Machine learning in heart failure diagnosis, prediction, and prognosis: review.

Globally, cardiovascular diseases take the lives of over 17 million people each year, mostly through myocardial infarction, or MI, and heart failure (HF). This comprehensive literature review examines various aspects related to the diagnosis, prediction, and prognosis of HF in the context of machine learning (ML). The review covers an array of topics, including the diagnosis of HF with preserved ejection fraction (HFpEF) and the identification of high-risk patients with HF with reduced ejection fraction (HFrEF). The prediction of mortality in different HF populations using different ML approaches is explored, encompassing patients in the ICU, and HFpEF patients using biomarkers and gene expression. The review also delves into the prediction of mortality and hospitalization rates in HF patients with mid-range ejection fraction (HFmrEF) using ML methods. The findings highlight the significance of a multidimensional approach that encompasses clinical evaluation, laboratory assessments, and comprehensive research to improve our understanding and management of HF. Promising predictive models incorporating biomarkers, gene expression, and consideration of epigenetics demonstrate potential in estimating mortality and identifying high-risk HFpEF patients. This literature review serves as a valuable resource for researchers, clinicians, and healthcare professionals seeking a comprehensive and updated understanding of the role of ML diagnosis, prediction, and prognosis of HF across different subtypes and patient populations.

The challenges and main recommendations to fight measles in India: A mini review.

The measles virus is an RNA virus belonging to the Paramyxoviridae family. It leads to an acute communicable illness that primarily involves the respiratory tract. Vaccination has significantly reduced the overall incidence and mortality worldwide; however, outbreaks still occur globally each year due to several factors. The SARS-CoV-2 pandemic has been a major hurdle since 2020. Despite the World Health Organization's goal to eradicate measles by 2023, there has been an increase in measles incidence in India, with 61,562 cases in 2022. Vaccination is a crucial preventive measure, and coverage needs to be increased through education, advocacy, and outreach to isolated communities.

Role of soluble urokinase type plasminogen activator receptor (suPAR) in predicting mortality, readmission, length of stay and discharge in emergency patients: A systematic review and meta analysis.

BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker that is used to predict mortality, readmission, early discharge, and LOS, thus, serves as a useful tool for ED physicians. Our study aims to analyze the efficacy of suPAR in predicting these prognostic markers in ED. METHODS: We performed a comprehensive search on 6 databases from the inception to 30th November 2022, to select the following eligibility criteria; a) observation or triage trial studies investigating the role of suPAR levels in predicting: 30 day and 90-day mortality, 30-day readmission, early discharge (within 24hr), and LOS in patients coming to AMU. RESULTS: A total of 13 studies were included, with a population size of 35,178, of which 52.9% were female with a mean age of 62.93 years. Increased risk of 30-day mortality (RR = 10.52; 95% CI = 4.82-22.95; I2 = 38%; P < .00001), and risk of 90-day mortality (RR = 5.76; 95% CI = 3.35-9.91; I2 = 36%; P < .00001) was observed in high suPAR patients. However, a slightly increased risk was observed for 30-day readmission (RR = 1.50; 95% CI = 1.16-1.94; I2 = 54%; P = .002). More people were discharged within 24hr in the low suPAR level group compared to high suPAR group (RR = 0.46; 95% CI = 0.40-0.53; I2 = 41%; P < .00001). LOS was thrice as long in high suPAR level patients than in patients with low suPAR (WMD = 3.20; 95% CI = 1.84-4.56; I2 = 99%; P < .00001). CONCLUSION: suPAR is proven to be a significant marker in predicting 30-day and 90-day mortality in ED patients.

Re-emergence of Lassa fever in Nigeria: A new challenge for public health authorities.

The Lassa virus is an RNA virus belonging to the Arenaviridae family. It is responsible for Lassa fever, an acute viral zoonosis of the severe hemorrhagic fever type with manifestations of fever, muscle pain, sore throat, nausea, vomiting, and chest and abdominal pain. Lassa fever is endemic in West Africa, where the first case was reported in 1969 in Lassa, a town in Nigeria, more than 50 years ago, and it is estimated that nearly 5000 deaths occur in West Africa each year. Nigeria is one of the endemic hotspots and has experienced numerous recurrent outbreaks of Lassa fever due to the increased multiplication of the host reservoir, Mastomys natalensis. For the Lassa epidemics in 2022 and January 2023 alone, Nigeria accounts for a quarter of the annual deaths from this disease. Poor lifestyle and hygiene, difficulty in diagnosis due to nonspecific symptomatology, lack of effective treatment based on clinical evidence, an ineffective human immunization program combined with a health system that is not adapted or equipped to control and prevent recurrent deadly epidemics, and an outdated regional disease surveillance system in West Africa are some of the challenges that must be overcome to rapidly and effectively eradicate this disease, whose area of spread is constantly expanding as a result of the movement of populations in the context of economic and socio-cultural activities.

Reflections on the surge in malaria cases after unprecedented flooding in Pakistan-A commentary.

Background: Malaria is a parasitic infection primarily caused by four main species of the genus Plasmodium, that is, Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax, and Plasmodium malariae. It is transmitted through the bite of the female Anopheles mosquito. It holds the status of one of the leading causes of death in the developing world. Malaria is endemic to Pakistan, and the country experienced the worst floods in its history from April to October 2022. The stagnant flood water served as a breeding ground for mosquitoes, culminating in an alarming spike in malaria cases. According to the World Health Organization (WHO), the number of cases reported till August 2022 was more than in the whole year of 2021. There was more than a twofold rise in cumulative cases in 62 high-burden Pakistani Districts in August 2022 as compared to August 2021. Aims: This commentary aims to bring this emerging issue to notice and highlight the most effective probable measures to help eliminate and prevent the hazards the current outbreak poses. Results: Rapid planning and execution are needed to ensure the most efficient and rapid elimination of malaria. To educate the general public, the national government must start public awareness efforts in electronic, print, and social media and deploy solar-powered mobile healthcare units to far-flung areas. Prophylactic and postexposure treatments should be planned because larvicidal preventive measures are less practical in flood-affected vicinities. Conclusion: The most effective preventive strategy is drug prophylaxis, followed by insecticide-treated nets, indoor residual spraying, and untreated nets. Scientists should intensify their investigations for effective medications to alleviate the malaria burden in Pakistan.

Management of Marjolin's ulcer with popliteal lymphadenopathy with surgical resection and lymphadenectomy in a young patient, an uncommon lesion and overlooked entity: A case report.

Key Clinical Message: In non-healing ulcers with a previous history of burns, clinicians should have a high index of suspicion for Marjolin's ulcer and a low threshold for biopsy, irrespective of age. Abstract: Marjolin's ulcer is a rare malignancy arising from chronic inflammation and commonly manifests in burn scars. Thus, in cases of chronic wounds or non-healing ulcers, health professionals should have a high index of suspicion and a low threshold for biopsy, irrespective of age. Early diagnosis and timely management of tumors can improve the prognosis and overall survival rate. Moreover, further studies are needed to develop an evidence-based management approach for Marjolin's ulcer.

Global trends of monkeypox-related articles: A bibliometric analysis over the last five decades (1964 - July 14, 2022).

BACKGROUND: The first human monkeypox (MPX) case was identified in the Democratic Republic of Congo (DRC) in 1970 with an outbreak in 2010 and the first human MPX case in the UK in 2022. In this study, we conducted a bibliometric analysis of the literature on monkeypox based on the Web of Science Core Collection (WOSCC) of the Institute for Scientific Information (ISI) to identify relevant topics and trends in monkeypox research. METHODS: We searched the Web of Science from 1964 until July 14, 2022, for all publications using the keywords "Monkeypox" and "Monkeypox virus." Results were compared using numerous bibliometric methodologies and stratified by journal, author, year, institution, and country-specific metrics. RESULTS: Out of 1170 publications initially selected, 1163 entered our analysis, with 65.26 % (n = 759) being original research articles and 9.37 % (n = 109) being review articles. Most MPX publications were in 2010, with 6.02 % (n = 70), followed by 2009 and 2022 at 5.67 % (n = 66) each. The USA was the country with the highest number of publications, with n = 662 (56.92 %) of total publications, followed by Germany with n = 82 (7.05 %), the UK with n = 74 (6.36 %), and Congo with n = 65 (5.59 %). Journal of Virology published the highest number of MPX publications, followed by Virology Journal and Emerging Infectious Diseases with n = 52 (9.25 %), n = 43 (7.65 %), and n = 32 (5.69 %) publications, respectively. The top contributing institutions were the Centers for Disease Control and Prevention (CDC), the US Army Medical Research Institute of Infectious Diseases, and the National Institutes of Health (NIH)National Institute of Allergy and Infectious Diseases (NIAID). CONCLUSION: Our analysis provides an objective and robust overview of the current literature on MPX and its global trends; this information could serve as a reference guide for those aiming to conduct further MPX-related research and as a source for those seeking information about MPX.

Alarming rise in HIV cases in Pakistan: Challenges and future recommendations at hand.

Background: Human immunodeficiency virus (HIV) is a retrovirus that suppresses the immune system by reducing the CD4+ T lymphocytes level. It has become a global challenge with fast prevalence ratio. Like other developing countries, Pakistan is also struggling for overcoming this viral disease since very first reported case in 1987. Aim: To update the society on the alarming rise in HIV cases in Pakistan: challenges and future recommendations at hand. Materials and Methods: The review paper utilized different search engines such pubmed central, scopus, web of science, google scholar etc. to conduct this review paper. Results: Lack of awareness, low literacy rate, practice of unhygienic equipment in healthcare departments, unstable economy, and unsafe sexual practices are the major factors behind the increasing rate of AIDS in Pakistan. Conclusion: By regulating healthcare practices and policies, promoting psychological counseling to HIV positive patients, educating the society and minimizing commercial sex practices, Pakistan can overcome this viral disease.

Diseases caused by floods with a spotlight on the present situation of unprecedented floods in Pakistan: a short communication.

Few natural calamities surpass floods in their destructive capabilities. The recent floods in Pakistan were declared the world's deadliest since the South Asian floods of 2020 and were, by far, the most destructive floods in the country's history. They have resulted in significant loss of life and property and have served as the harbingers of cutaneous and noncutaneous diseases. These floods have dealt a critical blow to the country's already struggling healthcare system, which lacks resources for the prompt mobilization of medical personnel and resources to the flood-hit areas. Having lost their houses, the flood victims are wholly exposed to the elements. Lack of access to a clean water supply has predisposed them to a myriad of diseases. We believe that the consolidation of efforts by the national and international community will put an end to the plight of these flood victims. Our article highlights the significant diseases associated with floods, the challenges faced by the flood victims, and recommendations on how their situation can be improved.

Diphtheria in Pakistan post-COVID-19, a potential public health threat: an update.

Diphtheria, a vaccine-preventable disease, remains a concern in Pakistan as cases have risen post-COVID-19 pandemic causing more than 45 deaths in Pakistan in the year 2022. The respiratory variant of the disease is more common and can lead to serious complications, such as myocarditis and respiratory insufficiency. Diphtheria has caused havoc in the past killing millions of people worldwide before the development of its vaccine. Although the diphtheria toxoid vaccine is effective against toxigenic strains, there have been cases of treatment-resistant strains, particularly the non-toxigenic strains of C. diphtheriae. Pakistan's economic and health systems have suffered setbacks, which have been exacerbated by the COVID-19 pandemic. The pandemic has disrupted routine vaccination programs, and recent floods have contributed to an increase in diphtheria cases and rendered millions homeless. Poor immunization services, inadequate training of vaccination teams, and wealth inequality have all contributed to unequal vaccination coverage in Pakistan. The rising cases of diphtheria call for prompt action, including booster shots, updating vaccination records and administering immediate doses of the toxoid to close contacts.

Rift Valley fever virus outbreak in Mauritania yet again in 2022: No room for complacency.

Rift Valley fever is an important yet ignored viral hemorrhagic fever claiming many lives of African and Arabian countries over the past decade. Unfortunately, a recent outbreak of Rift Valley fever is currently ravaging in Mauritania. Death toll is rising continuously with 23 deaths reported in the month of October, 2022. Our article aims to shed light on the ongoing Rift Valley fever outbreak and recommendations to eradicate this potential threat to public health. Online databases including PubMed, the Lancet, and Science Direct as well as conferences, news, and press releases were used to for data collection. All the available medical literature related to Rift Valley fever in Mauritania were taken into consideration while writing the manuscript. As of October 17, 2022, 47 cases have been documented out of which 23 are dead. Case fatality rate has been reached to 49% which has given a wakeup call to the authorities. Efforts are being made by the concerned authorities and World Health Organization to halt the progression of this outbreak. Further investigations are required to completely eradicate the recurrent outbreaks in Mauritania especially in the area of vaccine development. Active involvement of public with the government authorities is of extreme significance in combating this disease.

Year-round dengue fever in Pakistan, highlighting the surge amidst ongoing flood havoc and the COVID-19 pandemic: a comprehensive review.

Dengue fever (DF) is an arthropod-borne viral infection caused by four serotypes of dengue virus (DENV 1-4) transmitted to the host by the vector mosquito Aedes, which causes fever, vomiting, headache, joint pain, muscle pain, and a distinctive itching and skin rash, ultimately leading to dengue hemorrhagic fever and dengue shock syndrome. The first case of DF in Pakistan was documented in 1994, but outbreak patterns began in 2005. As of 20 August 2022, Pakistan has 875 confirmed cases, raising alarming concerns. Misdiagnosis due to mutual symptoms, lack of an effective vaccine, the weakened and overburdened health system of Pakistan, irrational urbanization, climate change in Pakistan, insufficient waste management system, and a lack of awareness are the significant challenges Pakistan faces and result in recurrent dengue outbreaks every year. The recent flood in Pakistan has caused massive destruction, and stagnant dirty water has facilitated mosquito breeding. Sanitization and spraying, proper waste management, an adequate and advanced diagnostic system, control of population size, public awareness, and promotion of medical research and global collaboration, especially amidst flood devastation, are recommended to combat this deadly infection in Pakistan. This article aims to comprehensively review the year-round DF in Pakistan, highlighting the surge amidst ongoing flood havoc and the coronavirus disease 2019 pandemic.

COVID-19 and Cardiovascular Diseases: A Literature Review From Pathogenesis to Diagnosis.

The coronavirus disease 2019 (COVID-19) took the world by storm after the first case of COVID-19 emerged in China on December 8, 2019. The disease is generally considered as an infection of the respiratory system, but serious life-threatening myocardial injuries have been reported with this infection. Coronavirus can damage cardiac myocytes by entering the cell through angiotensin-converting enzyme 2 (ACE-2) receptor binding. Myocardial infarction, myocarditis, heart failure, cardiac arrhythmias, and Takotsubo cardiomyopathy are cardiac clinical manifestations commonly seen among patients affected by COVID-19. These cardiac pathologies are seen both during ongoing infection and post-infection. Elevated levels of myoglobin, troponin, creatine kinase-MB, plasma interleukin-6, lactate dehydrogenase (LDH), and N-terminal pro-b-type natriuretic peptide (NT-proBNP) have been found in COVID-19-associated myocardial injuries. The diagnostic modalities used in myocardial injuries due to COVID-19 include electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), endomyocardial biopsy, echocardiography (Echo), and computerized tomography (CT-Scan). This literature review will discuss, in detail, the pathogenesis, clinical manifestations, and diagnosis of myocardial injuries due to COVID-19.

Radiological manifestation of optic nerve infarction in a patient with invasive mucormycosis secondary to diabetic ketoacidosis in Pakistan.

A 35 years old male patient presented in the hospital with complaints of left-sided facial swelling, blindness in the left eye, and left eye proptosis. He had a concomitant history of diabetic ketoacidosis. Magnetic resonance imaging was advised, which revealed infected tissue of the left cheek, optic nerve infarction, intracranial extension, and leptomeningeal involvement by the disease process.

Crimean-Congo hemorrhagic fever outbreak in Pakistan, 2022: A warning bell amidst unprecedented floods and COVID 19 pandemic.

Crimean-Congo hemorrhagic fever (CCHF) is an infection caused by a tick-borne virus (genus: Nairovirus, family: Bunyaviridae). The most important vector for CCHF is the ixodid tick. Along with tick bite, direct contact with the virus-affected animal is responsible for its spread. Pakistan witnessed its first case of CCHF in 1976 and has been a major victim of CCHF for years, but spikes in cases are seen after Eid-ul-Adha, an Islamic festival involving the sacrifice of cattle. The disease, in particular, is common among butchers, veterinarians, and livestock workers. From the start of this year till June 22, 2022, a total of four cases have been reported across the country. Pakistan faces major challenges in combating CCHF every year due to its specific geographical position and a majority of the population being involved with animal husbandry. There is no approved vaccine for its prevention. All these factors contribute to the burden on the already weakened healthcare system of Pakistan. Strict actions should be taken to contain the spread of the disease. The need of the hour is to engage the general population, raise awareness, and develop policies to ensure disease surveillance. This should be accompanied by fostering collaboration among animal and human health departments for efficient communication and early intervention. The focus should be on medical research to find an efficacious treatment and prophylaxis for the CCHF virus, which will be the cornerstone of future CCHF prevention and control strategies.