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Article ; Online: Massive post-partum haemorrhage in a SARS-CoV-2 positive primi gravid patient

Ushna Ahmed / Nida Najmi / Rozilla Sadia Khan

Journal of the Pakistan Medical Association, Vol 73, Iss

a case report

2023 Volume 7

Abstract: A 20-year-old, primi gravid, south Asian woman, was referred from secondary care to Aga Khan University Hospital for further management of primary post-partum haemorrhage after a normal vaginal delivery, on July 12, 2021. She was otherwise healthy, with ... ...

Abstract	A 20-year-old, primi gravid, south Asian woman, was referred from secondary care to Aga Khan University Hospital for further management of primary post-partum haemorrhage after a normal vaginal delivery, on July 12, 2021. She was otherwise healthy, with no known comorbidity. She tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during her admission, on account of universal Covid-19 testing policy. Initially, conservative measures were instituted to control bleeding, including bilateral internal iliac artery ligation, concluding with hysterectomy to stop the haemorrhage. Multiple units of blood products had to be transfused. Obstetrical haemorrhage being the menace in this case, the possibility of Covid-19 positive obstetrics patients being more susceptible to massive post-partum haemorrhage, requiring more radical life-saving procedures to be conducted earlier, was considered. In future, more observational studies will be needed to determine any association between Covid-19 infection and obstetric haemorrhage. Keywords: Pregnancy, Covid-19, haemorrhage.
Keywords	Medicine ; R
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Pakistan Medical Association
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: An Analysis of Watt’s Muhammad at Mecca and Muhammad at Madina

Sadia Khan

Hazara Islamicus, Vol 05, Iss 01, Pp 19-

2016 Volume 30

Abstract: Watt's writings on Islam, particularly his biographical works on the Prophet Muhammad, are now considered an authority on the subject. They are not only diligently well-researched, but are path-breaking in that they permanently and decisively answered ... ...

Abstract	Watt's writings on Islam, particularly his biographical works on the Prophet Muhammad, are now considered an authority on the subject. They are not only diligently well-researched, but are path-breaking in that they permanently and decisively answered certain doubts and suspicions that were raised in the Western scholarly study of Islam and Muhammad. Moreover, his objective stance on many issues has caused a methodological shift in the way Islam is approached in the West. His work and opinions have both theoretically and in practical terms have helped the Westerners towards an unbiased understanding and estimation of the Islamic culture. Watt's works will, in the near future, remain significant, they will continue to be studied, and indeed, continue to be refuted where necessary.
Keywords	Seerah ; William Montgomery Watt ; Prophet Muhammad ; Islam ; History ; Islam. Bahai Faith. Theosophy ; etc ; BP1-610 ; Social sciences (General) ; H1-99
Language	Arabic
Publishing date	2016-06-01T00:00:00Z
Publisher	Hazara University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Retrospective observational study to compare Xpert MTB/RIF assay with other diagnostic tests in lymph node tuberculosis

Nithya Haridas / Asmita Mehta / Akhilesh Kunoor / Sadia Khan

Indian Journal of Public Health, Vol 66, Iss 5, Pp 17-

2022 Volume 21

Abstract: Background: Lymph node tuberculosis (TB) is the most common form of extrapulmonary TB in India. Standards for TB care in India recommend microscopy/culture/CBNAAT/molecular test/histopathology examination and drug sensitivity testing on appropriate ... ...

Abstract	Background: Lymph node tuberculosis (TB) is the most common form of extrapulmonary TB in India. Standards for TB care in India recommend microscopy/culture/CBNAAT/molecular test/histopathology examination and drug sensitivity testing on appropriate specimens from the presumed sites of involvement for all patients with presumptive extrapulmonary TB. Objectives: To analyze the utility of Xpert MTB/Rif assay in lymph node TB. Methods: All patients who underwent lymph node sampling between July 2014 and June 2017 and for whom Xpert MTB/Rif assay was done were included. Demographic profile, Xpert MTB/Rif assay result, histopathology/cytology findings, smear acid-fast bacillus (AFB), and AFB culture results were noted. A composite reference score (CRS) was made. Results: Xpert MTB/Rif assay was positive in 63 of the 81 patients. Xpert had a sensitivity of 82.14% and specificity of 86.18%when compared against AFB culture and 75.61% and 98.97% when compared against CRS. Conclusion: Xpert MTB/Rif assay is a valuable test for rapid diagnosis of lymph node TB.
Keywords	lymph node ; polymerase chain reaction ; tuberculosis ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: De Quervain's Tenosynovitis and Thumb Pain in Physiotherapists Practicing Manual Therapy

Saba Riaz / Tooba Mazhar / Sumbal Riaz / Ayesha Batool / Awishbah Khan / Sadia Khan

BioMedica, Vol 39, Iss 1, Pp 38-

Prevalence and Associated Factors

2023 Volume 43

Abstract: Background and Objective: Manual therapy is a treatment approach by physical therapists where different techniques are applied to patients with hands for rehabilitation purposes. The objective of the study was to find the frequency of De’Quervain ... ...

Abstract	Background and Objective: Manual therapy is a treatment approach by physical therapists where different techniques are applied to patients with hands for rehabilitation purposes. The objective of the study was to find the frequency of De’Quervain tenosynovitis and thumb and wrist pain in physical therapists working in different rehabilitation centers in relation to age, body mass index (BMI), and working hours. Methods: A cross-sectional study was conducted on 135 physical therapists working in different settings in Lahore, Pakistan. Physiotherapists were enrolled by convenience sampling. Data were recorded on a questionnaire form. Finkelstein test was performed to check De Quervain’s tenosynovitis. A numeric pain rating scale was sued to measure pain. The data were tested for significance using statistical tests. Results: On the dominant hand, 99 (73.3%) physical therapists had no wrist pain, 104 (77%) had no thumb pain, 28 (20.7%) had mild wrist pain and 20 (14.8%) had mild thumb pain. Only 21 (15.6%) physiotherapists were tested positive for Finkelstein (De Quervain’s tenosynovitis). Finkelstein test reported 100% negative result on the non-dominant side. There is a negative correlation between thumb pain with the age (r = -0.005), BMI (r = -0.110) and working hours (r = -0.033) of the physical therapists. Conclusion : The study concluded that the prevalence of De Quervain’s tenosynovitis, thumb, and wrist pain was more on the dominant hand than on the non-dominant side. The majority of the physical therapists reported mild to no pain in the wrist and thumb. There is a negative correlation of thumb pain with age, BMI and working hours.
Keywords	Medicine ; R ; Biology (General) ; QH301-705.5
Subject code	796
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Discover STM Publishing Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: IMPACT OF EDUCATIONAL TRAINING ON NEUROLOGICAL ASSESSMENT SKILLS OF FEMALE NURSES IN EVALUATING TRAUMATIC BRAIN INJURY PATIENTS THROUGH GLASGOW COMA SCALE IN LAHORE GENERAL HOSPITAL, LAHORE, PAKISTAN

Nazia Yousef / Kabir Ozigi Abdullahi / Kousar Perveen / Sadia Khan

Gomal Journal of Medical Sciences, Vol 19, Iss 3, Pp 105-

2021 Volume 110

Abstract: Background: Traumatic Brain Injury (TBI) is a leading cause of death and disability worldwide. The objective of this study was to determine the impact of educational training on neurological assessment skill of female nurses in evaluating traumatic brain ...

Abstract	Background: Traumatic Brain Injury (TBI) is a leading cause of death and disability worldwide. The objective of this study was to determine the impact of educational training on neurological assessment skill of female nurses in evaluating traumatic brain injury patients through Glasgow Coma Scale in Lahore General Hospital, Lahore, Pakistan. Material Methods: This quasi-experimental one group pre-posttest design study was conducted at Lahore School of Nursing, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan from April 3, 2021 to May 15, 2021. Pre-test neurological assessment skill of 70 nurses was noted by an observer, two weeks educational training was given and four weeks later on, post-test score was noted. For neurological assessment skill, a 20 items observatory checklist was used. Age groups, marital status, job experience, work experience in recent department and work place were four demographic, while neurological assessment skill score was one research variable. Paired sample t test was used for hypothesis testing. Results: Out 70 nurses, 26 (37.1%) were in age group 25-30 years, 18 (25.7%) in 31-35, 16 (22.9%) in 36-40, six (8.6%) in 41-45 and four (5.7%) in 46-50 years. Marital status was; 36 (51.4%) single, 27 (38.6%) married, three (4.3%) divorced and four (5.7%) widow. Job experience was; eight (11.4%) had 2 years, 33 (47.1%) 2-5 years, 25 (35.7%) 6-10 years and four (5.7%) had 10 years. Work experience in recent department was; 16 (22.9%) had 1 year, 39 (55.7%) 1-3 years, 13 (18.6%) 4-5 years and two (2.9%) had 5 years. Work place was Trauma Unit in 12 (17.1%), neurosurgery ICUs in 38 (54.3%) and surgical units in 20 (28.6%) cases. Mean 16.89±2.52 posttest skills score was significantly higher than mean 12.56±2.67 pretest skills score (p=.0001). Conclusion: Our study confirmed that the effect of educational training was significant in improving neurological assessment skills of nurses in evaluating traumatic brain injury patients through Glasgow Coma Scale in Lahore ...
Keywords	traumatic brain injury ; head injuries: brain injuries ; neurological assessment ; glasgow coma scale ; nursing assessment ; skills ; nurses ; pakistan ; Medicine ; R
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Gomal Medical College, D.I.Khan, Pakistan
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Therapeutic Role of Sirtuins Targeting Unfolded Protein Response, Coagulation, and Inflammation in Hypoxia-Induced Thrombosis.

Sadia, Khan / Ashraf, Mohammad Zahid / Mishra, Aastha

Frontiers in physiology

2021 Volume 12, Page(s) 733453

Abstract: Thrombosis remains one of the leading causes of morbidity and mortality across the world. Many pathological milieus in the body resulting from multiple risk factors escort thrombosis. Hypoxic condition is one such risk factor that disturbs the integrity ... ...

Abstract	Thrombosis remains one of the leading causes of morbidity and mortality across the world. Many pathological milieus in the body resulting from multiple risk factors escort thrombosis. Hypoxic condition is one such risk factor that disturbs the integrity of endothelial cells to cause an imbalance between anticoagulant and procoagulant proteins. Hypoxia generates reactive oxygen species (ROS) and triggers inflammatory pathways to augment the coagulation cascade. Hypoxia in cells also activates unfolded protein response (UPR) signaling pathways in the endoplasmic reticulum (ER), which tries to restore ER homeostasis and function. But the sustained UPR linked with inflammation, generation of ROS and apoptosis stimulates the severity of thrombosis in the body. Sirtuins, a group of seven proteins, play a vast role in bringing down inflammation, oxidative and ER stress and apoptosis. As a result, sirtuins might provide a therapeutic approach towards the treatment or prevention of hypoxia-induced thrombosis. Sirtuins modulate hypoxia-inducible factors (HIFs) and counteract ER stress-induced apoptosis by attenuating protein kinase RNA-like endoplasmic reticulum kinase (PERK)/Eukaryotic translation initiation factor 2α (eIF2α) pathway activation. It prevents ER-stress mediated inflammation by targeting X-Box Binding Protein 1 (XBP1) and inhibiting nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κβ) signaling through deacetylation. Sirtuins also obstruct nucleotide-binding domain, leucine-rich-containing family, pyrin domain containing 3 (NLRP3) inflammasome activation to reduce the expression of several pro-inflammatory molecules. It protects cells against oxidative stress by targeting nuclear factor erythroid 2-related factor 2 (Nrf2), glutathione (GSH), forkhead box O3 (FOXO3), superoxide dismutase (SOD), catalase (CAT), peroxisome proliferator-activated receptor gamma coactivator 1-α (PGC-1α), glucose-6-phosphate dehydrogenase (G6PD), phosphoglucomutase-2 (PGAM2), and NF-κB, to name few. This review, thus, discusses the potential role of sirtuins as a new treatment for hypoxia-induced thrombosis that involves an intersection of UPR and inflammatory pathways in its pathological manifestation.
Language	English
Publishing date	2021-11-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2021.733453
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Hepatitis B vaccination for healthcare workers

Sadia Khan / Anil Kumar

Indian Journal of Medical Microbiology, Vol 35, Iss 2, Pp 315-

2017 Volume 315

Keywords	Science ; Q ; Microbiology ; QR1-502
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical outcomes of digital sensor alerting systems in remote monitoring

Fahad M. Iqbal / Kyle Lam / Meera Joshi / Sadia Khan / Hutan Ashrafian / Ara Darzi

npj Digital Medicine, Vol 4, Iss 1, Pp 1-

a systematic review and meta-analysis

2021 Volume 12

Abstract: Abstract Advances in digital technologies have allowed remote monitoring and digital alerting systems to gain popularity. Despite this, limited evidence exists to substantiate claims that digital alerting can improve clinical outcomes. The aim of this ... ...

Abstract	Abstract Advances in digital technologies have allowed remote monitoring and digital alerting systems to gain popularity. Despite this, limited evidence exists to substantiate claims that digital alerting can improve clinical outcomes. The aim of this study was to appraise the evidence on the clinical outcomes of digital alerting systems in remote monitoring through a systematic review and meta-analysis. A systematic literature search, with no language restrictions, was performed to identify studies evaluating healthcare outcomes of digital sensor alerting systems used in remote monitoring across all (medical and surgical) cohorts. The primary outcome was hospitalisation; secondary outcomes included hospital length of stay (LOS), mortality, emergency department and outpatient visits. Standard, pooled hazard ratio and proportion of means meta-analyses were performed. A total of 33 studies met the eligibility criteria; of which, 23 allowed for a meta-analysis. A 9.6% mean decrease in hospitalisation favouring digital alerting systems from a pooled random effects analysis was noted. However, pooled weighted mean differences and hazard ratios did not reproduce this finding. Digital alerting reduced hospital LOS by a mean difference of 1.043 days. A 3% mean decrease in all-cause mortality from digital alerting systems was noted. There was no benefit of digital alerting with respect to emergency department or outpatient visits. Digital alerts can considerably reduce hospitalisation and length of stay for certain cohorts in remote monitoring. Further research is required to confirm these findings and trial different alerting protocols to understand optimal alerting to guide future widespread implementation.
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The pilot, proof of concept REMOTE-COVID trial

Fahad Mujtaba Iqbal / Meera Joshi / Gary Davies / Sadia Khan / Hutan Ashrafian / Ara Darzi

BMC Public Health, Vol 21, Iss 1, Pp 1-

remote monitoring use in suspected cases of COVID-19 (SARS-CoV 2)

2021 Volume 8

Abstract: Abstract Background SARS-CoV-2 has ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters preceding an adverse event. Wearable sensors can measure vital signs continuously and remotely, ...

Abstract	Abstract Background SARS-CoV-2 has ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters preceding an adverse event. Wearable sensors can measure vital signs continuously and remotely, outside of hospital facilities, recognising early clinical deterioration. We aim to determine the feasibility & acceptability of remote monitoring systems for quarantined individuals in a hotel suspected of COVID-19. Methods A pilot, proof-of-concept, feasibility trial was conducted in engineered hotels near London airports (May–June 2020). Individuals arriving to London with mild suspected COVID-19 symptoms requiring quarantine, as recommended by Public Health England, or healthcare professionals with COVID-19 symptoms unable to isolate at home were eligible. The SensiumVitals™ patch, measuring temperature, heart & respiratory rates, was applied on arrival for the duration of their stay. Alerts were generated when pre-established thresholds were breeched; trained nursing staff could consequently intervene. Results Fourteen individuals (M = 7, F = 7) were recruited; the mean age was 34.9 (SD 11) years. Mean length of stay was 3 (SD 1.8) days. In total, 10 vital alerts were generated across 4 participants, resulting in telephone contact, reassurance, or adjustment of the sensor. No individuals required hospitalisation or virtual general practitioner review. Discussion This proof-of-concept trial demonstrated the feasibility of a rapidly implemented model of healthcare delivery through remote monitoring during a pandemic at a hotel, acting as an extension to a healthcare trust. Benefits included reduced viral exposure to healthcare staff, with recognition of clinical deterioration through ambulatory, continuous, remote monitoring using a discrete wearable sensor. Conclusion Remote monitoring systems can be applied to hotels to deliver healthcare safely in individuals suspected of COVID-19. Further work is required to evaluate this model on a larger scale. Trial registration Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04337489 (07/04/2020).
Keywords	Remote sensing technology ; Clinical trial ; Patient deterioration ; Monitoring ; ambulatory ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Design of the pilot, proof of concept REMOTE-COVID trial

Fahad Mujtaba Iqbal / Meera Joshi / Gary Davies / Sadia Khan / Hutan Ashrafian / Ara Darzi

Pilot and Feasibility Studies, Vol 7, Iss 1, Pp 1-

remote monitoring use in suspected cases of COVID-19 (SARS-CoV-2)

2021 Volume 7

Abstract: Abstract Background The outbreak of SARS-CoV-2 (coronavirus, COVID-19), declared a pandemic by the World Health Organization (WHO), is a global health problem with ever-increasing attributed deaths. Vital sign trends are routinely used to monitor ... ...

Abstract	Abstract Background The outbreak of SARS-CoV-2 (coronavirus, COVID-19), declared a pandemic by the World Health Organization (WHO), is a global health problem with ever-increasing attributed deaths. Vital sign trends are routinely used to monitor patients with changes in these parameters often preceding an adverse event. Wearable sensors can measure vital signs continuously (e.g. heart rate, respiratory rate, temperature) remotely and can be utilised to recognise early clinical deterioration. Methods We describe the protocol for a pilot, proof-of-concept, observational study to be conducted in an engineered hotel near London airports, UK. The study is set to continue for the duration of the pandemic. Individuals arriving to London with mild symptoms suggestive of COVID-19 or returning from high-risk areas requiring quarantine, as recommended by the Public Health England, or healthcare professionals with symptoms suggestive of COVID-19 unable to isolate at home will be eligible for a wearable patch to be applied for the duration of their stay. Notifications will be generated should deterioration be detected through the sensor and displayed on a central monitoring hub viewed by nursing staff, allowing for trend deterioration to be noted. The primary objective is to determine the feasibility of remote monitoring systems in detecting clinical deterioration for quarantined individuals in a hotel. Discussion This trial should prove the feasibility of a rapidly implemented model of healthcare delivery through remote monitoring during a global pandemic at a hotel, acting as an extension to a healthcare trust. Potential benefits would include reducing infection risk of COVID-19 to healthcare staff, with earlier recognition of clinical deterioration through ambulatory, continuous, remote monitoring using a discrete wearable sensor. We hope our results can power future, robust randomised trials. Trial registration ClinicalTrials.gov Identifier: NCT04337489 .
Keywords	Remote-sensing technology ; Protocol ; Clinical trial ; Patient deterioration ; Monitoring ; Ambulatory ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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