Journal of Medical and Health Research Insights (JMHRI)

The Impact of AI on Critical Thinking among Medical Students in Khyber Pakhtunkhwa A Cross-sectional Study

Abbas Inayat, Khalid Aziz, Muhammad Kamran — Sun, 07 Sep 2025 16:07:51 +0000

Background: Artificial Intelligence (AI) is increasingly being utilized in medical education, as learning tools and decision-making tools in the clinic. However, we are not yet certain of its impact on the critical thinking ability of medical students. Although AI has benefits such as improved diagnosis and quicker decision-making, its use is feared to decrease students' ability to problem-solve independently.

Objective: The study investigates the impact of AI on the critical thinking skills of Khyber Pakhtunkhwa (KPK), Pakistan medical students.

Methods: Cross-sectional study was conducted among 376 MBBS and BDS medical students of various study years. Data were collected using a structured questionnaire with due consideration of how AI is applied, what the students' perception is about its impact on critical thinking, and how it is applied in practical usage. Statistical analysis was performed with SPSS 26.

Results:The results indicated that 33% of the students use AI tools occasionally, 27.1% use them not very often, and 26.9% use them frequently. The most widely used AI tools were diagnostic software (46.5%) and educational chatbots (29.4%). Despite the perception that AI-powered learning benefited them in decision-making and problem-solving, 37.3% were concerned that overusing AI would reduce the capacity to think autonomously. Nevertheless, 71% had a very positive or quite positive perception of AI use in medical education.

Conclusion: AI may be employed to promote critical thinking in medical students if utilized appropriately. Its integration into education should be closely managed to prevent dependency and to ensure that it augments, rather than replaces, traditional approaches to problem-solving. There is much research that needs to be done to verify long-term effects and optimal practices in the integration of AI into medical education.

Eye Health Policy and the Challenge of Preventable Blindness in Pakistan

Asif Satti — Sun, 07 Sep 2025 16:10:01 +0000

Background: Blindness and visual impairment remain major public health challenges in low- and middle-income countries (LMICs). In Pakistan, more than 12 million people live with visual impairment, including 2 million who are blind, with most cases being preventable or treatable. Despite national programs aligned with WHO’s Vision 2020 and Vision 2030, gaps in implementation persist.

Objective: To analyze the epidemiology of blindness in Pakistan, review national eye health policies, identify cultural and systemic barriers to implementation, and propose policy recommendations for sustainable prevention of avoidable blindness.

Methods: A systematic narrative review was conducted using PRISMA guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched for articles published between 2000 and 2024. Government reports, WHO documents, and NGO publications were included. Data on prevalence, causes, policies, and interventions were extracted and narratively synthesized.

Results: Cataracts, uncorrected refractive errors, and diabetic retinopathy are the leading causes of blindness in Pakistan. National programs improved cataract surgical coverage and established over 300 district-level eye care centers, yet urban–rural disparities, gender inequities, and financial barriers persist. NGOs such as the Layton Rahmatulla Benevolent Trust (LRBT) have played a pivotal role in service provision, but sustainability remains a challenge. Integration of eye care into primary health care and universal health coverage is limited, while diabetic retinopathy is emerging as a growing threat due to Pakistan’s rising diabetes prevalence.

Conclusion: Preventable blindness in Pakistan reflects a policy–implementation gap. Strengthening eye health policy requires integration into primary healthcare, addressing gender and rural access barriers, and developing sustainable financing. Priority should be given to cataract and refractive error programs, diabetic retinopathy screening, female-centered outreach, and expansion of mid-level ophthalmic personnel to achieve equitable eye care and align with WHO’s Vision 2030.

Reproductive Health Policy and Cultural Challenges: Navigating Barriers to Women’s Health in Low- and Middle-Income Countries

Rehana Naz Soomro , Rafaqat Ali — Sun, 07 Sep 2025 16:12:16 +0000

Background: Reproductive health is fundamental to women’s well-being and maternal-child outcomes, yet low- and middle-income countries (LMICs) continue to experience high maternal mortality and low contraceptive uptake. Despite formal reproductive health policies, cultural, religious, and gender-related barriers limit effective implementation.

Objective: To examine how cultural and religious norms shape reproductive health outcomes, assess policy frameworks in LMICs, and evaluate culturally sensitive strategies for improving women’s access to reproductive health services.

Methods: A systematic narrative review was conducted using PRISMA guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched for studies published between 2000 and 2024. Eligible studies included peer-reviewed research and policy reports focusing on reproductive health policy, cultural barriers, and interventions in LMICs. Data were narratively synthesized and summarized into evidence tables.

Results: Policies in LMICs, including Pakistan and India, align with WHO and UNFPA recommendations but face weak governance and implementation gaps.¹¹,¹² Cultural and religious barriers—such as misconceptions that contraception is anti-Islamic reduce service uptake in Pakistan, Bangladesh, and Sub-Saharan Africa.⁶,¹⁵,¹⁶ Women’s autonomy and education strongly predict improved contraceptive use and antenatal care.¹³,¹⁷ Effective interventions include community-based female health workers, integration of religious leaders, and telemedicine platforms.²⁰⁻²³

Conclusion: Reproductive health policies in LMICs cannot succeed without addressing cultural and religious barriers and empowering women. Culturally sensitive, community-based, and technology-supported approaches are essential to bridge the gap between policy and practice. Strengthening women’s autonomy, engaging local leaders, and scaling innovative delivery models are key to reducing maternal mortality and improving reproductive health outcomes.

People’s University of Medical & Health Sciences for Women, Nawabshah

Saima Sohail Janjua — Sun, 07 Sep 2025 16:14:15 +0000

Importance: Knee osteoarthritis (OA) is a leading cause of pain and disability worldwide, with disproportionate impact in low- and middle-income countries (LMICs) where resource limitations constrain evidence-based care.

Objective: To synthesize current evidence on the management of knee OA and evaluate the challenges of translating global guidelines into resource-limited health systems, with a focus on Pakistan and comparable LMICs.

Evidence Review: A narrative review was conducted using PubMed, Scopus, Web of Science, and Cochrane Library (2000–2025). Randomized controlled trials, systematic reviews, meta-analyses, and clinical guidelines were included. Data were extracted on non-pharmacologic, pharmacologic, injection-based, and surgical interventions, with emphasis on feasibility in LMICs.

Findings: A total of 146 sources met inclusion criteria. Non-pharmacologic interventions (exercise therapy, weight reduction, and patient education) demonstrated consistent benefit and are strongly recommended by international guidelines. Oral and topical NSAIDs provide effective pain relief, though safety and affordability differ across settings. Acetaminophen shows limited efficacy. Corticosteroid injections offer short-term relief, while hyaluronic acid is no longer broadly supported. Platelet-rich plasma demonstrates promise but remains experimental and costly. Total knee arthroplasty is highly effective but inaccessible to most LMIC patients due to financial and infrastructural constraints. Cultural factors, gender inequities, and insufficient rehabilitation services further exacerbate care gaps.

Conclusions and Relevance: Management of knee OA in LMICs requires adaptation of evidence-based strategies to local constraints. Policy priorities should include integrating OA care into primary healthcare, task-shifting rehabilitation services, subsidizing surgical interventions, and expanding patient education. Strengthening musculoskeletal health systems will be essential to reduce disability and improve quality of life in resource-limited settings.

The Overlooked Burden: Mental Health Challenges Among Chronic Illness Patients and Clinical Pathways for Integrated Care

Sajjad Hussain Khan Jillani — Sun, 07 Sep 2025 16:16:19 +0000

Background: Chronic illnesses such as diabetes, cardiovascular disease, cancer, and COPD are frequently accompanied by depression and anxiety, which exacerbate disease burden and worsen clinical outcomes. Despite evidence of high prevalence, mental health care remains under-integrated into chronic disease management, particularly in low- and middle-income countries.

Objective: To synthesize evidence on the prevalence, clinical impact, and treatment of depression among patients with chronic illnesses, and to evaluate the effectiveness of pharmacological, non-pharmacological, and integrated care approaches.

Methods: A systematic review was conducted following PRISMA guidelines. PubMed, Scopus, Web of Science, and PsycINFO were searched for studies published between 2010 and 2024. Eligible studies included randomized controlled trials, meta-analyses, and observational studies that reported prevalence, treatment outcomes, or integrated care models. Data were narratively synthesized and summarized in evidence tables.

Results: Depression prevalence in chronic illness patients was nearly double that of the general population, ranging from 17% to 22% in diabetes cohorts.¹,² Comorbid depression was associated with poor adherence, worsened disease outcomes, increased complications, and higher mortality risk.³⁻⁵ Antidepressants demonstrated modest efficacy (SMD = 0.42), with stronger effects in cardiovascular disease, though tolerability was reduced.⁹⁻¹⁰ Psychosocial interventions—including cognitive behavioral therapy, behavioral activation, mindfulness-based therapy, and structured exercise—showed comparable or superior efficacy.¹²⁻¹⁵ Integrated care models improved both psychological and clinical outcomes (e.g., HbA1c, blood pressure, LDL cholesterol), highlighting the benefits of multidisciplinary management.⁶⁻⁷,¹¹

Conclusion: Depression is highly prevalent among chronic illness patients and significantly worsens clinical outcomes. Both pharmacological and psychosocial interventions are effective, but integrated care models provide the most comprehensive benefits by addressing physical and psychological needs simultaneously. Health systems—particularly in Pakistan—should prioritize routine mental health screening, adopt collaborative care frameworks, and invest in culturally adapted interventions to reduce the dual burden of chronic illness and depression.