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  • 1
    Online Resource
    Online Resource
    ASO Author Reflections: Demystifying the Drain Dilemma—Antibiotic Prophylaxis After Mastectomy with Indwelling Drains
    Springer Science and Business Media LLC ; 2023
    In:  Annals of Surgical Oncology Vol. 30, No. 10 ( 2023-10), p. 5976-5977
    Details
    In: Annals of Surgical Oncology, Springer Science and Business Media LLC, Vol. 30, No. 10 ( 2023-10), p. 5976-5977
    Type of Medium: Online Resource
    ISSN: 1068-9265 , 1534-4681
    URL: Article
    DOI: 10.1245/s10434-023-13908-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2074021-9
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  • 2
    Online Resource
    Online Resource
    Practice Patterns of Antibiotic Prophylaxis in Patients Undergoing Mastectomy: A Survey of Members of the American Society of Breast Surgeons
    Springer Science and Business Media LLC ; 2022
    In:  Annals of Surgical Oncology Vol. 29, No. 10 ( 2022-10), p. 6314-6322
    Details
    In: Annals of Surgical Oncology, Springer Science and Business Media LLC, Vol. 29, No. 10 ( 2022-10), p. 6314-6322
    Type of Medium: Online Resource
    ISSN: 1068-9265 , 1534-4681
    URL: Article
    DOI: 10.1245/s10434-022-12223-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2074021-9
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  • 3
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    A Review of Coronaviruses Associated With Kawasaki Disease: Possible Implications for Pathogenesis of the Multisystem Inflammatory Syndrome Associated With COVID-19
    SAGE Publications ; 2022
    In:  Clinical Medicine Insights: Pediatrics Vol. 16 ( 2022-01), p. 117955652210753-
    Details
    In: Clinical Medicine Insights: Pediatrics, SAGE Publications, Vol. 16 ( 2022-01), p. 117955652210753-
    Abstract: Multisystem Inflammatory Syndrome in Children (MIS-C), representing a new entity in the spectrum of manifestations of COVID-19, bears symptomatic resemblance with Kawasaki Disease (KD). This review explores the possible associations between KD and the human coronaviruses and discusses the pathophysiological similarities between KD and MIS-C and proposes implications for the pathogenesis of MIS-C in COVID-19. Since 2005, when a case-control study demonstrated the association of a strain of human coronavirus with KD, several studies have provided evidence regarding the association of different strains of the human coronaviruses with KD. Thus, the emergence of the KD-like disease MIS-C in COVID-19 may not be an unprecedented phenomenon. KD and MIS-C share a range of similarities in pathophysiology and possibly even genetics. Both share features of a cytokine storm, leading to a systemic inflammatory response and oxidative stress that may cause vasculitis and precipitate multi-organ failure. Moreover, antibody-dependent enhancement, a phenomenon demonstrated in previous coronaviruses, and the possible superantigenic behavior of SARS-CoV-2, possibly may also contribute toward the pathogenesis of MIS-C. Lastly, there is some evidence of complement-mediated microvascular injury in COVID-19, as well as of endotheliitis. Genetics may also represent a possible link between MIS-C and KD, with variations in FcγRII and IL-6 genes potentially increasing susceptibility to both conditions. Early detection and treatment are essential for the management of MIS-C in COVID-19. By highlighting the potential pathophysiological mechanisms that contribute to MIS-C, our review holds important implications for diagnostics, management, and further research of this rare manifestation of COVID-19.
    Type of Medium: Online Resource
    ISSN: 1179-5565 , 1179-5565
    URL: Article
    DOI: 10.1177/11795565221075319
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2579551-X
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  • 4
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    Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report
    Springer Science and Business Media LLC ; 2022
    In:  Cureus
    Details
    In: Cureus, Springer Science and Business Media LLC
    Type of Medium: Online Resource
    ISSN: 2168-8184
    URL: Article
    DOI: 10.7759/cureus.28744
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2747273-5
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  • 5
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    Socio-demographic and antenatal risk factors of brain tumor in children and young people: A matched case-control study from Karachi, Pakistan
    SAGE Publications ; 2023
    In:  Journal of Public Health Research Vol. 12, No. 3 ( 2023-07)
    Details
    In: Journal of Public Health Research, SAGE Publications, Vol. 12, No. 3 ( 2023-07)
    Abstract: Brain tumors are a common cause of morbidity, disability, cognitive deterioration and mortality in children, even after treatment. Little is know about the specific causes. The study aimed to assess potential socio-demographic and antenatal factors in primary brain tumor (PBTs) in children and young people (CYP) in Karachi, Pakistan. Designs and methods: A single center hospital based matched case control study in Karachi, Pakistan. Cases were defined as CYP aged between 5 and 21 years with any histological type and grade of primary brain tumor of any histology, stage or grade. Data were collected from parents of 244 patients at the selected center between 2017 and 2021 via telephonic interview. Controls were 5–21 years old CYP admitted with non-oncological diagnoses matched on age and sex. Matched Odds Ratios for predictors of brain tumor in children were derived. Those of statistical significance were included in a multivariable logistic regression model. Results: In the adjusted model, lower paternal education (matched adjusted odds ratio (maOR) 2.46; 95% CI 1.09–5.55), higher household monthly income (maOR 3.4; 95% CI 1.1–10.2), antenatal paternal use of addictive substances (maOR 19.5; 95% CI 2.1–179.8), and antenatal maternal use of analgesics during pregnancy (maOR 3.0; 95% CI 1.2–7.9) were all independently predictive of brain tumors. Conclusion: This matched case-control study found novel associations between maternal use of analgesics, paternal use of addictive substances, higher household income, and lower paternal education and Primary Brain Tumors in Children and Young People. Longitudinal multicenter studies will be required to test these associations prospectively.
    Type of Medium: Online Resource
    ISSN: 2279-9036 , 2279-9036
    URL: Article
    DOI: 10.1177/22799036231197185
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2672312-8
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  • 6
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    GRADE-ADOLOPMENT of clinical practice guidelines and creation of clinical pathways for the primary care management of chronic respiratory conditions in Pakistan
    Springer Science and Business Media LLC ; 2023
    In:  BMC Pulmonary Medicine Vol. 23, No. 1 ( 2023-04-17)
    Details
    In: BMC Pulmonary Medicine, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-04-17)
    Abstract: In Pakistan, chronic respiratory conditions contribute a large burden of morbidity and mortality. A major reason for this is the lack of availability of local evidence-based clinical practice guidelines (EBCPGs) in Pakistan, particularly at the primary care level. Thus, we developed EBCPGs and created clinical diagnosis and referral pathways for the primary care management of chronic respiratory conditions in Pakistan. Methods The source guidelines were selected by two local expert pulmonologists after a thorough literature review on PubMed and Google Scholar from 2010 to December 2021. The source guidelines covered idiopathic pulmonary fibrosis, asthma, chronic obstructive pulmonary disorders, and bronchiectasis. The GRADE-ADOLOPMENT process consists of three key elements: adoption (using recommendations as is or with minor changes), adaptation (effective context-specific changes to recommendations) or additions (including new recommendations to fill a gap in the EBCPG). We employed the GRADE-ADOLOPMENT process to adopt, adapt, adopt with minor changes, or exclude recommendations from a source guideline. Additional recommendations were added to the clinical pathways based on a best-evidence review process. Results 46 recommendations were excluded mainly due to the unavailability of recommended management in Pakistan and scope beyond the practice of general physicians. Clinical diagnosis and referral pathways were designed for the four chronic respiratory conditions, explicitly delineating the role of primary care practitioners in the diagnosis, basic management, and timely referral of patients. Across the four conditions, 18 recommendations were added (seven for IPF, three for bronchiectasis, four for COPD, and four for asthma). Conclusion The widespread use of the newly created EBCPGs and clinical pathways in the primary healthcare system of Pakistan can help alleviate the morbidity and mortality related to chronic respiratory conditions disease in the country.
    Type of Medium: Online Resource
    ISSN: 1471-2466
    URL: Article
    DOI: 10.1186/s12890-023-02409-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2059871-3
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  • 7
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    Low-cost peer-taught virtual research workshops for medical students in Pakistan: a creative, scalable, and sustainable solution for student research
    Springer Science and Business Media LLC ; 2021
    In:  BMC Medical Education Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Medical Education, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Pakistan has not been a major contributor to medical research, mainly because of the lack of learning opportunities to medical students. With the increase in online learning systems during COVID-19, research related skills can be taught to medical students via low-cost peer taught virtual research workshops. Aim of the Study To assess the effectiveness of a comprehensive low-cost peer-taught virtual research workshops amongst medical students in Pakistan. Methods This quasi-experimental study assessed the effectiveness of five virtual research workshops (RWs) in improving core research skills. RWs for medical students from across Pakistan were conducted over Zoom by medical students (peer-teachers) at the Aga Khan University, Pakistan, with minimal associated costs. The content of the workshops included types of research, ethical approval and research protocols, data collection and analysis, manuscript writing, and improving networking skills for research. Improvement was assessed via pre-and post-quizzes for each RW, self-efficacy scores across 16 domains, and feedback forms. Minimum criteria for completion of the RW series was attending at least 4/5 RWs and filling the post-RW series feedback form. A 6-month post-RW series follow-up survey was also emailed to the participants. Results Four hundred medical students from 36 (/117; 30.8%) different medical colleges in Pakistan were enrolled in the RWs. However, only 307/400 (76.75%) medical students met the minimum requirement for completion of the RW series. 56.4% of the participants belonged to the pre-clinical years while the rest were currently to clinical years. The cohort demonstrated significant improvement in pre-and post-quiz scores for all 5 RWs ( p   〈   0.001) with the greatest improvement in Data Collection and Analysis (+ 34.65%), and in self-efficacy scores across all domains ( p   〈   0.001). 166/307 (54.1%) participants responded to the 6 months post-RWs follow-up survey. Compared to pre-RWs, Research involvement increased from 40.4 to 62.8% ( p   〈   0.001) while proportion of participants with peer-reviewed publications increased from 8.4 to 15.8% ( p  = 0.043). Conclusion Virtual RWs allow for a wide outreach while effectively improving research-related knowledge and skills, with minimal associated costs. In lower-middle-income countries, virtual RWs are a creative and cost-effective use of web-based technologies to facilitate medical students to contribute to the local and global healthcare research community.
    Type of Medium: Online Resource
    ISSN: 1472-6920
    URL: Article
    DOI: 10.1186/s12909-021-02996-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2044473-4
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  • 8
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    Online Resource
    Understanding Variation in In-Hospital Mortality after Major Surgery in the United States
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Annals of Surgery Vol. Publish Ahead of Print ( 2023-03-30)
    Details
    In: Annals of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. Publish Ahead of Print ( 2023-03-30)
    Type of Medium: Online Resource
    ISSN: 0003-4932
    URL: Article
    DOI: 10.1097/SLA.0000000000005862
    RVK:
    XA 23900
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2002200-1
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  • 9
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    Online Resource
    Clinical and psychosocial factors associated with quality of life in patients with head and neck cancer: an analytical cross-sectional study from a lower-middle-income country
    Springer Science and Business Media LLC ; 2023
    In:  BMC Psychology Vol. 11, No. 1 ( 2023-09-05)
    Details
    In: BMC Psychology, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2023-09-05)
    Abstract: The disease course of head and neck (H & N) cancer can severely impair patients’ quality of life (QoL). In Pakistan, a South Asian lower-middle-income country (LMIC), psychosocial factors may impact QoL. We aimed to assess QoL and associated factors amongst patients with H & N cancer in Pakistan. Methods An analytical cross-sectional study was conducted amongst adult (≥ 18 years) patients with H & N cancer who were ≥ 4 weeks post-initiation of treatment. The survey assessed QoL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaires), anxiety and depression (Hospital Anxiety and Depression Scale), and social support (Enriched Social Support Instrument). Multivariable linear regression was performed for analysis. Results A total of 250 patients (mean age: 51.6 years) were included. The majority of patients were married (87%) and living with multigenerational/extended family households (53%). On multivariable linear regression, ongoing cancer treatment (beta coefficient: -13.93), having a tracheostomy (-10.02), and receiving adjuvant chemoradiotherapy (-8.17) were significantly associated with poorer global QoL. Additionally, poorer QoL was associated with depression (-24.37) and anxiety (-13.34). However, having more household family members was associated with better global QoL (0.34). Conclusion The QoL of patients with H & N cancer in Pakistan is affected by both the nature of cancer treatment as well as sociocultural factors such the number of household family members. Given that poorer QoL is associated with worse mental health outcomes, there is a need to develop and implement psychosocial interventions to improve the QoL of patients with H & N cancer in Pakistan, particularly during active treatment.
    Type of Medium: Online Resource
    ISSN: 2050-7283
    URL: Article
    DOI: 10.1186/s40359-023-01264-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2705921-2
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  • 10
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    Trauma in pregnant women: an experience from a level 1 trauma center
    Maad Rayan Publishing Company ; 2020
    In:  Journal of Emergency Practice and Trauma Vol. 6, No. 2 ( 2020-06-16), p. 87-91
    Details
    In: Journal of Emergency Practice and Trauma, Maad Rayan Publishing Company, Vol. 6, No. 2 ( 2020-06-16), p. 87-91
    Abstract: Objective: Trauma is the significant non-obstetrical cause of maternal mortality in women aged 35 years or younger. It is expected to complicate around 1 in 12 pregnancies and accounts for 46% of such deaths. In this study, we present our experience of trauma during pregnancy at a tertiary care hospital in Karachi. Methods: A standardized form was used to extract data from online records for all pregnant women who presented with traumatic injuries to the Aga Khan University Hospital from 2014 to 2019. Analysis was performed using SPSS v. 21. Chi-squared tests were performed for comparison of categorical data. Results: A total of 48 pregnant females with a mean age of 28.80 ± 6.50 years were included in this study. Road traffic accidents (RTA) accounted for the commonest cause of injury in the first (66.7%) and second (65%) trimesters. However, fall (45.5%) followed by RTA (27.3%) was the most frequent mechanism of injury during the third trimester. Gunshot injuries were seen in 4 patients only. Overall, fetal ultrasound was the most commonly performed imaging (87.5%) followed by limb X-ray and focused abdominal sonography for trauma (FAST) ultrasound. Out of total, 52.1% of the patients were surgically managed. Fetal demise in utero and spontaneous abortion was reported in 2 patients only. Conclusion: Road traffic accidents and falls comprise a significant burden of maternal and fetal morbidity and mortality. In terms of prevention, several policies and interventions at the government level need to be introduced in order to reduce the incidence of traumatic events.
    Type of Medium: Online Resource
    ISSN: 2383-4544
    URL: Article
    DOI: 10.34172/jept.2020.20
    Language: English
    Publisher: Maad Rayan Publishing Company
    Publication Date: 2020
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