Artificial Intelligence (AI) performs human intelligence-dependant tasks using tools such as Machine Learning, and its subtype Deep Learning. AI has incorporated itself in the field of cardiovascular medicine, and increasingly employed to revolutionize diagnosis, treatment, risk prediction, clinical care, and drug discovery. Heart failure has a high prevalence, and mortality rate following hospitalization being 10.4% at 30-days, 22% at 1-year, and 42.3% at 5-years. Early detection of heart failure is of vital importance in shaping the medical, and surgical interventions specific to HF patients. This has been accomplished with the advent of Neural Network (NN) model, the accuracy of which has proven to be 85%. AI can be of tremendous help in analyzing raw image data from cardiac imaging techniques (such as echocardiography, computed tomography, cardiac MRI amongst others) and electrocardiogram recordings through incorporation of an algorithm. The use of decision trees by Rough Sets (RS), and logistic regression (LR) methods utilized to construct decision-making model to diagnose congestive heart failure, and role of AI in early detection of future mortality and destabilization episodes has played a vital role in optimizing cardiovascular disease outcomes. The review highlights the major achievements of AI in recent years that has radically changed nearly all areas of HF prevention, diagnosis, and management.
We describe efforts towards introducing infection control (IC) practices and establishment of antimicrobial resistance (AMR) surveillance in a public sector hospital in Pakistan. The study was conducted in an eight-bed intensive care unit. IC principles, introduced through interactive sessions, were used as an intervention and their impact was observed by conducting surveillance for ventilator-associated pneumonia (VAP) before and after the intervention. Respiratory isolates of VAP patients in the period after intervention were screened for AMR, and empiric antibiotic at the time of admission was compared with the antimicrobial sensitivity pattern reported. VAP rates were high in general and declined in the period after intervention, although the difference was not significant. Of 37 VAP patients in the period after intervention, 68% had more than one clinically significant organism isolated from the respiratory specimen. Acinetobacter spp. were isolated from 76% of patients and Pseudomonas aeruginosa from 43%. All Acinetobacter spp. and 72% P. aeruginosa were multidrug resistant. The mean stay of the nosocomially infected patients was significantly higher than for the uninfected group (6.5 vs. 2.1 days, P<0.001). Our study suggests IC education needs to be supplemented by a hospital system that facilitates IC practices and development of surveillance programmes.
The coronavirus disease-19 (COVID-19) pandemic has forced hospitals to prioritize COVID-19 patients, restrict resources, and cancel all non-urgent elective cardiac procedures. Clinical visits have only been facilitated for emergency purposes. Fewer patients have been admitted to the hospital for both ST-segment elevation myocardial infarctions (STEMI) and non-ST segment elevation myocardial infarctions (NSTEMI) and a profound decrease in heart failure services has been reported. A similar reduction in the patient presentation is seen for ischemic heart disease, decompensated heart failure, and endocarditis. Cardiovascular services, including catheterization, primary percutaneous coronary intervention (PPCI), cardiac investigations such as electrocardiograms (ECGs), exercise tolerance test (ETT), dobutamine stress test, computed tomography (CT) angiography, transesophageal echocardiography (TOE) have been reported to have declined and performed on a priority basis. The long-term implications of this decline have been discussed with major concerns of severe cardiac complications and vulnerabilities in cardiac patients. The pandemic has also had psychological impacts on patients causing them to avoid seeking medical help. This review discusses the effects of the COVID-19 pandemic on the provision of various cardiology services and aims to provide strategies to restore cardiovascular services including structural changes in the hospital to make up for the reduced staff personnel, the use of personal protective equipment in healthcare workers, and provides alternatives for high-risk cardiac imaging, cardiac interventions, and procedures. Implementation of the triage system, risk assessment scores, and telemedicine services in patients and their adaptation to the cardiovascular department have been discussed.
A significant rise of 55% in blindness and vision impairment in Pakistan has been reported over the last few decades, with blindness being the third most common eye disorder in the country1. Among its different causes one of the leading cause is glaucoma, with an age standardized prevalence of 0.14 million1. Glaucoma comprises a group of diseases that can result in irreversible damage to optic nerves and vision loss, it affects 3.1 million people around the world2. The occurrence of glaucoma in elderly has increased in the last few decades and a significant rise in the burden of eye diseases, including glaucoma, in Pakistan, is predicted by the year 20251. Primary open-angle glaucoma is the most common form of glaucoma; it is asymptomatic in the early stages and patients usually present after significant damage to nerve fibres. One of the major risk factors for this disease is advancing age, being most prevalent in people over 40 years of age1. Moreover, a study conducted in Pakistan reported a high prevalence of primary open angle glaucoma in individuals over the age of 503. While glaucoma is one of the leading causes of blindness, the risk of blindness posed may be profoundly diminished with early diagnosis; a study suggests a marked decrease in blindness due to glaucoma owing to early diagnoses4. In Pakistan, however, health seeking behaviour is already suboptimal. Additionally, a significant lack of awareness about glaucoma has also been reported in Pakistan, specifically in populations over the age of 455, which is the age group at the greatest risk of development of glaucoma. Proper access to eye health has been associated with employment prospects and economic productivity, especially in developing countries like Pakistan2, while loss of vision can lead to poor quality of life, especially in a country with very few options for meeting the needs of those who are visually impaired, leaving them with limited options for employment, hence forcing them to be dependent on others. This can collectively have a negative impact on a developing nation’s economy. Considering the aforementioned factors, it goes without saying how incredibly imperative it is to devise a thorough strategic plan for screening, prevention and diagnosis, coupled with necessary awareness programmes to curb and reduce the instances of glaucoma and glaucoma-associated complications as a whole.
Mosquitoes have been widely responsible for the spread of two major diseases in the underdeveloped world – malaria and dengue. Around 240 million instances of malaria were estimated globally as of 2020, of which 627 000 resulted in fatalities, according to the World Health Organization (WHO) [1]. On the other hand, WHO estimates that there are […]
Background: Fine-needle aspiration cytology (FNAC) has been widely accepted as a diagnostic safe method for preoperative assessment of salivary gland lesions. This diagnostic tool is inexpensive, easy to perform, relatively painless and it provides useful information to differentiate between benign and malignant salivary gland tumors that helps in the management and surgical planning. This study was undertaken to compare FNAC results with permanent histopathological ndings of salivary gland tumors in order to assess its diagnostic accuracy
Monkeypox (MPX), caused by the Monkeypox virus (MPXV), is an endemic disease in African countries and is currently causing outbreaks in several European regions, amidst a recent surge in new COVID-19 cases. This can significantly impact already exhausted healthcare services, adding on to the economic and social burdens in the region. A lack of sufficient laboratory diagnostics, antivirals, vaccines may hinder effective clinical management of affected patients. Therefore, it is essential to increase awareness about MPX and its transmission among the general population, to ensure necessary precautions are taken and new cases are reported swiftly. This article discusses the impact of MPXV on the current reemergence of COVID-19 in Europe, lessons learnt during the COVID-19 pandemic and recommendations to address potential challenges.
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