Publications by authors named "Nanji K"

Background: Breaking bad news is one of the most difficult tasks for practicing doctors, especially for those working in health care specialties where life-threatening diseases are diagnosed and managed routinely. Our aim was to elicit the knowledge and practices of doctors and identify barriers faced by them in disclosure of bad news across the provinces of Pakistan.

Methods: Cross-sectional, multi-centered study supported by an external grant in 15 Government and Private Hospitals across Pakistan.

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Introduction: Spin reporting has been studied across a variety of study types and domains; however, it has yet to be studied in the context of pilot and feasibility trials. We designed this methodological survey to evaluate spin reporting in surgical pilot and feasibility trials.

Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials were searched from January 1, 2011, to December 31, 2011, and January 1, 2021, to December 31, 2021.

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Objective: Cataracts are the leading cause of global preventable and treatable blindness. Cystoid macular edema (CME) is among the most common complications following cataract surgery. The development of CME impacts patients' quality of life and has economic implications for patients and healthcare systems.

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Background: Randomized-clinical trials (RCTs) are the gold-standard for comparing health care interventions, but can be limited by early termination, feasibility issues, and prolonged time to trial reporting. Adaptive clinical trials (ACTs), which are defined by pre-planned modifications and analyses that occur after starting patient recruitment, are gaining popularity as they can streamline trial design and time to reporting. As adaptive methodologies continue to be adopted by researchers, it will be critical to develop a risk of bias tool that evaluates the unique methodological features of ACTs so that their quality can be improved and standardized for the future.

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Introduction: Tall cell subtype papillary thyroid cancer (TCS-PTC) is associated with aggressive disease features and worse patient outcomes. It remains unclear whether adjuvant radioactive iodine (RAI) ablation following thyroidectomy is associated with improved survival in TCS-PTC. The purpose of this review and meta-analysis was to determine whether adjuvant RAI was associated with improved survival in patients with TCS-PTC.

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Objective: Full-thickness macular holes (FTMH) are defects in the fovea involving all neural retinal layers. They reduce patients' visual acuity (VA) and impact their quality of life. FTMHs are repaired with pars plana vitrectomy (PPV) with intraocular gas tamponade and post-operative face-down positioning (FDP).

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Objective: To assess the effect of the COVID-19 pandemic on injection intervals among patients treated for neovascular age-related macular degeneration.

Design: Retrospective cohort study.

Participants: Patients treated at a single practice using a treat-and-extend regimen with intravitreal aflibercept between December 2018 and April 2021.

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Objective: The fragility index (FI) of a meta-analysis evaluates the extent that the statistical significance can be changed by modifying the event status of individuals from included trials. Understanding the FI improves the interpretation of the results of meta-analyses and can help to inform changes to clinical practice. This review determined the fragility of ophthalmology-related meta-analyses.

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Background: Medication errors in the operating room have high potential for patient harm. While electronic clinical decision support (CDS) software has been effective in preventing medication errors in many nonoperating room patient care areas, it is not yet widely used in operating rooms. The purpose of this study was to determine the percentage of self-reported intraoperative medication errors that could be prevented by CDS algorithms.

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Article Synopsis
  • The review aims to evaluate how thoroughly surgical pilot and feasibility trials report their findings according to the CONSORT guidelines, particularly focusing on completeness and any discrepancies in reporting.
  • An electronic search will be conducted across major databases to gather relevant studies, specifically targeting pilot or feasibility trials related to surgical interventions, with a focus on their adherence to a 40-item reporting checklist.
  • The study will also investigate the presence of spin reporting, the consistency between abstracts and main texts, and analyze the correlation between trial characteristics and the quality of reporting through statistical methods.
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Objectives: Given the key role that pilot and feasibility (PAF) trials play in addressing the challenges of surgical trials, adequate reporting completeness is essential. Our aim was to assess completeness of reporting and evaluate if the items of the Consolidated Standards of Reporting Trials (CONSORT) extension for PAF trials have been reported in surgical PAF trials.

Study Design: This is a metaresearch study reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

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Article Synopsis
  • New therapies for geographic atrophy (GA) are now available, allowing for better management in clinical settings.
  • A living systematic review found that inhibiting complement factors C3 and C5 may reduce the growth of GA over 12 and 24 months, with little difference in side effects compared to sham treatments.
  • However, these treatments do not seem to improve visual acuity significantly and may lead to more ocular adverse effects and new cases of neovascular age-related macular degeneration.
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Topic: To compare the efficacy and safety of subthreshold macular laser to conventional focal laser photocoagulation for the treatment of vision loss secondary to diabetic macular edema (DME).

Clinical Relevance: Macular laser remains an important and cost effective treatment option for vision loss secondary to DME. Although anti-VEGF therapy is often first-line, macular laser is of utility in low-resource or remote settings, for patients at risk of loss to follow-up, and for DME not meeting country-specific reimbursement criteria for anti-VEGF therapy.

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Topic: We reviewed the use of patient-reported outcome measures (PROMs) in the treatment of ophthalmologic conditions as recommended by the Clinical Practice Guidelines (CPGs) published by the American Academy of Ophthalmology (AAO).

Clinical Relevance: Patient-reported outcome measures are standardized instruments that provide information regarding a patient's health status or health-related quality of life. Patient-reported outcome measures are increasingly used to inform study end points in ophthalmology studies.

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Background: Understanding the epidemiology of ophthalmic presentations to emergency departments can help guide resource allocation, medical education programs, and optimize the patient experience. The purpose of this investigation was to summarize and assess the urgency of ophthalmic presentations in emergency departments (EDs) in Ontario, Canada over a 5-year period.

Methods: This was a multicentered retrospective review of all patient presentations to EDs in Ontario between January 1st, 2012, to December 31st, 2017.

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The purpose of this report was to estimate the additional annual cost to the U.S. healthcare system attributable to preventable medication errors (MEs) in the operating room.

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Background: Evidence-based point-of-care information (POCI) tools can facilitate patient safety and care by helping clinicians to answer disease state and drug information questions in less time and with less effort. However, these tools may also be visually challenging to navigate or lack the comprehensiveness needed to sufficiently address a medical issue.

Objective: This study aimed to collect clinicians' feedback and directly observe their use of the combined POCI tool DynaMed and Micromedex with Watson, now known as DynaMedex.

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Article Synopsis
  • The study investigates whether anti-VEGF therapy can slow down retinal non-perfusion (RNP) progression in diabetic retinopathy (DR) compared to laser treatments or sham.
  • A systematic review and meta-analysis of randomized controlled trials showed that anti-VEGF therapy may reduce RNP progression over 12 and 24 months, but the evidence is rated as low certainty due to some limitations.
  • The findings suggest that while anti-VEGF treatment could slightly influence RNP progression, more research is needed to clarify its effectiveness and the impact of specific treatment factors.
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The purpose of this study was to evaluate perioperative medication-related incidents (medication errors (MEs) and/or adverse medication events (AMEs)) identified by 2 different reporting methods (self-report and direct observation), and to compare the types and severity of incidents identified by each method. We compared perioperative medication-related incidents identified by direct observation in Nanji et al's 2016 study[1] to those identified by self-report via a facilitated incident reporting system at the same 1046-bed tertiary care academic medical center during the same 8-month period. Incidents, including MEs and AMEs were classified by type and severity.

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