Knowledge, attitudes, and perceptions of healthcare students and professionals on the use of artificial intelligence in healthcare in Pakistan

The advent of artificial intelligence (AI) technologies has emerged as a promising solution to enhance healthcare efficiency and improve patient outcomes. The objective of this study is to analyse the knowledge, attitudes, and perceptions of healthcare professionals in Pakistan about AI in healthcare. We conducted a cross-sectional study using a questionnaire distributed via Google Forms. This was distributed to healthcare professionals (e.g., doctors, nurses, medical students, and allied healthcare workers) working or studying in Pakistan. Consent was taken from all participants before initiating the questionnaire. The questions were related to participant demographics, basic understanding of AI, AI in education and practice, AI applications in healthcare systems, AI\u27s impact on healthcare professions and the socio-ethical consequences of the use of AI. We analyzed the data using Statistical Package for Social Sciences (SPSS) statistical software, version 26.0. Overall, 616 individuals responded to the survey while n = 610 (99.0%) of respondents consented to participate. The mean age of participants was 32.2 ± 12.5 years. Most of the participants (78.7%, n = 480) had never received any formal sessions or training in AI during their studies/employment. A majority of participants, 70.3% (n = 429), believed that AI would raise more ethical challenges in healthcare. In all, 66.4% (n = 405) of participants believed that AI should be taught at the undergraduate level. The survey suggests that there is insufficient training about AI in healthcare in Pakistan despite the interest of many in this area. Future work in developing a tailored curriculum regarding AI in healthcare will help bridge the gap between the interest in use of AI and training

Correlation of sonographic with intraoperative findings in laparoscopic managed ectopic pregnancies, a 10-year synopsis: a retrospective observational study

Background: Ectopic pregnancies (EP) are a common pregnancy complication that\u27s associated with significant morbidity and rarely mortality if not managed properly. Ultrasound examination forms the cornerstone of diagnosis of EP with some sonographic features occasionally not correlating with intraoperative findings. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the correlation and prediction of sonographic findings to intraoperative findings. Methods: This study was designed as a Retrospective Observational Study based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis of ectopic pregnancy that was surgically managed between the period of January 1st 2011 to December 31st 2020. Analysis of data was done against a pre-set checklist. Descriptive statistics for continuous variables was calculated and tabulated in graphs and tables. SPSS version 22 was used for analysis of data. Results: A total of 337 patients in this study had ultrasound findings. 99.7% (n = 336) of these patients had an intraoperatively confirmed EP. The commonest ultrasound finding was an adnexal mass in 97.1% (n = 309) of patients. These were confirmed surgically in 290 patients at the following locations: 76.6% (n = 222) were ampullary in location; 10.7% (n = 31) were fimbrial in location; 8.6%(n = 25) were isthmic in location; 2.4%(n = 7) were interstitial in location; 1%(n = 3) were abdominal in location; while 0.3% were located in the ovary(n = 1) or round ligament(n = 1) each. Interstitial EP on ultrasound were all (100%) confirmed in the same location intraoperatively, with ampullary EP also correlating fairly well with intraoperative location (75%). The distribution of location in the minor hemoperitoneum (HP) versus major HP groups were similar except for interstitial EP that increased from 1.4% in the minor HP group to 9.5% in the major HP group. Conclusion: In conclusion, ultrasonography still represents the best imaging modality for EP. The most common finding is usually an adnexal mass with no specific location. Most (99.7%) of the patients with this sonographic finding usually have a confirmed EP. Interstitial EP are the most well localized with ultrasound followed by ampullary EP. Furthermore, the presence of major (\u3e 500mls) hemoperitoneum may act as an adjunct for diagnosis of an interstitial EP

Post-vaccination SARS-CoV-2 IgG spike antibody responses among clinical and non-clinical healthcare workers at a tertiary facility in Kenya

Introduction: Following the coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, vaccination became the main strategy against disease severity and even death. Healthcare workers were considered high-risk for infection and, thus, were prioritised for vaccination. Methods: A follow-up to a SARS-CoV-2 seroprevalence study among clinical and non-clinical HCWs at the Aga Khan University Hospital, Nairobi, we assessed how vaccination influenced SARS-CoV-2 anti-spike IgG antibody responses and kinetics. Blood samples were drawn at two points spanning 6 to 18 months post-vaccination, and SARS-CoV-2 spike antibody levels were determined by enzyme-linked immunosorbent assay. Results: Almost all participants, 98% (961/981), received a second vaccine dose, and only 8.5% (83/981) received a third dose. SARS-CoV-2 spike IgG antibodies were detected in 100% (961/961) and 92.7% (707/762) of participants who received two vaccine doses, with the first and second post-vaccine test, respectively, and in 100% (83/83) and 91.4% (64/70) of those who received three vaccine doses at the first and second post-vaccine test, respectively. Seventy-six participants developed mild infections, not requiring hospitalisation even after receiving primary vaccination. Receiving three vaccine doses influenced the anti-spike S/Co at both the first (p\u3c0.001) and second post-vaccination testing (p\u3c0.001). Of those who tested SARS-CoV-2 positive, the anti-spike S/Co ratio was significantly higher than those who were seronegative at the first post-vaccine test (p = 0.001). Side effects were reported by almost half of those who received the first dose, 47.3% (464/981), 28.9% (278/961) and 25.3% (21/83) of those who received the second and third vaccine doses, respectively. Conclusion: Following the second dose of primary vaccination, all participants had detectable anti-spike antibodies. The observed mild breakthrough infections may have been due to emerging SARS-CoV-2 variants. Findings suggest that although protective antibodies are induced, vaccination protected against COVID-19 disease severity and not necessarily infection

The Lancet Breast Cancer Commission

The Lancet Breast Cancer Commission report shows inequities in prevention, detection, treatment, and supportive care, with many groups of people with breast cancer being systematically left behind and forgotten. This is a global error as people with breast cancer are indispensable to our culture and socioeconomic system. New findings: The number of people living with metastatic breast cancer is unknown and many do not receive appropriate care. With adequate resources and a shift in attitudes, it might be possible to cure some people, treat most, alleviate the suffering of all, and abandon no one. Hidden breast cancer costs and suffering can be financial, physical, psychological, emotional, and social, affecting children, families, communities, and wider society. Exposing and reducing costs and suffering provides incentives for policy makers to invest in prevention, early detection, cost-effective therapies, and optimal management of breast cancer. • Improving patient communication in breast cancer improves not only quality of life and body image, but also adherence to therapy, which can affect survival outcomes. Breast cancer can be seen as robbing many patients of power, but through good communication and facilitating patient autonomy, there could be an opportunity to regain power and exercise empowerment in other areas of their lives. Roadmap for change: Our inclusive roadmap addresses urgent breast cancer challenges through six themes:Society should prevent as many as possible of the 3 million new diagnoses of breast cancers that are predicted to occur per year by 2040, through global national policy changes to minimise modifiable risk factors and coordinated, systematic personalised risk prevention programmes. Health-care systems and clinicians should personalise the right treatment at the right time for individuals while respecting their personal needs and preferences. We call for high-quality cancer registry data on cancer relapses to be collected worldwide and include not just those with metastatic breast cancer, but also with other metastatic cancers. Collaboration is key to close the equity gap through global early diagnosis, treatment frameworks, and innovative technologies. We should identify the value that society places on relief of the hidden costs and suffering related to breast cancer and measure the benefits of addressing these costs. Placing patients at the centre of clinical communication and empowering them to exercise their voices about their breast cancer care is an achievable and necessary global goal

An analysis of the use of WhatsApp in the news-making process: a case of BBC Africa.

This study analyses the use of WhatsApp in the newsroom at BBC Africa, with a particular focus on the experiences of journalists, critical success factors and challenges journalists face when using the app. This study was guided by three objectives: To examine the experience of journalists in the use of WhatsApp in the BBC Africa newsroom, to assess the critical factors in the adoption and use of WhatsApp in the BBC Africa newsroom and to explore the challenges that Journalists face when using WhatsApp in the BBC Africa newsroom. It was anchored on the technology acceptance theory (Davis, 1989) and the domestication of technology theory (Silverstone, 1992). These constructs contend that when a new technology is developed, it must spread across society and become accepted. Consequently, these two theories were relevant to this study because they link the independent variable (use of WhatsApp) and the dependent variable (journalistic practices in BBC Africa). This study used a mixed-method approach and data was collected from 38 journalists working at BBC Africa; techniques that incorporate both qualitative and quantitative data were used to analyse the data gathered. The study found that WhatsApp significantly improves efficiency in the BBC Africa newsroom by facilitating quick information and multimedia sharing among journalists through real-time messaging and group chat features. Its success is attributed to its user-friendly interface, simplicity, and cost-free nature. However, challenges include verifying information authenticity and managing information overload due to the constant flow of messages. Accordingly, the study recommends that BBC Africa implements ongoing training programs for journalists and newsroom staff to ensure they are well-versed in the advanced features of WhatsApp and the evolving digital communication landscape; develop and disseminate clear and comprehensive guidelines outlining best practices for the use of WhatsApp within the newsroom

Factors associated with safe and successful postoperative day 1 discharge after lung operations: A systematic review and meta-analysis

Background: A shorter length of stay (LOS) is associated with fewer hospital-acquired adverse conditions and decreased utilization of hospital resources. While modern perioperative care protocols have enabled some ambitious surgical teams to achieve discharge as early as within postoperative day 1 (POD1), most other teams remain cautious about such an approach due to the perceived risk of missing postoperative complications and increased readmission rates. We aimed to identify factors that would help guide surgical teams aiming for safe and successful POD1 discharge after lung resection.Methods: We searched the PubMed, Embase, Scopus, Web of Science and CENTRAL databases for articles comparing perioperative characteristics in patients discharged within POD1 (DWPOD1) and after POD1 (DAPOD1) following lung resection. Meta-analysis was performed using a random-effects model.Results: We included eight retrospective cohort studies with a total of 216,887 patients, of which 22,250 (10.3%) patients were DWPOD1. Our meta-analysis showed that younger patients, those without cardiovascular and respiratory comorbidities, and those with better preoperative pulmonary function are more likely to qualify for DWPOD1. Certain operative factors, such as a minimally invasive approach, shorter operations, and sublobar resections, also favor DWPOD1. DWPOD1 appears to be safe, with comparable 30-day mortality and readmission rates, and significantly less postoperative morbidity than DAPOD1.Conclusions: In select patients with a favorable preoperative profile, DWPOD1 after lung resection can be achieved successfully and without increased risk of adverse outcomes such as postoperative morbidity, mortality, or readmissions

A case report and literature review on primary intracranial malignant melanoma: Challenges and insights

Introduction and importance: Primary central nervous system (CNS) melanoma is a rare entity. Primary CNS malignant melanomas account for 1 % of melanomas and 0.07 % of intracranial tumours. These are highly aggressive and are associated with poor prognosis. Herein, we have discussed one such rare case of PIMM.Case presentation: 62-year-old man with primary CNS melanoma underwent craniotomy and resection of left temporal lesion. Postoperative MRI showed no evidence of residual disease. He received 28 fractions of radiation. Follow-up MRI showed no evidence of disease. However, he later developed worsening symptoms and repeat imaging revealed disease progression with hydrocephalus and drop metastasis to spine. He underwent VP shunting and was started on Temozolomide. He progressively declined functionally and eventually died from his disease.Clinical discussion: Primary CNS melanoma is characterized by its rarity, challenging diagnosis, and aggressive behaviour. Current literature suggests limited treatment options, which depend on complete resection of the primary tumour. Molecular analysis may play a key role in deciding future treatment options, including immune checkpoint inhibitors and targeted therapies targeting the BRAFV600E mutation.Conclusion: Primary intracranial malignant melanoma (PIMM) is an extremely rare tumour of CNS, and its treatment paradigm is very limited based on available literature. Currently any long-term survival depends on the complete resection of tumour. Our case is unique as it talks about the limited therapeutic options in case of rapidly declining performance status in a resource constraint setting

Clinical and biological landscape of constitutional mismatch-repair deficiency syndrome: An international replication repair deficiency consortium cohort study

Background: Constitutional mismatch repair deficiency (CMMRD) syndrome is a rare and aggressive cancer predisposition syndrome. Because a scarcity of data on this condition contributes to management challenges and poor outcomes, we aimed to describe the clinical spectrum, cancer biology, and impact of genetics on patient survival in CMMRD.Methods: In this cohort study, we collected cross-sectional and longitudinal data on all patients with CMMRD, with no age limits, registered with the International Replication Repair Deficiency Consortium (IRRDC) across more than 50 countries. Clinical data were extracted from the IRRDC database, medical records, and physician-completed case record forms. The primary objective was to describe the clinical features, cancer spectrum, and biology of the condition. Secondary objectives included estimations of cancer incidence and of the impact of the specific mismatch-repair gene and genotype on cancer onset and survival, including after cancer surveillance and immunotherapy interventions.Findings: We analysed data from 201 patients (103 males, 98 females) enrolled between June 5, 2007 and Sept 9, 2022. Median age at diagnosis of CMMRD or a related cancer was 8·9 years (IQR 5·9-12·6), and median follow-up from diagnosis was 7·2 years (3·6-14·8). Endogamy among minorities and closed communities contributed to high homozygosity within countries with low consanguinity. Frequent dermatological manifestations (117 [93%] of 126 patients with complete data) led to a clinical overlap with neurofibromatosis type 1 (35 [28%] of 126). 339 cancers were reported in 194 (97%) of 201 patients. The cumulative cancer incidence by age 18 years was 90% (95% CI 80-99). Median time between cancer diagnoses for patients with more than one cancer was 1·9 years (IQR 0·8-3·9). Neoplasms developed in 15 organs and included early-onset adult cancers. CNS tumours were the most frequent (173 [51%] cancers), followed by gastrointestinal (75 [22%]), haematological (61 [18%]), and other cancer types (30 [9%]). Patients with CNS tumours had the poorest overall survival rates (39% [95% CI 30-52] at 10 years from diagnosis; log-rank pInterpretation: The very high cancer burden and unique genomic landscape of CMMRD highlight the benefit of comprehensive assays in timely diagnosis and precision approaches toward surveillance and immunotherapy. These data will guide the clinical management of children and patients who survive into adulthood with CMMRD.Funding: The Canadian Institutes for Health Research, Stand Up to Cancer, Children\u27s Oncology Group National Cancer Institute Community Oncology Research Program, Canadian Cancer Society, Brain Canada, The V Foundation for Cancer Research, BioCanRx, Harry and Agnieszka Hall, Meagan\u27s Walk, BRAINchild Canada, The LivWise Foundation, St Baldrick Foundation, Hold\u27em for Life, and Garron Family Cancer Center