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Article: Pattern of Abuse in Children With Behavioral Disorders Presenting to a Tertiary Care Hospital in Peshawar.

Muhammad, Amir / Wajid, Khawaja Kamran / Alia, Bibi / Munir, Rabiya / Bahadur, Muneeba Jan / Matloob, Uswa

2021 Volume 13, Issue 12, Page(s) e20379

Abstract: Objective To determine the different types of child abuse and its association with behavioral disorders in children presenting to a tertiary care hospital. Materials and methods One hundred abused Pakistani children, of both genders, were included. ... ...

Abstract	Objective To determine the different types of child abuse and its association with behavioral disorders in children presenting to a tertiary care hospital. Materials and methods One hundred abused Pakistani children, of both genders, were included. Children with cerebral palsy, a neurodegenerative disorder, chronic illness, chronic liver disease, congenital heart disease, chronic renal failure, and parents who refused to become part of the study were excluded. Descriptive statistics were calculated. The chi-square test was applied to compare the pattern of abuse among various types of behavioral disorders. P≤0.05 was considered significant. Results The mean age of the study was 10.38±2.64 years. The total number of males was 51 (51%); the rest (49; 49%) were females. The most common behavioral disorder was functional disorder (n=59, 59%) followed by depression (n=26, 26%). The most frequent abuse was physical (n=87, 87%) followed by verbal (n=7, 7%) and the least was sexual (n=6, 6%). There was no statistically significant association between type of behavioral disorder and type of abuse in children (P=0.162). Conclusion The most common type of child abuse among children with behavioral disorders is physical abuse followed by verbal. The type of behavioral disorder is not associated with a specific type of child abuse.
Language	English
Publishing date	2021-12-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.20379
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Hypertonic saline for severe symptomatic hyponatraemia: real-world findings from the UK.

Arshad, Muhammad Fahad / Iqbal, Ahmed / Weeks, James / Fonseca, Ines / Munir, Alia / Bennet, William

Endocrine connections

2022 Volume 11, Issue 5

Abstract: Objective: To evaluate 'real-world' safety and efficacy of the European Society of Endocrinology guidelines for the treatment of severe symptomatic hyponatraemia using hypertonic saline (HTS).: Design: Retrospective, observational, cohort study, ... ...

Abstract	Objective: To evaluate 'real-world' safety and efficacy of the European Society of Endocrinology guidelines for the treatment of severe symptomatic hyponatraemia using hypertonic saline (HTS). Design: Retrospective, observational, cohort study, examining the use of HTS for severe symptomatic hyponatraemia at Sheffield Teaching Hospitals between 2017 and 2020. Methods: Patients were identified from pharmacy records and demographic, clinical, and treatment data extracted. Results: Out of 112 patients (females:males = 61:51), the mean age ± s.d. was 66.3± 16.0 years and mean pre-treatment serum sodium ± s.d. was 113.8 ± 6.4 mmol/L. Overall, overcorrection rates at 24 and 48 h (>10 and >18 mmol/L) were 44.9 and 19.6%, respectively, while 19.6% of patients were treated for overcorrection. Above-target rise in sodium (>5 mmol/L) after first and second boluses was noted in 22.6 and 34.6% of patients, respectively. In-hospital and 12-month mortality was 7.1 and 18.7%, respectively, with no cases of osmotic demyelination. The mean venous blood gas (VBG) sodium was 1.9 mmol/L lower than paired serum sodium (n = 36) (113.6 ± 6.6 vs 115.7 ± 7.8 mmol/L). Conclusion: We report real-world data demonstrating that a significant number of patients overcorrected using current guidelines. Also, several patients had above-target rise in sodium after one bolus of HTS, and sodium measurement should be considered before the second bolus unless ongoing severe symptoms persist. A point of care VBG sodium concentration was useful for this purpose. In addition to careful monitoring, a cautious but anticipatory overcorrection prevention strategy should be considered in the first 24 h.
Language	English
Publishing date	2022-05-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2668428-7
ISSN	2049-3614
ISSN	2049-3614
DOI	10.1530/EC-22-0007
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Article ; Online: Neuroendocrine neoplasms: Consensus on a patient care pathway.

Hooper, Jessica / Jervis, Nikie / Morgan, Lucy / Beckett, Vivienne / Hand, Philippa / Higgs, Kate / Munir, Alia / Prinn, Jenny / Pritchard, D Mark / Sarker, Debashis / Srirajaskanthan, Raj / Ellis, Catherine Bouvier

Journal of neuroendocrinology

2024 Volume 36, Issue 4, Page(s) e13380

Abstract: People with neuroendocrine neoplasms (NENs) face a multitude of challenges, including delayed diagnosis, low awareness of the cancer among healthcare professionals and limited access to multidisciplinary care and expert centres. We have developed the ... ...

Abstract	People with neuroendocrine neoplasms (NENs) face a multitude of challenges, including delayed diagnosis, low awareness of the cancer among healthcare professionals and limited access to multidisciplinary care and expert centres. We have developed the first patient care pathway for people living with NENs in England to guide disease management and help overcome these barriers. The pathway was developed in two phases. First, a pragmatic review of the literature was conducted, which was used to develop a draft patient care pathway. Second, the draft pathway was then updated following semi-structured interviews with carefully selected expert stakeholders. After each phase, the pathway was discussed among a multidisciplinary, expert advisory group (which comprised the authors and the Deputy Chief Operating Officer, West Suffolk NHS Foundation Trust), who reached a consensus on the ideal care pathway. This article presents the outputs of this research. The pathway identified key barriers to care and highlighted how these may be addressed, with many of the findings relevant to the rest of the UK and international audiences. NENs are increasing in incidence and prevalence in England, compounding pre-existing inequities in diagnosis and disease management. Effective integration of this pathway within NHS England will help achieve optimal, equitable care provision for all people with NENs, and should be feasible within the existing expert multidisciplinary teams across the country.
MeSH term(s)	Humans ; Consensus ; Critical Pathways ; Neuroendocrine Tumors/diagnosis ; Neuroendocrine Tumors/epidemiology ; Neuroendocrine Tumors/therapy
Language	English
Publishing date	2024-03-12
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1007517-3
ISSN	1365-2826 ; 0953-8194
ISSN (online)	1365-2826
ISSN	0953-8194
DOI	10.1111/jne.13380
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Article ; Online: Analysis of Pelvic Organ Prolapse-related Content on Pinterest.

Pace, Lauren A / Herbert, Amber S / Munir, Alia / Malik, Rena D

Female pelvic medicine & reconstructive surgery

2020 Volume 27, Issue 2, Page(s) e372–e376

Abstract: Objectives: Our study is a cross-sectional, qualitative study analyzing pelvic organ prolapse-related content on Pinterest, a social media platform that also functions as a visual search engine. Primary outcomes assessed include quality, ... ...

Abstract	Objectives: Our study is a cross-sectional, qualitative study analyzing pelvic organ prolapse-related content on Pinterest, a social media platform that also functions as a visual search engine. Primary outcomes assessed include quality, understandability, and actionability of content. Secondary outcomes include levels of misinformation and commercial bias. Our study further characterizes sources of prolapse content and treatment modalities discussed. Methods: A Pinterest search was conducted using the term "pelvic organ prolapse," analyzing the first 100 relevant results. We examined the publisher of each pin and the writer of linked content. Using validated tools including the Patient Education Materials Assessment Tool and DISCERN criteria, we assessed understandability and actionability of content. We further compared content to professional guidelines for discussing and treating prolapse, evaluating for misinformation. We also evaluated for commercial bias and subjectively rated pin quality. Results: Of pins evaluated, low understandability was found in 16, low actionability in 30, and low-to-moderate quality in 69. The most common publisher of pins was health and wellness groups, and the most common writer of content was physical therapists. Pelvic floor muscle training (PFMT) is the treatment modality discussed most frequently on Pinterest. Conclusions: Pinterest content discussing pelvic organ prolapse shows good levels of understandability for patients at all levels of health literacy. However, the number of pins showing poor actionability raises concern that content may not encourage readers to take direct steps toward prolapse assessment and management. In all, a majority of prolapse-related content on Pinterest was of low-to-moderate quality.
MeSH term(s)	Consumer Health Information ; Cross-Sectional Studies ; Female ; Health Literacy ; Humans ; Pelvic Organ Prolapse ; Self-Help Groups ; Social Media
Language	English
Publishing date	2020-09-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2542707-6
ISSN	2154-4212 ; 2151-8378
ISSN (online)	2154-4212
ISSN	2151-8378
DOI	10.1097/SPV.0000000000000940
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Article: Recent advances in the diagnosis and management of pancreatic neuroendocrine tumours.

Hopper, Andrew D / Jalal, Mustafa / Munir, Alia

Frontline gastroenterology

2018 Volume 10, Issue 3, Page(s) 269–274

Abstract: The incidence of pancreatic neuroendocrine tumours (PNET) is rising mainly due to the increased use of cross-sectional imaging. Although many PNETs are asymptomatic and non-functioning, the overall 5-year survival is still less than 50%. In this article, ...

Abstract	The incidence of pancreatic neuroendocrine tumours (PNET) is rising mainly due to the increased use of cross-sectional imaging. Although many PNETs are asymptomatic and non-functioning, the overall 5-year survival is still less than 50%. In this article, we review the advances in diagnosis, classification and staging of PNET that have evolved with the development of new cross-sectional imaging methods and biopsy techniques. With accurate classification, evidence-based, individualised prognostic outcomes and treatments are able to be given which are also discussed.
Language	English
Publishing date	2018-10-09
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2018-101006
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Article: Synthesis, characterization and biological investigation of zinc nanoparticles using Acacia modesta Wall. leaves.

Ghauri, Hadsa / Zahra, Qandeel / Raza, Jamshaid / Muhammad Hammad, Rana / Farouk Elsadek, Mohamed / Almoajel, Alia / Abdel Gawwad, Mohamed Ragab / Aziz, Amir / Munir, Nida / Ullah, Hafiz / Ullah Khan, Rahat / Hayat, Shubana / Shireen, Farah

Pakistan journal of pharmaceutical sciences

2023 Volume 36, Issue 3(Special), Page(s) 981–987

Abstract: The study aimed to synthesize zinc nanoparticles (Zn-NPs) using an aqueous extract derived from Acacia modesta Wall. leaves. Several characterization techniques were employed to confirm the successful formation of zinc nanoparticles. UV-visible ... ...

Abstract	The study aimed to synthesize zinc nanoparticles (Zn-NPs) using an aqueous extract derived from Acacia modesta Wall. leaves. Several characterization techniques were employed to confirm the successful formation of zinc nanoparticles. UV-visible spectrophotometry indicated a peak at 374 nm, validating the bioreduction process. Scanning electron microscopy (SEM) was utilized to analyze the morphology, transmission electron microscopy (TEM) to determine particle size and shape, X-ray diffraction (XRD) for crystalline structure analysis, energy-dispersive X-ray spectroscopy (EDX) for elemental composition and Fourier-transform infrared spectroscopy (FTIR) to identify functional groups. The synthesized Zn-NPs demonstrated remarkable antibacterial activity against Escherichia coli (95% inhibition) and moderate antifungal activity against Candida albicans (70% inhibition). In phytotoxicity tests, the Zn-NPs exhibited a 55% reduction in the growth of Lamina minor at the highest dilution (1000 µl). Based on these findings, the study concluded that the green-synthesized Zn-NPs hold great potential as effective antibiotics against pathogenic bacteria and could be utilized in various industrial and agricultural applications.
MeSH term(s)	Acacia ; Zinc ; Metal Nanoparticles ; Agriculture ; Anti-Bacterial Agents/pharmacology ; Escherichia coli ; Fabaceae
Chemical Substances	Zinc (J41CSQ7QDS) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-08-16
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	885131-1
ISSN	1011-601X
ISSN	1011-601X
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Article ; Online: Evaluation of multidisciplinary team decisions in neuroendocrine neoplasms: Impact of expert centres.

Zandee, Wouter T / Merola, Elettra / Poczkaj, Karolina / de Mestier, Louis / Klümpen, Heinz-Josef / Geboes, Karen / de Herder, Wouter W / Munir, Alia

European journal of cancer care

2022 Volume 31, Issue 6, Page(s) e13639

Abstract: Objective: To evaluate the impact of multidisciplinary team (MDT) meetings on the management of patients with neuroendocrine neoplasms (NENs).: Methods: All newly referred gastro-entero-pancreatic (GEP)-NEN patients discussed from 1 April to 1 ... ...

Abstract	Objective: To evaluate the impact of multidisciplinary team (MDT) meetings on the management of patients with neuroendocrine neoplasms (NENs). Methods: All newly referred gastro-entero-pancreatic (GEP)-NEN patients discussed from 1 April to 1 October 2017 in the MDT of seven European expert centres were prospectively included. The impact on patients' management was defined as a change in diagnosis, grade, stage or treatment. Results: A total of 292 patients were included, mainly small intestinal (siNENs) (32%) and pancreatic NENs (28%), with distant metastases in 51%. Patients had received prior surgery in 43% of cases and prior medical treatment in 32%. A significant change occurred in 61% of NENs: 7% changes in diagnosis, 8% in grade and 16% in stage. The MDT recommended a new treatment for 51% of patients, mainly surgery (9%) or somatostatin analogues (20%). A significant change was most frequently observed in patients with Stage IV disease (hazard ratio [HR] 3.6, 95% confidence interval [CI]: 1.9-6.9 vs. Stage I) and G2 NENs (vs. G1, HR 2.1 95% CI: 1.2-3.8). Conclusion: NEN-dedicated MDT discussion in expert centres yields significant management changes in over 60% of patients and thus represents the gold standard for the management of these patients.
MeSH term(s)	Humans ; Intestinal Neoplasms/therapy ; Pancreatic Neoplasms/therapy ; Pancreatic Neoplasms/pathology ; Neuroendocrine Tumors/therapy ; Disease-Free Survival ; Patient Care Team ; Stomach Neoplasms/therapy
Language	English
Publishing date	2022-06-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1303114-4
ISSN	1365-2354 ; 0961-5423 ; 1360-5801
ISSN (online)	1365-2354
ISSN	0961-5423 ; 1360-5801
DOI	10.1111/ecc.13639
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Article ; Online: Barriers and Facilitators of Quality Family-Centered Communication in Pakistan.

Graetz, Dylan / Ahmad, Alia / Raza, Muhammad Rafie / Hameed, Ambreen / Naheed, Asma / Najmi, Atoofa / Tul Quanita, Afia / Munir, Shabnam / Ferrara, Gia / Staples, Courtney / Rodriguez Galindo, Carlos / Hamid, Syed Ahmer / Jeha, Sima / Mack, Jennifer W

JCO global oncology

2023 Volume 9, Page(s) e2300178

Abstract: Purpose: Communication is a fundamental aspect of patient- and family-centered care. Unfortunately, there is a dearth of evidence regarding pediatric cancer communication in low- and middle-income countries, where over 90% of all children with childhood ...

Abstract	Purpose: Communication is a fundamental aspect of patient- and family-centered care. Unfortunately, there is a dearth of evidence regarding pediatric cancer communication in low- and middle-income countries, where over 90% of all children with childhood cancer live. The purpose of this study was to explore barriers and facilitators of quality communication within two pediatric cancer centers in Pakistan. Methods: Semistructured interviews were conducted with 20 multidisciplinary pediatric cancer clinicians and 18 caregivers of children with cancer at Children's Hospital of Lahore and Indus Hospital in Karachi, Pakistan. Interviews were conducted in English or Urdu, audio-recorded, transcribed, and translated to English. Two researchers coded each transcript using an inductively derived codebook. Thematic content analysis focused on barriers and facilitators of high-quality communication. Results: Pakistani clinicians and caregivers identified factors that affected the quality of patient-centered cancer communication. These included structural factors including setting, available interpreters, documentation, patient volume, teamwork, and financial support. Clinician-level communication barriers and facilitators included communication training, clinician distress/boundaries, and the ability to have recurrent conversations. Patient or family characteristics affecting communication included education, income status, primary language, and geography; the child's specific disease type; and relational elements such as social support, empowerment, and split decision makers. Participants identified existing or potential interventions related to each factor. Conclusion: Multilevel factors serve as either barriers or facilitators for pediatric cancer communication in Pakistan. Identification of these elements of communication is an essential step toward interventions aimed at improving patient- and family-centered care in resource limited settings.
MeSH term(s)	Humans ; Child ; Pakistan ; Qualitative Research ; Communication ; Caregivers ; Neoplasms/therapy
Language	English
Publishing date	2023-12-12
Publishing country	United States
Document type	Journal Article
ISSN	2687-8941
ISSN (online)	2687-8941
DOI	10.1200/GO.23.00178
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Seroprevalence of contagious bovine pleuropneumonia in cattle of Punjab, Pakistan and assessment of risk factors

Anjum, Ahsan / Aslam, Asim / Akhtar, Raheela / Yaqub, Tahir / Naseer, Junaid / Mushtaq, Alia / Munir, Muhammad Asif / Khan, Azeem ullah

Indian journal of animal research. 2021 Jan., v. 55, no. 1

2021

Abstract: Contagious bovine pleuropneumonia (CBPP) is an important infectious disease of respiratory system of cattle, caused by Mycoplasma mycoides subspecies mycoides. A cross sectional study was conducted in Lahore, Kasur and Jhang districts of Punjab to ... ...

Abstract	Contagious bovine pleuropneumonia (CBPP) is an important infectious disease of respiratory system of cattle, caused by Mycoplasma mycoides subspecies mycoides. A cross sectional study was conducted in Lahore, Kasur and Jhang districts of Punjab to determine the prevalence of CBPP. A total of 560 serum samples were examined for the specific antibodies against M. mycoides subspecies mycoides, using a sandwich enzyme-linked immunosorbent assay. Associated risk factors that were evaluated include age, gender and breed. In this study, the overall seroprevalence was 8.75%. The seroprevalence of CBPP in Lahore, Kasur and Jhang were 8.26, 8.20 and 10.06%, respectively, but no significance difference (P<0.05) was observed. Among the assessed potential predisposing factors, gender and breed were not significantly associated with the serological status of the animal (P>0.05), in which the age affected significantly the positivity to CBPP (P<0.05). The highest seropositivity was observed in animals of more than 7 years of age (32.08%) followed by in 4-7 years of age (8.16%) and lowest in animals of less than 4 years old (0.79%). This study confirms the presence of CBPP in the state which could be a threat to livestock export market and warrants the implementation of control measures to mitigate the economic losses associated with the disease.
Keywords	Mycoplasma mycoides ; animal research ; blood serum ; cattle ; contagious bovine pleuropneumonia ; cross-sectional studies ; enzyme-linked immunosorbent assay ; exports ; gender ; markets ; respiratory system ; risk assessment ; seroprevalence ; Pakistan
Language	English
Dates of publication	2021-01
Size	p. 101-104.
Publishing place	Agricultural Research Communication Centre
Document type	Article
Note	NAL-AP-2-clean
ISSN	0976-0555
DOI	10.18805/ijar.B-1130
Database	NAL-Catalogue (AGRICOLA)

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Article: Use of Potassium Fertilization to Ameliorate the Adverse Effects of Saline-sodic Stress Condition (ECw: SARw Levels) in Rice (Oryza Sativa L.)

Munir, Alia / Shehzad, Muhammad Tahir / Qadir, Ayesha Abdul / Murtaza, Ghulam / Khalid, Hafiza Iqra

Communications in soil science and plant analysis. 2019 Sept. 8, v. 50, no. 16

2019

Abstract: Salt-affected soils expand around the world and become a critical handicap for high crop yield. Saline-sodic soil contributed a major portion in salt-affected soils. Such types of soils have a sizable amount of Na+ in nutrient medium and that reduce the ... ...

Abstract	Salt-affected soils expand around the world and become a critical handicap for high crop yield. Saline-sodic soil contributed a major portion in salt-affected soils. Such types of soils have a sizable amount of Na+ in nutrient medium and that reduce the K+ uptake in plants. A hydroponic experiment was performed to investigate the ameliorative effect of different doses of potassium fertilizer (K1 = 0.3, K2 = 0.6 and K3 = 1.2 mM L−1) on rice (Oryza sativa L.) under different ECw (6 dS m−1) and SARw [12 and 24 (mmol L−1)1/2] levels. Application of K+ at elevated levels under saline-sodic conditions improved the concentration of anti-oxidant enzymes, plant physiological, and biochemical attributes by improving the K+: Na+ ratio in plant tissues. Total phenolic content, total soluble protein, and soluble sugar content of rice plant were increased with an increase in potassium dose and saline-sodicity. Maximum K+: Na+ ratios, 4.13 and 2.0 were observed in shoot and root, respectively upon application of K+ at 1.2 mM L−1 in a solution having ECw: SARw level of 6: 12. This study suggested that application of potassium at elevated levels (1.2 mM L−1) has enhanced the rice growth by reducing the harmful effect of Na+ salts on plant physiology, biochemical attributes, and anti-oxidant enzymes under specific saline-sodic conditions.
Keywords	Oryza sativa ; adverse effects ; antioxidant enzymes ; crop yield ; fertilizer application ; hydroponics ; plant physiology ; plant tissues ; potassium ; potassium fertilizers ; rice ; roots ; saline sodic soils ; saline soils ; salts ; shoots ; sodium ; sugar content
Language	English
Dates of publication	2019-0908
Size	p. 1975-1985.
Publishing place	Taylor & Francis
Document type	Article
ZDB-ID	419718-5
ISSN	1532-2416 ; 0010-3624
ISSN (online)	1532-2416
ISSN	0010-3624
DOI	10.1080/00103624.2019.1648657
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