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Article: Sensitivity, Specificity and Accuracy of Androgen Deficiency in Ageing Male (ADAM) Questionnaire for the Clinical Detection of Androgen Deficiency in the Male Population in Pakistan.

Naz, Sidra / Mandhan, Nikeeta / Shankar, Prem / Raj, Kuldeep / Memon, Sidra

2020 Volume 12, Issue 11, Page(s) e11788

Abstract: Introduction: Androgen deficiency in relation to the increasing age is quite prevalent worldwide. However, diagnosing it in low-income countries is quite a challenge due to cost concerns. Through this study, we plan to measure the sensitivity and ... ...

Abstract	Introduction: Androgen deficiency in relation to the increasing age is quite prevalent worldwide. However, diagnosing it in low-income countries is quite a challenge due to cost concerns. Through this study, we plan to measure the sensitivity and specificity of the Androgen Deficiency in Ageing Male (ADAM) questionnaire in the Pakistani population. Methods: A cross-sectional survey study was conducted from September 2019 to November 2019 in a Pakistani tertiary care hospital. Two hundred and fifty-five participants belonging to ages 30-69 years completed the ADAM Questionnaire in the out-patient department. Venous blood samples were taken to check serum total testosterone levels. Results: The ADAM questionnaire revealed 90.12% sensitivity, 41.3% specificity, 45.34% positive predictive value, 90.80% negative predictive value, and 61.29% accuracy in the Pakistani population. Conclusion: Low specificity and positive predictive value have been shown by the ADAM questionnaire. Hence, it cannot be used as a diagnostic tool to detect androgen deficiency, replacing the blood sample.
Language	English
Publishing date	2020-11-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.11788
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Sensitivity and Specificity of Hepatitis B Virus Screening via Rapid Immunoassay Chromatographic Test.

Saboor Soomro, Rukhsana / Shah, Iftikhar Ali / Saboor, Abdul / Bhutto, Aman Ullah B / Memon, Sidra

Cureus

2021 Volume 13, Issue 1, Page(s) e12909

Abstract: Introduction: In low-income and high hepatitis B and C virus burden countries like Pakistan, it is important to develop cheap yet efficient strategies in diagnosing as well as treating hepatitis. The aim of this study is to assess the sensitivity and ... ...

Abstract	Introduction: In low-income and high hepatitis B and C virus burden countries like Pakistan, it is important to develop cheap yet efficient strategies in diagnosing as well as treating hepatitis. The aim of this study is to assess the sensitivity and specificity of serum hepatitis B surface antigen (HbsAg) via Rapid Immunoassay Chromatographic Test (RICT) for the screening of hepatitis B, compared to the gold standard laboratory-based method. Methods: The study was conducted in the Hepatology Clinic of Civil Hospital, Sukkur. All records of the clinic from June 1, 2018, to December 31, 2018, were accessed for identification of the records in which hepatitis B screening via RICT and then confirmatory polymerase chair reaction (PCR) by gene amplification with forward and reverse primers was done. Results: There were 151 samples in this study. There were 32 (94.1%) true-positive and three (5.8%) false-negative samples. There were two (2.5%) false-positive and 114 (97.4%) true-negative samples. The sensitivity of HbsAg detection via RICT for the screening of 1-1B V was 91.43%, specificity was 98.28% and the accuracy was 96.69%, compared to PCR. Conclusion: The RICT method has high sensitivity and specificity. In low-income and high-hepatitis B virus-burden countries like Pakistan, it serves as a very efficient screening tool that is easy to use, cheaper in cost, and gives rapid and accurate results.
Language	English
Publishing date	2021-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.12909
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Do COVID-19 Antibodies Provide Long-Term Protection?

Ansari, Sheeba / Memon, Mubeen / Kumar, Ratan / Memon, Sidra / Memon, Muhammad Khizar

Cureus

2021 Volume 13, Issue 1, Page(s) e12441

Abstract: Introduction: Post severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, an immune response is generated among healthy, immunocompetent individuals with immunoglobulins (IgG and IgM) antibodies. IgM rises earlier than IgG, indicating a ...

Abstract	Introduction: Post severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, an immune response is generated among healthy, immunocompetent individuals with immunoglobulins (IgG and IgM) antibodies. IgM rises earlier than IgG, indicating a recent infection. However, a detailed analysis is required to assess long-term immune reactions induced by antibodies. Method and materials: The study was conducted at a tertiary care hospital in Pakistan from June 2020 to October 2020 where serum samples were collected from patients. The samples were obtained by phlebotomy for antibody testing. All the reactive patients were followed up after 60 days of initial testing. Results: A total of 728 patients participated in the study, of which 79 (10.8%) were seropositive at baseline. Seventy-two (91.1%) participants came back for follow-up after 60 days (two months) and were included in the final analysis. Among the 72 participants, 35 (48.6%) exhibited symptoms of coronavirus disease 2019 (COVID-19) infection and 37 (51.4%) were asymptomatic. After 60 days, 37 (including 20 symptomatic and 17 asymptomatic) participants were still seropositive for SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) test. Mean change in percentage from seropositive to seronegative was more in asymptomatic compared to symptomatic patients (54.0% vs. 42.8%). Conclusion: In this study, humoral immunity against SARS-CoV-2 is not long-lasting among individuals with mild signs and symptoms. Care should be taken while implicating that antibodies can provide long term protection against SARS-CoV-2. Further large-scale studies are needed.
Language	English
Publishing date	2021-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.12441
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Prevalence of Falls and Fractures in Alzheimer's Patients Compared to General Population.

Dev, Kapeel / Javed, Alizay / Bai, Priya / Murlidhar / Memon, Sidra / Alam, Owais / Batool, Zoha

Cureus

2021 Volume 13, Issue 1, Page(s) e12923

Abstract: Introduction Alzheimer's disease (AD), found in the aging elderly population, is a progressive neurodegenerative disorder that leads to worsening memory loss and cognitive impairment. Falls and fractures are common in the overall elderly population. ... ...

Abstract	Introduction Alzheimer's disease (AD), found in the aging elderly population, is a progressive neurodegenerative disorder that leads to worsening memory loss and cognitive impairment. Falls and fractures are common in the overall elderly population. Hence, the purpose of this study is to determine the prevalence of falls and fractures in Alzheimer's patients compared to the general population. Methodology This longitudinal study was conducted at the neurology outpatient department (OPD) in a tertiary healthcare setup in Pakistan from November 2019 till April 2020. Previously confirmed diagnosed Alzheimer's patients from neurology OPD were included in one group. Equal number of gender and age-matched healthy participants were included in the reference group. Participants were followed for 12 months to determine the incidence of falls and non-vertebral fractures. Results The incidence of fall was significant in the Alzheimer group compared to the reference group (22.8% vs. 10.9%; relative risk (RR): 2.08; P-value: 0.01). Fractures were also significantly more common in the Alzheimer group compared to the reference group (12.8% vs. 5.1%; RR: 2.51; P-value: 0.03). Conclusion This study demonstrated a higher incidence of falls and fractures in Alzheimer's patients compared to healthy non-Alzheimer individuals. Management of AD should include measures to reduce falls and fractures in addition to standard therapy.
Language	English
Publishing date	2021-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.12923
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Risk of Major Adverse Cardiovascular Events in Patients With Rheumatoid Arthritis.

Mal, Kheraj / Kumar, Ratan / Mansoor, Farah / Kaur, Navneet / Kumar, Anil / Memon, Sidra / Rizwan, Amber

Cureus

2020 Volume 12, Issue 12, Page(s) e12246

Abstract: Introduction Rheumatoid arthritis is a chronic, inflammatory, and multisystem disease, which, along with the joints, can involve the cardiovascular system. The treatment of rheumatoid arthritis or rheumatoid arthritis itself can lead to atherosclerosis, ... ...

Abstract	Introduction Rheumatoid arthritis is a chronic, inflammatory, and multisystem disease, which, along with the joints, can involve the cardiovascular system. The treatment of rheumatoid arthritis or rheumatoid arthritis itself can lead to atherosclerosis, which is considered one of the major causes by which it can affect the cardiovascular system. In this study, we will assess the risk of cardiovascular events in patients with rheumatoid arthritis as compared to the general population. Method This case-control study was conducted from January 2018 to November 2018. Two-hundred twenty-two (222) patients with diagnosed rheumatoid arthritis were included as cases in the study. Two-hundred eleven (211) patients were included in the study as the control group (patients without rheumatoid arthritis). All the data were recorded in a self-structured questionnaire. Result Participants with rheumatoid arthritis also showed an increased risk of myocardial infarction (MI) by an odds ratio of 2.50 (95% CI; 0.77-8.14). There was also an increased risk of cardiovascular death in participants with rheumatoid arthritis by an odds ratio of 1.99 (0.58-6.71). Conclusion The study suggests that rheumatoid arthritis along with joint inflammation can also affect the cardiovascular system. Hence, a multidisciplinary team of rheumatologists and cardiologists should manage patients suffering from rheumatoid arthritis, which will improve morbidity and mortality in such patients.
Language	English
Publishing date	2020-12-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.12246
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Diabetic Ketoacidosis: Clinical Characteristics and Precipitating Factors.

Shahid, Wajeeha / Khan, Faria / Makda, Aamir / Kumar, Vinesh / Memon, Sidra / Rizwan, Amber

Cureus

2020 Volume 12, Issue 10, Page(s) e10792

Abstract: Introduction: Diabetic ketoacidosis (DKA) is a complication of hyperglycemia. Through this study we plan to study the clinical features of DKA and precipitating factors responsible for DKA in type 1 and type 2 diabetes.: Methods: This cross-sectional ...

Abstract	Introduction: Diabetic ketoacidosis (DKA) is a complication of hyperglycemia. Through this study we plan to study the clinical features of DKA and precipitating factors responsible for DKA in type 1 and type 2 diabetes. Methods: This cross-sectional observational study was conducted in the emergency department of a tertiary care hospital in Sukkur, Pakistan from August 2019 to February 2020. Symptoms and precipitating factors were noted in a self-structured questionnaire. Results: Out of 71 patients, 19 (26.7%) patients had type 1 diabetes mellitus and 52 (73.3%) patients had type 2 diabetes mellitus. The most common clinical symptom was nausea and vomiting (57.7%), followed by pain in abdomen (42.2%) and dehydration (42.2%). We found that the most common precipitating factors were infections (69.0%) and non-compliance to treatment (53.5%). Among various infections, people commonly presented with pneumonia (38.7%) and urinary tract infection (30.6%). Conclusion: Diabetic ketoacidosis presents with vague symptoms such as nausea, vomiting, and pain in abdomen. Characteristic findings of DKA such as Kussmaul breathing was present in limited patients. Infections in diabetic patients should be carefully monitored as they are the most common precipitating factors for DKA.
Language	English
Publishing date	2020-10-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.10792
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Role of Montelukast as Monotherapy in Improving Quality of Life of an Asthmatic Patient in Pakistan.

Kumari, Ankeeta / Ejaz, Mishal / Anis, Khurram / Kumar, Sumeet / Kumar, Besham / Memon, Sidra

Cureus

2020 Volume 12, Issue 10, Page(s) e10841

Abstract: Introduction: Uncontrolled and inadequately managed asthma substantially reduces Quality of Life (QOL) and can lead to premature death. The aim of this study is to understand the role of montelukast in improving quality of life in asthmatic patients by ... ...

Abstract	Introduction: Uncontrolled and inadequately managed asthma substantially reduces Quality of Life (QOL) and can lead to premature death. The aim of this study is to understand the role of montelukast in improving quality of life in asthmatic patients by comparing it with placebo. Methods: This prospective, single-arm, interventional study was conducted from September 2019 to February 2020 in the pulmonology outpatient department of a tertiary care hospital in Pakistan. All patients were prescribed montelukast (10 mg once daily). Results: At day 28, participants had a higher score on the Asthma Quality of Life Questionnaire-Standard (AQLQ-S) overall and in all sub-domains compared to day 0. The improvement was significant overall and for the sub-domains of symptoms, activity limitations, and environmental stimuli. Conclusion: Montelukast has an effective role in asthma control as well as in improving the quality of life in the Pakistani population.
Language	English
Publishing date	2020-10-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.10841
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Violence against doctors, a serious concern for healthcare organizations to ponder about.

Ahmed, Farah / Khizar Memon, Muhammad / Memon, Sidra

Annals of medicine and surgery (2012)

2017 Volume 25, Page(s) 3–5

Abstract: Background: Aggression and Violence against primary care physicians is reportedly common in Pakistan but there is no any documented study to-date on this burning issue.: Methods: A formed written questionnaire was distributed among 769 primary care ... ...

Abstract	Background: Aggression and Violence against primary care physicians is reportedly common in Pakistan but there is no any documented study to-date on this burning issue. Methods: A formed written questionnaire was distributed among 769 primary care physicians aged 31 ± 7.68 years. Apart from the demographic data, the questionnaire included questions regarding the level of safety that primary care physicians felt during their work setups and on-call duties, along with the experience of aggression against them by the perpetrators & the support provided by the hospital management in such cases. Result: Response rate was 68% i.e. 524 physicians agreed to participate in the study. It was found that majority (85%) of the physicians has faced mild events, 62% have faced moderate events and roughly 38% were subjected to severe violence. Some physicians revealed more than one form of aggression being faced by them in 12 months preceding months which makes the collective percentage greater than 100%. Verbal abuse is the most frequent type of mistreatment faced by the doctors from the patients or their attendants. Conclusion: A considerable number of physicians participated have faced mild violence in which verbal abuse was commonest; followed by moderate and severe events.
Language	English
Publishing date	2017-11-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2017.11.003
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Association Between Serum Vitamin D Levels and Frequency of Relapses in Patients With Multiple Sclerosis.

Mansoor, Farah / Kumar, Vikash / Kumar, Suneel / Kaur, Navneet / Naz, Sidra / Shahid, Simra / Anees, Faryal / Memon, Sidra / Rizwan, Amber

Cureus

2021 Volume 13, Issue 4, Page(s) e14383

Abstract: Introduction Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system affecting the myelin sheath of neurons with a wide range of symptoms. Among various risk factors studied that can increase the relapse, vitamin ... ...

Abstract	Introduction Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system affecting the myelin sheath of neurons with a wide range of symptoms. Among various risk factors studied that can increase the relapse, vitamin D is also a potential risk factor. In this study, we will determine the association between vitamin D status and frequency of relapses in patients with MS. Material and methods Seventy-four (74) patients with a confirmed diagnosis of MS, with more than one (01) relapse per year, for a minimum of two years, were included in the case group. Seventy-four (74) participants with a confirmed diagnosis of MS with one (01) or no relapse per year, for a minimum of two years, were included in the control group. After informed consent, the patient blood was drawn via phlebotomy and was sent to the lab for vitamin D levels. Results The mean serum vitamin D level was significantly lower in case group compared to control group (18.21 ± 4.21 ng/mL vs. 29.21 ± 5.72 ng/mL; p-value: < 0.0001). The number of participants with vitamin D level less than 30 ng/mL were significantly higher in patients with case group compared to control group (78.37% vs. 50.0%; p-value: 0.0003) Conclusion In this study, patients with more relapses per year had low level of serum vitamin D. There is emerging strong evidence that vitamin D plays an important role in the pathogenesis, progression, and disease burden of autoimmune disease, including MS.
Language	English
Publishing date	2021-04-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.14383
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The Role of Vitamin C in Reducing Pain Associated With Diabetic Neuropathy.

Bai, Amerta / Abdullah, Fnu / Kumar, Jatender / Lal, Amar / Abbas, Mohammed / Sandesh, Ram / Naz, Sidra / Shahid, Simra / Anees, Faryal / Memon, Sidra

Cureus

2021 Volume 13, Issue 6, Page(s) e15895

Abstract: Introduction: Neuropathic pain is a painful condition that arises after a lesion or an insult to the somatosensory nervous system, either in a central or peripheral location. The most common cause of neuropathic pain is diabetes. Controlled trials have ... ...

Abstract	Introduction: Neuropathic pain is a painful condition that arises after a lesion or an insult to the somatosensory nervous system, either in a central or peripheral location. The most common cause of neuropathic pain is diabetes. Controlled trials have been conducted on recent advancements in medicine to investigate the effect of vitamin C in the treatment of neuropathic pain. In this study, we aim to investigate the role of vitamin C in reducing pain associated with diabetic neuropathy. Methods: This open-label, parallel-arm, interventional study was conducted in a public tertiary care hospital in Pakistan from April 2019 to March 2021. A total of 300 type II diabetic patients with newly diagnosed painful peripheral diabetic neuropathy, of either gender, were enrolled in the study. The intervention group received 60 mg duloxetine along with 200 mg oral vitamin C. The control group received 60 mg duloxetine without any additional intervention. Patients were asked to return for follow-up after 12 weeks. Results: The mean visual analog score (VAS) was significantly lower in both, the intervention (5.54 ± 0.81 vs. 6.72 ± 0.90; p-value: <0.0001) and the control group (5.91 ± 0.80 vs. 6.79 ± 0.94; p-value: <0.0001), at week 12 compared to day 0. However, in comparison, VAS score in intervention at week 12 was significantly lower as compared to the control group (5.54 ± 0.81 vs. 5.91 ± 0.80; p-value: 0.0002). Conclusion: The use of vitamin C could be cost-effective and would be a safe and useful adjunctive therapy for pain associated with diabetic peripheral neuropathy.
Language	English
Publishing date	2021-06-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.15895
Database	MEDical Literature Analysis and Retrieval System OnLINE

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