8 research outputs found
Education Of females And impact On fertility
No full textAbstract are not provided by the author/publishe
Evaluating the publications output of Pakistan Journal of Information Management and Libraries based on the Scopus Database
No full textAim: This study is aimed to evaluate the bibliometric parameters of the literature published in the Pakistan Journal of Information Management and Libraries (PJIM&L) for the period of 2010 to 2019 and indexed in the Scopus database.
Methods: The retrospective method has been applied to the dataset that was downloaded from the Scopus-Elsevier database on 5th January 2021. Two source titles PJIM&L, and its earlier version “Pakistan Journal of Library and Information Science”, were selected and all the available bibliographic records of publications were downloaded in Comma Separated Value (CSV) file for analysis. The data was examined by chronological order, by the pattern of authorship and enlist the productive authors, further distribution of documents by affiliated country, keywords occurrence and most cited papers were presented. Statistical Package for Social Sciences (SPSS) was used to calculate the Mean and Standard Error of Means and the VOSviewer software was applied to visualize the keywords occurrence and author’s productivity.
Results: A total of 96 papers were identified by the Scopus database published in PJIM&L between 2010 to 2019 with an average of 9.6 papers per year with an average annual growth rate of 44.89. These papers were written by 127 authors and most of the papers (n=37; 40.21%) were written by a two-author pattern. Kanwal Ameen has emerged as a most productive author and most of the papers were contributed by the authors who belonged from Lahore and University of the Punjab found a productive institution. The research contributions from 15 foreign countries showed that international authors have trust in the credibility of the journal. Top-cited papers with their number of citations in Scopus and Google Scholar have been identified.
Conclusion: PJIM&L is a reputed and internationally recognized LIS journal. The citation analysis showed that its papers are being cited regularly worldwide. There is a need to change the frequency of publications from annual to biannual to attract more researchers
An excerpt from Urmila Pawar\u27s Autobiography
No full textThe term "Dalit literature" is used to describe works written by authors from the Dalit ethnic minority. The hardships and triumphs of the Dalit people were mirrored in this body of writing. It also revealed their uphill battle in life to the outside world. They are victims of centuries of discrimination and oppression at the hands of those in power in their own nation. Social transformation in this society owes a great deal to the efforts of notable individuals like B.R. Ambedkar. Dalit writings have emphasized the rights and agency of the Dalit community. Many authors of Dalit descent have written on the difficulties inherent in their language and culture. They questioned the privilege of the higher caste and advocated for the adoption of vernacular speech. Several Dalit authors have achieved widespread acclaim for their works. There are several famous authors from India, like Bama (K.R. Meera), Om Prakash Valmiki, Chetan Divate, Urmila Pawar, and Daya Pawar. Urmila Pawar is a well-known Marathi author and activist. She has achieved widespread renown as a writer due to the autobiographical nature of her books. Her works are impacted by both her time as a student and her time as an educator.
 
Efficacy and safety of oral GnRh antagonists in patients with uterine fibroids: A systematic review
No full textObjective: This review aimed to assess the efficacy and safety of GnRH antagonists in patients with symptomatic uterine fibroids.Data sources: A literature search was performed on PubMed, Web of Science, Embase, Cochrane, and clinicaltrials.gov using the MeSH and Emtree terms Leiomyoma and Gonadotropin-Releasing Hormone. Study selection: All clinical trials that provided efficacy and safety data in clinical terms (i.e., reduction in menstrual bleeding and discomfort, changes in the size of leiomyoma and uterine volume, etc.) were included. We excluded all preclinical studies, case reports, meta-analyses, review articles, and clinical studies irrelevant to the study question.Data extraction and synthesis: Two authors extracted data from 9 clinical studies. The extracted data included the study\u27s characteristics, participants\u27 baseline characteristics, treatment drugs, efficacy measures, and toxicity.Conclusion: Among oral GnRH antagonists, relugolix, elagolix, and linzagolix were safe in patients with uterine fibroids. These drugs, alone, and in combination with estradiol/norethindrone acetate (E2/NETA), showed significantly better efficacy than placebo in improving bleeding, discomfort, uterine/leiomyoma sizes, and quality of life in premenopausal patients with symptomatic uterine fibroids. However, more randomized double blind multicenter clinical trials are needed to confirm these results and to see long-term benefits
Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries
No full text© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
No full text© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research
The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy
No full textBackground: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p < 0.001), with the proportions of operations lasting > 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care.</p
Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy
No full textBackground:
A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.
Methods:
Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.
Results:
A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001).
Conclusion:
We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty
