Remote health monitoring systems for elderly people: a survey

This paper addresses the growing demand for healthcare systems, particularly among the elderly population. The need for these systems arises from the desire to enable patients and seniors to live independently in their homes without relying heavily on their families or caretakers. To achieve substantial improvements in healthcare, it is essential to ensure the continuous development and availability of information technologies tailored explicitly for patients and elderly individuals. The primary objective of this study is to comprehensively review the latest remote health monitoring systems, with a specific focus on those designed for older adults. To facilitate a comprehensive understanding, we categorize these remote monitoring systems and provide an overview of their general architectures. Additionally, we emphasize the standards utilized in their development and highlight the challenges encountered throughout the developmental processes. Moreover, this paper identifies several potential areas for future research, which promise further advancements in remote health monitoring systems. Addressing these research gaps can drive progress and innovation, ultimately enhancing the quality of healthcare services available to elderly individuals. This, in turn, empowers them to lead more independent and fulfilling lives while enjoying the comforts and familiarity of their own homes. By acknowledging the importance of healthcare systems for the elderly and recognizing the role of information technologies, we can address the evolving needs of this population. Through ongoing research and development, we can continue to enhance remote health monitoring systems, ensuring they remain effective, efficient, and responsive to the unique requirements of elderly individuals

Co-infections, secondary infections, and antimicrobial use in patients hospitalized with COVID-19 during the first five waves of the pandemic in Pakistan; findings and implications

Background: COVID-19 patients are typically prescribed antibiotics empirically despite concerns. There is a need to evaluate antibiotic use among hospitalized COVID-19 patients during successive pandemic waves in Pakistan alongside co-infection rates. Methods: Retrospective review of pa-tient records among five tertiary care hospitals during successive waves. Data collected from confirmed COVID-19 patients during first five waves. Results: 3,221 patients were included. The majority were male (51.53%), resident in urban areas (56.35%) and aged >50 years (52.06%). Cough, fever, and sore throat were clinical symptoms in 20.39%, 12.97% and 9.50% respectively. 23.62% of COVID-19 patients presented with typically mild disease and45.48% with moderate disease. High prevalence of antibiotic prescribing (89.69%), averaging 1.66 antibiotics per patient despite only 1.14% bacterial co-infections and 3.14% secondary infections. Antibiotics use significantly in-creased with increasing severity, elevated WBCs and CRP levels, need for oxygen and admittance to ICUs; however, decreased significantly after the second wave (p < 0.001). Commonly prescribed antibiotics were piperacillin plus enzyme inhibitor (20.66%), azithromycin (17.37%) and mero-penem (15.45%). Common pathogens were Staphylococcus aureus (24.19%) and Streptococcus pneumoniae (20.96%). The majority of the prescribed antibiotics (93.35%) were from WHO “Watch” category. Conclusion: Excessive prescribing of antibiotics is still occurring among COVID-19 patients in Pakistan; however, rates are reducing. Urgent measures are needed for further reduc-tions

Characterization of a new full length TMPRSS3 isoform and identification of mutant alleles responsible for nonsyndromic recessive deafness in Newfoundland and Pakistan

BACKGROUND: Mutant alleles of TMPRSS3 are associated with nonsyndromic recessive deafness (DFNB8/B10). TMPRSS3 encodes a predicted secreted serine protease, although the deduced amino acid sequence has no signal peptide. In this study, we searched for mutant alleles of TMPRSS3 in families from Pakistan and Newfoundland with recessive deafness co-segregating with DFNB8/B10 linked haplotypes and also more thoroughly characterized the genomic structure of TMPRSS3. METHODS: We enrolled families segregating recessive hearing loss from Pakistan and Newfoundland. Microsatellite markers flanking the TMPRSS3 locus were used for linkage analysis. DNA samples from participating individuals were sequenced for TMPRSS3. The structure of TMPRSS3 was characterized bioinformatically and experimentally by sequencing novel cDNA clones of TMPRSS3. RESULTS: We identified mutations in TMPRSS3 in four Pakistani families with recessive, nonsyndromic congenital deafness. We also identified two recessive mutations, one of which is novel, of TMPRSS3 segregating in a six-generation extended family from Newfoundland. The spectrum of TMPRSS3 mutations is reviewed in the context of a genotype-phenotype correlation. Our study also revealed a longer isoform of TMPRSS3 with a hitherto unidentified exon encoding a signal peptide, which is expressed in several tissues. CONCLUSION: Mutations of TMPRSS3 contribute to hearing loss in many communities worldwide and account for 1.8% (8 of 449) of Pakistani families segregating congenital deafness as an autosomal recessive trait. The newly identified TMPRSS3 isoform e will be helpful in the functional characterization of the full length protein

Analyzing hematological indices and clinical associations of FLT3 mutation in acute leukemia

Objective: The purpose of this research is to examine the relationship between FLT3 mutation and hematological indices and clinical correlates in patients with severe myelogenous leukemia &amp; acute lymphoblastic leukemia. Study Design: Descriptive Study. Place and Duration: Diagnostic and research Laboratory Liaquat university of Medical and health sciences jamshoro Hyderabad. January 2021 to December 2021. Methods: Total 79 cases of acute leukemia were included in this study. Patients provided written consent for detailed demographics and for self-structure questionnaire. All the data was obtained from laboratory records. The patients' clinico-hematologic and immunophenotypic characteristics were recorded, and the FLT3 mutation was analyzed molecularly. SPSS 24.0 was used to analyze all data. Results: Majority of the patients 44 (55.7%) were males and 35 (44.3%) cases were females. The included patients had mean age 37.21±14.59 years and had mean BMI 23.6±4.18 kg/m2. We found that 48 (60.8%) cases had acute myeloid leukemia (AML) and 31 (39.2%) cases had acute lymphoblastic leukemia (ALL). Frequency of FLT 3 mutations in AML patients was 6 (12.5%) and in ALL patients was 1 (3.2%) after polymerase chain reaction. WBC was the most statistically significant hematological and clinical result connected with FLT3 mutation.&nbsp

Acute renal failure as a manifestation of multiple myeloma frequency and clinical implications

Objective: Aim was to determine the association and clinical implications of renal failure among patients of multiple myeloma. Study Design: Prospective/observational study. Place and Duration: Diagnostic and research Laboratory Liaquat university of Medical and health sciences jamshoro Hyderabad. June 2021 to may 2022. Methods: Total 192 patients of multiple myeloma were presented in this study. Patients were enrolled after obtaining written consent detailing age, sex, and the presence or absence of any and all comorbidities. A serum creatinine level of 177 mol/L or above (&gt;2 mg/dL) was considered indicative of renal failure. All the patients received chemotherapy for recovery. Response rate to chemo and survival among all patients were determined. SPSS 23.0 was used to analyze all data. Results: There were 106 (55.2%) males and 86 (44.8%) cases were females. Patients mean age was 51.6 ±13.46 years. Chronic renal disease, diabetes, hypercalcemia, dehydration, and the use of nephrotoxic medicines were all risk factors. We found renal failure in 43 (22.4%) cases. Patients without renal failure had higher response rate 90 (60.4%) to chemotherapy as compared to patients of renal failure 16 (37.2%). 13 (30.2%) cases were recovered from renal failure and mean time of survival was 3.3±3.18 years.&nbsp

Socio-Economic Impact of the Interest-Free Community Investment Fund: A Case Study of Rural Sindh, Pakistan

This study aims to measure the impact of an intervention, the Community Investment Fund (CIF), on the socio-economic life of rural women. CIF is a community-managed fund aimed at improving the living standards of women by empowering them to undertake income-generating projects to become financially more stable and self-governed in the Khairpur, Shikarpur, Kandhkot-Kashmore and Jacobabad districts of Sindh, Pakistan. This study used a quasi-experimental design approach that involved two groups, i.e., the treatment group (beneficiaries) and control group (non-beneficiaries). The sample size of this study was 708 respondents including the treatment and control group. The results of comparison of mean indicate that there is a significant difference between treatment and control group in terms of socio-demographic variables (including monthly income and consumption, saving amount, total asset value, an asset purchased value and household diet) and women empowerment’s indicators, thereby suggesting that CIF has resulted in women empowerment. Concerning the results of the poverty scorecard, the higher graduation of beneficiaries (treatment group) asserts that the intervention of CIF has also a positive impact on targeted beneficiaries. In particular, the findings indicate that 72% of beneficiaries (treatment group) have graduated from one poverty band to another higher band compared to 59.4% of non-beneficiaries (control group) in poverty score. In addition, the findings of the logistic regression analysis confirmed that participation in the CIF program empowers women beneficiaries. This study will support policymakers to further improve CIF so that it can become more effective and sustainable

Pattern of anemia and associated parameters in HIV positive patients taking highly active retroviral therapy (HAART)

Objective: This study was designed to determine the pattern of anaemia among HIV positive patients taking HAART. Study Design: Cross-sectional study. Place and Duration: Diagnostic and research Laboratory Liaquat university of Medical and health sciences Jamshoro, Hyderabad. January 2022-December 2022. Methods: Total 250 HIV patients (aged 18 years and above) of both genders taking HAART for at least the past six months. After taking written informed consent, data was recorded with the help of a structured questionnaire that contained questions regarding basic bio-data and medical history, along with the interpretation of general physical and systemic examination. A blood complete picture was done to evaluate baseline haematological parameters. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 22.0. Results: The mean age of the patients was 32.09 (±SD12.165). Most of the individuals, i.e., 160 (64%), were males, and the number of females was 90 (36%). The mean viral load was 2674.60. Anaemia was present in 210 (84%) patients and 40 (16%)non-anemic with standard parameters. Among anaemic patients, 130 52% had mild disease, moderate anaemia was found in 105 (42%), and only a few (n=15) 6% had severe anaemia.&nbsp

Neurodevelopmental outcomes following possible serious bacterial infection in early infancy in Karachi, Pakistan: A prospective cohort study

Background: Pakistan reports a significant burden of neonatal mortality, with infections as one of the major causes. We aim to assess the long-term impact of early infancy infections on neurodevelopmental outcomes during later childhood.Methods: We conducted a prospective follow-up study of the cohort enrolled at the Karachi site of the Aetiology of Neonatal Infection in South Asia (ANISA) during 2019-2020. Children with a possible serious bacterial infection (based on the WHO IMCI algorithm) at early infancy were assessed for neurodevelopment at 6-9 years of age and compared with healthy controls. The Ten Questions (TQS) questionnaire, Strengths and Difficulties Questionnaire (SDQ), and Parent\u27s Evaluation of Developmental Stage Assessment Level (PEDS: DM-AL) neurodevelopmental assessment tools, were administered and scored by the research staff who were blinded to the child\u27s exposure status. Generalized Structural Equation Modelling (GSEM) was employed to verify relationships and associations among developmental milestones, anthropometry, and sociodemographic variables.Results: A total of 398 children (241 cases and 157 controls) completed neurodevelopmental and growth assessments. Cases had a significantly higher rate of abnormal TQS scores (54.5% vs. 35.0%, p-value 0.001), greater delays in motor milestones (21.2% vs. 12.1%, p-value 0.02), lower fine motor skills (78.4 ± 1.4 vs. 83.2 ± 1.5, p-value 0.02). The receptive language skills were well-developed in both groups. According to the logistic regression model, exposure to infection during the first 59 days of life was associated with delayed TQS milestones (β = -0.6, 95% CI -1.2,-0.04), TQS hearing domain (β = -0.3, 95% CI: -1.2 to 0.7), PEDS: DM-AL fine motor domain (β = -1.3, 95% CI: -4.4 to 1.7), PEDS: DM-AL receptive language development (β = -1.1, 95% CI: -3.7 to 1.4) and child anthropometric measurements such as weight and height (β = -0.2, 95% CI: -0.4 to 0.01 and β = -0.2, 95% CI: -0.4 to -0.01, respectively). Early pSBI exposure was positively associated with PEDS: DM-AL self-help domain (β = 0.6, 95% CI: -1.2 to 2.4) and SDQ-P overall score (β = 0.02, 95% CI: -0.3 to 0.3).Conclusion: Children exposed to PSBI during early infancy have higher rates of abnormal development, motor delays, and lower fine motor skills during later childhood in Pakistan. Socioeconomic challenges and limited healthcare access contribute to these challenges, highlighting the need for long-term follow-ups with integrated neurodevelopment assessment