Going from Primary to Primordial Prevention: Is the Juice Worth the Squeeze?

Purpose Of Review: While primary prevention strategies target individuals who are at high risk of cardiovascular disease, there is rising interest towards primordial prevention that focuses on preventing the development of risk factors upstream of disease detection. Therefore, we review the advantages of primordial prevention interventions on minimizing future cardiovascular events.

Recent Findings: Primordial prevention of atherosclerotic cardiovascular disease involves behavioral, genetic, and environmental strategies, starting from fetal/infant health and continuing throughout childhood and young adulthood.

Facilitators and barriers in acceptance of telemedicine among healthcare providers in Pakistan: A cross-sectional survey.

Objectives: This study aimed to assess healthcare professionals' awareness and acceptance of telemedicine residing in Pakistan.

Materials And Methods: A cross-sectional study was conducted across Pakistan from November 2021 to March 2022. Data entry was done through a self-administered questionnaire.

Comprehensive analysis of root canal morphology in maxillary premolars among the Pakistani subpopulation: a CBCT-based study.

Background: Understanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation.

Method: This cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore.

Early-onset atherosclerotic cardiovascular disease.

Recent trends indicate a concerning increase in early-onset atherosclerotic cardiovascular disease (ASCVD) among younger individuals (men aged <55 years women aged <65 years). These findings highlight the pathobiology of ASCVD as a disease process that begins early in life and underscores the need for more tailored screening methods and preventive strategies. Increasing attention has been placed on the growing burden of traditional cardiometabolic risk factors in young individuals while also recognizing unique factors that mediate risk of pre-mature atherosclerosis in this demographic such as substance use, socioeconomic disparities, adverse pregnancy outcomes, and chronic inflammatory states that contribute to the increasing incidence of early ASCVD.

COVID-19's influence on Karachi stock exchange: A comparative machine learning algorithms study for forecasting.

The COVID-19 pandemic has great effects for economies internationally. This study studies the interconnection between COVID-19 metrics and Pakistan's premier stock exchange, the Karachi Stock Exchange (KSE) with the object of identifying the most effective machine learning (ML) model for predicting KSE developments in the pandemic. Our investigation periods the peak COVID-19 period from March 1, 2020, to November 26, 2021, applying data from both the KSE 100 index and COVID-19 associated variables.

The Potential Impact of Renin-Angiotensin System Inhibitors on Cancer Survival and Recurrence: A Systemic Review and Meta-Analysis.

Renin-angiotensin system inhibitors (RASis), specifically angiotensin-converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs), are widely used antihypertensives. Their impact on the prognostic outcomes among patients with cancer has been subject to scrutiny and debate. The aim of this study was to evaluate the effect of RASis on survival in patients with cancer.

The Effectiveness of Nutritional Interventions Implemented through Lady Health Workers on the Reduction of Stunting in Children under 5 in Pakistan: The Difference-in-Difference Analysis.

In Pakistan, the 2018 National Nutrition Survey reported that 40% of children under five years old were stunted. This study assessed the effectiveness of nutritional supplementation in reducing stunting among children under five years old in two rural districts in Sindh, Pakistan. This was a mixed-method quasi-experimental study comprising intervention and control populations, with 3397 and 3277 children under five years old participating in the baseline and end-line surveys, respectively.

International facets of the 'chain of survival' for out-of-hospital and in-hospital cardiac arrest - A scoping review.

Background: The "chain of survival" was first systematically addressed in 1991, and its sequence still forms the cornerstone of current resuscitation guidelines. The term "chain of survival" is widely used around the world in literature, education, and awareness campaigns, but growing heterogeneity in the components of the chain has led to confusion. It is unclear which of these emerging chains is most suitable, or if adaptations are needed in particular contexts to depict key actions of resuscitation in the 21st century.

The feasibility, acceptability, appropriateness and impact of implementing person-centered communication for prevention of female genital mutilation in antenatal care settings in Guinea, Kenya and Somalia.

Background: There is limited evidence on how to engage health workers as advocates in preventing female genital mutilation (FGM). This study assesses the feasibility, acceptability, appropriateness and impact of a person-centered communication (PCC) approach for FGM prevention among antenatal care (ANC) providers in Guinea, Kenya and Somalia.

Methods: Between August 2020 and September 2021, a cluster randomised trial was conducted in 180 ANC clinics in three countries testing an intervention on PCC for FGM prevention.

Aetiologies of Leg Pain among Patients Presenting to a Vascular Surgery Clinic.

Objective: To determine the frequency and pattern of different aetiologies of leg pain among patients visiting vascular surgery clinics.

Study Design: Cross-sectional study. Place and Duration of the Study: Vascular Surgery Clinics of the Aga Khan University Hospital, Karachi, Pakistan, between February 2021 and June 2023.

Harnessing the Power of Big Data Analytics-Estimation of Reference Intervals for Neonatal Serum TSH in Pakistan Using RefineR Algorithm.

Objective: To estimate the population-specific reference intervals (RIs) for neonatal thyroid stimulating hormone (TSH) in Pakistani neonates, utilising the refineR algorithm.

Study Design: Observational study. Place and Duration of the Study: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, Pakistan, from 17th May to 30th November 2023.

Vitamin D and Lipid Profiles in Infertile PCOS and Non-PCOS Females.

Objective: This research is aimed to explore the relationship between vitamin D and lipid profile in females with PCOS and non-PCOS infertile female subjects.

Study Design: Comparative descriptive study. Place and Duration of the Study: Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan and Jinnah Postgraduate Medical Centre, Karachi, Pakistan in collaboration with the Australian Concept Infertility Medical Centre, from February 2021 to March 2023.

Impact of Epidural Catheter-Incision Congruency on Postoperative Analgesia after Major Abdominal Surgery: An Observational Study in a Teaching Hospital.

Objective: To determine the frequency of appropriate epidural catheter-incision congruency in adult patients undergoing major abdominal surgeries, as well as the frequency of ineffective postoperative analgesia with continuous epidural infusion, side effects, and complications of epidural insertion and epidural catheter infusion.

Study Design: Observational study. Place and Duration of the Study: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan, from September to November 2022.

The Current Landscape of Clinical Trials for Immunotherapy in Pancreatic Cancer: A State-of-the-Art Review.

Background: Pancreatic cancer remains a lethal malignancy with a 5-year survival rate below 6% and about 500,000 deaths annually worldwide. Pancreatic adenocarcinoma, the most prevalent form, is commonly associated with diabetes, chronic pancreatitis, obesity, and smoking, mainly affecting individuals aged 60 to 80 years. This systematic review aims to evaluate the efficacy of immunotherapeutic approaches in the treatment of pancreatic cancer.

Pharmacological activation of mesenchymal stem cells increases gene expression pattern of cell adhesion molecules and fusion with neonatal cardiomyocytes.

Cellular therapy is considered a better option for the treatment of degenerative disorders. Different cell types are being used for tissue regeneration. Despite extensive research in this field, several issues remain to be addressed concerning cell transplantation.

Reimagining nutrition education for pregnant adolescents in the face of climate change: a community approach.

Objectives: To explore challenges with current nutrition education for teenage pregnant women in a drought-prone community in Kenya and to elicit the communities' suggestions on how to best adapt it in the face of climate change.

Design: Nine serial focus group discussions (four with adolescents, two with their parents, two with community health volunteers and one with healthcare workers) were conducted on a purposively selected study population in Kaloleni, Kilifi County, Kenya. Data collection took place between March and November 2022, with a total of 73 participants.

Reproductive factors and their association with physical and comprehensive frailty in middle-aged and older women: a large-scale population-based study.

Study Question: Are women's reproductive factors associated with physical frailty and comprehensive frailty in middle-age and later life?

Summary Answer: Early menarche at <13 years, age at menopause <45 years, surgical menopause, experiencing miscarriage and a shorter reproductive period of <35 years were associated with increased odds of frailty, while having two or three children was related to decreased likelihood of frailty.

What Is Known Already: Evidence has shown that women are frailer than men in all age groups and across different populations, although women have longer lifespans. Female-specific reproductive factors may be related to risk of frailty in women.

Neonatal bacterial sepsis.

Neonatal sepsis remains one of the key challenges of neonatal medicine, and together with preterm birth, causes almost 50% of all deaths globally for children younger than 5 years. Compared with advances achieved for other serious neonatal and early childhood conditions globally, progress in reducing neonatal sepsis has been much slower, especially in low-resource settings that have the highest burden of neonatal sepsis morbidity and mortality. By contrast to sepsis in older patients, there is no universally accepted neonatal sepsis definition.