Mitral leaflet separation index correlation with mitral stenosis severity, a reliable easy 2-d echocardiography technique.

Objectives: To evaluate accuracy of mitral leaflet separation index for the determination of mitral stenosis severity in patients with rheumatic mitral stenosis.

Methods: The prospective, cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from March 2021 to February 2022, and comprised patients with rheumatic mitral stenosis detected on echocardiography. The best end-diastole parasternal long axis and apical four-chamber views were acquired and Mitral leaflet separation was measured as the distance between the inner edges of the tip of mitral leaflets.

Pregnant during the COVID-19 pandemic: Knowledge, concerns, attitudes and practices of Pakistani women.

Introduction: Data regarding pregnancy and related outcomes with COVID-19 are inconsistent, which leads to difficulties in counselling pregnant women. This brings uncertainty to pregnant women regarding mode of birth, transmission and issues that may occur in case they contract the disease. We conducted this study to assess the knowledge about COVID-19 risk during pregnancy and childbirth and to assess the concerns, attitudes, and practices of pregnant women during the pandemic.

Perceptions Regarding COVID-19 Vaccination Among a Representative Pakistani Population Coming to Tertiary Care Cardiac Hospital.

Background: The deleterious effects caused by coronavirus disease 2019 (COVID-19) infection have been compounded by COVID-19 vaccine hesitancy throughout the world, including Pakistan. We are lacking representative national data regarding the COVID-19 vaccine acceptance. This study aims to determine COVID-19 vaccination acceptance rates and predictors of its acceptance and hesitancy among a representative Pakistani population.

Frequency of pregnant women who accept HIV screening using rapid detection test and factors associated with acceptance.

To assess the frequency of pregnant women who accept HIV screening using rapid detection test and factors associated with acceptance we undertook a cross-sectional study conducted from July to December 2018. Women aged 20-45 years, who were pregnant and planned to deliver at the facility, were included. Women were counseled and offered about Human Immunodeficiency virus (HIV) screening.

Role of carbonated water technique to enhance Tc-99m tetrofosmin myocardial perfusion imaging by reducing subdiaphragmatic artefacts.

Objective: Myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT) is confounded by the extracardiac artefacts cause by hepatobiliary clearance of the radiotracers. Various techniques have been evaluated to lessen those artefacts. In this study, we endeavoured to determine the effect of carbonated water in reducing such infracardiac artefact so to improve MPI image quality, sensitivity and specificity.

A comparison of antenatally and intraoperatively diagnosed cases of placenta accreta spectrum.

Objective: To assess the effect of antenatal diagnosis of placenta accreta spectrum (PAS) on fetomaternal outcomes.

Material And Methods: This was a retrospective cohort study conducted from January 2017 to December 2018. Women with PAS diagnosed antenatally were designated as group A and those where diagnosis was suspected during operation and confirmed on histopathology (PAS diagnosed perioperatively) were designated as group B.

Medication Adherence In Post Myocardial Infarction Patients.

Background: Medication non-adherence after acute myocardial infarction is a global problem causing increased morbidity and mortality. This multifaceted problem has not been well studied in our part of the world. Our study aimed to determine the burden of medication non-adherence in post myocardial infarction patients.

An Overview of Menopausal Symptoms Using the Menopause Rating Scale in a Tertiary Care Center.

Context: Due to increased life expectancy worldwide, women are expected to spend a significant portion of their lives in menopause. Proven prevention strategies against serious risks and tested effective treatments for common symptoms may remain unutilized in our population if these women are not asked about these symptoms.

Aim: This study aims to assess the prevalence of different menopausal symptoms and their severity according to menopause rating scale (MRS) in women.

Reliability and validity of MicroScribe-3DXL system in comparison with radiographic cephalometric system: Angular measurements.

Aim: The aim of the study was to assess the reliability and validity of cephalometric variables from MicroScribe-3DXL.

Materials And Methods: Seven cephalometric variables (facial angle, ANB, maxillary depth, U1/FH, FMA, IMPA, FMIA) were measured by a dentist in 60 Malay subjects (30 males and 30 females) with class I occlusion and balanced face. Two standard images were taken for each subject with conventional cephalometric radiography and MicroScribe-3DXL.

Un-ruptured Non-Coronary Sinus of Valsalva Aneurysm with Complete Heart Block.

Sinus of Valsalva aneurysm is a rare cardiac anomaly with wide spectrum of clinical presentation ranging from asymptomatic state to dreadful complications due to compression of vital surrounding structures or aortic dissection. There are only few reported cases of sinus of Valsalva aneurysm presented with cardiac arrhythmias including complete heart block. We herein, present a case of a 50 year male who presented with complete heart block.

Evaluation of the effect of andrographolide on atherosclerotic rabbits induced by Porphyromonas gingivalis.

Epidemiologic evidence has demonstrated significant associations between atherosclerosis and Porphyromonas gingivalis (Pg). We had investigated the effect of andrographolide (AND) on atherosclerosis induced by Pg in rabbits. For experimental purpose, we separated thirty male white New Zealand rabbits into 5 groups.

Impact of malocclusion on oral health related quality of life in young people.

Background: The objectives for this study were to assess Oral Health Related Quality of Life (OHRQoL) in young people aged 15-25 who sought orthodontic treatment, and to measure the association between orthodontic treatment need (using the IOTN), sex, age and education level, and oral health related quality of life (OHRQoL).

Methods: Survey of a consecutive series of 323 young adults aged 15 to 25 years, attending orthodontic clinics at the Faculty of Dentistry, Universiti Teknologi MARA. Participants completed the Oral Health Impact Profile-14 (OHIP-14) and had a clinical examination including the Index of Orthodontic Treatment Need- Dental Health Component (IOTN-DHC).

Combined treatment with lenalidomide and epoetin alfa in lower-risk patients with myelodysplastic syndrome.

The erythropoietic effects of lenalidomide are cytokine dependent, suggesting that the erythroid hematologic improvement (HI-E) rate may be augmented by combined treatment (CT) with recombinant human erythropoietin (rhu-EPO) in myelodysplastic syndrome (MDS). In the present study, we explored the benefits of CT and the relationship between lenalidomide pharmacokinetics and hematologic toxicity in transfusion-dependent patients with low- to intermediate-1-risk MDS who failed prior rhu-EPO. In stage I, patients received 10 or 15 mg/d of lenalidomide monotherapy.

Challenges and successes in the treatment of hemophilia: the story of a patient with severe hemophilia A and high-titer inhibitors.

In the past, patients with severe hemophilia have suffered a substantially reduced quality of life with frequent bleeding episodes, disabling arthropathy, and shorter life expectancy. In addition, methods of treatment and management have been costly and time-consuming, and have placed a considerable burden on patients' physical and psychological well-being. With the advent of the on-demand therapy and prophylactic treatment paradigm, patients have been able to receive care with less interruption of daily activities.

Phase I combination trial of lenalidomide and azacitidine in patients with higher-risk myelodysplastic syndromes.

Purpose: Lenalidomide and azacitidine are active in patients with lower- and higher-risk myelodysplastic syndromes (MDS). These agents may complement each other by targeting both the bone marrow microenvironment and hypomethylating action on the malignant clone.

Patients And Methods: This phase I trial explored the safety of combination therapy in patients with higher-risk MDS.

DNA methylation predicts survival and response to therapy in patients with myelodysplastic syndromes.

Purpose: The current classification systems of myelodysplastic syndromes (MDS), including the International Prognostic Scoring System (IPSS), do not fully reflect the molecular heterogeneity of the disease. Molecular characterization may predict clinical outcome and help stratify patients for targeted therapies. Epigenetic therapy using decitabine, a DNA hypomethylating agent, is clinically effective for the treatment of MDS.

Decitabine in the treatment of myelodysplastic syndromes.

Patients with myelodysplastic syndromes (MDS) are challenging to treat, given the advanced median age and comorbidities of the population. For most patients, the standard therapy is supportive care, including broad-spectrum antibiotics, red blood cell/platelet transfusions, and growth factors. Decitabine, a hypomethylating agent that allows for the re-expression of tumor suppressor genes, represents an exciting new treatment option for MDS patients.

The pathogenesis and management of disseminated intravascular coagulation.

The pathologic and progressive generation of thrombin in human blood can result in the development of disseminated intravascular coagulation (DIC), a syndrome associated with many underlying conditions and manifested as microvascular thrombosis, tissue hypoxia, and organ damage. DIC can be either acute or chronic, with acute DIC resulting from generation of a large amount of thrombin in a brief time period and chronic (compensated) DIC developing as a result of exposure of the coagulation system to small amounts of tissue factor leading to increased but nonacute levels of thrombin generation. DIC can also be considered a thrombohemorrhagic syndrome.

Decitabine improves patient outcomes in myelodysplastic syndromes: results of a phase III randomized study.

Background: Aberrant DNA methylation, which results in leukemogenesis, is frequent in patients with myelodysplastic syndromes (MDS) and is a potential target for pharmacologic therapy. Decitabine indirectly depletes methylcytosine and causes hypomethylation of target gene promoters.

Methods: A total of 170 patients with MDS were randomized to receive either decitabine at a dose of 15 mg/m2 given intravenously over 3 hours every 8 hours for 3 days (at a dose of 135 mg/m2 per course) and repeated every 6 weeks, or best supportive care.