scholarly journals The new criteria for a COVID19 patient for the clinical practice to determine the need for an early therapeutic regimen and to decrease mortality

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Mulazim Hussain Bukhari ◽  
Shahzadi Zain ◽  
Mobeen Syed
Keyword(s):  
Clinical Practice ◽  
Tissue Damage ◽  
Electrolyte Imbalance ◽  
Therapeutic Regimen ◽  
Permanent Disability ◽  
Specific Criterion ◽  
Creative Commons ◽  
Inflammatory Status ◽  
Organ Tissue ◽  
New Criteria

A new predictive criterion is being proposed for the determination of cytokine storm (CS) in COVID-19 (COVID-CS). It is comprised of results of laboratory that associate the pro-inflammatory status, systemic cell death, multi-organ tissue damage, and pre-renal electrolyte imbalance. The data identifies the patients’ stay in hospitals and their mortality with the relevance of hyper-inflammation and tissue damage during the CS. The criteria can be readily used in clinical practice to determine the need for an early therapeutic regimen, block the hyper-immune response and possibly decrease mortality. It helps to understand the nature of the virus by following a specific criterion to predict the disease. The SARS-CoV-2 tells us in few days what nature has decided for the patient i.e., recovery, death or permanent disability. doi: https://doi.org/10.12669/pjms.37.5.3630 How to cite this:Bukhari MH, Zain S, Syed M. The new criteria for a COVID19 patient for the clinical practice to determine the need for an early therapeutic regimen and to decrease mortality. Pak J Med Sci. 2021;37(5):---------.  doi: https://doi.org/10.12669/pjms.37.5.3630 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Risk assessment criteria in liver transplantation for hepatocellular carcinoma: proposal to improve transplant oncology

2020 ◽  
Vol 7 (3) ◽  
pp. HEP26
Author(s):  
John C McVey ◽  
Kazunari Sasaki ◽  
Daniel J Firl
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Clinical Practice ◽  
Predictive Power ◽  
Liver Allocation ◽  
Recent Developments ◽  
The Right ◽  
Practice Patient ◽  
New Criteria ◽  
Key Questions

Liver transplantation for hepatocellular carcinoma has proved to be a highly effective cure if the right patient can be selected. Milan criteria has traditionally guided physicians toward appropriate liver allocation but changes in clinical practice, patient populations and recent developments in biomarkers are decreasing Milan criteria’s utility. At the same time, the literature has flooded with a diversity of new criteria that demonstrate strong predictive power and are better suited for current clinical practice. In this article, the utility of newly proposed criteria will be reviewed and important issues to improve future criteria will be addressed in hopes of opening a discussion on how key questions surrounding criteria for liver transplantation of hepatocellular carcinoma can be answered.

scholarly journals Electrolyte imbalance in critically ill paediatric patients

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Faizia Naseem ◽  
Ayesha Saleem ◽  
Imtiaz Ahmed Mahar ◽  
Fehmina Arif
Keyword(s):  
Critically Ill ◽  
Prognostic Indicator ◽  
Electrolyte Imbalance ◽  
Sodium Potassium ◽  
Creative Commons ◽  
Paediatric Patients ◽  
Public Sector Hospital ◽  
Calcium Magnesium ◽  
Seriously Ill ◽  
Open Access Article

Objective: To determine the frequency and outcome of electrolyte imbalance in seriously ill children admitted in Paediatric Intensive Care Unit (PICU) of a public sector hospital in Karachi. Methods: All children between the ages of one month to 12 years admitted in PICU from May 2017 to October 2017 were included. Blood samples were drawn to determine the baseline sodium, potassium, calcium, magnesium and phosphorous and followed 24 hourly or earlier, if needed (Those who had imbalance at admission or on subsequent repeat labs as per protocol). Results: A total of 101 children were included in the study. Electrolyte imbalance was seen in 84%. A single electrolyte imbalance was noted in 30.58%. Hypocalcemia was the most frequent abnormality noted in 57.6%. Among the total expiries during the study period 91% had electrolyte imbalance. Mortality within 48 hours and duration of stay was also increased in these patients. Conclusion: Electrolyte imbalance is an important prognostic indicator in critically ill patients. doi: https://doi.org/10.12669/pjms.35.4.286 How to cite this:Naseem F, Saleem A, Mahar IA, Arif F. Electrolyte imbalance in critically ill paediatric patients. Pak J Med Sci. 2019;35(4):---------.  doi: https://doi.org/10.12669/pjms.35.4.286 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Incidence of occupational injuries among adults residing in a selected rural area of India: A cross sectional study

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Shilpa Ravi ◽  
Bobby Joseph
Keyword(s):  
Rural Area ◽  
Injury Severity ◽  
Occupational Injuries ◽  
Health Centre ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Permanent Disability ◽  
Creative Commons

Objectives: The objectives of this study were to assess the incidence and profile of occupational injuries among rural workers of rural India. Methods: This study was conducted among all persons between the ages of 18 to 60 years and engaged in some occupation and residing in the villages under the three rural subcentres of Sarjapur Primary Health Centre during the time period of 2009-2012. The sample size was calculated to be 400 assuming a prevalence of 10% and absolute precision of 3% at 95% confidence limits and a systematic random sampling of the household was done to select the study population. Results: The incidence of occupational injuries in the study period of 2009-2012 was 22%. Out of the total 91 injuries, the proportion of injuries, which were agriculture-related, was 62%. The most common cause of injury was due to contact with plant thorns. Above half (54%) involved the upper limbs, and (30%) involved the lower limbs. By using the injury severity scale, 88% were of minor degree. 67% required treatment and 32% of the injured persons took treatment in a private hospital. Those who sustained an injury, 9% required admission to a hospital. Three participants have sustained a permanent disability during this study. Conclusion: The Incidence of occupational injuries was found to be 22% and agriculture showed to have the highest proportion of injuries. doi: https://doi.org/10.12669/pjms.35.3.293 How to cite this:Ravi S, Joseph B. Incidence of occupational injuries among adults residing in a selected rural area of India: A cross sectional study. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.293 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Medicinal Plants for the Treatment of Local Tissue Damage Induced by Snake Venoms: An Overview from Traditional Use to Pharmacological Evidence

2017 ◽  
Vol 2017 ◽  
pp. 1-52 ◽  
Author(s):  
Juliana Félix-Silva ◽  
Arnóbio Antônio Silva-Junior ◽  
Silvana Maria Zucolotto ◽  
Matheus de Freitas Fernandes-Pedrosa
Keyword(s):  
Medicinal Plants ◽  
Tissue Damage ◽  
Herbal Medicines ◽  
Specific Treatment ◽  
Future Research ◽  
Snake Venoms ◽  
Local Effects ◽  
Traditional Use ◽  
Permanent Disability ◽  
Local Tissue

Snakebites are a serious problem in public health due to their high morbimortality. Most of snake venoms produce intense local tissue damage, which could lead to temporary or permanent disability in victims. The available specific treatment is the antivenom serum therapy, whose effectiveness is reduced against these effects. Thus, the search for complementary alternatives for snakebite treatment is relevant. There are several reports of the popular use of medicinal plants against snakebites worldwide. In recent years, many studies have been published giving pharmacological evidence of benefits of several vegetal species against local effects induced by a broad range of snake venoms, including inhibitory potential against hyaluronidase, phospholipase, proteolytic, hemorrhagic, myotoxic, and edematogenic activities. In this context, this review aimed to provide an updated overview of medicinal plants used popularly as antiophidic agents and discuss the main species with pharmacological studies supporting the uses, with emphasis on plants inhibiting local effects of snake envenomation. The present review provides an updated scenario and insights into future research aiming at validation of medicinal plants as antiophidic agents and strengthens the potentiality of ethnopharmacology as a tool for design of potent inhibitors and/or development of herbal medicines against venom toxins, especially local tissue damage.

scholarly journals Classifying Alarms: Seeking Durability, Credibility, Consistency, and Simplicity

2017 ◽  
Vol 51 (s2) ◽  
pp. 50-57 ◽  
Author(s):  
Judy Reed Edworthy ◽  
Joseph J. Schlesinger ◽  
Richard R. McNeer ◽  
Michael Sonne Kristensen ◽  
Christopher L. Bennett
Keyword(s):  
Clinical Practice ◽  
Human Factors ◽  
Tissue Damage ◽  
International Electrotechnical Commission ◽  
Current Standard ◽  
New Developments ◽  
Flexible Approach ◽  
Tier System ◽  
Professional Perspectives

Alongside the development and testing of new audible alarms intended to support International Electrotechnical Commission 60601-1-8, a global standard concerned with alarm safety, the categories of risk that the standard denotes require further thought and possible updating. In this article, we revisit the origins of the categories covered by the standard. These categories were based on the ways that tissue damage can be caused. We consider these categories from the varied professional perspectives of the authors: human factors, semiotics, clinical practice, and the patient or family (layperson). We conclude that while the categories possess many clinically applicable and defensible features from our range of perspectives, the advances in alarm design now available may allow a more flexible approach. We present a three-tier system with superordinate, basic, and subordinate levels that fit both within the thinking embodied in the current standard and possible new developments.

scholarly journals Conceptualizing Medical Resident’s Journey through Wonderland of Clinical Practice: From transitional shock to role adaptation to independent practice

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Marium Sohail ◽  
Rahila Yasmeen
Keyword(s):  
Clinical Practice ◽  
Identity Formation ◽  
Phenomenological Study ◽  
Independent Practice ◽  
Structured Interviews ◽  
Electron Model ◽  
Medical College ◽  
Creative Commons ◽  
Multi Stage ◽  
Qualitative Phenomenological

Objectives: To explore experiences of medical residents about stages and nature of transitional journey from induction into residency program to achievement of consultant title. Methods: Qualitative phenomenological study was conducted at Sir Gangaram hospital and Fatima Memorial Hospital, Lahore for six months from Feb 2019-July 2019 after IRB/ERC approval from Islamic International Medical College (Ref# Riphah/IIMC/ERC/19/0320). Using purposive criterion sampling, 16 semi-structured interviews in four departments, four strata of junior residents, senior residents, newly-qualified consultants, and supervising consultants with four participants each were conducted till theoretical saturation of data was achieved. After informed consent, audio recorded data was transcribed verbatim & analyzed through Atlas.ti 7 using Interpretive Phenomenological Analysis. After Bracketing and horizontalization, data was coded line by line. Codes (324) were merged to categories (19) for structural and textural description. Composite description of phenomenon was done by abstraction of themes (eight for stages and two for nature of journey). Results: Eight themes for stages as merriment, anguish, melancholy, acceptance and efforts, intensive learning, burnishing to shine, identity formation and intra-stage oscillations were identified. Two themes for journey’s nature were exponential learning & oscillating journey. Conclusion: The transitional journey is a multi-stage complex, oscillating journey. An oscillating electron model is presented upon the findings of this study to explain resident transition doi: https://doi.org/10.12669/pjms.37.4.3853 How to cite this:Sohail M, Yasmeen R. Conceptualizing Medical Resident’s Journey through Wonderland of Clinical Practice: From transitional shock to role adaptation to independent practice. Pak J Med Sci. 2021;37(4):---------.  doi: https://doi.org/10.12669/pjms.37.4.3853 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Students’ perspectives regarding clinical preceptors (CPs) in the baccalaureate undergraduate nursing programme in Karachi, Pakistan

2019 ◽  
Vol 3 (1) ◽  
pp. 26
Author(s):  
Amina Aijaz Khowaja ◽  
Jacqueline Maria Dias
Keyword(s):  
Nursing Education ◽  
Clinical Practice ◽  
Nursing Students ◽  
Undergraduate Students ◽  
Private School ◽  
Teaching And Learning ◽  
Clinical Environment ◽  
Creative Commons ◽  
Undergraduate Nursing

Introduction Clinical practice is considered an integral part of nursing education. It is in the clinical area that the students integrate the theory learnt in the classroom into practice. An enabling clinical environment with the assistance of a clinical preceptor (CP) ensures that student nurses become independent practitioners and competent in their roles and responsibilities. DesignA comprehensive study was undertaken to explore the emerging role of CPs in Pakistan. This research has been reported in the literature. This paper will deal exclusively with the perceptions of nursing students when working with CPs in the four-year undergraduate baccalaureate program at a private school of nursing (SON) in Pakistan. Through focus group discussions, the perceptions of undergraduate students were explored. ResultsFour main themes emerged. These included the creation of a conducive clinical environment, development of competencies, engagement in patient care, and personal and professional development. ConclusionBased on the study findings, recommendations for strengthening the role of CPs in supporting undergraduate nursing students in their clinical practice are presented.   How to cite this article:  KHOWAJA, Amina Aijaz; DIAS, Jacqueline Maria. Students’ perspectives regarding clinical preceptors (CPs) in the baccalaureate undergraduate nursing programme in Karachi, Pakistan. Scholarship of Teaching and Learning in the South. v. 3, n. 1, p. 26-35, Apr. 2019. Available at: https://sotl-south-journal.net/?journal=sotls&page=article&op=view&path%5B%5D=68&path%5B%5D=39   This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/  

scholarly journals Telemedicine: A New Frontier in Clinical Practice

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Munazza Asad ◽  
Nooresahar . ◽  
Saniya R. Sabzwari
Keyword(s):  
Clinical Practice ◽  
Original Work ◽  
Healthcare Delivery ◽  
Creative Commons ◽  
New Frontier ◽  
Teaching Learning ◽  
Effective Use ◽  
Developed World ◽  
Open Access Article

The COVID-19 pandemic has highlighted the important role of telemedicine as a tool for safe healthcare delivery across the world. While its use was more common in the developed world, the developing world has also adopted this strategy. It is important to develop a clear process and contextual guidance for effective use of this strategy for better patient-doctor interaction and its role in teaching/learning of trainees. doi: https://doi.org/10.12669/pjms.37.2.3592 How to cite this:Asad M, Nooresahar, Sabzwari SR. Telemedicine: A New Frontier in Clinical Practice. Pak J Med Sci. 2021;37(2):---------.  doi: https://doi.org/10.12669/pjms.37.2.3592 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Efficacy of Liraglutide in clinical practice: Single centre experience

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Owais Rashid ◽  
Sumerah Jabeen ◽  
Adeel Khoja ◽  
Najmul Islam
Keyword(s):  
Clinical Practice ◽  
Clinical Judgment ◽  
University Hospital ◽  
Published Data ◽  
Single Centre ◽  
Dipeptidyl Peptidase 4 ◽  
Creative Commons ◽  
Single Centre Experience ◽  
Type Two Diabetes ◽  
Diabetes Patients

Background and Objective: GLP-one receptor agonists are amongst the unique antidiabetes medications that have significant metabolic and cardiovascular benefits in addition to glucose lowering effect. To best of our knowledge, there is no published data on efficacy of liraglutide use among Pakistani population.Our objective was to ascertain the efficacy of liraglutide use among type two diabetes patients. Methods: This retrospective study was conducted at the Endocrinology Clinics of Aga Khan University Hospital (AKUH) Karachi, Pakistan during the period from July 01, 2016 to 30th June, 2017. Liraglutide was prescribed to 68 obese type two diabetes patients with uncontrolled diabetes taking more than one oral medication ± insulin. Starting dose of Liraglutide was 0.6 mg, which was increased to 1.2 mg after 1-2 weeks with further increment to 1.8 mg/day based on tolerance and individual patient preference. Dose of other diabetes medications was adjusted according to clinical judgment whereas Dipeptidyl peptidase-4 (DPP-4) inhibitors were discontinued. Results: Mean age of cohort was 55 years (SD=10.94 years) with median body mass index of 36.45 kg/m2 and majority (57.35%) were on a dose of 1.2 mg of Liraglutide per day. Median HbA1c reduced to 7.50% and 7.40% at three months and six months respectively vs 8.45% at baseline. Mean reduction in weight after three month was two kilograms and at six months, it was 1.38 kilograms respectively. Conclusion: Liraglutide as add on therapy demonstrated favourable HbA1c and weight reduction in obese uncontrolled type two Diabetes Pakistani subjects. doi: https://doi.org/10.12669/pjms.36.3.358 How to cite this:Rashid MO, Jabeen S, Khoja A, Islam N. Efficacy of Liraglutide in clinical practice: Single centre experience. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.358 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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