Indocyanin Green Fluorescence Evaluation of Colonic Perfusion During Elective Open Abdominal Aortic Aneurysm Repair.

Objectives: Colonic ischaemia is a rare but devastating complication of open aortic aneurysm repair and is associated with high morbidity and a mortality of up to 50%. The aim of this study was to determine the safety and effectiveness of using indocyanin green florescence (ICG) to interrogate colonic perfusion intra-operatively.

Design: Prospective observational study.

Impact assessment of Intensified Malaria Control Project in transitioning a high malaria-endemic district to a low-endemic district: an epidemiological aspect.

Intensified Malaria Control Project (IMCP) was implemented in 2005 to control malaria in all North-Eastern and Odisha states of India. The present study aimed to investigate the impact of IMCP in reducing the malaria burden in Udalguri district, Assam state of North-East India. Malaria epidemiological data were obtained for IMCP intervention (Udalguri) and nonintervention district (West Singhbhumi, Jharkhand state).

Mental health assessment of healthcare workers in the emergency department of a low middle-income country during COVID-19 pandemic.

Introduction: Emergency department (ED) healthcare workers in Pakistan during the COVID-19 pandemic are facing an acute rise in mental illnesses. In this study, the authors aim to assess the frequency of anxiety and depression among healthcare workers in the ED.

Methods: A cross-sectional online google form-based survey was conducted in the ED of Aga Khan University Hospital, Karachi, Pakistan between July and August 2020.

Does small bite closure reduce the incidence of incisional hernia compared to standard mass closure for midline laparotomy?

A best evidence topic was constructed using a defined protocol. The three-part question addressed was: in closure of midline laparotomy, which technique had lower incidence of incisional hernia: small bite closure or mass closure? The best evidence demonstrated that small bite technique has lower incidence of hernia.

Does the eversion technique have a lower early postoperative stroke rate than the conventional technique in carotid endarterectomy?

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In carotid surgery, Does the eversion technique (ECEA) has an early postoperative lower stroke rate, As compared to conventional carotid endarterectomy (CCEA)? The outcome assessed was the stroke rate in the early potoperative period (30 days) in the two techniques. The best evidence confirmed that there is no statistically significant difference between ECEA and CCEA regarding the early postoperative stroke incidence.

Stroke incidence between stenting and endarterectomy for asymptomatic carotid artery stenosis.

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with significant asymptomatic carotid artery stenosis (ACAS), Does Carotid artery stenting (CAS) has a peri-procedural lower Stroke rate, As compared to Carotid endarterectomy (CEA)? The outcomes assessed were the stroke rate in the two management modalities. The best evidence showed no statistically significant difference between CAS and CEA regarding the peri-procedural and the long-term non-procedural stroke incidence.

Moderate Rainfall and High Humidity During the Monsoon Season, Negligence in Using Malaria Protection Methods and High Proportion of Mild Symptomatic Patients Were the Driving Forces for Upsurge of Malaria Cases in 2018 Among Tea Tribe Populations in Endemic Dolonibasti Health Sub-center, Udalguri District, Assam State, North-East India.

Malaria elimination is a global priority, which India has also adopted as a target. Despite the malaria control efforts like long-lasting insecticidal nets distribution, rounds of indoor residual spray, the introduction of bi-valent rapid diagnostic tests and artemisinin combination therapy, malaria remained consistent in Dolonibasti sub-center of Orang block primary health center (BPHC) under the district Udalguri, Assam state followed by abrupt rise in cases in 2018. Therefore, we aimed to investigate the factors driving the malaria transmission in the outbreak area of Dolonibasti sub-center.

Development and On-Field Deployment of a Mobile-Based Application 'MoSQuIT' for Malaria Surveillance in International Border Districts of Northeast India-Challenges and Opportunities.

The conventional paper-based system for malaria surveillance is time-consuming, difficult to track and resource-intensive. Few digital platforms are in use but wide-scale deployment and acceptability remain to be seen. To address this issue, we created a malaria surveillance mobile app that offers real-time data to stakeholders and establishes a centralised data repository.

Infraclavicular arterio-arterial prosthetic loop is a safe and effective vascular access technique for haemodialysis in frail patients: a prospective observational study.

Vascular access failure causes significant morbidity among end stage renal failure patients. With the increased life expectancy and frailty of those patients, maintaining vascular access became a great challenge. In this study, we assess the short and midterm outcomes of infraclavicular arterio-arterial prosthetic loop (IAAPL) as vascular access for haemodialysis in frail patients who have exhausted conventional vascular access methods.

The survival rate among endovascular and open surgical repair of abdominal aortic aneurysms.

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with Infrarenal abdominal aortic aneurysm (AAA), Does endovascular abdominal aortic repair (EVAR), AS compared to open surgical repair (OSR), has higher Survival rates? The outcomes assessed were the overall survival rates in both techniques. The best evidence showed that there is no statistically significant difference between EVAR and OSR in survival rates.

Incidence of secondary rupture after abdominal aortic aneurysms (endovascular vs. open surgical repair).

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with Infrarenal abdominal aortic aneurysm (AAA), Does endovascular abdominal aortic repair (EVAR), AS compared to open surgical repair (OSR), has lower secondary rupture rates? The outcomes assessed were the secondary rupture rate in both techniques. The best evidence showed that The OSR has statistically significant lower secondary rupture rates than the EVAR.

Re-intervention rate in endovascular vs open surgical repair for abdominal aortic aneurysms.

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with Infrarenal abdominal aortic aneurysm (AAA), Does endovascular abdominal aortic repair (EVAR), AS compared to open surgical repair (OSR), has lower re-intervention rates? The outcomes assessed were the re-interventional rates in both techniques. The best evidence showed that the OSR has lower statistically significant difference rates in re-intervention rates than the EVAR.

Incidence of anal incontinence among patients with anal fissure treated with Botox injection versus lateral sphincterotomy.

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients with anal fissure, which technique has a lower of incidence anal incontinence: Botox injection or lateral sphincterotomy? The best evidence showed that Botox injection has lower incidence of incontinence.

Upper gastrointestinal bleed in a toddler - an unusual encounter revealing foreign body ingestion.

Foreign body (FB) ingestion is common in children; however, management varies based on the object ingested, its location and clinical presentation. Urgent intervention is needed if any warning signs are present. We describe the case of a four-year-old child who presented with acute onset of life-threatening upper gastro intestinal bleeding.

Frequency of Exposure of Nephrotoxic Drugs and Drug-Induced Acute Kidney Injury in Pediatric Intensive Care Unit: A Retrospective Review From a Tertiary Care Centre in Pakistan.

Introduction Acute kidney injury (AKI) is one of the most common problems seen in the pediatric intensive care unit (PICU), with an overall 27% incidence. Besides many other factors, nephrotoxic medications (Nephrotoxins; Ntx) are also responsible for a large proportion of potentially avoidable pediatric AKI, directly accounting for 16% of AKI events. Objective To assess potential associations between nephrotoxic drugs and the risk of developing AKI in children admitted in PICU.

SARS-CoV-2 isolation from an appendix.

Efforts to recognize SARS-CoV-2 infection have focused on respiratory symptoms such as cough and shortness of breath. Although it is also well known that SARS-CoV-2 infection can cause gastrointestinal symptoms such as abdominal pain, nausea, vomiting and diarrhoea, there are emerging reports of SARS-CoV-2 infection causing surgical pathology. We present the first case report of SARS-CoV-2 infection directly causing acute appendicitis, first suspected due to highly atypical histological features and later confirmed as polymerase chain reaction positive appendicular tissue sample.

Pneumomediastinum in COVID-19 patients: a case series of a rare complication.

Pneumomediastinum is a rare clinical finding, but one which can be the source of significant concern for clinicians. By presenting 3 such cases, we highlight that pneumomediastinum can complicate the course of a severe coronavirus disease 2019 infection but emphasize that conservative management is the first-line method of treatment, with gradual resorption of the air from the tissues. It is important to be alert to the development of pneumothorax, which will require drainage.

Frequency of Pediatric Acute Respiratory Distress Syndrome Based on Oxygen Saturation Index in Pediatric Intensive Care Unit of a Developing Country.

Objectives To determine the frequency of pediatric acute respiratory distress syndrome based on oxygen saturation index in pediatric intensive care unit of a developing country. Methods We conducted a retrospective study of all children admitted in pediatric intensive care unit (PICU) of Aga Khan University Hospital, Karachi from July 2017 to June 2018 with respiratory rate >40 breaths/minute, shortness of breath, and bluish discoloration of skin and mucous membranes. The diagnosis of acute respiratory distress syndrome (ARDS) was made on the basis of standard operational definitions as mentioned (fulfilling criteria for ARDS).

Effects of longitudinal pavement edgeline condition on driver lane deviation.

Single vehicle crashes, particularly those classified as run-off-the-road, are very common on two-lane rural highways. One method to potentially reduce such crashes is to provide additional driver information in the form of wider longitudinal edgeline pavement markings. However, since these markings deteriorate over time, the primary objective of this research was to study the effects of longitudinal edgeline pavement markings with varying deterioration levels and widths and to assess a driver's ability to maintain lane position.

Cystic Adenomatoid Odontogenic Tumor.

Adenomatoid Odontogenic Tumor (AOT) is a well-established benign epithelial lesion of odontogenic origin. Rightfully called "the master of disguise," this lesion has been known for its varied clinical and histoarchitectural patterns. Not only does AOT predominantly present radiologically as a unilocular cystic lesion enclosing the unerupted tooth (which is commonly mistaken as a dentigerous cyst) but the lesion also presents rarely with a cystic component histopathologically.

Potential crash reduction benefits of shoulder rumble strips in two-lane rural highways.

This paper reports the findings from a study aimed at examining the effectiveness of shoulder rumble strips in reducing run-off-the-road (ROR) crashes on two-lane rural highways using the empirical Bayes (EB) before-and-after analysis method. Specifically, the study analyzed the effects of traffic volume, roadway geometry and paved right shoulder width on the effectiveness of shoulder rumble strips. The results of this study demonstrate the safety benefits of shoulder rumble strips in reducing the ROR crashes on two-lane rural highways using the state of Idaho 2001-2009 crash data.

Long-term outcome of transobturator suburethral tape procedure for treatment of female stress urinary incontinence.

Objective: The aim is to evaluate the long-term safety and efficacy of transobturator tape (TOT) procedure in the treatment of women with stress urinary incontinence (SUI) by subjective and objective measures.

Patients And Methods: A total 48 women with SUI underwent the TOT procedure during the period from December 2005 to February 2008. The follow-up period ranged between 60 and 84 months (mean 71 months).