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  1. Article ; Online: Revisiting the Corneal and Blink Reflexes for Primary and Secondary Trigeminal Facial Pain Differentiation.

    Khan, Zafar Ali

    Pain research & management

    2021  Volume 2021, Page(s) 6664736

    Abstract: Trigeminal neuralgia is often misdiagnosed at initial presentation due to close connotation with dental pain and is often over diagnosed for the very same reasons leading to numerous unnecessary surgical procedures such as peripheral neurectomy and ... ...

    Abstract Trigeminal neuralgia is often misdiagnosed at initial presentation due to close connotation with dental pain and is often over diagnosed for the very same reasons leading to numerous unnecessary surgical procedures such as peripheral neurectomy and alcohol injections, while the actual cause may remain elusive for decades. Evaluation of the neurosensory system may disclose the correct anatomical location of the etiology. The neurological examination may be clouded by the sensory deficits subsequent to previous peripheral surgical procedures. The corneal and blink reflexes are integral measures of the trigeminal and facial neurosensory assessment, and their abnormal function may facilitate the identification of intrinsic disease of the brain stem. These reflexes can be employed to discover pathological lesions including intracranial space-occupying trigeminal, lateral medullary, cerebral hemispheric lesions, and degenerative diseases of the central nervous system. Dental surgeons and oral and maxillofacial surgeons should consider corneal reflex in neurological assessment of patient presenting with trigeminal neuralgia-like symptoms. Failure to evaluate corneal sensitivity may lead to delayed or inaccurate diagnosis and unsuitable or redundant treatment interventions. This simple noninvasive reflex can be performed by chair-side and may provide significant information regarding the origin of facial pain and is an invaluable part of clinical methods especially in remote and peripheral healthcare center practitioners where sophisticated radiographic investigations such as computed tomography and magnetic resonance imaging may not be available.
    MeSH term(s) Blinking/physiology ; Cornea/physiology ; Facial Pain/diagnosis ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination/methods ; Reflex/physiology ; Trigeminal Neuralgia/diagnosis
    Language English
    Publishing date 2021-02-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2041085-2
    ISSN 1918-1523 ; 1203-6765
    ISSN (online) 1918-1523
    ISSN 1203-6765
    DOI 10.1155/2021/6664736
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Revisiting the Corneal and Blink Reflexes for Primary and Secondary Trigeminal Facial Pain Differentiation

    Zafar Ali Khan

    Pain Research and Management, Vol

    2021  Volume 2021

    Abstract: Trigeminal neuralgia is often misdiagnosed at initial presentation due to close connotation with dental pain and is often over diagnosed for the very same reasons leading to numerous unnecessary surgical procedures such as peripheral neurectomy and ... ...

    Abstract Trigeminal neuralgia is often misdiagnosed at initial presentation due to close connotation with dental pain and is often over diagnosed for the very same reasons leading to numerous unnecessary surgical procedures such as peripheral neurectomy and alcohol injections, while the actual cause may remain elusive for decades. Evaluation of the neurosensory system may disclose the correct anatomical location of the etiology. The neurological examination may be clouded by the sensory deficits subsequent to previous peripheral surgical procedures. The corneal and blink reflexes are integral measures of the trigeminal and facial neurosensory assessment, and their abnormal function may facilitate the identification of intrinsic disease of the brain stem. These reflexes can be employed to discover pathological lesions including intracranial space-occupying trigeminal, lateral medullary, cerebral hemispheric lesions, and degenerative diseases of the central nervous system. Dental surgeons and oral and maxillofacial surgeons should consider corneal reflex in neurological assessment of patient presenting with trigeminal neuralgia-like symptoms. Failure to evaluate corneal sensitivity may lead to delayed or inaccurate diagnosis and unsuitable or redundant treatment interventions. This simple noninvasive reflex can be performed by chair-side and may provide significant information regarding the origin of facial pain and is an invaluable part of clinical methods especially in remote and peripheral healthcare center practitioners where sophisticated radiographic investigations such as computed tomography and magnetic resonance imaging may not be available.
    Keywords Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Hindawi Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: FACTORS AFFECTING BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS VISITING A TERTIARY CARE HOSPITAL IN KHYBER PAKHTUNKHWA

    Yasmin Akhtar / Muhammad Abdur Rahman Afridi / Zafar Ali

    Khyber Medical University Journal, Vol 15, Iss 1, Pp 4-

    2023  Volume 8

    Abstract: OBJECTIVE: To determine the factors affecting blood pressure (BP) control in adult hypertensive patients. METHODS: A total of 246 adult hypertensive patients of both genders, age 20 years and above were included in this descriptive study conducted at the ...

    Abstract OBJECTIVE: To determine the factors affecting blood pressure (BP) control in adult hypertensive patients. METHODS: A total of 246 adult hypertensive patients of both genders, age 20 years and above were included in this descriptive study conducted at the Department of Medicine, Lady Reading Hospital, Peshawar from May 2019 to September 2019. Statistical analysis of the data was done with SPPS version 21; Chi-square (χ2) test was applied using crosstab/correlation for the association of factors affecting the control of BP in patients with hypertension. P-value≤0.05 was considered statistically significant. RESULTS: Out of 246 patients, 64 (26%) were males, and 182 (74%) were females. The mean age of patients was 56.09±10.33 years. Overall, BP was controlled in 74 (30.1%) and uncontrolled in 172 (69.9%) patients. Among the total, 107 (43.5%) patients were adherent and 139 (56.5%) were non-adherent to medications. Among the 107 adherent patients, 72 (67.3%) had controlled BP and 35 (32.7%) were uncontrolled. Among the 139 non-adherents, 134 (96.4%) had uncontrolled BP and 05 (3.6%) had controlled BP (p=0.000). Economically, 10.5% (n=4/38) of the ‘poor’ and 33.7% (n=70/208) of the ‘satisfactory’ patients had controlled BP whereas 89.5% (n=34/38) and 66.3% (n=138/208) had uncontrolled BP respectively (p=0.004). Age, gender, education level, duration, comorbidity, and a class of antihypertensive drugs did not affect the control of BP significantly (p>0.05). CONCLUSION: Overall, one-third of the study participants had controlled BP and two-thirds of the adherents had controlled BP. Good adherence to medications and economic status significantly correlated with the control of hypertension.
    Keywords hypertension ; blood pressure ; antihypertensive agents ; blood pressure determination ; blood pressure control ; medication adherence ; patient complianc ; calcium channel blockers ; angiotensin-converting enzyme inhibitors ; adrenergic beta-antagonists ; angiotensin receptor antagonists ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Khyber Medical University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: Management of Idiopathic Pyoderma Gangrenosum With Azathioprine As the Primary Adjunct in an Asian Man: A Case Report.

    Nazir, Alina / Zafar, Ali

    Cureus

    2022  Volume 14, Issue 5, Page(s) e25177

    Abstract: Pyoderma gangrenosum (PG) is a very rare, non-infectious, progressive inflammatory condition falling under the umbrella of neutrophilic dermatoses. It is an ulcerative condition with a wide variety of cutaneous manifestations and multiple clinical ... ...

    Abstract Pyoderma gangrenosum (PG) is a very rare, non-infectious, progressive inflammatory condition falling under the umbrella of neutrophilic dermatoses. It is an ulcerative condition with a wide variety of cutaneous manifestations and multiple clinical variants (classic ulcerative, pustular, bullous, and superficial granulomatous). Additionally, owing to similar patterns of mucocutaneous ulceration, it has certain overlaps with other neutrophilic diseases frequently observed in clinical practice. Pyoderma gangrenosum may occur in association with systemic conditions such as inflammatory bowel disease, hematological malignancies, or as a part of an inherited inflammatory syndrome. However, in rare cases, it may have an idiopathic origin as well. With no specific standardized diagnostic and treatment protocols in place, the management of pyoderma gangrenosum is primarily guided by pre-existing literature or is tailored according to the individual's disease pattern, type, and associations. Currently, the pathophysiology of pyoderma gangrenosum remains elusive at best. All the aforementioned reasons contribute significantly to PG being labeled as a "diagnostic dilemma" or more commonly as a "diagnosis of exclusion" with frequent incidences of delayed diagnosis or misdiagnosis resulting in catastrophic delays in management. A 35-year-old Asian male presented with bilateral painful, violaceous ulcers with undermined edges involving the shins for the past three months. Routine investigations carried out were indicative of an underlying infection owing to a raised leucocyte count. Discharge from the lesion, however, showed no evidence of microbial growth. The ulcer progressively increased in size, despite optimal wound care and empirical treatment. Skin biopsy demonstrated central necrosis and ulceration of the epidermis and dermis with neutrophilic infiltrates. Phenomenon of pathergy was demonstrated following the formation of a new ulcer at the site of intravenous cannulation during hospital admission. Additionally, aggravation of pre-existing ulcers following their debridement was also indicative of a positive pathergy test. Ultimately, the diagnosis of pyoderma gangrenosum was made upon the successful exclusion of all the other differential diagnoses. Presence of an associated systemic disease could not be appreciated, leading to it being labeled as a case of idiopathic pyoderma gangrenosum. Supportive treatment with non-adhesive, moist dressings was initiated along with topical tacrolimus (0.1%) application. Treatment modalities utilized were steroids and azathioprine in divided doses owing to contraindications to the traditional option of cyclosporine. The patient showed a rapid response to steroids and azathioprine. The ulcers healed with characteristic cribriform scarring within three months of initiation of treatment.
    Language English
    Publishing date 2022-05-21
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.25177
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Pathological Spectrum of Solitary Fibrous Tumours

    Zafar Ali / Asna Haroon / Ghazala Mudassir / Summera Moeen

    Journal of Rawalpindi Medical College, Vol 26, Iss

    A Study of 25 Cases Diagnosed at a Tertiary Care Institute

    2022  Volume 1

    Abstract: ABSTRACT Objective: To evaluate the clinicopathological and immunohistochemical features of Solitary Fibrous Tumor (SFT) in our hospital. Materials and Methods: This is a retrospective descriptive study. All cases of solitary fibrous tumor diagnosed on ... ...

    Abstract ABSTRACT Objective: To evaluate the clinicopathological and immunohistochemical features of Solitary Fibrous Tumor (SFT) in our hospital. Materials and Methods: This is a retrospective descriptive study. All cases of solitary fibrous tumor diagnosed on morphology from January 2012 till June 2018 were retrospectively retrieved from the histopathology department of a tertiary care hospital. The hematoxylin and eosin (H&E) stained slides as well as IHC slides were reviewed. Diagnosis was established on current standard histopathological and IHC criteria provided by World Health Organization (WHO) Classification of soft tissue tumors.8 Four micron thick sections from paraffin blocks were made of each sample and mounted onto glass slides. IHC staining for anti-STAT6 antibody (BioSB antibody, Roche kit) was available in our hospital from 2018 onwards. It was performed on all suspected cases of SFT using manufacturer’s instructions. The quality of expression was graded and interpreted as absent staining, weak expression or strong expression. The samples were graded based on diffuse (>50%) versus localized (<50% of tumor cells) staining, as well as localization of the stain within the cell (nuclear only, cytoplasmic only or both nuclear and cytoplasmic). Approval for acquisition of the tissue specimens and supporting case information and retrieval of glass slides was obtained by Institutional Review Board & Ethics Committee. Results: There were 25 cases of SFT in our study involving 12 males and 13 females. According to WHO 2013 criteria, eleven cases in our study were classified as malignant (44%) while 14 cases were in the benign group (56%). STAT6 was available in our hospital in 2018 and since then all the subsequent cases of SFT in the present study (seven in number) came positive for STAT6 (sensitivity 100%) while CD34 which was done throughout the duration of this study (January 2012-June 2018) was positive in 20 cases (86.9%) and negative in three cases (13%). Follow-up of 16 cases is available. ...
    Keywords solitary fibrous tumor ; STAT6 ; CD34 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher Rawalpindi Medical University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: POST-COVID COGNITIVE IMPAIRMENT AMONG GENERAL POPULATION OF KHYBER PAKHTUNKHWA

    Naveeda Sarwar / Saima Abid / Zafar Ali / Sanam Gul

    Khyber Medical University Journal, Vol 14, Iss 4, Pp 234-

    PAKISTAN

    2022  Volume 8

    Abstract: OBJECTIVE: To assess and compare the cognitive functioning of post-Covid patient with non-Covid person among the general population of Khyber Pakhtunkhwa province of Pakistan. METHODS: This descriptive cross-sectional study was conducted from January to ... ...

    Abstract OBJECTIVE: To assess and compare the cognitive functioning of post-Covid patient with non-Covid person among the general population of Khyber Pakhtunkhwa province of Pakistan. METHODS: This descriptive cross-sectional study was conducted from January to May 2021. Sample of 500 community members, including both post-Covid and non-Covid, from population of Khyber Pakhtunkhwa, Pakistan. Male and female with age of 18-64 years were included, age less than 18 years, having any nervous system or psychiatric illness or previous known cognitive impairment were excluded from the study. Validated Cognitive Functioning Self Reporting Scale (CFSS) questionnaire was used. Data was analyzed through SPSS V.25. RESULTS: Out of 600 approached, 500 (83.3%) participants responded to online questionnaire. Mean age of participants was 45±22 years, Majority (n=174: 34.7%) of participants were from 31- 40 years’ age group. Hypertension (n=33; 6.6%) and Diabetes Mellitus (n=30; 6%) were the most common comorbid conditions; while 378 (75.6%) had no comorbidities. Mean CFSS values was 38.4±11.5 and 42.2±12.04 for male (n=230) and female (n=270) participants respectively. Based on standard cut off values of CFSS, mild, moderate and severe cognitive impairment was observed in 46 (24.8 %), 127 (68.6%) and 12 (6.4 %) cases of post-COVID and 19 (20.4%), 73 (78.4 %) and 1 (1.0%) cases of non-COVID participants having no comorbidities. CONCLUSION: Cognitive performance was moderately affected among post COVID patients as compared to non-Covid population, compromising daily executive functioning as well as other elements of mental health such as attention, memory, spatial functioning & inhibition.
    Keywords cognitive impairment ; mental health ; descriptive cross sectional ; executive functioning ; cognitive dysfunction ; covid-19 ; general population ; Medicine ; R
    Subject code 150
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher Khyber Medical University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Transient ST Segment Elevation in Two Patients with COVID-19 and a Normal Transthoracic Echocardiogram

    Talal Asif / Zafar Ali

    European Journal of Case Reports in Internal Medicine (2020)

    2020  

    Abstract: We continue to learn about cardiac involvement in patients with COVID-19. These patients can develop acute coronary syndrome and severe myocarditis with a reduced ejection fraction. We describe two critically ill COVID-19 patients who developed ST ... ...

    Abstract We continue to learn about cardiac involvement in patients with COVID-19. These patients can develop acute coronary syndrome and severe myocarditis with a reduced ejection fraction. We describe two critically ill COVID-19 patients who developed ST elevation that resolved on repeat ECG without any intervention.
    Keywords st segment elevation ; covid-19 ; Medicine ; R ; covid19
    Language English
    Publishing date 2020-04-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article: Preparedness of Medical Graduates to serve in clinical settings independently: An exploratory qualitative study.

    Choudry, Zafar Ali / Ayub, Ayesha / Badar, Sumera Ehsan

    Pakistan journal of medical sciences

    2022  Volume 38, Issue 4Part-II, Page(s) 785–790

    Abstract: Objectives: To assess the preparedness of fresh medical graduates to perform the duties of an effective house officer in clinical settings independently.: Methods: A qualitative exploratory descriptive study was conducted at a public sector tertiary ... ...

    Abstract Objectives: To assess the preparedness of fresh medical graduates to perform the duties of an effective house officer in clinical settings independently.
    Methods: A qualitative exploratory descriptive study was conducted at a public sector tertiary care teaching hospital from September to October, 2021. A total of 14 interviews of the serving house officers were conducted (7 were from Medicine and Allied and seven were from Surgical and Allied). A verbatim Thematic analysis was done.
    Results: Initial analysis revealed 45 codes which were ultimately reduced to five main themes namely
    Conclusion: Medical graduates are not confident and well prepared to take the responsibility of patient care independently in clinical settings. Reforms in undergraduate curricula regarding skill training, hospital setup and workings and inter-professional education are advocated by young doctors to enhance their competencies for professional life.
    Language English
    Publishing date 2022-05-18
    Publishing country Pakistan
    Document type Journal Article
    ZDB-ID 2032827-8
    ISSN 1681-715X ; 1682-024X ; 1017-4699
    ISSN (online) 1681-715X
    ISSN 1682-024X ; 1017-4699
    DOI 10.12669/pjms.38.4.5517
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Towards the Optimal Use of Machine Learning Algorithms in Text Mining

    Syed Zafar Ali Shah / Sadaqat Jan / Ibrar Ali Shah

    University of Sindh Journal of Information and Communication Technology, Vol 6, Iss 3, Pp 89-

    A Quick Review

    2022  Volume 94

    Abstract: This paper aims to provide a quick review to jump-start the research in the field of text mining where Machine Learning (ML) algorithms have been used and several accomplishments have been reported by the research community. There are different ... ...

    Abstract This paper aims to provide a quick review to jump-start the research in the field of text mining where Machine Learning (ML) algorithms have been used and several accomplishments have been reported by the research community. There are different categories of text mining, and the implementation of ML algorithms and techniques have been supported in the literature to give promising results. However, in this area of study, most of the research activities in terms of time and efforts are consumed during the initial stages where implementations and experiments are carried out to evaluate various combinations. The accomplishments in this field can be further advanced by presenting early investigations concisely and analytically. Thus, the benefits of this paper are threefold: first, it will provide a platform for the new researchers to start quickly with a shorter literature review and knowing more precisely about the combinations of text mining and ML; secondly, clear analysis has been presented about the text mining categories where the performance of ML algorithms have been reported successful; and lastly, the problems have been identified for which the algorithms were used in various studies. This will enable the new researchers to directly target the problem instead of implementing the existing techniques. With the help of well-structured questions, the results are more analytical and present multidimensional views to this research issue. Main findings include that ML has been widely used in document classification and Support Vector Machine (SVM) is the most successful algorithm reported.
    Keywords text mining ; machine learning ; sentiment analysis ; support vector machine ; Information technology ; T58.5-58.64 ; Electronic computers. Computer science ; QA75.5-76.95
    Subject code 006
    Language English
    Publishing date 2022-09-01T00:00:00Z
    Publisher University of Sindh
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Book ; Online: Sensing the Environment with 5G Scattered Signals (5G-CommSense)

    Jana, Sandip / Mishra, Amit Kumar / Khan, Mohammed Zafar Ali

    A Feasibility Analysis

    2023  

    Abstract: By making use of the sensors and AI (SensAI) algorithms for a specialized task, Application Specific INstrumentation (ASIN) framework uses less computational overhead and gives a good performance. This work evaluates the feasibility of the ASIN framework ...

    Abstract By making use of the sensors and AI (SensAI) algorithms for a specialized task, Application Specific INstrumentation (ASIN) framework uses less computational overhead and gives a good performance. This work evaluates the feasibility of the ASIN framework dependent Communication based Sensing (CommSense) system using 5th Generation New Radio (5G NR) infrastructure. Since our proposed system is backed up by 5G NR infra, this system is termed as 5G-CommSense. In this paper, we have used NR channel models specified by the 3rd Generation Partnership Project (3GPP) and added white Gaussian noise (AWGN) to vary the signal to noise ratio at the receiver. Finally, from our simulation result, we conclude that the proposed system is practically feasible.

    Comment: 3 pages, Accepted in conference
    Keywords Electrical Engineering and Systems Science - Signal Processing
    Publishing date 2023-01-10
    Publishing country us
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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