�ݺ�ߣshows by User: ahmadozair2

Overseas Medical Students in Ukraine and War-Related Interruption in Education: Global Health Considerations from India.

ahmadozair2@slideshare.net(ahmadozair2) — Tue, 28 Mar 2023 12:39:00 GMT

Roy S#, Bhat V#, Ozair A# ***. Overseas Medical Students in Ukraine and War-Related Interruption in Education: Global Health Considerations from India. Annals of Global Health. 2022 Nov 3;88(1):98. doi: 10.5334/aogh.3926. ([Review Article], # Equal Contribution, PMID: 36380742, Available from: https://pubmed.ncbi.nlm.nih.gov/36380742)

COVID-19 Associated Mucormycosis in a Tertiary Care Hospital in India: A Case Series.

ahmadozair2@slideshare.net(ahmadozair2) — Tue, 28 Mar 2023 12:38:57 GMT

Singh S, Basera P, Anand A, Ozair A. COVID-19 Associated Mucormycosis in a Tertiary Care Hospital in India: A Case Series. Cureus. 2022 Aug; 14(8): e27906. ([Case Report], PMID: 36110469, Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9464320/)

Inequities in Country and Gender Diversity-Based Authorship Representation in Cardiology-Related Cochrane Reviews.

ahmadozair2@slideshare.net(ahmadozair2) — Tue, 28 Mar 2023 12:38:57 GMT

Bhat V, Ozair A, Bellur S, Subash NR, Kumar A, Majumdar M, Kalra A***. Inequities in Country and Gender Diversity-Based Authorship Representation in Cardiology-Related Cochrane Reviews. JACC Advances. Published Online November 30, 2022. ([Research Letter], Available from: https://www.jacc.org/doi/10.1016/j.jacadv.2022.100140)

DNA Methylation and Histone Modification in Low-Grade Gliomas: Current Understanding and Potential Clinical Targets.

ahmadozair2@slideshare.net(ahmadozair2) — Tue, 28 Mar 2023 12:38:56 GMT

Ozair A, Bhat V, Alisch RS, Khosla AA, Kotecha RR, Odia Y, McDermott MW, Ahluwalia MS***. DNA Methylation and Histone Modification in Low-Grade Gliomas: Current Understanding and Potential Clinical Targets. Cancers (Basel). 2023;15(4): 1342. ([Review Article], IF = 6.6, Available from: https://www.mdpi.com/2072-6694/15/4/1342)

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study.

ahmadozair2@slideshare.net(ahmadozair2) — Tue, 28 Mar 2023 12:38:56 GMT

Tabah A, Buetti N, Staiquly Q … EUROBACT-2 Study Group (including Ozair A). Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Medicine. 2023;1-13. doi:10.1007/s00134-022-06944-2. Published online 2023 Feb 10. (PMID: 36764959, I.F. = 41.7, Available from: https://link.springer.com/article/10.1007/s00134-022-06944-2)

Novel Therapeutic Approaches in Neoplastic Meningitis.

ahmadozair2@slideshare.net(ahmadozair2) — Tue, 28 Mar 2023 12:38:55 GMT

Khosla AA, Saxena S, Ozair A, Venur VA, Peereboom DM, Ahluwalia MS***. Novel Therapeutic Approaches in Neoplastic Meningitis. Cancers (Basel). 2023;15(1): 119. ([Review Article], IF = 6.6, PMID: 36612116, Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817816/)

The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators

ahmadozair2@slideshare.net(ahmadozair2) — Tue, 28 Mar 2023 12:38:55 GMT

Ozair A, Bhat V, Detchou D. The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators. JMIR Medical Education. 2023;9: e37069. ([Review Article], PMID: 36607718, Available from: https://mededu.jmir.org/2023/1/e37069)

Workshop on Principles of Cancer Epidemiology 2018 Brochure - Christian Medical College, Vellore

ahmadozair2@slideshare.net(ahmadozair2) — Sat, 30 Apr 2022 15:35:37 GMT

Workshop on Principles of Cancer Epidemiology. October 11-13, 2018 Course offered by Biostatistics Resource and Training Centre, Clinical Epidemiology Unit, Christian Medical College, Vellore, India. In collaboration with the Department of Health Research Methods, Evidence, and Impact (previously Clinical Epidemiology and Biostatistics) at McMaster University, Ontario, Canada, and the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, Maryland, United States. This course’s main purpose is to impart foundational knowledge in the principles and practice of cancer epidemiology, specifically in the areas of cancer etiology, surveillance, and survival analysis. The etiology module will cover the design, analysis, and interpretation of observational studies. The surveillance module will contain an overview of the infrastructure needed to conduct cancer surveillance, aspects of data quality, and tools for using the data (standardization, age-period-cohort models). Finally, the survival analysis module will include material related to life tables, survival curves, survival time models, and the application of survival analysis to screening trials and evaluation. Other topics that may be covered include: cancer etiology and surveillance in the local Indian setting, sample size calculation, and risk factor surveillance. An important aspect of this course will be hands-on exercises using examples to understand the theory and its applications in cancer epidemiology.

Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 17 Mar 2022 07:02:18 GMT

Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24–51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34–69) and the youngest in the low HDI tier (median 28 years, IQR 20–38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6–32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55–5·2) and high HDI tier (2·26, 1·23–4·15), but not the low HDI tier (1·66, 0·61–4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17–2·49).

State of Accredited Endovascular Neurosurgery Training in India in 2021: Challenges to Capacity Building in Subspecialty Neurosurgical Care

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 04:04:27 GMT

The incidence of stroke has seen over a 100% rise in low- and middle-income countries (LMICs), from 1970-1979 to 2000-2008, while it has stayed nearly the same or decreased in several high-income countries (HICs). However, it has been primarily in HICs that endovascular neurosurgery has evolved to become the standard of care in the management of stroke along with becoming a key modality for managing aneurysms, vascular malformations, carotid artery disease, amongst others. With 30 million individuals suffering from the aforementioned conditions and 7.3% of overall deaths due to stroke alone, India has a particularly high disease burden that can be tackled by neurointerventional therapies. Despite stroke being a leading cause of death and a public health priority in LMICs like India, provision of endovascular neurosurgical care is extremely scarce, both in its infrastructure and the number of trained subspecialist practitioners. This opinion piece utilizes the case scenario of India to highlight how the disparity of endovascular neurosurgical care exists in the face of excellent training and delivery of general neurosurgery and its other subspecialties and highlights key recommendations. One major reason, which this article focuses upon, is the near complete lack of accredited subspecialty training in endovascular care for neurosurgeons in India in 2021. Given that the majority of neurosurgery fellowships in India are currently non-accredited in nature, professional neurosurgical societies in LMICs will play a key role in supporting fellowship accrediting bodies. With the absolute dearth of dedicated neuroendovascular training during neurosurgery residency in developing countries, coupled with the unique and specific needs of this subspeciality, it will be the establishment of high-quality, accredited fellowships that would be crucial for having the framework for delivering endovascular care.

Percutaneous image-guided cryoablation of spinal metastases: A systematic review

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:58:59 GMT

Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.

Pediatric Brain Tumors: From Modern Classification System to Current Principles of Management

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:56:54 GMT

Central nervous system (CNS) malignancies contribute significantly to the global burden of cancer. Brain tumors constitute the most common solid organ tumors in children and the second most common malignancies of childhood overall. Accounting for nearly 20% of all pediatric malignancies, these are the foremost cause of cancer-related deaths in children 0-14 years of age. This book chapter provides a state-of-the-art overview of pediatric brain tumors. It discusses their morbidity and mortality and introduces the WHO 2021 classification of CNS tumors, which is critical to therapeutic decision-making. It then describes the modern understanding of tumor grading and its clinical implications, followed by the general principles of diagnosis and management. The chapter then discusses, in detail, those brain tumors which have the highest disease burden in children, including medulloblastoma, astrocytoma, ependymoma, schwannoma, meningioma, amongst others. The landscape of treatment of pediatric brain tumors has been rapidly evolving, with several effective therapies on the horizon.

Scrub Typhus Presenting with Hemiparesis: Case Report of a Rare Manifestation

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:55:15 GMT

We here present a case of scrub typhus (ST) manifesting with hemiparesis, which, to the best of our knowledge, has been reported few times prior. ST typically presents with headache, fever, cough, dyspnoea, and/or gastrointestinal symptoms. Early treatment ensures swift improvement. However, this common cause of febrile illness is often overlooked, even in endemic regions. This is due to a nonspecific presentation, low index of suspicion, and lack of diagnostic facilities. Even our institution, an apex public referral center of northern India, lacked affordable testing a decade ago. After testing began, a significant number of cases, which would have previously been labeled as “fever of unknown origin,” were found to be of ST and confirmed by response to doxycycline.

Large Cerebral Infarction in Tuberculous Meningitis: Case Report of an Uncommon Complication

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:38:24 GMT

We here present an illustrative case of tuberculous meningitis (TBM) with a rare complication of large cerebral infarction. TBM is the most common type of chronic CNS infection in developing countries.[1] Strokes occur in 15–57% of TBM cases; mostly being associated with advanced illness.[2] An 18-year-old male was brought to a tertiary care centre in northern India with high-grade fever and headache for 3 months; followed by right-sided bodily weakness and inability to speak, for a week. He was conscious, having neck rigidity, positive Kernig's sign, global aphasia, and hemiplegia. Brain MRI suggested basal exudates, hydrocephalus, and tuberculoma in the left cerebellar hemisphere. Diffusion-weighted imaging indicated large infarct involving anterior cerebral artery (ACA) and middle cerebral artery (MCA) territories [Figure 1]. Guarded lumbar puncture was done in view of focal deficit and mass effect. CSF analysis revealed protein 3.5 g/L, glucose 1.66 mmol/L (blood glucose 7.2 mmol/L), leukocyte count of 250 with lymphocytosis, and positive Gene Xpert MTB/RIF assay. He was started on first-line anti-tuberculosis therapy (ATT), steroids, and aspirin. After 3 months, his fever and headache had improved but he still had hemiparesis and aphasia, confirming the diagnosis of grade 3 TBM. After 12 months of ATT coverage and follow-up, his motor function had improved with some residual deficits.

Letter: Is the Stupp Protocol an expensive and unsustainable standard of care for Glioblastoma in LMIC settings? A call to action!

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:34:23 GMT

Glioblastoma multiforme (GBM) is the most common and aggressive primary adult brain neoplasm with an age-adjusted incidence rate of 3.22 per 100 000 individuals and a 5-yr survival rate of 6.8%.1 In 2005, Stupp and colleagues proposed maximal safe resection, concomitant temozolomide (TMZ) with radiotherapy, and adjuvant TMZ as the optimal treatment. Implementation of the Stupp protocol in high-income countries (HICs) has resulted in increased survival compared to previous regimens. With little-to-no literature on the management and outcomes of patients with GBM in low- and middle-income countries (LMICs), it is unclear whether the Stupp protocol is being adopted or whether it is, or ever can be, the optimal strategy in LMICs...

Learning to practice medicine during COVID-19 and mucormycosis epidemics: an intern perspective from India

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:24:30 GMT

The COVID-19 pandemic has greatly affected medical education and training experiences for interns and resident doctors. As medical schools shifted their teaching curriculum to virtual platforms, most senior medical students lacked sufficient clinical exposure as they missed out on in-hospital rotations before beginning their intern year. In this article, we share our experience in transitioning from medical school to our intern year while working in COVID and non-COVID facilities. We discuss our challenges while learning basic skills in a resource-limited setting during a period of high patient mortality because of COVID-19 and Mucormycosis.

Medical Students in Global Neurosurgery: Rationale and Role

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:22:54 GMT

Approximately 5 million essential neurosurgical cases are unmet each year, all in low- and middle-income countries (1). After the Lancet Commission on Global Surgery described the absence of global surgery from global health discourse in January 2014 (2), the field of neurosurgery quickly recognized the importance of increasing equity in care globally (3-5). Although existing initiatives in global neurosurgery have focused on neurosurgeons and trainees, medical students represent a promising group for sustainable long-term engagement. We characterize why medical students are fundamental to success, outline the importance of incorporating medical students, and delineate how to increase medical student interest and participation in global neurosurgery.

Impaled roadside guardrail in the neck: Case of a failed motorcycle stunt

ahmadozair2@slideshare.net(ahmadozair2) — Thu, 13 Jan 2022 03:21:12 GMT

Trauma is currently the leading cause of death in the age group 15 to 44 years globally, with road trauma now representing the sixth leading cause of death worldwide. We present a case of a young male, who was brought to the apex trauma centre of the province with a metallic roadside guardrail impaled in his neck up to his oral cavity, which had to be cut to transport him to the hospital. A meticulous local exploration resulted in the successful removal of the spiked guardrail, with no damage to critical structures. We discuss the paradigm changes in and the expertise required for the management of such penetrating neck injuries (PNIs). For family physicians, this case represents one of the wide variety of cases they will be called to help upon and administer prehospital care. Thus, utilization of principles of basic life support, recognition of the severity of road trauma cases, and ensuring urgency of referral by general practitioners are all critical.

Scrub typhus manifesting with intracerebral hemorrhage: Case report and review of literature

ahmadozair2@slideshare.net(ahmadozair2) — Wed, 12 Jan 2022 17:36:35 GMT

Scrub typhus (ST), hitherto absent from many parts of India, is now recently being recognized as a significant cause of morbidity and mortality throughout the country. Its diverse clinical presentations, low of the index of suspicion by the treating physician, and lack of diagnostic testing in many parts of the country result in delayed treatment, leading to a host of complications. We here report such a complication, where ST manifested with a large intracerebral hemorrhage, of which, to the best of our knowledge, only nine cases have been reported in the English language worldwide. Family physicians, who are the often first point of contact for treatment of febrile illness, as ST typically manifests, need to be aware of this entity to prevent such catastrophic consequences.

Bilateral limb gangrene in an HIV patient due to vasculopathy: Managing the dual challenge of psychosocial issues and an uncommon medical condition

ahmadozair2@slideshare.net(ahmadozair2) — Wed, 12 Jan 2022 17:34:21 GMT

Patients with human immunodeficiency virus (HIV) have been reported to experience a spectrum of homeostatic dysregulation and resulting manifestations in their vascular system. This may be due to either disruption in the coagulation-anticoagulation pathways or due to damage to vessels from either HIV or other opportunistic infections. However, gangrene in an HIV-infected patient is an uncommon phenomenon. We herein report a case of a 30-year-old female, who had been taking antiretrovirals irregularly for 10 years, developing bilateral limb gangrene during her hospitalization for cryptococcal meningitis. Unfortunately, her condition continued to deteriorate and her attendants took her from the hospital against medical advice, with her death soon after. We illustrate how several biopsychosocial factors came together here to result in poor outcomes. To note, peripheral arterial disease (PAD) in HIV can rapidly lead to critical limb ischemia, resulting in limb gangrene. Aggravating risk factors for the same include smoking, poor glycemic control, and/or low CD4 T-cell count (<200 cells/mm3). General practitioners should be aware that HIV patients are far more prone to PAD than the normal population. Early recognition of at-risk patients, both medically and psychosocially, by family physicians is thus critical.