Publications by authors named "A T M Mostafa Kamal"

1,509 Publications

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Comparative diagnostic accuracy of EUS needles in solid pancreatic masses: a network meta-analysis.

Endosc Int Open 2021 Jun 27;9(6):E853-E862. Epub 2021 May 27.

Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States.

Endoscopic ultrasound (EUS)-guided tissue sampling is the standard of care for diagnosing solid pancreatic lesions. While many two-way comparisons between needle types have been made in randomized controlled trials (RCTs), it is unclear which size and type of needle offers the best probability of diagnosis. We therefore performed a network meta-analysis (NMA) to compare different sized and shaped needles to rank the diagnostic performance of each needle. We searched MEDLINE, EMBASE and Cochrane Library databases through August, 2020 for RCTs that compared the diagnostic accuracy of EUS fine-needle aspiration (FNA) and biopsy (FNB) needles in solid pancreatic masses. Using a random-effects NMA under the frequentist framework, RCTs were analyzed to identify the best needle type and sampling technique. Performance scores (P-scores) were used to rank the different needles based on pooled diagnostic accuracy. The NMA model was used to calculate pairwise relative risk (RR) with 95 % confidence intervals. Review of 2577 studies yielded 29 RCTs for quantitative synthesis, comparing 13 different needle types. All 22G FNB needles had an RR > 1 compared to the reference 22G FNA (Cook) needle. The highest P-scores were seen with the 22G Medtronic FNB needle (0.9279), followed by the 22G Olympus FNB needle (0.8962) and the 22G Boston Scientific FNB needle (0.8739). Diagnostic accuracy was not significantly different between needles with or without suction. In comparison to FNA needles, FNB needles offer the highest diagnostic performance in sampling pancreatic masses, particularly with 22G FNB needles.
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http://dx.doi.org/10.1055/a-1381-7301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159621PMC
June 2021

Comparing Palliative Care Knowledge in Metropolitan and Nonmetropolitan Areas of the United States: Results from a National Survey.

J Palliat Med 2021 May 28. Epub 2021 May 28.

Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.

Despite recent growth in access to specialty palliative care (PC) services, awareness of PC by patients and caregivers is limited and misconceptions about PC persist. Identifying gaps in PC knowledge may help inform initiatives that seek to reduce inequities in access to PC in rural areas. We compared knowledge of PC in metropolitan and nonmetropolitan areas of the United States using a nationally representative sample of U.S. adults. We used data from the 2018 Health Information National Trends Survey (HINTS) 5 Cycle 2 to compare prevalence and predictors of PC knowledge and misconceptions in nonmetropolitan and metropolitan areas as defined by the 2013 Urban-Rural Classification (URC) Scheme for Counties. We estimated the association between nonmetro status and knowledge of PC, adjusted for respondent characteristics, using multivariable logistic regression. More respondents reported that they had never heard of PC in nonmetro (78.8%) than metro (70.1%) areas ( < 0.05). Controlling for other factors, nonmetro residence was associated with a 41% lower odds of PC knowledge (odds ratio [OR] = 0.59; 95% confidence interval [CI] = 0.37-0.94), and Hispanic respondents also demonstrated significantly lower odds of PC knowledge conditional on rural status (OR = 0.47; CI = 0.27-0.83). Misconceptions about PC were high in both metro and nonmetro areas. Awareness of PC was lower in rural and micropolitan areas compared with metropolitan areas, suggesting the need for tailored educational strategies. The reduced awareness of PC among Hispanic respondents regardless of rural status raises concerns about equitable access to PC services for this population.
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http://dx.doi.org/10.1089/jpm.2021.0114DOI Listing
May 2021

Creating a Blueprint of Well-Being in Oncology: An Approach for Addressing Burnout From ASCO's Clinician Well-Being Taskforce.

Am Soc Clin Oncol Educ Book 2021 Jun;41:e339-e353

Kaiser Permanente, Northern California (NCAL), Oakland, CA.

Optimizing the well-being of the oncology clinician has never been more important. Well-being is a critical priority for the cancer organization because burnout adversely impacts the quality of care, patient satisfaction, the workforce, and overall practice success. To date, 45% of U.S. ASCO member medical oncologists report experiencing burnout symptoms of emotional exhaustion and depersonalization. As the COVID-19 pandemic remains widespread with periods of outbreaks, recovery, and response with substantial personal and professional consequences for the clinician, it is imperative that the oncologist, team, and organization gain direct access to resources addressing burnout. In response, the Clinician Well-Being Task Force was created to improve the quality, safety, and value of cancer care by enhancing oncology clinician well-being and practice sustainability. Well-being is an integrative concept that characterizes quality of life and encompasses an individual's work- and personal health-related environmental, organizational, and psychosocial factors. These resources can be useful for the cancer organization to develop a well-being blueprint: a detailed start plan with recognized strategies and interventions targeting all oncology stakeholders to support a culture of community in oncology.
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http://dx.doi.org/10.1200/EDBK_320873DOI Listing
June 2021

Differentials and determinants of neonatal mortality in Pakistan: A cross sectional analysis; Pakistan Demographic and Health Survey (2017-18).

J Pak Med Assoc 2021 Mar;71(3):900-904

Department of Statistics, Lahore College for Women University, Lahore, Pakistan.

Objective: To investigate differentials and determinants of neonatal mortality in Pakistan.

Methods: The cross-sectional data-based study was conducted at Lahore College for Women University, Lahore, Pakistan from February to July 2019, and comprised data obtained from the Pakistan Demographic and Health Survey 2017-18 which related to the period from November 22, 2017, to April 30, 2018. Neonatal mortality rates were computed to observe the differentials in relation to various categories of socio-demographic factors. Cox proportional hazard model was used to identify significant factors affecting neonatal mortality.

Results: Hazard of neonatal mortality significantly decreased as household size increased (hazard ratio: 0.41 and 0.36). Household with improved toilet facility had significantly lower chances (hazard ratio: 0.57) of neonatal death compared to that with unimproved toilet facility. Significantly elevated risk (hazard ratio: 5.56) of neonate death was observed in case of multiple births. Children had better chances (hazard ratio: 0.32 and 0.34) of surviving in neonatal period as duration of birth spacing increased (24-35 months; 36 or more months).

Conclusions: Household size, improved toilet facilities, multiple births and preceding birth intervals had significant effect on neonatal mortality.
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http://dx.doi.org/10.47391/JPMA.1458DOI Listing
March 2021