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  • 1
    Online Resource
    Online Resource
    Mary Ann Liebert Inc ; 2020
    In:  Metabolic Syndrome and Related Disorders Vol. 18, No. 1 ( 2020-02-01), p. 56-64
    In: Metabolic Syndrome and Related Disorders, Mary Ann Liebert Inc, Vol. 18, No. 1 ( 2020-02-01), p. 56-64
    Type of Medium: Online Resource
    ISSN: 1540-4196 , 1557-8518
    Language: English
    Publisher: Mary Ann Liebert Inc
    Publication Date: 2020
    detail.hit.zdb_id: 2110505-4
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  • 2
    Online Resource
    Online Resource
    Elsevier BV ; 2019
    In:  Journal of Psychiatric Research Vol. 116 ( 2019-09), p. 83-87
    In: Journal of Psychiatric Research, Elsevier BV, Vol. 116 ( 2019-09), p. 83-87
    Type of Medium: Online Resource
    ISSN: 0022-3956
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 1500641-4
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  • 3
    Online Resource
    Online Resource
    S. Karger AG ; 2018
    In:  Interventional Neurology Vol. 7, No. 1-2 ( 2018), p. 99-109
    In: Interventional Neurology, S. Karger AG, Vol. 7, No. 1-2 ( 2018), p. 99-109
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Digital subtraction angiography (DSA) remains the gold standard imaging modality for cerebrovascular disorders. In contrast to developed countries, the safety of the procedure is not extensively reported from the developing countries. Herein, we present a retrospective analysis of the basic technique, indications, and outcomes in 286 patients undergoing diagnostic cerebral and spinal angiography in a developing country, Pakistan. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A retrospective review of patient demographics, procedural technique and complication rates of 286 consecutive patients undergoing the diagnostic cerebral/spinal angiography procedure at one institution from May 2013 to December 2015 was performed. Neurological, systemic, or local complications occurring within and after 24 h of the procedure were recorded. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Mean age reported for all patients was 49.7 years. Of all the 286 cases, 175 were male (61.2%) and the rest female (111, 38.8%). Cerebral DSA was performed in 279 cases (97.6%), with 7 cases of spinal DSA (2.4%). Subarachnoid hemorrhage was the most common indication for DSA accounting for 88 cases (30.8%), closely followed by stroke (26.6%) and arteriosclerotic vascular disease (23.1%). No intra- or post-procedural neurological complications of any severity were seen in any of the 286 cases. One case of asymptomatic aortic dissection was reported (0.3%) in the entire cohort of patient population. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Diagnostic cerebral/spinal digital subtraction angiography was found to be safe in Pakistan, with complication rates at par with and comparable to those reported in the developed world.
    Type of Medium: Online Resource
    ISSN: 1664-9737 , 1664-5545
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 2662855-7
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  • 4
    Online Resource
    Online Resource
    S. Karger AG ; 2018
    In:  Interventional Neurology Vol. 7, No. 6 ( 2018), p. 378-388
    In: Interventional Neurology, S. Karger AG, Vol. 7, No. 6 ( 2018), p. 378-388
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 To assess the safety and clinical efficacy of carotid artery stenting with and without an embolic protection device (EPD) in both symptomatic and asymptomatic carotid disease cases. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Retrospective data of 55 symptomatic (≥50% occlusion by digital subtraction angiography [DSA], ≥70% by ultrasound, computed tomography angiography [CTA] , and magnetic resonance angiography [MRA]) and asymptomatic (≥60% by DSA, ≥70% by ultrasound, ≥80% by CTA and MRA) carotid disease cases undergoing carotid stenting/angioplasty revascularization from February 2014 to October 2017 was reviewed. All symptomatic patients either experienced recurrent transient ischemic attacks or one or more stroke attacks. An EPD protocol was designed for its selective use based on plaque morphologies and working diameters. The primary end points at 30 days of follow-up were a periprocedural incidence of any stroke, myocardial infarction or death, and ipsilateral stroke during the follow-up period. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 55 cases, 39 were males and 16 females; mean age was 64.8 years. Fifty-one patients (92.7%) were symptomatic, with a mean stenosis of 80.1%. EPD was used in only 11 cases (20%). Minor stroke rate during the first 30 postoperative days was 1.8% (1 case) with EPD; no myocardial infarction or mortality. No stroke occurred during the median 1.5 years’ follow-up. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Based on our single-center experience and findings of a relatively small sample size, carotid revascularization with stenting and angioplasty without EPD in experienced hands was found to be safe and efficacious. In addition, it proves cost-effective for patients by limiting the use of unnecessary disposables. These results are comparable to those reported in major trials and are well within the complication thresholds suggested in current guidelines. These results also show promise and illustrate the need for a larger, randomized controlled trial in order to thoroughly address this aspect of carotid revascularization.
    Type of Medium: Online Resource
    ISSN: 1664-9737 , 1664-5545
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 2662855-7
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  • 5
    In: Metabolic Syndrome and Related Disorders, Mary Ann Liebert Inc, Vol. 19, No. 9 ( 2021-11-01), p. 483-490
    Type of Medium: Online Resource
    ISSN: 1540-4196 , 1557-8518
    Language: English
    Publisher: Mary Ann Liebert Inc
    Publication Date: 2021
    detail.hit.zdb_id: 2110505-4
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  • 6
    In: PeerJ, PeerJ, Vol. 6 ( 2018-09-10), p. e5519-
    Abstract: Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor–patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor–patient relationship. Methods A descriptive, cross-sectional study design with convenience (non-probability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or “HOs” (recent graduates doing their 1 year long internship) and post-graduate trainees or “PGRs” (residents for 4–5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor–patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS ( P   〉  0.05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson’s burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor–patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced.
    Type of Medium: Online Resource
    ISSN: 2167-8359
    Language: English
    Publisher: PeerJ
    Publication Date: 2018
    detail.hit.zdb_id: 2703241-3
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