Muhammad Irfan

Peshawar Medical College Peshawar Pakistan · Psychiatry

Introduction Accreditation in Health Professions Education is a pivotal process to ensure the quality of medical institutions and health professionals. ‘ Equity’ is an umbrella term reflecting the principles of justice and support to disadvantaged entities according to their needs. While commonly applied to various domains in medical education, the...

Objective: To identify the mental health implications among perimenopausal, menopausal, and post-menopausal women undergoing natural, surgical, or medical menopause in Sri Lanka. Design: A mixed-methods study was designed and used. Methods: The study secured ethics approval prior to commence the recruitment. This interim evaluation included 38 S...

Background: Menopause is the natural biological process marking the end of a woman's reproductive years. Common symptoms include hot flushes, night sweats, mood changes, and sleep disturbances. Menopause is diagnosed after 12 consecutive months without a period. While it’s a normal stage of life, the severity of symptoms can vary widely among women...

Objective: To assess the mental health implications among peri- menopausal, menopausal, or post-menopausal women who were undergoing natural, surgical, or medical menopause in Malaysia. Design: A mixed-methods study was designed and conducted in Malaysia following Ethics committee approval. Methods: This interim analysis involved 50 women, aged 18–...

Objective: To assess the mental health implications among per- imenopausal, menopausal, or post-menopausal women. Design: A mixed-methods study was designed and conducted in Nigeria following Ethics committee approval. Methods: This interim analysis encompasses 40 participants, including all women aged 18–90 living in Nigeria who pro- vided inform...

Objective: This study aims to determine the mental health im- pact and workforce issues of perimenopausal, menopausal, or post-menopausal women and trans men who have had natural, surgical, or medical menopause. Design: A mixed-methods study was conducted in England, Wales, Scotland and Northern Ireland following Ethics commit- tee and Health Resea...

Objective: This study aims to report the efficacy of hormone replacement therapy (HRT) in modulating lipid profile includ- ing a decrease in triglycerides (TG), subcutaneous fat thickness (SFH), and low-density lipoprotein cholesterol (LDL-C), along- side an increase in high-density lipoprotein cholesterol (HDL-C) and serum Estradiol levels. Design...

Objective: To identify the prevalence and outcomes of women undergoing pelvic organ prolapse (POP). Design: An evidence synthesis was conducted using a system- atic reivew and meta-analysis. Method: A systematic methodology was developed and pub- lished in PROSPERO (CRD42022346051). Searches were con- ducted using PubMed and Science Direct between...

Menopause marks the end of the menstruation period which can incur naturally or due to surgery where the ovaries or the uterus is removed, or the use of other treatments like chemotherapy. Menopause elicits both physiological and psychological changes such as joint or pelvic pain, headaches or migraine, cognitive function and mental health problems...

Objective: To determine the prevalence of Emotional and Behavioral problems in school-aged children of Pesha-war Pakistan. Methodology: A cross-sectional survey was conducted on students with the age range of 10-13 years from different private institutions of Peshawar from January to June 2022. The strength and difficulty questionnaire was used to...

Abstract: This study was conducted to validate the Evaluation and Nurturing Relationship Issues, Communication and Happiness (ENRICH) scale in Pashto was conducted in tertiary care teaching hospitals of Peshawar from August to October 2021 on 658 married women. The mean age of the sample was 29.56 ± 7.99 years. Majority were uneducated (n = 335, 50...

This study was conducted to validate the Evaluation and Nurturing Relationship Issues, Communication and Happiness (ENRICH) scale in Pashto was conducted in tertiary care teaching hospitals of Peshawar from August to October 2021 on 658 married women. The mean age of the sample was 29.56±7.99years. Majority were uneducated (n=335, 50.9%) and were u...

Background Self-harm is an important predictor of a suicide death. Culturally appropriate strategies for the prevention of self-harm and suicide are needed but the evidence is very limited from low- and middle-income countries (LMICs). This study aims to investigate the effectiveness of a culturally adapted manual-assisted problem-solving intervent...

A condition of exposure to multiple stressors resulting in a mixed clinical picture spanning conventional categories without meeting any of them in full, encompasses a risk for a list of comorbidities preventing appropriate prevention and treatment. New transformative transdiagnostic approaches suggest changes spanning conventional categories. They...

Objective: To assess the understanding of the patients with common mental disorders, towards issues related to their mental health. Methods: This qualitative study was conducted from December 2018 to April 2020. Thirty-four patients, suffering from common mental disorders, were interviewed in public and private sector hospitals of Peshawar. The...

Objectives In low/middle-income countries (LMICs), more than half of patients with first-episode psychosis initially seek treatment from traditional and religious healers as their first care. This contributes to an excessively long duration of untreated psychosis (DUP). There is a need for culturally appropriate interventions to involve traditional...

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Objective: To translate and validate the Hamilton Rating Scale (HAM-D) for Depression in Pashto language. Methods: The cross-sectional study was conducted at a tertiary care teaching hospital in Peshawar, Pakistan, from June to November 2021, and comprised patients of either gender diagnosed with depressive illness. The Hamilton Rating Scale for...

ABSTRACT: Objective: To assess the perception, potential benefits and perceived barriers in the application of Animal-Assisted Therapy in Pakistan. Methodology: This phenomenological qualitative study was conducted from January to February 2020. Data was collected from psychologists and psychiatrists working in Peshawar via individual interviews.10...

Objective: To determine the prevalence of Emotional and Behavioral problems in school-aged children of Pesha­war Pakistan. Methodology: A cross-sectional survey was conducted on students with the age range of 10-13 years from dif­ferent private institutions of Peshawar from January to June 2022. The strength and difficulty questionnaire was used to...

Background: The doctor-patient relationship is a central feature of the healthcare system. The recent developments in the delivery of health care have tended to focus on patient satisfaction. Therefore, this study was planned to find out the satisfaction of patients attending the outpatient department of teaching hospitals in Peshawar. Methods:...

In people with TB, co-existence of long-term conditions (e.g., depression, diabetes and HIV) and risk factors (e.g.,alcohol misuse, malnutrition, and smoking) are associated with increased mortality and poor treatment outcomes including delayed recovery, TB treatment failure and relapse. However, it is unclear as to what extent these comorbidities...

Objective To assess the effect of COVID-19 vaccination on menstrual patterns and mental health of medical students and to explore the students’ perspective regarding this effect. Materials and methods This mixed-method study was conducted on the medical and dental students of the private and public sector institutions of Peshawar from September 20...

Background: Cross-cultural adaptation and validation are important for the reliable use of a scale. This study was conducted to translate and validate the polycystic ovarian syndrome quality of life scale (PCOSQOL) in Pashto. Methods: This study was conducted in tertiary care teaching hospitals of Peshawar from August to December 2021 on 333 pat...

What motivates an individual to become an entrepreneur is at the heart of entrepreneurship research, although the topic is nebulous and requires further elaboration. Extrinsic motivation has always been related to understanding the entrepreneurial motivation of underdog entrepreneurs. We contribute to a more practical understanding of their many mo...

Online cognitive behaviour therapy (CBT), self-help and guided self-help (GSH) interventions have been found to be efficacious and cost-effective for treatment of anxiety and depression, but there are limited data from low- and middle-income countries on culturally adapted digital interventions for these common mental disorders. The aim of this stu...

The quality of mental health treatment in low and middle-income countries is a source of concern despite publications claiming that mental healthcare is improv­ing.1 Despite the presence of available evidence, that mental healthcare service development has been slow in pace in most of the developing countries.2 There are various mental health barri...

Objective: To find out the relationship between smartphone addiction and musculoskeletal discomfort in the neck and hand among medical students of Peshawar. Methodology: This cross-sectional study was conducted in the medical and dental institutions of Peshawar, Pakistan using a convenience sampling technique. The duration of the study was from Dec...

PIDD1 encodes p53-Induced Death Domain protein 1, which acts as a sensor surveilling centrosome numbers and p53 activity in mammalian cells. Early results also suggest a role in DNA damage response where PIDD1 may act as a cell-fate switch, through interaction with RIP1 and NEMO/IKKg, activating NF-κB signaling for survival, or as an apoptosis-indu...

Background: Stigma towards mental illness is among the main reasons of higher mental health burden in Pakistan, especially in women. Therefore, this study was planned to explore gender differences regarding stigma towards mental illness among medical students of Peshawar. Methods: A Cross-sectional study was conducted among the students of medic...

Background: This study aimed to test the psychometric properties of the Urdu version of the Safety Attitudes Questionnaire for inpatient settings in Pakistan. Methods: The SAQ short form (inpatient version) was translated with the back-translation technique into Urdu. The SAQ-Urdu was administered in three teaching hospitals in Pakistan to a sam...

Background: High number of SARS CoV2 infected patients has overburdened healthcare delivery system, particularly in low-income countries. In the recent past many studies from the developed countries have been published on the prevalence of SARS CoV2 antibodies and the risk factors of COVID 19 in healthcare-workers but little is known from developin...

Abstract Background: Cognitive behaviour therapy (CBT), self-help and guided self-help interventions have been found to be efficacious and cost effective for victims of trauma, but there are limited data from low- and middle-income countries on culturally adapted interventions for trauma. Aims: To investigate the feasibility and acceptability of c...

Objective: To find out the association of dysfunctional beliefs and attitudes about sleep with sleep quality in undergraduate medical and dental students. Methodology: This was a cross-sectional study which included undergraduate medical and dental students of Peshawar, conducted from December 2018 to March 2019. Participants were asked to fill out...

In a humanitarian crisis, healthcare workers are on the frontline in providing their services. Despite being crisis management personnel, healthcare workers may get exposed to occupational stress due to unprecedented circumstances, challenges in delivery of high-quality care, lack of resources, and most importantly for being at high risk to suffer...

Background Social anxiety is common among adolescents in Pakistan and is associated with low self-esteem. Among the recommended treatments, cognitive behavioural therapy (CBT) is effective, and self-help approaches are encouraged. Aim To determine the effectiveness of culturally adapted CBT-based guided self-help (CACBT-GSH) intervention, using a...

At the start of 2020, originating from Wuhan city, coronavirus disease 2019 (COVID-19) started to spread throughout China.1 The World Health Organization has declared this to be a pandemic.2 Both healthcare workers and the general public have been experiencing psychological problems, including anxiety, depression, and stress, as a result of the rap...

Objective: To find out the relationship between emotional intelligence and self-perception of medical and dental students. Methodology: A cross-sectional study was conducted in the medical and dental institutions of Peshawar-Pakistan from November 2018 to June 2019. A convenience sampling technique was used. Schutte Emotional Intelligence Scale (SE...

The preponderance of western psychological concepts are often relied upon to conceptualise health-related phenomena. It is hardly surprising therefore that despite the availability of a number of interventions, studies have concluded that outcomes for minority cultural groups are not as good as for Caucasian people (western Europe and North America...

ABSTRACT Objective: To estimate the frequency of mindfulness and correlate the impact of social support on it in medical and dental students of Peshawar. Methodology: This cross-sectional study conducted from December 2017 to March 2018, included students of medical and dental colleges of Peshawar. Participants were selected by convenience sampli...

Background: Internet gaming, though getting popular, is becoming a risk to physical and psychological health, especially in adolescents, as it contributes to sedentary lifestyle. To gauge the extent of the problem in our setup, we decided to find the frequency of internet gaming disorder in students of Peshawar and identify their motives for playi...

Western values influence cognitive behavioural therapy (CBT) as it was primarily developed and practised in the West. As understanding the cultural context has been linked to better therapy outcomes, it has been suggested that CBT might need modification to non-Western clients’ cultural backgrounds. Previously we developed a cost-effective approach...

Background The waiting room in psychiatric services can provide an ideal setting for offering evidence-based psychological interventions that can be delivered through electronic media. Currently, there is no intervention available that have been developed or tested in mental health.AimsThis proof-of-concept study aimed to evaluate a pilot design of...

p>Given the growing evidence base of psychotherapies for schizophrenia and bipolar disorder, it is timely to explore their relevance to global mental health. In this chapter, we review the evidence base for psychotherapies used in high-income countries and discuss whether and how these can be extrapolated to low- and middle-income countries (LMIC)....

Background: Biomedical knowledge, though pre-requisite, needs to be supported by other important skills, in order to transform medical education and healthcare delivery. This study was thus planned to analyze the correlation between emotional intelligence (EI) and empathy in medical and dental undergraduate students.. Methods: This cross-section...

Objective: To assess the knowledge and concepts of the patients with schizophrenia about their illness by using a vignette. Methodology: This cross sectional study was conducted in the Department of Psychiatry, Lady Reading Hospital Peshawar, from February to April 2015. One hundred and three patients with schizophrenia were included in the study t...

Abstract Objective: To find out the relationship between emotional intelligence and self-perception of medical and dental students. Methodology: A cross sectional study was conducted in the medical and dental institutions of Peshawar-Pakistan from November 2018 to June 2019. Convenience sampling technique was used. Schutte Emotional Intelligence S...

Objective: : To investigate personality disorders in medical students appearing for medical school entrance exam. Methods: The cross-sectional study was conducted at Peshawar Medical College from August 2015 to May 2016, and comprised all the students who undertook medical school entrance examination of the College. They were asked to fill scree...

Objective: To explore psychological distress in terms of depression, anxiety, social dysfunction, depressive and somatic symptoms among students appearing for medical school entrance examination. Methods: The cross-sectional study was conducted at Peshawar Medical College, Peshawar, Pakistan, from August 2015 to May 2016, and comprised all stude...

Objective: To estimate the frequency of burnout in medical students of Peshawar and correlate the impact of social support on it. Methodology: The study was conducted by using cross-sectional research design that included students of medical colleges of Peshawar, from January to March 2017. Oldenburg Burnout Inventory (OLBI) and Social Support Rati...

Objective: To find out the frequency of body-focused repetitive behaviours (BFRBs) in medical students of Peshawar. Methodology: This cross-sectional study included students from different medical colleges of Peshawar. Habit questionnaire was used to check the common habits; it consists of 11 questions with a simple ‘Yes’ or ‘No’ responses and noti...

Objective: To study psychiatric problems among those attending primary care clinics in two major cities in Punjab, Pakistan. Methodology: This was a cross-sectional study. The participants attending primary care clinics in Lahore and Faisalabad in Punjab, Pakistan were interviewed from October 2015 to October 2016. The Mini International Neuropsych...

Aim The aim of this study was to inform thinking around the terminology for ‘schizophrenia’ in different countries. Objectives The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatisin...

Objective: To translate and validate the Bradford Somatic Inventory (BSI) in Pashto. Methodology: This study was conducted in Peshawar from July 2015 to January 2016 on 216 participants. The participants consisted of two groups; students (n=111), and patients (n=105) with a mean age of 21.8 ±5.6 years. Three bilingual experts, using forward-backwar...

Objective: To translate and validate the hospital anxiety and depression scale (HADS) in Pashto. Methodology: This study was conducted in Peshawar from July 2015 to January 2016 on 216 participants. The participants consisted of two groups; students (n=111) and patients (n=105). Mean age of the sample was 21.8 ±5.6 years. Majority were females [n=1...

Objective: To translate and validate the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in Pashto. Methodology: This study was conducted in Peshawar from July 2015 to January 2016 on 216 participants. The participants consisted of two groups; students (n=111) and patients (n=105) with a mean age of 21.8 ±5.6 years. Three...

Objective: To find out the relationship between mindfulness and bullying behaviour among school children in Pakistan. Methodology: This cross sectional research was conducted in three private sector schools of Multan from March to August 2015. Two hundred gender- matched students, aged between 8 to 11 years were enrolled for the study. The assessme...

The current paper provides an overview of the cultural and religious background of Pakistan; the current situation of mental health in Pakistan with special emphasis on cultural adaptation of cognitive behaviour therapy (CBT) in Pakistan. In the context of Sufism- Islamic Mindfulness, it is interesting to note that it has been easy to explain the c...

This paper discusses the provision of mental health services in lower- and middle-income countries (LAMIC) with a view to identifying culture-specific areas that can be improved and generalised within and across different countries and services. The paper highlights the need for prioritisation of mental health services by incorporating local popula...

This randomized controlled trial was conducted at Department of Psychiatry, Lady Reading Hospital, Peshawar from February to August 2015 to explore beliefs and concepts of patients with schizophrenia about their illness and to find out the effectiveness of structured educational intervention in changing the explanatory models of illness of the pati...

Objective: To find out the extent of use of essential medicines in the prescriptions and the knowledge of medical practitioners about the national essential medicines list of Pakistan. Methodology: This paper describes two phases of a study focused on national essential medicines list of Pakistan. Conducted at Kuwait Teaching Hospital, Peshawar bet...

Objective: To find out the relationship of irritable bowel syndrome (IBS) and generalized anxiety disorder (GAD) among students of Peshawar Medical College and Peshawar Dental College. Methodology: This Cross sectional study was conducted in Peshawar Medical College and Peshawar Dental College from November 2015 to February 2016. ROME III criteria...

What CAREIF proposes There is an urgent need to review the availability of culturally adapted interventions and available adaptation frameworks. Standardised guidelines including lists or catalogues of resources and some measures of effectiveness and acceptability for different adapted interventions are required. This would not only require a serie...

Low- and middle-income countries (LAMIC) have enormous burden of psychotic disorders with prevalence of schizophrenia between 1.4 and 4.6 per 1,000 (Jablensky 2000). While the burden is very heavy, the resources available to treat them are very limited. “For example, per 100,000 population, Psychiatrists working in the mental health sector in the m...

‘Some editors are failed writers, but so are most writers.’ TS Eliot (1888–1965) Have you ever wondered what medical journal editors do? Most editors in the medical field are unpaid and the work is part of the wider culture of service provided by so many in the medical profession. Together with the editorial board and the publisher, an editor will...

Objectives: To find out the choices of female medical students in selection of their future specialties and to study the factors influencing their decision. Methodology: This cross-sectional study was conducted among public & private sector medical colleges of Peshawar including Khyber Medical College (KMC), Rahman Medical College (RMC), Peshawar M...

Objective: To assess the knowledge and practices of general practitioners about diagnosis and treatment of schizophrenia and determine their association with clinical exposure to such cases in practice. Methods: The cross-sectional study was conducted in Peshawar from August 2009 to December 2011 at the clinics of general practitioners enrolled wit...

Objective: To demonstrate the effectiveness of Brief Culturally adapted Cognitive Behavior Therapy (CaCBT) in the treatment of Obsessive Compulsive Disorder (OCD). Methods: This pre and post design study was conducted on out-patients with OCD at Centre for Cognitive Behaviour Therapy, Fountain House, Lahore, from April 2011 to April 2012. A semi...

The Death Adjustment Hypothesis (DAH) postulates two key themes. Its first part postulates that death should not be considered the end of existence and the second part emphasizes that the belief in immortal pattern of human existence can only be adopted in a morally rich life with the attitude towards morality and materialism balanced mutually. We...

This study was conducted to objectively assess whether the medical education environment across Pakistan was at an acceptable standard and to determine factors influencing its perception. The cross-sectional study was conducted from August to November 2012 at six undergraduate medical institutions across Pakistan. The Dundee Ready Education Environ...

This study was conducted to elicit the beliefs and perception of patients with schizophrenia about their illness by using Short Explanatory Model Interview (SEMI). This cross sectional study was conducted in the department of psychiatry, Lady Reading Hospital. One hundred and three patients of schizophrenia were included in the study. Short Explana...

Evidence for the effectiveness of Culturally adapted CBT for psychosis in Low And Middle Income Countries (LAMIC) is limited. Therefore, brief Culturally adapted CBT for psychosis (CaCBTp) targeted at symptoms of schizophrenia for outpatients plus treatment as usual (TAU) is compared with TAU. A total of 116 participants with schizophrenia were rec...

Evidence for the effectiveness of Culturally adapted CBT for psychosis in Low And Middle Income Countries (LAMIC) is limited. Therefore, brief Culturally adapted CBT for psychosis (CaCBTp) targeted at symptoms of schizophrenia for outpatients plus treatment as usual (TAU) is compared with TAU. A total of 116 participants with schizophrenia were rec...

Objectives To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Treatment As usual (TAU)– delivered by trained therapists using a manual compared with alone TAU. Methods This was an assessor-blinded, randomised controlled clinical trial. Particpants with a diagnosis of depression, attending psychiatry depa...

This study was conducted to determine the efficacy of brief Culturally adapted CBT(CaCBT) for depression when added to Treatment As usual(TAU) delivered by trained therapists using a manual compared with alone TAU. This was an assessor-blinded, randomised controlled clinical trial. Participants with a diagnosis of depression,attending psychiatry de...

This study was conducted to compare the frequency of postnatal depression in women following Normal Vaginal Delivery and Caesarian Section. A comparative study was conducted in Departments of Obstetrics & Gynecology of Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar from November 2009 to January 2010. A total...

To test the reliability and applicability of Urdu translation of the International personality disorder examination (IPDE) in a psychiatric outpatient population in Pakistan, this study was conducted at the outpatient department of Fatima Memorial Hospital Lahore from April 2012 to March 2013. Patients considered to have a personality disorder by a...

To test the reliability and applicability of Urdu translation of the International personality disorder examination (IPDE) in a psychiatric outpatient population in Pakistan. This study was conducted at the outpatient department of Fatima Memorial Hospital Lahore from April 2012 to March 2013. Patients considered to have a personality disorder by a...

To find out prescription patterns of general practitioners in Peshawar, a cross-sectional survey of drug prescriptions was done at six major hospitals and pharmacies of Peshawar between April and May 2011. A total of 1097 prescriptions that included 3640 drugs, were analyzed to assess completeness, average number of drugs, prescription frequency of...

Objectives: To find out prescription patterns of general practitioners in Peshawar. Methods: Cross-sectional survey of drug prescriptions was done at six major hospitals and pharmacies of Peshawar between April and May 2011. A total of 1097 prescriptions that included 3640 drugs, were analyzed to assess completeness, average number of drugs, presc...