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  • 1
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    Online Resource
    Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair : The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) Study
    American Medical Association (AMA) ; 2023
    In:  JAMA Surgery Vol. 158, No. 8 ( 2023-08-01), p. 865-
    Details
    In: JAMA Surgery, American Medical Association (AMA), Vol. 158, No. 8 ( 2023-08-01), p. 865-
    Abstract: Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors. Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR. Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR. Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia. Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients. Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72). Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies.
    Type of Medium: Online Resource
    ISSN: 2168-6254
    URL: Article
    DOI: 10.1001/jamasurg.2023.2137
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2023
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  • 2
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    The Era of Polypills in the Management of Cardiovascular Diseases: Are We There Yet?
    Elsevier BV ; 2023
    In:  Current Problems in Cardiology Vol. 48, No. 8 ( 2023-08), p. 101233-
    Details
    In: Current Problems in Cardiology, Elsevier BV, Vol. 48, No. 8 ( 2023-08), p. 101233-
    Type of Medium: Online Resource
    ISSN: 0146-2806
    URL: Article
    DOI: 10.1016/j.cpcardiol.2022.101233
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2060920-6
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  • 3
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    Mutation spectrum of MYO7A and evaluation of a novel nonsyndromic deafness DFNB2 allele with residual function
    Hindawi Limited ; 2008
    In:  Human Mutation Vol. 29, No. 4 ( 2008-04), p. 502-511
    Details
    In: Human Mutation, Hindawi Limited, Vol. 29, No. 4 ( 2008-04), p. 502-511
    Type of Medium: Online Resource
    ISSN: 1059-7794
    URL: Article
    DOI: 10.1002/humu.20677
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2008
    detail.hit.zdb_id: 1498165-8
    SSG: 12
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  • 4
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    Current Challenges of Digital Health Interventions in Pakistan: Mixed Methods Analysis
    JMIR Publications Inc. ; 2020
    In:  Journal of Medical Internet Research Vol. 22, No. 9 ( 2020-9-3), p. e21691-
    Details
    In: Journal of Medical Internet Research, JMIR Publications Inc., Vol. 22, No. 9 ( 2020-9-3), p. e21691-
    Abstract: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Objective The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Methods This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization’s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy. Results Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations’ inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects. Conclusions We conclude that while digital health has a promising future in Pakistan, it is still in its infancy at the time of this study. However, due to the coronavirus disease 2019 (COVID-19) pandemic, there is an increase in demand for digital health and implementation of health outcomes following global social distancing protocols, especially in LMICs. Hence, there is a need for active involvement by public and private organizations to regulate, mobilize, and expand the digital health sector for the improvement of health care systems in countries.
    Type of Medium: Online Resource
    ISSN: 1438-8871
    URL: Article
    DOI: 10.2196/21691
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2028830-X
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  • 5
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    Usability and Acceptability of a Mobile App for Behavior Change and to Improve Immunization Coverage among Children in Pakistan: A Mixed-Methods Study
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 18 ( 2021-09-09), p. 9527-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 18 ( 2021-09-09), p. 9527-
    Abstract: Background: Pakistan’s immunization uptake rates are still significantly lower than anticipated despite several initiatives. Lack of awareness, forgetting about vaccination schedule, and vaccine misconception/misinformation are a few of the major drivers that mitigate the rates of immunization. The current COVID-19 pandemic emphasizes the importance of immunization. The significant reductions in regular childhood vaccination during pandemic have increased the risk of outbreaks of vaccine-preventable diseases. Concerns among parents over possibly exposing their children to COVID-19 during child visits may have contributed to the reported declines. Innovative and cost-effective mHealth interventions must be implemented in order to address the problem of inadequate immunization rates. In addition, it is also critical to understand the end user needs in order to reflect on the highly relevant essence of the customized healthcare experience. Objective: The aim of this study was to learn about caregivers’ attitudes toward the usability and acceptability of behavior-change smartphone applications (mobile phones) for improving immunization coverage in Pakistan. Methods: A mixed-method design was employed for this study. The study was conducted at Aga Khan University, Hospital. Parents visiting the Community Health Center for 6-week vaccination of their children were recruited. The study was conducted in two stages. Stage 1 consisted of qualitative interviews that grasped the parent’s attitudes and challenges to immunization, as well as their acceptability and accessibility of the smartphone-based behavior-change application to increase vaccine uptake. Stage 1 was followed by stage 2, in which data were collected through a questionnaire designed by using data from qualitative interviews. Results: The majority of participants agreed that immunization serves an important role in protecting their child from illnesses that cause morbidity and mortality. Almost all of them emphasized the importance of using a pre-appointment method at vaccination center in order to reduce the waiting time. Furthermore, participants were also interested in AI-based behavior modification applications related to immunization. They also wanted to have applications in their native language for better understanding and communication of related information. In our study, approximately 95.2 percent of participants agreed to accept SMS immunization updates, which was also reasonably high. Lastly, the majority of them identified forgetfulness as a significant contributor to regular immunization. Conclusion: To enhance the uptake of childhood vaccines, overall vaccination rates, and overcome barriers related to vaccination coverage, cost-effective and user-friendly mHealth AI-based smart phone applications are required to raise awareness regarding the continuation of vaccination service and the importance of timely vaccination. Parents’ experiences and attitudes must be considered while designing and evaluating the efficacy of mHealth-based interventions.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18189527
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 6
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    The clinical characteristics and outcomes of patients with pulmonary hypertension in association with hyperthyroid state: A systematic review
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Medicine Vol. 101, No. 26 ( 2022-07-1), p. e29832-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 101, No. 26 ( 2022-07-1), p. e29832-
    Abstract: Pulmonary hypertension (PHTN) may occur in thyroid disorders, especially in hypothyroidism. However, there is increasing evidence of PHTN in hyperthyroidism (HTH). The etiology, clinical course, management, and factors associated with outcomes of PHTN in the setting of HTH are unascertained. This systematic review consolidates available evidence on patients with HTH who developed PHTN. Methods: We conducted a systematic review on English articles from PubMed, Scopus, and Google Scholar reporting PHTN in patients with hyperthyroidism. Data were analyzed and reported in Microsoft Excel 2020, SPSS version 26, and Jamovi version 1.2. Results: We identified 589 patients with PHTN in the setting of HTH. Etiologies included Grave disease 66.7%), toxic multinodular goiter (TMNG) (16.8%), drug-induced HTH (0.3%), thyroiditis(0.8%), and toxic adenoma(0.1%). Most patients did not receive any specific management for PHTN and were managed by antithyroid treatment (97.4%). Outcomes of PHTN were reported in 181 patients, with a 94% recovery rate. Pulmonary artery pressures (PAP) before and after HTH management ranged from 22.5 to 75 mm Hg and from 24 to 50 mm Hg, respectively. Outcome analysis performed on data from case reports and series with individually identifiable data revealed a 67.6% female preponderance. An estimated 73.5% of the patients had PHTN at the initial presentation of HTH, which was associated with a better resolution rate of PHTN(OR: 12, P -value: 0.048). TRAB was positive in 47% patients with no clinical difference in outcomes. antiTG AB was reported positive in 29.4%, all of whom had an improvement, compared to an 83.3% improvement rate in those with negative antiTG AB. Various etiologies and treatments did not have any significant differences in the outcome of PHTN. Conclusions: PHTN can be present at the initial diagnosis of HTH, which is associated with better outcomes of PHTN. There is a clear female preponderance in the development of PHTN. However, resolution rates seem to be better in males. Although TRAB is associated with the development of PHTN, it does not seem to affect the outcomes. PHTN in patients with HTH does not need any specific management, with 〉 90% resolution with antithyroid therapy. Whether any specific antithyroid therapy has a better outcome in PHTN needs to be explored prospectively.
    Type of Medium: Online Resource
    ISSN: 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000029832
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2049818-4
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  • 7
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    Awareness of hepatitis B and C among students of nonmedical universities in Karachi
    Walter de Gruyter GmbH ; 2017
    In:  Asian Biomedicine Vol. 9, No. 2 ( 2017-1-31), p. 155-159
    Details
    In: Asian Biomedicine, Walter de Gruyter GmbH, Vol. 9, No. 2 ( 2017-1-31), p. 155-159
    Abstract: Pakistan is highly endemic with hepatitis B virus (HBV) and the incidence of HBV infection is rising steadily. The reasons may include poor public awareness about the transmission of HBV and HCV. Objectives To assess the awareness of HBV and HCV among students in nonmedical universities. Methods The study instrument was a structured 36 item questionnaire. After obtaining permission from the respective administrations, students were approached within their university campuses and were included by convenience sampling. The results were expressed as frequencies. Results Five hundred students from 5 different institutions participated in the survey, with 100 students representing each institute. Most students did not recognize the possible modes of infection of hepatitis B that include reuse of syringes (57.2%), blood transfusions (62.6%), and sexual contact (57.4%). However, most (67.8%) students correctly believe that there is a vaccination available for the prevention of HBV. Most students did not recognize the possible modes of infection of hepatitis C that include reuse of syringes (61.8%), use of intravenous drugs of addiction (71.4%), sexual contact (55.6%), and blood transfusions (55.2%) as possible modes of transmission. Most students (51.8%) incorrectly believed that there is a vaccination available for the prevention of HCV. Conclusions There is a prominent lack of awareness regarding the risk factors for HBV and HCV infection among the student community of nonmedical universities in Karachi, and an immediate need to conduct nationwide awareness programs to raise the awareness of HBV and HCV transmission in the Pakistani population exists.
    Type of Medium: Online Resource
    ISSN: 1875-855X
    URL: Article
    DOI: 10.5372/1905-7415.0902.381
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2017
    detail.hit.zdb_id: 2583850-7
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  • 8
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    Online Resource
    An Artificial Intelligence–Based, Personalized Smartphone App to Improve Childhood Immunization Coverage and Timelines Among Children in Pakistan: Protocol for a Randomized Controlled Trial
    JMIR Publications Inc. ; 2020
    In:  JMIR Research Protocols Vol. 9, No. 12 ( 2020-12-4), p. e22996-
    Details
    In: JMIR Research Protocols, JMIR Publications Inc., Vol. 9, No. 12 ( 2020-12-4), p. e22996-
    Abstract: The immunization uptake rates in Pakistan are much lower than desired. Major reasons include lack of awareness, parental forgetfulness regarding schedules, and misinformation regarding vaccines. In light of the COVID-19 pandemic and distancing measures, routine childhood immunization (RCI) coverage has been adversely affected, as caregivers avoid tertiary care hospitals or primary health centers. Innovative and cost-effective measures must be taken to understand and deal with the issue of low immunization rates. However, only a few smartphone-based interventions have been carried out in low- and middle-income countries (LMICs) to improve RCI. Objective The primary objectives of this study are to evaluate whether a personalized mobile app can improve children’s on-time visits at 10 and 14 weeks of age for RCI as compared with standard care and to determine whether an artificial intelligence model can be incorporated into the app. Secondary objectives are to determine the perceptions and attitudes of caregivers regarding childhood vaccinations and to understand the factors that might influence the effect of a mobile phone–based app on vaccination improvement. Methods A mixed methods randomized controlled trial was designed with intervention and control arms. The study will be conducted at the Aga Khan University Hospital vaccination center. Caregivers of newborns or infants visiting the center for their children’s 6-week vaccination will be recruited. The intervention arm will have access to a smartphone app with text, voice, video, and pictorial messages regarding RCI. This app will be developed based on the findings of the pretrial qualitative component of the study, in addition to no-show study findings, which will explore caregivers’ perceptions about RCI and a mobile phone–based app in improving RCI coverage. Results Pretrial qualitative in-depth interviews were conducted in February 2020. Enrollment of study participants for the randomized controlled trial is in process. Study exit interviews will be conducted at the 14-week immunization visits, provided the caregivers visit the immunization facility at that time, or over the phone when the children are 18 weeks of age. Conclusions This study will generate useful insights into the feasibility, acceptability, and usability of an Android-based smartphone app for improving RCI in Pakistan and in LMICs. Trial Registration ClinicalTrials.gov NCT04449107; https://clinicaltrials.gov/ct2/show/NCT04449107 International Registered Report Identifier (IRRID) DERR1-10.2196/22996
    Type of Medium: Online Resource
    ISSN: 1929-0748
    URL: Article
    DOI: 10.2196/22996
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2719222-2
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  • 9
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    Frequency and Determinants of Postpartum Depression among Mothers Living in Karachi
    Bahria University Medical and Dental College ; 2022
    In:  Journal of Bahria University Medical and Dental College Vol. 12, No. 04 ( 2022-10-01), p. 202-206
    Details
    In: Journal of Bahria University Medical and Dental College, Bahria University Medical and Dental College, Vol. 12, No. 04 ( 2022-10-01), p. 202-206
    Abstract: Objective: To determine the frequency of Postpartum Depression (PPD) among mothers living in Karachi and to find out the determinants of predispose mothers to Postpartum Depression. Study Design and Setting: The study was cross sectional analytical and was carried by online survey of mothers living in Karachi Methodology: Total duration was six months from 1st January, 2020 to 31st July, 2020. The calculated sample size of study was 369. The study was approved by the Ethical Review Committee of Bahria University Health Sciences Campus, Karachi. Random sampling technique was used to recruit subjects. 294 participants were part of the research. Mothers with previous history of depression and those who had given birth to healthy babies were included in the study. Mothers who have had miscarriage or pre-mature babies were excluded. Questionnaires in both English and Urdu languages were used for the research. PPD was assessed by the help of Edinburgh Post Natal Depression Scale (EPDS). The score of greater than 12 was considered to be indicative of PPD. Results: A total of 294 mothers were enrolled in the study, 187 mothers had an EPDS score 〉 12 giving prevalence of PPD as 63.6%. This study showed that mothers with PPD were more likely not to breastfeed their child (p=0.01), had lack of family support (p=0.00) and had previous history of depression as well (p=0.00). Conclusion: The present study concluded that frequency of postpartum depression was 63.6%. Lack of breastfeeding, previous history of depression and lack of family support were among the determinants that predispose mothers to postpartum depression.
    Type of Medium: Online Resource
    ISSN: 2220-7562 , 2617-9482
    URL: Journal
    URL: Article
    DOI: 10.51985/ALUU2996
    DOI: 10.51985/JBUMDC202158
    Language: Unknown
    Publisher: Bahria University Medical and Dental College
    Publication Date: 2022
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  • 10
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    Efficacy of Aloe vera in human health especially against COVID-19 : Fareeha Iqbal, Ambreen Ahmed
    Lahore Garrison University ; 2023
    In:  Lahore Garrison University Journal of Life Sciences Vol. 7, No. 02 ( 2023-06-26), p. 199-215
    Details
    In: Lahore Garrison University Journal of Life Sciences, Lahore Garrison University, Vol. 7, No. 02 ( 2023-06-26), p. 199-215
    Abstract: The world is full of enchanted natural flora and one of its charmed plant is Aloe vera. It showed the presence of number of novel compounds that engaged in multiple pharmacological activities and are in use to cure diseases. The present review of A. vera is currently about the debacles of COVID-19 i.e., its component involvement as stumbling block for virus proteases. It has also been noted as an effective anti-COVID cloth coating that will bio-actively lower the impact of differential microbe’s expansion along with minimizing the spread of COVID-19. It boosts the immune system in variable circumstances potentially being an anti-inflammatory, anti-cancerous, anti-microbial and wound healing agent. A. vera has made drastic contributions regarding differential human ailments such as wound healing, dental issues, digestive complications, and skin diseases. Moreover, commercial applications of A. vera focuses on manufacturing of bioethanol and nutritionally engaging it in food. Furthermore, inquiries are being carried out to unfold the new wonders of this plant specifically against COVID-19.
    Type of Medium: Online Resource
    ISSN: 2521-0130 , 2519-9404
    URL: Article
    DOI: 10.54692/lgujls.2023.0702263
    Language: Unknown
    Publisher: Lahore Garrison University
    Publication Date: 2023
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