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  1. Article ; Online: Weighted aggregation through probability based ranking: An optimized federated learning architecture to classify respiratory diseases.

    Abdul Sattar Shaikh, Abdullah / Bhargavi, M S / Kumar C, Pavan

    Computer methods and programs in biomedicine

    2023  Volume 242, Page(s) 107821

    Abstract: Background and Objective Respiratory Diseases are one of the leading chronic illnesses in the world according to the reports by World Health Organization. Diagnosing these respiratory diseases is done through auscultation where a medical professional ... ...

    Abstract Background and Objective Respiratory Diseases are one of the leading chronic illnesses in the world according to the reports by World Health Organization. Diagnosing these respiratory diseases is done through auscultation where a medical professional listens to sounds of air in the lungs for anomalies through a stethoscope. This method necessitates extensive experience and can also be misinterpreted by the medical professional. To address this issue, we introduce an AI-based solution that listens to the lung sounds and classifies the respiratory disease detected. Since the research work deals with medical data that is tightly under wraps due to privacy concerns in the medical field, we introduce a Deep learning solution to classify the diseases and a custom Federated learning (FL) approach to further improve the accuracy of the deep learning model and simultaneously maintain data privacy. Federated Learning architecture maintains data privacy and facilitates a distributed learning system for medical infrastructures. Methods The approach utilizes Generative Adversarial Networks (GAN) based Federated learning approach to ensure data privacy. Generative Adversarial Networks generate new data by synthesizing new lung sounds. This new synthesized data is then converted to spectrograms and trained on a neural network to classify four lung diseases, Heart Attack and Normal breathing patterns. Furthermore, to address performance loss during FL, we also propose a new "Weighted Aggregation through Probability-based Ranking (FedWAPR)" algorithm for optimizing the FL aggregation process. The FedWAPR aggregation takes inspiration from exponential distribution function and ranks better performing clients according to it. Results and Conclusion A test accuracy of about 92% was achieved by the trained model while classifying various respiratory diseases and heart failure. Additionally, we developed a novel FedWAPR approach that significantly outperformed the FedAVG approach for the FL aggregate function. A patient can be checked for respiratory diseases using this improved learning approach without the need for extensive sensitive data recording or for making sure the data sample obtained is secure. In a decentralized training runtime, the trained model successfully classifies various respiratory diseases and heart failure using lung sounds with a test accuracy on par with a centralized model.
    MeSH term(s) Humans ; Respiratory Sounds ; Respiratory Tract Diseases ; Algorithms ; Heart Failure ; Probability
    Language English
    Publishing date 2023-09-21
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 632564-6
    ISSN 1872-7565 ; 0169-2607
    ISSN (online) 1872-7565
    ISSN 0169-2607
    DOI 10.1016/j.cmpb.2023.107821
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Impact of Cardiopulmonary Bypass Time and Aortic Cross Clamp Time on Immediate PostOperative Outcomes in Patients with Congenital Heart Disease Undergoing Open Heart Surgery

    Nazish Alisher / Rajab Ali Khokhar / Mujeeb Ur Rehman / Abdul Sattar Shaikh / Hussain Bux Korejo / Rumana Sangi

    Pakistan Armed Forces Medical Journal, Vol 73, Iss

    2023  Volume 2

    Abstract: Objective: to find out the impact of cardiopulmonary bypass time (CPBT) and aortic cross-clamp time (ACCT) on immediate post-operative outcomes in patients with congenital heart disease (CHD) undergoing open heart surgery at a tertiary care centre. Study ...

    Abstract Objective: to find out the impact of cardiopulmonary bypass time (CPBT) and aortic cross-clamp time (ACCT) on immediate post-operative outcomes in patients with congenital heart disease (CHD) undergoing open heart surgery at a tertiary care centre. Study Design: Prospective longitudinal study. Place and Duration of the Study: Department of Paediatric, Cardiac Intensive Care Unit, National Institute of Cardiovascular Diseases (NICVD), Karachi Pakistan, from Jul to Dec 2021. Methodology: We enrolled 104 patients of both genders up to any age with CHD undergoing open heart surgeries. At the time of admission, age, gender, body weight, presence of cyanosis and types of CHDs were noted. Duration of mechanical ventilation, pediatric cardiac intensive care unit (PCICU) stay, and mortality was recorded. Baseline characteristics and postsurgery parameters were compared about CPBT and ACCT. Results: Of 104 patients, 58(55.8%) were males. Overall, the mean age was 7.9±5.1 years. Cyanosis was noted in 34(32.7%) cases. Mean CPBT was 74.6±42.9 minutes, while the mean ACCT was 43.5±29.5 minutes. Most types of CHDs were noted to be tetralogy of Fallot (ToF) 28(26.9%). An increase in the duration of CPBT and ACCT was found to have a significant association with post-surgical morbidity (p<0.001). Conclusion: Increased cardiopulmonary bypass time and aortic cross-clamp time were found to have a significant association with post-surgical morbidity and outcomes among cases undergoing open heart surgeries for congenital heart diseases.
    Keywords Cardiopulmonary bypass time ; aortic cross-clamp time ; congenital heart disease ; Medicine ; R ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Army Medical College Rawalpindi
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Factors associated with poor outcomes after congenital heart surgery in low-resource setting in Pakistan

    Muneer Amanullah / Abdul Sattar Shaikh / Shumaila Furnaz / Musa Karim / Rayyan Qureshi / Subhani Fatima / Sohail Khan Bangash

    BMJ Open, Vol 13, Iss

    insight from the IQIC Registry – a descriptive analysis

    2023  Volume 12

    Abstract: Objective This study aimed to assess the International Quality Improvement Collaborative single-site data from a developing country to identify trends in outcomes and factors associated with poor outcomes.Design Retrospective descriptive study.Setting ... ...

    Abstract Objective This study aimed to assess the International Quality Improvement Collaborative single-site data from a developing country to identify trends in outcomes and factors associated with poor outcomes.Design Retrospective descriptive study.Setting The National Institute of Cardiovascular Diseases, Karachi, Pakistan.Participants Patients undergoing surgery for congenital heart disease (CHD).Outcome measure Key factors were examined, including preoperative, procedural and demographic data, as well as surgical complications and outcomes. We identified risk factors for mortality, bacterial sepsis and 30-day mortality using multivariable logistic regression.Results A total of 3367 CHD surgical cases were evaluated; of these, 59.4% (2001) were male and 82.8% (2787) were between the ages of 1 and 17 years. Only 0.2% (n=6) were infants (≤30 days) and 2.3% (n=77) were adults (≥18 years). The in-hospital mortality rate was 6.7% (n=224), and 4.4% (n=147) and 0.8% (n=27) had bacterial sepsis and surgical site infections, respectively. The 30-day status was known for 90.8% (n=3058) of the patients, of whom 91.6% (n=2800) were alive. On multivariable analysis, the adjusted OR for in-hospital mortality was 0.40 (0.29–0.56) for teenagers compared with infancy/childhood and 1.95 (1.45–2.61) for patients with oxygen saturation <85%. Compared with Risk Adjustment for Congenital Heart Surgery (RACHS-1) risk category 1, the adjusted OR for in-hospital mortality was 1.78 (1.1–2.87) for RACHS-1 risk category 3 and 2.92 (1.03–8.31) for categories 4–6. The adjusted OR for 30-day mortality was 0.40 (0.30–0.55) for teenagers and 1.52 (1.16–1.98) for patients with oxygen saturation <85%. The 30-day mortality rate was significantly higher in RACHS-1 risk category 3 compared with category 1, with an adjusted OR of 1.64 (1.06–2.55).Conclusions We observed a high prevalence of postoperative infections and mortality, especially for high-risk procedures, according to RACHS-1 risk category, in infancy/childhood, in children with genetic ...
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Clinical and epidemiological features of pediatric population hospitalized with COVID-19

    Qalab Abbas / Farah Khalid / Fatima Farrukh Shahbaz / Javeria Khan / Shazia Mohsin / Murtaza Ali Gowa / Abdul Sattar Shaikh / Rai Muhammad Asghar / Javairia Khalid / Sehrish Karim / Fyezah Jehan / Masood Sadiq / Junaid Rashid

    The Lancet Regional Health - Southeast Asia, Vol 11, Iss , Pp 100176- (2023)

    a multicenter longitudinal study (March 2020–December 2021) from PakistanResearch in context

    2023  

    Abstract: Summary: Background: We aimed to explore the epidemiological, clinical, and phenotypic parameters of pediatric patients hospitalized with COVID-19 in Pakistan. Methods: This longitudinal cohort study was conducted in five tertiary care hospitals in ... ...

    Abstract Summary: Background: We aimed to explore the epidemiological, clinical, and phenotypic parameters of pediatric patients hospitalized with COVID-19 in Pakistan. Methods: This longitudinal cohort study was conducted in five tertiary care hospitals in Pakistan from March 2020 to December 2021. Data on various epidemiological and clinical variables were collected using Case Report Forms (CRFs) adapted from the WHO COVID-19 clinical data platform at baseline and at monthly follow-ups for 3 months. Findings: A total of 1090 children were included. The median age was 5 years (Interquartile range 1–10), and the majority presented due to new signs/symptoms associated with COVID-19 (57.8%; n = 631), the most common being general and respiratory symptoms. Comorbidities were present in 417 (38.3%) children. Acute COVID-19 alone was found in 932 (85.5%) children, 81 (7.4%) had multisystem inflammatory syndrome (MIS-C), 77 (7.0%) had overlapping features of acute COVID-19 and MIS-C, and severe disease was found in 775/1086 (71.4%). Steroids were given to 351 (32.2%) patients while 77 (7.1%) children received intravenous immunoglobulins. Intensive care unit (ICU) care was required in 334 (31.6%) patients, and 203 (18.3%) deaths were reported during the study period. The largest spike in cases and mortality was from July to September 2021 when the Delta variant first emerged. During the first and second follow-ups, 37 and 10 children expired respectively, and medical care after discharge was required in 204 (25.4%), 94 (16.6%), and 70 (13.7%) children respectively during each monthly follow-up. Interpretation: Our study highlights that acute COVID-19 was the major phenotype associated with high severity and mortality in children in Pakistan in contrast to what has been observed globally. Funding: The study was supported by the World Health Organization (WHO), which was involved in the study design but played no role in its analysis, writeup, or publication.
    Keywords Pediatric COVID-19 ; Epidemiology ; SARS-CoV-2 ; Pakistan ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Incidence, clinical profile and short term outcome of cerebral abscess in cyanotic congenital heart diseases

    Rumana Sangi / Aliya Kemal Ahsan / Abdul Sattar Shaikh / Ali Raza / Hussain Bux Korejo / Veena Kumari / Musarat Nazir Sandano / Ume Rubab Sandano

    Heliyon, Vol 9, Iss 12, Pp e22198- (2023)

    2023  

    Abstract: Background: Brain abscess is a serious infection of brain parenchyma in patients with cyanotic congenital heart disease (CCHD) and around 25–46 % of unrepaired CCHD patients develop brain abscess. Aim of this study was to determine the incidence, ... ...

    Abstract Background: Brain abscess is a serious infection of brain parenchyma in patients with cyanotic congenital heart disease (CCHD) and around 25–46 % of unrepaired CCHD patients develop brain abscess. Aim of this study was to determine the incidence, clinical features, microbiology and factors associated with early and short term outcome of cerebral abscess in CCHD. Method: ology: This is a retrospective study, conducted at Pediatric cardiology department, National Institute of Cardiovascular Diseases (NICVD) Karachi. The data was collected from January 2019 to December 2021. All CCHD patients between 1 and 25 years of age were included. Data of patients with cerebral abscess was reviewed. Results: Among the 544 pediatric patients hospitalized in the last two years, brain abscesses were identified in 51 (9.3 %). Polycythemia (31.4 %) was the most significant contributing factor, especially in patients aged above 10 years. The most frequently seen CCHD was tetralogy of fallot (TOF) 60.8 %. Majority of the patients (84.3 %) had a single abscess while 15.7 % had multiple abscesses. E coli (9.7 %) was the most common isolated pathogen. Immediate complication identified was cerebral edema in 22 (43.1 %). Four patients (7.8 %) died, 47 (92.2 %) patients completed treatment course. 45.1 % had complete recovery however, 17 (33.3 %) had neurological deficits, 8 (15.7 %) had seizures and 2 (3.9 %) patients had residual abscess. Prolonged hospitalization was observed in patients of age group <10 years. Conclusion: In patients with underlying CCHD,early referrals and intervention are key to mitigating the severe consequences of cerebral abscesses and can drastically improve patient outcomes.
    Keywords Incidence ; Brain abscess ; CCHD and outcome ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
    Subject code 610 ; 616
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Knowledge Attitude and Practices of Mothers regarding Complementary Feeding

    Shazia Samad Mohsin / Abdul Sattar Shaikh

    Journal of the Dow University of Health Sciences, Vol 8, Iss

    2014  Volume 1

    Abstract: Objectives: To determine the knowledge attitude and practices of mothers regarding complementary feeing. Study Design: Descriptive study conducted at outpatient department of Civil Hospital Karachi over duration of 12 months. Material and Methods: One ... ...

    Abstract Objectives: To determine the knowledge attitude and practices of mothers regarding complementary feeing. Study Design: Descriptive study conducted at outpatient department of Civil Hospital Karachi over duration of 12 months. Material and Methods: One hundred and thirty-eight mothers of children age up till 2 years attending OPDof Pediatrics Civil Hospital Karachi were selected for the study. Mothers were interviewed to ascertain their infant feeding practices and various beliefs/taboos/ feeding during illness affecting these practices. Results: Malnutrition Hundred and thirty-eight mothers were interviewed. Hundred and nineteen (86.2%) mothers started breast milk soon after birth. The frequency of breastfeeding was high initially but then declined rapidly with supplementation of bottle feeding. Exclusive breastfeeding was of short duration. Knowledge attitude and practices of mothers regarding complementary feeing was poor in terms of quantity and quality. Commonestage of introduction of complementary feeding was before 6 months with readymade items as their first choice. Conclusion: The knowledge attitude and practices of mothers regarding EBF, complementary feeding, is defective. Therefore there is a need to educate mothers to ensure better growth and development of our children.
    Keywords Malnutrition ; complementary feeding practices ; breast feeding ; infant ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2014-04-01T00:00:00Z
    Publisher Dow University of Health Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Knowledge Attitude and Practices of Mothers regarding Complementary Feeding

    Shazia Samad Mohsin / Abdul Sattar Shaikh

    Journal of the Dow University of Health Sciences, Vol 8, Iss

    2014  Volume 1

    Abstract: Objectives: To determine the knowledge attitude and practices of mothers regarding complementary feeing. Study Design: Descriptive study conducted at outpatient department of Civil Hospital Karachi over duration of 12 months. Material and Methods: One ... ...

    Abstract Objectives: To determine the knowledge attitude and practices of mothers regarding complementary feeing. Study Design: Descriptive study conducted at outpatient department of Civil Hospital Karachi over duration of 12 months. Material and Methods: One hundred and thirty-eight mothers of children age up till 2 years attending OPDof Pediatrics Civil Hospital Karachi were selected for the study. Mothers were interviewed to ascertain their infant feeding practices and various beliefs/taboos/ feeding during illness affecting these practices. Results: Malnutrition Hundred and thirty-eight mothers were interviewed. Hundred and nineteen (86.2%) mothers started breast milk soon after birth. The frequency of breastfeeding was high initially but then declined rapidly with supplementation of bottle feeding. Exclusive breastfeeding was of short duration. Knowledge attitude and practices of mothers regarding complementary feeing was poor in terms of quantity and quality. Commonestage of introduction of complementary feeding was before 6 months with readymade items as their first choice. Conclusion: The knowledge attitude and practices of mothers regarding EBF, complementary feeding, is defective. Therefore there is a need to educate mothers to ensure better growth and development of our children.
    Keywords Malnutrition ; complementary feeding practices ; breast feeding ; infant ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2014-04-01T00:00:00Z
    Publisher Dow University of Health Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Knowledge Attitude and Practices of Mothers regarding Complementary Feeding

    Shazia Samad Mohsin / Abdul Sattar Shaikh / Rehana Shaikh / Nighat Haider / Arit Parkash

    Journal of the Dow University of Health Sciences, Vol 8, Iss 1, Pp 21-

    2014  Volume 25

    Abstract: Objectives: To determine the knowledge attitude and practices of mothers regarding complementary feeing. Study Design: Descriptive study conducted at outpatient department of Civil Hospital Karachi over duration of 12 months. Material and Methods: One ... ...

    Abstract Objectives: To determine the knowledge attitude and practices of mothers regarding complementary feeing. Study Design: Descriptive study conducted at outpatient department of Civil Hospital Karachi over duration of 12 months. Material and Methods: One hundred and thirty-eight mothers of children age up till 2 years attending OPDof Pediatrics Civil Hospital Karachi were selected for the study. Mothers were interviewed to ascertain their infant feeding practices and various beliefs/taboos/ feeding during illness affecting these practices. Results: Malnutrition Hundred and thirty-eight mothers were interviewed. Hundred and nineteen (86.2%) mothers started breast milk soon after birth. The frequency of breastfeeding was high initially but then declined rapidly with supplementation of bottle feeding. Exclusive breastfeeding was of short duration. Knowledge attitude and practices of mothers regarding complementary feeing was poor in terms of quantity and quality. Commonestage of introduction of complementary feeding was before 6 months with readymade items as their first choice. Conclusion: The knowledge attitude and practices of mothers regarding EBF, complementary feeding, is defective. Therefore there is a need to educate mothers to ensure better growth and development of our children.
    Keywords malnutrition ; complementary feeding practices ; breast feeding ; infant ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2014-04-01T00:00:00Z
    Publisher Dow University of Health Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Risk Factors Associated with Anthracycline Induced Cardiac Dysfunction in Pediatric Patients

    Abdul Sattar Shaikh / Muhammad Matloob Alam / Shazia Samad Mohsin / Qalab Abbas / Zehra Fadoo / Mehnaz Atiq

    World Journal of Cardiovascular Diseases , Vol 04, Iss 07, Pp 377-

    2014  Volume 383

    Abstract: Anthracyclines ( i.e. , doxorubicin, daunorubicin) have significant impact on outcome in many pediatric chemotherapy protocols and therefore remain the mainstay of treatment. The objective of this study was to identify the risk factors for anthracycline ... ...

    Abstract Anthracyclines ( i.e. , doxorubicin, daunorubicin) have significant impact on outcome in many pediatric chemotherapy protocols and therefore remain the mainstay of treatment. The objective of this study was to identify the risk factors for anthracycline induced cardiac dysfunction in pediatric patients. Multiple logistic regression model was applied to assess the risk factors for development of cardiac dysfunction. 110 pediatric oncology patients were available for final analysis. 75 (66%) children were males and mean age was 74 ± 44 months. ALL ( n = 70, 64%) was the most common primary diagnosis followed by lymphoma ( n = 19; 17%) and AML ( n = 12, 11%). Daunorubicin alone or in combination with doxorubicin was used in ( n = 94, 85%) patients and cumulative dose < 300 mg was used in ( n = 95; 86%) children. 24 (22%) children received radiation therapy as per protocol and sepsis were observed in 47 (43%) cases. Post anthracycline, 15 (14%) children had cardiac dysfunction within a month; out of them 10/15 (67%) had isolated diastolic dysfunction, while 28 (25%) developed dysfunction within a year. 19 (17%) had pericardial effusion. 11 expired and out of them, 7 had significant cardiac dysfunction. Cumulative dose > 300 mg/m 2 ( p < 0.001; AOR 2.3), radiation therapy ( p = 0.009; AOR 3.5) and sepsis ( p = 0.002; AOR 2.6) were found to be independent risk factors associated anthracycline induced cardiac dysfunction. At univariant level use of daunorubicin alone or in combination therapy ( p < 0.001, OR 7) and mode of delivery ( p 0.048, OR 9.7) were also found statistically significant. In conclusion anthracycline induced cardiac dysfunction is mostly related to cumulative dose > 300 mg/m 2 , use of Daunorubicin alone or in combination with doxorubicin, mode of delivery, radiation therapy and sepsis. Regular long term follow-up with cardiologist is the key point for early diagnosis and therapy for a long term survival.
    Keywords Anthracycline ; Cardiac Dysfunction ; Risk Factors ; Pediatric Oncology ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 610 ; 616
    Language English
    Publishing date 2014-06-01T00:00:00Z
    Publisher Scientific Research Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: A Simple Method Adopted for Tooth Sectioning in Dr. Ishratul- Ebad Khan Institute of Oral Health Sciences, DUHS

    Samina Tariq / Iqbal A Memon / Ainey Razzak / Asma Aijaz / Abdul Sattar Shaikh

    Journal of the Dow University of Health Sciences, Vol 4, Iss 2, Pp 84-

    2010  Volume 86

    Abstract: From the third world countries including Pakistan, needfor effective techniques for the study ofhistological toothsectioning at undergraduate level is lacking. This is primarilydue to poor resources. ...

    Abstract From the third world countries including Pakistan, needfor effective techniques for the study ofhistological toothsectioning at undergraduate level is lacking. This is primarilydue to poor resources.
    Keywords ambiguous genitalia ; congenital adrenal hyperplasia (cah) ; 5-alpha reductase deficiency ; intersex ; Medicine ; R
    Language English
    Publishing date 2010-01-01T00:00:00Z
    Publisher Dow University of Health Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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