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Articles 2641 - 2670 of 9507

Full-Text Articles in Medicine and Health Sciences

Stress And Coping Among Surgery Residents In A Developing Country, Qamar Riaz, Syeda Kausar Ali, Muhammad Rizwan Khan, Abdul Rehman Alvi Jan 2021

Stress And Coping Among Surgery Residents In A Developing Country, Qamar Riaz, Syeda Kausar Ali, Muhammad Rizwan Khan, Abdul Rehman Alvi

Department for Educational Development

Objective: Stress during residency training in surgical disciplines not only hampers professional development but can also compromise patient care and personal health. The purpose of this study was to measure the stress level among the surgical residents, identify factors within the learning and work environment that cause stress, and identify different strategies that the residents use habitually to cope with these stresses.
Methodology: This mix method study was conducted in the department of Surgery at Aga Khan University, Pakistan. Residents' stress level was measured using Perceived Stress Scale (PSS); focus group discussions (FGDs) with faculty and residents explored stressors during …


Evaluating The Effectiveness Of 'Mcq Development Workshop Using Cognitive Model Framework: A Pre-Post Study, Rahila Ali, Amber Shahmim Sultan, Nida Zahid Jan 2021

Evaluating The Effectiveness Of 'Mcq Development Workshop Using Cognitive Model Framework: A Pre-Post Study, Rahila Ali, Amber Shahmim Sultan, Nida Zahid

Department for Educational Development

A workshop on MCQ development using cognitive model framework was conducted for health educators from Aga Khan University (AKU) and other academic institutions. The aim was to develop the skill of preparing MCQs for assessing higher cognitive levels. A pre-post study was conducted, participant satisfaction was evaluated and pre-post test scores were used to assess learning capability of the workshop participants. Out of the 19 who attended the workshop, 16 participated in the pre- and post-tests and were included in the study through convenience sampling. The total duration of the study was six months. There was a significant difference in …


Student-Led Surgical Research Network: Enhancing Medical Student Research Opportunities, Ronika Devi Ukrani, Muhammad Musaab Munir, Areesh Bhatti, Shahryar Noordin Jan 2021

Student-Led Surgical Research Network: Enhancing Medical Student Research Opportunities, Ronika Devi Ukrani, Muhammad Musaab Munir, Areesh Bhatti, Shahryar Noordin

Medical College Documents

The current paper was planned to describe a student-led surgical research network established by the Research Division of the Surgery Interest Group at the Aga Khan University, Karachi. The project involved the creation of a collaborative network to provide opportunities to medical students to work with faculty on research projects. Over 25 students were directly connected with faculty and research mentors to work on research projects in the surgical specialty of their choice. The initiative of establishing a student-led surgical research network was successfully implemented and provided medical students with novel research opportunities by helping bridge the gap between the …


To Determine The Efficacy Of Bilateral Inferior Petrosal Sinus Sampling In Differentiating Cushing Disease From Ectopic Cushing Syndrome, Muhammad Azeemuddin, Tanveer Ul Haq, Shahmeer Khan, Raza Sayani, Ayesha Shoukat Hussain, Rumaisa Khan Jan 2021

To Determine The Efficacy Of Bilateral Inferior Petrosal Sinus Sampling In Differentiating Cushing Disease From Ectopic Cushing Syndrome, Muhammad Azeemuddin, Tanveer Ul Haq, Shahmeer Khan, Raza Sayani, Ayesha Shoukat Hussain, Rumaisa Khan

Department of Radiology

Management of endogenous Cushing syndrome is based on its aetiology. Increased Adrenocorticotropic Hormone (ACTH) levels are the most common cause of this disorder and, therefore, it is critical to determine the source of ACTH before further management. Dynamic post contrast MRI is currently the most common investigation implied to diagnose pituitary adenoma; however, it comes with the drawback of low specificity and high false positive results. Inferior petrosal sinus sampling (IPSS) is an established invasive procedure performed to differentiate central versus peripheral source of ACTH which, in turn, results in hypercortesolaemia. This is a series of 14 patients who underwent …


Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand Jan 2021

Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand

Department of Paediatrics and Child Health

With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of pediatric …


High Flow Nasal Cannula Therapy In Children With Acute Respiratory Insufficiency In The Pediatric Intensive Care Unit Of A Resource-Limited Country: A Preliminary Experience, Bushra Saeed, Asim Azim, Anwar Ul Haque, Qalab Abbas Jan 2021

High Flow Nasal Cannula Therapy In Children With Acute Respiratory Insufficiency In The Pediatric Intensive Care Unit Of A Resource-Limited Country: A Preliminary Experience, Bushra Saeed, Asim Azim, Anwar Ul Haque, Qalab Abbas

Department of Paediatrics and Child Health

A retrospective study was performed in children (aged one month - 16 years) receiving HFNC to determine the frequency, efficacy and adverse effects of high flow nasal cannula (HFNC) therapy in the pediatric intensive care unit (PICU), from January to December 2017. Treatment failure was defined as clinical deterioration on HFNC therapy such that mechanical ventilation (MV) was required. Clinical parameters before and after HFNC were assessed using repeated measures analysis of variance. A total of 120 patients received HFNC therapy (21% of total admissions). Primary diagnosis were respiratory disease (50%), central nervous system diseases (14.2%), sepsis (10.8%), and postoperative …


Understanding And Promoting Racial Diversity In Healthcare Settings To Address Disparities In Pandemic Crisis Management, Azza Sarfraz, Zouina Sarfraz, Alanna Barrios, Kuchalambal Agadi, Sindhu Thevuthasan, Krunal Pandav, Manish Kc, Muzna Sarfraz, Pedram Rad, George Michel Jan 2021

Understanding And Promoting Racial Diversity In Healthcare Settings To Address Disparities In Pandemic Crisis Management, Azza Sarfraz, Zouina Sarfraz, Alanna Barrios, Kuchalambal Agadi, Sindhu Thevuthasan, Krunal Pandav, Manish Kc, Muzna Sarfraz, Pedram Rad, George Michel

Department of Paediatrics and Child Health

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States.
Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: …


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 Jan 2021

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, …


Covid-19 Vaccine-Associated Thrombosis With Thrombocytopenia Syndrome (Tts): A Systematic Review And Post Hoc Analysis, Muhammad Usman Hafeez, Maha Ikram, Zunaira Shafiq, Azza Sarfraz, Zouina Sarfraz, Vikash Jaiswal, Muzna Sarfraz, Ivan Chérrez-Ojeda Jan 2021

Covid-19 Vaccine-Associated Thrombosis With Thrombocytopenia Syndrome (Tts): A Systematic Review And Post Hoc Analysis, Muhammad Usman Hafeez, Maha Ikram, Zunaira Shafiq, Azza Sarfraz, Zouina Sarfraz, Vikash Jaiswal, Muzna Sarfraz, Ivan Chérrez-Ojeda

Department of Paediatrics and Child Health

Background: A new clinical syndrome has been recognized following the COVID-19 vaccine, termed thrombosis with thrombocytopenia syndrome (TTS). The following systematic review focuses on extrapolating thrombotic risk factors, clinical manifestations, and outcomes of patients diagnosed with TTS following the COVID-19 vaccine.
Methods: We utilized the World Health Organization's criteria for a confirmed and probable case of TTS following COVID-19 vaccination and conducted a systematic review and posthoc analysis using the PRISMA 2020 statement. Data analysis was conducted using SPSS V25 for factors associated with mortality, including age, gender, anti-PF4/heparin antibodies, platelet nadir, D-dimer peak, time to event diagnosis, arterial or …


Enhancing The Efficiency Of Bag Mask Ventilation: New Method, Muhammad Irfan Ul Haq Jan 2021

Enhancing The Efficiency Of Bag Mask Ventilation: New Method, Muhammad Irfan Ul Haq

Department of Anaesthesia

No abstract provided.


Post Operative Sore Throat: Comparison Between Macintosh Versus Video Laryngoscope In Patients Intubated By Trainee Anaesthetists - A Randomised Control Trial, Amin Ahmed Kapadia, Faraz Shafiq, Amir Raza Jan 2021

Post Operative Sore Throat: Comparison Between Macintosh Versus Video Laryngoscope In Patients Intubated By Trainee Anaesthetists - A Randomised Control Trial, Amin Ahmed Kapadia, Faraz Shafiq, Amir Raza

Department of Anaesthesia

Objectives: Postoperative sore throat (POST) is a common complication related to endotracheal intubation. The aim of this study was to compare the incidence of POST in patients intubated by trainee anaesthetist using Video Laryngoscope™ (VDL) or Conventional Macintosh Laryngoscope (CL).
Methods: Total 110 patient scheduled for elective laparoscopic cholecystectomy were included from main operating room of Aga Khan University Hospital between June 2017-2018. The standardized perioperative protocol was used for general anaesthesia. Selected patients were randomly allocated into conventional laryngoscopy (CL) group or video laryngoscopy (VDL) group. The evaluation of sore throat was done at 1st, 12th and 24th hour …


Right To Play's Intervention To Reduce Peer Violence Among Children In Public Schools In Pakistan: A Cluster-Randomized Controlled Trial, Rozina Karmaliani, Judith Mcfarlane, Hussain Maqbool Ahmed Khuwaja, Yasmeen Hassan Somani, Shireen Shehzad, Tazeen Saeed Ali, Nargis Asad, Esnat D. Chirwa, Rachel Jewkes Dec 2020

Right To Play's Intervention To Reduce Peer Violence Among Children In Public Schools In Pakistan: A Cluster-Randomized Controlled Trial, Rozina Karmaliani, Judith Mcfarlane, Hussain Maqbool Ahmed Khuwaja, Yasmeen Hassan Somani, Shireen Shehzad, Tazeen Saeed Ali, Nargis Asad, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Peer violence is common globally, but a little researched topic in low-and middle-income countries. This study presents the evaluation of a two-year randomized controlled trial of a structured play-based life-skills intervention implemented in schools in Hyderabad, Pakistan.
Objective: To determine the impact of the intervention on school-based peer violence (victimization and perpetration) and depression among school children.
Methods: 40 single-sex public schools were randomized into two study arms (20 per arm 10 of each sex). A total of 1752 grade 6 students (929 from intervention and 823 from control schools) were enrolled in the trial. The two-year intervention was …


Impact Of The Covid-19 Pandemic On Mental Health And Well-Being Of Communities: An Exploratory Qualitative Study Protocol, Anam Shahil Feroz, Naureen Akber Ali, Noshaba Akber Ali, Ridah Feroz, Salima Nazim Meghani, Sarah Saleem Dec 2020

Impact Of The Covid-19 Pandemic On Mental Health And Well-Being Of Communities: An Exploratory Qualitative Study Protocol, Anam Shahil Feroz, Naureen Akber Ali, Noshaba Akber Ali, Ridah Feroz, Salima Nazim Meghani, Sarah Saleem

Community Health Sciences

Introduction: The COVID-19 pandemic has certainly resulted in an increased level of anxiety and fear in communities in terms of disease management and infection spread. Due to fear and social stigma linked with COVID-19, many individuals in the community hide their disease and do not access healthcare facilities in a timely manner. In addition, with the widespread use of social media, rumours, myths and inaccurate information about the virus are spreading rapidly, leading to intensified irritability, fearfulness, insomnia, oppositional behaviours and somatic complaints. Considering the relevance of all these factors, we aim to explore the perceptions and attitudes of community …


Preconceptional Lipid-Based Nutrient Supplementation In 2 Low-Resource Countries Results In Distinctly Different Igf-1/Mtor Placental Responses, Marisol Castillo-Castrejon, Ivana V. Yang, Elizabeth J. Davidson, Sarah J. Borengasser, Purevsuren Jambal, Jamie Westcott, Jennifer F. Kemp, Ana Garces, Sumera Aziz Ali, Sarah Saleem Dec 2020

Preconceptional Lipid-Based Nutrient Supplementation In 2 Low-Resource Countries Results In Distinctly Different Igf-1/Mtor Placental Responses, Marisol Castillo-Castrejon, Ivana V. Yang, Elizabeth J. Davidson, Sarah J. Borengasser, Purevsuren Jambal, Jamie Westcott, Jennifer F. Kemp, Ana Garces, Sumera Aziz Ali, Sarah Saleem

Community Health Sciences

Background: Preconceptional maternal small-quantity lipid-based nutrient supplementation (SQLNS) improved intrauterine linear growth in low-resource countries as demonstrated by the Women First Preconception Maternal Nutrition Trial (WF). Fetal growth is dependent on nutrient availability and regulated by insulin-like growth factor 1 (IGF-1) through changes in placental transfer capacity, mediated by the mechanistic target of rapamycin (mTOR) pathway.
Objectives: Our objective was to evaluate the role of placental mTOR and IGF-1 signaling on fetal growth in women from 2 low-resource countries with high rates of stunting after they received preconceptional SQLNS.
Methods: We studied 48 women from preconception through delivery who were …


Malignant Eccrine Adenoma With Sarcomatous (Heterologous) Components: Report Of A Rare Skin Adnexal Neoplasm With Literature Review, Hira Ishtiaq, Muhammad Abdulwaasey, Muhammad Usman Tariq, Saira Fatima Dec 2020

Malignant Eccrine Adenoma With Sarcomatous (Heterologous) Components: Report Of A Rare Skin Adnexal Neoplasm With Literature Review, Hira Ishtiaq, Muhammad Abdulwaasey, Muhammad Usman Tariq, Saira Fatima

Department of Pathology and Laboratory Medicine

Malignant eccrine spiradenoma (MES) is an exceedingly rare skin adnexal tumor that arises from pre-existing benign eccrine spiradenoma (BES). MES tumors show a wide spectrum of morphological features, posing a diagnostic challenge to the pathologist. Sarcomatous (heterologous) elements are seen in a few of these tumors, further complicating the morphological picture. We herein describe a case of a 66-year-old male who presented with a recently enlarging, ulcerated, nodular skin lesion over the right leg that had been present for the last 25 years. The patient underwent wide local excision of the tumor. Microscopic examination revealed a neoplastic lesion comprising benign …


Predictors Of Mortality In Hospitalized Patients With Influenza: A Five-Year Experience From A Tertiary Care Centre In Pakistan, Iffat Khanum, Amber Sabeen Ahmed, Safia Awan, Sabiha Banu, Bushra Jamil Dec 2020

Predictors Of Mortality In Hospitalized Patients With Influenza: A Five-Year Experience From A Tertiary Care Centre In Pakistan, Iffat Khanum, Amber Sabeen Ahmed, Safia Awan, Sabiha Banu, Bushra Jamil

Department of Medicine

Influenza outbreaks are associated with significant morbidity. Our aim was to determine the factors associated with increased mortality in hospitalized patients admitted with diagnosis of influenza, at a tertiary care center in Pakistan. This study included all adult patients with an influenza infection, confirmed by realtime reverse-transcriptase polymerase-chain-reaction (RT-PCR) at Aga Khan University Hospital Pakistan. In our study, 112 patients with laboratory-confirmed influenza virus infection were admittedat our hospital from the 1st of January 2013 to the 31st of December 2018. Eighty-nine patients (79.46%) were managed in ward or special care units and 23 patients (20.5%) received treatment in intensive …


Sarcoidosis Presenting As Vocal Cord Palsy: An Unusual Presentation And Literature Review, Mohummad Hassan Raza Raja, Muhammad Abdullah Javed, Ali Bin Sarwar Zubairi Dec 2020

Sarcoidosis Presenting As Vocal Cord Palsy: An Unusual Presentation And Literature Review, Mohummad Hassan Raza Raja, Muhammad Abdullah Javed, Ali Bin Sarwar Zubairi

Medical College Documents

We report the case of a 60-year-old woman, presenting with left vocal cord paralysis (VCP). Diagnostic evaluation revealed sarcoidosis to be the underlying pathology. Computed tomography (CT) scans exhibited enlarged subcarinal, pretracheal, and prevascular lymph nodes as the possible mechanism of left VCP through compression of the left recurrent laryngeal nerve. Initial treatment with oral prednisolone and azathioprine led to remission of symptoms; however, tapering of dosage led to relapse of cough without any signs of VCP. The dosage of prednisolone was further boosted, leading to complete remission. A review of literature reveals 20 cases have been reported to date, …


Elderly Musculoskeletal Disease Burden In Karachi, Pakistan: Associations And Implications For Developing Countries, Saniya Sabzwari, Zafar Fatmi, Adeel Ahmed Khan Dec 2020

Elderly Musculoskeletal Disease Burden In Karachi, Pakistan: Associations And Implications For Developing Countries, Saniya Sabzwari, Zafar Fatmi, Adeel Ahmed Khan

Department of Family Medicine

Objective: The global rise in the older population has increased the rates of osteoporosis and osteoarthritis, conditions that impact mobility and functionality. There is limited data on musculoskeletal disease in older populations residing in developing countries.
Methods: A community-based study using multistage cluster random sampling of older individuals was conducted in Karachi. Predefined criteria were used for osteoporosis and osteoarthritis. Gait assessment was performed.
Results: More than half of the participants were females and 53% reported illiteracy. Around 30% had osteoporosis and two-thirds had osteoarthritis. Multivariate analysis showed associations of female sex, Pashtun ethnicity, illiteracy, and hypertension with the combined …


Current Role Of Laser Interstitial Thermal Therapy In The Treatment Of Intracranial Tumors, Farhan A. Mirza, Rida Mitha, Muhammad Shahzad Shamim Dec 2020

Current Role Of Laser Interstitial Thermal Therapy In The Treatment Of Intracranial Tumors, Farhan A. Mirza, Rida Mitha, Muhammad Shahzad Shamim

Section of Neurosurgery

Laser interstitial thermal therapy (LITT) is gaining popularity in the treatment of both primary and secondary intracranial tumors. The goal of LITT is to deliver thermal energy in a predictable, controlled, and minimally invasive fashion. It can be particularly valuable in patients with recurrent tumors who, due to previous radiation or surgery, may have a potentially higher risk of wound breakdown or infection with repeat craniotomy. Deep-seated lesions that are often inaccessible through open approaches (thalamus, hypothalamus, mesial basal temporal lobe, brainstem) may also be suitable targets. The experience and data published thus far on this modality is limited but …


Oral Rehydration Therapies In Senegal, Mali, And Sierra Leone: A Spatial Analysis Of Changes Over Time And Implications For Policy, Kirsten E. Wiens, Lauren E. Schaeffer, Samba O. Sow, Babacar Ndoye, Carrie Jo Cain, Mathew M. Baumann, Kimberly B. Johnson, Paulina A. Lindstedt, Brigette F. Blacker, Zulfiqar Ahmed Bhutta Dec 2020

Oral Rehydration Therapies In Senegal, Mali, And Sierra Leone: A Spatial Analysis Of Changes Over Time And Implications For Policy, Kirsten E. Wiens, Lauren E. Schaeffer, Samba O. Sow, Babacar Ndoye, Carrie Jo Cain, Mathew M. Baumann, Kimberly B. Johnson, Paulina A. Lindstedt, Brigette F. Blacker, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes.
Methods: We used a Bayesian geostatistical model and …


Regional Trends In Birth Weight In Low- And Middle-Income Countries 2013-2018, Irene Marete, Osayame Ekhaguere, Carla M. Bann, Sherri L. Bucher, Paul Nyongesa, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar Dec 2020

Regional Trends In Birth Weight In Low- And Middle-Income Countries 2013-2018, Irene Marete, Osayame Ekhaguere, Carla M. Bann, Sherri L. Bucher, Paul Nyongesa, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar

Community Health Sciences

Background: Birth weight (BW) is a strong predictor of neonatal outcomes. The purpose of this study was to compare BWs between global regions (south Asia, sub-Saharan Africa, Central America) prospectively and to determine if trends exist in BW over time using the population-based maternal and newborn registry (MNHR) of the Global Network for Women'sand Children's Health Research (Global Network).
Methods: The MNHR is a prospective observational population-based registryof six research sites participating in the Global Network (2013-2018), within five low- and middle-income countries (Kenya, Zambia, India, Pakistan, and Guatemala) in threeglobal regions (sub-Saharan Af rica, south Asia, Central America). The …


Association Of Parity With Birthweight And Neonatal Death In Five Sites: The Global Network's Maternal Newborn Health Registry Study, Ana Garces, Wilton Perez, Margo S. Harrison, Kay S. Hwang, Tracy L. Nolen, Robert L. Goldenberg, Archana B. Patel, Patricia L. Hibberd, Adrien Lokangaka, Sarah Saleem Dec 2020

Association Of Parity With Birthweight And Neonatal Death In Five Sites: The Global Network's Maternal Newborn Health Registry Study, Ana Garces, Wilton Perez, Margo S. Harrison, Kay S. Hwang, Tracy L. Nolen, Robert L. Goldenberg, Archana B. Patel, Patricia L. Hibberd, Adrien Lokangaka, Sarah Saleem

Community Health Sciences

Background: Nulliparity has been associated with lower birth weight (BW) and other adverse pregnancy outcomes, with most of the data coming from high-income countries. In this study, we examined birth weight for gestational age z-scores and neonatal (28-day) mortality in a large prospective cohort of women dated by first trimester ultrasound from multiple sites in low and middle-income countries.
Methods: Pregnant women were recruited during the first trimester of pregnancy and followed through 6 weeks postpartum from Maternal Newborn Health Registry (MNHR) sites in the Democratic Republic of Congo (DRC), Guatemala, Belagavi and Nagpur, India, and Pakistan from 2017 and …


Development Of The Global Network For Women's And Children's Health Research's Socioeconomic Status Index For Use In The Network's Sites In Low And Lower Middle-Income Countries, Archana B. Patel, Carla M. Bann, Ana L. Garces, Nancy F. Krebs, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar Dec 2020

Development Of The Global Network For Women's And Children's Health Research's Socioeconomic Status Index For Use In The Network's Sites In Low And Lower Middle-Income Countries, Archana B. Patel, Carla M. Bann, Ana L. Garces, Nancy F. Krebs, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar

Community Health Sciences

Background: Socioeconomic status (SES) is an important determinant of health globally and an important explanatory variable to assess causality in epidemiological research. The 10th Sustainable Development Goal is to reduce disparities in SES that impact health outcomes globally. It is easier to study SES in high-income countries because household income is representative of the SES. However, it is well recognized that income is poorly reported in low- and middle- income countries (LMIC) and is an unreliable indicator of SES. Therefore, there is a need for a robust index that will help to discriminate the SES of rural households in a …


Why Are The Pakistani Maternal, Fetal And Newborn Outcomes So Poor Compared To Other Low And Middle-Income Countries?, Aleha Aziz, Sarah Saleem, Tracy L. Nolen, Nousheen Akber Pradhan, Elizabeth M. Mcclure, Saleem Jessani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Sameen Siddiqi Dec 2020

Why Are The Pakistani Maternal, Fetal And Newborn Outcomes So Poor Compared To Other Low And Middle-Income Countries?, Aleha Aziz, Sarah Saleem, Tracy L. Nolen, Nousheen Akber Pradhan, Elizabeth M. Mcclure, Saleem Jessani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Sameen Siddiqi

Community Health Sciences

Background: Pakistan has among the poorest pregnancy outcomes worldwide, significantly worse than many other low-resource countries. The reasons for these differences are not clear. In this study, we compared pregnancy outcomes in Pakistan to other low-resource countries and explored factors that might help explain these differences.
Methods: The Global Network (GN) Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and their pregnancy outcomes in defined geographic communities in six low-middle income countries (India, Pakistan, Democratic Republic of Congo, Guatemala, Kenya, Zambia). Study staff enroll women in early pregnancy and follow-up soon after …


Cesarean Birth In The Global Network For Women's And Children's Health Research: Trends In Utilization, Risk Factors, And Subgroups With High Cesarean Birth Rates, Margo S. Harrison, Ana L. Garces, Shivaprasad S. Goudar, Sarah Saleem, Janet L. Moore, Fabian Esamai, Archana B. Patel, Elwyn Chomba, Carl L. Bose, Edward A. Liechty Dec 2020

Cesarean Birth In The Global Network For Women's And Children's Health Research: Trends In Utilization, Risk Factors, And Subgroups With High Cesarean Birth Rates, Margo S. Harrison, Ana L. Garces, Shivaprasad S. Goudar, Sarah Saleem, Janet L. Moore, Fabian Esamai, Archana B. Patel, Elwyn Chomba, Carl L. Bose, Edward A. Liechty

Community Health Sciences

Background: The objectives of this analysis were to document trends in and risk factors associated with the cesarean birth rate in low- and middle-income country sites participating in the Global Network for Women's and Children's Health Research (Global Network).
Methods: This is a secondary analysis of a prospective, population-based study of home and facility births conducted in the Global Network sites.
Results: Cesarean birth rates increased uniformly across all sites between 2010 and 2018. Across all sites in multivariable analyses, women younger than age twenty had a reduced risk of cesarean birth (RR 0.9 [0.9, 0.9]) and women over 35 …


Institutional Deliveries And Stillbirth And Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Shivaprasad S. Goudar, Norman Goco, Manjunath S. Somannavar, Avinash Kavi, Sunil S. Vernekar, Antoinette Tshefu, Elwyn Chomba, Ana L. Garces, Sarah Saleem, Farnaz Naqvi Dec 2020

Institutional Deliveries And Stillbirth And Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Shivaprasad S. Goudar, Norman Goco, Manjunath S. Somannavar, Avinash Kavi, Sunil S. Vernekar, Antoinette Tshefu, Elwyn Chomba, Ana L. Garces, Sarah Saleem, Farnaz Naqvi

Community Health Sciences

Background: Few studies have shown how the move toward institutional delivery in low and middle-income countries (LMIC) impacts stillbirth and newborn mortality.
Objectives: The study evaluated trends in institutional delivery in research sites in Belagavi and Nagpur India, Guatemala, Kenya, Pakistan, and Zambia from 2010 to 2018 and compared them to changes in the rates of neonatal mortality and stillbirth.
Methods: We analyzed data from a nine-year interval captured in the Global Network (GN) Maternal Newborn Health Registry (MNHR). Mortality rates were estimated from generalized estimating equations controlling for within-cluster correlation. Cluster-level analyses were performed to assess the association between …


Association Between Duration Of Residence And Prevalence Of Type 2 Diabetes Among Male South Asian Expatriate Workers In The United Arab Emirates: A Cross-Sectional Study, Syed Mahboob Shah, Lindsay M. Jaacks, Fatima Al-Maskari, Juma Al-Kaabi, Faisal Aziz, Elpidoforos Soteriades, Tom Loney, Hamed Farooqi, Anjum Memon, Raghib Ali Dec 2020

Association Between Duration Of Residence And Prevalence Of Type 2 Diabetes Among Male South Asian Expatriate Workers In The United Arab Emirates: A Cross-Sectional Study, Syed Mahboob Shah, Lindsay M. Jaacks, Fatima Al-Maskari, Juma Al-Kaabi, Faisal Aziz, Elpidoforos Soteriades, Tom Loney, Hamed Farooqi, Anjum Memon, Raghib Ali

Department of Family Medicine

Expatriates account for about 80% of the total population in the United Arab Emirates (UAE). This study aimed to evaluate the hypothesis that prevalence of type 2 diabetes in male South Asian expatriates increases with increased length of residence in the UAE.
Design, settings and participants: This cross-sectional study recruited a representative sample (n=1375) of male South Asian expatriates aged ≥18 years in Al Ain, UAE. Sociodemographic, anthropometric and lifestyle data were obtained using a pilot-tested adapted version of the WHO STEPS instrument.
Main outcome measures: Duration of residence was used as a marker for acculturation. Type 2 diabetes was …


Open Drug Discovery Of Anti-Virals Critical For Canada’S Pandemic Strategy, Tania M. Bubela, E. Richard Gold, Vivek Goel, Max Morgan, Karen Mossman, Jason Nickerson, David Patrick, Aled Edwards Dec 2020

Open Drug Discovery Of Anti-Virals Critical For Canada’S Pandemic Strategy, Tania M. Bubela, E. Richard Gold, Vivek Goel, Max Morgan, Karen Mossman, Jason Nickerson, David Patrick, Aled Edwards

Office of the Provost

In the event of the current COVID-19 pandemic and in preparation for future pandemics, open science can support mission-oriented research and development, as well as commercialization. Open science shares skills and resources across sectors; avoids duplication and provides the basis for rapid and effective validation due to full transparency. It is a strategy that can adjust quickly to reflect changing incentives and priorities, because it does not rely on any one actor or sector. While eschewing patents, it can ensure high-quality drugs, low pricing, and access through existing regulatory mechanisms. Open science practices and partnerships decrease transaction costs, increase diversity …


Does Early Surgery Prevent Postoperative Icu Admission After Surgery For The Fracture Of The Hip. Nested Case Control Study Of 911 Patients, Obada Hasan, Laraib Mazhar, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin Dec 2020

Does Early Surgery Prevent Postoperative Icu Admission After Surgery For The Fracture Of The Hip. Nested Case Control Study Of 911 Patients, Obada Hasan, Laraib Mazhar, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin

Department of Medicine

Introduction: Since most hip fractures are treated surgically, it is imperative to find an optimum fracture-to-surgery time to decrease the potential complications and enhance postoperative outcomes. In comparison to the vast plethora of literature available on surgical delay and its implications on mortality, very little, if any, research is available on the impact of delayed surgery on postoperative ICU admission. The primary objective of our study is to examine the factors influencing post-surgical ICU admission in order to work on preventive strategies to reduce the potential associated morbidity.
Material and methods: Investigators did a nested case control study in a …


Gender Variations In Neonatal And Early Infant Mortality In India And Pakistan: A Secondary Analysis From The Global Network Maternal Newborn Health Registry, Zubair H. Aghai, Shivaprasad S. Goudar, Archana Patel, Sarah Saleem, Sangappa M. Dhaded, Avinash Kavi, Parth Lalakia, Farnaz Naqvi, Patricia L. Hibberd, Elizabeth M. Mcclure Dec 2020

Gender Variations In Neonatal And Early Infant Mortality In India And Pakistan: A Secondary Analysis From The Global Network Maternal Newborn Health Registry, Zubair H. Aghai, Shivaprasad S. Goudar, Archana Patel, Sarah Saleem, Sangappa M. Dhaded, Avinash Kavi, Parth Lalakia, Farnaz Naqvi, Patricia L. Hibberd, Elizabeth M. Mcclure

Community Health Sciences

Background: To determine the gender differences in neonatal mortality, stillbirths, and perinatal mortality in south Asia using the Global Network data from the Maternal Newborn Health Registry.
Methods: This study is a secondary analysis of prospectively collected data from the three south Asian sites of the Global Network. The maternal and neonatal demographic, clinical characteristics, rates of stillbirths, early neonatal mortality (1-7 days), late neonatal mortality (8-28 days), mortality between 29-42 days and the number of infants hospitalized after birth were compared between the male and female infants.
Results: Between 2010 and 2018, 297,509 births [154,790 males (52.03%) and 142,719 …