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Effect of early thrombolysis on the clinical outcome of ventricular septal rupture in patients with myocardial infarction
Get PDFBackground: Ventricular septal rupture is one of the most lethal complications of myocardial ischemia with timely treatment preventing the catastrophic results for the patients.1 Objective: To determine whether early thrombolysis’ in patients with VSR increases or decreases mortality and to assess the risk factors for development of VSR in patients with ST elevation MI. Materials and Methods: This cross-sectional study was done at Peshawar Institute of Cardiology after the approval of synopsis from ethical research committee of the institution bearing IRC/23/54 dated 28 September 2023. The sample size was 34 and method was non-probability convenient. The inclusion criteria were all those patients who had acute myocardial infarction and detectable VSR on ECHO. Data collection will be started after IRB approval. All patients admitted via ER to CCUs and diagnosed as cases of VSR through clinical exam and ECHO findings. Descriptive analysis was employed to find out the mean age and Chi Square test and Pearson Correlation was employed to compare the outcomes of the patients after receiving thrombolysis with a p value of less than 0.05 as significant
The impact of medication therapy management services on patient outcomes
Get PDFThis extensive analysis investigates the influence of Medication Therapy Management (MTM) services on patient outcomes, specifically emphasizing medication adherence, health-related quality of life, healthcare usage, and cost savings. We performed a comprehensive review and meta-analysis of relevant literature over the last decade to assess the efficacy of MTM services. The study included research that encompassed a wide range of patient demographics, with particular emphasis on individuals with chronic ailments and the elderly. The analysis demonstrated that MTM interventions had a substantial impact on enhancing drug adherence, leading to a noteworthy 10% rise in adherence rates when compared to conventional treatment. Moreover, MTM services have shown beneficial impacts on the health-related quality of life, especially in patients with chronic ailments like diabetes and hypertension. Patients who received MTM services reported enhanced physical and mental health ratings, suggesting a more extensive influence on their overall well-being. Furthermore, it was shown that MTM services effectively decrease healthcare consumption, resulting in a decrease in hospitalizations and trips to the emergency room. Significantly, those suffering from heart failure and numerous chronic ailments saw a noteworthy 20% decline in hospitalizations and a 15% drop in visits to the emergency room, respectively. 
Personalized approaches to cardiovascular care for the elderly-patient centered care
Get PDFIntroduction: The aging population in the United States is set to expand significantly by 2050, with over 80 million Americans aged 65 and older. This demographic faces complex health challenges, including high rates of cardiovascular diseases often accompanied by multimorbidity. Traditional disease-specific guidelines, which do not account for the multifaceted nature of aging, leave gaps in managing these conditions effectively. Aim: This review aims to propose a framework for integrating personalized, patient-centered approaches into cardiovascular care for the elderly. The focus is on addressing the unique needs of this population through comprehensive, goal-directed care. Methods: The review synthesizes current literature and guidelines from major cardiovascular and geriatric organizations, including the American College of Cardiology (ACC) and the European Society of Cardiology (ESC). It discusses the integration of patient goals, comprehensive geriatric assessments, and proactive management of aging-related risks, including polypharmacy, falls, and frailty. Results: The review highlights the importance of incorporating patient preferences and values into treatment decisions. It finds that goal-directed care, informed by comprehensive assessments and proactive management, can enhance treatment adherence, reduce low-value care, and improve overall quality of life for older adults with cardiovascular diseases. 
Exploring the future of surgical practices: Advances in minimally invasive techniques and the integration of robotic technology
Get PDFBackground: Robotic-Assisted Minimally Invasive Surgery (RAMIS) represents a significant advancement in surgical techniques, leveraging robotic systems to enhance precision, reduce invasiveness, and improve patient outcomes. The da Vinci surgical system has been a leading example, demonstrating the potential of robotic assistance in minimally invasive procedures. Aim: This paper explores the evolution of RAMIS, focusing on technological advancements, integration with Artificial Intelligence (AI), and future directions in surgical robotics. Methods: The study reviews the development and current state of RAMIS technologies, including the historical background, state-of-the-art systems, and emerging innovations. It analyzes data from a range of sources including literature reviews, market reports, and recent research developments. Results: RAMIS systems, particularly the da Vinci surgical system, have achieved widespread adoption due to their advanced features, such as enhanced vision, improved ergonomics, and training programs. Recent advancements include AI integration, new sensor technologies, and enhanced imaging modalities. Despite these improvements, challenges remain in achieving higher levels of autonomy and addressing cost and regulatory issues. Conclusion: RAMIS continues to evolve with significant advancements in AI, haptic feedback, and simulation technologies. Future developments are expected to further enhance surgical precision and outcomes. 
Autoimmune disorders: Mechanisms, diagnosis, and the future of therapeutic approaches-review article for healthcare staff about autoantibodies
Get PDFBackground: Autoimmune disorders, characterized by the presence of autoantibodies, play a critical role in disease pathogenesis through their interaction with self-antigens. These immunoglobulins can induce inflammation and tissue damage by mediating immune responses against the body’s own cells. Aim: This review aims to provide a comprehensive overview of functional autoantibodies, focusing on their mechanisms of action, origins, and implications in both autoimmune and non-autoimmune conditions. Methods: The review synthesizes findings from recent literature regarding the classification of functional autoantibodies based on their pathogenic mechanisms, including receptor activation, blockade, and neutralization. It also examines the role of tumors, infections, and immunodeficiency in the generation of these autoantibodies. Results: Functional autoantibodies can activate or inhibit receptors, induce receptor internalization, and disrupt protein interactions, contributing to various autoimmune diseases such as Graves' disease and myasthenia gravis. Emerging evidence links functional autoantibodies to non-autoimmune conditions, particularly in the context of infections like COVID-19. Conclusion: A nuanced understanding of functional autoantibodies is essential for advancing diagnostic and therapeutic approaches in autoimmune disorders. Further research is warranted to elucidate their complex roles in health and disease
Non-traumatic headache as an emergent conditions-role of MRI: A review article
Get PDFBackground: Non-traumatic headaches are a prevalent neurological issue in emergency departments, affecting about 1–4% of patients. These headaches can be classified as primary or secondary, with the latter posing a risk of severe complications. Neuroimaging is critical for identifying secondary headache causes, with CT traditionally used to reveal abnormalities in 13–15% of patients. MRI offers superior soft tissue imaging without ionizing radiation, yet its use in emergency settings remains under-explored. Risk scoring systems have been developed to guide imaging decisions, focusing on patient age, neurological deficits, and other symptoms as predictors of intracranial pathology. Aim: This review aims to evaluate the role of MRI in diagnosing non-traumatic headaches in emergency settings and to analyze clinical guidelines for its appropriate use. Methods: A retrospective investigation was conducted on emergency patients presenting with non-traumatic headaches, analyzing MRI findings, demographics, and clinical presentations. Results: MRI identified significant abnormalities in approximately 20% of patients. Factors such as age, smoking status, and signs of infection correlated with abnormal findings, while a history of migraine appeared protective. The predictive model for identifying significant imaging outcomes showed limited clinical utility. Conclusion: MRI is a valuable tool in assessing non-traumatic headaches in emergency departments, particularly in high-risk patients. 
The importance of histopathological evaluation in cancer diagnosis and treatment
Get PDFBackground: Histopathological evaluation is a cornerstone in cancer diagnosis and treatment, providing critical insights into tumor biology, grading, and staging. Accurate histopathology informs clinical decision-making, ensuring tailored therapeutic approaches. Aim: This article aims to elucidate the importance of histopathological examination in diagnosing cancer, guiding treatment decisions, monitoring responses, and contributing to research advancements. Methods: A comprehensive review of literature was conducted, including prospective and retrospective studies that assess the value of histopathological examination in cancer diagnosis and treatment. Results: Histopathological analysis accurately identifies malignancies, guides tumor grading and staging, and detects biomarkers that influence treatment. It also facilitates monitoring of treatment responses and disease progression. Furthermore, it plays a vital role in cancer research and clinical trials, contributing to the development of novel therapies. Conclusion: Histopathological evaluation is indispensable for effective cancer management, ensuring precise diagnoses, appropriate treatments, and improved patient outcomes. Enhanced collaboration between pathologists and clinicians is essential for optimizing cancer care
Challenges and solutions in medical record keeping and data security
Get PDFThis literature review analyzes the challenges and solutions associated with the security and privacy of electronic health records (EHR). The extensive implementation of electronic health records (EHRs) provides advantages, including cost savings and enhanced quality of care, yet it also presents considerable vulnerabilities. Patient concerns regarding data protection are significant, driven by fears of unauthorized access and data breaches. This review examines the security risks associated with EHR systems, emphasizing three primary categories of safeguards: administrative, physical, and technical. This study examines the challenges presented by the Internet of Things (IoT) in relation to Electronic Health Records (EHRs), emphasizing the necessity for strong security protocols to manage heterogeneity, uncontrolled environments, and scalability requirements. This paper examines diverse security solutions, such as encryption and access control mechanisms, including Role-Based Access Control (RBAC), while emphasizing the significance of a multidisciplinary approach in the management of Electronic Health Record (EHR) systems. The rising frequency of cyberattacks on healthcare organizations highlights the necessity for proactive risk management strategies, which should encompass regular security audits, staff training, and the establishment of robust physical and technical safeguards. 
Effect of exercise and light exposure on sleep and sleep related factors in elderly women
Get PDFAs we enter an aging society due to increasing life expectancy, there are many social pathology problems such as generation conflict. This study is intended to find out the effects of sunlight on elderly women’s sleep related elements. Participants of this study are 40 elderly women (age 70.5±3.5years, height 155.8± 4.3cm, weight 67.8± 4.1kg) who haven’t engaged in planned exercise or nourishment control for one year. The participants were randomly divided into four groups of sunlight group, exercise group, sunlight and exercise combination group, and control group, and 10-week-long experiment was done. Regarding sleep quality related items and sleep related hormone changes according to the experiment, One-way ANOVA analysis and Duncan post-hoc were done, and the results are as follows. Regarding the bedtime among the quality of sleep, the combination group fall asleep the soonest followed by the exercise group, the sunlight group, and the control group. The combination group also woke up the earliest followed by the sunlight group, the exercise group, and the control group. Regarding the potential sleep time (time to take until falling asleep), the combination group had the shortest time followed by the sunlight group, the exercise group, and the control group
Women’s empowerment and current contraceptive use among married women in Punjab: In-depth analysis of PDHS 2017-18
Get PDFBackground: It is well-known fact that less empowered married women have less uptake of contraception. Indicators of women’s empowerment and demographic characteristics have strong influence on current use of contraceptive methods. The core objective of this paper is to assess the relationship between the indicators of women’s empowerment (women’s participation in household decision making, ownership of assets and control over her income) and current contraceptive use. Methods and Materials: In the PDHS2017-18, 10825 married women of reproductive age (15-49 years) were covered in the province of Punjab, Province. Association between indicators of women’s empowerment and current contraceptive use are showed by using descriptive analysis, Cross-tabulation and Chi-Square test. Multi-variate binary logistic regression is performed to assess the net effect of indicators of women’s empowerment and background characteristics on the current use of contraceptive methods. Results: Results show that women’s empowerment is a recognized tool to improve the current use of contraceptive. It is also observed that women who have not participation in household decision making, women who have not ownership of any assets and women who have not control over own income have less use of any contraceptive methods.