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  1. Article ; Online: Integrating telemedicine into sleep medicine: a learner's perspective.

    Ryba-White, Benjamin / Gupta, Saurabh / Khalil, Wajahat / Irfan, Muna

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2021  Volume 17, Issue 12, Page(s) 2573–2576

    MeSH term(s) Humans ; Physicians ; Sleep ; Telemedicine
    Language English
    Publishing date 2021-06-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.9480
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  2. Article ; Online: Practicing sleep medicine amidst a pandemic: a paradigm shift.

    Irfan, Muna / Khalil, Wajahat / Iber, Conrad

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2020  Volume 16, Issue 8, Page(s) 1405–1408

    MeSH term(s) Humans ; Pandemics ; Physicians ; Sleep
    Keywords covid19
    Language English
    Publishing date 2020-05-19
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.8590
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  3. Article ; Online: الاكتئاب في علم النفس المعاصر ودراسته في ضوء الإسلام

    Wajahat Khan / Dr. Khalil al-Rehman

    ایقان, Vol 3, Iss 01, Pp 65-

    2021  Volume 86

    Abstract: Immense sadness is called depression which is a common and serious mood disorder affecting 121 million people worldwide. It affects thoughts, feelings, behaviors, physical health and social life of a person. Depressed person overwhelms with sadness, ... ...

    Abstract Immense sadness is called depression which is a common and serious mood disorder affecting 121 million people worldwide. It affects thoughts, feelings, behaviors, physical health and social life of a person. Depressed person overwhelms with sadness, loses interest in life and feels difficulty in making decisions. Brain chemistry, genetics, social and environmental factors may cause depression. Antidepressants and talking therapies are major treatment of depression. Islam is a true religion on the earth, which covers all aspects of life, bridges gap between spirit and matter, balances between individualism and collectivism. Fundamentals of Islam help in prevention and treatment of depression. A true Muslim believes in oneness of Allah almighty, he believes that Allah almighty alone runs all affairs of universe, considers life as a place of trials and tribulations, remains patient in difficulties of life, his heart is peaceful with the remembrance of Allah, he puts trust in Allah almighty, whenever he commits sin repents, seeks forgiveness from Allah almighty for his sin.
    Keywords depression ; brain chemistry ; genetics ; antidepressant ; therapy ; Islam. Bahai Faith. Theosophy ; etc ; BP1-610 ; Religion (General) ; BL1-50
    Subject code 290
    Language Arabic
    Publishing date 2021-01-01T00:00:00Z
    Publisher Riphah International University Faisalabad Campus
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Non-Caseating Granulomas in Skin Biopsies of Leishmania Cases

    Siyab Ahmad / Nadeem Zafar / Muhammad Owais Qurni / Shabir Ahmad Orakzai / Muhammad Atif Khalil / Wajahat Ahmad Khan

    Journal of Islamic International Medical College, Vol 18, Iss 1, Pp 15-

    2023  Volume 21

    Abstract: Objective: To determine the frequencies of different types of granulomas in patients suffering from cutaneous leishmaniasis. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology, Combined ... ...

    Abstract Objective: To determine the frequencies of different types of granulomas in patients suffering from cutaneous leishmaniasis. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology, Combined Military Hospital, Rawalpindi, Dec 2021 to Oct 2022. Materials and Methods: This study was conducted on 290 patients suffering from cutaneous leishmaniasis. Patients aged between 18 and 70 years of both genders were included, while those who had already received treatment for leishmaniasis, or suffered frommucocutaneous or visceral leishmaniasis were excluded. All patients underwent a punch biopsy, tissue which was stained with hematoxylin and eosin, and then studied for the presence of granulomas and Parasitic Index. PCR was done to confirm species of Leishmania causing disease. Data was analyzed using SPSS 26.0. Results: Our study population had a median age of 38.00 (16 - 63) years, with a male majority: 185 (63.8%). Granuloma formation was seen in 185 (63.8%) patients: 121 (41.7%) had a tuberculoid granuloma and 13 (4.5%) had suppurative granulomas, while 51 (17.6%) had caseating ones. L. Tropica was the most seen organism accounting for 255 (87.9%) cases, L. Major was the infective organism in 26 (9.0%) patients, while L. Infantum was found in 9 (3.1%) cases. Factors such as gender (p=0.273), age of the patient (p=0.901), disease duration (p=0.366), site of lesion (p=0.669), type of skin lesion (p=0.490), parasite index (p=0.297) and species of Leishmania (p=0.870) did not have any significant association with the development of non-caseating granulomas. Conclusion: Chronic granulomatous inflammation is a common finding on histopathology in cutaneous leishmaniasis and vigilance is required to avoid confusion with other endemic granulomatous skin conditions.
    Keywords cutaneous leishmaniasis ; mycobacterium tuberculosis ; non caseating granulomas ; polymerase chain reaction ; ridley modified parasitic index ; Medicine ; R
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Riphah International University, Islamabad
    Document type Article ; Online
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  6. Article ; Online: Effect of Modified Ultrafiltration (MUF) on Lactate Levels in Pediatric Patients Undergoing Cardiac Surgery

    Jahanzaib Azam / Muhammad Imran Asghar / Nasir Ali / Shoaib Umer / Naseem Azad / Hafsa Khalil / Fatima Azam / Arslan Muneer / Zainab Khatoon / Wajahat Naeem

    Pakistan Armed Forces Medical Journal, Vol 72, Iss SUPPL-

    2022  Volume 3

    Abstract: Objective: To determine the effect of MUF on pre and post MUF lactate levels. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Pediatric Operation Theater at Armed Forces Institute of Cardiology/National Institute of Heart ... ...

    Abstract Objective: To determine the effect of MUF on pre and post MUF lactate levels. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Pediatric Operation Theater at Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi Pakistan from Oct 2021 to Dec 2021. Methodology: It was descriptive cross-sectional study and non-probability consecutive sampling technique was used. Data was collected during Oct 2021 to Dec 2021, from Tertiary Care Hospital, Rawalpindi Pakistan. Current study was conducted in pediatric OT at Armed Forces Institute of Cardiology/National Institute of Heart Disease. MUF technique was applied to 115 pediatric patients during congenital cardiac surgeries. Pre and post MUF lactate levels were noted. Inferential statistics were applied with the help of test of significance (Paired T-Test), p value ≤ 0.05 was considered statistically significant at 95% Confidence Interval (CI) with margin of error 5%. Collected data was analyzed by IBM SPSS version 25. Result: Significant decrease in post MUF lactate level (p<0.05) was observed. This result revealed that MUF had significant effect on lactate levels. Out of 115 study participants, 46(40%) were female and 69(60%) were male patients having mean age 3.44±2.25 years, mean height 95.60±18.78cm, mean weight 15.06±5.18kg, mean body surface area 0.63±0.17 m2 CPB time 127.95±36.78 minutes and cross clamp time 92.60±40.49 minutes. Paired t-test was applied to check the mean difference between pre and post lactate levels and it revealed statistically significant findings (p-value < 0.05). Conclusion: Current result revealed that use of MUF caused decrease in lactate levels. MUF technique showed beneficial effects in maintaining normal physiology of the body. Current results encouraged the use of MUF technique in every cardiac surgery.
    Keywords Cardiopulmonary bypass ; Lactate levels ; Modified ultrafiltration ; Medicine ; R ; Medicine (General) ; R5-920
    Subject code 796
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher Army Medical College Rawalpindi
    Document type Article ; Online
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  7. Article ; Online: Provider Types and Outcomes in Obstructive Sleep Apnea Case Finding and Treatment: A Systematic Review.

    Kunisaki, Ken M / Greer, Nancy / Khalil, Wajahat / Koffel, Erin / Koeller, Eva / MacDonald, Roderick / Wilt, Timothy J

    Annals of internal medicine

    2018  Volume 168, Issue 3, Page(s) 195–202

    Abstract: Background: Obstructive sleep apnea (OSA) diagnosis and care models rely on sleep specialist physicians (SSPs) and can be expensive and inefficient.: Purpose: To assess OSA case-finding accuracy and comparative effectiveness of care by non-sleep ... ...

    Abstract Background: Obstructive sleep apnea (OSA) diagnosis and care models rely on sleep specialist physicians (SSPs) and can be expensive and inefficient.
    Purpose: To assess OSA case-finding accuracy and comparative effectiveness of care by non-sleep specialists (NSSs) and SSPs.
    Data sources: MEDLINE and CINAHL from January 2000 through July 2017.
    Study selection: English-language trials or observational studies comparing case finding or care by SSPs versus providers not specifically trained as SSPs (NSSs) for adults with suspected or diagnosed OSA.
    Data extraction: One investigator extracted data and assessed risk of bias and strength of evidence, with confirmation by a second investigator. Primary outcomes were patient-centered (mortality, access to care, quality of life, patient satisfaction, adherence, symptom scores, and adverse events). Intermediate outcomes included resource use, costs, time to initiation of treatment, and case finding.
    Data synthesis: Four observational studies (n = 580; mean age, 52 years; 77% male) reported good agreement between NSSs and SSPs on appropriate diagnostic testing and classification of OSA severity (low-strength evidence). Five randomized trials and 3 observational studies (n = 1515; mean age, 52 years; 68% male) found that care provided by NSSs and SSPs resulted in similar quality of life, adherence, and symptom scores (low-strength evidence). Evidence was insufficient for access to care and adverse events.
    Limitations: Many outcomes were reported infrequently or not at all. Many NSSs had extensive training or experience in sleep medicine, which limits generalizability of findings to providers with less experience.
    Conclusion: Care by NSSs and SSPs resulted in similar outcomes in adults with known or suspected OSA. Studies are needed to determine care model implementation and reproducibility of results in nonacademic settings and among less experienced NSSs.
    Primary funding source: Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. (PROSPERO: CRD42016036810 [full Veterans Affairs Evidence-based Synthesis Program report]).
    MeSH term(s) Adult ; Clinical Competence ; Humans ; Medicine ; Outcome Assessment (Health Care) ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/therapy
    Language English
    Publishing date 2018-01-30
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Systematic Review
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M17-2511
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  8. Article ; Online: Sleep Apnea Symptoms as a Predictor of Fatigue in an Urban HIV Clinic.

    Goswami, Umesh / Baker, Jason V / Wang, Qi / Khalil, Wajahat / Kunisaki, Ken M

    AIDS patient care and STDs

    2015  Volume 29, Issue 11, Page(s) 591–596

    Abstract: Fatigue is common among persons living with HIV (PLWH), and risk factors for obstructive sleep apnea (OSA) such as older age and obesity are increasingly prevalent. Studies of OSA among PLWH are lacking, so we aimed to characterize OSA symptoms and ... ...

    Abstract Fatigue is common among persons living with HIV (PLWH), and risk factors for obstructive sleep apnea (OSA) such as older age and obesity are increasingly prevalent. Studies of OSA among PLWH are lacking, so we aimed to characterize OSA symptoms and associated clinical consequences (e.g., fatigue) among a contemporary population of PLWH. Self-administered surveys containing 23 items that included self-reported snoring, witnessed apneas, estimated sleep duration, the Epworth Sleepiness Score (ESS), and the FACIT-Fatigue score were mailed to PLWH receiving care at an urban HIV clinic. Clinical/demographic data were collected from the medical record. Multivariable linear regression models were created to study relationships between fatigue, clinical variables, and OSA symptoms. Of 535 surveys, 203 (38%) responded. Eight patients (3.9%) had known OSA. Among those without known OSA, mean respondent characteristics included: age 47 years; 80% male, 41% African American, 48% Caucasian, BMI 26.4 kg/m(2), duration of HIV diagnosis 12 years, 93% on antiretroviral therapy, and 81% with <50 HIV RNA copies/mL. 27% reported snoring, 24% reported witnessed apneas, and 38% had excessive daytime sleepiness. Witnessed apnea was the strongest independent predictor of fatigue (lower FACIT-Fatigue score; β = -6.49; p < 0.001); this difference of 6.49 points exceeds the accepted minimal clinically important difference of 3.0 points. Other predictors included opioid use (β = -5.53; p < 0.001), depression (β = -4.18; p = 0.02), antidepressant use (β = -4.25; p = 0.02), and sleep duration < 6 h (β = -3.42; p = 0.02). Our data strongly support the need for increased efforts directed at OSA screening and treatment in PLWH.
    MeSH term(s) Adult ; Aged ; Airway Obstruction/etiology ; Ambulatory Care Facilities ; Depression/epidemiology ; Fatigue/epidemiology ; Female ; HIV Infections/complications ; HIV Infections/epidemiology ; HIV Infections/psychology ; Humans ; Male ; Middle Aged ; Minnesota/epidemiology ; Prevalence ; Risk Factors ; Self Report ; Sleep Apnea Syndromes/diagnosis ; Sleep Apnea Syndromes/epidemiology ; Sleep Apnea Syndromes/psychology ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/epidemiology ; Sleep Apnea, Obstructive/psychology ; Snoring/etiology ; Surveys and Questionnaires
    Language English
    Publishing date 2015-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1326868-5
    ISSN 1557-7449 ; 0893-5068 ; 1087-2914
    ISSN (online) 1557-7449
    ISSN 0893-5068 ; 1087-2914
    DOI 10.1089/apc.2015.0079
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  9. Article: Sleep Disorders in Human Immunodeficiency Virus: A Substudy of the Pharmacokinetics and Clinical Observations in People Over Fifty (POPPY) Study.

    Kunisaki, Ken M / De Francesco, Davide / Sabin, Caroline A / Winston, Alan / Mallon, Patrick W G / Anderson, Jane / Bagkeris, Emmanouil / Boffito, Marta / Doyle, Nicki / Haddow, Lewis / Post, Frank A / Sachikonye, Memory / Vera, Jaime / Khalil, Wajahat / Redline, Susan

    Open forum infectious diseases

    2020  Volume 8, Issue 1, Page(s) ofaa561

    Abstract: Background: Self-reported sleep quality is poor in persons with human immunodeficiency virus (PWH), but prior studies commonly used nonspecific questionnaires, investigated only single sleep disorders, or lacked human immunodeficiency virus (HIV)- ... ...

    Abstract Background: Self-reported sleep quality is poor in persons with human immunodeficiency virus (PWH), but prior studies commonly used nonspecific questionnaires, investigated only single sleep disorders, or lacked human immunodeficiency virus (HIV)-negative controls. We addressed these limitations in the Pharmacokinetics and Clinical Observations in People Over Fifty (POPPY) Sleep Substudy by assessing PWH and HIV-negative controls for insomnia, restless legs syndrome (RLS), and sleep apnea (SA).
    Methods: Previously enrolled POPPY participants coenrolled in this substudy without regard to sleep symptoms. Participants completed validated sleep assessments including the Insomnia Severity Index questionnaire, International Restless Legs Syndrome Study Group questionnaire, and in-home, wrist-worn overnight oximetry. They also completed health-related quality of life questionnaires including 36-item Short Form (SF-36) and Patient-Reported Outcomes Measurement Information System (PROMIS) sleep questionnaires.
    Results: We enrolled 357 PWH (246 >50 years of age; 111 between 18 and 50 years) and 126 HIV-negative controls >50 years of age. Among PWH, criteria were met by 21% for insomnia, 13% for RLS, and 6% for SA. Compared with HIV-negative controls, PWH had a higher risk of insomnia (adjusted odds ratio, 5.3; 95% confidence interval, 2.2-12.9) but not RLS or SA. Compared with PWH without insomnia, those with insomnia reported significantly worse scores on all SF-36 and PROMIS components; fewer than 30% reported previous diagnosis or treatment for insomnia.
    Conclusions: Insomnia was more common in PWH, associated with worse health-related quality of life, and frequently undiagnosed. Further research should focus on the pathogenesis of insomnia in PWH and the development of effective screening and intervention strategies for this unique population.
    Language English
    Publishing date 2020-11-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2757767-3
    ISSN 2328-8957
    ISSN 2328-8957
    DOI 10.1093/ofid/ofaa561
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  10. Article ; Online: Pathologic caveolin-1 regulation of PTEN in idiopathic pulmonary fibrosis.

    Xia, Hong / Khalil, Wajahat / Kahm, Judy / Jessurun, Jose / Kleidon, Jill / Henke, Craig A

    The American journal of pathology

    2010  Volume 176, Issue 6, Page(s) 2626–2637

    Abstract: Idiopathic pulmonary fibrosis (IPF) is a progressive fibroproliferative disorder refractory to current pharmacological therapies. Fibroblasts isolated from IPF patients display pathological activation of PI3K/Akt caused by low PTEN phosphatase activity. ... ...

    Abstract Idiopathic pulmonary fibrosis (IPF) is a progressive fibroproliferative disorder refractory to current pharmacological therapies. Fibroblasts isolated from IPF patients display pathological activation of PI3K/Akt caused by low PTEN phosphatase activity. This enables these cells to escape the negative proliferative properties of polymerized collagen. The mechanism underlying low PTEN activity in IPF fibroblasts is unclear, but our prior studies indicate that membrane-associated PTEN expression is decreased in these cells. Caveolin-1 is an integral membrane protein whose expression is decreased in IPF lung tissue, but how low caveolin-1 contributes to pathological fibrosis is incompletely understood. The objective of this study was to examine the hypothesis that caveolin-1 regulates PTEN function in IPF fibroblasts. Here we demonstrate that caveolin-1 expression is a determinant of membrane PTEN levels and show that PTEN interacts with caveolin-1 via its caveolin-1-binding sequence. We demonstrate that caveolin-1 expression is low in IPF fibroblasts and that this correlates with low membrane PTEN levels, whereas overexpression of caveolin-1 restores membrane PTEN levels, inhibits Akt phosphorylation, and suppresses proliferation. We demonstrate that caveolin-1 and PTEN expression are low in myofibroblasts within IPF fibroblastic foci. These data indicate that IPF fibroblasts display low caveolin-1 expression, which results in low membrane-associated PTEN expression. This creates a membrane microenvironment depleted of inhibitory phosphatase activity, facilitating the aberrant activation PI3K/Akt and pathological proliferation.
    MeSH term(s) Animals ; Apoptosis/physiology ; Caveolin 1/genetics ; Caveolin 1/metabolism ; Cell Line ; Cell Membrane/metabolism ; Collagen/metabolism ; Fibroblasts/cytology ; Fibroblasts/metabolism ; Humans ; Idiopathic Pulmonary Fibrosis/metabolism ; PTEN Phosphohydrolase/genetics ; PTEN Phosphohydrolase/metabolism ; Proto-Oncogene Proteins c-akt/metabolism
    Chemical Substances Caveolin 1 ; Collagen (9007-34-5) ; Proto-Oncogene Proteins c-akt (EC 2.7.11.1) ; PTEN Phosphohydrolase (EC 3.1.3.67) ; PTEN protein, human (EC 3.1.3.67)
    Language English
    Publishing date 2010-04-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2943-9
    ISSN 1525-2191 ; 0002-9440
    ISSN (online) 1525-2191
    ISSN 0002-9440
    DOI 10.2353/ajpath.2010.091117
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