This study analyzes the impact of these three cognitive forces (occupational stress, interpersonal trust and organizational commitment) on valence, Organizational citizenship behavior (OCB) and job satisfaction in the healthcare sector of Karachi (Pakistan). A sample of 375 responses is drawn from seven healthcare institutions of Karachi on a self-administered questionnaire. Using PLS-SEM, hypotheses and predictive relevance are tested with bootstrapping method and cross-validated redundancy analysis respectively. The results show that all three cognitive forces have significant impact on valence with the minor exception of affective commitment and strain. Moreover, valence has significant impact on both OCB has also shown a significant effect on job satisfaction. OCB has also shown a significant effect on job satisfaction. The findings of this study substantially contribute in the under-researched domain of OCB and job satisfaction in the context of the healthcare sector of Pakistan. Managerial implications and directions for future research are also discussed.

Treatment of rheumatoid arthritis (RA) is complicated, with numerous aspects influencing decision-making, including disease severity, comorbidities, and patient preferences. The present study aimed to evaluate healthcare professionals’ (HCPs) knowledge of biological disease-modifying anti-rheumatic drugs (bDMARDs) and their compliance with the standard management guidelines for assuring optimal RA therapy. The cross-sectional, survey-based study was performed in various healthcare and academic settings in Karachi, Pakistan to probe HCPs’ knowledge of bDMARDs and their compliance with the European League against Rheumatism (EULAR) recommendations for the management of RA patients. Overall, n = 413 questionnaires were included in our study (response rate: 82.6%). The physicians were further well-informed about the indications (n = 276, 91.3%, p = 0.001) and monitoring requirements (n = 258, 85.4%, p = 0.004). The pharmacists were more knowledgeable about the drug targets (n = 96, 86.4%, p = 0.029) and their mechanisms of action (n = 80, 72.0%, p = 0.013). Male respondents as compared with females (41.3% vs. 35.6%, p = 0.04), and physicians as compared with pharmacists (40.7% vs. 37.8%, p = 0.012), were more confident in using bDMARDs than conventional treatment in RA patients. Our findings show that the respondents were familiar with the attributes of bDMARDs and the standard management guidelines for RA care. Our results may be relevant in creating new methods, guidelines, and treatments to enhance RA treatment adherence, satisfaction, and health outcomes.

Cognitive enhancers (CEs) encompass a wide range of drugs, including prescription medications for attention deficit disorders and pharmacological compounds for cognitive enhancement. It is well-documented that the students are the leading cohort of CEs users. Exploring how healthcare professionals perceive the use of CEs for academic accomplishments is significant to understand their encouragement of CE use. Hence, the purpose of the current study was to look at healthcare professionals' attitudes and perceived understanding about the usage of CEs in academic contexts. The study was a quantitative cross-sectional research design conducted in different healthcare and academic settings of Karachi. The respondents were approached either through social media platforms or the official email addresses of their working organizations. Data were collected through a web link of an online questionnaire that included four sections; inquiring about the respondents' demographics characteristics, their knowledge about CEs, their attitudes towards the use and impact of CEs, and their inclination to use a hypothetical prescription-only CE. The response rate of the study was 73.3%. The majority of the respondents negated to permit university students to using CEs for cognitive boost (n ¼ 360, 67.1%), to concentrate (n ¼ 406, 75.7%), to increase vigilance (n ¼ 394, 73.5%) or to mitigate the effects of other medicines (n ¼ 312, 58.2%). The pharmacists were more likely to refute that using CEs by the students is safe (pharmacists 10.8% vs. physicians 8.3%, p¼<0.001), beneficial (pharmacists 12.7% vs. physicians 5.3%, p¼<0.001), or necessary (pharmacists 17.6% vs. physicians 12.8%, p¼<0.001). The major reasons for not encouraging the use of CEs were fear of misuse (n ¼ 510, 95.1%), safety concerns (n ¼ 495, 92.3%), and their consideration for CE as unnecessary medical intervention (n ¼ 441, 82.2%). The findings indicated that overall, respondents have a clear consensus of not letting university students use CEs for cognitive improvement or any other purpose implying that cognitive enhancement is not yet a common or approved medical practice by the healthcare professionals in Pakistan.

The cosmetic treatment strategies have been considerably popular over the last few decades among the population with respect to age, gender, and ethnicity. These procedures are easily accessible safer, minimally invasive, and more precise. Botox therapy is one of the most common non-surgical cosmetic treatment. Thus, the current study was accomplished to assess the knowledge of female students towards Botox therapy for beautification as well as for therapeutic purposes. The study was conducted form June 2018 to December 2018 in different medical colleges and universities of Karachi-Pakistan. Overall, three hundred and eighty-six female students participated in the study. Descriptive statistics were used to reveal the students' demographic information. Pearson's chi-squared test was carried out to estimate the relationship between independent variables and responses. The response rate was 77.2%. The mean age of study participants was 26.44±3.33 years. The findings of the present study revealed that 58.3% of the participants were aware of Botox therapy and found it effective in cosmetology. The unexpected side effects, high procedure costs, and lack of cosmetologists were thought to be the main reasons that limit people from using Botox in Karachi-Pakistan.

Community-acquired pneumonia (CAP) is among the most commonly prevailing acute infections in children that may require hospitalization. Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians’ compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children <6 months old with suspected bacterial CAP will probably receive better therapeutic care by hospitalization. Restricting exposure to the antibiotic as much as possible (n = 71; 29.9%), improving antibiotic prescribing (n = 59; 24.8%), and using the appropriate dose of antimicrobials (n = 29; 12.2%) were considered the major factors by the respondents to reduce antimicrobials resistance. Conclusions: The selection of antibiotics and diagnostic approach was as per the recommendations, but indication, duration of treatment, and hospitalization still can be further improved.