A retrospective, cross-sectional, analytical study of acute coronary syndrome (ACS) patients aged over 18 was conducted at Aga Khan University Hospital, Karachi, from January 2019 to December 2019, and then from July 2020 to December 2020. The data includes attributes regarding demographics, comorbidities, smoking history, and the presence of a history of dyslipidaemia. An exploration of the association between infections and acute coronary syndrome was undertaken using binary logistic regression. A statistical analysis of the data was performed with SPSS 26.
Within the 1202 individuals diagnosed with acute coronary syndrome, 189 (157 percent) showed evidence of infection preceding the coronary event. BI9787 The mean patient age was 685124 years, and a notable 97(513%) of the patients identified as female. A substantial 105 (556%) patients presented with community-acquired pneumonia, followed by urinary tract infections affecting 64 (339%) patients, and finally, cellulitis diagnosed in 8 (42%) patients. Patients with pneumonia had a 11-fold (95% confidence interval 0.4-30) greater chance of experiencing a non-ST elevated myocardial infarction compared to those without pneumonia. A statistically significant association was found between urinary tract infections and unstable angina, with an odd ratio of 42 (95% confidence interval 1-174), and a separate link between urinary tract infections and ST-elevation myocardial infarction, with an odds ratio of 37 (95% confidence interval 0.04-31).
Bacterial infections were identified as contributors to the development of acute coronary syndrome. Myocardial ischemia was observed more frequently in cases of bacterial pneumonia and urinary tract infections.
Cases of acute coronary syndrome frequently involved the presence of bacterial infections. Bacterial infections, frequently accompanied by pneumonia and urinary tract infections, exhibited a statistically significant relationship with the occurrence of myocardial ischemia.

Analyzing the magnitude and motivating factors that form the glass ceiling for Pakistani women physicians in positions of leadership.
A qualitative narrative study, undertaken at the Department of Medical Education, Riphah International University, Islamabad, Pakistan, from March to July 2021, involved female doctors with 10-15 years of professional experience. These doctors were either currently in or had previously held senior leadership positions within public and private medical clinical settings, including hospitals and colleges. Data collection involved in-depth interviews conducted via Zoom, due to the global health crisis of COVID-19. Employing an inductive approach, the transcribed data was analyzed for themes using the ATLAS.ti.9 software package.
Among the 9 subjects, aged 47 to 72 years, with 11 to 39 years of professional experience, 4 (44.4%) identified as clinicians, 3 (33.3%) held a background in basic medical sciences, and 2 (22.2%) were health professions educators. Regarding the qualifications of the individuals, four (444%) held PhDs, four (444%) were Fellows of the College of Physicians and Surgeons, Pakistan, and one (111%) possessed an M.Phil. Furthermore, four subjects (444%) hailed from the public sector, and five (555%) from the private sector; one (111%) had retired from their position. The experience of encountering the glass ceiling was almost universal, affecting all but one participant. Key factors recognized included 'institutional impediments', 'familial support concerns', 'personal struggles', and 'social intolerance'. The comprehensive evaluation revealed the 'malicious intent of senior staff' targeting women in leadership, causing 'discrimination', 'negative labeling', 'a lack of mentorship', and 'prejudice based on ethnic background' within the organization's structure. Regarding their personal lives, they endured the lack of support from their in-laws, the insecurity and anxieties their husbands experienced, the perceived absence of desired personal attributes, and the considerable weight of beauty standards as a roadblock.
In both clinical and academic settings, Pakistani female doctors in leadership roles discovered the glass ceiling to be a considerable obstacle.
Pakistani female doctors in clinical and academic leadership experienced the glass ceiling as a persistent challenge.

In order to determine the rate of deep vein thrombosis and its widespread impact, and to assess the diagnostic utility of D-dimer in its identification.
Observational study at a tertiary care hospital's critical care unit in Pakistan, involving consecutively admitted adult critically ill patients on therapeutic-dose anticoagulation, was carried out from February to September 2021, with a prospective design. Deep venous thrombosis screening, employing color Doppler and compression ultrasonography, was completed on day one for every patient. Patients without deep vein thrombosis on the initial scan underwent follow-up evaluations every 72 hours. SPSS 26 served as the tool for analyzing the provided data.
A breakdown of the one hundred forty-two patients reveals ninety-nine males, which accounts for sixty-nine point seven percent of the sample, and forty-three females, comprising thirty point three percent. A mean age of 5320 years was observed, with a margin of error of 133 years. Of the patients screened in the first scan, 25 (176%) presented with deep vein thrombosis. From the pool of 117 remaining patients, 78 (684%) underwent 72-hour follow-ups, and from this cohort, 23 (2948%) unfortunately developed deep venous thrombosis. The common femoral vein was the predominant site of deep vein thrombosis (DVT), affecting 46 patients (95.8%), with a considerable portion (28, or 58.33%) presenting as unilateral thrombosis. No discernible differentiation in deep vein thrombosis diagnoses was observed based on D-dimer levels (p=0.79). BI9787 No discernible risk factors were implicated in the genesis of deep vein thrombosis.
The presence and frequency of deep venous thrombosis, surprisingly, were substantial even with therapeutic-dose anticoagulation. The common femoral vein, a frequent site of deep vein thrombosis, was affected in most cases with the condition occurring on a single limb. Deep vein thrombosis (DVT) diagnosis showed no discriminatory ability in D-dimer levels.
Despite receiving a therapeutic dose of anticoagulation, there was a significant frequency and widespread occurrence of deep vein thrombosis. The common femoral vein was the most frequent target of deep vein thrombosis, and a majority of these cases were unilateral. BI9787 D-dimer levels failed to differentiate cases of deep vein thrombosis (DVT), demonstrating no discriminative capacity.

Investigating the influence of a pharmacovigilance system on the prescribing of potentially inappropriate medications for older adults.
Following ethical review committee approval at Shaanxi Provincial People's Hospital, China, a retrospective study was undertaken, including prescription data for patients aged 65 or older, covering the period from May 2020 to April 2021. Evaluations encompassed the counts of medication risk assessment entries, interventions on inpatients' and outpatients' medical orders, medical order prompts, and physician communications with prescription-checking pharmacists. Comparison of potential drug interaction rates was undertaken between the pre-implementation period (May-October 2020) and the post-implementation period, encompassing the dates from November 2020 to April 2021. Apart from that, the prescription and usage of sedatives, hypnotics, and perhaps inappropriate medications were examined from January to June 2021, to assess the long-term effectiveness of the pharmacovigilance initiative. Employing SPSS version 19, the data underwent meticulous analysis.
Among the 3911 outpatient prescription warning entries, 118 distinct drugs were implicated. Strikingly, a subset of 19 of these drugs accounted for 3156 warnings (80% of the total). Furthermore, 113 distinct medications featured in the 3999 inpatient prescription warnings; 19 of these drugs comprised 80% (3199) of the warnings. The warning percentage for inpatients demonstrated an increase of 306% in January, subsequently decreasing to 61% in June.
To prevent the use of potentially inappropriate medications and facilitate more extensive technical support for medical safety, particularly in the individualized treatment of patients, a pharmacovigilance system is crucial.
A pharmacovigilance system's implementation can help reduce instances of potentially inappropriate medications, along with providing advanced technical support for the safety of medical practices and customized patient treatment.

Essential clinical examination skills for final-year medical students are identified and practiced extensively before the examination to ensure their proficiency.
A cross-sectional study, carried out from February to November 2019 at the Aga Khan University in Karachi, included final-year medical students and internal examiners hailing from a range of academic specialties. Details regarding the organizational context, exam structure, and process were recorded.
Ninety-six medical students filled the lecture hall to overflowing. A multidisciplinary consensus on essential undergraduate medical skills across five years, alongside student motivation for practical training, examiner tool unfamiliarity, and the urgent need for capacity building were the key areas emphasized. Stakeholder feedback and post-hoc analysis informed the key areas.
This assessment method will allow for a comprehensive evaluation of student readiness to practice independently as doctors from the start of their internship, and further improve subsequent exams, utilizing feedback gathered from faculty and students.
By enabling a complete evaluation of student readiness to practice medicine independently as undifferentiated interns at the start of their careers, this assessment form will bolster the quality of subsequent exams, informed by faculty and student input.

Normative data for the elderly, regarding the modified Romberg balance test and fall risk, needs to be generated.
A cross-sectional study, encompassing healthy adults aged 60 years and older from various Pakistani cities, spanned from July 1st, 2021, to December 31st, 2021.