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Road to recompensation:BavenoⅦcriteria and transjugular intrahepatic portosystemic shunt in liver cirrhosis

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World Journal of Gastroenterology 2024年第32期30卷 3743-3747页

作者： Muhammad Aarish Anis Ammara Abdul Majeed Shahab Abid Department of Medicine Section of GastroenterologyAga Khan University HospitalSindhKarachi 74800Pakistan

Liver cirrhosis has long been considered a point of no return,with limited hope for ***,recent advancements,particularly the Baveno VII criteria and the utilization of transjugular intrahepatic portosystemic shunt(TIPS),have illuminated the concept of hepatic *** this editorial we comment on the article by Gao et al published in the recent *** editorial provides a comprehensive overview of the evolution of understanding cirrhosis,the criteria for recompensation,and the efficacy of TIPS in achieving *** discuss key findings from recent studies,including the promising outcomes observed in patients who achieved recompensation post-TIPS *** further research is needed to validate these findings and elucidate the mechanisms underlying recompensation,the insights presented here offer renewed hope for patients with decompensated cirrhosis and highlight the potential of TIPS as a therapeutic option in their management.

关键词： Decompensated hepatic cirrhosis Hepatic recompensation Transjugular intrahepatic portosystemic shunt Variceal bleeding Refractory ascites

Post-operative visual outcomes based on morphological staging of idiopathic epiretinal membranes on OCT

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International Journal of Ophthalmology(English edition) 2022年第12期15卷 1966-1970页

作者： Sehrish Nizar Ali Momin Roha Ahmad Choudhary MARehman Siddiqui Shiraz Hashmi Abdul Sami Memon Haroon Tayyab Department of Ophthalmology and Visual Sciences the Aga Khan University HospitalKarachiSindh 74800Pakistan

AIM:To evaluate the recently described optical coherence tomography(OCT)based classification of epiretinal membrane(ERM)and its usefulness in predicting the functional ***:A retrospective observational review of OCT scans of patients with the diagnosis of idiopathic ERM was carried out from January 2016 to June *** consecutive images diagnosed with any stage of idiopathic ERM and fulfilled the eligibility criteria were included in the *** was identified on OCT scans as a thin hyperreflective layer over the inner layers of *** scans of patients with ERM who underwent vitrectomy,were independently staged as per the new classification by two independent retinal surgeons to form a consensus on *** corrected visual acuity(BCVA)in logMAR scale and central subfield thickness(CST)on pre-and post-operative spectral domain OCT scans were the variables noted for all patients at the time of diagnosis and at 6 and 12 mo follow up visit after undergoing *** correlation coefficient was computed between BCVA(logMAR)and CST by ERM stage adjusting by baseline ***:Clinical charts of 74 patients with idiopathic ERM were *** significant improvement in BCVA overtime was observed with significant difference in median visual acuity of patients with StageⅡ-ⅣERM with P0.3).CONCLUSION:Equally significant visual outcomes of patients with ERM stagedⅡ-Ⅳand therefore can be couns

关键词： optical coherence tomography epiretinal membrane cotton ball sign vitreoschisis vitrectomy

Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan

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World Journal of Emergency Medicine 2017年第3期8卷 214-222页

作者： Salima Kerai Omrana Pasha Uzma khan Muhammad Islam Nargis Asad Junaid Razzak Epidemiology and Biostatistics Community Health Sciences Department Aga Khan University Community Health Sciences Department Aga Khan University Psychiatry Department Aga Khan University Emergency Medicine Department Johns Hopkins University School of Medicine

BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, ***: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction ***: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or ***: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

关键词： Emergency medical service Karachi Pakistan Post-traumatic stress disorder Stress Work performance

Impact of community-based interventions on HIV knowledge, attitudes, and transmission

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Infectious Diseases of Poverty 2014年第1期3卷 250-260页

作者： Rehana A Salam Sarah Haroon Hashim H Ahmed Jai K Das Zulfiqar A Bhutta Division of Women and Child Health Aga Khan UniversityKarachiPakistan Center of Excellence in Women&Child Health The Aga Khan UniversityKarachiPakistan Center for Global Child Health hospital for Sick Children TorontoCanada

In 2012,an estimated 35.3 million people lived with HIV,while approximately two million new HIV infections were ***-based interventions(CBIs)for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk,or already infected with,*** paper evaluates the impact of CBIs on HIV knowledge,attitudes,and *** included 39 studies on educational activities,counseling sessions,home visits,mentoring,women’s groups,peer leadership,and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment *** review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge,attitudes,and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS(SMD:0.66,95%CI:0.25,1.07),protected sexual encounters(RR:1.19,95%CI:1.13,1.25),condom use(SMD:0.96,95%CI:0.03,1.58),and decreased frequency of sexual intercourse(RR:0.76,95%CI:0.61,0.96).Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and *** found very limited evidence on community-based management for HIV infected population and prevention of mother-to-child transmission(MTCT)for HIV-infected pregnant *** synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and ***-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth *** studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT,and various emerging models of care to improve morbidity and mortality outcomes.

关键词： Community-based interventions Antiretroviral therapy HIV prevention HIV/AIDS

Impact of community-based interventions for the prevention and control of malaria on intervention coverage and health outcomes for the prevention and control of malaria

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Infectious Diseases of Poverty 2014年第1期3卷 235-249页

作者： Rehana A Salam Jai K Das Zohra S Lassi Zulfiqar A Bhutta Division of Women and Child Health The Aga Khan UniversityKarachiPakistan Center of Excellence in Women&Child Health The Aga Khan UniversityKarachiPakistan Center for Global Child Health hospital for Sick Children TorontoCanada

In this paper,we aim to evaluate the effectiveness of community-based interventions(CBIs)for the prevention and management of *** conducted a systematic review and identified 42 studies for ***-five of the included studies evaluated the impact of the community-based distribution of insecticide-treated nets(ITNs),indoor residual spraying(IRS),or impregnated bed sheets;14 studies evaluated intermittent preventive therapy(IPT)delivered in community settings;two studies focused on community-based education for malaria prevention;and one study evaluated environmental management through drain *** analysis suggests that,overall,the community-based delivery of interventions to prevent and control malaria resulted in a significant increase in ITNs ownership(RR:2.16,95%CI:1.86,2.52)and usage(RR:1.77,95%CI:1.48,2.11).However,usage of ITNs was limited to two-thirds of the population who owned ***-based strategies also led to a significant decrease in parasitemia(RR:0.56,95%CI:0.42,0.74),malaria prevalence(RR:0.46,95%CI:0.29,0.73),malaria incidence(RR:0.70,95%CI:0.54,0.90),and anemia prevalence(RR:0.79,95%CI:0.64,0.97).We found a non-significant impact on splenomegaly,birth outcomes(low birth weight,prematurity,stillbirth/miscarriage),anthropometric measures(stunting,wasting,and underweight),and mortality(all-cause and malaria-specific).The subgroup analysis suggested that community-based distribution of ITNs,impregnated bed sheets and IRS,and IPT are effective *** synthesis suggests that high coverage could be achieved at a lower cost with the integration of CBIs with existing antenatal care and immunization ***-based delivery of interventions to prevent and control malaria are effective strategies to improve coverage and access and reduce malaria burden,however,efforts should also be concerted to prevent over diagnosis and drug resistance.

关键词： Malaria Community-based interventions Malarial control Malaria treatment

Clinical characteristics of childhood cancer in emergency room in a tertiary hospital in Pakistan

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World Journal of Emergency Medicine 2016年第4期7卷 300-302页

作者： Amna Jawaid Khubaib Arif Nick Brown Zehra Fadoo Department of Emergency Medicine Aga Khan University Hospital Karachi 74800 Pakistan Visiting faculty Salisbury District hospital Salisbury United Kingdom Department of Oncology and Pediatrics Aga Khan University Hospital Karachi 74800 Pakistan

INTRODUCTION Worldwide, cancer is an important cause of mortality in children aged over 1 year. Numerically, the major cancers include acute lymphoblastic leukemia, CNS tumors and lymphomas. Cancer incidence is increasing in children globally as well as in Pakistan but the etiology is poorly understood. There are an estimated 160 000 new cases and 90 000 deaths per year worldwide in children aged under 15 *** exact incidence in Pakistan is not known as there is no national tumor registry

关键词： Clinical characteristics childhood cancer

The conceptual framework and assessment methodology for the systematic reviews of community-based interventions for the prevention and control of infectious diseases of poverty

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Infectious Diseases of Poverty 2014年第1期3卷 199-205页

作者： Zohra S Lassi Rehana A Salam Jai K Das Zulfiqar A Bhutta Division of Women and Child Health The Aga Khan UniversityKarachiPakistan Center of Excellence in Women&Child Health The Aga Khan UniversityKarachiPakistan Center for Global Child Health hospital for Sick Children TorontoCanada

This paper describes the conceptual framework and the methodology used to guide the systematic reviews of community-based interventions(CBIs)for the prevention and control of infectious diseases of poverty(IDoP).We adapted the conceptual framework from the 3ie work on the‘Community-Based Intervention Packages for Preventing Maternal Morbidity and Mortality and Improving Neonatal Outcomes’to aid in the analyzing of the existing CBIs for *** conceptual framework revolves around objectives,inputs,processes,outputs,outcomes,and impacts showing the theoretical linkages between the delivery of the interventions targeting these diseases through various community delivery platforms and the consequent health *** also describe the methodology undertaken to conduct the systematic reviews and the meta-analyses.

关键词： IDoPs Conceptual framework Prevention and control Community platforms CHWs

Community based interventions for the prevention and control of tuberculosis

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Infectious Diseases of Poverty 2014年第1期3卷 261-270页

作者： Ahmed Arshad Rehana A Salam Zohra S Lassi Jai K Das Imama Naqvi Zulfiqar A Bhutta Division of Women and Child Health The Aga Khan University74800 KarachiPakistan Center of Excellence in Women&Child Health The Aga Khan UniversityKarachiPakistan Center for Global Child Health hospital for Sick Children TorontoCanada

In 2012,an estimated 8.6 million people developed tuberculosis(TB)and 1.3 million died from the *** its recent resurgence with the human immunodeficiency virus(HIV);TB prevention and management has become further *** systematically evaluated the effectiveness of community based interventions(CBI)for the prevention and treatment of TB and a total of 41 studies were identified for *** suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates(RR:3.1,95%CI:2.92,3.28)with non-significant impact on TB *** for treating patients with active TB showed an overall improvement in treatment success rates(RR:1.09,95%CI:1.07,1.11)and evidence from a single study suggests significant reduction in relapse rate(RR:0.26,95%CI:0.18,0.39).The results were consistent for various study design and delivery *** synthesis suggests that community based TB treatment delivery through community health workers(CHW)not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting *** coupled with the DOTS strategy seem to be an effective approach,however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.

关键词： Community-based interventions Tuberculosis DOTS integrated delivery CHWs

Emerging evidence of neuronal cells-targeting SARS-CoV-2 causing anosmia associated with COVID-19

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Neural Regeneration Research 2023年第2期18卷 463-464页

作者： Abdul Mannan Baig Department of Biological and Biomedical Sciences Aga Khan UniversityKarachiPakistan

The anosmia and hypogeusia that accompany the syndromic manifestations of coronavirus disease2019(COVID-19)have become an increasing area of research during the current *** deficits are experienced as a major concern and are found to compromise the lifestyle of patients during and after acute phase of *** key issue is the prevalence of smell and taste disorders that have been reported in some patients after partial recovery from COVID-19.

关键词： acute patients prevalence