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Articles 1 - 19 of 19
Full-Text Articles in Medicine and Health Sciences
Pulse Oximetry: Why Oxygen Saturation Is Still Not A Part Of Standard Pediatric Guidelines In Low-And-Middle-Income Countries (Lmics), Maheen Sheikh, Huzaifa Ahmad, Romesa Ibrahim, Muhammad Imran Nisar, Fyezah Jehan
Pulse Oximetry: Why Oxygen Saturation Is Still Not A Part Of Standard Pediatric Guidelines In Low-And-Middle-Income Countries (Lmics), Maheen Sheikh, Huzaifa Ahmad, Romesa Ibrahim, Muhammad Imran Nisar, Fyezah Jehan
Department of Paediatrics and Child Health
Background: With the high frequency of acute respiratory infections in children worldwide, particularly so in low-resource countries, the development of effective diagnostic support is crucial. While pulse oximetry has been found to be an acceptable method of hypoxemia detection, improving clinical decision making and efficient referral, many healthcare set ups in low- and middle-income countries have not been able to implement pulse oximetry into their practice.
Main body: A review of past pulse oximetry implementation attempts in low- and middle-income countries proposes the barriers and potential solutions for complete integration in the healthcare systems. The addition of pulse oximetry into …
Diagnostic Accuracy Of Various Immunochromatographic Tests For Ns1 Antigen And Igm Antibodies Detection In Acute Dengue Virus Infection, Mughees Haider, Saira Yousaf, Asifa Zaib, Azza Sarfraz, Zouina Sarfraz, Ivan Cherrez-Ojeda
Diagnostic Accuracy Of Various Immunochromatographic Tests For Ns1 Antigen And Igm Antibodies Detection In Acute Dengue Virus Infection, Mughees Haider, Saira Yousaf, Asifa Zaib, Azza Sarfraz, Zouina Sarfraz, Ivan Cherrez-Ojeda
Department of Paediatrics and Child Health
Introduction: Rapid diagnostic tests (RDTs) were evaluated, in this paper, for their utility as a reliable test, using resource-constrained studies. In most studies, NS1 antigen and immunoglobulin M (IgM)-based immunochromatographic tests (ICTs) were considered for acute phase detection. We aimed to evaluate the diagnostic accuracy of NS1, IgM, and NS1/IgM-based ICTs to detect acute dengue virus (DENV) infection in dengue-endemic regions.
Methods: Studies were electronically identified using the following databases: MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL Plus. Keywords including dengue, rapid diagnostic test, immunochromatography, sensitivity, specificity, and diagnosis were applied across databases. In total, 15 studies were …
Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi
Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi
Department of Paediatrics and Child Health
Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan.
Method: We followed a group of children of age 6-8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the 'Aetiology of Neonatal Infection in South Asia (ANISA)' study. We standardised the research methods for the sites, trained field staff …
A Changing Epidemic And The Rise Of Opioid-Stimulant Co-Use, Saeed Ahmed, Zouina Sarfraz, Azza Sarfraz
A Changing Epidemic And The Rise Of Opioid-Stimulant Co-Use, Saeed Ahmed, Zouina Sarfraz, Azza Sarfraz
Department of Paediatrics and Child Health
No abstract provided.
Physician's Attitudes On Pulmonary Rehabilitation Following Covid-19: A Brief Perspective From A Developing Country, Ivan Cherrez-Ojeda, Emanuel Vanegas, Miguel Felix, María José Farfán Bajaña, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho, Alanna Barrios-Ruiz, Jack Michel
Physician's Attitudes On Pulmonary Rehabilitation Following Covid-19: A Brief Perspective From A Developing Country, Ivan Cherrez-Ojeda, Emanuel Vanegas, Miguel Felix, María José Farfán Bajaña, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho, Alanna Barrios-Ruiz, Jack Michel
Department of Paediatrics and Child Health
Despite the uncertainty about the follow up of COVID-19 survivors, there is a growing body of evidence supporting specific interventions including pulmonary rehabilitation, which may lead to a reduced hospital stay and improved overall respiratory function. The aim of this short report was to assess the attitudes toward pulmonary rehabilitation following COVID-19 among Ecuadorian physicians. A cross-sectional study was conducted, in which a 5-question survey was used to assess the level of agreement to specific statements with a 5-point Likert scale. Out of the 282 participants, 48.2% (n=136) were male, with a mean of 12.6 (SD=11.3) years of experience. More …
The Radiological Presentation Of Rasmussen Aneurysm Secondary To Pulmonary Tuberculosis And Covid-19: A Case Report, Adnan Arif, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Chérrez-Ojeda
The Radiological Presentation Of Rasmussen Aneurysm Secondary To Pulmonary Tuberculosis And Covid-19: A Case Report, Adnan Arif, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Chérrez-Ojeda
Department of Paediatrics and Child Health
Rasmussen aneurysm is rare diagnosis occurring in patients with long-standing tuberculosis. TB-COVID-19 co-infection in the context of Rasmussen aneurysm is a rare occurrence, yet new cases are emerging. An elderly male was recently diagnosed with TB-COVID-19 co-infection and presented with sudden onset massive hemoptysis. The patient was diagnosed with Rasmussen aneurysm after being evaluated by computed tomography pulmonary angiogram due to a suggestive clinical presentation. Interventional radiologists planned for embolization of pulmonary artery, with an unidentifiable source. It was suspected that the patient's source of bleeding was hampered due to local tamponade effect or thrombosis of the aneurysm. The patient …
Accuracy Of Spontaneous Breathing Trial Using Et-Cpap In Predicting Successful Extubation Of Neonates, Azeem Khan, Vikram Kumar, Ali Shabbir Hussain, Erum Choudry, Muhammad Khalid, Sheharyar Khan, Fayaz Ahmed Memon, Anum Rahim, Syed Rehan Ali
Accuracy Of Spontaneous Breathing Trial Using Et-Cpap In Predicting Successful Extubation Of Neonates, Azeem Khan, Vikram Kumar, Ali Shabbir Hussain, Erum Choudry, Muhammad Khalid, Sheharyar Khan, Fayaz Ahmed Memon, Anum Rahim, Syed Rehan Ali
Department of Paediatrics and Child Health
Objective: Extubation failure is common in mechanically ventilated neonates. Finding objective criteria for predicting successful extubation may help to reduce the incidence of failure and the length of mechanical ventilation (MV). We conducted this study to determine the accuracy of the spontaneous breathing trial (SBT) and lung function measurements in predicting successful extubation in neonates.
Methodology: This cross-sectional validation study was conducted at a tertiary care neonatal intensive care unit (NICU) over 12 months from December 2019 to December 2020. Neonates intubated for >24 hours and considered ready for extubation were enrolled in the study. Neonates who met defined eligibility …
Challenges Of Assessing Community Mortality Due To Respiratory Viruses In Children Aged Less Than 5 Years, Mauricio T. Caballero, Ashish Satav, Christopher J. Gill, Saad B. Omer, Rachel C. Pieciak, Abdul Momin Kazi, Eric Af Simões, Fernando P. Polack
Challenges Of Assessing Community Mortality Due To Respiratory Viruses In Children Aged Less Than 5 Years, Mauricio T. Caballero, Ashish Satav, Christopher J. Gill, Saad B. Omer, Rachel C. Pieciak, Abdul Momin Kazi, Eric Af Simões, Fernando P. Polack
Department of Paediatrics and Child Health
Background: Estimating the real impact of respiratory syncytial virus (RSV) disease is key for the development of vaccines and treatments. Ascertaining the burden of community mortality due to RSV is challenging due to the lack of primary data. Therefore, conducting observational studies to determine the factors associated with community mortality due to the virus in developing countries is important.
Objective: Our aim in this study was to describe the obstacles, gaps, and challenges that investigators face in low-income, vulnerable regions in 4 developing countries on 3 continents.
Results: The main obstacles and challenges of ascertaining community mortality due to RSV …
Global Respiratory Syncytial Virus-Related Infant Community Deaths, Natalie I. Mazur, Yvette N. Löwensteyn, Joukje E. Willemsen, Christopher J. Gill, Leah Forman, Lawrence M. Mwananyanda, Dianna M. Blau, Robert F. Breiman, Shabir A. Madhi, Abdul Momin Kazi
Global Respiratory Syncytial Virus-Related Infant Community Deaths, Natalie I. Mazur, Yvette N. Löwensteyn, Joukje E. Willemsen, Christopher J. Gill, Leah Forman, Lawrence M. Mwananyanda, Dianna M. Blau, Robert F. Breiman, Shabir A. Madhi, Abdul Momin Kazi
Department of Paediatrics and Child Health
Background: Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized.
Methods: The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed …
Risk Factors Leading To Pulmonary Exacerbation In Patients With Cystic Fibrosis: A Systematic Review, Danish Abdul Aziz, Syeda Khadija Fatima, Hasan Nawaz Tahir
Risk Factors Leading To Pulmonary Exacerbation In Patients With Cystic Fibrosis: A Systematic Review, Danish Abdul Aziz, Syeda Khadija Fatima, Hasan Nawaz Tahir
Department of Paediatrics and Child Health
Objective: To ascertain major risk factors associated with pulmonary exacerbation and pulmonary function decline in cystic fibrosis.
Methods: The systematic review was conducted at Aga Khan University, Karachi, in September 2018, and comprised electronic search of PubMed, Ovid, Science Direct and Cumulative Index of Nursing and Allied Health Literature databases of studies conducted from January 1990 to September 2018 which were categorised into 3 sets; 1990-98, 1999-2007 and 2008-18. Studies included for review focussed on articles with pulmonary exacerbation as the health outcome indicator, and had diagnosis of cystic fibrosis as the inclusion criteria, while risk factors were the exposure …
Balancing Science And Public Policy In Pakistan's Covid-19 Response, Zulfiqar Ahmed Bhutta, Faisal Sultan, Aamer Ikram, Adil H. Haider, Assad Hafeez, Muhammad Islam
Balancing Science And Public Policy In Pakistan's Covid-19 Response, Zulfiqar Ahmed Bhutta, Faisal Sultan, Aamer Ikram, Adil H. Haider, Assad Hafeez, Muhammad Islam
Department of Paediatrics and Child Health
Background: Coronavirus disease 2019 (COVID-19) has affected the world in an unprecedented manner and South Asian countries were among the first to experience imported cases. Pakistan's response to COVID-19 has been under scrutiny for its granularity, reach and impact.
Aims: to evaluate objectively the chronology and depth of the response to COVID-19 in Pakistan.
Methods: We evaluated available national and subnational epidemiological and burden information on COVID-19 cases and deaths in Pakistan, including projection models available to the Government at an early stage of the pandemic.
Results: Pakistan, with a population of 215 million and considerable geographic diversity, experienced case …
Acceptance Of Covid-19 Vaccine In Pakistan: A Nationwide Cross-Sectional Study, Mohammad Aadil Qamar, Omar Irfan, Rubaid A. Dhillon, Areesh Bhatti, Mir Ibrahim Sajid, Safia Awan, Wajiha Rizwan, Ali Bin Sarwar Zubairi, Zouina Sarfraz, Javaid Ahmed Khan
Acceptance Of Covid-19 Vaccine In Pakistan: A Nationwide Cross-Sectional Study, Mohammad Aadil Qamar, Omar Irfan, Rubaid A. Dhillon, Areesh Bhatti, Mir Ibrahim Sajid, Safia Awan, Wajiha Rizwan, Ali Bin Sarwar Zubairi, Zouina Sarfraz, Javaid Ahmed Khan
Department of Paediatrics and Child Health
Introduction: The coronavirus disease 2019 (COVID-19) vaccine is available across various countries worldwide, with public-private partnerships ensuring all individuals are vaccinated through a phased approach. Irrespective of the geographical spread, several myths pertaining to the COVID-19 vaccine have stemmed, ultimately limiting the national administration of vaccines and rollouts. This study assessed the acceptance of the COVID-19 vaccine among the general public in Pakistan.
Methods: A pre-validated questionnaire was administered from January 2021 to February 2021 to assess the public attitude and acceptance of the COVID-19 vaccine. Logistic regression analyses were run to identify factors associated with the acceptance among the …
Vitamin D Status And Pulmonary Exacerbations In Children And Adolescents With Cystic Fibrosis: Experience From A Tertiary Care Center, Danish Abdul Aziz, Syeda Khadija Fatima, Haissan Iftikhar, Fatima Mir
Vitamin D Status And Pulmonary Exacerbations In Children And Adolescents With Cystic Fibrosis: Experience From A Tertiary Care Center, Danish Abdul Aziz, Syeda Khadija Fatima, Haissan Iftikhar, Fatima Mir
Department of Paediatrics and Child Health
Background: The function of Vitamin D in preventing inflammation and infection has been studied previously for different pathologies in different populations globally. Relationships between serum Vitamin D levels and its effect on pulmonary exacerbations in the cystic fibrosis (CF) population are not well studied in our part of the world. Therefore, we aimed to ascertain the Vitamin D status in pediatric and adolescent CF patients and its association with pulmonary exacerbations.
Materials and methods: A retrospective study was conducted at The Aga Khan University Hospital from 2015 to 2018. Patients of CF with sweat chloride value >60 mmol/l and who …
Serial Lung Ultrasounds In Pediatric Pneumonia In Mozambique And Pakistan, Amy Sarah Ginsburg, Muhammad Imran Nisar, Lola Madrid, Jennifer L. Lenahan, Benazir Baloch, Pio Vitorino, Jun Hwang, Alessandro Lamort, Nee Kanth, Fyezah Jehan
Serial Lung Ultrasounds In Pediatric Pneumonia In Mozambique And Pakistan, Amy Sarah Ginsburg, Muhammad Imran Nisar, Lola Madrid, Jennifer L. Lenahan, Benazir Baloch, Pio Vitorino, Jun Hwang, Alessandro Lamort, Nee Kanth, Fyezah Jehan
Department of Paediatrics and Child Health
Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing and managing pneumonia. We sought to explore serial LUS examinations in children with chest-indrawing pneumonia in resource-constrained settings and compare their clinical and LUS imaging courses longitudinally. We conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at 2 district hospitals in Mozambique and Pakistan. We assessed serial LUS at enrollment, 2, 6, and 14 days, and performed a secondary analysis of …
Feasibility, Usability And Acceptability Of Paediatric Lung Ultrasound Among Healthcare Providers And Caregivers For The Diagnosis Of Childhood Pneumonia In Resource-Constrained Settings: A Qualitative Study, Atif Riaz, Olga Cambaco, Laura Elizabeth Ellington, Jennifer L. Lenahan, Khatia Munguambe, Usma Mehmood, Sana Qaisar, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan
Feasibility, Usability And Acceptability Of Paediatric Lung Ultrasound Among Healthcare Providers And Caregivers For The Diagnosis Of Childhood Pneumonia In Resource-Constrained Settings: A Qualitative Study, Atif Riaz, Olga Cambaco, Laura Elizabeth Ellington, Jennifer L. Lenahan, Khatia Munguambe, Usma Mehmood, Sana Qaisar, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan
Department of Paediatrics and Child Health
Objectives: Paediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.
Design: Prospective qualitative study using semistructured interviews SETTING: Two referral hospitals in Mozambique and Pakistan PARTICIPANTS: A total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.
Results: HCPs …
Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda
Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda
Department of Paediatrics and Child Health
Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.
Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords "COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication." We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, …
Global Burden Of Acute Lower Respiratory Infection Associated With Human Metapneumovirus In Children Under 5 Years In 2018: A Systematic Review And Modelling Study, Xin Wang, You Li, Maria Deloria-Knoll, Shabir A. Madhi, Cheryl Cohen, Syed Asad Ali, Sudha Basne, Quique Bassat, W Abdullah Brooks, Malinee Chittaganpitch
Global Burden Of Acute Lower Respiratory Infection Associated With Human Metapneumovirus In Children Under 5 Years In 2018: A Systematic Review And Modelling Study, Xin Wang, You Li, Maria Deloria-Knoll, Shabir A. Madhi, Cheryl Cohen, Syed Asad Ali, Sudha Basne, Quique Bassat, W Abdullah Brooks, Malinee Chittaganpitch
Department of Paediatrics and Child Health
Background: Human metapneumovirus is a common virus associated with acute lower respiratory infections (ALRIs) in children. No global burden estimates are available for ALRIs associated with human metapneumovirus in children, and no licensed vaccines or drugs exist for human metapneumovirus infections. We aimed to estimate the age-stratified human metapneumovirus-associated ALRI global incidence, hospital admissions, and mortality burden in children younger than 5 years.
Methods: We estimated the global burden of human metapneumovirus-associated ALRIs in children younger than 5 years from a systematic review of 119 studies published between Jan 1, 2001, and Dec 31, 2019, and a further 40 high …
Performance Of Lung Ultrasound In The Diagnosis Of Pediatric Pneumonia In Mozambique And Pakistan, Amy Sarah Ginsburg, Jennifer L. Lenahan, Fyezah Jehan, Rubao Bila, Alessandro Lamorte, Jun Hwang, Lola Madrid, Muhammad Imran Nisar, Benazir Baloch, Naila Nadeem
Performance Of Lung Ultrasound In The Diagnosis Of Pediatric Pneumonia In Mozambique And Pakistan, Amy Sarah Ginsburg, Jennifer L. Lenahan, Fyezah Jehan, Rubao Bila, Alessandro Lamorte, Jun Hwang, Lola Madrid, Muhammad Imran Nisar, Benazir Baloch, Naila Nadeem
Department of Paediatrics and Child Health
Introduction: Improved pneumonia diagnostics are needed in low-resource settings (LRS); lung ultrasound (LUS) is a promising diagnostic technology for pneumonia. The objective was to compare LUS versus chest radiograph (CXR), and among LUS interpreters, to compare expert versus limited training with respect to interrater reliability.
Methods: We conducted a prospective, observational study among children with World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) chest-indrawing pneumonia at two district hospitals in Mozambique and Pakistan, and assessed LUS and CXR examinations. The primary endpoint was interrater reliability between LUS and CXR interpreters for pneumonia diagnosis among children with WHO IMCI …
Simulator-Based Ultrasound Training For Identification Of Endotracheal Tube Placement In A Neonatal Intensive Care Unit Using Point Of Care Ultrasound, Khushboo Qaim Ali, Sajid Bashir Soofi, Ali Shabbir Hussain, Uzair Ansari, Shaun Morris, Mark Oliver Tessaro, Shabina Ariff, Hasan Merali
Simulator-Based Ultrasound Training For Identification Of Endotracheal Tube Placement In A Neonatal Intensive Care Unit Using Point Of Care Ultrasound, Khushboo Qaim Ali, Sajid Bashir Soofi, Ali Shabbir Hussain, Uzair Ansari, Shaun Morris, Mark Oliver Tessaro, Shabina Ariff, Hasan Merali
Department of Paediatrics and Child Health
Background: Simulators are an extensively utilized teaching tool in clinical settings. Simulation enables learners to practice and improve their skills in a safe and controlled environment before using these skills on patients. We evaluated the effect of a training session utilizing a novel intubation ultrasound simulator on the accuracy of provider detection of tracheal versus esophageal neonatal endotracheal tube (ETT) placement using point-of-care ultrasound (POCUS). We also investigated whether the time to POCUS image interpretation decreased with repeated simulator attempts.
Methods: Sixty neonatal health care providers participated in a three-hour simulator-based training session in the neonatal intensive care unit (NICU) …