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  • 1
    Online Resource
    Online Resource
    Maternal near miss, mortality and their correlates at tertiary care hospital
    Pakistan Medical Association ; 2021
    In:  Journal of the Pakistan Medical Association ( 2021-04-13), p. 1-15
    Details
    In: Journal of the Pakistan Medical Association, Pakistan Medical Association, ( 2021-04-13), p. 1-15
    Abstract: ABSTRACT        OBJECTIVE:  To determine the frequency and causes of maternal near miss and mortality among pregnant women. METHODS: This cross-sectional study was conducted Jan 2016 - Dec 2018. All near miss cases, admitted in Gynecology department of Services Hospital Lahore during the study period, were prospectively recruited. WHO criteria was used to identify maternal near miss cases. Primary outcome measures were frequency and causes of near miss and maternal mortality to near miss ratio. Secondary outcome measures were delays, need for massive blood transfusion, ICU admission, obstetric hysterectomy and hospital stay 〉 7 days. RESULTS: During the study period, there were 10,739 live births, 305 near miss cases and 29 maternal deaths. Frequency of near miss was 28.4/ 1000 live births and maternal mortality to near miss ratio was 1:10.5. There were 215(70.4%) unbooked patients and 23(79.3%) of them died (p 〈 0.001). Hemorrhage accounted for 150 (49.18%), hypertensive disorders 102 (33.44%),cardiac disease 25 (8.28%) and infection for 12 (3.97%) near miss cases respectively. Maternal mortality was significantly low for hemorrhage, hypertension, sepsis and cardiac disease; 6 vs 150, 8 vs102, 3vs 12 and 10 vs 25 respectively (p 〈 0.001). Massive blood transfusion was given to 20.98%patients, 15.74% underwent hysterectomy, 32.13% required ICU admission. First and second delay was seen in 78.6% of patients with 86.2% deaths (p 〈 0.001) CONCLUSION: Hemorrhage and hypertension are major reasons for near miss but timely intervention can prevent mortality. Strengthening care at primary and secondary level can reduce the burden of maternal morbidity.  Continuous....
    Type of Medium: Online Resource
    ISSN: 0030-9982
    URL: Article
    DOI: 10.47391/JPMA.05-678
    Language: Unknown
    Publisher: Pakistan Medical Association
    Publication Date: 2021
    detail.hit.zdb_id: 2128872-0
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  • 2
    Online Resource
    Online Resource
    Machine learning risk prediction of mortality for patients undergoing surgery with perioperative SARS-CoV-2: the COVIDSurg mortality score
    Oxford University Press (OUP) ; 2021
    In:  British Journal of Surgery Vol. 108, No. 11 ( 2021-11-11), p. 1274-1292
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 108, No. 11 ( 2021-11-11), p. 1274-1292
    Abstract: To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znab183
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2006309-X
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  • 3
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    Online Resource
    Synthesis and Characterization of Processable Polyimide Titania Nanohybrids
    Trans Tech Publications, Ltd. ; 2011
    In:  Advanced Materials Research Vol. 326 ( 2011-9), p. 88-96
    Details
    In: Advanced Materials Research, Trans Tech Publications, Ltd., Vol. 326 ( 2011-9), p. 88-96
    Abstract: A new aromatic diamine monomer {4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine (DPA -4) were synthesized in high yield and purity. {4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine (DPA -4) monomer were reacted with Tetra carboxylic dianhydride (BT) leading to the formation of polyamic acid, followed by the preparation of polyimide/Titania hybrid films through non-hydrolytic sol-gel method. The synthesized polyimide were considered as blank & compared with the nano-hybrids derived from polyimides/Titania blends of different TiO 2 content. Synthesized polyimide showed excellent solubility in aprotic solvents like DMF, DMSO, NMP, and DMAC proving best processibility in various applications. Polyimide exhibited excellent thermal stability and its glass transition temperature was 450°C & 5% weight loss is in the range of 500°C~600°C. The thermal stability of Polyimide/Titania composites decreased slightly with increase of TiO 2 content. Result show decrease in thermal stability of nano-hybrids caused by the decomposition of catalytic activity of Titania & incomplete imidizations of polyamic acid. The absorption band of PI-O-Ti bonds in FTIR spectra of hybrids films revealed the formation of hybrid inorganic network between polyimide and TiO 2 .Scanning electron microscopy results indicated that the nanometer-scaled inorganic domains were homogeneously dispersed in polyimides matrix due to the introduction of TiO 2. The studies on the optical properties of hybrids films indicated the red-shift to the absorption band increased with increasing TiO 2 content, while all the hybrids films maintained their transparencies. This kind of hybrid materials has potential commercial application in the field of opto-electronics appliances.
    Type of Medium: Online Resource
    ISSN: 1662-8985
    URL: Issue
    URL: Article
    DOI: 10.4028/www.scientific.net/AMR.326
    DOI: 10.4028/www.scientific.net/AMR.326.88
    Language: Unknown
    Publisher: Trans Tech Publications, Ltd.
    Publication Date: 2011
    detail.hit.zdb_id: 2265002-7
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  • 4
    Online Resource
    Online Resource
    Hepatitis B Virus (HBV) a Severe Health Problem in Mardan, Khyber Pakhtunkhwa: A Molecular Based Study
    University of Management and Technology ; 2019
    In:  BioScientific Review Vol. 01, No. 01 ( 2019-02), p. 25-32
    Details
    In: BioScientific Review, University of Management and Technology, Vol. 01, No. 01 ( 2019-02), p. 25-32
    Type of Medium: Online Resource
    ISSN: 2663-4198 , 2663-4201
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.32350/BSR.0101
    DOI: 10.32350/BSR
    DOI: 10.32350/BSR.0101.03
    Language: Unknown
    Publisher: University of Management and Technology
    Publication Date: 2019
    detail.hit.zdb_id: 3041603-6
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  • 5
    Online Resource
    Online Resource
    Lumbar Canal Stenosis Decompression Using Bilateral Interlaminar Versus Classic Laminectomy Technique
    Pakistan Society of Neurosurgeons ; 2022
    In:  Pakistan Journal Of Neurological Surgery Vol. 26, No. 4 ( 2022-12-23), p. 554-561
    Details
    In: Pakistan Journal Of Neurological Surgery, Pakistan Society of Neurosurgeons, Vol. 26, No. 4 ( 2022-12-23), p. 554-561
    Abstract: Objective:  The study compared the postoperative back pain VAS score in bilateral interlaminar and classic laminectomy techniques in patients with lumbar canal stenosis. Material and Methods:  This randomized controlled experiment was carried out at Ayub Teaching Hospital's Neurosurgery Department. 30 patients were in the bilateral interlaminar (BIL) group (A) and 30 were in the traditional laminectomy group (B). The bilateral interlaminar decompression technique was carried out utilizing the operating microscope. Both groups employed facet joint undercutting to reduce the 61-facet joint excision. All patients had postoperative CT scans to assess how well the decompression went. Postoperative VAS score was stratified to age, gender, duration of complaints, and duration of the procedure. Results:  In group A, the mean age of patients was 51.10 years while in group B, the mean age was 54.500 years. There was a male dominance of male patients in both groups. The baseline mean VAS score was 7.9 in group A and group B both. The duration of the procedure was 71.2 minutes in group A, and 104.7 minutes in group B. Mean postoperative VAS score was 5.4 in group A and 3.3 in group B. There existed a significant difference in mean postoperative VAS scores between groups concerning gender, the duration of complaints, and procedures. Conclusion:  In patients with lumbar canal stenosis, bilateral interlaminar allows for safe and adequate spinal canal decompression. Keywords:  Lumbar canal stenosis (LCS), Bilateral Interlaminar (BIL), Classic Laminectomy, Visual Analog Scale (VAS).
    Type of Medium: Online Resource
    ISSN: 2409-5567 , 1995-8811
    URL: Article
    DOI: 10.36552/pjns.v26i4.800
    Language: Unknown
    Publisher: Pakistan Society of Neurosurgeons
    Publication Date: 2022
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  • 6
    Online Resource
    Online Resource
    Diagnosis and Management of Diffuse Large B-Cell Lymphoma: Society of Medical Oncology, Pakistan Society of Hematology, and Pakistan Society of Clinical Oncology Joint Clinical Practice Guideline
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  JCO Global Oncology , No. 7 ( 2021-12), p. 1647-1658
    Details
    In: JCO Global Oncology, American Society of Clinical Oncology (ASCO), , No. 7 ( 2021-12), p. 1647-1658
    Abstract: Diffuse large B-cell lymphoma (DLBCL) is the commonest non-Hodgkin lymphoma encountered by hematopathologists and oncologists. Management guidelines for DLBCL are developed and published by countries with high income and do not cater for practical challenges faced in resource-constrained settings. This report by a multidisciplinary panel of experts from Pakistan is on behalf of three major national cancer societies: Society of Medical Oncology Pakistan, Pakistan Society of Hematology, and Pakistan Society of Clinical Oncology. The aim is to develop a practical and standardized guideline for managing DLBCL in Pakistan, keeping in view local challenges, which are similar across most of the low- and middle-income countries across the globe. Modified Delphi methodology was used to develop consensus guidelines. Guidelines questions were drafted, and meetings were convened by a steering committee to develop initial recommendations on the basis of local challenges and review of the literature. A consensus panel reviewed the initial draft recommendations and rated the guidelines on a five-point Likert scale; recommendations achieving more than 75% consensus were accepted. Resource grouping initially suggested by Breast Health Global Initiative was applied for resource stratification into basic, limited, and enhanced resource settings. The panel generated consensus ratings for 35 questions of interest and concluded that diagnosis and treatment recommendations in resource-constrained settings need to be based on available resources and management expertise.
    Type of Medium: Online Resource
    ISSN: 2687-8941
    URL: Article
    DOI: 10.1200/GO.21.00320
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 3018917-2
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  • 7
    Online Resource
    Online Resource
    Effect of Simvastatin on Hepatic Venous Portal Gradient for Maintenance of Lipid Profile of Liver Cirrhosis patients
    Lahore Medical and Dental College ; 2022
    In:  Pakistan Journal of Medical and Health Sciences Vol. 16, No. 10 ( 2022-10-30), p. 78-80
    Details
    In: Pakistan Journal of Medical and Health Sciences, Lahore Medical and Dental College, Vol. 16, No. 10 ( 2022-10-30), p. 78-80
    Abstract: Background: Liver cirrhosis has an essential influence on the lipid profile. Statins have well-known beneficial cardiovascular effects reducing cardiovascular events and mortality. Aim: To compare the change in hepatic venous portal gradient with or without simvastatin for maintenance of lipid profile of liver cirrhosis patients Methods: This Randomized controlled trial was done at Department of Medicine, South medical ward, Mayo hospital, Lahore from October 2021 to March 2022.patients were randomly divided in two groups. In group A, patients were given simvastatin with standard treatment. In group B, patients were given standard treatment only. Before and after 1 month of treatment, lipid profile and HVPG level were assessed again. The change in HVPG and lipid profile was calculated. Data was entered and analyzed in SPSS version 25. Results: The mean age of patients received simvastatin was 55.26 ± 13.24 years and mean age of patients in control was 53.74 ± 16.88 years. In simvastatin group, there were 82 (54.7%) males and 68(45.3%) females. In control group, there were 93 (62.0%) males and 57(38%) females. With simvastatin, the mean HVPG level was reduced from 20.11± 6.21mg/dl to 15.42±4.71 mg/dl after a month (mean change = 4.69 ± 1.50 mg/dl). While in control group, mean HVPG level was reduced from 19.28±7.61 mg/dl to 17.82± 6.52 mg/dl after a month (mean change = 1.46±1.09 mg/dl). The effect size was 23.3% with simvastatin while 7.6% without simvastatin for reduction of HVPG in cirrhotic patients. The difference was observed to be significant (p 〈 0.05). Conclusion: Thus, addition of simvastatin is effective in controlling lipid profile of patients with liver cirrhosis. It also has beneficial role in improving condition of liver cirrhosis patients. Keywords: hepatic venous portal gradient, simvastatin, lipid profile, liver cirrhosis, LDL, HDL, total cholesterol, triglycerides
    Type of Medium: Online Resource
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.53350/pjmhs221610
    DOI: 10.53350/pjmhs2216
    DOI: 10.53350/pjmhs22161078
    Language: Unknown
    Publisher: Lahore Medical and Dental College
    Publication Date: 2022
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  • 8
    Online Resource
    Online Resource
    SUPRACONDYLAR FRACTURE OF HUMERUS; : RADIOLOGICAL ASSESSMENT OF CLOSED REDUCTION BY BAUMANN ANGLE
    Independent Medical Trust ; 2012
    In:  The Professional Medical Journal Vol. 19, No. 03 ( 2012-05-10), p. 308-311
    Details
    In: The Professional Medical Journal, Independent Medical Trust, Vol. 19, No. 03 ( 2012-05-10), p. 308-311
    Abstract: Objectives: To assess closed reduction by Baumann angle in supracondylar fractures humerus treated by closed reduction andpercutaneous pinning. Material and Methods: This prospective study of 50 patients who presented with displaced supracondylar fracture ofhumerus in children between ages 1-12 years were admitted to Orthopedic and Trauma unit of Hayatabad Medical Complex Peshawar overperiod from January 2008 to July 2009. Closed reduction and percutaneous pinning were performed under general anesthesia and postoperativereduction was assessed by Baumann angle. All patients were followed for one year. Results: Mean age of the patients was 7.02 years± 2.25 SD. Loss of Baumann angle in injured side was range from 2O to 8O. Loss of carrying angle in injured side was range from 3O to 9O. WhenBaumann angle and carrying angle of both sides were compared the mean Baumann angle loss and carrying angle loss were 5.360 ± 2.22 SDand 4.320 ± 1.52 SD respectively. Using Flynn’s criteria 36 (72%) patients out of 50 patients with carrying-angle loss considered to be excellentresults and 14(28%) good results. Neither of the patient developed cubitus varus deformit y after one year of follow-up. Conclusions: Baumannangle of the humerus is a simple and reliable measurement of closed reduction that can be used to predict final carrying angle in supracondylarhumeral fractures in children.
    Type of Medium: Online Resource
    ISSN: 2071-7733 , 1024-8919
    URL: Article
    DOI: 10.29309/TPMJ/2012.19.03.2118
    Language: Unknown
    Publisher: Independent Medical Trust
    Publication Date: 2012
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  • 9
    Online Resource
    Online Resource
    Diagnosis and Management of Diffuse Large B Cell Lymphoma in Resource Constraint Settings: Society of Medical Oncology Pakistan, Pakistan Society of Haematology and Pakistan Society of Clinical Oncology Joint Clinical Practice Guideline
    American Society of Hematology ; 2021
    In:  Blood Vol. 138, No. Supplement 1 ( 2021-11-05), p. 4971-4971
    Details
    In: Blood, American Society of Hematology, Vol. 138, No. Supplement 1 ( 2021-11-05), p. 4971-4971
    Abstract: Purpose: To provide evidence-based recommendations for health care professionals on diagnosis and management of diffuse large B cell lymphoma (DLBCL) in resource constraint settings with variable and often limited access to standard of care and advanced diagnostic and therapeutic facilities. Methods: Modified Delphi methodology[1] was used to generate consensus by experts of three major cancer societies of Pakistan; namely Society of Medical Oncology Pakistan (SMOP), Pakistan Society of Hematology (PSH) and Pakistan Society of Clinical Oncology (PSCO). Guidelines questions were drafted and meetings were convened by steering committee to develop initial recommendations based on local challenges and review of the literature. Consensus panel reviewed the initial draft recommendations and rated the guidelines on five-point Likert scale; recommendations achieving more than 75% consensus were accepted. Resource grouping initially suggested by Breast Health Global Initiative[2] was applied for resource stratification into basic, core and enhanced resource settings. Results: The expert panel advised use of limited immunohistochemistry (IHC) including CD20, CD3 and Ki67% for initial diagnosis in core (limited) resource settings and extended panel in enhanced resources. Cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) with or without rituximab (as per resource setting) remains the standard first line treatment while second line treatment should be offered based on resource availability and patient related factors. Both intra thecal and high dose methotrexate can be used for CNS prophylaxis. Recommendations by guideline committee are listed in Table 1. Conclusion: Diagnosis and treatment recommendations in resource constraint settings should be developed based on available diagnostic, therapeutic resources and management expertise. References: Niederberger, M. and J.J.F.i.p.h. Spranger, Delphi Technique in Health Sciences: A Map. 2020. 8: p. 457.Eniu, A., et al., Guideline implementation for breast healthcare in low-and middle-Income countries: Treatment resource allocation. 2008. 113(S8): p. 2269-2281. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood-2021-145488
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2021
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 10
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    Online Resource
    Physicochemical and Pharmacokinetic Evaluation of Praziquantel Co-Crystals by Varying the Spacer Group of Co-Crystal Formers
    Penerbit Universiti Kebangsaan Malaysia (UKM Press) ; 2022
    In:  Sains Malaysiana Vol. 51, No. 10 ( 2022-10-31), p. 3271-3284
    Details
    In: Sains Malaysiana, Penerbit Universiti Kebangsaan Malaysia (UKM Press), Vol. 51, No. 10 ( 2022-10-31), p. 3271-3284
    Abstract: The research work focuses on investigating the effects of spacer group (varying aliphatic chain length=n) of co-crystal formers (oxalic acid (OA, n=0), (malonic acid (MA, n=1), (succinic acid (SA, n=2), (glutaric acid (GA, n=3), and (adipic acid (AA, n=4) on the physicochemical properties and oral bioavailability of praziquantel (PZQ) co-crystals. For this purpose, different co-crystals of PZQ with dicarboxylic acid co-crystal formers (OA, MA, SA, GA, and AA) were synthesized. These co-crystals were characterized by powder X-ray diffractometry (XRPD), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FT-IR), and thermogravimetry (TG) techniques. The in-vitro (solubility and dissolution) and in-vivo pharmacokinetic (P.K) studies were performed for PZQ co-crystals. Additionally, the effect of polymer hydroxypropyl cellulose (HPC) on the formation of PZQ co-crystals was also investigated. According to the study results, PZQ-SA co-crystal showed improved solubility, dissolution, and oral bioavailability. Overall, the solubility, dissolution, and oral bioavailability are consistent with each other. The order of improved solubility, dissolution, and oral bioavailability is observed as consistent like PZQ-SA 〉 PZQ-AA 〉 PZQ-GA 〉 PZQ-OA 〉 PZQ-MA 〉 pure PZQ. Concerning HPC polymer effects, PZQ-OA, PZQ-MA, PZQ-GA, and PZQ-AA co-crystals were formed successfully in the presence of HPC polymer but the PZQ-SA co-crystal was inhibited.
    Type of Medium: Online Resource
    ISSN: 0126-6039 , 2735-0118
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.17576/jsm-2022-5110
    DOI: 10.17576/jsm
    DOI: 10.17576/jsm-2022-5110-13
    Language: Unknown
    Publisher: Penerbit Universiti Kebangsaan Malaysia (UKM Press)
    Publication Date: 2022
    detail.hit.zdb_id: 2751030-X
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