Muhammad Ijaz

Bio: Muhammad Ijaz is an academic researcher from University of Lahore. The author has contributed to research in topics: Health care & Preparedness. The author has an hindex of 2, co-authored 3 publications receiving 45 citations.

Comparison of the BISAP scores for predicting the severity of acute pancreatitis in Chinese patients according to the latest Atlanta classification

Abstract: Background The bedside index of severity in acute pancreatitis (BISAP) is a new, convenient, prognostic multifactor scoring system. As there were no studies designed to validate this system according to the latest Atlanta classification in China and more data are needed before clinical application, we compared BISAP, the Acute Physiology and Chronic Health Evaluation (APACHE) II and Ranson scoring systems in predicting the severity, pancreatic necrosis and mortality of acute pancreatitis (AP) using the latest 2012 Atlanta classification in a tertiary care center in China. Methods The medical records of all patients with AP admitted to our hospitals between January 2010 and June 2013 were reviewed retrospectively. Severe AP was defined as the persistence of organ failure for more than 48 h. The capacity of the BISAP, APACHE II and Ranson's score system to predict severity, pancreatic necrosis and mortality was evaluated using linear-by-linear association. The predictive accuracy of the BISAP, APACHE II and Ranson's score was measured as the area under the receiver operating characteristic curve (AUC). Results Of 155 patients enrolled in the study, 16.7% were classified as having severe AP, and six (3.2%) died. There were statistically significant trends for increasing severity (P < 0.001), PNec (P < 0.001) and mortality (P < 0.001) with increasing BISAP. The AUC for severity predicted by BISAP was 0.793 (95% confidence interval [CI] 0.700–0.886), APACHE II 0.836 (95% CI 0.744–0.928) and by Ranson score was 0.903 (95% CI 0.814–0.992). The AUC for PNec predicted by BISAP was 0.834 (95% CI 0.739–0.929), APACHE II 0.801 (95% CI 0.691–0.910) and by Ranson score was 0.840 (95% CI 0.741–0.939). The AUC for mortality predicted by BISAP was 0.791 (95% CI 0.593–0.989), APACHE II 0.812 (95% CI 0.717–0.906) and by Ranson score was 0.904 (95% CI 0.829–0.979). Conclusions BISAP score may be a valuable source for risk stratification and prognostic prediction in Chinese patients with AP. A prospective and multicenter validation study is required to confirm our results and further our recognition of BISAP scores in AP.

Nurse Manager's Attitudes and Preparedness Towards Effective Delegation in a Tertiary Care Public Hospital Lahore

Abstract: Background: Delegation is among the oldest concepts associated to professional and clinical nursing. With the rapid changes in the profession, delegation is becoming more important for nurse leaders and managers. It is highly expected from the manager nurses to effectively organize tasks of other health care workers and supervise them successfully. The ability of a nurse manager is very Crucial to the success of delegation among nurses. Objective: The main purpose of this study was, to assess The Nurse Managers’ attitudes and Preparedness towards Effective Delegation in a Tertiary Care Public Hospital Lahore. Method: A cross sectional descriptive survey was performed to assess the knowledge of nurse managers, (nursing supervisors, head nurses,and charge nurses) working at Punjab Institute of Cardiology & Services Hospital Lahore. A convenient sample of n=150 was used to collect the data from both hospitals, (85) from PIC and (65) from SHL. A structured adopted questionnaire was used to collect data and study's questionnaire, Data used in this study consisted of two main scales as well as demographic data sheets were collected. The data was analyzed on SPSS version 21. Results: The results of this study reveals that majority of the participants, 88% were having positive attitude towards delegation who scored 35 or above on a scale of 55 total score, while 12% had negative attitude who scored below 35 on attitude scale of 55. The results of this study indicate that 82.67% participants had good preparedness, who scored 75 or above in a total of 100 score, while remaining 17.3% scored less than 75 and had poor preparedness.

Pharmacogenetics; mini review

Abstract: The extent of genetic variations found in drug metabolism genes and its contribution to inter individual variation in response to medication remains incompletely understood Pharmacogenetics is study of the role of inheritance in inter individual variation in drug response Different factors can influence the drug metabolism which in turn changes the response of drugs The topic provides the overview the role of genetic variations that can affects the drug response Cytochrome P enzyme system is super family of metabolizing enzymes responsible for metabolism of many clinically used drugs biosynthesis and degradation of many endogenous substances Metabolism is generally occurs in two phases phase I and phase II reactions CYP is mostly involved in phase I reactions The enzyme system is involved in approximately of oxidative metabolism of drugs and of overall elimination of drugs nbsp

The early prediction of mortality in acute pancreatitis : a large population-based study. Commentary

Abstract: Background: Identification of patients at risk for mortality early in the course of acute pancreatitis (AP) is an important step in improving outcome. Methods: Using Classification and Regression Tree (CART) analysis, a clinical scoring system was developed for prediction of in-hospital mortality in AP. The scoring system was derived on data collected from 17 992 cases of AP from 212 hospitals in 2000-2001. The new scoring system was validated on data collected from 18 256 AP cases from 177 hospitals in 2004-2005. The accuracy of the scoring system for prediction of mortality was measured by the area under the receiver operating characteristic curve (AUC). The performance of the new scoring system was further validated by comparing its predictive accuracy with that of Acute Physiology and Chronic Health Examination (APACHE) II. Results: CART analysis identified five variables for prediction of in-hospital mortality. One point is assigned for the presence of each of the following during the first 24 h: blood urea nitrogen (BUN) >25 mg/dl; impaired mental status; systemic inflammatory response syndrome (SIRS); age >60 years; or the presence of a pleural effusion (BISAP). Mortality ranged from >20% in the highest risk group to <1% in the lowest risk group. In the validation cohort, the BISAP AUC was 0.82 (95% Cl 0.79 to 0.84) versus APACHE II AUC of 0.83 (95% Cl 0.80 to 0.85). Conclusions: A new mortality-based prognostic scoring system for use in AP has been derived and validated. The BISAP is a simple and accurate method for the early identification of patients at increased risk for in-hospital mortality.

The Value of BISAP Score for Predicting Mortality and Severity in Acute Pancreatitis: A Systematic Review and Meta-Analysis

Abstract: There is an error in the affiliation for all of the authors. The affiliation should be: Department of Intensive Care Unit, the Second Hospital of Shandong University, Jinan, 250033, China.

Acute Pancreatitis-Progress and Challenges: A Report on an International Symposium.

Abstract: An international symposium entitled "Acute pancreatitis: progress and challenges" was held on November 5, 2014 at the Hapuna Beach Hotel, Big Island, Hawaii, as part of the 45th Anniversary Meeting of the American Pancreatic Association and the Japanese Pancreas Society. The course was organized and directed by Drs. Stephen Pandol, Tooru Shimosegawa, Robert Sutton, Bechien Wu, and Santhi Swaroop Vege. The symposium objectives were to: (1) highlight current issues in management of acute pancreatitis, (2) discuss promising treatments, (3) consider development of quality indicators and improved measures of disease activity, and (4) present a framework for international collaboration for development of new therapies. This article represents a compilation and adaptation of brief summaries prepared by speakers at the symposium with the purpose of broadly disseminating information and initiatives.

BISAP, RANSON, lactate and others biomarkers in prediction of severe acute pancreatitis in a European cohort.

Abstract: Background and Aim The study aims to assess and compare the predicting ability of some scores and biomarkers in acute pancreatitis. Methods We prospectively collected data from 269 patients diagnosed of acute pancreatitis, admitted to Virgen de las Nieves University Hospital between June 2010 and June 2012. Blood urea nitrogen (BUN), C-reactive protein, and creatinine were measured on admission and after 48 h, lactate and bedside index for severity acute pancreatitis (BISAP) only on admission and RANSON within the first 48 h. Definitions from 2012 Atlanta Classification were used. Area under the curve (AUC) was calculated for each scoring system for predicting severe acute pancreatitis (SAP), mortality, and intensive care unit (ICU) admission, obtaining optimal cut-off values from the receiver operating characteristic curves. Results Eight (3%) patients died, 17 (6.3%) were classified as SAP, and 10 (3.7%) were admitted in ICU. BISAP was the best predictor on admission for SAP, mortality, and ICU admission with an AUC of 0.9 (95% CI 0.83–0.97); 0.97 (95% CI 0.95–0.99); and 0.89 (95% CI 0.79–0.99), respectively. After 48 h, BUN 48 h was the best predictor of SAP (AUC = 0.96 CI: 0.92–0.99); BUN 48 h and BISAP were the best predictors for mortality (AUC = 0.97 CI: 0.95–0.99) and creatinine 48 h for ICU admission (AUC = 0.96 CI: 0.92–0.99). Lactate showed an AUC of 0.79 (CI: 0.71–0.88), 0.87 (CI: 0.78–0.96), and 0.77 (CI: 0.67–0.87) for SAP, mortality, and ICU admission, respectively. All parameters were predictors for SAP, mortality, and ICU admission, but C-reactive protein on admission was only a significant predictor of SAP. Conclusion Bedside index for severity acute pancreatitis is a good predictive system for SAP, mortality, and ICU admission, being useful for triaging patients for ICU management. Lactate could be useful for developing new scores.