49 research outputs found
Median survival time of patients after transcatheter chemo-embolization for hepatocellular carcinoma
Objective: To determine the effect on survival after transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC).Design: Longitudinal cohort study.PLACE AND DURATION OF STUDY: Radiology Department, The Aga Khan University Hospital, Stadium Road, Karachi, from December 1997 to September 2005.PATIENTS AND Methods: Patients undergoing TACE procedure for HCC were prospectively followed. Fortythree patients were enrolled from December 1997 to March 2003 in the study and subjected to chemoembolization therapy. Eight out of 43 patients were excluded from the study, who lost to follow-up. All the patients were followed till their death. Median and mean survival were calculated.Results: The median survival of these 35 patients was 410 days (13.6 months), with 95% confidence interval (236 days lower bound and 536 days upper bound). Mean survival time was 603 days (20.1 months) with 95% confidence interval (394 days lower bound and 812 days upper bound). There was significant difference in mean survival time (in days) by Child s Pugh class (chi(2) = 12.384; df=2, p-value=0.002).CONCLUSION: The study showed that TACE is an effective palliative treatment. TACE increases the median survival time
Handwashing Practices in Health Care Professionals of allied Hospitals of Rawalpindi Medical University
Objective: To assess the practice of hand washing in the teaching hospitals of Rawalpindi Medical University.
Methodology: A descriptive cross sectional study was conducted by on-site observations of HCP regarding hand-hygiene compliance in allied hospitals of Rawalpindi Medical University. Health care professionals having any sort of allergy or sensitivity problem of hands were excluded. A predesigned checklist was used to collect the data. In all the hospitals included in our study, a proper technique, provided by the World Health Organization (WHO), is displayed in almost all the wards.
Results: A total of 218 respondents (74 doctors, 71 medical students and 73 nurses) were observed. Out of these, medical students had best hand-washing practices when compared to that of doctors and nurses. Basic hand-washing facilities were available in all the hospitals but only 36.6% of health-care professionals (10.58% Doctors, 19.58% Medical students, 6.45% nurses) with p value=0.05 practiced hand-washing. Moreover, out of the 36.6%, only 19.22% (p=0.01) followed WHO technique of handwashing, whereas, 86.7% of them used antiseptic solution.
Conclusion: Despite the bedside availability of antiseptic solution in all the three hospitals, inadequate compliance was seen in health-care professionals. A multi-disciplinary, multidimensional approach is required to challenge the problems of non-compliance. 
Comparative Bony Union Time Analysis of Dynamic Hip Screw and Proximal Femoral Plate Implants
Objective: To determine the comparative and effective applicability of the Dynamic Hip Screw (DHS), and proximal femoral plate (PFP) in terms of the rapid bony union and complications for treating unstable pertrochanteric fractures.
Methodology: This comparative study was conducted at the Department of Orthopedic surgery, Pakistan Institute of Medical Sciences, Islamabad during a period of 8 months from August 2016 to April 2017. Patients ages of 45 to 90 years, with close fresh unstable pertrochanteric fractures (one week) and of either gender were included. All the patients were divided into two groups. Patients in group A underwent PFP treatment and patients of group B underwent DHS treatment. Patients were followed up after 6 weeks and then every 2 weekly afterwards for a total period of 3 months for assessment of bony union both clinically and radiologically. The data was collected on a pre-structured Performa, and analysis was done using SPSS version 26.
Results: A total of 84 patients were analysed, and average age of the patients in the PFP group was 66.57 ± 11.71 years and in the DHS group was 70.14 ± 9.03 years. Females were found in majority in both groups. No union was found till six weeks in both groups, while on 2nd month followup, union was found significantly high 19.0% in cases of the PFP group, compared to the 2.4% in the DHS group (p-0.014). On 2.5th months the union rate was significantly higher 59.5% in the PFP group, compared to the 7.1% DHS group (p-0.014), while on the 3rd month followup the union was almost in all cases in both groups (p-0.557) and the overall average union duration was significantly lower in PFP group compared to the DHS (p-0.001).
Conclusion: The proximal femoral plate technique for treating unstable pertrochanteric fractures was observed to be more effective in terms of significant rapid bony union with minimum complications compared to the Dynamic Hip Screw (DHS)
RDSP: Rapidly Deployable Wireless Ad Hoc System for Post-Disaster Management
In post-disaster scenarios, such as after floods, earthquakes, and in war
zones, the cellular communication infrastructure may be destroyed or seriously
disrupted. In such emergency scenarios, it becomes very important for first aid
responders to communicate with other rescue teams in order to provide feedback
to both the central office and the disaster survivors. To address this issue,
rapidly deployable systems are required to re-establish connectivity and assist
users and first responders in the region of incident. In this work, we describe
the design, implementation, and evaluation of a rapidly deployable system for
first response applications in post-disaster situations, named RDSP. The
proposed system helps early rescue responders and victims by sharing their
location information to remotely located servers by utilizing a novel routing
scheme. This novel routing scheme consists of the Dynamic ID Assignment (DIA)
algorithm and the Minimum Maximum Neighbor (MMN) algorithm. The DIA algorithm
is used by relay devices to dynamically select their IDs on the basis of all
the available IDs of networks. Whereas, the MMN algorithm is used by the client
and relay devices to dynamically select their next neighbor relays for the
transmission of messages. The RDSP contains three devices; the client device
sends the victim's location information to the server, the relay device relays
information between client and server device, the server device receives
messages from the client device to alert the rescue team. We deployed and
evaluated our system in the outdoor environment of the university campus. The
experimental results show that the RDSP system reduces the message delivery
delay and improves the message delivery ratio with lower communication
overhead.Comment: 23 pages, 12 figures, accepted for publication in Sensors 202
Untypeable hepatitis C virus subtypes in Pakistan: A neglected section
Diagnostically untypeable subtypes contribute a considerable percent of hepatitis C virus (HCV) subtypes in Pakistan. In the present study, chronically infected HCV patients with known viremia were subjected to HCV genotyping. Among the total retrieved samples, 92.7% (64/69) were found typeable while 7.24% (5/69) were diagnostically untypeable. In conclusion, the presence of large number of untypeable HCV subtypes emphasizes the need of an updated type-specific genotyping assay and consideration of primers for proportionally rare subtypes to minimize the number of untypeable HCV subtypes
Identification of Novel Dihydrofolate Reductase Inhibitor as Potential Antimalarial Drug: In silico Studies
Abstract.-Advancement in computational biology leads to improve the efficacy for new compounds to cure the diseases. Malaria is the most virulent diseases and causing millions of deaths annually, especially in developing and under-developed countries. Plasmodium falciparum dihydrofolate reductase (PfDHFR) is one of the most important drug target for different antifolates. Pyrimethamine with sulphadoxine complex is the most recommended and efficient antifolate prescribed against PfDHFR. But malarial parasites have developed resistance against this drug due to the point mutations in PfDHFR. This study focus to design a novel antimalarial drug (analog) against mutated PfDHFR by considering the in silico approaches. The new antimalarial drugs were designed by the addition/substitution of different functional groups and molecules in parent compound of pyrimethamine. The docking studies of newly designed compound and pyrimethamine with mutated receptor protein of PfDHFR were performed by using different docking servers. Various in silico therapeutic calculations for novel antimalarial compound and pyrimethamine were executed using computational approaches. The basic of ligand properties, docking results, energy calculations and drug score favor indicated that the new antimalarial drug compound have potential to show better efficacy than pyrimethamine. This designed analog could be used for preclinical test and have the potential to eradicate P. falciparum
Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.
BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden