Does Time Matter? Impact of Residency Start Month on EGS Outcome in Pakistan.

Background: Trainee turnover in hospitals with induction of new, less experienced residents and changeover in the clinical teams has been considered an essential factor for increased morbidity and mortality. In high-income countries (HICs), this is known as the July effect-the time for new inductees. We aim to study the January effect (time of new inductees in our setting) and patient outcomes in an Emergency General Surgery (EGS) cohort.

Epidemiological characteristics of elderly population receiving pre-hospital emergency care after road traffic injuries in Punjab, Pakistan.

Background: Every year, 1.3 million lives are lost to road traffic injuries (RTIs). 90% of these deaths disproportionately occur in Lower-Middle Income Countries (LMICs).

The modification of risk assessment ranking when considering the female population and children in the INFORM risk index for selected countries.

The INFORM (Index for Risk Management) identifies risk hotspots by assessing Hazard and Exposure, Vulnerability, and Coping capacity across 76 indicators. However, the original index may have overlooked the specific vulnerabilities of women and children, even within the vulnerable group in emergencies. This study recalibrated the index by redefining key indicators to better reflect risks for these groups.

When Is Old NOT Gold? Identifying Global Age Risk Surgical Thresholds to Improve Outcomes.

Introduction: Patient age has been shown to influence health-care outcomes; however, there is limited evidence on the optimal cutoff where age increases the risk of adverse outcomes. This study aims to identify the age at which patients undergoing surgery in Pakistan can be classified as high-risk using the modified frailty index which can help in preoperative risk stratification, optimizing surgical outcomes, and guiding clinical decision-making.

Methods: American College of Surgeons National Surgical Quality Improvement Program data of adult patients undergoing major elective surgeries from 2019 to 2022 were used.

Bimodal, But Not the Same: Persistent Late Peaks in Trauma Mortality.

Background: Trauma is a significant cause of morbidity and mortality, disproportionately affecting low- and middle-income countries (LMICs). Data from high-income countries (HIC) show an evolution of Trunkey's trimodal distribution of at-scene, first 48 h and after 7 days mortality to bimodal distribution caused by the flattening of the third peak. The mortality distribution in LMICs is not well described.

A Matched Comparison of Patient Outcomes in Emergency General Surgery Conditions: Understanding Variability in Operative and Nonoperative Cases.

Background: Emergency general surgery (EGS) is a subset of acute care surgery that can be managed surgically and conservatively. Various factors influence decisions regarding operative or nonoperative management. Our study aimed to identify EGS patients who underwent surgical intervention and compare their outcomes to those who underwent nonoperative management.

Weekends at risk: Uncovering the impact of the weekend effect on emergency general surgery.

Background: Weekend admissions have been proposed to be associated with the worst outcomes across varied patient populations and health care systems. However, there is a dearth of literature on weekend effects in low- and middle-income countries like Pakistan. This study aimed to assess the role of the "weekend effect" on the outcomes of emergency general surgery patients admitted to a tertiary care center in Pakistan.

Toward Resilient Maternal, Neonatal and Child Health Care: A Qualitative Study Involving Afghan Refugee Women in Pakistan.

Background: Afghan refugees in Pakistan, particularly in Quetta, Balochistan, encounter formidable barriers in accessing maternal, newborn, and child health (MNCH) services. These challenges have been intensified by the COVID-19 pandemic and entrenched systemic health inequities.

Methods: This qualitative study, conducted from February to April 2023, aimed to assess the obstacles within health systems and community environments that hinder MNCH service access among Afghan refugees.

Outcomes of COVID-19 Disease in Comparison with Influenza in Renal Transplant Recipients: Results from a Large Nationwide Research Network in the United States.

COVID-19 infection has worse outcomes in immunocompromised individuals. This includes those with diabetes mellitus, cancer, chronic autoimmune diseases requiring immunomodulatory therapy, and solid-organ transplant recipients on chronic immunosuppression. Using the National Inpatient Sample Database, this study retrospectively compared 14,915 renal transplant recipients who were hospitalized with either COVID-19 or Influenza virus infection in the US at any point between 1st January 2020 and 31st December 2020.