Deepening Roots and Creating Space: Building a Better Future for New York's South Asians

South Asians are among New York City's fastest growing ethnic populations, experiencing a growth rate of more than 159 percent in the past two decades. Like many in New York City, the South Asian community was hard hit in the last decade by the economic downturn and collapse of the housing market. With the community's rapid growth during the most difficult economic period our country has faced in decades, South Asians are living in severely overcrowded housing conditions, are at high-risk of displacement, and face great barriers to achieving economic growth. This study aims to profile the South Asian community's housing and economic development needs. Using these insights as a window into the challenges faced by immigrant communities around the City, the ultimate goal is to explore specific public policy approaches to boost these groups that are core to ensuring the City's recovery to a thriving economy

Haemovigilance as a quality indicator in transfusion medicine: Pakistan’s perspective

In transfusion medicine, the concept of haemovigilance has emerged during the last three decades. It is structured and systematic surveillance of the entire vein-to-vein transfusion chain and a powerful quality tool. Haemovigilance has become an integral component of transfusion medicine. It helps increase safety and improves quality during blood donation and blood transfusion, from the blood donor to recipient of blood and blood components. The haemovigilance can be successfully implemented and maximum benefit obtained if the data analysis and resulting conclusions are mutually shared with the shareholders. Although haemovigilance has proven to be an effective tool to influence policy development, it is is not well established in Pakistan. The government’s Safe Blood Transfusion Programme has taken key initiatives to introduce, support, and consolidate the haemovigilance system necessitating many changes, in the system, in the institutions, in attitude, and behaviour. The implementation of haemovigilance in Pakistan will require a major paradigm shift. It will be a stepwise or staged approach, starting from institutional to regional/provincial levels and ending at the national level

PCR-based efficacy assessment of hepatitis B core antibody and hepatitis B surface antigen screening tests in the blood donor population

Objectives: To assess the screening efficacy of HBsAg and HBcAb serological assays in comparison with Polymerase Chain Reaction (PCR), as the gold standard.Methodology: This was a cross-sectional prospective study was conducted from November 2019 to February 2020, at the Department of Pathology and Transfusion Medicine, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. A total of 7,550 donations were screened for HBsAg through Chemiluminescence Microparticle Immunoassay. Out of 7,550, 186 HBsAg reactive, and 208 HBsAg non-reactive samples were selected randomly for the study. The screening tests for HBsAg and HBcAb were run in parallel with PCR as the gold standard. In the statistical analyses, the specificity, sensitivity, and positive and negative predictive values were calculated using the PCR results as the gold standard. Kappa agreement was also calculated. Results: A total of 394 blood samples were tested with reactivity rate of HBsAg (n= 186) 47.2% (186/394), HBcAb (n= 210) 53.2% (210/394) and PCR (n= 188) 47.7% (188/394). Kappa agreement for HBsAg and HBcAb were calculated as 0.961 and 0.886 respectively. The results showed 5.5% false positive results by HBcAb test.Conclusion: HBcAb screening showed false-positive results. HBsAg screening found to be the best possible choice that can give credible results, considering the high cost of the molecular assays

Voces Del Canal: Building Safe Communities Through Strong Partnerships in the Canal

The Canal, a vibrant community of Latino immigrant families, is rich in diversity and cultural traditions, strong family networks, and a determination towards economic selfsufficiency. Latino immigrants in Marin County are heavily concentrated in the Canal and have the highest labor force participation rates in the County.i Despite being a vital part of Marin’s social, economic, and cultural society, Canal residents continue to struggle to meet basic necessities for their families. To this end, a coalition of resident leaders from the community came together to form Voces del Canal to lead an unprecedented community-driven research project. Residents wanted to affirm their role as authentic, local experts and give power to the collective experiences of 678 residents who shared their personal stories, opinions, and vision for a stronger and safer Canal

Compliance with continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea among privately paying patients- a cross sectional study

Background: To evaluate the compliance, benefits and side effects associated with continuous positive airway pressure (CPAP) therapy among Pakistani patients treated for obstructive sleep apnea (OSA) in private sector.Methods: Patients diagnosed to have OSA based on overnight study who were recommended for CPAP therapy, between 1998 and 2003, were evaluated by telephonic survey and review of hospital notes. Compliance, benefits and side effects associated with CPAP therapy were assessed.Results: Out of 135 patients who were prescribed CPAP therapy, 75 could be contacted. Sixty (80%) started using CPAP within one month of diagnosis and 46 (61%) continued to use it long-term (beyond one year). Compliance with CPAP therapy was associated with higher body mass index, higher Epworth sleepiness scale score, history of witnessed apnea, and reduction in daytime sleepiness with CPAP therapy. OSA severity as assessed by apnea-hypopnea index did not affect compliance with CPAP therapy. Use of anti-depressants and CPAP induced sleep disturbances were associated with poor compliance with CPAP therapy.CONCLUSIONS: Obesity, excessive daytime sleepiness, witnessed apnea and improvement of daytime symptoms following use of CPAP were predictors of improved compliance. Use of antidepressants and CPAP induced sleep disturbances were predictors of poor compliance

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension