Integration of Artificial Intelligence and Human Computer Interaction in Healthcare

Artificial intelligence (AI) and human-computer interaction (HCI) are two important fields that are increasingly being used in the healthcare industry. AI technologies such as machine learning and natural language processing can be used to analyze large amounts of data, identify patterns and trends, and make predictions. This can be helpful in a variety of healthcare applications, such as predicting the likelihood of a patient developing a particular disease or condition, helping doctors diagnose patients more accurately, and identifying potential side effects of drugs. HCI, on the other hand, focuses on the design of user-friendly and effective interfaces between humans and computers. In healthcare, HCI plays a crucial role in the development of electronic health record systems, telemedicine platforms, and other digital health tools that allow healthcare professionals to more easily access and manage patient data. AI alone cannot provide the insights that healthcare providers need without effective HCI to enable interpretation and action, while HCI alone cannot provide the level of accuracy and efficiency that AI can deliver. By using AI and HCI together, healthcare providers can leverage the strengths of both technologies, allowing for more efficient and accurate analysis of data, improved diagnosis and treatment, and ultimately, better patient outcomes. Overall, the future of AI and HCI in healthcare looks bright, and these technologies have the potential to greatly improve the way that healthcare is delivered and to make it more accessible and affordable for people around the world

Emergence of Tigecycline Resistance among Extended Spectrum Beta Lactamases Producing Gram-Negative Organisms

Objective: To highlight the emergence of Tigecycline resistance among ESBL producer gram negative organisms.Material and Methods: This cross-sectional study was conducted in Lahore College for Women University Lahore Pakistan during the period of 1st October 2015 to 20th March 2016. A total of 360 isolates of gram-negative rods were selected and processed for the identification of ESBL producers via double disc synergy technique. In total 100 isolates were identified as ESBL producing gram-negative rods (Escherichia coli, Klebsiella spp., Proteus spp. and Acinetobacter spp.) and were further processed for antimicrobial resistance testing against Tigecycline disks (30ug) via Kirby Bauer Disc Diffusion method.Results: Out of 360 identified gram-negative rods, 100 (27.7%) were ESBL producers. Total 46% samples were from males and 54% from females. A maximum number of ESBL producers were recovered from pus & wound samples (54%). The most common ESBL producer was Escherichia coli followed by Klebsiella spp., Proteus spp. and Acinetobacter spp. Overall susceptibility rate of Tigecycline was 54%. Tigecycline resistance was greatest for ESBL producing Acinetobacter (n=8), followed by Proteus (n=14), Escherichia coli (n=18) and Klebsiella (n=6) (p=0.004).Conclusion: Although tigecycline showed very good results against ESBL producers, emergence of Tigecycline resistant ESBL producers is an alarming situation

Comparing Intradermal (ID) Rabies Vaccination with Conventional IM Regimen on Humoral Response of New Zealand White Rabbits for the Production of Animal-Derived Polyclonal Antibodies

In developing countries, it is imperative to implement cost-effective strategies for animal humoral response development in the production of antiserum. This study compared the effect of immunization regimens on the humoral immune response of New Zealand White (NZW) rabbits (N = 24) using cell culture rabies vaccine (CCRV) through intradermal (ID) and traditional intramuscular (IM) routes. The rabbits were divided into three experimental groups: (a) IPC-R2 with a two-site one-week regimen; (b) TRC-R3 with a two-site twenty-eight-day regimen; and (c) Alternate-R4 with a four-site one-week regimen. These regimens were then compared to the standard IM schedule of five doses of rabies vaccine administered at days 0, 3, 7, 14, and 28 in control group R-1. The results were evaluated at days 14 and 35 postvaccination using rabies-specific Platelia II (TM) ELISA kit method. The results showed a better response to the ID regimen than the IM route regarding immunogenicity and volume consumption of the vaccine. The three selected ID regimes showed significantly higher mean titer values than the control IM regimen group R-1 (p < 0.001). The study aims to explore simple immunization strategies to enhance the RV-specific antibody titers for immunization donor animals. This method would produce polyclonal antibodies and strengthen local production of polyclonal antibodies in Pakistan to deal with vaccine and rabies immunoglobulin (RIG) shortage, thus providing effective postexposure prophylaxis (PEP) for better control of rabies in developing countries

Applying a mixed-method approach to improve on-the-job learning and job satisfaction in a cohort of interns at a university hospital

Introduction: Job satisfaction is vital for the optimal functioning of medical practitioners. Herein, we report our experience of restructuring the internship program by identifying the gaps, developing, implementing strategies to overcome gaps and sharing the results of the pre-implementation and post-implementation audit, as an example for establishing a system for improving intern\u27s work-based learning and satisfaction in a university hospital setting.Methods: Using Kern\u27s six-step instructional model, a prospective mixed-method study was conducted at Aga Khan University Hospital. In phase 1 (2013) gaps were identified by evaluating various aspects of the internship program. Strategies were developed and implemented to overcome the identified gaps. In phase 2 (2014-2016) the impact of these developmental strategies was assessed.Results: A total of 65 interns, 30 residents, and 22 faculty members participated in phase I, while 71 interns participated in phase II. The reformation of orientation sessions, including practical exposure and content of sessions, opportunities to enhance hands-on experience and supervision in inpatient areas, operating rooms, supervision by fellows, supervision for hands-on procedures, career counseling, and mentorship, led to significant improvement in satisfaction. It was identified that the lack of hands-on opportunities can be overcome by surgical skills-based workshops. These reforms led to an overall rise in intern satisfaction (50% vs 75.4%, p=0.02).Conclusion: Periodic restructuring of an existing program helps to improve the work-based learning experience and overall satisfaction among interns. This not only maximizes learning but also eases interns into their postgraduate life and workload subsequently enabling them to become more competent and well-rounded health practitioners

Sonographic Evaluation of Cholelithiasis and Its Correlation with Normal/Fatty Liver

Cholelithiasis and Fatty Liver disease are usually observed to coexist. Patients who have gallstones also have Fatty Liver as both of the conditions have same associated risk factors I.e., diabetes mellitus, gender, age, obesity, metabolic syndrome, insulin resistance and high lipids level. Non-Alcoholic Fatty Liver Disease (NAFLD) is also an independent accountable risk factor for the formation of gallstones. We aimed to determine whether there is any correlation between cholelithiasis and fatty liver disease. The study was conducted in Lahore General Hospital, Lahore, Pakistan. The data was collected from March 24,2021 to May 24,2021. Informed consent was taken from all the participants. We did a cohort study comprising the data of 51 patients undergoing physical checkup. The data gathered included age, gender and whether they had normal or fatty liver. Cholelithiasis was diagnosed by confirming the presence of gallstones on abdominal ultrasonography after fasting for approximately 8hrs. it was an observational study for the assessment of correlation between cholelithiasis and fatty liver in the participants. A Total of 51 patients with cholelithiasis were included in our study. Most of the patients were 29 to 70 years of age. The average age of the patients was 42.3 ± 10.1 years. Out of 51 patients, there were 60.8% (P=31) females and 39.2%(P=20) males. Out of 51 cholelithiasis patients there were 31.4%(P=16) had Normal Liver and 68.6%(P=35) were positive with Fatty liver disease. Patients with stone size ranges from 1.90mm to 4.6mm hade Grade 1 Fatty liver as shown in table-5.4, Grade 2 Fatty liver was seen in patients with stone size ranges from 4.5mm to 5.8mm. Fatty liver Grade 3 was not observed in any included patient with cholelithiasis. Results of our study showed that both cholelithiasis and Fatty Liver disease are correlated with each other. Females are at higher risk to be affected by these with diseases. Early detection of Fatty liver in patients of cholelithiasis can help patients to prevent them further complications regarded to fatty liver and cholelithiasis and can play important role in health care of society. Keywords: Non-Alcoholic Fatty Liver Disease, Cholelithiasis, Fatty liver, Ultrasonography. DOI: 10.7176/JHMN/91-07 Publication date:July 31st 202

National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.Peer reviewe

Antibiotic susceptibility surveillance in the Punjab Province of Pakistan : findings and implications

Background and Objectives: The increase in antimicrobial resistance (AMR) across countries has seriously impacted the effective management of infectious diseases, with subsequent impact on morbidity, mortality and costs. This includes Pakistan. Antimicrobial surveillance activities should be mandatory to continually assess the extent of multidrug-resistant bacteria and the implications for future empiric prescribing. The objective of this retrospective observational study was to monitor the susceptibility pattern of microbes in Pakistan. Materials and Methods: Clinical samples from seven laboratories in Punjab, Pakistan were collected between January 2018 and April 2019, with Punjab being the most populous province in Pakistan. The isolates were identified and their antimicrobial susceptibility was tested using the Kirby-Bauer disc diffusion assay and micro broth dilution methods. The antibiotics assessed were those typically prescribed in Pakistan. Results: In total, 2523 bacterial cultural reports were studied. The most frequently isolated pathogens were Staphylococcus aureus (866, 34.3%), followed by Escherichia coli (814, 32.2%), Pseudomonas aeruginosa (454, 18.0%) and Klebsiella pneumoniae (269, 10.7%). Most pathogens were isolated from pus (1464, 58.0%), followed by urine (718, 28.5%), blood (164, 6.5%) and sputum (81, 3.2%). Conclusions: The findings suggest that current antimicrobial options are severally restricted in Pakistan due to the emergence of multidrug-resistant pathogens. This calls for urgent actions including initiating antimicrobial stewardship programs to enhance prudent prescribing of antibiotics. This includes agreeing on appropriate empiric therapy as part of agreed guidelines, in line with the WHO EML and AWaRe book, whilst awaiting culture reports. This is alongside other measures to reduce inappropriate antimicrobial prescribing and reverse the threat of rising AMR

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Marriages, New Women and Changing Intra-Group Dynamics of the Trader Families in Rawalpindi

This research expounds on the question of how the micro-foundations of power are constituted and manifested in middle class trader families? In the pursuit of answering this question, the present study aims to focus on the domestic sphere of traders who primarily belong to Nirankari Bazaar1 in Rawalpindi, historically a mercantilist city2. This work is based on my ethnographic study and observation of the community norms and practices within the homes of the traders. This work will explore how relationships in the domestic sphere are made, contested and befriended so as to know how the intra-group dynamics unfold in traders’ families. The underlying focus of this is to understand the significance of women of traders in the making of the families, formulating or breaking linkages to consolidate or disintegrate the economic position of the trader. In this regard, we look at the institution of marriage as the basic unit of intra-group dynamics and relationships whereby ‘new’ relatives are designated as instrumental drivers of the family and house.  The central argument in this study is how the new woman after being included in the trader household is expected to connect or disconnect family unity and property which is a marker of significance for the trader. The paper draws semblance with literature on domestic relationships in Punjab from the historic, economic and social context. Further, the paper is based on the theoretical foundation from Levi-Strauss’s structural analysis within anthropology that explains, society as like language is based on rules and patterns that constitute the deeply embedded structures within. The embedded or unconscious3 structure in this case of marriage determines the subsequent conscious4 social relations and practices of making and unmaking alliances in the trader household. This purpose of the research is to elucidate the role of new women in contouring family dynamics despite the dominance of men in the traders families

Development Expenditure Allocation and District Wise Social Development: A Case Study of Punjab Pakistan

In the wake of achieving Sustainable Development Goals, this study sets to investigate the allocation of development expenditures as government policy intervention and its role in the uplifting the social condition in districts of Punjab. The constriction of a comprehensive social development is indexed using principal factor analysis. This study considered panel data for 36 districts of Punjab ranging from 2008 to 2017. Estimates from the panel Random Effect model advocated that the rise in the development expenditures by the Government of Punjab follows U shape relationship with the social condition of the province. This quadratic model helps to estimate district-wise effects of government development intervention on social development and its components via which resource mobilization optimization can be done.&nbsp