Background: Many acute stroke clinical trials (ASCTs) are underpowered, inconclusive, or terminat... more Background: Many acute stroke clinical trials (ASCTs) are underpowered, inconclusive, or terminated early. A pervasive challenge to ASCT recruitment is the physical separation of patients, their legally authorized representatives, research coordinators, and clinician investigators when trial-eligible patients present emergently. Remote research practices (RRPs) may aid time-critical ASCT enrollment and follow-up, however, their feasibility and effectiveness are understudied. Methods: We retrospectively reviewed ASCT enrollment (NCT03785678, NCT03735979, NCT02072681) at two institutions. Essential clinical trial elements (ECTEs) consisted of eligibility screening, informed consent, randomization, study intervention, and inpatient/outpatient follow-up assessments. When conventional in-person clinical research was not possible, ECTEs were attempted via RRPs utilizing either telemedicine evaluation or telephone communication. The primary outcome was the successful execution of accurate,...
Introduction Male and female sexual dysfunction is frequently found in patients with hypertension... more Introduction Male and female sexual dysfunction is frequently found in patients with hypertension. Many studies indicate that this is found more frequently in patients treated with beta-blockers rather than due to hypertension itself; however, almost all studies have been done on male population. This study aims to study the effect of two commonly used beta-blockers on sexual function of a hypertensive female patient. Methods This two-arm open-label randomized prospective study was conducted from April 1, 2019 to March 30, 2020 in a tertiary care hospital at Pakistan. One hundred and fifty participants randomized to group A were given nebivolol 5 mg once daily in addition to their current hypertensive treatment. Another 150 participants randomized to group B were given bisoprolol 5 mg once daily in addition to their hypertensive therapy. Sexual function was assessed on day 0 and day 90 using female sexual function index (FSFI). Results The mean sexual score in the nebivolol group si...
The International Court of Justice (ICJ) has generally had a liberal stance towards the admissibi... more The International Court of Justice (ICJ) has generally had a liberal stance towards the admissibility of evidence and indeed in most of the instances the Court accepts the evidence submitted by the parties, however when it comes to evidence which is circumstantial, classified, or illicitly obtained the Court has deviated from this general rule. This article focuses on exactly these issues and tackles some specifics within these issues e.g. the Court’s treatment of press reports, public knowledge, maps, and the weight accorded to them etc. The paper also discusses the significance of Wikileaks and the likely outcome if a party ever presents it as evidence before the Court. Lastly, it discusses the potential approach taken by the Court if a paucity or a lack of evidence arises.
The paper is composed of distinct reviews on various fabrication technologies of the CMOS family ... more The paper is composed of distinct reviews on various fabrication technologies of the CMOS family and the characterization of MOS capacitors. The initial part of the article essentially presents a systemic review on an already conducted work on different fabrication technologies such as Si MOSFET, SiGe HBT, and InP HBT. Device and circuit-level performance for broadband and tuned millimetre-wave applications is discussed in detail relative to the underlying CMOS technologies. The comparison is made for various performance metrics for 180 nm, 130 nm, and 90 nm n-MOSFET devices for SiGe and InP HBTs. In the latter part of the study, a comprehensive review on a previously conducted research on electrical and physical characterization of metal-oxide-semiconductor (MOS) capacitors fabricated on a 2.5 μm epitaxial germanium layer grown on (100) silicon substrate is undertaken. The focus and crux of the study is the influence of germanium surface preparation on MOS electrical characteristic...
BACKGROUND The risk of prosthetic valve endocarditis (PVE) in patients who underwent transcathete... more BACKGROUND The risk of prosthetic valve endocarditis (PVE) in patients who underwent transcatheter aortic valve replacement (TAVR) is presumed to be high. METHODS Electronic databases were searched to identify articles comparing the rate of PVE in post-TAVR and post-surgical aortic valve replacement (SAVR) patients. Pooled adjusted odds ratio (OR) was computed using a random-effects model. RESULTS A total of 19 studies consisting of 84,288 patients, were identified. There was no significant difference in the odds of PVE between patients undergoing TAVR and SAVR, at 30-day (OR 0.62, 95% confidence interval (CI) 0.20-1.92, p = 0.41), 1-year (OR 0.99 95% CI 0.89-1.11, p = 0.84), 2-year (OR 1.02 95% CI 0.68-1.54, p = 0.92) and 5-year (OR 1.03 95% CI 0.80-1.33, p = 0.81). A subgroup sensitivity analysis also showed no significant inter-group differences in the rate of PVE at all time points, when stratified by the study design (clinical trial vs. observational), type of TAVR valves used (self-expanding bioprosthetic valves vs. balloon expanded bioprosthetic valves) and surgical risk of patients (high vs. intermediate vs. low). There was no heterogeneity (I2 = 0%) in the outcomes of the included studies at 30-day, 1-year and 2-year, while the heterogeneity in studies at 5-year was minimal (I2 = 22%). CONCLUSIONS In comparison to SAVR, both short and long-term risk of prosthetic valve endocarditis appears to be identical in patients undergoing TAVR. This risk is unaffected by the type of valve, duration of follow-up, study design and surgical risk of the patients.
Introduction: Endothelial dysfunction is an early marker of atherosclerosis. Flow-mediated dilati... more Introduction: Endothelial dysfunction is an early marker of atherosclerosis. Flow-mediated dilation (FMD), measured by ultrasonography, is used to noninvasively assess endothelial dysfunction. Preparations of curcumin, a naturally occurring pigment found in turmeric, may improve FMD and thus endothelial dysfunction. We did a systematic review and meta-analysis to analyze the effect of curcumin preparations on endothelial dysfunction. Methods: Five randomized clinical trials met the inclusion criteria for meta-analysis. The primary outcome was an improvement in FMD, as measured at brachial artery, after supplementations with curcumin preparations compared to the control group. Standardized mean difference and Hedges’ g were used for effect size (ES) measurement. An ES of 0.2–0.5 is considered small, 0.5–0.8 is medium, and more than 0.8 is large. Publication bias was studied too. Results: We found supplementation with curcumin preparations had an overall ES (standard difference in mea...
Background: Many acute stroke clinical trials (ASCTs) are underpowered, inconclusive, or terminat... more Background: Many acute stroke clinical trials (ASCTs) are underpowered, inconclusive, or terminated early. A pervasive challenge to ASCT recruitment is the physical separation of patients, their legally authorized representatives, research coordinators, and clinician investigators when trial-eligible patients present emergently. Remote research practices (RRPs) may aid time-critical ASCT enrollment and follow-up, however, their feasibility and effectiveness are understudied. Methods: We retrospectively reviewed ASCT enrollment (NCT03785678, NCT03735979, NCT02072681) at two institutions. Essential clinical trial elements (ECTEs) consisted of eligibility screening, informed consent, randomization, study intervention, and inpatient/outpatient follow-up assessments. When conventional in-person clinical research was not possible, ECTEs were attempted via RRPs utilizing either telemedicine evaluation or telephone communication. The primary outcome was the successful execution of accurate,...
Introduction Male and female sexual dysfunction is frequently found in patients with hypertension... more Introduction Male and female sexual dysfunction is frequently found in patients with hypertension. Many studies indicate that this is found more frequently in patients treated with beta-blockers rather than due to hypertension itself; however, almost all studies have been done on male population. This study aims to study the effect of two commonly used beta-blockers on sexual function of a hypertensive female patient. Methods This two-arm open-label randomized prospective study was conducted from April 1, 2019 to March 30, 2020 in a tertiary care hospital at Pakistan. One hundred and fifty participants randomized to group A were given nebivolol 5 mg once daily in addition to their current hypertensive treatment. Another 150 participants randomized to group B were given bisoprolol 5 mg once daily in addition to their hypertensive therapy. Sexual function was assessed on day 0 and day 90 using female sexual function index (FSFI). Results The mean sexual score in the nebivolol group si...
The International Court of Justice (ICJ) has generally had a liberal stance towards the admissibi... more The International Court of Justice (ICJ) has generally had a liberal stance towards the admissibility of evidence and indeed in most of the instances the Court accepts the evidence submitted by the parties, however when it comes to evidence which is circumstantial, classified, or illicitly obtained the Court has deviated from this general rule. This article focuses on exactly these issues and tackles some specifics within these issues e.g. the Court’s treatment of press reports, public knowledge, maps, and the weight accorded to them etc. The paper also discusses the significance of Wikileaks and the likely outcome if a party ever presents it as evidence before the Court. Lastly, it discusses the potential approach taken by the Court if a paucity or a lack of evidence arises.
The paper is composed of distinct reviews on various fabrication technologies of the CMOS family ... more The paper is composed of distinct reviews on various fabrication technologies of the CMOS family and the characterization of MOS capacitors. The initial part of the article essentially presents a systemic review on an already conducted work on different fabrication technologies such as Si MOSFET, SiGe HBT, and InP HBT. Device and circuit-level performance for broadband and tuned millimetre-wave applications is discussed in detail relative to the underlying CMOS technologies. The comparison is made for various performance metrics for 180 nm, 130 nm, and 90 nm n-MOSFET devices for SiGe and InP HBTs. In the latter part of the study, a comprehensive review on a previously conducted research on electrical and physical characterization of metal-oxide-semiconductor (MOS) capacitors fabricated on a 2.5 μm epitaxial germanium layer grown on (100) silicon substrate is undertaken. The focus and crux of the study is the influence of germanium surface preparation on MOS electrical characteristic...
BACKGROUND The risk of prosthetic valve endocarditis (PVE) in patients who underwent transcathete... more BACKGROUND The risk of prosthetic valve endocarditis (PVE) in patients who underwent transcatheter aortic valve replacement (TAVR) is presumed to be high. METHODS Electronic databases were searched to identify articles comparing the rate of PVE in post-TAVR and post-surgical aortic valve replacement (SAVR) patients. Pooled adjusted odds ratio (OR) was computed using a random-effects model. RESULTS A total of 19 studies consisting of 84,288 patients, were identified. There was no significant difference in the odds of PVE between patients undergoing TAVR and SAVR, at 30-day (OR 0.62, 95% confidence interval (CI) 0.20-1.92, p = 0.41), 1-year (OR 0.99 95% CI 0.89-1.11, p = 0.84), 2-year (OR 1.02 95% CI 0.68-1.54, p = 0.92) and 5-year (OR 1.03 95% CI 0.80-1.33, p = 0.81). A subgroup sensitivity analysis also showed no significant inter-group differences in the rate of PVE at all time points, when stratified by the study design (clinical trial vs. observational), type of TAVR valves used (self-expanding bioprosthetic valves vs. balloon expanded bioprosthetic valves) and surgical risk of patients (high vs. intermediate vs. low). There was no heterogeneity (I2 = 0%) in the outcomes of the included studies at 30-day, 1-year and 2-year, while the heterogeneity in studies at 5-year was minimal (I2 = 22%). CONCLUSIONS In comparison to SAVR, both short and long-term risk of prosthetic valve endocarditis appears to be identical in patients undergoing TAVR. This risk is unaffected by the type of valve, duration of follow-up, study design and surgical risk of the patients.
Introduction: Endothelial dysfunction is an early marker of atherosclerosis. Flow-mediated dilati... more Introduction: Endothelial dysfunction is an early marker of atherosclerosis. Flow-mediated dilation (FMD), measured by ultrasonography, is used to noninvasively assess endothelial dysfunction. Preparations of curcumin, a naturally occurring pigment found in turmeric, may improve FMD and thus endothelial dysfunction. We did a systematic review and meta-analysis to analyze the effect of curcumin preparations on endothelial dysfunction. Methods: Five randomized clinical trials met the inclusion criteria for meta-analysis. The primary outcome was an improvement in FMD, as measured at brachial artery, after supplementations with curcumin preparations compared to the control group. Standardized mean difference and Hedges’ g were used for effect size (ES) measurement. An ES of 0.2–0.5 is considered small, 0.5–0.8 is medium, and more than 0.8 is large. Publication bias was studied too. Results: We found supplementation with curcumin preparations had an overall ES (standard difference in mea...
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