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Article ; Online: Evaluation of the FAST-M maternal sepsis intervention in Pakistan: A qualitative exploratory study.

Ahmed, Sheikh Irfan / Khowaja, Bakhtawar M Hanif / Barolia, Rubina / Sikandar, Raheel / Rind, Ghulam Kubra / Jahangir, Arshia / Parveen, Fahmida / Cheshire, James / Dunlop, Catherine / Petrucka, Pammla Margaret / Sheikh, Lumaan / Coomarasamy, Arri / Lissauer, David

PloS one

2023 Volume 18, Issue 4, Page(s) e0284530

Abstract: ... about the implementation of the FAST-M intervention in Pakistan.: Materials and methods: The study was conducted ... including doctors, nurses, and healthcare administrators (n = 22) who implemented the FAST-M intervention ... Five overarching themes emerged: (I) FAST-M intervention and its significance including HCPs believing ...

Abstract	Introduction: The World Health Organization and partners developed and evaluated a maternity-specific sepsis care bundle called 'FAST-M' for low-resource settings. However, this bundle has not yet been studied in Asia. Our study sought to evaluate the perceptions of healthcare providers about the implementation of the FAST-M intervention in Pakistan. Materials and methods: The study was conducted at a public sector hospital in Hyderabad. We conducted three focus group discussions with healthcare providers including doctors, nurses, and healthcare administrators (n = 22) who implemented the FAST-M intervention. The Consolidated Framework for Implementation Research was used as a guiding framework for data collection and analysis. The data were analyzed using a thematic analysis approach and deductive methods. Results: Five overarching themes emerged: (I) FAST-M intervention and its significance including HCPs believing in the advantages of using the intervention to improve clinical practices; (II) Influence of outer and inner settings including non-availability of resources in the facility for sepsis care; (III) HCPs perceptions about sustainability, which were positive (IV) Integration into the clinical setting including HCPs views on the existing gaps, for example, shortage of HCPs and communication gaps, and their recommendations to improve these; and (V) Outcomes of the intervention including improved clinical processes and outcomes using the FAST-M intervention. Significant improvement in patient monitoring and FAST-M bundle completion within an hour of diagnosis of sepsis was reported by the HCPs. Conclusions: The healthcare providers' views were positive about the intervention, its outcomes, and long-term sustainability. The qualitative data provided findings on the acceptability of the overall implementation processes to support subsequent scaling up of the intervention.
MeSH term(s)	Humans ; Pregnancy ; Female ; Pakistan ; Qualitative Research ; Pregnancy Complications, Infectious ; Focus Groups ; Health Personnel ; Pre-Eclampsia
Language	English
Publishing date	2023-04-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0284530
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evaluation of the FAST-M maternal sepsis intervention in Pakistan

Sheikh Irfan Ahmed / Bakhtawar M Hanif Khowaja / Rubina Barolia / Raheel Sikandar / Ghulam Kubra Rind / Arshia Jahangir / Fahmida Parveen / James Cheshire / Catherine Dunlop / Pammla Margaret Petrucka / Lumaan Sheikh / Arri Coomarasamy / David Lissauer

PLoS ONE, Vol 18, Iss 4, p e

A qualitative exploratory study.

2023 Volume 0284530

Abstract: ... about the implementation of the FAST-M intervention in Pakistan. Materials and methods The study was conducted ... including doctors, nurses, and healthcare administrators (n = 22) who implemented the FAST-M intervention ... overarching themes emerged: (I) FAST-M intervention and its significance including HCPs believing ...

Abstract	Introduction The World Health Organization and partners developed and evaluated a maternity-specific sepsis care bundle called 'FAST-M' for low-resource settings. However, this bundle has not yet been studied in Asia. Our study sought to evaluate the perceptions of healthcare providers about the implementation of the FAST-M intervention in Pakistan. Materials and methods The study was conducted at a public sector hospital in Hyderabad. We conducted three focus group discussions with healthcare providers including doctors, nurses, and healthcare administrators (n = 22) who implemented the FAST-M intervention. The Consolidated Framework for Implementation Research was used as a guiding framework for data collection and analysis. The data were analyzed using a thematic analysis approach and deductive methods. Results Five overarching themes emerged: (I) FAST-M intervention and its significance including HCPs believing in the advantages of using the intervention to improve clinical practices; (II) Influence of outer and inner settings including non-availability of resources in the facility for sepsis care; (III) HCPs perceptions about sustainability, which were positive (IV) Integration into the clinical setting including HCPs views on the existing gaps, for example, shortage of HCPs and communication gaps, and their recommendations to improve these; and (V) Outcomes of the intervention including improved clinical processes and outcomes using the FAST-M intervention. Significant improvement in patient monitoring and FAST-M bundle completion within an hour of diagnosis of sepsis was reported by the HCPs. Conclusions The healthcare providers' views were positive about the intervention, its outcomes, and long-term sustainability. The qualitative data provided findings on the acceptability of the overall implementation processes to support subsequent scaling up of the intervention.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Early recognition and management of maternal sepsis in Pakistan: a feasibility study of the implementation of FAST-M intervention.

Ahmed, Sheikh Irfan / Rind, Ghulam Kubra / Sikandar, Raheel / Raza, Amir / Khowaja, Bakhtawar M Hanif / Parveen, Fahmida / Khan, Sehrish / Memon, Nazia / Jahangir, Arshia / Mirza, Daayl Naim / Cheshire, James / Dunlop, Catherine Louise / Shakoor, Sadia / Barolia, Rubina / Sheikh, Lumaan / Saleem, Sarah / Coomarasamy, Arri / Lissauer, David

BMJ open

2023 Volume 13, Issue 7, Page(s) e069135

Abstract: ... collaborators developed a care bundle called FAST-M (: Design and setting: A feasibility study ... recorded, followed by a training programme for healthcare providers on the application of FAST-M tools ... compared with the baseline phase.: Results: During the FAST-M implementation, 439 women were included ...

Abstract	Objective: Maternal sepsis is the third leading cause of maternal mortality globally. WHO and collaborators developed a care bundle called FAST-M ( Design and setting: A feasibility study with before and after design was conducted in women with suspected maternal sepsis admitted at the Liaquat University of Medical and Health Sciences hospital Hyderabad. The study outcomes were compared between baseline and intervention phases. In the baseline phase (2 months), the existing sepsis care practices were recorded, followed by a training programme for healthcare providers on the application of FAST-M tools. These tools were implemented in the intervention phase (4 months) to assess any change in clinical practices compared with the baseline phase. Results: During the FAST-M implementation, 439 women were included in the study. 242/439 were suspected maternal infection cases, and 138/242 were women with suspected maternal sepsis. The FAST-M bundle was implemented in women with suspected maternal sepsis. Following the FAST-M intervention, significant changes were observed. Improvements were seen in the monitoring of oxygen saturation measurements (25.5% vs 100%; difference: 74%; 95% CI: 68.4% to 80.5%; p<0.01), fetal heart rate assessment (58% vs 100%; difference: 42.0%; 95% CI: 33.7% to 50.3%; p≤0.01) and measurement of urine output (76.5% vs 100%; difference: 23.5%; 95% CI: 17.6% to 29.4%; p<0.01). Women with suspected maternal sepsis received all components of the treatment bundle within 1 hour of sepsis recognition (0% vs 70.5%; difference: 70.5%; 95% CI: 60.4% to 80.6%; p<0.01). Conclusion: Implementation of the FAST-M intervention was considered feasible and enhanced early identification and management of maternal sepsis at the study site. Trial registration number: ISRCTN17105658.
MeSH term(s)	Female ; Humans ; Pregnancy ; Anti-Bacterial Agents/therapeutic use ; Feasibility Studies ; Pakistan ; Pregnancy Complications, Infectious/diagnosis ; Sepsis/diagnosis ; Sepsis/therapy ; Sepsis/etiology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-07-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-069135
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Article ; Online: Non-random mtDNA segregation patterns indicate a metastable heteroplasmic segregation unit in m.3243A>G cybrid cells.

Raap, Anton K / Jahangir Tafrechi, Roshan S / van de Rijke, Frans M / Pyle, Angela / Wählby, Carolina / Szuhai, Karoly / Ravelli, Raimond B G / de Coo, René F M / Rajasimha, Harsha K / Nilsson, Mats / Chinnery, Patrick F / Samuels, David C / Janssen, George M C

PloS one

2012 Volume 7, Issue 12, Page(s) e52080

Abstract: ... that measure m.3243A>G point mutation loads directly in hundreds of individual cells to determine ... through the faithful replication of segregating units with a fixed wild-type/m.3243A>G mutant ratio, and shifts occur ...

Abstract	Many pathogenic mitochondrial DNA mutations are heteroplasmic, with a mixture of mutated and wild-type mtDNA present within individual cells. The severity and extent of the clinical phenotype is largely due to the distribution of mutated molecules between cells in different tissues, but mechanisms underpinning segregation are not fully understood. To facilitate mtDNA segregation studies we developed assays that measure m.3243A>G point mutation loads directly in hundreds of individual cells to determine the mechanisms of segregation over time. In the first study of this size, we observed a number of discrete shifts in cellular heteroplasmy between periods of stable heteroplasmy. The observed patterns could not be parsimoniously explained by random mitotic drift of individual mtDNAs. Instead, a genetically metastable, heteroplasmic mtDNA segregation unit provides the likely explanation, where stable heteroplasmy is maintained through the faithful replication of segregating units with a fixed wild-type/m.3243A>G mutant ratio, and shifts occur through the temporary disruption and re-organization of the segregation units. While the nature of the physical equivalent of the segregation unit remains uncertain, the factors regulating its organization are of major importance for the pathogenesis of mtDNA diseases.
MeSH term(s)	DNA, Mitochondrial ; Evolution, Molecular ; Genetic Heterogeneity ; Genomic Instability ; Humans ; Mitochondrial Diseases/genetics ; Mitosis ; Mutation ; Point Mutation
Chemical Substances	DNA, Mitochondrial
Language	English
Publishing date	2012-12-18
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0052080
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Article ; Online: Non-random mtDNA segregation patterns indicate a metastable heteroplasmic segregation unit in m.3243A>G cybrid cells.

Anton K Raap / Roshan S Jahangir Tafrechi / Frans M van de Rijke / Angela Pyle / Carolina Wählby / Karoly Szuhai / Raimond B G Ravelli / René F M de Coo / Harsha K Rajasimha / Mats Nilsson / Patrick F Chinnery / David C Samuels / George M C Janssen

PLoS ONE, Vol 7, Iss 12, p e

2012 Volume 52080

Abstract	Many pathogenic mitochondrial DNA mutations are heteroplasmic, with a mixture of mutated and wild-type mtDNA present within individual cells. The severity and extent of the clinical phenotype is largely due to the distribution of mutated molecules between cells in different tissues, but mechanisms underpinning segregation are not fully understood. To facilitate mtDNA segregation studies we developed assays that measure m.3243A>G point mutation loads directly in hundreds of individual cells to determine the mechanisms of segregation over time. In the first study of this size, we observed a number of discrete shifts in cellular heteroplasmy between periods of stable heteroplasmy. The observed patterns could not be parsimoniously explained by random mitotic drift of individual mtDNAs. Instead, a genetically metastable, heteroplasmic mtDNA segregation unit provides the likely explanation, where stable heteroplasmy is maintained through the faithful replication of segregating units with a fixed wild-type/m.3243A>G mutant ratio, and shifts occur through the temporary disruption and re-organization of the segregation units. While the nature of the physical equivalent of the segregation unit remains uncertain, the factors regulating its organization are of major importance for the pathogenesis of mtDNA diseases.
Keywords	Medicine ; R ; Science ; Q
Subject code	612
Language	English
Publishing date	2012-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Uncertain Benefit from Implantable Cardioverter-Defibrillators in Nonischemic Cardiomyopathy: How to Guide Clinical Decision-Making?

Khan, Mohsin / Jahangir, Arshad

Cardiology clinics

2023 Volume 41, Issue 4, Page(s) 545–555

Abstract: Life-threatening dysrhythmias remain a significant cause of mortality in patients with nonischemic cardiomyopathy (NICM). Implantable cardioverter-defibrillators (ICD) effectively reduce mortality in patients who have survived a life-threatening ... ...

Abstract	Life-threatening dysrhythmias remain a significant cause of mortality in patients with nonischemic cardiomyopathy (NICM). Implantable cardioverter-defibrillators (ICD) effectively reduce mortality in patients who have survived a life-threatening arrhythmic event. The evidence for survival benefit of primary prevention ICD for patients with high-risk NICM on guideline-directed medical therapy is not as robust, with efficacy questioned by recent studies. In this review, we summarize the data on the risk of life-threatening arrhythmias in NICM, the recommendations, and the evidence supporting the efficacy of primary prevention ICD, and highlight tools that may improve the identification of patients who could benefit from primary prevention ICD implantation.
MeSH term(s)	Humans ; Defibrillators, Implantable ; Clinical Decision-Making ; Cardiomyopathies/therapy
Language	English
Publishing date	2023-07-24
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1196385-2
ISSN	1558-2264 ; 0733-8651
ISSN (online)	1558-2264
ISSN	0733-8651
DOI	10.1016/j.ccl.2023.06.005
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Article ; Online: Comment on ablation success in various arrhythmias: When it is appropriate to recommend ablation?: Letter to the editor.

Hamza, Muhammad / Jahangir, Amna / Ahmed, Muhammad

Current problems in cardiology

2024 Volume 49, Issue 3, Page(s) 102375

MeSH term(s)	Humans ; Arrhythmias, Cardiac/surgery ; Electrocardiography
Language	English
Publishing date	2024-01-05
Publishing country	Netherlands
Document type	Letter
ZDB-ID	441230-8
ISSN	1535-6280 ; 0146-2806
ISSN (online)	1535-6280
ISSN	0146-2806
DOI	10.1016/j.cpcardiol.2024.102375
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Article ; Online: In older patients at high risk for stroke, intensive AF screening with an implantable loop recorder did not reduce stroke.

Yousufuddin, Mohammed / Jahangir, Arshad

Annals of internal medicine

2022 Volume 175, Issue 1, Page(s) JC8

Abstract: Source citation: Svendsen JH, Diederichsen SZ, Højberg S, et al. ...

Abstract	Source citation: Svendsen JH, Diederichsen SZ, Højberg S, et al.
MeSH term(s)	Aged ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Electrocardiography, Ambulatory ; Humans ; Mass Screening ; Stroke/diagnosis ; Stroke/prevention & control
Language	English
Publishing date	2022-01-04
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/J21-0011
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Article ; Online: In adults aged 75 to 76 y, systematic AF screening reduced morbidity and mortality at 6 y.

Yousufuddin, Mohammed / Jahangir, Arshad

Annals of internal medicine

2022 Volume 175, Issue 1, Page(s) JC9

Abstract: Source citation: Svennberg E, Friberg L, Frykman V, et al. ...

Abstract	Source citation: Svennberg E, Friberg L, Frykman V, et al.
MeSH term(s)	Atrial Fibrillation/diagnosis ; Electrocardiography ; Humans ; Mass Screening ; Morbidity
Language	English
Publishing date	2022-01-04
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/J21-0012
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Article: Evaluation of surface energy and surface stability and adherence of

Jahangir, Majid / Hadi, Alireza / Yadegari, Zahra / Shahbazi, Razieh / Amdjadi, Parisa

Dental research journal

2024 Volume 21, Page(s) 4

Abstract: Background: Polyetheretherketone (PEEK) has favorable properties that make it able to be used as a denture base material, but it is also susceptible to the adhesion of microorganisms. In this study, we applied Octafluoropentyl (meth) acrylate (OFPA) ... ...

Abstract	Background: Polyetheretherketone (PEEK) has favorable properties that make it able to be used as a denture base material, but it is also susceptible to the adhesion of microorganisms. In this study, we applied Octafluoropentyl (meth) acrylate (OFPA) coating on the PEEK polymer surface by using plasma spray and investigated the functional groups present on the surface, changes in the surface energy and Materials and methods: In this experimental study, the samples were placed in a control group without surface preparation and three experimental groups that were subjected to plasma spray for 10, 30, and 60 s and then impregnated with degassed Octa fluoropentyl (meth) acrylate (Sigma-Aldrich, USA) monomer. Fourier transform infrared spectroscopy (FTIR) was used to identify the functional groups and new chemical bonds between PEEK and OFPA, and Sessile Drop Method was used to evaluate the surface's wettability. The surface morphology was checked using a LEXT OLS4000 (Olympus Results: FTIR analysis confirmed that a chemical between OFPA and PEEK was established. The samples showed a significant increase in the contact angle after 30 s of plasma application (CA = 88.2 ± 7.3). The contact angle decreased again by increasing the surface modification to 60 s (CA = 64.33 ± 5.5). Examining the surface morphology of the samples shows an increase in surface roughness with increasing plasma time up to 60 s. The number of adherent colonies was the lowest in 30 s group, but it was not statistically significant ( Conclusion: No statistically significant difference in
Language	English
Publishing date	2024-01-25
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2418290-4
ISSN	2008-0255 ; 1735-3327
ISSN (online)	2008-0255
ISSN	1735-3327
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