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Article ; Online: Zinc Supplementation and the Prevention and Treatment of Sepsis in Young Infants: A Systematic Review and Meta-Analysis.

Irfan, Omar / Black, Robert E / Lassi, Zohra S / Bhutta, Zulfiqar A

2024 Volume 119, Issue 2, Page(s) 164–175

Abstract: Background: Prematurity and low birth weight are major risk factors for neonatal sepsis. Zinc supplements have been previously shown to be beneficial in pregnancy and small for gestational age birth outcomes. There is sparse information, however, on the ...

Abstract	Background: Prematurity and low birth weight are major risk factors for neonatal sepsis. Zinc supplements have been previously shown to be beneficial in pregnancy and small for gestational age birth outcomes. There is sparse information, however, on the potential benefits of zinc supplementation to prevent or treat serious infections in this age group. Objective: The aim of this study was to assess the efficacy of preventive and therapeutic zinc supplementation in young infant (<4 months) sepsis. Methods: MEDLINE, Cochrane CENTRAL, and other databases were searched from inception until 18 June 2021. Studies assessing preventive and therapeutic zinc supplementation in young infants in relation to incidence and outcomes of suspected sepsis were included. Meta-analyses of pooled effects were calculated for sepsis-related outcomes. Results: Nine randomized controlled trials involving 2,553 infants were included. Six studies reported therapeutic efficacy, whereas 3 evaluated preventive benefits of zinc supplementation. Preventive studies suggest a protective effect of zinc supplementation on neonatal mortality rate (NMR) (risk ratio (RR) 0.28; 95% CI 0.12-0.67, LOW certainty), but with no effect on the incidence of sepsis, both in preterm neonates. Among young infants, therapeutic zinc was associated with significant reductions in treatment failure (RR 0.61; 95% CI 0.44-0.85; MODERATE certainty) and further subgroup analysis showing significant reduction in infant mortality rate with 3 mg/kg/twice a day dosage only (RR 0.49; 95% CI 0.27-0.87, LOW certainty). Therapeutic zinc supplementation in neonates did not show any effect on hospital stay or NMR. Conclusion: Zinc supplementation could potentially reduce mortality and treatment failure in young infants but has no noteworthy influence on hospital stay and in the prevention of sepsis. Further studies with larger sample sizes are needed to confirm the direction and magnitude of effects if any.
Language	English
Publishing date	2024-03-22
Publishing country	Switzerland
Document type	Meta-Analysis
ZDB-ID	2266911-5
ISSN	1661-7819 ; 1661-7800
ISSN (online)	1661-7819
ISSN	1661-7800
DOI	10.1159/000521275
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Article ; Online: Evaluation of Antihypertensives for Post Partum Management of Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.

Irfan, Areeka / Haider, Syed Hamza / Sheikh, Samir Mustafa / Larik, Omar / Abbas, Mudassir / Hashmi, Mahnoor Rehan

Current problems in cardiology

2024 , Page(s) 102584

Abstract: Background: There is a lack of evidence that directly shows the best antihypertensive treatment options for post partum management of the hypertensive disorders of pregnancy. Our objective was to analyze the safest and most effective antihypertensive ... ...

Abstract	Background: There is a lack of evidence that directly shows the best antihypertensive treatment options for post partum management of the hypertensive disorders of pregnancy. Our objective was to analyze the safest and most effective antihypertensive drugs post partum for patients with hypertensive disorders of pregnancy. Methods: PubMed, Cochrane, and MEDLINE were searched to find relevant articles published from inception to Feb 2024. We included randomized control trials, in English, featuring a population of postnatal women with hypertensive disorders of pregnancy or postpartum women with de novo hypertension with a follow-up of up to 6 months in which any antihypertensive medication was compared with Placebo or a comparison between different doses of antihypertensives was done. The statistical analyses were conducted using Review Manager with a random-effects model. Results: Our analysis revealed that almost all antihypertensives are effective in treating postpartum hypertension. However, some medications had alternating roles in controlling specific outcomes. Using calcium channel blockers resulted in a faster time to sustain BP control than the control (SMD: -0.37; 95% CI: -0.73 to -0.01; P = 0.04). In contrast, using ACE inhibitors or ARBs demanded the use of other antihypertensives in contrast to all other drugs assessed (RR: 2.09; 95% CI: 1.07 to 4.07; P = 0.03). Conclusion: Timely management of the hypertensive disorders of pregnancy postpartum is life-saving. All the traditional antihypertensives we assessed effectively manage hypertension postpartum, thus allowing the physician to tailor the particular drug regimen according to the patient's needs and comorbidities without any hindrance.
Language	English
Publishing date	2024-04-26
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	441230-8
ISSN	1535-6280 ; 0146-2806
ISSN (online)	1535-6280
ISSN	0146-2806
DOI	10.1016/j.cpcardiol.2024.102584
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Article: Effect of Semisolid and Heat Treatment Process on Microstructural Refinement of Al-7Si Alloy.

Gebril, Mohamed Abdelgawad / Omar, Mohd Zaidi / Mohamed, Intan Fadhlina / Othman, Norinsan Kamil / Elabar, Dawod Mohamed / Haider, Farag Ibrahim / Samat, Saziana / Irfan, Osama M

Materials (Basel, Switzerland)

2023 Volume 16, Issue 3

Abstract: Improving the engineering properties of Al-7Si cast alloys (300 series) provides an attractive alternative to automotive and aircraft engine industries. The solubility limit of silicon (Si) in Al contributes to the precipitation of flake-shaped Si ... ...

Abstract	Improving the engineering properties of Al-7Si cast alloys (300 series) provides an attractive alternative to automotive and aircraft engine industries. The solubility limit of silicon (Si) in Al contributes to the precipitation of flake-shaped Si particles with sharp edges, which function as a stress riser and promote crack propagation during the eutectic phase while also weakening the protective layer's durability. In this study, the impact of microstructure refinement of Al-7Si alloys by using cooling slope, thixoforming and the T6 heat treatment process on hardness and corrosion resistance behavior was investigated. Results showed that the microstructures of the as-cast alloy had a very coarse dendritic shape, whereas the dendritic transferred to the globular α-Al phase, and the Si particles were replaced into a lamellar- or acicular-like shape after the cooling slope and thixoforming process, respectively. The as-cast, cooling slope and thixoformed samples were subjected to the T6 heat treatment process, which enhanced the hardness to 79, 99 and 104 HV, respectively, due to Si particle refinement. The potentiodynamic test revealed that the corrosion rate dropped to 0.00790 and 0.00736 mmpy
Language	English
Publishing date	2023-01-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2487261-1
ISSN	1996-1944
ISSN	1996-1944
DOI	10.3390/ma16031086
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Article ; Online: Assessing the Efficacy of Omega-3 Fatty Acids + Statins vs. Statins Only on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of 40,991 Patients.

Irfan, Areeka / Haider, Syed Hamza / Nasir, Aiman / Larik, Muhammad Omar / Naz, Turba

Current problems in cardiology

2023 Volume 49, Issue 2, Page(s) 102245

Abstract: Background: Clinical guidelines recommend statin use in patients with a vast array of cardiovascular disturbances. However, there is insufficient evidence regarding the concomitant use of omega-3 fatty acids in addition to statins. This meta-analysis ... ...

Abstract	Background: Clinical guidelines recommend statin use in patients with a vast array of cardiovascular disturbances. However, there is insufficient evidence regarding the concomitant use of omega-3 fatty acids in addition to statins. This meta-analysis aims to uncover the complete effects of this combination therapy on cardiovascular outcomes, lipid biomarkers, inflammatory markers, and plaque markers. Methods: A detailed literature search was conducted using PubMed, Cochrane, and MEDLINE databases, and all the relevant studies found up to September 2023 were included. The primary outcomes assessed in this meta-analysis was 1) Composite of fatal and non-fatal myocardial infarction, 2) Composite of fatal and non-fatal stroke, 3) Coronary revascularization, 4) Death due to cardiovascular causes, 5) MACE (Major Adverse Cardiovascular Events), 6) Unstable angina, 7) Hospitalization due to unstable angina, 8) and lipid volume index. Secondary outcomes included lipid markers, hsCRP, EPA levels, and EPA/AA ratio. Results: 14 RCTs were included, featuring a total of 40,991 patients. Patients receiving the omega-3 + statin regimen were associated with a statistically significant decrease in the incidence of MI, MACE, unstable angina, hospitalization due to unstable angina, Total cholesterol levels, triglycerides, hsCRP, and lipid volume index in comparison to their counterparts receiving placebo + statin (P < 0.05). In contrast, our analysis found no statistically significant difference in the incidence of fatal and non-fatal stroke, coronary revascularization, and cardiovascular mortality. Conclusion: Our research reinforces that all patients, regardless of their cardiovascular health, may benefit from adding omega-3 fatty acids to their statin therapy.
MeSH term(s)	Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Fatty Acids, Omega-3/therapeutic use ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; C-Reactive Protein ; Myocardial Infarction/drug therapy ; Stroke/epidemiology ; Angina, Unstable/drug therapy ; Angina, Unstable/epidemiology
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Fatty Acids, Omega-3 ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2023-11-30
Publishing country	Netherlands
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	441230-8
ISSN	1535-6280 ; 0146-2806
ISSN (online)	1535-6280
ISSN	0146-2806
DOI	10.1016/j.cpcardiol.2023.102245
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Article ; Online: Competency-based epilepsy training: A comparison between U.S.-based milestones and ILAE curriculum.

Gogou, Maria / Sheikh, Irfan S / Tamula, Omar R M / Katyal, Roohi / Beniczky, Sándor / Nascimento, Fábio A

Epileptic disorders : international epilepsy journal with videotape

2023 Volume 25, Issue 4, Page(s) 586–589

MeSH term(s)	Humans ; Curriculum ; Competency-Based Education ; Epilepsy
Language	English
Publishing date	2023-05-31
Publishing country	United States
Document type	Letter
ZDB-ID	2086797-9
ISSN	1950-6945 ; 1294-9361
ISSN (online)	1950-6945
ISSN	1294-9361
DOI	10.1002/epd2.20037
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Article: Perceptions and practices regarding the process of obtaining informed consent from surgical patients at a tertiary care hospital.

Arshad, Muhammad Asharib / Omar, Naureen / Amjad, Zaid / Bashir, Khalid / Irfan, Muhammad / Ullah, Irfan

Annals of medicine and surgery (2012)

2021 Volume 73, Page(s) 103195

Abstract: Background: Proper informed consent is essential for patients to have sound knowledge about the indication, risks, and benefits of a proposed surgical procedure. The study aim was to assess the perceptions of postoperative patients about the informed ... ...

Abstract	Background: Proper informed consent is essential for patients to have sound knowledge about the indication, risks, and benefits of a proposed surgical procedure. The study aim was to assess the perceptions of postoperative patients about the informed consent process and identify various influential factors in a tertiary care hospital. Methods: A cross-sectional study was conducted from February to August 2018 at a tertiary care hospital in Lahore, Pakistan. A validated questionnaire was used to conduct interviews of 101 patients planning to undergo elective surgery after fulfilling all ethical considerations. A purposive sampling technique was employed to enroll and the data analysis was performed by using SPSS version 23. Results: Out of total 101 patients, 50 (49.5%) of them were males and the mean age of total sample was 36.98 ± 14.23 years. The majority 92 (91.1%) considered informed consent to be important and that it did not influence their surgical decision 85 (84.2%). Consent was obtained by the consulting surgeon from 41 (40.6%) patients and by the residents/house officer from 60 (59.4%) patients. Fifteen (14.8%) patients signed the consent form themselves, and 86 (85.1%) relatives of patients signed. Ninety-eight (97.0) patients were told about indications of the surgery, and 54 (53.5%) were told about possible complications. Seventy-five (74.3%) patients were informed about alternatives to surgery. Significant reasons for not signing were language (p = 0.03), educational status (p = 0.002), and not being informed by relatives before signing (p = 0.02). Conclusion: The patients had adequate knowledge about the process of informed consent and considered it important. Factors identified as barriers to signing the consent form by the patients themselves included language, better educational status, and not being asked by relatives. It is imperative to involve the patients in the process of consent, especially in signing by them or in their presence by their surrogate.
Language	English
Publishing date	2021-12-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2021.103195
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Article ; Online: A Hybrid Approach for Efficient and Secure Point Multiplication on Binary Edwards Curves

Asher Sajid / Omar S. Sonbul / Muhammad Rashid / Muhammad Yousuf Irfan Zia

Applied Sciences, Vol 13, Iss 5799, p

2023 Volume 5799

Abstract: The focus of this article is to present a novel crypto-accelerator architecture for a resource-constrained embedded system that utilizes elliptic curve cryptography (ECC). The architecture is built around Binary Edwards curves (BEC) to provide resistance ...

Abstract	The focus of this article is to present a novel crypto-accelerator architecture for a resource-constrained embedded system that utilizes elliptic curve cryptography (ECC). The architecture is built around Binary Edwards curves (BEC) to provide resistance against simple power analysis (SPA) attacks. Furthermore, the proposed architecture incorporates several optimizations to achieve efficient hardware resource utilization for the point multiplication process over <semantics> G F ( 2 m ) </semantics> . This includes the use of a Montgomery radix-2 multiplier and the projective coordinate hybrid algorithm (combination of Montgomery ladder and double and add algorithm) for scalar multiplication. A two-stage pipelined architecture is employed to enhance throughput. The design is modeled in Verilog HDL and verified using Vivado and ISE design suites from Xilinx. The obtained results demonstrate that the proposed BEC accelerator offers significant performance improvements compared to existing solutions. The obtained throughput over area ratio for <semantics> G F ( 2 233 ) </semantics> on Virtex-4, Virtex-5, Virtex-6, and Virtex-7 Xilinx FPGAs are 9.43, 14.39, 26.14, and 28.79, respectively. The computation time required for a single point multiplication operation on the Virtex-7 device is 19.61 µs. These findings indicate that the proposed architecture has the potential to address the challenges posed by resource-constrained embedded systems that require high throughput and efficient use of available resources.
Keywords	elliptic curve cryptography ; binary Edwards curve ; scalar multiplication ; Montgomery radix-4 multiplier ; FPGA ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
Subject code	511
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Polycythaemia Vera Presenting As A Porta Hepatis Mass.

Ahmed, Shanila / Irfan, Omar / Siddique, Sabeeh / Abid, Shahab

Journal of Ayub Medical College, Abbottabad : JAMC

2020 Volume 31, Issue 4, Page(s) 627–628

Abstract: Polycythaemia Vera (PV) is a myeloproliferative disorder in which bone marrow has increased production of red blood cells, white blood cells and platelets. The hallmarks of the disease are veno-occlusive events, secondary to increased blood viscosity. ... ...

Abstract	Polycythaemia Vera (PV) is a myeloproliferative disorder in which bone marrow has increased production of red blood cells, white blood cells and platelets. The hallmarks of the disease are veno-occlusive events, secondary to increased blood viscosity. Polycythaemia Vera rarely presents with portal vein thrombosis below age of 55 years especially in absence of any chronic liver disease. We report a case of 30-years-old South Asian male presenting with abdominal pain, weight loss and vomiting for 3 months. On evaluation, he was found to have oesophageal varices. Furthermore, CT scan showed infiltration at porta-hepatis and portal venous thrombosis. Polycythaemia Vera was diagnosed with a positive JAK2 mutation and increased haemoglobin. Laparoscopy was done to perform biopsy of the porta-hepatis mass. Biopsy showed engorged vessels with no sign of malignancy. Patient underwent repeated sessions of upper GI endoscopy for band ligation and multiple sessions of venous phlebotomy which drastically improved his blood indices. He was started on lifelong aspirin and was advised regular follow-ups. With early recognition and prompt management patients can be prevented from potential complications which can prove to be detrimental.
MeSH term(s)	Adult ; Aspirin/therapeutic use ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/surgery ; Humans ; Male ; Phlebotomy ; Platelet Aggregation Inhibitors/therapeutic use ; Polycythemia Vera/complications ; Polycythemia Vera/diagnosis ; Polycythemia Vera/therapy ; Portal Vein ; Venous Thrombosis/etiology ; Venous Thrombosis/therapy
Chemical Substances	Platelet Aggregation Inhibitors ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2020-01-13
Publishing country	Pakistan
Document type	Case Reports ; Journal Article
ZDB-ID	2192473-9
ISSN	1819-2718 ; 1025-9589
ISSN (online)	1819-2718
ISSN	1025-9589
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Article: Long-term Follow-up of Exstrophy-epispadias Complex from a Lower-middle Income Country: A Case Report and Review of the Literature.

Irfan, Omar / Ladiwala, Zoya Fatima Rizwan / Zaidi, Zafar

Cureus

2020 Volume 12, Issue 4, Page(s) e7723

Abstract: Bladder exstrophy-epispadias complex (EEC) is a rare congenital defect where the abdominal muscles and bones fail to close in the mid-pelvis. It is crucial to understand the health-related quality of life (QOL) of exstrophy patients who have undergone ... ...

Abstract	Bladder exstrophy-epispadias complex (EEC) is a rare congenital defect where the abdominal muscles and bones fail to close in the mid-pelvis. It is crucial to understand the health-related quality of life (QOL) of exstrophy patients who have undergone multiple correctional surgeries. We herein discuss a case of bladder EEC that was repaired through a series of procedures at a resource-limited hospital in Karachi, Pakistan. A 21-year-old male, who was born with EEC, underwent bladder augmentation, Mitrofanoff procedure, bladder neck reconstruction, ureter implantation and a right nephrectomy in a single one-stage procedure during late childhood for urinary incontinence. However, this required a further revision because the urinary incontinence persisted, with difficulty in catheterizing the Mitrofanoff channel. On follow-up after 10 years, our patient currently describes normal QOL with near-normal sexual function. Validated questionnaires for QOL, erectile dysfunction, incontinence and prostatic function were used to assess the patient's post-operative status in these domains. Through our report, we conclude that such patients can have a normal QOL by means of a holistic multidisciplinary management, which includes timely surgical corrections along with an additional focus on the psycho-social and sexual aspects of this condition.
Language	English
Publishing date	2020-04-18
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.7723
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Article ; Online: Mental Health and Positive Development Prevention Interventions: Overview of Systematic Reviews.

Harrison, Leila / Sharma, Naeha / Irfan, Omar / Zaman, Michele / Vaivada, Tyler / Bhutta, Zulfiqar A

Pediatrics

2022 Volume 149, Issue Suppl 5

Abstract: Context: Previous reviews of mental health interventions have focused on adolescents (10-19 years), with a paucity of comprehensive evidence syntheses on preventive interventions for school-aged children (5-10 years).: Objective: To summarize and ... ...

Abstract	Context: Previous reviews of mental health interventions have focused on adolescents (10-19 years), with a paucity of comprehensive evidence syntheses on preventive interventions for school-aged children (5-10 years). Objective: To summarize and synthesize the available evidence from systematic reviews of mental health and positive development interventions for children aged 5-14.9 years in both high-income (HIC) and low- and middle-income countries (LMIC), with a focus on preventive and promotive strategies. Data sources: This overview includes all relevant reviews from OVID Medline, The Cochrane Library, and Campbell Systematic Reviews through December 2020. Study selection: We included systematic reviews that synthesized empirical studies using experimental or quasi-experimental designs to evaluate the effectiveness of interventions in children aged 5-14.9 years. Data extraction: Data extraction and quality assessment were completed independently and in duplicate by two review authors. The AMSTAR2 tool was used to assess methodological quality. Results: We included 162 reviews. The greatest evidence was found in support of school-based universal and anti-bullying interventions in predominantly HIC. Moderate evidence was found for the use of substance abuse prevention, and early learning and positive development interventions in mixed settings. In LMIC-only contexts, the most promising evidence was found for positive youth development programs. Limitations: The review was primarily limited by paucity of high-quality research due to methodological issues and high heterogeneity. Conclusions: This overview of reviews highlights the need for further research to consolidate findings and understand the specific criteria involved in creating positive mental health and development outcomes from the various interventions considered.
MeSH term(s)	Adolescent ; Child ; Humans ; Income ; Mental Health ; Poverty ; Schools ; Systematic Reviews as Topic
Language	English
Publishing date	2022-03-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2021-053852G
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