Background Pakistan being a low‐ and middle‐income country, its institutes are substantially deficient in scientific and technological aspects and share limited research contributions to the world repositories. Therefore, there is a rising concern to reflect on the history and status of publishing attitudes among medical students in Pakistan and to highlight and address the barriers that they are facing. Methods A study was conducted aiming to determine the experience, motivation, and attitude of medical students in regarding publishing practices throughout Pakistan in several medical colleges. A multivariable logistic regression model was used to find the independent predictors of students publishing a research article. Forward selection was used to arrive at the final stepwise logistic regression. Odds ratio (OR) and 95% confidence interval (CI) were calculated. p < 0.05 was considered significant for all statistical tests. Results From a sample size of 1225 participants, only 6.6% of students had published an article in our study. Of these, 59% were males and 31.3% were in final year. Males were more likely to publish articles than females (OR = 2.69, 95% CI: 1.37–5.26) and final‐year students were more likely to publish articles than first‐year students (OR = 7.48, 95% CI: 1.34–41.81). Students that had the knowledge that performing research is the way through which they will be judged for jobs had significantly higher odds of getting an article published (OR = 16.21, 95% CI: 3.65–71.88). Additionally, students who had been taught how to write a paper and those who knew the process of submitting an article were more likely to get published than the others. Conclusion Our study has successfully highlighted the status of publishing among medical students in Pakistan. Our findings serve as an eye opener and call to action for authorities to address the grievances of students in terms of barriers, lack of mentorship, and lack of research teaching. We hope our findings can guide a strong policy change to facilitate the next generation of passionate researchers.
IntroductionIntraventricular hemorrhage (IVH) is a common cause of morbidity and mortality in preterm neonates. IVH leads to complications such as posthemorrhagic hydrocephalus (PHH), which commonly occurs in neonates with a more severe degree of IVH. Hence, we aimed to evaluate the characteristics and outcomes of PHH in neonates with IVH. MethodsWe performed a systematic review of cases reported from January 1978 to December 2020 through the PubMed database, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the keywords 'intraventricular hemorrhage,' 'cerebral intraventricular hemorrhage,' and 'newborn.' A total of 79 articles were considered for analysis, and data on neonatal and maternal characteristics and outcomes were collected. The analysis was performed by using the χ2 test, Wilcoxon rank-sum test, and multivariate logistic regression model. ResultsWe analyzed a total of 101 IVH cases, 54.5% were male and 62.4% preterm. Thirteen point nine percent (13.9%) presented with grade I, 35.6% grade II, and grade III respectively, and 8% grade IV IVH. Among the 59 (58.4%) neonates with PHH, 33.6% had resolved PHH and 24.8% had unresolved. In adjusted regression analysis, we found that neonates with resolved PHH have lower odds of having neurodevelopmental delay (OR:0.15, 95%CI:0.03-0.74; p=0.02) and death (OR:0.9;95%CI:0.01-0.99; p=0.049) as compared to unresolved PHH. ConclusionOur study showed that neonates with resolved PHH have a statistically significant lower risk of neurodevelopmental delay (NDD) and mortality. Future studies should be planned to evaluate the role of treatment and its effect on outcomes in IVH neonates with PHH as a complication.
Black race was not associated with increased exposure to continuous infusion sedatives compared to White race. This is the first known study to investigate racial disparities in sedation strategies in mechanically ventilated adults in the ICU with sepsis.
Introduction: Headache disorders have been linked with enhanced atherosclerosis, cortical spreading depression, endovascular dysfunction, vasoconstriction, neurogenic inflammation, hypercoagulability, and cervical artery dissection. We aimed to evaluate the risk of cardiovascular and cerebrovascular disorders amongst patients with status migrainosus and migraine with aura. Methods: We planned a cross-sectional observational study from nationwide inpatient data from 2016-2018. Patients with status migrainosus with intractable migraine, migraine with aura, migraine without aura (simple migraine) were identified and compared with population without no migraine (control) using ICD-10-CM codes. Chi-square test) and mix-effect multivariate survey logistic regression analysis adjusted for vascular events were performed to identify prevalence and risk of association between cerebrovascular and cardiovascular disorders and migraine. Results: We identified 1184130 migraineurs out of which 60140 had status migrainosus with intractable migraine, 45285 had migraine with aura, and 16860 had migraine without aura. Prevalence of identified acute ischemic stroke (AIS) (5.5% vs no-migraine: 1.71%), transient ischemic attack (TIA) (3.99% vs 0.38%), subarachnoid hemorrhage (SAH) (0.13% vs 0.08%), angina (0.07% vs 0.06%) was higher in patients with migraine with aura compared to non-migraineurs. (p<0.0001) In regression analysis, migraine with aura was associated with higher odds of AIS (aOR: 3.7, 95%CI 3.4-4.1) and TIA (11.8, 10.5-13.2). In risk adjusted effect modification analysis, patients with AIS (1.5, 1.2-1.9) and TIA (3.0, 2.1-4.3) had higher odds of severe and extreme disability (APR DRG Severity) in patients with migraine with aura compared to patients with intractable migraine. Conclusion: We found that the patients with migraine with aura had higher risk of stroke than patients with intractable or simple migraine. More prospective studies should be planned to evaluate the effect of long-term management of migraine with aura to mitigate the burden of cerebrovascular events and associated disability. Further studies should be directed towards identifying the relationship between migraine and cardiovascular disorders.
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