Shaikh Zayed Medical Complex Lahore

The COVID-19 pandemic has profoundly impacted healthcare systems worldwide, necessitating the development of rapid and accurate diagnostic tools. The study aimed to compare the performance of a Rapid Antigen Test (RAK) with reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 diagnosis, considering its global usage, promising data, and the convenience of using saliva samples. Methods — A cross-sectional, single-blinded study was conducted in Lahore, Pakistan, using 7,580 samples collected between May 2021 and June 2022. Three hundred twenty samples were tested with RAK and RT-PCR using logistic regression analysis to look at sensitivity, specificity, and accuracy and whether there was a link between RAK results and RT-PCR cycle threshold values. Results — Overall, the RAK demonstrated 67% sensitivity and 75% specificity. Likelihood ratios were 2.71 (positive) and 0.43 (negative). The disease prevalence was 70.00%. PPV and NPV were 86.36% and 50.00%, respectively. Logistic regression showed a significant association between RAK results and RT-PCR CT values (odds ratio=6.333). Kit sensitivity varied by viral load: 100% at CT≤20, 63% at CT 21-25, and 22% at CT>26. Conclusion — This study would provide an insight to the work efficiency of commercially used rapid antigen based COVID-19 screening kit.

BACKGROUND: Neurosurgery is a rapidly advancing surgical specialty. Social media has significantly impacted the landscape of advancements in the field of neurosurgery. Research on the subject of neurosurgery and social media plays a vital role in combating disability and mortality due to neurological diseases, especially in trauma-affected individuals by increasing cooperation and sharing of clinical experiences between neurosurgeons via social media. This study aimed to evaluate the global neurosurgery and social media research performance from 2004 to 2023. - METHODS: All the data for neurosurgery and social media-related research publications from 2004 to 2023 were extracted from the Web of Science database and a comprehensive analysis was performed on the R-bibliometrix package. - RESULTS: An increasing number of publications with an annual growth rate of 22.04% was observed, with >91% of total articles published in the last decade. The United States, the United Kingdom, Italy, France, Canada, and India made up of more than 67% of the global contribution. Out of 1449 authors, Chaurasia B was the most productive with 14 publications and the most globally cited document was JEAN WC, 2020 with 117 citations. The University of Cambridge was the leading institutional affiliation. World Neurosurgery was the most productive with >60 articles. CONCLUSIONS: Exploring neurosurgery on social media enhances global collaboration, utilizing dynamic platforms for real-time knowledge exchange and holds immense potential for the field's global advancement.

Moyamoya disease (MMD) is considered a primary disorder of an unknown etiology. In contrast, Moyamoya syndrome (MMS) refers to MMD associated with other underlying diseases, such as meningitis in childhood, neurofibromatosis type II, Down syndrome, cranial irradiation, and different types of anemias, particularly hemoglobinopathies. We aimed to provide a comprehensive clinicopathological overview of MMS. All case reports and case series published from 2000 to 2023 pertaining to MMD were included in the study. Case studies, original articles, editorials, letters to editors, and clinical images were excluded. The search was conducted using the Boolean operators ("AND" and "OR") on PubMed and Google Scholar. A total of 13 case reports and one case series study were included. The study suggests infection might be a trigger in susceptible individuals. The autoimmune antibody findings (anti-double stranded DNA IgG) suggest a potential autoimmune component in some cases. There were diverse presentations and outcomes of post-infectious MMS, with a striking predominance of pediatric cases (66.66%) and a possible female predominance. Both computerized tomography (CT) and magnetic resonance imaging (MRI) showed evidence of restricted blood flow. CT showed that stenosis, occlusion, and collateral formation were frequent vascular findings, but often unspecified in severity. Infarction, hypodensities, and hematoma were the most common parenchymal findings (22.22% each). The findings on MRI were stenosis (50%) and collateral formation (44.44%). Infarction was the most common finding (66.66%) in parenchyma. Hydrocephalus, encephalomalacia, and atrophy were less frequent. Lesions were most frequent in the internal carotid artery (66.66%), middle cerebral artery (66.66%), and anterior cerebral artery (50%). Lesions were less frequent in the posterior cerebral, vertebral, and basilar arteries. The frontal lobe (38.89%) and basal ganglia (33.33%) were commonly affected parenchymal regions. The most common risk factor was human immunodeficiency virus (HIV) infection (50%), followed by trisomy 21, cryptococcal, and other types of meningitides. Aspirin (50%) and antiretroviral therapy (38.89%) were the cornerstones of treatment for MMS. This review accentuates the noteworthy obstacles presented by post-infectious MMS, especially its catastrophic effect on children and its correlation with HIV/AIDS. According to our elaborate literature search using PubMed and Google Scholar, this is the first narrative review in the existing scientific literature summarizing the literature on post-infectious MMS.

Bacckground: Swine flu is a viral disease affecting upper as well as lower respiratory tracts. Due to limited resources in a developing country like Pakistan, medical students (the future medical practitioners) should be familiar with the basic knowledge, attitude and practice regarding this infectious disease so that they can help the community during its outbreaks. Objective: To determine the basic knowledge and awareness of swine flu among the medical students of Shaikh Zayed Medical College, Rahim Yar Khan. Methodology: This cross sectional observational study was carried out among the medical students of Shaikh Zayed Medical College, Rahim Yar Khan during April – May 2019 through a pre-designed pro-forma. A total of three hundred pro-forma were distributed in all classes of MBBS from first year to final year, among which 211 were returned, completely filled by the respondents. The responses of 45 students were disregarded as they hadn’t heard about swine flu. Remaining 166 questionnaires were included in the study and further analyzed for results. Data was then analyzed with SPSS version 22.0. Results: Majority of respondents (n=151, 91%) correctly replied “virus as its causative agent”. Majority of respondents (n=138, 83.1%) responded “respiratory droplet as mode of transmission”. One hundred and sixty six questionnaires were further analyzed for results. Regarding treatment and prevention of swine flu, 123 (74.1%) replied it as treatable disease and a significant number of students (n=154, 92.8%) deemed it as preventable. About half (45.8%) of participants did not know about vaccine availability in Pakistan and only 42 (25.3%) students correctly answered that vaccination was the best measure to prevent swine flu. Conclusion: Satisfactory results were seen about knowledge and awareness regarding epidemiology, etiology and mode of transmission. However, deficiencies were seen in awareness about vaccination and prevention of swine flu. So there is a need for health education awareness programs in medical and dental schools on regular basis.

Heart failure (HF) patients frequently present with comorbidities such as atrial fibrillation (AF) or other cardiovascular conditions, elevating their risk of thromboembolic events. Consequently, anticoagulation therapy is often considered for thromboprophylaxis, although its initiation in HF patients is complicated by concomitant bleeding risk factors. This review explores the paradoxical relationship between HF, increased bleeding risk, and the potential benefits of anticoagulation. Through an examination of existing evidence from clinical trials, observational studies, and meta-analyses, we aim to elucidate the role of anticoagulation in HF patients with increased bleeding risk. Despite guidelines recommending anticoagulation for certain HF patients with AF or other thromboembolic risk factors, uncertainty persists regarding the optimal management strategy for those at heightened risk of bleeding. The review discusses the pathophysiological mechanisms linking HF and thrombosis, challenges in bleeding risk assessment, and strategies to minimize bleeding risk while optimizing thromboprophylaxis. Shared decision-making between clinicians and patients is emphasized as essential for individualized treatment plans that balance the potential benefits of anticoagulation against the risk of bleeding complications. Furthermore, it examines emerging anticoagulant agents and their potential role in HF management, highlighting the need for further research to delineate optimal management strategies and inform evidence-based practice. In conclusion, while anticoagulation holds promise for improving outcomes in HF patients, careful consideration of patient-specific factors and ongoing research efforts are essential to optimize therapeutic strategies in this population.