A comparative performance assessment of artificial intelligence based classifiers and optimized feature reduction technique for breast cancer diagnosis.

Breast cancer (BC) is a catastrophic global health concern that causes numerous fatalities worldwide. Early detection of breast cancer may mitigate death rates; however, the prevailing diagnostic procedure for the malignancy necessitates numerous multifaceted laboratory tests that must be performed by medical professionals. In this article machine learning, a branch of Artificial Intelligence (AI), has been employed to improve cancer diagnosis, prognoses and survival rates while reducing the vulnerability of humans. Support Vector Machine (SVM), K-nearest Neighbors (KNN), Decision Tree (DT), Random Forest (RF) and Grey Wolf Optimizer (GWO) are implemented to prognosticate breast cancer. Comprehensive insights into the efficacy of these approaches for breast cancer prognosis are provided by the performance assessment that is accomplished using the confusion matrix, Receiver Operating Characteristic (ROC) curves and parallel coordinate plots. Both UCI (University of California Irvine) and SEER (Surveillance, Epidemiology and End Results) datasets have been utilized to confirm the investigation's findings and ensure their generalizability across diverse data sources. The results conclusively demonstrate that SVM is the cohort's most accurate classifier. With a stupendous accuracy rate of 99.1 %, the GWO-SVM compares favorably to all other algorithms. Furthermore, feature reduction approaches such as Minimum Redundancy Maximum Relevance (mRMR), ReliefF and Principal Component Analysis (PCA) are utilized. ReliefF has demonstrated exceptional effectiveness with a maximum accuracy of 98.2 %.

Does team-based learning affect test scores of the basic medical sciences students in a modular curriculum?

Objectives: The aim of the study was to determine the effectiveness of team-based learning (TBL) sessions as a learning tool and to assess the satisfaction level of medical students towards TBL in modular curriculum. Methods: Using the quasi-experimental study design, TBL sessions were conducted, involving students of 1st and 2nd year of Bachelor of Medicine and Bachelor of Surgery. The TBL infrastructure comprised of pre-class preparation, in-class individual readiness assurance pre-test and post-test, before and after group discussion, respectively. The responses of the students regarding TBL satisfaction were recorded through a structured questionnaire (5-point Likert-type scale) while Wilcoxon signed rank test was applied to measure the effectiveness of TBL sessions. Results: Out of 192 students, 85% agreed or strongly agreed that TBL helped them think critically, identify their knowledge gaps, boosted their confidence, and motivated them in group participation. Significantly better post-test scores were found in all modules where TBL was used as a teaching tool (Z range = -5.33 to -11.81, P < 0.00). Conclusion: TBL increases the post-test score in majority of the students, indicating improved learning process. It not only keeps students engaged throughout the learning process but incites critical thinking, problem solving skills, and confidence. Further studies are required to see long-term benefit of TBL in students' learning.

Healthy ageing: Assessment of health-promoting lifestyle among the elderly population in Karachi Pakistan.

BACKGROUND: The growth in the elderly population is predicted to expand exponentially and developing countries like Pakistan have about two-third of the global elderly population. It is vital to maintain the health of the elderly aged population to reduce disabilities and health-care cost. AIM: This study aimed to determine the health promotion practices among the older aged population in Pakistan and to explore the factors associate with adopting healthy lifestyle practices. MATERIALS AND METHODS: This was a cross-sectional study spanning from 2019 to 2020 conducted on 317 participants of age more than 60 years in Pakistan. The participants included healthy attendants of patients visiting the outpatient clinics of different disciplines in the Liaquat National Hospital Karachi through purposive sampling technique. The health-promoting practices were assessed using Health-Promoting Lifestyle Profile II Questionnaire. The factors that determined the healthy practices among the elderly population were identified using independent t-test and analysis of variance and Tukey test, with a significance level of P < 0.05. IBM SPSS Statistics 22 was used for data entry and analysis. RESULTS: The highest subscale was detected from interpersonal relationships and spiritual growth. The lowest score was detected from physical activity. The scores differed significantly by occupation, education, and the marital status of the participants. Females, unmarried people, those who were less educated, and participants relying on others for financial support had lower health-promoting lifestyle scores. CONCLUSION: The overall health-promoting practices were good among the old-aged population of Pakistan. These practices differed particularly for physical activity, spiritual growth, and interpersonal relationships.

Knowledge scores in annual and modular curriculum among medical students from Karachi, Pakistan.

OBJECTIVE: To compare the knowledge scores of basic medical subjects in annual versus modular system among undergraduate medical students. METHODS: A cross-sectional survey was conducted on 4th year undergraduate medical students of annual and modular system of Liaquat National Medical College, Pakistan. Study was conducted from 30th November 2017 to 1st June 2018 for a total of 6 months. Sample size was calculated to be 82 students. The data was collected using a structured questionnaire. The student's t-test was applied to compare the mean difference of knowledge scores between the two groups. RESULTS: Students in modular system retained better knowledge of anatomy as compared to annual students. However, the annual system students retained higher knowledge in subjects of community medicine and pharmacology. Mean knowledge score among students for annual system was 12.98 ± 2.92 and semester system was 13.1 ± 3.03. There was no significant difference observed in overall mean knowledge scores between the two groups (p=0.85). CONCLUSIONS: Students in the annual system scored higher in pharmacology and community medicine. This highlighted the need to address the issues of time allocation and implementation strategies for the subjects in the new system. There was no difference between overall knowledge scores in each group, hence, it would be inappropriate to conclude that one system is superior to the other.

Prevalence and predictors of respiratory symptoms and illnesses among farmers: a cross-sectional survey, Pakistan.

BACKGROUND: Occupational exposures are one of the major causes of chronic respiratory symptoms and illnesses, where farming and its related activities make a significant contribution, especially in low- and middle-income countries such as Pakistan. AIMS: This study aimed to estimate burden of chronic respiratory symptoms and illnesses among farmers and to identify associated factors. METHODS: A translated version of American Thoracic Society Division of Lung Disease questionnaire (ATS-DLD-78A) was used among 381 farmers in Thatta District, Pakistan in 2011. Logistic regression analysis was used to assess the association between socio-demographic and occupational risk factors and respiratory illnesses. RESULTS: Chronic wheeze was reported in 65.9% of farmers exposed to pesticides compared to 34.1% of farmers not exposed (P-value: 0.10). Frequencies of other health events were almost similar among the two groups. On multivariable logistic regression analysis every 5 year increase in age of the farmer increased the risk of having respiratory illnesses by 18% (Adjusted OR [AOR]: 1.18; 95% CI: 1.03-1.35). Each 1000 Pakistani Rupees (PKR) increase in household income increased the risk of having respiratory illnesses by 10% (AOR: 1.10; 95% CI: 1.01-1.25). CONCLUSIONS: Occupational Health and safety is a neglected area in many parts of the country especially when it comes to farmers. This study highlights the importance of factors other than pesticides impacting the respiratory health of the farmers, emphasizing on those who smoke tobacco.

An insight into frequency and predictors leading psychiatric patients to visit faith healers: A hospital-based cross-sectional survey, Karachi, Pakistan.

BACKGROUND: Psychiatric illnesses have recently escalated in numbers, with patients resorting to various forms of healthcare providers, including faith healers. This delays early psychiatric treatment, resulting in further mental health deterioration of the patient. Various factors impact the mode of treatment preferred by psychiatric patients. AIMS: To determine the frequency of psychiatric patients visiting faith healers, presenting at the outpatient department of Liaquat National Hospital, Karachi, Pakistan, and to explore the predictors that direct them toward visiting faith healers. METHODS: This cross-sectional survey was conducted using a semi-structured pre-tested questionnaire, employing a total of 219 male and female psychiatric patients. Patients were recruited through non-random consecutive sampling technique. SPSS 18 was used for statistical analysis. RESULTS: About 32% of the patients had visited a faith healer in their lifetime. Frequency of current visitors declined; the most frequent reason being stated was no relief from their treatment. Students, patients of upper middle class and those coming for initial visit to a psychiatrist were more likely to visit a faith healer. Patients who knew of someone previously visiting a faith healer were less likely to have visited a faith healer. CONCLUSION: This study highlights the importance of a multisectoral approach to dealing with psychiatric patients to help in bridging the treatment gap in mental health.

Experience of Liver Transplant in Patients Diagnosed with Budd-Chiari Syndrome.

OBJECTIVES: Budd-Chiari syndrome can lead to fulminant hepatic failure and cirrhosis. The treatment depends on the severity of disease. Liver transplant is a successful treatment option for those with advanced-stage disease. MATERIALS AND METHODS: In this retrospective study, we analyzed all liver transplants conducted for Budd-Chiari syndrome at the organ transplant unit of Shiraz University of Medical Sciences, Iran, from 1993 to January 2016. Overall, 3201 liver transplant procedures were performed. Among these, 68 presented with Budd-Chiari syndrome. RESULTS: The median age was 31 years among 27 male and 41 female patients. Five patients received pretransplant interventions, with 2 treated with inferior vena cava stenting and 3 having transjugular intrahepatic portosystemic shunts. Sixty-five patients with Budd-Chiari syndrome received deceased-donor grafts and 3 received living-donor grafts. Among the Budd-Chiari transplant patients, 6 patients died. Five deaths occurred in the early posttransplant period, and 1 patient retransplanted after 2 years for recurrence of disease died due to graft failure. The five-year survival rate was 89% among patients with Budd-Chiari syndrome. CONCLUSIONS: Liver transplant along with posttransplant anticoagulation therapy can improve the survival of patients with advanced-stage Budd-Chiari syndrome.

Scalpel versus diathermy of midline skin incisions: comparison of mean pain scores on second post-operative day.

OBJECTIVE: To determine the mean post-operative pain in scalpel versus diathermy opening of midline laparotomies. METHODS: The randomised controlled study was conducted at Civil Hospital and Dow University of Health Sciences, Karachi, from May to November 2010, and comprised patients undergoing midline laparotomy. Patients were equally divided into two groups; those who received incision with diathermy were placed in group A, and those who received incision with scalpel in group B. Mean post-operative pain scores were recorded using numerical analogue scale on second post-operative day. SPSS 16 was used for statistical analysis. RESULTS: Of the 58 patients, there were 29(50%) in each group. The overall mean age of the patients was 31.8±12.8 years. Besides, 40(68.9%) patients were male. The mean post-operative pain scores at 48 hours in diathermy group was 1.48±0.68 while in scalpel group it was 2.17±0.46 (p<0.05). CONCLUSIONS: The use of diathermy for midline laparotomy incision had significant advantage over scalpel in reducing pain on second post-operative day.

Nutritional status and physical abuse among the children involved in domestic labour in Karachi Pakistan: a cross-sectional survey.

OBJECTIVE: To determine the prevalence of physical abuse among domestic child labours and to assess the nutritional status by calculating the Body Mass Index of children involved in domestic labour in Karachi. METHODS: A cross sectional study was conducted in the squatter settlements of Karachi. Questionnaire based interviews were conducted to capture physical abuse with 385 children who worked as domestic labour in the household of their employer. The ages of the children were between 10 to 14 years belonging to both genders. The children were enrolled in study by snow-ball sampling technique. RESULTS: The overall prevalence of physical abuse among domestic child labour in Karachi was found to be 8.3 %. Over 9 % had low weight and about 90% were stunted. This study also highlighted that 95% of the children involved in domestic labour perform overtime work in their employer's home, more than once per week. CONCLUSIONS: There is high burden of physical abuse among the domestic child labour and these children are malnourished. There is a need to recognize and regulate this form of labour in Pakistan.

Risk factors for depression among married women belonging to higher and lower socioeconomic status in Karachi, Pakistan.

OBJECTIVES: To determine the risk factors for depression among married women belonging to low and high socioeconomic status in Karachi. METHODS: The study design was cross-sectional. The data was collected from 128 adult married women during July to September 2005. The women were selected from different socioeconomic classes from five hospitals/institutes in Karachi. The Centre for Epidemiology Studies-Depression (CES-D) scale was used to screen the subjects for depression and a structured questionnaire was used to identify the factors for depression. RESULT: According to the CES-D scale, 65% of the study population was found to be depressed. Among the women from high socioeconomic status, social conditions were identified as a significant factor for causing depression, whereas social relations, specifically relationship problems with husband, were the major factor for depression among women belonging to the low socioeconomic status. CONCLUSION: The prevalence of depression among married women living in Karachi is high. However, underlying factors for causing depression vary among women belonging to low and high socioeconomic status.