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Artikel ; Online: Telehealth-Enabled In-Home Elbow Rehabilitation for Brachial Plexus Injuries Using Deep-Reinforcement-Learning-Assisted Telepresence Robots.

Khan, Muhammad Nasir / Altalbe, Ali / Naseer, Fawad / Awais, Qasim

2024 Band 24, Heft 4

Abstract: Due to damage to the network of nerves that regulate the muscles and feeling in the shoulder, arm, and forearm, brachial plexus injuries (BPIs) are known to significantly reduce the function and quality of life of affected persons. According to the World ...

Abstract	Due to damage to the network of nerves that regulate the muscles and feeling in the shoulder, arm, and forearm, brachial plexus injuries (BPIs) are known to significantly reduce the function and quality of life of affected persons. According to the World Health Organization (WHO), a considerable share of global disability-adjusted life years (DALYs) is attributable to upper limb injuries, including BPIs. Telehealth can improve access concerns for patients with BPIs, particularly in lower-middle-income nations. This study used deep reinforcement learning (DRL)-assisted telepresence robots, specifically the deep deterministic policy gradient (DDPG) algorithm, to provide in-home elbow rehabilitation with elbow flexion exercises for BPI patients. The telepresence robots were used for a six-month deployment period, and DDPG drove the DRL architecture to maximize patient-centric exercises with its robotic arm. Compared to conventional rehabilitation techniques, patients demonstrated an average increase of 4.7% in force exertion and a 5.2% improvement in range of motion (ROM) with the assistance of the telepresence robot arm. According to the findings of this study, telepresence robots are a valuable and practical method for BPI patients' at-home rehabilitation. This technology paves the way for further research and development in telerehabilitation and can be crucial in addressing broader physical rehabilitation challenges.
Mesh-Begriff(e)	Humans ; Elbow ; Robotics ; Quality of Life ; Brachial Plexus/injuries ; Elbow Joint ; Telemedicine ; Range of Motion, Articular/physiology ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2024-02-17
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s24041273
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Educational climate of a pathology residency program at a tertiary care hospital.

Ali, Zafar / Ghafoor, Hashaam Bin / Ayub Khan, Muhammad Nasir / Atiq, Muslim / Akhlaq, Saira

PloS one

2024 Band 19, Heft 5, Seite(n) e0303534

Abstract: Evaluating educational climate (EC) is imperative for ensuring postgraduate trainees' competencies and quality in residency training programs. This study assessed the EC experiences of pathology postgraduate residents (PGRs) during their postgraduate ... ...

Abstract	Evaluating educational climate (EC) is imperative for ensuring postgraduate trainees' competencies and quality in residency training programs. This study assessed the EC experiences of pathology postgraduate residents (PGRs) during their postgraduate training in pathology residency programs-a cross-sectional study design assigned EC scores in the pathology residency program at a prestigious institution in Islamabad, which were measured using the Dutch Residency Educational Climate Test (D-RECT) questionnaire. Scores from the D-RECT were employed to conduct descriptive statistics and comparison of means across groups to evaluate EC scores by years of training and compared to assess where the differences were located. Among FCPS-II pathology residents, most of whom were females (94.4%), the mean age was 28.11±2.91 years. A mean positive score was observed among all pathology residents (M≥3.6) for all D-RECT subscales except for the feedback subscale: the average score for feedback was below the average mean score of 3.6 (M = 3.19). A significant difference p = 0.016 was observed in EC scores across different groups through the Analysis of Variances (ANOVA) test. The most significant difference was between less than two and greater than two groups p = 0.027, followed by the difference between equal to two groups and greater than two groups p = 0.052. Overall, positive scores for EC in the pathology residency program were observed. Thus, targeted interventions are needed to increase feedback scores and address observed differences in EC scores by years of training.
Mesh-Begriff(e)	Humans ; Internship and Residency ; Female ; Male ; Adult ; Cross-Sectional Studies ; Tertiary Care Centers ; Surveys and Questionnaires ; Pathology/education ; Clinical Competence
Sprache	Englisch
Erscheinungsdatum	2024-05-23
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0303534
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: The Diagnostic Accuracy of Carotid Doppler in Detecting Anechoic Thrombus Against CT Angiography as the Gold Standard.

Naeem Khan, Muhammad Nasir / Ahmed, Aliya / Zafar, Ibtesam / Akhtar, Samina / Aurangzeb, Muhammad Haris / Khan, Amir

Cureus

2022 Band 14, Heft 7, Seite(n) e26951

Abstract: Objective In this study, we aimed to assess the diagnostic accuracy of carotid Doppler ultrasound (CDU) in detecting anechoic carotid artery thrombus when compared to CT angiography (CTA) as the gold standard. Materials and methods This prospective ... ...

Abstract	Objective In this study, we aimed to assess the diagnostic accuracy of carotid Doppler ultrasound (CDU) in detecting anechoic carotid artery thrombus when compared to CT angiography (CTA) as the gold standard. Materials and methods This prospective comparative study was conducted at the Radiology Department of the Pakistan Institute of Medical Sciences, Islamabad from January 2022 to May 2022. The study enrolled 32 patients who met the inclusion criteria. We evaluated patients admitted to the neurology ward/OPD who were referred to radiology as part of a stroke workup based on their clinical examination and medical history. In all patients, CDU was used to detect free-floating thrombus (FFT)/anechoic thrombus. CTA was used as the gold standard to assess the diagnostic accuracy of CDU. Results The mean age of the study participants was 45.63 ± 7.05 years (range: 33-59 years). Out of 32 patients, 19 (59.4%) were male and 13 (40.6%) were female. The results of CDU were confirmed by CTA in all patients. The diagnostic accuracy of CDU was 53.12% for detecting FFT. The values for sensitivity (54.55%), specificity (50%), positive predictive value (PPV, 70.59%), and negative predictive value (NPV, 33.33%) were also calculated. Conclusion Despite the limited sample size, the study concludes that CDU has a diagnostic accuracy of 53%. CTA still remains the gold standard imaging modality for anechoic thrombus if strong clinical suspicion is present.
Sprache	Englisch
Erscheinungsdatum	2022-07-17
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.26951
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Critical Care Management of Severe COVID-19 in Pregnant Patients.

Ghafoor, Hashsaam / Abdus Samad, Aijaz / Bel Khair, Ali O Mohamed / Ahmed, Osman / Khan, Muhammad Nasir Ayub

Cureus

2022 Band 14, Heft 5, Seite(n) e24885

Abstract: Since December 2019, the coronavirus disease (COVID-19) pandemic has had a disastrous impact worldwide. COVID-19 is caused by the SARS-CoV-2 virus and was declared a pandemic by the WHO on March 11, 2020. The virus has been linked to a wide range of ... ...

Abstract	Since December 2019, the coronavirus disease (COVID-19) pandemic has had a disastrous impact worldwide. COVID-19 is caused by the SARS-CoV-2 virus and was declared a pandemic by the WHO on March 11, 2020. The virus has been linked to a wide range of respiratory illnesses, ranging from mild symptoms to acute pneumonia and severe respiratory distress syndrome. Pregnant women are more vulnerable to COVID-19 complications owing to the physiological and immunological changes caused by pregnancy. According to the CDC, pregnant patients with COVID-19 are commonly hospitalized and often require admission to ICUs and ventilator support. Therefore, it is especially important for pregnant women to adhere to disease prevention measures to lower the risk of contracting the disease. In addition, the guidelines of several clinical societies and local health authorities should be followed when caring for pregnant women with suspected or confirmed COVID-19. In this review article, we discuss the epidemiology of COVID-19 during delivery, its effect on the physiological and immunological changes during pregnancy, the classification of COVID-19 severity, maternal and fetal risks, antenatal care, respiratory management, treatment/medication safety, timing and mode of delivery, anesthetic considerations, and the outcome of critically ill pregnant patients with COVID-19, as well as their post-delivery care and weaning from mechanical ventilation.
Sprache	Englisch
Erscheinungsdatum	2022-05-10
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.24885
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Comparison of Continuous Thoracic Epidural With Erector Spinae Block for Postoperative Analgesia in Adult Living Donor Hepatectomy.

Zubair, Muhammad / Adil Khan, Muhammad / Khan, Muhammad Nasir Ayub / Iqbal, Sajida / Ashraf, Muhammad / Saleem, Salman A

Cureus

2022 Band 14, Heft 3, Seite(n) e23151

Abstract: Background: Thoracic epidural analgesia (TEA) is commonly used for pain management in donor hepatectomy. Erector spinae plane block (ESPB) is a newer ultrasound-guided block described for the management of thoracic and abdominal pain. There is limited ... ...

Abstract	Background: Thoracic epidural analgesia (TEA) is commonly used for pain management in donor hepatectomy. Erector spinae plane block (ESPB) is a newer ultrasound-guided block described for the management of thoracic and abdominal pain. There is limited literature available comparing the two techniques. The objective of this study was to compare the postoperative analgesic efficacy and adverse effects of continuous ESPB to continuous TEA in donor hepatectomy. Methodology: The randomized controlled trial (RCT) was registered on ClinicalTrials.gov (NCT04151511). A total of 82 patients undergoing donor hepatectomy between January 2020 and December 2020 were recruited, of whom 41 received TEA and 41 received ESPB. Randomization was done by the sealed opaque envelope method. Results: The mean visual analog scale (VAS) scores in donors who received TEA and ESPB in post-anesthesia care unit (PACU) (2.7 + 0.9 vs. 2.4 + 0.5; P = 0.02) at one hour (2.7 + 0.9 vs. 2.2 + 0.6; P = 0.008), six hours (1.8 + 0.9 vs. 0.8 + 0.5; P < 0.001), 12 hours (0.9 + 0.7 vs. 0.2 + 0.7; P < 0.001), and 24 hours (0.48 + 0.5 vs. 0.08 + 0.3; P < 0.001) were significantly different. Mean opioid consumption was 3.38 ± 6.24 mg in the ESPB group and 10.75 ± 9.64 mg in the TEA group (P < 0.001). Mean lung volume (MLV) at 24 hours in the TEA group and ESPB group was 1543 ml and 1815 ml (P < 0.001). MLV was 2545 ml in the TEA group and 2820 ml in the ESPB group at 48 hours (P < 0.001). Mean nausea and vomiting score at six hours was 0.1 vs. 0.03 (P = 0.02). Conclusion:
Sprache	Englisch
Erscheinungsdatum	2022-03-14
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.23151
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Task-based training to prevent surgical site infection: A formative evaluation.

Ayub Khan, Muhammad Nasir / Verstegen, Daniëlle M L / Islam, Sameen / Dolmans, Diana H J M / van Mook, Walther N A

Infection prevention in practice

2022 Band 4, Heft 4, Seite(n) 100235

Abstract: Background: Lack of evidence-based training constitutes a serious impediment to preventing surgical site infections in low-middle income countries (LMIC). The purpose of this study was to design and implement an infection prevention training programme ... ...

Abstract	Background: Lack of evidence-based training constitutes a serious impediment to preventing surgical site infections in low-middle income countries (LMIC). The purpose of this study was to design and implement an infection prevention training programme and investigate how it might work in an LMIC. Intended for healthcare professionals working in operating rooms, the programme was based on current instructional design principles of interprofessional, task-based learning. The second aim was to carry out a formative evaluation exploring participants' and facilitators' perceptions and experiences of the training. Methods: In undertaking this design-based research, we used a mixed-methods approach. The four session training was attended by anaesthesia and surgical trainees, registered nurses, technologists and included a video showing best practices, role plays, and peer-group reflection. We evaluated the programme through questionnaires, focus-group interviews with participants, written reflections by participants, and individual interviews with facilitators. Quantitative analysis was complemented by thematic analysis of focus-group and interview transcripts, reflections, and observer notes. Results: Our analysis revealed that participants had positive attitudes towards the training. They felt they had learned a lot from each other and the facilitators offered them the opportunity to interact with each other. Trainees especially valued the video presentation as it inspired them to revise old concepts and presented an excellent practical example of infection prevention in their specific setting. Conclusion: The training seemed to bridge the gap between knowledge and practice. However, direct observation of procedural skills and peer feedback could further reduce the gap, by enhancing the transfer of knowledge to practice.
Sprache	Englisch
Erscheinungsdatum	2022-08-07
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2590-0889
ISSN (online)	2590-0889
DOI	10.1016/j.infpip.2022.100235
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The impact of interprofessional task-based training on the prevention of surgical site infection in a low-income country.

Khan, Muhammad Nasir Ayub / Verstegen, Daniëlle M L / Shahid, Asma / Dolmans, Diana H J M / van Mook, Walther Nicolaas Anton

BMC medical education

2021 Band 21, Heft 1, Seite(n) 607

Abstract: Background: Training is considered instrumental in reducing surgical site infection. We developed training based on authentic tasks, interprofessional learning, and reflective learning for implementation in a low-income country where such training ... ...

Abstract	Background: Training is considered instrumental in reducing surgical site infection. We developed training based on authentic tasks, interprofessional learning, and reflective learning for implementation in a low-income country where such training opportunities are rare. This study evaluated the results of training in terms of participants' acceptance, participants' knowledge acquisition, and their self-perceived behavior change. Methods: We included 145 participants in the voluntary training program, comprising 66 technologists (45.5%), 43 nurses (29.7%), and 36 doctors (24.8%) from Shifa International Hospital, Islamabad, Pakistan. We measured "satisfaction" using a questionnaire at the end of the training, "knowledge" through pre-and post-intervention assessments, and "self-perceived behavior change" using a questionnaire and interviews 8 weeks post-training. Results: Pre- and post-test scores showed a significant increase in knowledge. Participants were favorable to the training and eager to participate. They positively applied in practice what they had learned about preventing surgical site infection. Our qualitative data analysis revealed two categories of themes, representing the upsides of the training as it stood, and existing factors or downsides that hindered the effective transfer of learning to practice. Conclusion: Participants were very enthusiastic about the training format. The knowledge test showed a gain in knowledge. Moreover, participants acknowledged that their behavior toward the prevention of surgical site infection in the operating rooms had changed. The use of authentic tasks from daily clinical practice, as well as the interprofessional approach and reflection, were considered to promote the transfer of learning. Although promising, our findings also pointed to obstacles limiting the application of evidence-based knowledge, such as a shortage of supplies and conventional practices.
Mesh-Begriff(e)	Clinical Competence ; Humans ; Interprofessional Relations ; Learning ; Operating Rooms ; Pakistan ; Surgical Wound Infection/prevention & control
Sprache	Englisch
Erscheinungsdatum	2021-12-09
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-021-03046-3
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Diagnostic Accuracy of Different Computed Tomography Signs for Differentiating Between Malignant and Cirrhotic Ascites Keeping Ascitic Fluid Cytology as Gold Standard.

Zafar, Ibtesam / Majeed, Ayesha Isani / Asad, Muhammad Waseem / Khan, Amir / Bhutta, Muzammil Rasheed / Naeem Khan, Muhammad Nasir

Cureus

2021 Band 13, Heft 12, Seite(n) e20254

Abstract: Objective The goal of this research was to define the diagnostic precision of CT signs to distinguish malignant ascites from cirrhotic ascites. Ascitic fluid cytology was kept as the gold standard. Study design This research was a prospective cross- ... ...

Abstract	Objective The goal of this research was to define the diagnostic precision of CT signs to distinguish malignant ascites from cirrhotic ascites. Ascitic fluid cytology was kept as the gold standard. Study design This research was a prospective cross-sectional study. Place and duration of the study Participants' recruitment started on July 15, 2021, and the whole study lasted about three months till October 15, 2021, at the Radiology Department of Pakistan Institute of Medical Sciences, Islamabad. Patients and methods A total of 80 patients were included in the research and divided into two groups grounded on the cirrhotic or malignant etiology of the ascites based on their fluid cytology. Ascites volume, relative spread between the lesser sac and greater peritoneal cavity, the wall thickness of gallbladder, density of ascites, parietal peritoneum thickness and degree of its enhancement, and presence of septa and loculations were some of the major CT signs studied. Results The average age of patients included in this study was 36.2 ± 6.67 years (range 29-49 years). Of the 80 patients, 50 (62.5 %) were men, and 30 (37.5 %) were women. CT signs associated with the malignant ascites reported in this study were fluid present in the lesser sac (p = 0.03), peritoneal thickening and degree of its enhancement (p = 0.05), increased ascites density (p= 0.001), and presence of septa and loculations (63.6 % of malignant ascites). However, gallbladder wall thickness did not show any variation between both groups. Conclusion We conclude that in the diagnosis of malignant ascites, CT scan imaging can play a vital role. This research approves and testifies the benefits of indirect signs such as the spread of ascites, increased density of ascites, thickening and enhancement of parietal peritoneum, and ascitic fluid complexity in pointing out malignancy as a cause of ascites.
Sprache	Englisch
Erscheinungsdatum	2021-12-07
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.20254
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Skin Lesion Segmentation from Dermoscopic Images Using Convolutional Neural Network.

Zafar, Kashan / Gilani, Syed Omer / Waris, Asim / Ahmed, Ali / Jamil, Mohsin / Khan, Muhammad Nasir / Sohail Kashif, Amer

Sensors (Basel, Switzerland)

2020 Band 20, Heft 6

Abstract: Clinical treatment of skin lesion is primarily dependent on timely detection and delimitation of lesion boundaries for accurate cancerous region localization. Prevalence of skin cancer is on the higher side, especially that of melanoma, which is ... ...

Abstract	Clinical treatment of skin lesion is primarily dependent on timely detection and delimitation of lesion boundaries for accurate cancerous region localization. Prevalence of skin cancer is on the higher side, especially that of melanoma, which is aggressive in nature due to its high metastasis rate. Therefore, timely diagnosis is critical for its treatment before the onset of malignancy. To address this problem, medical imaging is used for the analysis and segmentation of lesion boundaries from dermoscopic images. Various methods have been used, ranging from visual inspection to the textural analysis of the images. However, accuracy of these methods is low for proper clinical treatment because of the sensitivity involved in surgical procedures or drug application. This presents an opportunity to develop an automated model with good accuracy so that it may be used in a clinical setting. This paper proposes an automated method for segmenting lesion boundaries that combines two architectures, the U-Net and the ResNet, collectively called Res-Unet. Moreover, we also used image inpainting for hair removal, which improved the segmentation results significantly. We trained our model on the ISIC 2017 dataset and validated it on the ISIC 2017 test set as well as the PH
Mesh-Begriff(e)	Algorithms ; Artifacts ; Dermoscopy/methods ; Humans ; Image Processing, Computer-Assisted/methods ; Neural Networks, Computer ; Skin/diagnostic imaging ; Skin/pathology ; Skin Diseases/diagnostic imaging ; Skin Diseases/pathology ; Skin Neoplasms/diagnostic imaging ; Skin Neoplasms/pathology
Sprache	Englisch
Erscheinungsdatum	2020-03-13
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s20061601
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Fabrication of Nanostructured Cadmium Selenide Thin Films for Optoelectronics Applications.

Hussain, Shahnwaz / Iqbal, Mazhar / Khan, Ayaz Arif / Khan, Muhammad Nasir / Mehboob, Ghazanfar / Ajmal, Sohaib / Ashfaq, J M / Mehboob, Gohar / Ahmed, M Shafiq / Khisro, Said Nasir / Li, Chang-Jiu / Chikwenze, Raphael / Ezugwu, Sabastine

Frontiers in chemistry

2021 Band 9, Seite(n) 661723

Abstract: There is lot of research work at enhancing the performance of energy conversion and energy storage devices such as solar cells, supercapacitors, and batteries. In this regard, the low bandgap and a high absorption coefficient of CdSe thin films in the ... ...

Abstract	There is lot of research work at enhancing the performance of energy conversion and energy storage devices such as solar cells, supercapacitors, and batteries. In this regard, the low bandgap and a high absorption coefficient of CdSe thin films in the visible region, as well as, the low electrical resistivity make them ideal for the next generation of chalcogenide-based photovoltaic and electrochemical energy storage devices. Here, we present the properties of CdSe thin films synthesized at temperatures (below 100°C using readily available precursors) that are reproducible, efficient and economical. The samples were characterized using XRD, FTIR, RBS, UV-vis spectroscopy. Annealed samples showed crystalline cubic structure along (111) preferential direction with the grain size of the nanostructures increasing from 2.23 to 4.13 nm with increasing annealing temperatures. The optical properties of the samples indicate a small shift in the bandgap energy, from 2.20 to 2.12 eV with a decreasing deposition temperature. The band gap is suitably located in the visible solar energy region, which make these CdSe thin films ideal for solar energy harvesting. It also has potential to be used in electrochemical energy storage applications.
Sprache	Englisch
Erscheinungsdatum	2021-04-07
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2711776-5
ISSN	2296-2646
ISSN	2296-2646
DOI	10.3389/fchem.2021.661723
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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