Summary Besides a global health crisis, the COVID-19 pandemic has potential to have a severe and long-lasting psychological impact on frontline healthcare workers such as paramedics. It is imperative to shed light on these mental health issues and employ interventions to protect the mental wellness of this vulnerable group of healthcare workers.

Traveling in search of healing is quite common in Pakistan, where people gravitate toward large urban tertiary-care centers. In this article the authors explore psychodynamic aspects of the therapeutic journey, with respect to the traveler, the healer, and other symbolic aspects of the doctor-patient relationship in the multicultural nation of Pakistan.

Mental health problems like schizophrenia, bipolar affective disorder and use of second generation antipsychotics (SGA) are linked to the risk of developing metabolic syndrome. The purpose of our study was to determine the level of compliance to monitoring metabolic symptoms associated with second generation antipsychotics according to the standards of NICE guidelines. Secondly, we aim to develop a workable standardized protocol. A total of 385 patients admitted to psychiatric ward from February 2015-January 2016 were included in the study. Case files were reviewed to obtain relevant clinical information. Assessment of height, weight, pulse, blood pressure, movement disorders, level of physical activity and nutritional status were measured in all patients. Fasting blood glucose was measured in 99 (26.5%), glycosylated hemoglobin (HbA1c) in 39 (10.4%), blood lipid profile in 44 (11.8%) and prolactin in 3 (0.8%) patients. Less than half of the patients (118, 31.6%) underwent ECG investigation. Slow titration of medication (331, 88.5%) and a trial at optimum dosage (343, 81.7%) were routinely seen. Overall physical health and patient well-being was recorded in the majority of subjects (310, 82. 9%). A significant number of physical and biochemical parameters were not routinely monitored. Our study reports findings consistent with previous literature. With this we hope to highlight important concerns and make recommendations, especially in country like Pakistan where these monitoring systems are non-existing. This will not only reduce the risk of a number of complications secondary to antipsychotic medications, but will also improve patient adherence and compliance to the pharmacological treatment.