Comparison of Verapamil With Adenosine After Vagal Maneuvers in Patients Presenting With Paroxysmal Supraventricular Tachycardia (pSVT), in a Tertiary Care Hospital of Lahore, Pakistan

Supraventricular tachycardia (SVT) is a term widely used to describe tachycardial dysrhythmias, paroxysmal SVT (PSVT) is a narrow term including only AV nodal re-entrant tachycardia (AVNRT) and atrioventricular re-entrant tachycardia (AVRT), both of which can cause discomfort and, in some cases, life-threatening symptoms.
Usually Carotid sinus massage is done to lower the pulse rate and after the standard time specific verapamil dose is administered. In this study after carotid sinus massage Conventional Valsalva or modified Valsalva maneuver will be randomly applied. In case, the normal sinus rhythm (NSR) is not achieved then verapamil of or adenosine dose will be administered to the patients after after taking the consent.

开始日期2024-10-28

申办/合作机构

Rashid Latif Medical College

[+1]

IRCT20221205056713N3

/ RecruitingN/AIIT

Combined Effects of Retro Walking Exercises and Clamshell Exercises on Pain, Strength and Balance among Osteoarthritis Patients

开始日期2024-07-25

申办/合作机构

Rashid Latif Medical College

IRCT20221205056713N2

/ RecruitingN/AIIT

Effectiveness of JANDAS approach Versus McKenzie retraction exercises on pain, disability and quality of life among chronic neck pain patients

开始日期2024-07-23

申办/合作机构

Rashid Latif Medical College

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项与 Rashid Latif Medical College 相关的文献（医药）

2025-06-01·Journal of Stroke and Cerebrovascular Diseases

Tenecteplase versus alteplase in patients with acute ischemic stroke: An updated meta-analysis of randomized controlled trials

Article

作者: Amine Ghenai, Mohamed ; Bouyarden, Elmehdi ; Ahmed, Raheel ; Khubaib Khan, Muhammad ; Oriana Alfieri, Caterina ; Asif, Nawal ; Ahmed, Mushood ; Khan, Ariba ; Ehsan, Muhammad ; Maaz Bin Rehan, Muhammad ; Tayyab Amer Ch, Muhammad ; Alareed, Ahmad ; Sadain Khalid, Ahmed ; Sheraz, Maheen

INTRODUCTIONAcute ischemic stroke (AIS) is a leading cause of morbidity and mortality worldwide. While alteplase has been widely used for acute management, recent clinical trials suggest that tenecteplase (TNK) may offer improved clinical outcomes. This study aims to compare the efficacy and safety of TNK compared with alteplase.METHODSA comprehensive literature search was conducted using PubMed, Embase and Cochrane Library from inception to October 2024 to identify randomized controlled trials that compared TNK at 0.25 mg/kg dosage with alteplase. Data about clinical outcomes was extracted from both groups and assessed by generating forest plots using the random-effects model and pooling odds ratios (ORs).RESULTSA total of 11 RCTs with 7,546 patients were included in the analysis. TNK showed statistically significant improvement in excellent functional outcome (mRS 0-1) compared with alteplase (OR= 1.14, 95 % CI= 1.03-1.25). No statistically significant difference was observed for good functional outcome (mRS 0-2) (OR= 1.11, 95 % CI= 0.9-1.25), early neurological improvement (OR=1.08, 95 % CI= 0.93-1.26), all-cause death (OR=0.99, 95 % CI= 0.81-1.19), symptomatic intracranial hemorrhage (OR=1.11, 95 % CI=0.81-1.52) and poor functional outcome (mRS=4-6) (OR=0.95, 95 % CI=0.79-1.14).CONCLUSIONIn patients with acute ischemic stroke, TNK demonstrated a significant advantage over alteplase in achieving excellent functional outcomes. The incidence of early neurological improvement, symptomatic intracranial hemorrhage, all-cause death, and poor functional outcome remained comparable across the two groups.

2025-04-01·Journal of the American Medical Informatics Association

Collaborative large language models for automated data extraction in living systematic reviews

Article

作者: Naqvi, Syed Arsalan Ahmed ; Khan, Muhammad Ali ; Kehl, Kenneth L ; Rumble, Robert Bryan ; Zou, Jia ; Riaz, Irbaz bin ; Murad, Mohammad Hassan ; Khakwani, Kaneez Zahra Rubab ; Sipra, Zaryab bin Riaz ; Ayub, Umair ; Raina, Ammad ; He, Huan ; Leventakos, Konstantinos ; Zhou, Sihan ; Tevaarwerk, Amye J ; Warner, Jeremy L ; Palmer, Jeanne M ; Hasan, Bashar ; Saeidi, Amir ; Baral, Chitta ; Bitterman, Danielle S

AbstractObjectiveData extraction from the published literature is the most laborious step in conducting living systematic reviews (LSRs). We aim to build a generalizable, automated data extraction workflow leveraging large language models (LLMs) that mimics the real-world 2-reviewer process.Materials and MethodsA dataset of 10 trials (22 publications) from a published LSR was used, focusing on 23 variables related to trial, population, and outcomes data. The dataset was split into prompt development (n = 5) and held-out test sets (n = 17). GPT-4-turbo and Claude-3-Opus were used for data extraction. Responses from the 2 LLMs were considered concordant if they were the same for a given variable. The discordant responses from each LLM were provided to the other LLM for cross-critique. Accuracy, ie, the total number of correct responses divided by the total number of responses, was computed to assess performance.ResultsIn the prompt development set, 110 (96%) responses were concordant, achieving an accuracy of 0.99 against the gold standard. In the test set, 342 (87%) responses were concordant. The accuracy of the concordant responses was 0.94. The accuracy of the discordant responses was 0.41 for GPT-4-turbo and 0.50 for Claude-3-Opus. Of the 49 discordant responses, 25 (51%) became concordant after cross-critique, increasing accuracy to 0.76.DiscussionConcordant responses by the LLMs are likely to be accurate. In instances of discordant responses, cross-critique can further increase the accuracy.ConclusionLarge language models, when simulated in a collaborative, 2-reviewer workflow, can extract data with reasonable performance, enabling truly “living” systematic reviews.

2025-02-10·Journal of Clinical Oncology

Survival in advanced prostate cancer (PCa) patients with visceral metastasis: A population-based SEER study.

作者: Childs, Daniel S ; Bryce, Alan Haruo ; Naqvi, Syed Arsalan Ahmed ; Cobran, Ewan Kemar ; Khan, Muhammad Ali ; Jajja, Salman Ayub ; Zakharia, Yousef ; Swati, Fnu ; Riaz, Irbaz Bin ; Anjum, Muhammad Umair ; Raina, Ammad ; Afzal, Muhammad Umar ; Singh, Parminder ; Riaz, Zaryab Bin ; Jain, Prateek

134Background: Prostate cancer patients with visceral metastases at diagnosis are often treated using one-size-fits-all approach. For example, CHAARTED criteria treats any visceral metastasis as high volume. Therefore, we aimed to assess overall survival (OS) by site of visceral involvement in patients with metastatic PCa. Methods: Surveillance, Epidemiology, and End Results (SEER) database (2010-2021) was queried to obtain case listing data on metastatic PCa patients from 17 registries. The patients were categorized into three groups based on visceral metastasis at diagnosis: lung metastasis, liver metastasis, and others. Kaplan-Meier survival analysis was performed to estimate median OS with 95% confidence interval (CI). Log-rank test was conducted to assess if survival was significantly different among the groups. Cox proportional hazard regression analysis was performed to assess the magnitude of difference among the groups. P-value <0.05 established statistical significance. Results: This analysis included 21,007 metastatic PCa patients (lung: n=319; liver: n=123; brain: 107; bone: 20538). Metastatic PCa population with lung metastasis exhibited a median OS of 60 months (95% CI: 48-72) compared to 24 months (95% CI: 12-36) in population with liver metastases and to 36 months (95% CI: 36-36) in population with other metastases. The difference in OS among the groups was statistically significant (p < 0.001). Compared to population with lung metastasis, those with liver (HR: 1.91; 95% CI: 1.41-2.57) but not those with other metastases (1.16; 0.97-1.39) had significantly worse OS adjusting for Gleason score, PSA and race (Table). Conclusions: In metastatic PCa, patients with lung-only metastasis have significantly better overall survival and should be considered differently in prognostication to liver metastases. Consideration of site of visceral metastasis is critical for treatment intensification decisions. Limitations of this analysis include lack of accounting for confounding relationships at individual patient level. VariableHazard Ratio (95% CI)Metastases (Lung)REFERENCEMetastases (Liver)1.91 (1.41-2.57)Metastases (Other)1.16 (0.97-1.39)Gleason score≥8REFERENCEGleason score <80.68 (0.64 -0.72)PSA - ng/dL1.01 (1.00 – 1.01)Race (White)REFERENCERace (Black)0.99 (0.94 – 1.05)Race (Asian or Pacific Islander)0.70 (0.64 – 0.76)

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