This study retrospectively analyzes the organizational handling of the COVID-19 pandemic by Mexico’s health authorities, from its outbreak in February 2020 to the final phase of the pandemic. The analysis begins with the undercounting of infected persons and deaths, which led to distorted figures and an abnormally high case fatality rate. The underestimation is examined separately for infections, deaths, and case fatality rates. The number of infected persons was affected by insufficient COVID-19 testing and restrictions on hospitalization. Death figures were evaluated by comparing mortality trends observed during the five years preceding the outbreak with the postpandemic data disaggregated by cause of death. These data were first collected by health authorities, reviewed by the Interinstitutional Group for the Estimation of Excess Mortality (GIEM, in Spanish), and later consolidated by the National Institute of Statistics and Geography (INEGI, in Spanish). The case fatality rate was calculated as the relationship between both variables on the basis of the original figures published by health authorities. After different calculation methods were explored, a more plausible estimate of the real COVID-19 death toll was established. Despite the need to correct the initial figures, the official database has not been updated. This lack of correction misinforms the public about the real impact of COVID-19 and risks leading the health system to repeat the statistical and organizational failures observed during the pandemic, potentially underestimating future health emergencies.

Premenstrual syndrome (PMS) affects many adolescent girls in terms of physique, behavior, and psychology. However, evidence regarding the association between PMS severity and academic performance among adolescents in peri-urban areas of Pakistan remains limited. This cross-sectional analytical study was conducted from May to September 2024 among 270 adolescent girls enrolled in secondary and higher secondary schools in Bara Kahu, Islamabad, using multistage cluster sampling. This study determined the frequency and severity of PMS and examined its association with academic performance. Overall, 85.93% of the participants reported PMS symptoms, with 35.19% experiencing mild, 30.00% moderate, 12.59% severe, and 8.15% very severe symptoms. For inferential analysis, PMS severity was categorized into mild, moderate, and severe levels. A statistically significant association was observed between PMS severity and academic performance (χ² = 34.565; p < 0.001). Spearman’s rank correlation further demonstrated a significant negative correlation between PMS severity and academic performance (ρ = −0.356, p < 0.01), indicating poorer academic performance with increasing symptom severity. These findings suggest that greater PMS severity is associated with reduced academic performance among adolescent girls in peri-urban Islamabad. While causality cannot be inferred because of the cross-sectional design, the results highlight the relevance of menstrual health in educational contexts during adolescence.

Acute watery diarrhea (AWD) is a significant contributor to morbidity as well as mortality among underfive children, predominantly in resource-limited settings. Although rehydration therapy is the cornerstone of management, it has a limited role in reducing the duration and severity of diarrhea. This study compared the duration of hospital stay in children aged 6–60 months with AWD and some or severe dehydration, with or without acute malnutrition, who received racecadotril as an adjunct to standard therapy versus standard therapy alone. This comparative interventional study was conducted in the Pediatric Medicine Department, Mayo Hospital, Lahore. A total of 208 children fulfilling the selection criteria were enrolled and allocated into two groups (104 participants per group) using a random number table. All participants received standard treatment for AWD. Children in Group A received three divided doses of racecadotril (1.5 mg/kg/day) in addition to the standard treatment, whereas children in Group B were administered only the standard treatment. The duration of hospital stay and reduction in loose stool frequency were recorded for all participants. Our results revealed that the median hospital stay duration was significantly shorter in Group A [22.75 hours (IQR = 11.00) versus 61.00 hours (IQR = 24.00) in Group B; p < 0.001]. Similarly, the median decrease in the frequency of loose stools during hospitalization was significantly greater in Group A [9.00 (IQR = 2.00) versus 5.00 (IQR = 2.00) in Group B; p < 0.001]. Among children with moderate acute malnutrition (MAM), the median hospital stay duration was significantly shorter in Group A [40.00 hours (IQR = 35.00)] than in Group B [65.00 hours (IQR = 29.00)] (p = 0.003). Similarly, among children with varying degrees of dehydration (some or severe) classified according to the WHO criteria, the median duration of hospital stay remained significantly lower in Group A (p < 0.001) than in Group B (p = 0.013). Racecadotril as an adjunct to standard therapy significantly reduced the duration of hospital stay in children aged 6–60 months with AWD, including those with MAM and some or severe dehydration.

Mobile phone applications have increasingly been used as tools for literacy development in children with hearing impairment. This cross-sectional study determined parental knowledge of mobile applications and explored how demographic factors relate to that knowledge; and included 376 parents of children with hearing impairment. The study used a structured questionnaire and a purposive sampling technique for data collection. Results of the study highlighted that most parents showed a moderate level of knowledge (67.55%), while 21.81% had high knowledge and 10.64% had low knowledge. Many parents felt that mobile applications helped their children’s learning activities, including communication, vocabulary development, problem solving, and understanding of educational content. Parental knowledge was significantly associated with parent or guardian gender (χ² = 7.605; p = 0.022), parent or guardian education (χ² = 20.572; p = 0.008), and child’s academic grade (χ² = 39.361; p < 0.001). Our study found that parents or guardians generally had a moderate level of knowledge about using mobile applications to support literacy which varies by gender, educational level, and child’s academic grade suggesting digital awareness is not evenly distributed across different parent groups. These findings suggest a need for targeted educational intervention in order to strengthen digital literacy, especially among parents with lower educational attainment. Such interventions could help these parents better support their children’s literacy development.

Anxiety and poor quality of sleep are common among medical students, and they are affected by exhaustive academic schedules as well as different curricular models at teaching institutions. This study examined differences in the levels of anxiety and sleep experiences among medical students who were registered in two different types of curricula at a private medical college, determined whether curriculum type is related to differences in anxiety and sleep patterns, as well as explored the relationships between anxiety and sleep features among students for each type of curriculum. This  cross-sectional comparative study was conducted for six months at Niazi Medical & Dental College (NMDC) and included 184 students, with 92 participants in each curriculum group. A nonprobability quota sampling technique with equal distribution was used, and anxiety and quality of sleep were determined by using the Hamilton Anxiety Rating Scale (HAM-A) and Pittsburgh Sleep Quality Index (PSQI), respectively. The results of the study revealed that most participants were from the 4th year (n = 66, 35.9%), the median HAM-A score was 23.00, and the median PSQI score was 7.00. No statistically significant difference was observed in the levels of anxiety between the two curriculum groups (p = 0.137). However, students in the modular curriculum reported significantly poorer quality of sleep (p = 0.036) and shorter sleep duration (p = 0.009). Anxiety was significantly positively correlated with overall PSQI scores in both the annual (p < 0.001) and the modular (p < 0.001) curricula. In the modular group, anxiety was significantly associated with overall quality of sleep, sleep latency, sleep disturbance, reduced sleep efficiency, and fewer hours in bed (all p < 0.05). The study concluded that anxiety levels did not differ significantly between the two curriculum types. However, students in the modular curriculum experienced poor quality and shorter durations of sleep. Furthermore, anxiety was significantly associated with adverse sleep outcomes.