process is even more cumbersome.&rdquo;

The delays affect more than just the hospitals and labs. They have a direct impact on how soon, and how accurately, patients are diagnosed. &ldquo;This delay in availability results in either test results not being done at all or done after the clinical window has passed,&rdquo; he says. &ldquo;You cannot run an efficient diagnostic setup like this.&rdquo;

Even when devices and kits do arrive, there&rsquo;s little assurance that what&rsquo;s available in the market is up to standard. &ldquo;Unfortunately, quality is not prioritised,&rdquo; he adds. &ldquo;There&rsquo;s no uniform check or regulatory mechanism to ensure that imported products are functioning to the level that&rsquo;s required. Sometimes substandard products slip through just because they are cheaper and clear customs faster.&rdquo;

Still, Dr. Alvi insists that affordability doesn&rsquo;t have to come at the expense of quality. &ldquo;China offers equipment across a range, from subpar to world-class. The key is knowing what you&rsquo;re buying,&rdquo; he explains. &ldquo;When we partner with Chinese manufacturers, we make sure they&rsquo;re certified either by the European Union or the U.S. FDA. If a device can be sold legally in the U.S. or Europe, it should absolutely be good enough for Pakistan.&rdquo;

According to him, many of these Chinese products are certified to international standards and are also far more cost-effective than their Western counterparts. &ldquo;We are representing several such Chinese companies in Pakistan whose devices are affordable and meet global quality benchmarks. But despite this, public procurement policies in many government hospitals still block Chinese equipment by default.&rdquo;

He describes the practice as outdated and discriminatory. &ldquo;There are public tenders that outright exclude China by listing only a few &lsquo;acceptable&rsquo; countries, like the U.S., Germany, Japan, or other EU nations. That&rsquo;s unfair. Instead of focusing on country of origin, tenders should ask for EU or IMDA certification. That&rsquo;s what truly guarantees quality.&rdquo;

Dr. Naila offers a sharper critique from the public sector end. She points to the flawed tendering system as a key reason public labs struggle with quality.

&ldquo;Tenders are always manipulated. The lowest bid gets the tender,&rdquo; she says. &ldquo;So you cannot maintain the quality. The same glucose analysis kit can be purchased for 10,000 rupees, or upto 30,000, and there&rsquo;s no way to ensure what ends up being used in the lab.&rdquo;

She adds that taxation makes it even harder to access reliable tools. &ldquo;They have now added duties on duties on duties. Rather than encouraging diagnostic improvements, the government is focused on retrieving as much money as it can through taxes.&rdquo;

She believes the problem goes beyond policy, it&#39;s also about enforcement. &ldquo;They&#39;re not focusing where they should. Whether the kits are coming in acceptable condition, whether temperature is maintained, no one checks that. Instead, they&rsquo;re only counting revenue.&rdquo;

Dr. Alvi agrees that reform must start with cutting down red tape and prioritising reliability over lowest cost. &ldquo;There should be a fast-track mechanism for essential diagnostic devices, especially for high-burden diseases like TB, hepatitis, and cancer. Right now, there&rsquo;s no urgency from the system, but the diseases aren&rsquo;t waiting.&rdquo;

Quality control and trust deficit

Even when diagnostic services are available, one question continues to haunt the system: can the results be trusted?

&ldquo;Standardisation is missing. There&rsquo;s no enforced framework for quality control across labs,&rdquo; says Dr. Alvi. &ldquo;Different labs report different results for the same patient, we&rsquo;ve seen glucose, cholesterol, or liver function tests vary significantly from one report to another. How do we expect doctors to make decisions based on that?&rdquo;

The lack of consistency is not just frustrating, it&rsquo;s dangerous. When clinicians don&rsquo;t trust results, they either delay treatment, repeat tests, or rely on assumptions. &ldquo;This is how misdiagnosis happens. And this is why patient outcomes don&rsquo;t improve even after we spend so much on healthcare,&rdquo; Dr. Alvi adds.

Dr. Naila calls the situation &ldquo;deeply flawed at the root.&rdquo; According to her, the absence of a central regulatory body that enforces strict quality assurance measures has left the sector to function in silos, without checks or balances.

&ldquo;There is no central body monitoring the quality assurance,&rdquo; she states firmly. &ldquo;Although they have formed all sorts of commissions, Sindh Healthcare Commission, Punjab Healthcare Commission, Khyber Pakhtunkhwa, Balochistan, none are delivering.&rdquo;

She believes the chaos has fueled a culture of profit over precision. &ldquo;Smaller labs are working on a commission basis. Even now, the bigger labs are also working on commission basis, they&rsquo;re doing B2B businesses. The result is that obviously, they are not maintaining the required standards.&rdquo;

What&rsquo;s worse is the illusion of regulation. &ldquo;This ISO business and accreditation business. it&rsquo;s only sold because of money. I don&rsquo;t believe in this ISO certified or, I don&rsquo;t know, AYZ accredited, because this is now being sold. This is a gimmick,&rdquo; she says.

Dr. Alvi echoes that for diagnostics to be reliable, trust must be backed by transparency and uniformity. &ldquo;We need proper licensing and surprise audits,&rdquo; he says. &ldquo;Without enforcement, any lab can call itself certified. But who&rsquo;s checking the calibration? Who&rsquo;s validating the reports?&rdquo;

Despite widespread concerns around standardisation and trust, some large diagnostic players are setting high benchmarks. &ldquo;There are labs in Pakistan doing world-class work, they follow strict quality protocols, have internationally certified equipment, and report highly accurate results,&rdquo; Dr. Alvi points out. &ldquo;But unfortunately, their reach is limited. These labs are mostly present in major urban centers, leaving the rest of the country underserved.&rdquo;

At the core of the issue is a public increasingly skeptical of the results they receive, a dangerous position for any healthcare system. Trust in labs, once broken, takes far more than just updated machines to rebuild.

Education, reform &amp; the way forward

Pakistan&rsquo;s diagnostics crisis doesn&rsquo;t end at infrastructure and regulation, it begins much earlier, in classrooms and hospitals, where the next generation of doctors is being trained.

&ldquo;We have to rethink how we teach diagnostics,&rdquo; says Dr. Alvi. &ldquo;Most young doctors learn treatment protocols, but they don&rsquo;t fully understand the diagnostic process. They rely on outdated methods or overprescribe tests without knowing what&rsquo;s really needed. That&rsquo;s dangerous.&rdquo;

He believes training must go beyond textbooks. &ldquo;If junior doctors and final-year MBBS students don&rsquo;t understand what each test actually indicates, how samples should be collected, or what factors can affect the result, we&rsquo;re creating a cycle of guesswork, not precision medicine.&rdquo;

Dr. Naila agrees, but pushes for structural training reforms during house jobs. &ldquo;While doing their house job or rotations, they should be given specific training in the clinical pathology laboratories,&rdquo; she says. &ldquo;They need to know exactly what is the prerequisite for certain samples, how they have to be sent, how much amount of blood should be collected, in which bottle. If they don&rsquo;t know it, how can they expect that the technicians or nurses know how to do it?&rdquo;

Beyond education, both doctors strongly emphasise the need for national-level reform, not just policy documents, but real enforcement on the ground.

Dr. Alvi believes this requires coordinated public-private collaboration. &ldquo;We don&rsquo;t need another policy report,&rdquo; he says. &ldquo;We need implementation. We need audits. We need better licensing, mandatory quality assurance standards, and incentives for local manufacturing. And we need these reforms to be owned by all stakeholders, industry, government, medical associations, and hospitals.&rdquo;

Dr. Naila&rsquo;s call is more prescriptive. &ldquo;There should be quality control evaluation analysis, there should be standard deviation curve analysis, everything should be jotted down. And there should be teams monitoring it, going lab to lab, assessing whether they are delivering or not.&rdquo;

She believes technology can help. &ldquo;Everything is on automation now, and everything can be retrieved through the software,&rdquo; she says. &ldquo;So there&rsquo;s no excuse left. These are the things which we can definitely ensure, and definitely our accuracy and specificity would improve.&rdquo;

But systemic change is slow. For now, both experts agree that patient outcomes are compromised daily by a system that fails to recognise the full weight of diagnostics in healthcare.

&ldquo;There&rsquo;s no point in building cardiac centers or liver institutes,&rdquo; says Dr. Alvi, &ldquo;if we cannot diagnose the disease in the first place.&rdquo;

We live in a country where treatment often begins too late and ends too soon, the quiet work of diagnostics rarely makes headlines. Yet it is this very first step, a timely test, an accurate report, a doctor&rsquo;s trust in a result, that determines whether a patient lives with clarity or confusion. Experts like Dr. Alvi and Dr. Naila remind us that until diagnostics are treated not as a side note but as the backbone of healthcare, even the most well-intentioned reforms will fall short. And as long as labs continue to function without oversight, training remains patchy, and affordability remains elusive, the answers we seek will stay just out of reach, buried not in complexity, but in our failure to simply look closely enough, early enough.]]>
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			<title>No space to nurse</title>
			<link>https://tribune.com.pk/story/2559373/no-space-to-nurse</link>
			<comments>https://tribune.com.pk/story/2559373/no-space-to-nurse#comments</comments>
			<pubDate>Sun, 03 Aug 25 04:40:34 +0500</pubDate>
			<dc:creator>
				<![CDATA[Tufail Ahmed]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2559373</guid>
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				<![CDATA[Lack of nursing arrangements mean mothers find formula feeding more convenient]]>
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				<![CDATA[There was once a time when motherhood was stereotypically associated with a life of stagnation. The new mother&rsquo;s life would revolve around caring for her child, with no room for personal or professional growth. In these times, breastfeeding, despite its challenges and constraints, came naturally to women since motherhood was the only role they were expected to fit. With time, however, the social expectations facing new mothers have gradually started to change.

While husbands and families unfairly pressure some women to hop back into pre-pregnancy shape soon after birth others have to confront the looming prospect of lagging in careers they had spent years building. Amidst this cacophony of external judgment and inner insecurity, even the thought of breastfeeding a child every two to four hours, each day for two whole years, became physically exhausting and mentally burdensome.

Although it can be argued that such shifts happened pretty much all over the globe, the decline in breastfeeding practices has happened starkly in Pakistan, where formula feeding is openly advertised as the &ldquo;healthy&rdquo; option while lactation support is more or less non-existent. In a country where childcare is still considered the woman&rsquo;s primary responsibility, little or no arrangements have been made to facilitate nursing mothers in public and private institutions through designated breastfeeding corners.

At airports, offices, hospitals, malls, courts, mass transit systems, railway stations, and universities, nursing mothers still have to tacitly locate secluded spots in restrooms and prayer rooms to feed their bawling babies. In 2017, the Parliament was the only state institution to build a nursing room for female parliamentarians with the help of UNICEF. In this context, formula milk naturally emerged not only as a saviour for overburdened mothers but also a facilitator of female empowerment. However, despite its positives, nothing about this normalized, artificial feeding practice could be termed natural.

According to the World Health Organization (WHO), breastfeeding is one of the most effective ways to ensure child health and survival since breastmilk is safe, clean and contains antibodies that help protect against many common childhood illnesses. Furthermore, research has shown that breast-fed children perform better on intelligence tests, are less likely to be overweight or obese, and are less prone to diabetes later in life. Similarly, women who breastfeed also have a reduced risk of breast and ovarian cancers. However, contrary to WHO recommendations, fewer than half of infants under six months old are exclusively breastfed.

&ldquo;While countries such as the United States and the United Kingdom have since re-emphasized breastfeeding due to its well-documented health benefits, Pakistan continues to see low exclusive breastfeeding rates during the first six months postpartum. National surveys have estimated that only 37 per cent of babies are exclusively breastfed,&rdquo; said Dr Ayesha Shahbaz, a lactation specialist.

Finding health in a tin

Despite their numerous benefits, breastfeeding practices are on the decline in Pakistan, where mothers are increasingly turning to formula milk either out of necessity or choice. While in some cases professional responsibilities or nutritional deficiencies necessitate formula supplementation, oftentimes the irresponsible marketing of formula milk convinces new mothers that the key to their little one&rsquo;s growth and development is hidden in a tin.

Dr Shahbaz, a registered medical practitioner, agreed that in certain cases, concerns about milk supply were valid, especially when maternal malnutrition or anaemia was present&mdash;both of which are prevalent among women in Pakistan. &ldquo;Nutritional deficiencies can affect both the quantity and quality of breastmilk. However, a significant barrier also lies in maternal perception. Many mothers doubt their ability to produce sufficient milk and view formula as a more reliable option; a belief that is reinforced by pervasive marketing campaigns depicting robust, chubby babies being fed with formula. Such portrayals can cause anxiety among mothers who fear that exclusive breastfeeding may not be enough for their child&rsquo;s development,&rdquo; noted Dr Shahbaz.

According to the World Health Organization (WHO), the inappropriate marketing of breast milk substitutes continues to undermine efforts to improve breastfeeding rates and duration worldwide. Therefore, breastfeeding counseling, along with baby-friendly hospital support and community mobilization approaches, is a key intervention to improve breastfeeding rates.

&ldquo;Despite the proven importance of this approach, it remains underutilized in Pakistan. There is limited integration of lactation counseling into routine maternal healthcare, and in many cases, even gynaecologists may not be familiar with the role of lactation consultants. As a result, new mothers are often discharged from hospitals with formula milk prescriptions, without being offered adequate breastfeeding guidance,&rdquo; explained Dr Shahbaz.

According to sources of the Express Tribune, the baby milk and infant formula sector in Pakistan is projected to generate approximately 440 million US dollars in revenue in 2025, with an anticipated annual growth rate of 4.26 per cent from 2025 to 2029. Currently, eight companies are leading the infant formula market, with their prices ranging from Rs1,000 to Rs10,000 for a 400 grams standard tin.

However, despite the booming infant formula industry, nutrition levels among the masses have remained alarmingly poor. In the National Nutrition Survey 2018, which surveyed the nutritional status of children under the age of five, 40 per cent of children were stunted, 15 per cent wasted, and 23.1 per cent were underweight. Furthermore, the nutritional status of women of reproductive age was equally concerning, with an estimated 38.2 per cent suffering from anaemia, 47.7 per cent deficient in vitamin A, and an alarming 76.4 per cent living with a vitamin D deficiency.

While nutritional deficiencies and women&rsquo;s psychological inclination towards formula could partly explain the shift away from breastfeeding, extended living arrangements and the unavailability of breastfeeding spaces in public areas are also discouraging factors.

Dr Nighat Khan, General Secretary of the Women Care Foundation, estimated that 15,500 children were born in Pakistan every day. &ldquo;All these children need mother&#39;s milk for two years. Women can easily breastfeed newborn children at home however, oftentimes there are many modesty constraints in the joint family system. Furthermore, nursing women cannot breastfeed their babies in markets, railway stations, and parks, which is a tragedy,&rdquo; said Dr Khan.

Expanding on the problem, Professor Dr Nasreen Aslam Shah, former Head of the Department of Social Work at the University of Karachi, reiterated the fact there were no designated spaces for breastfeeding babies at bus stops, parks, shopping centers, or public places. &ldquo;When a newborn baby gets hungry in a public place, mothers are forced to feed their child inside a chador or burqa, which is difficult. Other women are forced to carry formula milk to deal with such situations,&rdquo; emphasized Dr Shah.

Nursing spaces and gender inclusivity

&ldquo;Designed by women, for women.&rdquo; Although the presence of this label on a product or service might create an illusion of female empowerment, it is a subtle reminder of a much more sinister reality. Everything else in the world is neither for women nor designed by women.

From the seating alignment in cars to the standard temperature maintained in indoor public spaces and even the height of shelves at stores, the subject user or citizen is by default always a man. In Pakistan, this male bias in urban planning manifests in the design of urban spaces, which often neglect the provision of infrastructural arrangements like daycare centres or nursing spaces, which are necessary to accommodate women in the public sphere through different life stages.

Javeria, a 30-year-old new mother pursuing her higher studies at the University of Peshawar revealed that her daughter was just six months old. &ldquo;Travelling to the university through public transport every day is a challenge since no separate breastfeeding area is designated in public spaces. Even the BRT Peshawar does not have such a facility. Since nursing a child in public is against the norms of our culture, many working or studying mothers are compelled to feed formula milk through a bottle,&rdquo; explained Javeria.

Similarly, Humaira Ahmed, a resident of Karimabad, agreed that breast milk was essential for the health of the child however, breastfeeding mothers faced many difficulties upon setting foot outside the home. &ldquo;It is impossible to breastfeed a child outside the house. There should be separate nursing rooms designated in markets, shopping centers, railway stations, airports, and public entertainment centers,&rdquo; opined Ahmed.

In Punjab, guidelines have been established by the Punjab Women Development Department for the establishment of daycare facilities however, many public and private institutions still lack designated spaces for breastfeeding.

Dr Uzma Ashiq Khan, Executive Member of the Punjab Day Care Fund Society and Assistant Professor of Gender Studies at the Lahore College for Women University (LCWU) revealed that initiatives aimed at establishing a nursing corner or daycare facility for women often received a mixed response.

&ldquo;While some institutions claim they do not have space for a daycare others feel they are not necessary. However, the debate on daycare centres holds immense significance in the field of gender especially when it comes to assisting working women. Mothers looking for a job often check whether an organization provides a daycare facility or not. Even if such spaces are designated, consistent monitoring is needed to ensure that they are not misused,&rdquo; opined Dr Khan.

Barrister Rida Noor stated that a law regarding daycare centers was passed in the National Assembly in 2022, however, by 2023, there were still no daycare centres established. &ldquo;According to the law, if any company or institution fails to offer such spaces, a warning is issued, after which a fine of Rs100,000 may be imposed along with up to six months of imprisonment,&rdquo; said Noor.

Vice President of the Pakistan Paediatric Association Professor Mohammad Hussain conceded that the lack of dedicated breastfeeding spaces in public places such as airports, universities, and even hospitals posed a significant barrier for mothers. &ldquo;While Pakistan has made commitments under global frameworks like the Global Strategy for Infant and Young Child Feeding, there is limited national legislation mandating breastfeeding-friendly spaces in public institutions. Even where policies exist, implementation remains weak due to lack of awareness, funding, and administrative will,&rdquo; implored Hussain.

Facilitating breastfeeding

&ldquo;A mother should breastfeed her child for at least two years.&rdquo; In our society, the aforementioned comment is casually thrown around by older women trying hard to school a new mother on the correct way of being a mother. However, practically, very little support is afforded to the anxious mother, who lacks the necessary guidance on both motherhood and lactation.

According to Dr Shahbaz, who is also a public health consultant, effective maternal and infant health is dependent on a coordinated approach involving gynaecologists, paediatricians, and lactation specialists. &ldquo;Integrating lactation counseling into the essential antenatal and postpartum visits is crucial to equip new mothers with the knowledge and skills needed for successful breastfeeding. These sessions not only promote awareness of the health benefits of breastfeeding but also prepare mothers to manage common breastfeeding challenges,&rdquo; advocated Dr Shahbaz, who also felt that training nursing staff in basic lactation management could further strengthen lactation support.

Dr Shahbaz also stressed the need for early consultation with lactation specialists, who could provide dietary guidance and recommend appropriate supplementation to support lactation. &ldquo;Health systems strengthening through the training of staff, revival, and support of baby-friendly hospital initiatives and incorporation of lactation specialists into the triangle of care could make a significant impact. On a policy level, initiatives such as nursing rooms in public and private spaces are a step forward, but their impact will be limited unless broader cultural and healthcare shifts actively encourage breastfeeding,&rdquo; claimed Dr Shahbaz.

On the other hand, Dr Samrina Hashmi, a gynaecologist, still felt that ensuring gender-inclusive infrastructure in public spaces was crucial to facilitate breastfeeding practices. &ldquo;The tragedy is that there aren&rsquo;t even proper female washrooms in many areas of major cities let alone breastfeeding rooms. Women&#39;s issues are continuously ignored in our cities, and a lack of such basic facilities causes significant stress to women,&rdquo; noted Dr Hashmi.

Considering the lack of nursing spaces in institutions and public areas, pumping could be a good option for mothers wishing to avoid formula milk when breastfeeding is not feasible. However, in Pakistan, the high cost of breast pumps, which are available at prices between Rs12,000 to Rs35,000, and the lack of accessibility for lactation support make formula milk the more convenient option.

Sindh government spokesperson and member of the provincial assembly, Sadia Javed conceded that breastfeeding facilities were not available in Karachi however, the government was making efforts in this regard. &quot;The Karachi Terminal has been built on the superhighway, where facilities have been provided for women, while seven major bus terminals are also being built in Sindh as part of the 2025-26 budget. Under these projects, rest areas, waiting areas, and breastfeeding facilities will be established for women. The private sector is also being included in these initiatives,&rdquo; claimed Javed.

Ms Zainab Naveed, an officer at the Women Development Department, stated that institutions applying for funding were provided financial assistance by the government to build the necessary daycare infrastructure. &ldquo;Three categories are defined based on the number of children, and guidelines have been issued on providing the required facilities. Office employees and security arrangements are also part of the setup,&rdquo; said Naveed.

Director Nutrition Khyber-Pakhtunkhwa Fazal Majeed revealed that the K-P government had established 22 daycare centres and breastfeeding corners across universities and hospitals. &ldquo;Under the Khyber-Pakhtunkhwa Protection of Breast-Feeding and Child Nutrition Act 2015, it is mandatory to establish separate breastfeeding spaces for mothers in public places across the province,&quot; said Majeed.]]>
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			<title>Transplanting hope: organ donation still a distant dream</title>
			<link>https://tribune.com.pk/story/2558092/transplanting-hope-organ-donation-still-a-distant-dream</link>
			<comments>https://tribune.com.pk/story/2558092/transplanting-hope-organ-donation-still-a-distant-dream#comments</comments>
			<pubDate>Sun, 27 Jul 25 05:25:34 +0500</pubDate>
			<dc:creator>
				<![CDATA[Tufail Ahmed]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2558092</guid>
			<description>
				<![CDATA[With low public awareness &amp; meagre facilities, patients with organ failure have dimmed hopes of survival]]>
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				<![CDATA[It is often said that the end of one thing is just the beginning of another. For one family bidding farewell to a deceased child and multiple others praying for the survival of an ailing loved one, organ donation can be the delicate thread tying together the distant trajectories of death and life.

In a heart wrenching yet inspiring story emerging from Khyber-Pakhtunkhwa, a 15-year-old boy from Rustam, Mardan became a symbol of hope and humanity after his untimely death. Jawad Khan, critically injured in a road accident, was declared brain-dead days after battling for his life. Jawad&rsquo;s family decided to donate his organs. The boy&#39;s liver, kidneys, eyes, and other organs were transplanted into five critically ill patients, each of whom was given a second chance at life.

&ldquo;I now feel proud beyond words. My son gave life to five others. This was his final gift to the world. I hope more families will consider donating organs in such circumstances. This is an act of divine compassion,&rdquo; said his father. Jawad&rsquo;s uncle, Farhad, echoed a similar sentiment. &ldquo;I am proud to be Jawad&rsquo;s uncle. He is now a role model for many others. His short life has left a long-lasting legacy,&rdquo; he said.

Dr Izharullah, who was part of the surgical team, emphasized how critical the family&rsquo;s cooperation was during such an emotionally charged time. &ldquo;It wasn&rsquo;t easy, but the courage and conviction of Jawad&rsquo;s family inspired us all. In our society, organ donation awareness is very limited. But stories like Jawad&rsquo;s can help change that. Nearly 70 per cent of patients who die waiting for organs could be saved if organ donation was more widely accepted and practiced in Pakistan,&rdquo; opined Dr Izharullah.

Jawad&rsquo;s story has already sparked a movement. Health Minister Ehtesham Ali told The Express Tribune that Jawad was the first minor in K-P to donate multiple organs after being declared brain dead. &ldquo;Jawad Khan is no longer among us, but he has written his name in the history of our province with golden words. The Institute of Kidney Diseases Peshawar would be renamed after him. Additionally, the hospital in Rustam, Jawad&rsquo;s hometown, will be upgraded to a Category-C facility as a tribute,&rdquo; claimed Ali.

In a region often overshadowed by conflict and crisis, Jawad Khan&rsquo;s story shines as a beacon of humanity, empathy, and hope. However, this is the only posthumous organ donation case reported from K-P, where despite the stablishment of an Organ Transplant Authority, awareness about organ donation remains limited among the general public.

According to a report published by the Khyber-Pakhtunkhwa Organ Authority, around 300 organ transplant cases have been recorded in the province so far, including liver, kidney, and corneal transplants. The Chairman of the Khyber Pakhtunkhwa Medical Transplant Regulatory Authority (MTRA) stated that while approximately 1,800 renal (kidney) transplants have been carried out across Pakistan, the actual demand stands at nearly 10,000 cases.

&ldquo;Countries like India, Sri Lanka, Bangladesh, and various European nations have developed a strong culture of organ donation, whereas in Pakistan, a lack of awareness leads not only to high treatment costs but also to an avoidable loss of precious lives. If more people were aware, many lives could be saved and fewer families would be burdened with the cost of expensive transplants,&rdquo; said the official.

Earlier, in March 2024, the family of Uzair Bin Yaseen from Rawalpindi also donated his organs following brain death. Uzair&rsquo;s liver was transplanted to two recipients, his pancreas was given to a diabetic patient while his kidneys and corneas were transplanted to four other patients. This marked the first-ever pancreas transplant in Pakistan, saving a total of seven lives and demonstrating the life-saving potential of organ donation.

The Human Organ Transplant Authority (HOTA) was established at the federal level to regulate all transplant-related matters. Similarly, provincial authorities such as the Punjab Human Organ Transplant Authority (PHOTA) and Sindh Organ Transplant Authority (SOTA) oversee transplant procedures in their respective provinces. In Sindh, institutions like the Sindh Institute of Urology and Transplantation (SIUT), Dow University of Health Sciences, and Gambat Institute of Medical Sciences offer free kidney, liver, and other organ transplants.

Speaking to The Express Tribune, SIUT surgeon Dr Bakhsh Ali revealed that only four patients at the institute had received kidneys from cadaveric (deceased) donors, with the first transplant performed in January 1995. &ldquo;Organ transplantation and posthumous donation remain significant challenges in Pakistan. No central body in Pakistan maintains official statistics on organ transplants, including kidney donations. SIUT&rsquo;s emergency unit alone sees 20 to 22 kidney failure cases daily, with many patients requiring urgent transplants but receiving only dialysis. Sindh faces multiple challenges when it comes to organ donation. Even though the law permits deceased organ donation, people remain unwilling to register as donors,&rdquo; said Dr Ali.

It is worth noting that kidney transplant is the most common type of organ transplant in Pakistan, primarily conducted with donations from living blood relatives. Liver transplant, being more complex, is performed at a few specialized centers. In 2023, approximately 1,850 to 2,000 organ transplants were performed across Pakistan, including kidney, liver, and corneal (eye) procedures. It is estimated that Pakistan sees around 1,000 kidney and 500 liver transplants annually, though these numbers are unverified due to gaps in reporting and monitoring.

The Transplantation of Human Organs and Tissues Act was enacted in 2010, banning the illegal sale and purchase of human organs. Under this law, only close blood relatives or registered donors were permitted to donate organs. However, as a result of the dearth of legal transplant options, the illegal organ trade has emerged as a serious concern for authorities, who have arrested at least 23 organ traffickers nationwide.

Recent years, however, have seen a significant rise in public awareness as well as more organized efforts at the state level. In Punjab, the government, medical institutions, and relevant regulatory authorities are working together to ensure that patients in urgent need of organs receive timely transplants. The National Database Registration Authority (NADRA) also issues special identification cards to citizens who consent to organ donation.

In February 2025, the Punjab government announced that five types of transplants-liver, kidney, bone marrow, cornea, cochlear implant-would be offered completely free of charge at both public and private hospitals under the supervision of PHOTA. Currently, 400 individuals have registered as organ donors.

Abdur Rahman, a 28-year-old resident of Lahore, registered as an organ donor eighteen months ago. &ldquo;Every part of my body is a gift from God, and if after my death any of my organs can give someone else life and health, that too will be a blessing from God,&quot; said Rahman.

Despite these critical initiatives, Professor Dr Muhammad Amir Zaman Khan, Director General of PHOTA, pointed out the fact that the success of organ transplantation was ultimately contingent upon the timing of the transplant. &ldquo;Liver should be transplanted within 12 to 18 hours, kidney within 24 to 48 hours, heart within 4 to 6 hours, lungs within 6 to 8 hours, pancreas within 12 to 18 hours, and intestines within 8 to 16 hours under expert medical supervision,&rdquo; noted Dr Khan.

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			<title>From crisis to control: Balochistan’s polio breakthrough</title>
			<link>https://tribune.com.pk/story/2558091/from-crisis-to-control-balochistans-polio-breakthrough</link>
			<comments>https://tribune.com.pk/story/2558091/from-crisis-to-control-balochistans-polio-breakthrough#comments</comments>
			<pubDate>Sun, 27 Jul 25 05:23:35 +0500</pubDate>
			<dc:creator>
				<![CDATA[MOHAMMAD ZAFAR BALOCH]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2558091</guid>
			<description>
				<![CDATA[Zero wild virus cases in 2025 mark a hopeful turnaround for the province]]>
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				<![CDATA[Balochistan is witnessing a remarkable turnaround in its battle against poliovirus, with 2025 marking a period of steady progress and renewed hope. Once grappling with some of the country&rsquo;s highest poliovirus transmission rates, the province now shows a significant decline in environmental surveillance positivity and&mdash;most notably&mdash;has not reported a single wild poliovirus case so far this year.

In 2024, Balochistan faced an alarming situation: all 23 of its environmental surveillance (ES) sites tested positive for poliovirus, pushing the provincial positivity rate to 72%. The crisis peaked in September when 95% of samples were positive and five cases of wild poliovirus were confirmed. The Quetta Block, a historically high-risk area, recorded an alarming 98% positivity rate&mdash;sparking serious concern among public health officials.

However, since late 2024, a steady and promising decline has emerged. By June 2025, only 4 out of 23 environmental samples tested positive, reflecting a sharp drop in positivity to 17%. This downward trend is a result of strengthened surveillance, timely interventions, and consistent community engagement, signaling a major shift in the province&rsquo;s epidemiological landscape.

When viewed against the national backdrop, Balochistan&rsquo;s progress stands out. In Sindh, environmental surveillance positivity rose from 70% in 2024 to 84% in 2025, with the Karachi Block still struggling&mdash;reporting 94% positivity this year and 83% in June alone. Khyber Pakhtunkhwa (KP) has reported 22 polio cases in 2024 and 8 more in 2025, mostly concentrated in its southern belt. Sindh has confirmed 4 new cases this year after reporting 23 in 2024, while Punjab and Gilgit-Baltistan have reported one case each.

In contrast, Balochistan&rsquo;s zero-case status in 2025 is a notable public health milestone. Officials attribute this success to an integrated approach combining high-quality immunization campaigns, community trust-building efforts, and the unwavering commitment of health workers, government authorities, and partner organizations.

&ldquo;This progress reflects the resilience and dedication of everyone involved&mdash;from frontline vaccinators to local leaders,&rdquo; said Inamul Haque, Coordinator of the Emergency Operations Center (EOC) Balochistan.

Religious leaders have played a pivotal role, using Friday sermons and local gatherings to encourage vaccination. Media partners have countered misinformation and amplified credible voices, while development agencies have provided technical and logistical support. The provincial government and district administrations have demonstrated strong ownership, ensuring each campaign is thoroughly planned, resourced, and monitored.

Initiatives like the Immunity Express, journalist engagement at the divisional level, community outreach by social mobilizers, and localized engagement activities have played a key role in increasing vaccine acceptance&mdash;especially in historically resistant areas.

&ldquo;Environmental sample positivity is declining&mdash;and that gives us hope,&rdquo; added Inamul Haque. &ldquo;But the virus still lurks. The moment we become complacent, it will strike again.&rdquo;

As Balochistan moves forward, its progress serves as a powerful reminder of what can be achieved through unity, persistence, and public trust.

&nbsp;

Mohammad Zafar Baloch is a freelance journalist based in Quetta

All facts and information are the sole responsibility of the writer

&nbsp;]]>
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			<title>No country for a woman alone</title>
			<link>https://tribune.com.pk/story/2556880/no-country-for-a-woman-alone</link>
			<comments>https://tribune.com.pk/story/2556880/no-country-for-a-woman-alone#comments</comments>
			<pubDate>Sun, 20 Jul 25 07:52:09 +0500</pubDate>
			<dc:creator>
				<![CDATA[Yusra Salim]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2556880</guid>
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				<![CDATA[For many Pakistani women, living alone is a daily tightrope walk between freedom and fear]]>
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				<![CDATA[&ldquo;It was in the early 2000s that my daughter decided to move to the US where her father lived, to finish her high school,&rdquo; recounts Fareeha Mirza*, a teacher in her 50s, her temples graying, her eyes soft brown.

&#39;Life in Karachi was getting stifling for her as a 15-year-old being pestered by her mother to dress according to what area you are in Karachi &mdash; cover up and drape appropriately in varying shades of cultural acceptance and norms that we have created for ourselves in our metropolis.&#39;

&ldquo;When she left, I was left alone in our apartment. My parents lived separately in their apartment not far from our rented 2-bed in an upper middle-class residential building in Clifton. One thing was to miss her, with the depression and loneliness that followed. However, the more difficult part was to create the impression of not living completely alone. A single woman in our society is treated differently from a single woman with a daughter or a single woman with a son, as well as a single woman with a son and daughters. Let&rsquo;s be honest, us Pakistanis are way too judgmental for our own good. We instantly form opinions about others, and mostly they are negative, as we live in our own holier-than-thou bubbles.

&ldquo;Also, let&rsquo;s not pretend that it doesn&rsquo;t matter to those being judged, it certainly does &mdash; the heads being turned around, the nudges, smirks, and stares by women. The lingering looks by single and married men in the neighbourhood, in which case their mothers and sisters want to keep you at a distance, while their wives become insecure and sometimes even look a bit hostile.

I decided to keep a low-profile. The first thing I did was to dress down a bit. Try and deliberately look a little dowdy. Second, I made sure to step out and return home at decent hours. I stopped going to weddings which begin and end late and from where I would have to return home looking like a Christmas tree at late hours. I didn&rsquo;t want to give the wrong impression, everything should be and look kosher.

&ldquo;I used to read the news in those days as a part-time stint and sometimes return home with make up and a jacket on, but stopped doing that also when one neighbourhood gentleman, let&rsquo;s call him Mr Bored-With-His-Marriage, who after politely greeting me when I returned home once, suggested that instead of news reading, I should model! I started to clean my face before I left the studios. Also, I put the jacket in the car on a hanger and draped a dupatta around my collared shirt. Now this to me is the worst form of encroachment on one&rsquo;s personal space. But the average Pakistani doesn&rsquo;t know about its existence.

&ldquo;An electrician who came to the house a few times taught me another lesson. Seeing me alone in the house when he fixed a bulb or board, he actually had the audacity to suggest that some &lsquo;madam&rsquo; whose house he worked in shared her problems with him. So he had become close to her, and I should feel free to do so, if I needed a friend. I was shocked, boiling, enraged, scared, and trembling all at the same time. I got his money out and mustered up the courage to politely tell him to leave whether the work was done or not.

&ldquo;Later I bought a big pair of men&rsquo;s shoes and slippers and kept them prominently visible in the house before any repairman arrived. I also learned that with dry cleaners etc where they need receipt on names, one must always brazenly declare that you are a &ldquo;Mrs&rdquo; and then give them a man&rsquo;s name, never your own, or they tend to get fresh, quite unnecessarily.

&ldquo;After many of years of calculated living, it so happened that I began to take care of a little boy from a humble family. It was an impulsive decision but worked wonders for both of us. I pay for his education and grooming expenses. I am like a foster parent to him but he goes home every evening after spending the day with me, doing homework, watching TV or playing in the house or outside with the building kids. This has been my life for the past seven years, in which both our lives have transformed. While he is on the fast track to becoming the first educated person in his family, I live alone yet I don&rsquo;t feel depressed, bored or lonely. The biggest thing to happen in my life is that the acceptance level in my current building is of a family. I am respected, accepted and treated like a family or to be more precise, a woman with a family. There is a mountain of difference compared to me living alone and now with this little boy always being with me. It is hard to explain the difference in people&rsquo;s attitudes and what I feel. But there it is and it is real. I am now seen and I am heard respectably. Even though I have basically remained the same person through the years, the presence of a little boy with me has changed how people see me in their warped heads. When I am visiting my daughter and people don&rsquo;t see me around in the parking lot, they call up and ask where and how I am, and this is not a development post the sad demise of Humera Asghar Ali. In conclusion, I would say who knows what pressures she had, what kind of rejections and exceptions she went through while looking for acceptance as an actor, a woman and a person. May she rest in peace.&rdquo;

Fareeha&rsquo;s story is a deeply personal narrative of a single woman in Karachi struggling through the Pakistani society by living alone since the early 2000s. It chronicles the daily challenges she tackled to avoid judgment, harassment, and isolation &mdash; from altering her wardrobe to fabricating the presence of a man in the house. It ends with a poignant reflection on how the mere presence of a foster child changed her social acceptability, highlighting the disturbing reality that women are only respected when tethered to a &quot;family.&quot;

While Fareeha&rsquo;s is just one voice, there are countless others echoing the same struggles. Take Areeba Khalid, for instance &mdash; 27-year-old software engineer who moved to Karachi from Multan for a well-paying job opportunity. She envisioned freedom, growth, and a life built on her terms. Instead, she found herself drawing curtains too early, whispering on phone calls, and hesitating before inviting a female friend over, fearing the neighbours&rsquo; gaze or worse, the landlord&rsquo;s wrath. Living alone, it turned out, came at a price to her peace of mind.

Across Pakistan, many women who choose to live alone, whether for work, education, or independence, face an unspoken resistance. These women are not just fighting for their careers or dreams; they are silently fighting to exist in spaces not designed to accept them as independent individuals. They are questioned, judged, and often harassed.



Judged for choosing independence

In a deeply patriarchal society, a woman living on her own is often seen as a deviation from societal norms. While men are presumed to be independent, women who break the family-centric living arrangement are met with suspicion.

The questions come in quickly, and they are mostly personal such as, &ldquo;Where is your family?&rdquo;, &ldquo;Why aren&rsquo;t you married?&rdquo;, &ldquo;Are you divorced?&rdquo;, &ldquo;Do you bring men over?&rdquo;, &ldquo;Why do you work late?&rdquo;, &ldquo;Are you even respectable?&rdquo;

These interrogations don&rsquo;t just come from curious neighbours but often from landlords, security guards, shopkeepers, and sometimes, even coworkers. &ldquo;My landlord made it a point to ask if I have male visitors,&rdquo; says Khalid. &ldquo;He had no such rules for the male tenant living upstairs.&rdquo;

The constant policing isn&rsquo;t always verbal. It manifests through silent surveillance CCTV cameras mysteriously pointed toward their apartment doors, unannounced visits by building watchmen, or even neighbours reporting them for suspicious behaviour, which often means coming home late or not dressing appropriately.

&ldquo;Women mostly don&rsquo;t interact with people in the building they live in because they get all kinds of judgment. In the building I am living in right now, I don&rsquo;t talk to anyone. Still, one of the uncles, whose children are also married, tried to be friends with me because, for him, if I live alone, then I am available for casual relationships,&rdquo; said Laraib Ahmed, who lives in Lahore due to work commitments. She also explained how when she was on a house hunt, an aunty asked her to submit pictures of her father and brother, and also if she had a boyfriend, a picture of him as well, and other than them, no man would be allowed to come and visit her.

The lonely death

In a chilling incident that shook the country, Humaira Asghar, who was found dead in her apartment months after she had passed away. Humaira lived alone and, according to neighbours, &ldquo;kept to herself.&rdquo; She didn&rsquo;t interact much, didn&rsquo;t share her personal life, and avoided socialising with other tenants, perhaps a survival mechanism in a culture that quickly labels and punishes women for being &ldquo;too visible.&rdquo;

Her death raised disturbing questions, Why didn&rsquo;t anyone check on her sooner? Was her isolation a choice or a necessity? Would her life or death have been any different if society were more accepting of single women?

There was no official foul play reported, but what remained clear was the devastating loneliness many women like Humaira experience when choosing independence.

Harassment under curiosity

The most dangerous repercussion of this scrutiny is the vulnerability to harassment. Men, whether neighbours or strangers, often assume a woman living alone is &ldquo;available,&rdquo; or worse, morally lax. This misperception is not just offensive, it&rsquo;s dangerous.

Women have reported unsolicited advances from neighbours, landlords entering without permission, and stalkers tailing them from work to home. &ldquo;I had a man in the apartment opposite mine stare at my door for weeks,&rdquo; shares Shanzay, a university student in Lahore. &ldquo;One day, he slipped a note under my door asking if I needed company.&rdquo;

The ordeal doesn&rsquo;t just end with the house hunt, but managing other things too, such as any maintenance work, is another hassle. &ldquo;When you live alone for any reason, people such as plumbers or electricians judge your character. If they come, I dress appropriately so they don&rsquo;t think they have a chance and similarly I was keeping myself very harsh with other tenants specially male bachelors so that they don&rsquo;t try to be friends,&rdquo; shares Ahmed.

In 2024, a case in Karachi&rsquo;s Gulistan-e-Jauhar surfaced on social media where a woman living alone called the police after her landlord barged into her flat, citing a &quot;gas leak emergency&quot; as an excuse. He was later found to have been harassing her for months.

The incident ignited a brief online conversation around women&rsquo;s safety, but like most digital outrage, it fizzled out without structural reforms.

For women living solo, the home should be a sanctuary. Instead, it becomes a fortress they constantly have to protect. They double-check locks, avoid taking cabs at night, install peephole cameras, and often lie about not living alone, saying a brother or father stays with them to avoid predatory intentions.

Security concerns also influence every aspect of women&rsquo;s daily routines, such as avoiding ordering food at odd hours, fearing that delivery boys might judge or stalk them later. They hesitate to post anything personal on social media that could hint at their residential status. They avoid friendly conversations with male neighbours, lest it be misconstrued. &ldquo;I never tell any colleague or even male friend that I live alone, I always tell them that I have a flat-mate,&rdquo; shared Kiran Butt, who has been living in Islamabad for the last four years. She also pointed out that all of this culminates in a state of hypervigilance where she uses CCTV, does not share addresses, gives false information about flat-mates, and does not go to any colleague&rsquo;s house as she might have to invite them over next.

Landlords and the housing dilemma 

Many single women find it nearly impossible to rent homes or apartments on their own. They are turned down by conservative landlords who don&rsquo;t want trouble in their buildings. &ldquo;Every time I called a property agent and said I am unmarried and living alone, they&rsquo;d hang up or say the flat is not available anymore,&rdquo; says Sana, a 34-year-old who lives alone in Karachi. &ldquo;I don&rsquo;t understand the idea that why do we have to explain anyone that we need an apartment and who will be living with us? Their main concern should be bills and rent paid on time but people have no boundaries and try to intervene in matters that doesn&rsquo;t concern them, such as why aren&rsquo;t we married yet, why we are not living with parents or why we are coming to another city to work,&rdquo; Sana laments.

Even hostels or women&rsquo;s housing facilities aren&rsquo;t safe havens. Many enforce outdated moral codes, curfews, visitor bans, or even prayer-monitoring imposing layers of patriarchal control in the name of safety.

The irony is that it is not limited to only single young women but also make women who are single mothers suffer, as in the case of 45-year-old Amber Saba. When she meets landlords along with her 23-year-old son, they ask her all type of questions such as where is her husband, is she a widow or divorced and what were the reasons for her divorce or even to the extent that who will be visiting her if she lives here and how many siblings she has. &ldquo;I don&rsquo;t get it, what does the landlady have to do with the number of my siblings,&rdquo; she says. &ldquo;Despite my young son, she was adamant to know about my marital problems with my husband.&rdquo;

Saba, who is a mother of four, isn&rsquo;t considered a family because her husband has divorced her, and she usually has to pay extra rent for places that are given at lower prices to other families, but just because she is a single mother, many landlords exploit her. &ldquo;While my divorce case was in the court, my landlady kept on asking all kinds of questions as to why I didn&rsquo;t reconcile or why the police keeps coming to investigate or why I have not gone to my parents house, to me all these are very personal questions but for her it was like she is being concerned about me as an elder,&rdquo; Saba shares adding that in our society many people keep crossing boundaries out of concern and for being an elderly figure.

Beyond the logistical and safety challenges lies a psychological war that single women must endure. Living alone in a community-driven culture often isolates them. While male tenants or bachelors are seen as independent or even charming, women are often branded as rebellious, promiscuous, or &ldquo;westernised.&rdquo;

Rumours spread fast in residential buildings. A woman returning late from work becomes an subject of gossip. Any male friend or relative visiting her becomes &ldquo;evidence&rdquo; of moral laxity. Many women prefer avoiding interactions altogether, like Humaira and Ayesha did, not out of arrogance, but self-preservation.

The psychological toll on women living alone is rarely addressed. Constant surveillance, fear, and judgment can lead to anxiety, depression, and severe loneliness. The lack of emotional support, especially when families disapprove of their decision to live independently, only compounds the problem.

Therapists confirm that a growing number of young, single women reach out for counselling due to issues rooted in societal rejection and constant fear.

What needs to change

There is no singular solution to this multi-layered problem, but there are several ways forward, such as legal protections and housing rights where laws should be implemented (and enforced) to prevent gender-based housing discrimination. Rent agreements should protect tenants specially women, from illegal entry and harassment by landlords. Harassment by neighbours or strangers must be treated with urgency. Reporting mechanisms should be simple, accessible, and effective. Police training on gender sensitivity is crucial. Public awareness campaigns can help dismantle harmful stereotypes about single women. Promoting narratives of successful, independent women can and normalise their choices.

Other than these major aspects, steps that can be done on an individual level such as women-led community groups, can be a lifeline. Whether through safe WhatsApp groups, co-living spaces with vetted security, or mental health circles, having a community to fall back on makes a difference. Also, employers should offer flexibility to reduce commuting risks, especially for night shifts or extended hours. Housing stipends or safe residence options can also be introduced for female employees.

The decision to live alone should be as unremarkable as choosing a career path or selecting a university. Yet, for women in Pakistan, it is treated as an act of rebellion, met not with support, but suspicion.

The broader implications of these safety concerns extend beyond individual discomfort; they affect women&rsquo;s access to employment, education, mental health, and overall autonomy. When a woman feels unsafe in her own home, harassed by landlords, judged by neighbours, or policed by society, she is being denied one of her most basic rights: the right to exist in peace.

Women often restrict their mobility, limit social interactions, and adapt their behaviour not out of preference, but necessity. This self-censorship is not empowerment it is silent survival. And it reflects how we have collectively failed to make cities livable for half the population.

Policy-level interventions are overdue. There must be legal frameworks that prohibit housing discrimination based on gender or marital status.

Police reforms are equally important. Many women do not report harassment or stalking due to fear of being blamed or not being taken seriously. We need trained, gender-sensitive officers, preferably women-led units, who understand the nuances of safety concerns without moral policing.

At the urban planning level, safety audits of neighbourhoods, improved street lighting, security infrastructure, and women-only complaint desks in residential associations can make a real difference. City governments must collaborate with civil society to create mechanisms for women to report incidents confidentially and access immediate support.

Changing the societal lens

But perhaps the hardest and most crucial transformation must occur in our social attitudes. Living alone is not a moral statement it is a logistical, financial, or personal decision. Media and educational institutions have a powerful role to play in reshaping this narrative. Positive representation of single women in dramas, films, and public campaigns can challenge outdated stereotypes. Community awareness drives in urban neighborhoods can help normalise women&#39;s independent living and encourage bystander support in case of harassment.

In a just society, no woman should fear judgment or harm for the simple act of living on her own. Until we ensure her safety and dignity, we are all complicit in reinforcing the walls she must build around herself.

At its core, the issue is not just about living arrangements it is about autonomy. A woman choosing to live alone is asserting that she can navigate life without constant guardianship. For some, it is a necessity; for others, a choice. Either way, society needs to catch up with the fact that women are not vessels of family honour but individuals with full agency.

Until then, every woman living solo is waging a quiet war &mdash; a war not just for personal space, but for societal acceptance.

Women living alone in Pakistan today are not anomalies; they are trailblazers. Their solitude isn&rsquo;t a rebellion; it&rsquo;s resilience. While society may still view them with suspicion, their presence in urban and even semi-urban landscapes is growing. The need of the hour is not to question why women live alone, but to ask why, in 2025, they still have to justify it.

*Names have been changed to ensure privacy]]>
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			<title>Why some women want to die every month</title>
			<link>https://tribune.com.pk/story/2554442/unseen-misunderstood-suicidal</link>
			<comments>https://tribune.com.pk/story/2554442/unseen-misunderstood-suicidal#comments</comments>
			<pubDate>Sun, 06 Jul 25 05:28:23 +0500</pubDate>
			<dc:creator>
				<![CDATA[Makeisha Mirza]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2554442</guid>
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				<![CDATA[PMDD isn’t bad PMS — it’s a severe, cyclical mood disorder that hijacks the brain and raises suicide risk sevenfold]]>
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				<![CDATA[On paper, M* is living the life. She has a job she likes as a biomedical scientist and research fellow in women&rsquo;s health. She has found her purpose: working to improve the lives of women with chronic health conditions through her FemTech start-up. So why does she want to kill herself every month?

What is PMDD?

M suffers from PMDD, Premenstrual Dysphoric Disorder, a much more severe form of PMS, premenstrual syndrome. According to Dr. Benicio Frey, a psychiatrist at the Women&#39;s Health Concerns Clinic at St. Joseph&#39;s Healthcare in Hamilton, Canada, both PMS and PMDD are recognised through mental and physical symptoms in the preceding 1-2 weeks before menstruation, in what is called the luteal phase. The mental symptoms may include emotional sensitivity, depression, anxiety, feeling overwhelmed, difficulty paying attention, memory issues and irritability, while the physical symptoms may include breast tenderness, cramps, bloating, fatigue, increased appetite for carbs, changes in sleep, and changes in appetite.

&ldquo;Both PMDD and PMS affect the quality of life, but PMDD brings the patient to the hospital,&rdquo; says Dr. Anum Aziz, an Obstetrician-Gynecologist at Agha Khan University Hospital in Karachi.

PMDD has symptoms that &ldquo;are severe enough to cause patients difficulty functioning in their daily life, whether it&#39;s work, relationships, family dynamics, and so forth,&rdquo; adds Dr. Frey. Another relatively common symptom of PMDD is suicidal ideation/thoughts that may lead to suicide attempts.

&ldquo;PMDD is a different beast from PMS. It&rsquo;s a severe, disabling mood disorder linked to your cycle. We&rsquo;re talking panic attacks, rage, crushing sadness, suicidal thoughts, and full-body dysregulation. It&#39;s not bad PMS. It&rsquo;s a hormonal hijacking of your brain chemistry,&rdquo; says BACP-certified psychotherapist Shifa Lodhi.

PMDD affects around 3% of the population. &ldquo;3% is pretty significant if you think about it from a population perspective. Schizophrenia affects 1% of the population, it&#39;s a big deal. OCD affects 2% of the population, it&#39;s a big deal. Bipolar type 1 affects 1% of the population, it&#39;s a big deal. So, 3% of PMDD is equally a big deal,&rdquo; Dr. Frey says.

What causes PMDD?

Unlike other mental health conditions and mood disorders where the cause is often not easily pinpointed, researchers and doctors have been able to identify the cause of PMDD: the brain&rsquo;s sensitivity to hormonal changes. &ldquo;It is the estrogen hormone, which when deficient leads to irritability, and progesterone, if it is in abundant range, leads to emotional unwellness,&rdquo; says Dr. Aziz.

&ldquo;It&#39;s not the hormone itself, it&#39;s the fluctuation from low to high, and sometimes from high to low, that really triggers the brain to respond with symptoms,&rdquo; Dr. Frey elaborates. Those with PMDD have brains that are more sensitive to this change than those with just PMS or neither.

&ldquo;When progesterone drops, serotonin does too, especially in PMDD. That disrupts the brain&rsquo;s ability to regulate distress. Cortisol may also spike, adding panic and anxiety. You end up with a chemical cocktail of despair, rage, and hopelessness,&rdquo; adds Shifa.

There are also pre-existing conditions that make people at a higher risk for PMDD. &ldquo;There&#39;s a high prevalence of other comorbid psychiatric conditions, especially PTSD and mood disorders. So someone suffering from PMDD, just about half of them, at least, have another psychiatric condition,&rdquo; says Dr. Frey.

&ldquo;People often come with the problems of menstrual irregularities. So, that brings them to the hospital and then we diagnose them to have PMDD or PMS. PCOS, polycystic ovarian syndrome, is mostly related, as well as obesity, menstrual irregularities, and subfertility,&rdquo; adds Dr. Aziz.

Depression, anxiety, ADHD, generational trauma history, and thyroid disorders also make PMDD more likely, according to Shifa. &ldquo;Think of PMDD as an amplifier for what&rsquo;s already underneath. It doesn&rsquo;t create the wound, but it rips off the scab,&rdquo; she says.

L*, a 44-year-old educator from Lahore with PMDD and complex PTSD adds to this, saying, &ldquo;a lot of these diseases are definitely connected to traumas, especially childhood traumas. I&#39;ve grown up in a very dysfunctional household. My dad was an alcoholic, with some serious mental health issues. My mom is sort of not emotionally there or available at all. So, wanting to disappear, wanting to kill myself, the ideation started pretty young and then there were attempts which usually had to do with my dad.&rdquo;

How can it make one suicidal?

People with PMDD are almost seven times at higher risk of suicide attempt and almost four times as likely to exhibit suicidal ideation. The hormonal fluctuations that come with PMDD can cause patients to become so depressed and fatigued they become suicidal. &ldquo;In many people, this is the only time in their lives that they feel suicidal. They don&#39;t feel suicidal outside of the premenstrual phase,&rdquo; says Dr. Frey, cementing just how alarming this condition sometimes is. He has had some patients who needed to stay at the hospital for a few days before their period because they felt unsafe during this time.

&ldquo;For many, it feels like their personality changes. The intrusive thoughts get louder. Hope disappears. The person doesn&rsquo;t want to die, they just want the suffering to stop. But at that moment, it&rsquo;s hard to tell the difference and many women can&rsquo;t,&rdquo; says Shifa. &ldquo;I think I&rsquo;m a monster for 10 days every month. I cry, scream, there have been instances I lashed out at my husband and children and then fantasized about ending it all. Then my period comes, and I&rsquo;m okay again but ashamed,&rdquo; one patient told Shifa. Another patient&rsquo;s mood swings and sudden suicidal thoughts were so extreme she thought she had bipolar disorder.

&ldquo;The pain would become unbearable, sometimes so intense that I couldn&rsquo;t get out of bed without help. I would feel completely drained and immobilised, both physically and mentally. It felt like I was losing control of myself for two weeks out of every month,&rdquo; says M.

M* also struggles with other chronic conditions such as chronic fatigue syndrome and fibromyalgia. These conditions feed into her PMDD and vice versa. &ldquo;Each condition flares at the same time or triggers the others, creating layers of pain, fatigue, and neurological disruption that feel inescapable. The physical suffering fuels emotional distress, and the emotional distress makes it even harder to cope physically. It&rsquo;s relentless, month after month, with no real break in between,&rdquo; she says.

&ldquo;The suicidal ideation doesn&rsquo;t stem from a desire to die, but rather from a desperate need for the pain, physical, emotional, existential, to stop. In the darkest moments, it feels like I am drowning in something invisible and inescapable, and that there&rsquo;s no lifeline in sight,&rdquo; says M.

Perhaps the most impacted area of life for those suffering from PMDD is their social life. &ldquo;The relationships are mostly affected and people are affected by the irritability of that person,&rdquo; says Dr. Aziz.

&ldquo;I&rsquo;ve lost friendships and relationships because of this condition. People often don&rsquo;t understand, or they grow tired of the inconsistency and unpredictability of my health. Being left behind or misunderstood by people I love has added another layer of grief and loneliness, fuelling further depression and anxiety,&rdquo; says M.

L adds to this, talking about how her PMDD has affected her relationship with her partner. &ldquo;I might start snapping and yelling at him. I got my period yesterday and the day before yesterday, everything he was doing was getting on my nerves. So my patience level gets really low. I want to cry and I want to just disappear,&rdquo; she says.

PMDD can also aggravate other pre-existing mental illnesses or traumas to make the patient suicidal. &ldquo;Quite often the premenstrual period is a period of exacerbation of other psychiatric conditions as well. So the hormonal sensitivity may play a role worsening whatever else someone might be suffering from,&rdquo; says Dr. Frey.

For M this looked like worse mental symptoms following her father&rsquo;s death and for one of Dr. Aziz&rsquo;s patients, it looked like needing to be admitted into the psychiatric ward after being on the verge of killing herself because of bullying. L&rsquo;s symptoms also worsened after her father&rsquo;s death, along with perimenopause, leading to her not having her period at all for 2 months.

How can PMDD be treated?

Despite the severity of PMDD, all is not lost. Since we know the exact cause of the disorder, PMDD can be treated.

The first step is diagnosis. &ldquo;The diagnosis requires a two-menstrual cycle daily symptom charting for us to be really accurate about the validity of the diagnosis of PMDD. So, people need to track their symptoms daily for two months and bring that information to the clinician so we can confirm that it is a case of PMDD,&rdquo; says Dr. Frey. Then the patient&rsquo;s mental symptoms can be tracked on the DSM scale, a manual used by mental health professionals to diagnose mental conditions and disorders, according to Dr. Aziz.

Once a diagnosis has been secured, treatment can begin. There are several methods of treating PMDD. &ldquo;First line treatments tend to be serotonin-based antidepressants.Then the hormonal treatments, like oral contraceptives, are second-line treatment,&rdquo; says Dr. Frey. &ldquo;If they cannot use hormones and antidepressants also didn&#39;t work, there is a natural compound, a berry called Chasteberry or Vitex, which has been shown in some meta-analysis to help people with particularly milder forms of PMDD or PMS,&rdquo; he adds.

&ldquo;We should not be treating just their physical symptoms. The focus should be on mental well-being, as well as their lifestyle choices,&rdquo; says Dr. Aziz, advocating for a more multi-faceted approach in PMDD treatment. Shifa suggests talk therapy and CBT, while M advocates for making more compassionate and thorough mental health resources that focus on hormonal disorders readily available.

&ldquo;First of all, there&#39;s very few trauma-informed therapists. Secondly, there are next to none trauma-informed gynecologists. In all of Pakistan, I found one,&rdquo; adds L.

&ldquo;Healthcare systems should also integrate holistic care models that consider the interplay of PMDD with other chronic conditions, such as endometriosis or fibromyalgia, rather than treating symptoms in isolation,&rdquo; says M.

&ldquo;Some choose to suppress ovulation entirely. In extreme cases, even hysterectomy is considered. It&rsquo;s that serious,&rdquo; says Shifa, highlighting the severity of the condition.

Why have you not heard about this?

If PMDD is such a big deal, why have you not heard about it and its link to suicidal ideation? The answer is simple: our society deems both women&rsquo;s bodies and mental health too taboo to talk about.

A prime example of how women&rsquo;s bodies are often overlooked in the medical and scientific field is how painkillers are less effective on women because the majority of them are tested only on men. &ldquo;Science was built for men, by men. For centuries, female bodies were considered too complicated to study. Female hormone cycles were excluded from research to avoid data variability. It&rsquo;s sexist, lazy science,&rdquo; says Shifa.

Shifa also talks about how women&rsquo;s bodies themselves are often considered too &lsquo;vulgar&rsquo; to talk about in Pakistan, even if just natural processes like menstruation are being discussed. &ldquo;Sadly, we live in a society which in some sectors doesn&rsquo;t even acknowledge that women have periods,&rdquo; she says, &ldquo;We don&#39;t talk about periods, pain, or mental health. Patriarchy wants women to be strong but not too emotional. It&rsquo;s also tied to control, silencing women&rsquo;s experiences keeps them manageable.&rdquo;

&ldquo;Women&#39;s health, including women&#39;s mental health, has been largely dismissed, neglected and minimized throughout the years,&rdquo; says Dr. Frey. &ldquo;The PMDD and suicidal ideation connection isn&rsquo;t mainstream knowledge partly because many doctors aren&rsquo;t trained to spot it, and partly because women are taught to downplay their pain,&rdquo; adds Shifa.

Dr. Aziz talks about how often when she brings up psychiatric help to her patients, their families refuse the idea because of how controversial the topic is in Pakistan. &ldquo;They have to plan for their marriage. And if their in-laws or proposed in-laws know that the patient is visiting the psychiatrist, there would be a threat to her future life. They would rather go to some spiritual hakim instead of going to a proper psychiatrist,&rdquo; she says.

L elaborates on this saying that she is reluctant to voice her suicidal thoughts out of fear of people taking advantage of her mental state rather than understanding it. She also expressed how rather than viewing suicidal ideation as a mental health crisis, people in Pakistan often view it as a &ldquo;comment on one&rsquo;s character being bad.&rdquo;

In fact, this is also the reason PMDD is underdiagnosed, which then feeds back into the cycle of lack of awareness about it since many people don&rsquo;t know they have it to begin with.&ldquo;It&#39;s because PMDD and even women&#39;s mental health in general is not a core part of the educational curriculum in training health professionals. if we don&#39;t train professionals on assessment and diagnosis and treatment, you know, what can they do when they see people with PMDD?,&rdquo; says Dr. Frey.

&ldquo;I did notice it in my 20s but there was no validation for it until my 40s. So I would say I did notice it pretty young but at the time there was no talk of PMDD. It didn&#39;t exist technically back then, this idea that women are emotional, and they are just crazy, especially around their period. I felt like I was constantly fighting that. So I didn&#39;t pay attention to my own PMS because I felt that that would do a disservice to women in the world,&rdquo; adds L.

&ldquo;The diagnosis of PMDD is DSM-5 scale-based diagnosis. Physicians do not use this scale as it is mostly used by the psychiatrist or a specialist. So, it is not well diagnosed,&rdquo; adds Dr. Aziz.

This lack of awareness in doctors often leads to them misdiagnosing patients, undermining them and simply refusing to hear them out. &ldquo;I believe doctors need to have good bedside manners, to be empathetic, compassionate, and truly listen to their patients instead of dismissing their experiences or approaching medical care with a god syndrome attitude,&rdquo; says M. L agrees with the notion that Pakistani doctors&rsquo; bedside manner needs improvement, saying, &ldquo;our doctors really are not good with that.&rdquo;

Raising awareness 

So now that you know about PMDD, what should you do? &ldquo;Normalize it. De-shame it. And create spaces where people can say, &lsquo;I think I have PMDD&rsquo; without being dismissed,&rdquo; says Shifa. She emphasizes the need for government and private companies to play their part as well as social media in destigmatising menstrual health.

M seconds this, saying &ldquo;building a strong support network of understanding friends, family, and healthcare professionals has been crucial. I also use my platform on social media to share my experience, which not only helps me process my feelings but also connects me with others going through similar challenges.&rdquo; &ldquo;Advocating for myself and connecting with others who understand what I&rsquo;m going through has been empowering,&rdquo; she adds.

Dr. Frey backs this, further emphasizing the need for community when dealing with PMDD. &ldquo;I would also recommend they be linked to support groups like IAPMD and PMDD Canada, these are open to international people.They have peer support, educational programs, tons of reliable information people can get about their premenstrual disorders and get help and support,&rdquo; he says.

&ldquo;Greater awareness and education are crucial, both among healthcare professionals and the general public. Many people, including doctors, still underestimate how severe and disabling PMDD can be, which leads to delayed diagnosis and inadequate support,&rdquo; says M. &ldquo;If there had been more awareness and honest conversations when I first started experiencing symptoms, I might have felt less isolated and more empowered to seek help sooner,&rdquo; she adds.

&ldquo;I think if therapists sort of take a lead and say that this is a real thing, and there&#39;s solutions for it, and it can happen to a lot of people. It&#39;ll be up to the psychologists or therapists to put out videos, explainers, things like that, that have outreach, especially for our population,&rdquo; says L.

Pakistan is a country where the entire reproductive chapter is often ripped out of school books or simply skipped. This has a long lasting impact on how ill-informed the general public is on life altering and saving information about their bodies. Dr. Aziz brings up how menstrual and mental health should be topics that are covered in school curriculums. She adds that doctors like herself are willing to hold information sessions in schools if teachers are unable or unwilling to teach about this necessary topic.

It is also important to remember that just because the emotional symptoms and suicidal ideation caused by PMDD are a result of a hormonal imbalance, they are not any less valid and acting like they are can have a further detrimental effect on patient&rsquo;s mental health.

&ldquo;Because it&rsquo;s connected to menstruation, there&rsquo;s often a tendency for others, sometimes even healthcare professionals, to minimize or dismiss the emotional pain as &ldquo;just hormones&rdquo; or typical PMS. This can make the pain feel misunderstood or invalidated, which is incredibly frustrating when the symptoms are so severe and disabling. So, while the link to the menstrual cycle brings clarity for me, it doesn&rsquo;t always translate into better understanding or empathy from others,&rdquo; says M.

&ldquo;For those who don&rsquo;t get it: believe her. Don&rsquo;t gaslight or joke about &lsquo;that time of the month.&rsquo; This is serious, and your empathy might just be her lifeline,&rdquo; adds Shifa.

This increased awareness can help lead to a diagnosis which in turn validates people&rsquo;s struggles and helps them prepare for their symptoms. &ldquo;Getting a name for what I was experiencing was both a relief and a wake-up call; it validated my pain and gave me the motivation to seek proper support,&rdquo; says M.

Getting a diagnosis can also help people with PMDD explain their symptoms to loved ones and be understood. &ldquo;People around me have also understood it a lot better including the boomer lot, like my parents. By the end of his life, with my diagnosis, my dad would just flat out say, you&#39;re about to get your period, like, is this the situation? My mother&#39;s even become aware of it,&rdquo; says L.

&ldquo;If people knew suicidal thoughts were hormonally driven and treatable, they&rsquo;d get help instead of feeling broken. Awareness doesn&rsquo;t just validate Pakistani women&rsquo;s experience, it saves lives,&rdquo; Shifa concludes.

&nbsp;

*Names changed to preserve privacy]]>
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			<title>Weight-loss drugs may lower oral contraceptive effectiveness.: UK's MHRA</title>
			<link>https://tribune.com.pk/story/2549645/weight-loss-drugs-may-lower-oral-contraceptive-effectiveness-uks-mhra-warns</link>
			<comments>https://tribune.com.pk/story/2549645/weight-loss-drugs-may-lower-oral-contraceptive-effectiveness-uks-mhra-warns#comments</comments>
			<pubDate>Thu, 05 Jun 25 11:13:05 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2549645</guid>
			<description>
				<![CDATA[Alert follows 40 reports of pregnancy in women taking these weight-loss drugs such as Ozempic, Wegovy, and Mounjaro]]>
			</description>
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				<![CDATA[The UK&rsquo;s Medicines and Healthcare products Regulatory Agency (MHRA) has issued an alert urging women using weight-loss medications such as Ozempic, Wegovy, and Mounjaro to use effective contraception after receiving multiple reports of pregnancies among users, The Guardian reported on June 5, 2025.

The alert follows 40 reports of pregnancy in women taking these weight-loss drugs, prompting the MHRA to warn that Mounjaro, in particular, may reduce the effectiveness of oral contraceptives.

The agency advises that women taking this drug use barrier contraception, such as condoms, in addition to oral contraceptives, according to The Guardian.

The MHRA received 26 pregnancy-related reports concerning Mounjaro and an additional eight reports linked to semaglutide-based drugs (Ozempic and Wegovy).

Another weight-loss medication, Saxenda, which contains liraglutide, also garnered nine reports.

Read more: Ozempic shows promise in reversing liver disease, research finds

While it&#39;s unclear whether the pregnancies were unintended, some women confirmed their pregnancies were unplanned, as reported by The Guardian.

The MHRA has emphasised that these medications should not be used during pregnancy or while trying to conceive due to insufficient safety data regarding potential harm to a developing baby.

Women taking these drugs are also advised to continue contraception for up to two months after stopping the medication before attempting to become pregnant, as noted by the health agency.

Also read: Popular weight loss drug Ozempic linked to higher risk of blindness

Dr. Channa Jayasena, a consultant in reproductive endocrinology, noted that GLP-1 medications like Ozempic and Wegovy are effective in aiding weight loss but could increase fertility in women with obesity by enhancing fertility.

However, these drugs may also interfere with the absorption of oral contraceptives, potentially increasing the risk of unintended pregnancies. This was also highlighted in The Guardian&rsquo;s coverage.

Read: Ozempic-fueled weight loss takes over Oscars 2025 as Hollywood&rsquo;s size zero trend returns

Dr. Alison Cave, the MHRA&#39;s chief safety officer, urged patients not to misuse these medications for weight loss, stressing that they are licensed for specific medical conditions and not for cosmetic purposes.

She further recommended that patients read the provided patient information leaflets and consult healthcare professionals before using these powerful treatments, as reported in The Guardian.]]>
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			<title>Coffee boosts healthy aging odds for women: 30-year study</title>
			<link>https://tribune.com.pk/story/2549446/coffee-boosts-healthy-aging-odds-for-women-30-year-study</link>
			<comments>https://tribune.com.pk/story/2549446/coffee-boosts-healthy-aging-odds-for-women-30-year-study#comments</comments>
			<pubDate>Wed, 04 Jun 25 06:27:53 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2549446</guid>
			<description>
				<![CDATA[Study of 47,513 women links higher caffeine intake, especially from coffee, to better odds of healthy aging.]]>
			</description>
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				<![CDATA[A recent study from the Nurses&#39; Health Study (NHS) explored&nbsp;the relationship between caffeine consumption in midlife and the likelihood of healthy aging (HA) in women during older adulthood.

The study, involving 47,513 women with data collected since 1984, found that caffeine intake was modestly associated with better odds of achieving healthy aging.

Healthy aging was defined as living to at least 70 years old without major chronic diseases, physical function limitations, mental health or cognitive impairments, or memory complaints.

Caffeine intake, measured through food frequency questionnaires (FFQs) covering coffee, tea, cola, and decaffeinated beverages, was assessed based on data from 1984 and 1986.

Results showed that by 2016, 3,706 women met the criteria for healthy aging.

The median baseline caffeine intake was 315 mg/day, with regular coffee accounting for over 80% of total caffeine consumption.

After 30 years of follow-up, the study revealed that higher caffeine intake, particularly from regular coffee, was associated with a modest increase in the likelihood of healthy aging.

For every 80 mg/day increase in caffeine, the odds of healthy aging and the likelihood of being free from major chronic diseases, physical function limitations, and cognitive impairments slightly improved.

Regular coffee intake, in particular, showed a positive association with healthy aging. For each additional cup of coffee consumed daily, the odds of achieving healthy aging increased by 5%, with similar increases in each domain of health. In contrast, no significant associations were found for tea or decaffeinated coffee intake.

Cola consumption, however, was linked to worse health outcomes, with higher intake associated with lower odds of healthy aging across all domains.

For each additional glass of cola consumed per day, the odds of achieving healthy aging dropped by 19% to 26%.

The findings suggest that caffeine, particularly from regular coffee, may have a modest beneficial effect on healthy aging in women, while cola intake appears to be detrimental.

However, no significant benefits were observed from tea or decaffeinated coffee.

Full findings of the report were presented at NUTRITION 2025, the American Society for Nutrition&#39;s annual meeting, held from May 31 to June 3 in Orlando.]]>
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			<title>UK disposable vape ban goes into effect from June 1</title>
			<link>https://tribune.com.pk/story/2548590/uk-disposable-vape-ban-goes-into-effect</link>
			<comments>https://tribune.com.pk/story/2548590/uk-disposable-vape-ban-goes-into-effect#comments</comments>
			<pubDate>Fri, 30 May 25 07:38:01 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[World]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2548590</guid>
			<description>
				<![CDATA[UK disposable vape sales banned from June 1 amid environmental concerns and rising youth vaping rates]]>
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				<![CDATA[The UK government&rsquo;s ban on disposable vapes comes into force this Sunday, signalling the end of easy access to single-use vaping devices in shops and online.

The move, first announced in January 2024, aims to tackle the growing environmental impact caused by disposable vapes, which have surged in popularity over the past decade.

Usage has increased by over 400% between 2012 and 2023, according to official data.

Disposable vapes, also known as single-use vapes, are non-rechargeable devices discarded after use.

Research by Material Focus revealed that around 8.2 million disposable vapes are thrown away or littered weekly in the UK&mdash;equivalent to 13 per second. Most end up in general waste bins or as litter rather than being recycled.

The government criticised disposable vapes as an &ldquo;inefficient use of critical resources&rdquo; that pose threats to biodiversity.

Their lithium-ion batteries risk causing fires, while harmful substances like plastic, lead, and mercury can leach into waterways, contaminating wildlife habitats.

The ban does not make possession of disposable vapes illegal, but sales and supply will be prohibited. Shops that have remaining stock must collect and recycle them responsibly.

Penalties for selling disposable vapes will vary across the UK:


	
	England and Wales: Civil sanctions include stop or compliance notices and fines of &pound;200. Repeat offenders could face unlimited fines and up to two years in prison.
	
	
	Scotland: Fixed penalty notices start at &pound;200, reduced to &pound;150 if paid within 14 days, with fines escalating for repeat offences. More serious breaches may result in fines up to &pound;5,000 or two-year prison sentences.
	
	
	Northern Ireland: No civil sanctions apply, but offenders face fines up to &pound;5,000 and possible prison sentences for repeat violations.
	


Reusable vapes, which are rechargeable and refillable with e-liquid, remain legal.

To be classed as reusable, products must have replaceable components such as coils or refillable pods, available separately in stores or online. The Medicines and Healthcare Products Regulatory Agency maintains a list of approved products.

The ban has shown early signs of impact. A University College London study reported a significant drop in disposable vape use among 16- to 24-year-olds, from 63% to 35% after the ban announcement.

However, overall vaping rates remained steady, suggesting many users may switch to reusable devices rather than quit.

Vaping is often promoted as a less harmful alternative to smoking because it does not produce tar or carbon monoxide. Yet, the long-term health effects are still under investigation.

The government supports a 10-year study tracking 100,000 young people to provide further insight.

While there are no current plans for a broader vape ban, upcoming legislation could restrict e-cigarette packaging, marketing, and flavours.]]>
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			<title>The Days Aren’t Longer: Drowsiness and Lack of Sleep in Climate Change</title>
			<link>https://tribune.com.pk/story/2546179/the-days-arent-longer-drowsiness-and-lack-of-sleep-in-climate-change</link>
			<comments>https://tribune.com.pk/story/2546179/the-days-arent-longer-drowsiness-and-lack-of-sleep-in-climate-change#comments</comments>
			<pubDate>Fri, 16 May 25 07:50:48 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2546179</guid>
			<description>
				<![CDATA[With prolonged heat waves and little overnight cooling, heat exhaustion is emerging as a public health concern.]]>
			</description>
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				<![CDATA[The human brain is highly sensitive to heat. According to scientists studying the impact of climate change on health, higher temperatures trigger the body&rsquo;s central thermostat and activate stress responses.

Our bodies prioritize cooling over everything else in extreme heat, meaning less oxygen and blood flow reach the brain and muscles. That&rsquo;s why we feel sluggish, foggy, and unmotivated during hot days.

Such changes arising from heat are more noticeable in temperate regions, with Pakistan being one of them.

It&rsquo;s not that Karachi afternoons have stretched into infinity; it&rsquo;s the heat and humidity that make it difficult to move, to function, to want anything other than a nap.

Researchers are increasingly examining how rising global temperatures are affecting sleep patterns and contributing to broader health complications.

&ldquo;Rising temperatures induced by climate change and urbanisation pose a planetary threat to human sleep, and therefore health, performance, and wellbeing,&rdquo; a 2024 review published in the journal Sleep Medicine said.

A separate study published in One Earth in 2022 found that humans lost an average of 44 hours of sleep per year during the first two decades of the 21st century compared with earlier periods, linking the trend directly to rising nighttime temperatures.

Chronic sleep deprivation disrupts the body&rsquo;s ability to recover, increasing the risk of fatigue, drowsiness, and accidents at work or on the road, researchers say.

Over time, accumulated sleep loss &mdash; often referred to as &quot;sleep debt&quot; &mdash; can worsen metabolic function and increase the risk of obesity, diabetes, cardiovascular disease, and neurodegenerative conditions such as Alzheimer&rsquo;s, according to neuroscientist Armelle Rancillac.

This heat-induced fatigue is emerging as a public health concern, particularly in regions experiencing prolonged heat waves with little overnight cooling.

Experts say the effects are not just physical but psychological, as chronic heat exposure has also been linked to increased anxiety and decreased mental well-being.

How do we adapt to it, then, in our everyday lives as citizens of a city where the heat doesn&rsquo;t dissipate even in October?

Cold showers before sleeping, less chai and coffee, more seasonal fruit drinks such as Falsa and unripened mango puree mixed in cold water, drinking lassi, placing wet clothes over windows, placing a tub full of water in the corner of the room, and the list goes on.

As the weather becomes unbearable, more and more people are falling back on localized practices of staying cool.

However, this is not something that can be tackled solely on an individual basis.

With global warming showing no signs of slowing, scientists urge governments to factor in the hidden toll of heat on human behavior and capacity, from productivity drops to rising healthcare needs, as part of broader climate resilience strategies.]]>
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			<title>Top 5 mistakes Med students make during Clinical Rotations and how to avoid them</title>
			<link>https://tribune.com.pk/story/2547426/top-5-mistakes-med-students-make-during-clinical-rotations-and-how-to-avoid-them</link>
			<comments>https://tribune.com.pk/story/2547426/top-5-mistakes-med-students-make-during-clinical-rotations-and-how-to-avoid-them#comments</comments>
			<pubDate>Fri, 23 May 25 10:47:55 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2547426</guid>
			<description>
				<![CDATA[Avoid these top mistakes in clinical rotations, from time management to self-care, says Medscape &amp; Dr. Guedikian.]]>
			</description>
			<content:encoded>
				<![CDATA[Medical rotations are a crucial part of your education, but they can also be overwhelming.

It&rsquo;s easy to fall into some common traps that hinder your learning and professional growth.

Here&rsquo;s a breakdown of the top five mistakes many med students make during their clinical rotations&mdash;and how to avoid them, as highlighted by Medscape and Dr. Nayiri Guedikian, MD, MPH.


	
	Not Asking Enough Questions
	It&rsquo;s easy to be intimidated, but asking questions shows you&#39;re engaged and eager to learn. Don&rsquo;t hesitate to clarify doubts&mdash;whether it&rsquo;s about a diagnosis or the rationale behind a treatment plan. It demonstrates curiosity and a desire to grow.
	
	
	Trying Too Hard to Impress
	Focusing solely on impressing attendings or senior residents can be a distraction. Instead, concentrate on gaining knowledge and refining your skills. By focusing on your learning and development, your competence will naturally leave a positive impression.
	
	
	Neglecting Team Dynamics
	Rotations are all about teamwork. Failing to recognize this can limit your effectiveness. Offer to help with small tasks, like gathering supplies or updating patient charts. These actions build camaraderie and demonstrate your commitment to the team&rsquo;s success.
	
	
	Poor Time Management
	A cluttered day leads to stress and missed learning opportunities. Take time to review the patient list, plan your day ahead, and prioritize tasks. Effective time management helps you stay organized and ensures you&#39;re not scrambling at the last minute.
	
	
	Neglecting Self-Care
	The demands of rotations can lead many students to overlook their own well-being. However, staying on top of nutrition, sleep, and stress management is crucial for maintaining focus and energy. You can&rsquo;t provide quality care if you&rsquo;re not taking care of yourself first.
	


Clinical rotations are a pivotal time in your medical career.

By avoiding these common mistakes and staying mindful of your learning process, you&rsquo;ll not only excel as a student but also make meaningful contributions to the healthcare team.]]>
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			<title>WHO adopts pandemic accord without US as RFK Jr. confirms Washington's withdrawal</title>
			<link>https://tribune.com.pk/story/2546883/who-adopts-pandemic-accord-without-us-as-rfk-jr-confirms-washingtons-withdrawal</link>
			<comments>https://tribune.com.pk/story/2546883/who-adopts-pandemic-accord-without-us-as-rfk-jr-confirms-washingtons-withdrawal#comments</comments>
			<pubDate>Tue, 20 May 25 11:08:41 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2546883</guid>
			<description>
				<![CDATA[US Health Secretary Kennedy Jr. says Washington will not join the WHO’s pandemic preparedness agreement.]]>
			</description>
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				<![CDATA[The World Health Organization adopted a landmark agreement on Tuesday to strengthen global preparedness for future pandemics, marking the end of three years of negotiations driven by the chaotic response to COVID-19.

Applause broke out at the World Health Assembly in Geneva as member states approved the legally binding accord, which aims to ensure equitable access to medical tools such as vaccines, treatments and diagnostics during future global health emergencies.

&ldquo;The agreement is a victory for public health, science and multilateral action. It will ensure we, collectively, can better protect the world from future pandemic threats,&rdquo; said WHO Director-General Tedros Adhanom Ghebreyesus.

Under the agreement, pharmaceutical manufacturers in participating countries will be required to reserve 20% of their pandemic-related medical products&mdash;including vaccines, therapeutics and tests&mdash;for the WHO.

These supplies would be redistributed to low- and middle-income countries to avoid the supply bottlenecks and inequities that plagued the global COVID-19 response.

However, the absence of the United States&mdash;traditionally the WHO&rsquo;s largest financial contributor&mdash;has raised concerns about the treaty&rsquo;s effectiveness.

Meanwhile, US&nbsp;Health Secretary Kennedy Jr. told Fox News that Washington will not join the WHO&rsquo;s pandemic preparedness agreement.

US negotiators stepped away from the process after President Donald Trump initiated a formal withdrawal from the WHO upon taking office in January, a move that strained relations between the global health agency and Washington.

As a result, the United States will not be legally bound by the new accord, despite having invested billions in vaccine development during the COVID-19 pandemic.

The pact, while historic in scope, includes no enforcement mechanism. Countries failing to implement its provisions will not face penalties, underscoring the continued reliance on voluntary compliance and diplomatic goodwill.

Global health advocates have welcomed the agreement but acknowledge the limits imposed by political divisions.
Without full participation from major powers, including the US, questions remain about how equitable and coordinated the next global pandemic response can be.

The agreement was finalized after Slovakia requested a vote on Monday, prompted by its vaccine-skeptic prime minister&rsquo;s insistence that the country oppose the treaty&rsquo;s adoption.

In the end, 124 nations voted in favor, none opposed it, and 11&mdash;including Poland, Israel, Italy, Russia, Slovakia, and Iran&mdash;chose to abstain.

Some public health professionals viewed the deal as progress toward improved global health equity, especially given how low-income countries were left behind in vaccine and test distribution during the COVID-19 crisis.

&quot;It contains critical provisions, especially in research and development, that&mdash;if implemented&mdash;could shift the global pandemic response toward greater equity,&quot; said Michelle Childs, Policy Advocacy Director at the Drugs for Neglected Diseases initiative, speaking to media.

However, others criticized the agreement as falling short of the original goals. They cautioned that without effective enforcement mechanisms, the pact may not deliver during the next pandemic.

&quot;It is an empty shell...It&#39;s difficult to say that it&#39;s a treaty with firm obligation where there is a strong commitment...It&#39;s a good starting point.

But it will have to be developed,&quot; said Gian Luca Burci, academic adviser at the Global Health Centre at the Geneva Graduate Institute.

The treaty will not come into force until an accompanying annex on pathogen data sharing is finalized. The WHO stated that negotiations on this annex are set to begin in July, with the aim of presenting it for adoption at a future World Health Assembly.

A Western diplomatic source noted that reaching consensus on this annex could take as long as two years.]]>
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			<title>What fluoride supplements really do — and why the FDA’s cracking down</title>
			<link>https://tribune.com.pk/story/2546191/what-fluoride-supplements-really-do-and-why-the-fdas-cracking-down</link>
			<comments>https://tribune.com.pk/story/2546191/what-fluoride-supplements-really-do-and-why-the-fdas-cracking-down#comments</comments>
			<pubDate>Fri, 16 May 25 09:30:00 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2546191</guid>
			<description>
				<![CDATA[FDA cites potential links between fluoride and altered gut bacteria, thyroid issues, and reduced IQ.]]>
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				<![CDATA[A long-standing dental treatment aimed at preventing cavities in children may soon disappear from the US market, as the Food and Drug Administration (FDA) moves to eliminate fluoride supplements over safety concerns.

The agency announced on May 13 that it intends to remove prescription fluoride tablets and drops, citing potential links to altered gut bacteria, thyroid disorders, and lowered IQ. The decision does not affect fluoride in toothpaste, gels, or mouthwashes.

&ldquo;The best way to prevent cavities in children is by avoiding excessive sugar intake and good dental hygiene, not by altering a child&rsquo;s microbiome,&rdquo; said FDA Commissioner Martin Makary, who is directing the agency to reassess the risks of these supplements.

The announcement has drawn swift criticism from dental professionals and scientists, who argue that the FDA&rsquo;s concerns are based on weak and irrelevant studies.

They warn that the move could deepen existing oral health disparities, particularly in rural areas where fluoridated water is unavailable.

&ldquo;It is a complete mystery to me why they think that this is an appropriate way to make the American public healthier,&rdquo; said Scott Tomar, a dentist and epidemiologist at the University of Illinois Chicago. &ldquo;The decision is based on some of the flimsiest evidence I&rsquo;ve seen.&rdquo;

Tomar noted that fluoride supplements have been prescribed for decades with proven success in reducing tooth decay.

He also questioned the relevance of studies cited by the FDA, many of which involve communities in rural China exposed to extremely high fluoride levels from coal burning and contaminated water&mdash;conditions not present in the United States.

The American Dental Association also pushed back, saying the cited research does not support banning fluoride at levels currently prescribed.

&ldquo;A review of the studies offered does not in fact demonstrate any harmful effects,&rdquo; the association said in a statement.

Even scientists involved in the FDA&rsquo;s cited studies were surprised by the decision.

&ldquo;There is no convincing evidence to support a stance that fluoride use in childhood has a detrimental effect on microbiome development,&rdquo; said microbiologist Gary Moran of Trinity College Dublin.

Meanwhile, states such as Florida and Utah have moved to ban the addition of fluoride to public water systems, further narrowing access.

Health experts warn that eliminating fluoride supplements would remove a critical line of defense for children in unfluoridated regions.

Fluoride supplements, available as drops or tablets, have long been prescribed to children living in areas where water supplies lack fluoridation. The aim is to prevent cavities by mimicking the protective benefits of fluoridated drinking water, said Scott Tomar

&quot;The dosage ranges from 0.25 to 1 milligram, depending on the child&#39;s age,&quot; Tomar explained. &quot;It&rsquo;s comparable to what children would ingest naturally if they drank water containing 0.7 milligrams per litre of fluoride.&quot;

Caroline Orr, a microbiologist at Teesside University, described fluoride&rsquo;s benefits as &ldquo;proven,&rdquo; pointing to its role in remineralising tooth enamel, reversing early decay, and disrupting harmful bacteria. &ldquo;It strengthens the teeth and reduces cavities,&rdquo; she said.

Despite these long-standing advantages, the FDA has signalled plans to remove ingestible fluoride supplements for children, citing concerns about their impact on gut microbiota, IQ, thyroid function, and even weight gain.

Tomar was critical of the evidence being used to justify the decision. &ldquo;Most of the literature the FDA cited is low-quality and high-risk for bias,&rdquo; he said.

&ldquo;The strong studies from countries like Denmark, Australia, Spain and Sweden show no link to IQ or neurodevelopment issues.&rdquo;

&ldquo;The thyroid accusation has no substantial scientific support,&rdquo; said Tomar. &ldquo;As for weight gain, that&#39;s a new and unsupported claim.&rdquo;

&ldquo;The science just isn&rsquo;t there,&rdquo; he added. &ldquo;These claims are not new, and they&rsquo;ve consistently failed under scrutiny.]]>
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			<title>Eco-friendly plastics may not be as safe as believed, scientists warn</title>
			<link>https://tribune.com.pk/story/2545830/eco-friendly-plastics-may-not-be-as-safe-as-believed-scientists-warn</link>
			<comments>https://tribune.com.pk/story/2545830/eco-friendly-plastics-may-not-be-as-safe-as-believed-scientists-warn#comments</comments>
			<pubDate>Wed, 14 May 25 09:25:47 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2545830</guid>
			<description>
				<![CDATA[A growing industry faces new questions about long-term safety risks.]]>
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				<![CDATA[Starch-based bioplastics, often marketed as sustainable and biodegradable alternatives to petroleum-based plastics, may pose similar health risks, new peer-reviewed research has found.

Scientists who studied the effects of long-term exposure to bioplastics in mice reported toxic effects on organs, genetic functions, and gut bacteria &ndash; similar to those caused by conventional plastic.

The findings challenge the perception of bioplastics as a safer, eco-friendly alternative, especially as their use becomes more widespread in products such as fast fashion, cutlery, straws, and wet wipes.

&ldquo;Biodegradable starch-based plastics may not be as safe and health-promoting as originally assumed,&rdquo; said Yongfeng Deng, one of the study&rsquo;s authors.

In the three-month study, mice were fed food and water contaminated with what researchers described as &ldquo;environmentally relevant&rdquo; levels of bioplastics. Control groups received no bioplastic exposure.

The researchers found plastic-related chemicals in the liver, ovaries, and intestines of exposed mice. These caused microlesions, organ abnormalities, gut microbiota disruption, and affected metabolic and genetic pathways.

The changes were more severe in mice exposed to higher levels of bioplastics. Disruptions in gut bacteria were linked to increased risk of cardiovascular disease and alterations in glucose levels.

The researchers said their study is the first to confirm the adverse effects of long-term exposure to bioplastics in mice, and urged further investigation into potential risks for humans.

Plastic, including bioplastics, can shed into the environment as microplastics and micro-bioplastics, and previous studies have raised concerns about their presence in food and water.

Despite their green image, bioplastics do not break down as quickly or as safely as often advertised, and the sector remains poorly regulated in terms of chemical safety.

More than 2.5 million metric tonnes of bioplastics were produced globally last year, a figure expected to more than double in five years, according to industry estimates.]]>
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			<title>Bananas may vanish from export shelves by 2080: report</title>
			<link>https://tribune.com.pk/story/2545402/bananas-may-vanish-from-export-shelves-by-2080-report</link>
			<comments>https://tribune.com.pk/story/2545402/bananas-may-vanish-from-export-shelves-by-2080-report#comments</comments>
			<pubDate>Mon, 12 May 25 11:11:50 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2545402</guid>
			<description>
				<![CDATA[Climate change is fuelling crop disease and slashing yields for vulnerable farmers]]>
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				<![CDATA[Climate change could render nearly two-thirds of banana-growing areas in Latin America and the Caribbean unsuitable by 2080, threatening the world&rsquo;s most consumed fruit, according to a new report from Christian Aid.

Rising temperatures, erratic rainfall, stronger storms, and fungal diseases are already damaging yields in key producing countries like Guatemala, Costa Rica and Colombia, the report said.

Bananas are a vital food source and cash crop. Globally, more than 400 million people rely on the fruit for up to 27% of their daily calories.

While 80% of bananas are consumed locally, the vast majority of global exports come from Latin America and the Caribbean&mdash;one of the regions most exposed to climate extremes.

The report, titled Going Bananas: How Climate Change Threatens the World&rsquo;s Favourite Fruit, highlights that climate-driven impacts are already being felt on the ground.

&ldquo;Climate change has been killing our crops. This means there is no income because we cannot sell anything,&rdquo; said Aurelia Pop Xo, a 53-year-old banana farmer in Guatemala. &ldquo;What is happening is that my plantation has been dying.&rdquo;

Bananas, especially the cavendish variety, are highly climate-sensitive. They thrive within a narrow temperature range of 15C to 35C and require carefully balanced rainfall.

Excess water and violent storms can damage leaves, weakening the plant&rsquo;s ability to photosynthesise.

The lack of genetic diversity in the global banana trade, which largely depends on the cavendish, makes the fruit especially vulnerable to climate-related threats.

Fungal diseases such as black leaf fungus and fusarium wilt are spreading faster under changing weather patterns, further threatening plantations.

Christian Aid is urging wealthy, high-emitting countries to rapidly phase out fossil fuels and provide financial support for adaptation in low-income communities most affected by climate change.

&ldquo;Bananas are not just the world&rsquo;s favourite fruit, they are also an essential food for millions of people,&rdquo; said Osai Ojigho, Christian Aid&rsquo;s policy and campaigns director.

&ldquo;The lives and livelihoods of people who have done nothing to cause the climate crisis are already under threat.&rdquo;]]>
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			<title>Cervical cancer silently claims lives</title>
			<link>https://tribune.com.pk/story/2545187/cervical-cancer-silently-claims-lives</link>
			<comments>https://tribune.com.pk/story/2545187/cervical-cancer-silently-claims-lives#comments</comments>
			<pubDate>Sun, 11 May 25 02:40:01 +0500</pubDate>
			<dc:creator>
				<![CDATA[Mahnoor Tahir Ali]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2545187</guid>
			<description>
				<![CDATA[Taboos and lack of awareness on HPV transmission lead to thousands of premature deaths among women]]>
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				<![CDATA[In a patriarchal society, where women&rsquo;s reproductive health is a hushed affair, the secondary socialisation of young women encourages them to silently endure the suffering that comes with having a womb since physical pain is considered a normal aspect of womanhood. Abiding by this unspoken expectation of stoicism, adolescent girls enduring severe menstrual cramping might miss out on a few days of school; however, for women unknowingly battling cervical cancer, the decision to choose shame over survival often costs them their lives. 

According to the World Health Organisation (WHO), cervical cancer, which develops at the cervix or entrance to the uterus, is the fourth most common cancer among women. The primary cause of cervical cancer is persistent infection from the high-risk variants of the human papillomavirus (HPV) transmitted through sexual contact. In 2022, an estimated 660,000 women were diagnosed with cervical cancer worldwide, while nearly 350,000 women died from the disease.

The situation in Pakistan is even more worrisome. Data obtained from the HPV Information Centre revealed that cervical cancer is the second most common cancer among women between 15 and 44 years of age in the country. Each year, more than 5,000 women are diagnosed with cervical cancer in Pakistan, out of which at least 3,000 succumb to the disease. Alarmingly, the mortality rate for cervical cancer is between 60 to 85 per cent in Pakistan, which is significantly higher than the expected mortality rate of 45 per cent.

According to the Cancer Council, precancerous changes in cervical cells rarely cause symptoms; therefore, cervical screenings are the only way to identify abnormal cells. In case the malignant cells escape timely diagnosis, they may develop into cervical cancer, causing the patient to experience a myriad of symptoms, including bleeding between periods, heavy menstrual bleeding, pain or bleeding during intercourse, bleeding after menopause, pelvic pain, or unusual discharge.

&ldquo;At least 80 per cent of cases of cervical cancer are caused by HPV, which is a sexually transmitted virus. Sexually active reproductive-aged women should undergo cervical cancer screenings once every three years. However, in our country, neither the female patients nor the healthcare providers know their importance. Since the detection of HPV does not happen in time through regular pap smears, women battling cervical cancer succumb to the illness,&rdquo; explained Dr Malahat Mansoor, Head of Obstetrics and Gynaecology at the Sahara Medical College.

Culture of neglect

A factory supplying a few hundred loaves of bread would judiciously invest in regularly maintaining its ovens even when the baking apparatus is not operational. Ironically, in a country with an annual birth rate of millions, women&rsquo;s bodies have less value than commercial machinery.

From puberty to menopause, women&rsquo;s child-bearing phase lasts nearly four to five decades. However, when society extensively views women as little more than vessels for carrying life, the female reproductive organs are deemed worthy of receiving medical attention only during the nine-odd months when they are serving their &ldquo;true&rdquo; purpose. The vessel may crack, bleed, or shatter in the remaining years, yet nobody would ever know since objects cannot convey pain. Given such unabashed objectification of the womb, perhaps it is no surprise that cervical cancer continues to silently claim the lives of thousands of women across the country.

&ldquo;Most women only visit the gynaecologist during pregnancy since that is the only time families prioritise their health. However, the detection of cervical cancer during pregnancy is difficult. Even today, women do not visit a gynaecologist for regular checkups, while general practitioners and gynecologists do not emphasize the importance of cervical screening. Hence, doctors have no data or records available on cervical cancer and its actual prevalence,&rdquo; noted Dr Mansoor.

According to the results of a study published by the Pakistan Development Review, nearly 50 to 80 per cent of married women between the ages of 15-49 years refrain from seeking medical help for a variety of reproductive tract issues, including abnormal discharge, lower pelvic pain, irregular or painful menstruation, painful urination, and discomfort or bleeding during intercourse. Shockingly, of all the women who ignored their gynecological complaints, a significant percentage felt that the symptoms, especially those involving pain, which are often associated with cervical cancer, were a &ldquo;normal&rdquo; part of womanhood.

In their book titled &ldquo;Outrageous Practices: How Gender Bias Threatens Women&rsquo;s Health,&rdquo; Leslie Laurence and Beth Weinhouse highlighted the subtle ways in which the cultural disregard of women&rsquo;s suffering during various life stages, including menstruation, pregnancy, and childbirth desensitised them to the point where they no longer identified pain as a sign of a serious physical ailment. Hence, as compared to men, women were more likely to ignore severe pain and wait for it to go away.

Expanding on the culture of neglect prevalent among women in Pakistan, Dr Uzma Ashiq Khan, Assistant Professor of Gender Studies at the Lahore College for Women University (LCWU), felt that although lack of awareness and affordability contributed significantly to women&rsquo;s poor access to reproductive healthcare, the stigma attached to women&rsquo;s health led families to ignore reproductive issues intentionally. &ldquo;As a result, women often turn to traditional medicine or hearsay for addressing gynecological issues, which can lead to further complications,&rdquo; noted Dr Khan.

Tabooed transmission

Being a sexually transmitted disease, the human papillomavirus (HPV) can transfer between people through a range of sexual contacts. However, regardless of whether a woman herself was involved in an illicit union or was ill-fatedly married to an unfaithful partner, the brunt of the encounter is borne single-handedly by the partner with a cervix.

&ldquo;In my locality, I have observed that a significant percentage of men who work overseas are involved in extramarital affairs. When they return home, they transmit the HPV infection to their wives, who end up with cervical cancer,&rdquo; revealed Dr Mansoor.

On the other hand, Dr Basmaa Ali, Resident Scientist at the Lahore University of Management Sciences (LUMS), revealed that premarital sex, too, had become very common in Pakistan. &ldquo;Given the tabooed nature of the topic, unmarried women engaged in sexual activity are often unaware of sexually transmitted diseases and the need for barrier protection. The spread of HPV is a concern, particularly among women between the age they become sexually active and the age of 35,&rdquo; noted Dr Ali.

However, according to research published by the Annals of Medicine and Surgery, testing for cervical cancer is relatively low among women in Pakistan due to a lack of awareness, fear and embarrassment, misconceptions about screening, stigma around sexual health, and lack of family support.

Interestingly, although premarital sex, despite its stigmatised nature, has increasingly emerged as a social concern, cervical cancer screening, recommended for all sexually active women, is reserved for married women only. As a result, single women engaged in sexual activity, who are perhaps most prone to acquiring HPV, are systemically denied screening.

&ldquo;In our society, we normally conflate sexual activity with marriage. Therefore, pap smears are not offered to unmarried women since, in our culture, doctors find it offensive to inquire a never-married woman about her sexual history. Unless the patient herself talks to the doctor, we never ask,&rdquo; explained Dr Mansoor.

In light of such cultural biases, Dr Ali felt that to curtail the incidence of cervical cancer, disseminating information on safe sex was the need of the hour. &ldquo;We need to engage young women in conversations highlighting the benefits of abstinence, which will save them from a bunch of trouble, including unwanted pregnancy and HPV. All you need to get HPV is one unprotected sexual encounter with a partner who simultaneously has had many other sexual partners,&rdquo; informed Dr Ali.

Global action, local inaction

According to the WHO&rsquo;s Global Action Plan for the elimination of cervical cancer as a public health problem, low to middle-income countries (LMICs) must follow the 90-70-90 target to reduce the incidence of cervical cancer by 2030.

Under this target, 90 per cent of girls must be fully vaccinated with the HPV vaccine by the age of 15, 70 per cent of women should be screened with a high-performance test by the age of 35 and 45, and 90 per cent of women identified with cervical disease, including those with precancer and invasive cancer, must receive treatment.

While developed countries have nearly eliminated cervical cancer, several developing countries across the economic spectrum have announced comprehensive national plans to combat cervical cancer among their local populations. 

For instance, in the United Arab Emirates, the Ministry of Health and Prevention (MoHAP) has aimed to vaccinate 90 per cent of girls aged 13-14 by 2030 while ensuring early screening for cervical cancer starting at age 25 and international standard treatment for diagnosed patients. In 2018, the UAE became the first country in the Eastern Mediterranean region to introduce the HPV vaccine in its national immunisation programme. In 2022, neighbouring India, which currently reports one cervical cancer death every seven minutes, manufactured its vaccine against HPV, known as Cervavac. India, too, plans to introduce the vaccine in its immunisation programme.

The best example for Pakistan to study is Rwanda, which was one of the first developing countries to launch an HPV vaccination drive for female adolescents under the age of 15 back in 2011. Interestingly, despite its status as a low-income country (LIC), good governance and a strong commitment to public health have allowed the government to maintain the ideal 90 per cent coverage. As a result of its timely action, just this year, Rwanda announced its aim to eliminate cervical cancer by 2027, three years ahead of the WHO target. Experts predict that Rwanda might be on its way to becoming the first country in the world to eliminate cervical cancer.

Pakistan, however, is far from reaching these goals even in the next one hundred years. According to a study published by the Journal of Clinical Laboratory Analysis, eight different subtypes of HPV have been identified among cervical cancer patients in Pakistan, with HPV 16 accounting for 80 per cent of all cases. However, the state has failed to address the serious need for widespread screening and vaccination.

Although the government has decided to launch a cervical cancer vaccination drive for girls aged 9 to 14 in September 2025, public health experts are not too optimistic about the success of the initiative, given the current abysmal state of the public healthcare system.

According to Dr Basmaa Ali, a Clinical Instructor in Internal Medicine at Harvard Medical School, the data on the HPV vaccine, also known as Gardasil, show that it works on the HPV variant present in the Western population.

&ldquo;From a scientific perspective, introducing the vaccine makes sense. However, realistically speaking, to date, we have failed to offer mammography to women in the country and even administer the polio vaccine to a sizeable population. Therefore, it is unreasonable to think that in the current situation, without improving the existing healthcare system, the government can administer the Gardasil vaccine to a sizeable population of young girls to the extent that pap smears are no longer required,&rdquo; opined Dr Ali.

On the other hand, Dr Mansoor revealed that even in the private sector, the availability and affordability of the HPV vaccine were significant hindrances. &ldquo;First of all, the availability of the HPV vaccine is a challenge since import and export barriers have halted the supply of several vaccines. Even when the vaccine is available in Pakistan, its cost is between Rs12,000 and Rs17,000, which is not affordable for the local population. Moreover, the majority of doctors do not have knowledge or information regarding the cervical cancer vaccine. Most importantly, the HPV vaccine only offers protection against a few strains of HPV; hence, it does not guarantee 100 per cent protection. Therefore, screening is still mandatory for battling cervical cancer,&rdquo; urged Dr Mansoor. 

The way forward

Although the elimination of cervical cancer is not possible without developing a national long-term strategy for achieving the vaccination and treatment targets, the current strain on the country&rsquo;s public healthcare system necessitates the adoption of a short-term plan for curtailing the spread of HPV by raising awareness on safe sex and abstinence.

&ldquo;Even though condoms can offer a barrier, they are not 100 percent safe; therefore, young women should abstain from premarital sex. While premarital sex has increased among the youth, cultural and religious principles that discourage the practice and emphasise its negative consequences still hold. Therefore, the government must adopt a holistic approach to tackling cervical cancer by creating accessible content on body literacy, which can talk about abstinence, safe sex, and sexually transmitted diseases in a very gentle manner. Simultaneously, pap smears should be encouraged among women, and introducing the vaccine could also be a good decision,&rdquo; noted Dr Ali.

On the other hand, Dr Khan stressed the importance of educating men on women&rsquo;s health issues since she believed this could have a positive impact on reducing cases of cervical cancer. &ldquo;Whenever you want to bring about change in a patriarchal society, you have to sensitize the dominant gender, which is in power. Therefore, society should include men in these discussions as facilitators to encourage a positive development of masculinity. Furthermore, the government should mobilize the media and influential figures like celebrities and bloggers to spread awareness on such issues,&rdquo; implored Dr Khan.

Similarly, Dr Mansoor also felt that the mainstream media, as well as social media, could play a part in spreading awareness of cervical cancer. &ldquo;The government should also use television programs and short-form content through social media reels to disseminate information. People should know that cervical cancer is a preventable cancer. If we as a society work on tackling its spread and facilitating its diagnosis, we can save our women&rsquo;s lives,&rdquo; urged Dr Mansoor.

All facts and information are the sole responsibility of the writer]]>
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			<title>Cinnamon supplements can pose risks for people on anticoagulant medication: research</title>
			<link>https://tribune.com.pk/story/2544924/cinnamon-supplements-can-pose-risks-for-people-on-anticoagulant-medication-research</link>
			<comments>https://tribune.com.pk/story/2544924/cinnamon-supplements-can-pose-risks-for-people-on-anticoagulant-medication-research#comments</comments>
			<pubDate>Fri, 09 May 25 11:05:09 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2544924</guid>
			<description>
				<![CDATA[Study offers fresh insight into how natural products may affect medical treatments.]]>
			</description>
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				<![CDATA[Cinnamon may be a beloved spice in kitchens and health stores alike, but a new study has found that overconsumption could interfere with how the body processes prescription drugs.

Published in the journal Food Chemistry: Molecular Sciences, the study found that cinnamaldehyde &ndash; the active compound in cinnamon &ndash; is highly bioaccessible and may interact with enzymes that affect drug metabolism.

The findings suggest that excessive intake of cinnamon-containing supplements or products could result in herb-drug interactions, particularly for individuals taking medications or managing chronic conditions.

&ldquo;Cinnamon is not harmless just because it&rsquo;s natural,&rdquo; said Dr Leana Wen, a health policy expert and physician. &ldquo;People need to understand its potential risks, especially if they are on prescription drugs.&rdquo;

Cinnamon, especially the Cassia variety commonly sold in North America, contains high levels of coumarin &ndash; a naturally occurring compound known to thin blood.

In large quantities, this could increase the risk of bleeding, particularly in individuals already on anticoagulant medication.

The National Center for Complementary and Integrative Health (NCCIH) has stated that research does not currently support the use of cinnamon for any specific health condition, and the US Food and Drug Administration has not approved cinnamon as a treatment.

While Ceylon cinnamon, often marketed as &ldquo;true&rdquo; cinnamon, contains less coumarin, it too may pose risks if consumed in large amounts over time.

Liver damage and possible interference with anti-cancer drugs or nicotine are among the potential issues raised.

The study&rsquo;s authors called for further research to determine the extent of drug interactions and recommended that individuals consult healthcare professionals before taking cinnamon supplements.

Despite some early studies suggesting benefits for weight loss or managing diabetes, experts caution against relying on cinnamon as a therapeutic aid without clear clinical evidence.]]>
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			<title>RFK Jr unveils autism research plan using Medicare and Medicaid data</title>
			<link>https://tribune.com.pk/story/2544670/rfk-jr-unveils-autism-research-plan-using-medicare-and-medicaid-data</link>
			<comments>https://tribune.com.pk/story/2544670/rfk-jr-unveils-autism-research-plan-using-medicare-and-medicaid-data#comments</comments>
			<pubDate>Thu, 08 May 25 06:24:33 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2544670</guid>
			<description>
				<![CDATA[Initiative may bridge gaps in care and reveal hidden trends affecting autism outcomes]]>
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				<![CDATA[US&nbsp;federal health agencies will develop a national database of autism patients enrolled in Medicare and Medicaid, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr said on Wednesday.

The initiative is aimed at supporting research into the causes of autism spectrum disorder (ASD) and could later expand to include other chronic conditions, according to the department.

Kennedy, who has publicly supported a discredited theory linking vaccines to autism, said the effort would bring &quot;full transparency and accountability&quot; and offer families long-awaited answers.

The National Institutes of Health (NIH) and the Centers for Medicare and Medicaid Services (CMS) will collaborate on building the platform. It will aggregate real-world data from claims, electronic health records, and wearable devices, HHS said.

The project is part of a broader $50 million research campaign to explore autism&#39;s origins&mdash;a neurological condition that affects communication, behaviour and learning.

Researchers will be able to study autism diagnoses over time, treatment outcomes, access to care, health disparities, and the economic impact on families.

But not all experts are convinced the new initiative will deliver on its central aim.

&ldquo;These areas don&rsquo;t address the root causes of autism,&rdquo; said Dr Helen Tager-Flusberg, director of the Center for Autism Research Excellence at Boston University.

She noted that a similar NIH database had already existed for over a decade but had recently gone offline without explanation.

Eric Rubenstein, another autism researcher at Boston University, said researchers have used Medicare and Medicaid data for years.

It is helpful for studying disparities, he said, but lacks data on environmental exposures&mdash;an area Kennedy has pledged to examine.

Kennedy said the new registry would be voluntary and would not collect private information. HHS stated the project would adhere to privacy laws but did not confirm whether data would be anonymised.

NIH, HHS and CMS declined to provide further details on how the data would be used or managed.

Kennedy has said the NIH will determine the causes of autism by September&mdash;a timeline most scientists view as unrealistic.

Autism now affects 1 in 31 US&nbsp;children aged eight, according to the Centers for Disease Control and Prevention.

Experts believe a mix of genetic and environmental factors likely contributes to the condition, alongside improved detection and diagnosis.]]>
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			<title>Haenyeo divers reveal DNA secrets of endurance and low blood pressure: study</title>
			<link>https://tribune.com.pk/story/2544681/haenyeo-divers-reveal-dna-secrets-of-endurance-and-low-blood-pressure-study</link>
			<comments>https://tribune.com.pk/story/2544681/haenyeo-divers-reveal-dna-secrets-of-endurance-and-low-blood-pressure-study#comments</comments>
			<pubDate>Thu, 08 May 25 07:06:59 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2544681</guid>
			<description>
				<![CDATA[A unique way of life may open doors for medicine beyond cultural preservation.]]>
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				<![CDATA[A study published in Cell Reports has revealed that the women of Jeju Island, South Korea, known as Haenyeo, may hold key genetic insights that could lead to breakthroughs in human biology, particularly in the treatment of blood pressure disorders. The Haenyeo, who dive deep into the cold sea without oxygen tanks, have long defied human endurance limits in their centuries-old tradition of harvesting seafood.

The research, led by geneticist Melissa Ilardo from the University of Utah, focused on the genetic adaptations of the Haenyeo divers compared to local non-diving women and women from mainland Korea. The study found that Haenyeo women are more than four times as likely to carry a genetic variant associated with lower blood pressure spikes, a trait that may have evolved to protect women during pregnancy.

&ldquo;They dive throughout winter, sometimes in snow, and until the 1980s they did this in cotton clothes with no protection,&rdquo; said Ilardo. This adaptation, the study suggests, may help them endure the cold and physiological stress of free diving at great depths.

The research also revealed that Haenyeo divers exhibit more efficient oxygen conservation, with heart rates dropping significantly during cold-water tests. This response was more pronounced than in non-diving women, highlighting the Haenyeo&rsquo;s ability to handle extreme conditions.

Ilardo&rsquo;s team had previously found similar adaptations in the Bajau divers of Indonesia, who evolved large spleens to support underwater endurance. While the Haenyeo divers also showed signs of enlarged spleens, the size difference was not statistically significant when other factors were accounted for.

Ben Trumble, an evolutionary scientist at Arizona State University, commented on the potential medical implications of the findings. &quot;That gene reduced blood pressure by over 10% &mdash; that&rsquo;s remarkable,&quot; he said, suggesting it could be a promising target for drug development.

Despite the scientific breakthroughs, the Haenyeo culture, once integral to life on Jeju Island, is in decline. The average age of a Haenyeo diver is now around 70, and fewer young women are taking up the practice. There are concerns that this could be the last generation of Haenyeo divers.

Nevertheless, the study&rsquo;s findings underscore the unique biological traits of these women, whose centuries-old practice could offer a wealth of knowledge. As Ilardo stated, &ldquo;What they do is unique and worth celebrating.&rdquo;]]>
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			<title>Measles surge signals post-herd-immunity era in North America, experts warn</title>
			<link>https://tribune.com.pk/story/2544088/measles-surge-signals-post-herd-immunity-era-in-north-america-experts-warn</link>
			<comments>https://tribune.com.pk/story/2544088/measles-surge-signals-post-herd-immunity-era-in-north-america-experts-warn#comments</comments>
			<pubDate>Mon, 05 May 25 08:43:45 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2544088</guid>
			<description>
				<![CDATA[Experts stress the power of prevention as communities face rising risk from preventable illness.]]>
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				<![CDATA[A prominent immunologist has issued a stark warning of a &quot;post-herd-immunity world&quot; as measles outbreaks ravage communities in the American Southwest, Mexico, and Canada, with inadequate vaccination coverage.

The United States is now facing its worst measles outbreak in 25 years, centred in west Texas and spreading into New Mexico and Oklahoma. The outbreak has claimed the lives of two unvaccinated children and one adult.

Dr Paul Offit, director of the Vaccine Education Center at Children&rsquo;s Hospital of Philadelphia, said the virus&rsquo;s return shows the consequences of declining vaccination. &ldquo;Measles is the most contagious of all vaccine-preventable diseases &ndash; it&rsquo;s the first to come back,&rdquo; he said.

As of 1 May, the US Centers for Disease Control and Prevention (CDC) reported 935 confirmed cases across 30 jurisdictions. Nearly a third of those infected under the age of five have been hospitalised.

Measles was declared eliminated in the US in 2000. But if sustained transmission continues for 12 months, that status could be lost.

The virus is now also spreading in Mexico and Canada, particularly among tight-knit Mennonite communities, where vaccination rates are low.

The World Health Organization says three major outbreaks across North America account for most of the 2,300 confirmed measles cases in the region this year. The risk of infection has grown 11-fold compared to 2024.

Cases are also surging in Europe. The European Centre for Disease Prevention and Control reported more than 35,000 cases in 2024 so far &mdash; a tenfold increase over the previous year. Romania accounts for 87% of these cases.

In the US, experts say the rise in cases is being worsened by health secretary Robert F Kennedy Jr&rsquo;s promotion of vaccine misinformation.

Though he has expressed limited support for the measles, mumps and rubella (MMR) vaccine, Kennedy continues to spread false claims, including that the vaccine contains &ldquo;aborted fetus debris&rdquo;.

His department has announced vague plans for new vaccine safety systems and approval procedures, but experts warn these could undermine long-established immunisation practices.

Kennedy also visited affected communities in Texas, claiming that antibiotics and steroids had led to &ldquo;miraculous&rdquo; recoveries from measles. Medical experts dismissed this as dangerous misinformation.

&ldquo;There is no cure for measles,&rdquo; the American Academy of Pediatrics stated. &ldquo;It is misleading and dangerous to promote unproven therapies.&rdquo;

The MMR vaccine is 97% effective. Since 1974, it has saved more than 93 million lives globally, according to the WHO.]]>
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			<title>Six raw foods to beat summer heat naturally</title>
			<link>https://tribune.com.pk/story/2544050/six-raw-foods-to-beat-summer-heat-naturally</link>
			<comments>https://tribune.com.pk/story/2544050/six-raw-foods-to-beat-summer-heat-naturally#comments</comments>
			<pubDate>Mon, 05 May 25 06:18:32 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2544050</guid>
			<description>
				<![CDATA[Raw foods not only save cooking time during hot weather but also offer essential hydration and nutrients]]>
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				<![CDATA[As heatwave conditions intensify across the region, health experts are urging the public to incorporate specific raw foods into their daily diets to help combat the risk of heatstroke and related illnesses. With soaring temperatures and high humidity, the human body faces increased stress, dehydration, and overheating.

According to nutritionists, raw foods not only save cooking time during hot weather but also offer essential hydration and nutrients that can naturally cool the body from within.

Why raw foods help in extreme Heat:

Hydration boost: Raw foods with high water content help maintain fluid balance.

Nutrient preservation: Uncooked fruits and vegetables retain more vitamins and antioxidants.

Cooling effect: Certain foods reduce internal body heat and inflammation.

Stable blood sugar: Fibre-rich options support sustained energy levels.

Six cooling raw foods:

Cucumber &ndash; Contains 95% water; supports hydration and skin health.

Watermelon &ndash; High in water and lycopene; helps prevent sun damage.

Mango &ndash; Rich in vitamin C and antioxidants; fights fatigue.

Coconut water &ndash; Packed with electrolytes like sodium and potassium.

Mint &amp; coriander &ndash; Antioxidant-rich herbs with natural cooling properties.

Tomatoes &ndash; Contain potassium and lycopene; help protect against UV rays.]]>
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			<title>What is 'Red 40,' food dye banned by United States' FDA?</title>
			<link>https://tribune.com.pk/story/2541796/what-is-red-40-food-dye-banned-by-united-states-fda</link>
			<comments>https://tribune.com.pk/story/2541796/what-is-red-40-food-dye-banned-by-united-states-fda#comments</comments>
			<pubDate>Wed, 23 Apr 25 11:59:03 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[World]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2541796</guid>
			<description>
				<![CDATA[FDA bans Red Dye 40, citing links to hyperactivity in kids; food firms now shifting to natural alternatives.]]>
			</description>
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				<![CDATA[The U.S. Food and Drug Administration (FDA)&nbsp;has banned Red Dye No. 40 in food and drinks, citing growing evidence that the artificial colouring may contribute to hyperactivity and behavioural issues in children.

Red Dye 40, also known as Allura Red, has been a staple in children&rsquo;s snacks for decades, brightening cereals, candies, and drinks with vivid red hues. But amid increasing scrutiny, the FDA has now prohibited its use, triggering a major shift in the food industry.

The agency said its decision followed new research showing potential links between the dye and neurobehavioral changes in children, including hyperactivity, impulsiveness, and attention issues.

A 2022 meta-analysis reviewing 25 studies found consistent behavioural effects in some children following consumption of Red 40.

Although not all children are affected, the FDA concluded the risks outweigh the benefits of using the dye. Officials also noted allergic and inflammatory responses in animal studies, strengthening the case for a ban.

European regulators had long required warning labels on products containing Red 40. The FDA&rsquo;s new ban goes further, removing the ingredient entirely from the U.S. market.

Products impacted include cereals like Froot Loops, candies such as Skittles, and beverages including fruit punches and sports drinks. Red 40 has also been used in baked goods, flavoured snacks, condiments, and even some vitamin drinks.

Manufacturers are already preparing to reformulate products using natural colourants. These include plant-based alternatives such as beet juice, carrot extract, spirulina, and paprika.

Companies like Kellogg&rsquo;s and Mars, Inc. are among those exploring natural replacements.

Food scientists say natural colourings may produce subtler shades than artificial dyes, but they expect minimal impact on flavour or texture.

The move has been widely praised by parents and paediatricians. Many parents who had already removed Red 40 from their children&rsquo;s diets reported noticeable improvements in behaviour, sleep, and focus.

The American Academy of Pediatrics welcomed the FDA&rsquo;s action, calling it a win for child health. Still, experts advise parents to consider other factors such as sugar and sleep that can also affect behaviour.

The FDA&rsquo;s decision marks a shift in public health policy, acknowledging consumer concerns and scientific findings. While foods may look a little less vibrant, many families see the change as a positive step towards safer nutrition for children.]]>
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			<title>Can AI really pick juiciest watermelon?</title>
			<link>https://tribune.com.pk/story/2541499/can-ai-really-pick-juiciest-watermelon</link>
			<comments>https://tribune.com.pk/story/2541499/can-ai-really-pick-juiciest-watermelon#comments</comments>
			<pubDate>Tue, 22 Apr 25 07:34:14 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Deak]]>
			</dc:creator>
			<category><![CDATA[Health]]></category><category><![CDATA[Life &amp; Style]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2541499</guid>
			<description>
				<![CDATA[While, experts have not dismissed the idea, but they remain cautious about fully relying on AI for fruit selection.]]>
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				<![CDATA[As watermelon season kicks off, consumers once again face the age-old challenge of selecting the ripest and juiciest fruit.

A growing trend on social media, meanwhile, suggests that artificial intelligence (AI) can help solve the summer dilemma of selecting the sweetest watermelon by analyzing images to identify the best fruit.

To test the claim, a photo was taken of a watermelon bin at a local store, with each melon numbered from 1 to 11.

The image was then processed through an AI tool with the prompt: &ldquo;Which one looks the juiciest?&rdquo;







The AI chose watermelon number 5 as the most promising based on its visual features.

After purchasing the selected melon and cutting it open, the result matched the AI&rsquo;s prediction&mdash; it was notably juicy. However, other melons from the same batch yielded mixed results.

Despite the success, experts remain cautious about fully relying on AI for fruit selection.

One AI system acknowledged its limitations, noting that judging a watermelon&rsquo;s sweetness typically requires physical cues such as weight, tapping sounds, and appearance&mdash;factors that images alone cannot accurately assess.

On the other hand, as the summer heat intensifies, watermelon emerges not just as a refreshing seasonal treat, but as a powerful source of hydration and nutrition, offering a range of science-backed health benefits when included in your summer diet.

&nbsp;]]>
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			<title>9 health benefits of Apricots you should know</title>
			<link>https://tribune.com.pk/story/2541130/9-health-benefits-of-apricots-you-should-know</link>
			<comments>https://tribune.com.pk/story/2541130/9-health-benefits-of-apricots-you-should-know#comments</comments>
			<pubDate>Sun, 20 Apr 25 11:03:38 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2541130</guid>
			<description>
				<![CDATA[One cup of sliced apricots provides about two-thirds of a cup of water.]]>
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				<![CDATA[Apricots, also known as Armenian plums, are not just delicious &mdash;they also boast a wide range of health benefits, both internally and externally.

These yellow-orange fruits, often compared to small peaches in appearance and plums in flavour, are rich in nutrients that support overall well-being.

Rich in nutrients and low in calories

Apricots are a nutrient-dense fruit that deliver key vitamins and minerals with very few calories. Just two fresh apricots (70 grams) contain only 34 calories, yet provide valuable amounts of vitamins A, C, and E, as well as potassium and fibre.

They also contain beneficial plant compounds like beta carotene, lutein, and zeaxanthin, which support overall health.

High in antioxidants

Apricots are an excellent source of antioxidants, including flavonoids such as chlorogenic acid, catechins, and quercetin.

These compounds help protect the body from oxidative stress, which is linked to chronic diseases like diabetes, heart disease, and obesity.

Studies show that a high intake of flavonoids is associated with reduced inflammation and improved cellular health.

Supports eye health

Packed with nutrients that support vision, apricots contain vitamins A and E, along with beta carotene, lutein, and zeaxanthin.

Vitamin A is essential for preventing night blindness, while vitamin E helps protect the eyes from oxidative damage.

Lutein and zeaxanthin play a key role in maintaining healthy retinas and reducing the risk of age-related eye conditions.

Promotes healthy skin

Antioxidants in apricots can help defend the skin against environmental damage from sun exposure, pollution, and smoking.

Vitamin C, in particular, promotes collagen production, helping to maintain skin elasticity and reduce wrinkles.

Beta carotene also plays a role in protecting the skin from sunburn. Regular consumption of apricots may contribute to healthier, more resilient skin.

Aids digestive health

Apricots are a good source of dietary fibre, particularly soluble fibre, which helps regulate digestion and supports healthy blood sugar and cholesterol levels.

One cup of sliced apricots provides over 3 grams of fibre, promoting regular bowel movements and feeding beneficial gut bacteria.

A healthy gut microbiome is associated with improved digestion and reduced risk of metabolic diseases.

Good source of potassium

Potassium is a crucial mineral that helps maintain fluid balance, supports muscle function, and regulates blood pressure.

Two apricots provide around 181 mg of potassium. A diet rich in potassium can help reduce the risk of high blood pressure and stroke.

Apricots offer a natural, low-sodium way to maintain healthy electrolyte levels.

Helps keep you hydrated

Apricots are high in water content, which helps with hydration and supports key bodily functions like circulation, temperature regulation, and joint health.

One cup of sliced apricots provides about two-thirds of a cup of water. Their combination of water and potassium makes them ideal for replenishing fluids and electrolytes after exercise or during hot weather.

May protect liver health

Studies suggest that the antioxidants in apricots may help protect the liver from damage caused by oxidative stress, particularly in cases of excessive alcohol consumption.

In studies, rats fed with apricots showed reduced inflammation and liver enzyme levels compared to those not given the fruit. While more research in humans is needed, early findings are promising.

Easy to incorporate into your diet

Whether fresh or dried, apricots are a convenient and versatile addition to any diet. They can be enjoyed on their own, mixed into yoghurt or salads, added to trail mix, or used in savoury dishes and desserts.

Their sweet-tart flavour makes them a great substitute for peaches or plums in a variety of recipes.]]>
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			<title>Top 10 health benefits of eating watermelon during summer</title>
			<link>https://tribune.com.pk/story/2539821/top-10-health-benefits-of-eating-watermelon-during-summer</link>
			<comments>https://tribune.com.pk/story/2539821/top-10-health-benefits-of-eating-watermelon-during-summer#comments</comments>
			<pubDate>Mon, 14 Apr 25 11:01:32 +0500</pubDate>
			<dc:creator>
				<![CDATA[News Desk]]>
			</dc:creator>
			<category><![CDATA[Life &amp; Style]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2539821</guid>
			<description>
				<![CDATA[Here are ten science-backed benefits of incorporating watermelon into your summer diet]]>
			</description>
			<content:encoded>
				<![CDATA[As the summer heat intensifies, watermelon emerges not just as a refreshing seasonal treat, but as a powerful source of hydration and nutrition. Here are ten science-backed benefits of incorporating watermelon into your summer diet:

Hydrates the body

Watermelon is composed of over 90% water, making it one of the most hydrating fruits available. It helps regulate body temperature and replenishes fluids lost through sweat during hot weather.

Supports heart health

Watermelon is rich in lycopene, an antioxidant known to reduce inflammation and improve blood circulation. It also contains citrulline, an amino acid that helps lower blood pressure, making it heart-friendly.

Boosts digestion

The combination of water and dietary fibre in watermelon supports smooth digestion, prevents constipation, and helps maintain regular bowel movements.

Improves skin health

Vitamin C in watermelon aids collagen production, while its water content keeps the skin moisturised. Regular consumption can contribute to a radiant and healthy complexion, especially under sun exposure.

Promotes eye health

Watermelon contains beta-carotene and lycopene, both known to protect against age-related macular degeneration and support overall eye health.

Aids in weight management

Low in calories and high in water and fibre, watermelon makes for a satisfying and guilt-free snack that can help curb appetite and support weight loss goals.

Enhances kidney function

The potassium and high water content in watermelon support kidney function by helping flush out toxins and preventing kidney stone formation, especially important during dehydration-prone months.

Relieves muscle soreness

Citrulline in watermelon is also known to aid muscle recovery, making it beneficial for those engaging in summer sports or outdoor activities.

Boosts immune system

With its high vitamin C content, watermelon helps strengthen the immune system &mdash; a vital defence mechanism, especially during seasonal transitions and prolonged sun exposure.

Cools the body naturally

Eating chilled watermelon helps lower core body temperature naturally, providing instant relief from the scorching summer heat while maintaining electrolyte balance.]]>
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			<title>Blood, sweat and tears</title>
			<link>https://tribune.com.pk/story/2533215/blood-sweat-and-tears-1</link>
			<comments>https://tribune.com.pk/story/2533215/blood-sweat-and-tears-1#comments</comments>
			<pubDate>Sun, 09 Mar 25 06:50:44 +0500</pubDate>
			<dc:creator>
				<![CDATA[Tufail Ahmed]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[T-Magazine]]></category><category><![CDATA[Health]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2533215</guid>
			<description>
				<![CDATA[With no national blood drives, low-income families struggle to arrange blood for ailing loved ones]]>
			</description>
			<content:encoded>
				<![CDATA[They say life and death is in the hands of God. But sometimes the delicate thread of fate suddenly lands in the hands of distraught family members, who barely have minutes to find, match and trade a few bags of blood in return for the irreplaceable lives of their loved ones.

In a heart-wrenching scene outside a government hospital in Peshawar, Rakhshinda Bibi, an elderly woman, was seen pleading passersby for blood donations for her 10-year-old son suffering from thalassemia. Highlighting the gravity of her situation, Rakhshinda tearfully shared that she was left with no other option. &ldquo;After facing repeated rejections and delays at both private and public hospitals, I have no choice but to beg random strangers to help save my son&rsquo;s life,&rdquo; she cried.

Rakshinda&rsquo;s pain is deeply felt by millions of families across the country, who in the absence of adequate blood banks and state-initiated blood drives, have to put their blood, sweat and tears into urgently arranging blood for their loved ones. One such mother was Shumaila from Lahore who was struggling to find O negative blood, the rarest kind, for her sick son. &ldquo;When I brought my son to the emergency, I faced a lot of difficulties since the blood bank of the hospital was vacant,&rdquo; shared Shumaila.

Down south in Karachi, Gulfam, brother of a patient, faced a similar predicament, when he was unable to find blood for his brother&rsquo;s transfusion at the New Karachi Hospital. &ldquo;My brother&rsquo;s haemoglobin was very low and the doctors asked me to arrange three bottles of blood. Since there was no blood bank in the hospital, I went to a private blood bank to buy blood,&rdquo; revealed Gulfam, who complained about the shortage of blood at government hospitals.



The donation crisis

As per sources from the Health Department, almost 2.5 to 3.0 million blood donations are required across the country each year to meet the requirements of patients suffering from blood loss following surgery, childbirth, accidents or those with thalassemia.

There are 191 blood banks registered in private and government hospitals across Sindh, including Karachi, of which 80 per cent are private blood banks. According to the Sindh Blood Transfusion Authority, 523,713 voluntary blood donations are made in Karachi annually. Thus, only one per cent of Karachi&rsquo;s population donates blood voluntarily and the majority of these donations are made by the patient&rsquo;s family. As a result, there is a severe shortage of blood, particularly the O positive and negative groups in Karachi.

The situation is conspicuously more alarming in Punjab, where the Punjab Blood Transfusion Authority has been inoperational in the absence of a head. In Punjab, blood donations come to blood banks established in government and private hospitals, which are voluntarily given to the needy. Simultaneously, there are illegal blood banks established outside hospitals, which sell blood with the connivance of hospital staff.

Punjab is the largest province in terms of population, and it requires 700,000 to 800,000 blood bags annually. At present, there are 56 registered blood banks at the state level in Punjab, while 60 blood banks are working at the private level. However, despite these blood banks, the demand for blood is met with great difficulty and many a times people even lose their lives.

Sundus Foundation has a private blood bank, which requires 400 bags of blood every day however, only ten percent of this need is met through blood banks and the remaining 90 per cent of people requiring blood urgently have to take help from relatives, friends and other sources.

Up north in K-P, the Blood Transfusion Authority (BTA) K-P revealed that a total number of 485 blood banks were collecting approximately 250,000 donations each year. The Regional Blood Centre (RBC) in Peshawar serves a population of about 4.26 million and provides just 180,000 units of blood to local hospitals and thalassemia centers.

Limited awareness plays a major role in the decline in donor interest. Other limiting factors include a severe lack of motivation, recognition and appreciation for voluntary donors. In addition, the prevalence of diabetes, hepatitis and HIV in Pakistan is very high, due to which patients of these diseases are not eligible to donate blood. Other ineligibility factors include socio-demographic factors such as education, gender, age, marital status and residential area, which also become barriers to voluntary blood donation.

What further worsens the shortage of blood is the fact the even today whole blood is donated in various hospitals, due to which the other three components in the blood are wasted. Dr Usman Waheed, technical expert at the National Health Regulatory Services revealed that whole blood has been banned for patients around the world, while in Pakistan, whole blood is still administered.

&ldquo;A bottle of blood contains four components, including plasma, red cells, white cells and platelets. All over the world, patients are given only those components which they require while the other components are preserved to save the lives of other patients,&rdquo; revealed Dr Waheed.

No national blood drives

According to the American Red Cross, one blood donation can save up to three lives. However, research shows that donating a bag of blood not only benefits the recipient but also positively impacts the mental health of the donor. Findings published by the Mental Health Foundation have revealed that people who donate blood experience reduced mental stress, improved emotional well-being, and an enhanced sense of belonging.

Unfortunately, despite the many advantages of blood donation, people across the country have little or no awareness over its importance thanks to the failure of the government to organise a national blood drive and encourage and empower people to play their part in saving lives.

&ldquo;The tendency of voluntary blood donation is very low among people in Pakistan. Therefore, in case of blood shortage, we have to organise blood camps in universities, colleges and other institutions for collecting blood donations,&rdquo; said Dr Mazhar Khamisani, manager of the blood bank at the Civil Hospital Karachi.

Sources of the Express Tribune have revealed that a voluntary blood donation campaign has not been launched at the government level in Karachi till date. Hence, voluntary blood donation campaigns are organised by various private blood banks operating across colleges and universities. In these camps, young students are encouraged to donate blood voluntarily.

Similar is the case in the heart of Punjab, Lahore, where no government agency is willing to collect blood for patients. Although the Blood Transfusion Authority and the Blood Transfusion Institute were formed in the past, neither could be sustained and are no longer active.

&ldquo;These bodies were formed for collecting, preserving and storing blood in government hospitals but due to the lack of planning, they were discontinued. Now, there are blood banks in the hospitals, but they have measly facilities to store blood hence very little blood is available in case of emergencies. If these institutions are made active, it can be a great convenience for the people who are currently relying on private institutions,&rdquo; said Saeed Ilahi, health minister during the PML-N era.

Up north in Khyber-Pakhtunkhwa, Shahid Khan, an employee at a government hospital, explained that although blood banks were established in public hospitals, there was an alarming discrepancy in the allocation of blood. &ldquo;When relatives of patient&rsquo;s demand blood, the hospital staff asks for blood bags, but during the surgery, the same blood is often not used and instead ends up being sold in the black market,&rdquo; revealed Khan.



Women and barriers to donation

In spite of endless debates highlighting gender difference, the solid proof of the shared humanity of men and women is evident in the fact that the same blood flows through the veins of both. However, when it comes to donating blood, women are generally discouraged from playing their part in serving humanity due to various social and health barriers.

Shumaila, a student at Jinnah University, expressed her willingness to donate blood. However, she believed that myths and a lack of available information on blood donation acted as major barriers. &ldquo;Young women are often made to believe that donating blood might lead to complications during their future pregnancies and deliveries. Furthermore, there are no awareness campaigns at the government level to promote blood donation. Therefore, women do not know where to donate blood,&rdquo; said Shumaila.

Similarly, Amna, a homemaker, felt that the burden of household responsibilities including childcare and daily chores often left women too exhausted to even consider blood donation. &ldquo;Furthermore, family members, particularly husbands, discourage us from donating blood since they fear that it may cause weakness. Therefore, voluntary blood donation is extremely rare among women in our society,&rdquo; opined Amna.

According to sources of the Express Tribune, the overall rate of blood donation in Pakistan stands at 18 per cent, to which women, who comprise 55 per cent of the country&rsquo;s population, rarely contribute. These figures are alarming when compared to 70 countries around the world including the US and Canada, where the tendency of donating blood voluntarily is 100 per cent.

Although myths around donation could partly withhold healthy women from saving lives, the reality is that the high incidence of anaemia among women across urban and rural areas means that a significant percentage of the female reproductive aged population is more likely to be the recipient rather than the donor of blood.

As per the guidelines issued by the Punjab Blood Transfusion Authority, women can donate blood however, those who are pregnant, breastfeeding, recovering from miscarriage or childbirth or suffering from heavy menstrual bleeding or cramping are advised against donation. Due to the aforementioned reproductive conditions, many women develop low haemoglobin levels and are unable to donate since their levels fall below 12.5 g/dl.

According to the National Nutrition Survey of Pakistan 2018, 40.2 per cent of women in urban areas and 44.3 percent women in rural areas suffer from iron-deficiency anaemia also known as low haemoglobin. Deputy Director of Health Services Karachi, Dr Pir Ghulam Nabi Jillani revealed that malnutrition among women was a leading factor contributing to anaemia.

&ldquo;This is particularly the case in rural areas, where women face a plethora of health problems due to food shortages. Furthermore, many rural women suffer from parasitic infections, which also contribute to anaemia. Additionally, the consumption of harmful substances such as betel nut, chewing tobacco and clay too contribute to blood deficiency,&rdquo; emphasised Dr Jillani.

Selling or saving lives?

Blood donations are often seen as noble acts of kindness aimed at serving humanity. However, when heartless profiteers start capitalising even on people&#39;s misery, it is hard to tell whether they are actually saving lives or simply selling them.

Tariq Iqbal, husband of a pregnant woman, had to deal with a similar blood bank mafia when he was unable to find blood for his anaemic wife requiring a transfusion. &ldquo;The doctors asked me to arrange two bottles of blood. However, the private hospital&rsquo;s blood bank demanded Rs8,000 to Rs10,000. There is no uniform policy for taking blood in exchange for a donor, due to which the patient&rsquo;s family has to face countless difficulties,&rdquo; regretted Iqbal.

Shahid, the brother of another patient requiring a transfusion, revealed that people in need of blood bags from private blood banks were required to first present a donor. &ldquo;The blood bank demands Rs8,000 to Rs20,000 for a bag of blood and other components including platelets,&rdquo; said Shahid.

The situation was not much different in Punjab, where government hospitals commonly ask the relatives of patients to arrange blood of another group in exchange for the required blood group. In other instances, the relatives themselves are expected to make a direct donation. Blood is stored at blood banks in government and private hospitals and families can buy the required blood bag for Rs10,000 to Rs15,000 but if A, B and O negative blood is required, then the banks charge their desired price. Unfortunately, there is no check and balance and if someone complains, the police take minor action but no crackdown is organised by the health department regularly.

Dr Murad Ali, a medical practitioner from Peshawar, pointed out the fact that private blood centers had turned into a highly profitable business. &ldquo;Apart from a few reputable private blood centers, many are operating illegally. They set up blood donation camps on the streets, only to take the donations and sell them at inflated rates,&rdquo; he said.

Zakir Khan, a medical storeowner from Peshawar, also highlighted the rampant exploitation in the city&rsquo;s medical sector. &ldquo;Sadly, many medical stores are involved in the black market, selling blood bags to patients at exorbitant prices, ranging from Rs10,000 to Rs20,000. If the blood is O-negative, then these dealers make even more money,&rdquo; disclosed Khan.

&ldquo;We have imposed bans on several private blood centers for unethical practices. Our authority is committed to taking strict action against those involved in this illegal blood trade, which can lead to the spread of diseases,&rdquo; said a senior official from the Khyber Pakhtunkhwa Blood Transfusion Authority, on the condition of anonymity.

According to the instructions of the Sindh Blood Transfusion Authority, any donor who donates blood must first undergo a screening for HIV, Hepatitis B, Hepatitis C, syphilis, and malaria before their blood can be given to the patient.

Speaking to the Express Tribune on the matter, Dr Waheed revealed that the country&rsquo;s safe blood transfusion policy was formulated back in 2014. &ldquo;This policy is now being reviewed, and amendments are being drafted. Uniform kits are also being devised for blood screening under the new policy,&rdquo; said Dr Waheed.]]>
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			<title>ADHD &amp; women: the story you haven’t been told</title>
			<link>https://tribune.com.pk/story/2533214/adhd-women-the-story-you-havent-been-told</link>
			<comments>https://tribune.com.pk/story/2533214/adhd-women-the-story-you-havent-been-told#comments</comments>
			<pubDate>Sun, 09 Mar 25 06:50:39 +0500</pubDate>
			<dc:creator>
				<![CDATA[Ayesha Aslam]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Health]]></category><category><![CDATA[T-Magazine]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=2533214</guid>
			<description>
				<![CDATA[ADHD in women is often a hidden storm, masked by societal expectations &amp; internalised shame]]>
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				<![CDATA[I sat in the clinic&rsquo;s waiting room staring at the walls. Fear and anxiety crept in but I was ready to seek help. This moment came after a long struggle with concentration and self-discipline. What I accepted as a character flaw got a new name when a friend shared a similar experience and it rang a bell. Scouring the internet for my symptoms pointed out it could be ADHD (Attention deficit hyperactivity disorder).

I signed up for therapy despite hearing terrible stories from my circle. Part of me was happy for finally taking this step, part of me dreaded the imminent outcome.

After giving my history, finally saw the psychiatrist. A male, in his 60s, I could sense where it was headed but I resisted stereotyping.

&ldquo;What&rsquo;s your qualification?&rdquo; he asked.

&ldquo;Masters,&rdquo; I replied.

Psychiatrist: Masters ki hui larki ko ADHD hota hai? Aise bachay panchwi pass nahi kar patay [Can a girl who has done her Masters have ADHD? Such kids cannot go past grade 5]. 

The session progressed dismissing the concerns and ended with a prescription for antidepressants.

Fuelled with curiosity, I dug the internet and it showed this isn&rsquo;t an isolated case, women all over the globe are in this together. We are misunderstood, misdiagnosed and perceived to be a creature too good to have ADHD.

My personal journey leaned into learning coping mechanisms and to make do without medication until I hit the point where medical intervention became inevitable. So, I began reaching out to women with the same predicament to be fully aware of what comes with the territory.

My 20s went by being distracted, inattentive and impulsive, on the surface what looked like a lack of discipline or bad memory was just a manifestation of one of the symptoms. With my head always up in the cloud, halfway through the movie, I&rsquo;d forget the plot or the protagonist&#39;s name. It was troublesome but my inner monologue screamed &ldquo;You&rsquo;re the issue&rsquo;&rsquo; because who asks for the hero&#39;s name mid-movie?

Wanting to get things done the neurotypical way, my neurodivergent self would make a to-do list hoping to check off the list item by item. The activity would get me pumped up but my impulsive nature looked for a little inconvenience to get off the track. Building a habit was another nightmare, I turned to productivity apps and soon would be back to square one.

Beating myself for zoning out frequently, what I got wrong was, it&rsquo;s not inattention but dysregulated attention. In girls, the signs of ADHD are subtle, and internalised such having trouble focusing, staying organised, anxiety and depression, but merely because they aren&rsquo;t physically disruptive doesn&rsquo;t absolve them from the probability of being affected.

Later, I connected with Saba who&#39;s in the same boat and has been struggling to get screened for ADHD for the past two years.

&ldquo;Typically, women who exhibit ADHD symptoms are prescribed medicine for anxiety and depression. Mine was mislabelled as OCD (Obsessive-Compusive disorder), though I knew it was ADHD because one, it&#39;s genetic and runs in our family. Two, I&rsquo;m a doctor and understand better.

&ldquo;Let down by one therapist, I went to see two more but had the same misfortune every time,&rdquo; Saba shared, expressing her sheer disappointment. &ldquo;Though I had glaring symptoms of a stereotypical ADHD-er, I was shut down, even told I&rsquo;m acting up to score medicine for myself.&rdquo;

The stories of exhaustion continued. Maria, a close friend, shared the hardships she faced looking for validation of her feelings.

Recounting her experiences, she explained, &quot;That journey of mental health was a trainwreck.

&ldquo;I signed up for therapy to understand why I swung between dull moments to intense concentration only to hear, &ldquo;You can&rsquo;t have ADHD, that happens to kids only&rdquo;. I requested psych evaluations, but was told to try therapy as well. In the three sessions I took, the psychiatrist talked more than I did. When I emphasised getting assessed for ADHD, the psychiatrist dismissed the possibility stating ADHD only happens to kids and people grow out of it in adulthood. Keep in mind that no evaluation tools (tests and such) were used for any of these diagnoses.&rdquo;

As prevalent in such cases, he assumed she had BPD (Bipolar disorder) which was appalling as she has something one can refer to as textbook ADHD.

&ldquo;In my personal life, I often overcommit to multiple social events and exhaust myself keeping up with them,&rdquo; she adds. &ldquo;I also am horrible at time management at work, school, and housework, and my sleep suffers as a consequence. I also struggle with personal hygiene because the task is so daunting. In my professional life, I am often unable to concentrate and often in need of deadline extensions both at work and at school.&rdquo;

Both the ladies withdrew from therapy after a short while.

While talking to ladies navigating their lives with ADHD, the questionable demeanour of mental health professionals show how stigmatised and gendered mental health is in Pakistani culture where being born in a female body means you can have cancer but not ADHD.

Untreated ADHD

&ldquo;My ADHD almost landed me in a psych ward,&rdquo; recalled Areeba, a married professional with teenage kids discovering having ADHD at 40. &ldquo;I had a major breakdown two and a half years ago. My clueless husband ringed a close relative (related to my dad) who&rsquo;s a doctor and a well-wisher for help. She revealed, this breakdown was due to the fact that I have had ADHD just like my dad ever since I was kid, and the pieces started to fall together. My long list of always seen as attitude problems growing up and that no one cared to probe into were symptoms of ADHD. Results? Always shamed for my slow reflexes, focus was a nightmare. Science and maths weren&#39;t impossible to get, they were not just not taught in a way my brain would understand. Now diagnosed with clinical depression, I have given up trying to blend in. Despite flagging my ADHD, I still get treated for depression only. A little awareness back then and much more inclusive/accommodating medical help now could have done the trick.&rdquo;

In Asian cultures, women have this silent expectation to be super. Anything less is unacceptable.

When we hear the word ADHD most of us think of it as a guy&rsquo;s thing because society boxes us as compliant and competent beings. The research skewed heavily towards boys adds insult to injury. What this stigma perpetuates is a culture of denying diagnosis to women.

The popular myths about ADHD have an equally negative impact just as the condition itself and are very damaging, especially for women. Disorders aren&rsquo;t gendered. When it comes to ADHD, girls are as likely to have it as boys. But because it doesn&rsquo;t resonate with the fallacy of &lsquo;unruly schoolboy&rsquo; women are subjected to a point-blank refusal in therapy.

ADHD is a reality not a gendered disorder 

&ldquo;This bias is implicit not only in Asia but all over the world that ADHD is a man&#39;s disorder because of how it manifests in men and women&rdquo;, said Dr Samiya Iqbal, Adult and Child and adolescent Psychiatrist.

&ldquo;The precursors of ADHD in childhood are inattention, hyperactivity and impulsivity. Inattention is a prevalent behaviour in girls as compared to externally observable attributes of hyperactivity and impulsivity in boys.&rdquo;

&ldquo;Hyperactivity includes cutting people, inability to sit in peace while inattentiveness is careless mistakes, say, losing things, appearing forgetful, or zoning out. Symptoms in boys are more noticeable as they&#39;re bothersome to people around and hence get on the radar. Girls aren&#39;t typically that unruly or show such symptoms and there&#39;s not much scientific basis to understand why this happens.&rdquo; She said, talking about how ADHD manifests in men and women.

&ldquo;If the teacher to student ratio in a class gets high the kids are more likely to get an assessment of ADHD and this diagnostic criteria of picking only externally observable behaviour is a challenging situation.&rdquo;

Unfortunately this explicit difference in manifestation of ADHD and the diagnostic criteria favouring the boys makes the assessment process discriminatory for young girls.

&ldquo;Another factor is the way we raise girls is that they conform to social norms which masks the hyperactivity or impulsivity in girls and consequently they&#39;re misdiagnosed a lot of times. This bias in the screening process can be addressed by configuring the early childhood diagnosis criteria and making it more considerate of internal feelings.&rdquo;

&ldquo;In adulthood, untreated ADHD triggers behavioural problems which become the major contributor to misdiagnosis of ADHD as personality issues.&rdquo; 

&ldquo;When one grows up with untreated ADHD, they are predisposed to esteem issues. For instance, if we internalise the problem and think of the struggles as our own fault it gives rise to anxiety and depression which eventually becomes the point of focus in treatment not ADHD.&rdquo;

This is the reason girls are put on schizophrenic medicine instead of given treatment for ADHD.

Boys on the other hand are likely to get into substance abuse or risky behaviours which again prompts the people around to point them to help.

ADHD manifests in all aspects of life, personally and professionally 

Discussing the consequences of ADHD Dr Samiya said, &ldquo;As humans we typically have an idea about how capable or intelligent we are as humans. What ADHD does is despite our capabilities it impairs our ability to initiate, prioritise or organise any task, complimented by a warped perception of time, also called &ldquo;time blindness&rdquo; that leads to punctuality and planning issues.&rdquo;

&ldquo;The consequences of this can be underachievement in childhood but they&#39;re more detrimental in adulthood/professional life leading to high personal and societal cost. An example could be a barrier to equal opportunity to work. In most of the cases the symptoms are presumed to be personal shortcomings instead of any underlying condition inciting esteem issues. That&#39;s why adults with ADHD come up with issues in emotional regulation and managing relationships.&rdquo;

Adult life and ADHD

&ldquo;Navigating life with ADHD as an adult is tricky, the dopamine ebbs and flows, distraction is a constant and consistency is an uphill battle. Even an ad during an important video draws my attention,&rdquo; shared Hafsa. &ldquo;I grew up doing great in studies, my only gripe was with time management and although I worked at prestigious places my career trajectory never went up. My peers progressed but I didn&rsquo;t progress much, pitting myself against them I started beating myself up. Our work was the same but what was special about them? I always wondered. My output was meticulous but procrastination was my biggest hurdle, report writing gave me chills making extensions in deadlines my permanent ask. When I moved continents the pressure to prove myself intensified. Again, it was me against the superficial standards I set for myself. Seeing my anxiety about falling short sneaking in, my husband suggested therapy to me. After taking sessions for 1.5 years my therapist suspected ADHD. I went for an assessment and the results affirmed ADHD.&rdquo; She recalled her experience of getting diagnosed at the age of 32. When asked if having a female therapist on board helped her in the diagnosis? She replied, &ldquo;Having a therapist with ADHD helped me, I had seen other therapists and was always told I had anxiety, depression. Only she was able to identify the loop of repeated patterns I was stuck in. Rejection sensitivity, time blindness, sluggish cognitive tempo, she put a finger on what felt like mere emotions and kept me in the perpetual phase of self-shame. It was relieving to know my condition was pathological and not a personal issue.&rdquo;

This case might not be a norm but it&#39;s evident to demonstrate that psychologists and therapists have a key role in providing support to adults with ADHD. A heightened awareness about adult ADHD and administering the skills and resources needed to facilitate proper diagnosis of ADHD in adults can decrease the subjectivity in evaluation and break the cycle.

In our side of the hemisphere where the masses grapple with the concept of equal pay and equal rights this health disparity is yet another man-made calamity inflicted upon women. The criminal discrimination is surprising but nothing new. You might have encountered one or more females with (diagnosed/undiagnosed) ADHD in your circle, given the prevalence the number could be high.

Here&rsquo;s the thing to understand, women are underdiagnosed/misdiagnosed because of their ability to mask the symptoms. But putting a bandage on the wound conceals the wound but doesn&#39;t heal the pain. Early intervention can do wonders for us otherwise the symptoms get worse with time translating into low self-esteem, troubled relationships and greater healthcare costs for women.

&nbsp;

Ayesha Aslam is a freelance contributor 

All facts and information are the sole responsibility of the writer

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