Publications by authors named "Ayesha Ali"

Splenic masses are common in dogs and vary dramatically in their clinical behavior. Clinically, and even with histology, it can be challenging to differentiate between benign and malignant splenic masses. Hemangiosarcoma (HSA), the most common malignancy of the spleen, is a very aggressive tumor with a poor prognosis.

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Introduction: Near-term and intrapartum care play pivotal roles in ensuring a safe childbirth experience and are essential components of a comprehensive approach to maternal and neonatal health.

Methods: The following interventions were identified: antibiotics for preterm premature rupture of membrane, antenatal corticosteroids for fetal lung maturation, partograph use during labor and delivery, induction of labor at or post-term, skilled birth care and safe childbirth checklist during labor and delivery. A scoping exercise was conducted to ascertain the most up-to-date evidence, and reviews of topics of interest were updated in case the evidence was not recent, with a focus on low- and middle-income countries (LMICs).

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Objective: To develop evidence-based local clinical practice guidelines and primary care referral pathways for general physicians to help streamline the management of glomerular diseases and diabetes in chronic kidney disease patients in Pakistan.

Methods: The study was conducted from October 2021 to February 2023 at the Centre for Clinical Best Practices, Aga Khan University Hospital, Karachi, in collaboration with the AKUH Section of Nephrology. Two source guidelines were selected by the local nephrologists after a thorough literature review on PubMed and Google Scholar.

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Background And Objectives: Administration of intraventricular chemotherapy through Ommaya reservoir is indicated for certain forms of leptomeningeal disease. However, ventricular reservoirs carry a substantial risk of infection. The conventional approach to managing reservoir-associated infections involves removal of the reservoir and systemic antibiotic therapy, but this strategy necessitates additional procedures to remove and subsequently replace the device.

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Appendicular central osteosarcoma (OSA) is a common and highly aggressive tumour in dogs. Metastatic disease to the lungs is common and even with chemotherapy the prognosis is generally poor. However, few cases survive well beyond reported median survival times.

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Background: Exposure to high anticholinergic burden is associated with adverse outcomes in older adults. Older adults with frailty have greater vulnerability to adverse anticholinergic effects. There is limited data on anticholinergic burden in hospitalised older adults with frailty particularly, in New Zealand.

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Background: Glioblastoma is the most aggressive adult primary brain cancer, characterized by significant heterogeneity, posing challenges for patient management, treatment planning, and clinical trial stratification.

Methods: We developed a highly reproducible, personalized prognostication and clinical subgrouping system using machine learning (ML) on routine clinical data, MRI, and molecular measures from 2,838 demographically diverse patients across 22 institutions and 3 continents. Patients were stratified into favorable, intermediate, and poor prognostic subgroups (I, II, III) using Kaplan-Meier analysis (Cox proportional model and hazard ratios [HR]).

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Background: Zinc is a micronutrient that plays a role in immune system strengthening and regulation of intestinal epithelial cells, and can reduce the duration and severity of diarrhoea. We conducted a systematic review of randomised controlled trials (RCTs) to assess the effectiveness of zinc compared to no zinc for the management of acute and persistent diarrhoea in children.

Methods: We searched PubMed, the Cochrane Library, Scopus, CINAHL, ClinicalTrials.

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Background: Oral rehydration solution (ORS) is crucial in the management of diarrhoea. Until the early 2000s, the standard formulation of glucose-based ORS with a total osmolarity of 311 mmol/L was being used for this purpose. However, due to concerns about sodium levels and cases of hypernatremia, a low-osmolarity ORS solution (LORS) with an osmolarity of 245mmol/L or less was developed to replace the standard ORS.

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Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea.

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Introduction: Appropriate perinatal care provision and utilization is crucial to improve maternal and newborn survival and potentially meet Sustainable Development Goal 3. Ensuring availability of healthcare infrastructure as well as skilled personnel can potentially help improve maternal and neonatal outcomes globally as well as in resource-limited settings.

Methods: A systematic review on effectiveness of perinatal care regionalization was updated, and a new review on facility-based interventions to improve postnatal care coverage and outcomes was conducted.

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Background And Objective: Severe asthma is a heterogeneous disease with subtype classification according to dominant airway infiltrates, including eosinophilic (Type 2 high), or non-eosinophilic asthma. Non-eosinophilic asthma is further divided into paucigranulocytic or neutrophilic asthma characterized by elevated neutrophils, and mixed Type 1 and Type 17 cytokines in the airways. Severe non-eosinophilic asthma has few effective treatments and many patients do not qualify for biologic therapies.

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The spread of misinformation through media and social networks threatens many aspects of society, including public health and the state of democracies. One approach to mitigating the effect of misinformation focuses on individual-level interventions, equipping policymakers and the public with essential tools to curb the spread and influence of falsehoods. Here we introduce a toolbox of individual-level interventions for reducing harm from online misinformation.

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Objective: Treatment of craniopharyngioma typically entails gross total resection (GTR) or subtotal resection with adjuvant radiation (STR-RT). We analyzed outcomes in adults with craniopharyngioma undergoing GTR versus STR-RT.

Methods: This retrospective study enrolled 115 patients with craniopharyngioma in 5 institutions.

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Article Synopsis
  • Gliomatosis cerebri (GC) is a rare and aggressive brain tumor that affects multiple lobes and is associated with a poorer prognosis compared to other gliomas, despite being classified differently under new WHO guidelines.
  • The case study describes a 64-year-old male with GBM and extensive GC who responded well to treatment with tumor-treating fields (TTFields) combined with radiation and chemotherapy, showing significant improvement in his condition shortly after treatment.
  • Though his glioma recurred 11 months after surgery, the aggressive GC remained under control, leading to a progression-free survival of 11 months and an overall survival of 17 months before his passing.
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Article Synopsis
  • Substance Use Disorder (SUD) significantly decreases individuals' quality of life (QOL), with this systematic review examining its impact across physical, mental, social, and environmental domains for various substances.
  • The review included 19 studies analyzing 6079 patients, primarily polysubstance users, where cocaine, alcohol, and amphetamines were among the most common substances used.
  • Key factors negatively affecting QOL were identified as mental disorders, long-term substance use, criminal history, unemployment, low education levels, and specific health issues like sleep problems and dental decay, highlighting the critical need for comprehensive interventions.
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BACKGROUND Spontaneous abscesses are generally typical in patients with significant risk factors and have been linked to numerous muscle groups. The sternocleidomastoid muscle, however, piqued our interest as an unusual location, especially in this patient who, other than diabetes mellitus, had no associated risk factors or signs of trauma. CASE REPORT A 61-year-old man appeared with neck pain, erythema, and swelling that had been present for 9 days and for which he had previously been examined in the Emergency Department.

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Article Synopsis
  • - The study assessed barriers faced by healthcare workers in British Columbia that hinder their adherence to infection prevention and control (IPAC) practices during the COVID-19 pandemic, based on a web survey conducted with 2,488 respondents.
  • - Key obstacles identified included inadequate staffing (58%), limited space in staff rooms (57%), multibed room setups (51%), and unclear messaging regarding IPAC protocols (51%).
  • - Suggestions for improvement included increased support from IPAC leadership and better communication about IPAC requirements, which aim to enhance safety measures for both patients and staff in healthcare settings.
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Group A streptococcus (GAS) is known to cause many different kinds of infections, including invasive pneumonia in rare cases. When it is the causative agent, it is associated with a more severe disease course, but it can often be adequately treated if caught early enough. We hereby present the case of a 32-year-old male with no past medical history who presented with fever, hemoptysis, and tachycardia.

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Background: The COVID-19 pandemic disproportionately impacted long-term care and assisted living (LTC/AL) facilities in Canada, where infection prevention and control (IPAC) programs had been suboptimal. We aimed to identify barriers affecting healthcare workers' (HCW) adherence to IPAC practices during the pandemic in British Columbia in LTC/AL compared to acute care settings.

Methods: We conducted a web-based survey of direct care providers and IPAC professionals across BC from August to September 2021, focused on knowledge and attitudes toward IPAC within the context of the COVID-19 pandemic, and barriers that affected respondents' abilities to follow IPAC practices throughout the pandemic.

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Antiphospholipid antibody (aPL)-associated thrombophilia has been implicated in various adverse pregnancy outcomes, including preterm birth and impaired fetal development. This systematic review aimed to elucidate the relationship between aPL-associated thrombophilia and these outcomes, as well as to identify potential modifiers of this relationship such as maternal age, coexisting maternal medical conditions, type of aPL antibodies involved, and the timing of thrombophilia diagnosis during gestation. We conducted a comprehensive literature search in PubMed, Web of Science, Cochrane, and Scopus in May 2023, covering literature published within the last 10 years.

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The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had significant impacts on pulmonary function. This study aimed to comprehensively evaluate pulmonary function and structure in patients 40 days post-SARS-CoV-2 infection, employing an array of testing methodologies including spirometry, plethysmography, forced oscillometry, and CT scanning. It also sought to establish potential correlations between these metrics and evaluate if forced oscillometry could provide additional value in post-infective lung function assessment.

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Background: The combination of nivolumab and ipilimumab has been approved for the treatment of multiple solid tumors. This was a phase I study investigating definitive radioimmunotherapy (RIT) with nivolumab and ipilimumab for the treatment of locally advanced (LA) squamous cell carcinoma of the head and neck (SCCHN).

Methods: Patients with newly diagnosed, stage IVA-IVB SCCHN eligible for cisplatin-based chemotherapy received nivolumab (3 mg/kg every 2 weeks for a total of 17 doses) and ipilimumab (1 mg/kg every 6 weeks for a total of 6 doses) starting 2 weeks prior to radiotherapy.

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