Documented History Research Articles

Comparison of electronic health records and electronic source data in clinical research trials: a retrospective review

Accurate documentation of medications and medical history is a critical component in ensuring the integrity of subject data in clinical research trials. With a mandate to use electronic health records (EHR) in healthcare settings, there has been a parallel movement towards integrating EHR and electronic data capture (EDC) software in clinical trials to improve efficiency and accuracy of data entry. However, there is increasing evidence that EHR data tend to be erroneous. The present study is a retrospective review comparing the medications and medical history documented in the EHR versus the EDC of subjects in active, ongoing clinical research studies to assess the validity of the assumption of the utility of using EHR data directly. Our results show significant data deviation from the EHR to the EDC, where 98% of all records were modified for clarity in some capacity. Only 31.3% of all medication records were concordant, and only 45.7% of all medical problem records were concordant. This suggests that Principal Investigators play a crucial role in parsing out incomplete, inaccurate, and irrelevant information when transferring data from the EHR to the EDC.

Sexual assault/rape and serial sexual homicide: Clinical and investigative considerations.

The frequent absence of a documented history of sexual assault/rape in the prior research on serial sexual murderers is curious. In order to address several methodological problems in prior research, a closed-case archival review of a nonrandom national sample of 53 serial sexual homicide cases was conducted which identified 14 offenders with a history of sexual assault/rape for an overall prevalence rate of 26.4%. Of the 14 offenders with a prior known history of sexual assault/rape, 11 (78.6%) sexually penetrated at least one of their homicide victims at the crime scene. Implications for investigation of serial sexual homicide as well as for further understanding of this exceptionally rare crime are presented.

Improving Lung Cancer Screening at an Academic Medical Center.

Lung cancer ranks as the third most prevalent cancer in the United States. The use of low-dose computed tomography (LDCT) screening significantly reduces mortality from this disease. Unfortunately, Texas lags in completing lung cancer screening (LCS) for high-risk patients, ranking 48th among all states. It is crucial to implement quality improvement (QI) initiatives in Texas. In collaboration with the American Cancer Society, the primary care center (PCC) at our institution led a multidisciplinary QI project aimed at enhancing LCS through LDCT for eligible PCC patients. The study included patients eligible for screening and who fall into the following categories: established patients with Medicaid, low-income or uninsured established patients, and established patients with either Medicare or commercial insurance. Enhancements to electronic medical records, education for clinical staff and patients, and a coordinated, multidisciplinary effort were implemented. The study revealed a substantial 40.2% improvement in LCS rates. The US Preventive Services Task Force guidelines rely on an accurate history of patient's tobacco use to identify patients eligible for LCS. This QI project achieved success in improving the thoroughness of tobacco use history documentation and surpassed our target for increasing LCS by more than 10%.

Abstract WP232: The Association Between Migraine and Postpartum Adverse Vascular Events

Background: We evaluate the association of migraine before and during pregnancy with the development of major adverse vascular events (MAVE) during an extended postpartum period of 24 weeks. Methods: We identified pregnant women aged between 12 and 44 years from the state inpatient databases of New York, Florida, Georgia, Maryland, and Washington (2016 - 2019). Patients were followed up for up to 24 weeks postpartum. Patients with migraine (ICD-10 code: G43) before or during pregnancy were considered to have a history of migraine. We fit multivariable logistic regression models to evaluate the association between the history of migraine and the development of MAVE (stroke, acute coronary syndrome, systemic thromboembolism, hypertensive encephalopathy, pulmonary heart disease, or death) up to 24 weeks after delivery. Patients with a history of MAVE before or during pregnancy were excluded. Adjusted odds ratios (aOR) and 95% confidence interval (CI) are reported. Results: Among 1,568,646 eligible participants (mean age [SD]: 29 [5.7] years), 43,840 (2.79%) had a documented history of migraine. Women with a history of migraine (vs. those without a history of migraine) had higher odds of experiencing MAVE (268/43840 [0.61%] vs. 4556/1524806 [0.3%], aOR, 95% CI: 1.47, 1.30 - 1.67). Also, older age (aOR, CI: 1.02, 1.02 - 1.03), smoking during pregnancy (2.14, 1.97 - 2.32), and pre-eclampsia (1.87, 1.72 - 2.03) were independently associated with a higher likelihood of developing postpartum MAVE. Additionally, those with a history of kidney failure (2, 1.76 - 2.27), liver disease (1.32, 1.11 - 1.56), and heart failure (1.59, 1.35 - 1.86) had higher odds of experiencing MAVE. Furthermore, those with a history of hypertension (1.23, 1.13 - 1.33), diabetes (1.30, 1.17 - 1.45), obesity (1.31, 1.22 - 1.41), and coagulopathy (2.36, 2.17 - 2.57) were more likely to experience MAVE. Conclusions: Migraine seems to be independently associated with a higher risk of post-partum MAVE. Further studies are needed to assess the utility of extended workup for evaluating the risk of MAVE among pregnant females with migraines.

The Role of Muhammad Ibn Al-Munkadir in the Intellectual Life and the Blogging Movement in the Umayyad Era (41-132 AH / 661-749 AD)

ABSTRACT Ibn al-Mankadr was an Umayyad-era scholar who possessed a wide range of knowledge in various fields, contributing significantly to the intellectual movement and Arab-Islamic civilization. The narratives that contributed to the documentation of Arab-Islamic history originated from Adam and subsequent prophets, and continued through the pre-Islamic era, the era of prophecy, the Rightly Guided Caliphate, and the Umayyad era, up until the time preceding the latter's demise. The author's narratives are characterized by quality, reliability, and truthfulness. Despite their large number, totaling just over 200 hadiths, they were not considered excessive during that period. The author's literary and artistic sensibilities were apparent in his storytelling, prayers, and commentary on certain poems. He supported the Arab-Islamic codification movement at its beginning, which was a crucial source for scholars who codified the Sunnah during his time and afterwards. One of his students, Ibn Shihab al-Zuhri, is considered the first to comprehensively codify the Sunnah and was a contemporary of Ibn al-Munkadir. This represents a fundamental aspect of the initial phase of the Islamic blogging movement.

Screening of Geriatric Depression in Makkah, Saudi Arabia: A Pilot Study.

There is currently limited evidence about the prevalence of depression among elderly people residing in Makkah, Saudi Arabia. This study aims to report the magnitude of depression among the older population in Makkah, Saudi Arabia, and the related risk factors. An online cross-sectional pilot survey was carried out in Makkah City, Saudi Arabia. Data were collected using an online self-administered questionnaire. The study questionnaire was completed by 191 older people. The participants' ages varied from 60 to 88 years. 55.5% were women, 47.9% were married, and 21.5% were divorced/widowed. 46.6% had hypertension, 42.4% had diabetes, 17.3% had hypothyroidism, 7.9% had cardiovascular diseases (CVDs), and 6.3% reported psychiatric problems. 44.5% of the subjects had no depression, 23.5% had mild, 15.2% had moderate, and 16.8% had severe depression. The sample included 32% who had been classified as having major depression. Elderly participants with insomnia, cognitive diseases, and chronic diseases showed a high risk for experiencing severe depression (OR=2.74; 95% CI: 1.42-5.28),(OR=2.63; 95% CI: 1.29-5.40), and (OR=2.62; 95% CI: 1.11-6.14) respectively. Depression was common among the elderly population in Makkah, particularly among those with a documented history of insomnia, cognitive diseases, and chronic diseases. Depression screening and treatment for old people in medical settings is recommended.

Assessing Camp Provider Needs Related to the Mental, Emotional, and Social Health of Youth and Staff: Implications for Parent Communication, Human Resources, and Transition of Care

Children, adolescents, and young adults are experiencing increases in mental, emotional, and social health (MESH) challenges including anxiety and depression. Out-of-school time (OST) program providers such as summer camps rely on effective communication with parents and other stakeholders to provide for these MESH needs, and the development of before and after program communication processes are viewed as a promising strategy for MESH response across youth program settings. In addition, OST program providers seek human and educational resources for meeting the MESH needs of program participants, and they also try to match available MESH resources to the work demands of their frontline staff who are tasked with responding to youth MESH needs when they arise. The importance of these topics is not reflected in available research informing recommended OST provider practices. Thus, this study examined program provider communications with parents about their youth’s MESH needs as well as program provider MESH resource utilization. Our three research questions were as follows: (1) What parent communication approaches do camp providers use to support youth MESH needs?; (2) What information is communicated to parents, teachers, or healthcare providers regarding youth MESH before and after camp?; and (3) What supports and resources do camp providers need to better manage MESH issues? Findings from this research highlight camp provider MESH-related parent communications and resource utilization. Notably, while respondents indicated requesting general MESH information on the health history form, further assessment and documentation of these identified MESH issues within- and across-camp seasons was lacking. Respondents also indicated camp nurses as the most prevalent human resource. Collectively, these results indicate that camp providers and out-of-camp stakeholders acknowledge the benefit of health history reporting and communication with regard to MESH challenges as well as providing MESH resources to meet employee job demands.

Clinical characteristics and prognosis of pediatric Listeria monocytogenes meningitis based on 10-year data from a large children's hospital in China.

This study aims to summarize the clinical characteristics and prognosis of Listeria monocytogenes (LM) meningitis in children in Chongqing, China. A retrospective analysis of the clinical data and follow-up results of 20 LM meningitis patients admitted to the Children's Hospital of Chongqing Medical University (CHCMU) from January 2012 to December 2022 was performed. The LM meningitis incidence rate was between 0 and 14.3 per 100,000 persons. The median age at onset was 8.98 months. There were five neonate cases, which all had perinatal abnormalities. Seven non-neonatal cases (7/15, 46.7%) had a documented history of contaminated food intake. One case had primary immunodeficiency. The most common symptoms were fever (20/20), altered consciousness (19/20), and vomiting (15/20). Seven cases had seizures, eight cases had cranial nerve involvement, eight cases had positive Babinski sign, and 10 cases had positive meningeal signs. The most common complications were hyponatremia (6/20), hypokalemia (6/20), respiratory failure (5/20), subdural effusion (3/20), and hydrocephalus (2/20). Treatment primarily involved monotherapy or combination therapy with meropenem (15/20) and ampicillin (10/20). Fifteen cases were treated with monotherapy or combination therapy using vancomycin. Twelve cases were successfully followed up from 10 months to 9 years and 6 months, and all had favorable long-term outcomes. LM meningitis incidence in children is low and with nonspecific clinical manifestations. Strengthening food hygiene and safety education, and avoiding infections during pregnancy are important to prevent LM infection in neonates and high-risk individuals. Meropenem and ampicillin are the preferred treatments. Early diagnosis and treatment can improve prognosis.IMPORTANCEThe incidence of LM meningitis is extremely low, and there is currently no standardized treatment. We conducted a retrospective analysis of ten years of data from CHCMU regarding diagnosed LM meningitis cases, aiming to provide clinical evidence for the diagnosis and treatment.

Hypertension and other vascular risk factors in patients with functional seizures

ObjectiveRecent literature has suggested that functional seizures are associated with an elevated risk for vascular disease and mortality. We investigated the prevalence of risk factors for vascular disease in patients who were admitted to the epilepsy monitoring unit. MethodsPatients who were admitted to the epilepsy monitoring unit and received a definitive diagnosis of either functional seizures or epilepsy were identified. Data collected included demographic, clinical characteristics, medication list, comorbidities, and scheduled blood pressure measurements that occurred every 12 h during the admission. The mean blood pressures were calculated and if they were above the American College of Cardiology and the American Heart Association guideline cutoff of 130/80 mm Hg or the patient had a documented history of hypertension the patient was counted as having the condition. A multiple logistic regression model was developed to evaluate the independent association of the patient’s diagnosis (i.e., epilepsy or functional seizures) and vascular risk factors that controlled for the number of blood pressure measurements, age, sex, and if the patient was taking antihypertensive medications. Results270 patients were included in this study of which 147 patients had epilepsy and 123 had functional seizures. Among those with functional seizures, 57.72 % had either a history of hypertension or a mean blood pressure above 130/80 compared to 38.78 % of those with epilepsy (p = 0.0022). In addition, 30.89 % of functional seizures patients had hyperlipidemia and 63.41 % were obese. The logistic regression model indicated that functional seizures were independently associated with high blood pressure (OR: 2.47, 95 % CI 1.10–5.69), hyperlipidemia (OR: 3.38, 95 % CI 1.35–8.86), and obesity (OR: 4.25, 95 % CI 2.22–8.36) compared to those with epilepsy. There was no significant difference in the prevalence of diabetes (OR: 0.81, 95 % CI 0.24–2.77) or current tobacco use (OR: 1.04, 95 % CI 0.48–2.25) between the groups. SignificancePatients with functional seizures had an elevated prevalence of several vascular risk factors. These findings may partially account for complications associated with functional seizures and have implications related to their pathophysiology.

P283 Efficacy and safety of etrasimod in patients with moderately to severely active UC in Japan: Integrated analysis of the phase 3 ELEVATE UC 12 and ELEVATE UC 40 JAPAN trials

Abstract Background Etrasimod is an oral, once-daily (QD), selective sphingosine 1-phosphate (S1P)1,4,5 receptor modulator for the treatment of moderately to severely active ulcerative colitis (UC). We evaluated efficacy and safety among Japanese patients with moderately to severely active UC with contextualisation to the global population. Methods ELEVATE UC 40 JAPAN (NCT04706793) was a multicentre, double-blind, 40-week trial of patients from Japan who completed the 12-week phase 3 ELEVATE UC 12 induction trial (NCT03996369; study design described elsewhere1), resulting in a combined 52-week treatment period. Eligible patients were aged 16–80 years with documented history of inadequate/loss of response or intolerance to ≥1 approved UC therapies. Patients (hereafter the ‘Japan cohort’) continued baseline-assigned treatments from ELEVATE UC 12 (etrasimod 2 mg QD or placebo QD). Efficacy was assessed at Weeks 12 and 52 in patients with a Modified Mayo score (MMS) 5–9; the primary endpoint was clinical remission at Weeks 12 and 52. Pooled treatment-emergent adverse events (TEAEs) from ELEVATE UC 12 and ELEVATE UC 40 JAPAN were assessed up to Week 52. Results The Japan cohort comprised 32 and 16 patients receiving etrasimod and placebo, respectively; 28 and 14 patients with an MMS of 5–9, respectively, were included in the analysis. Baseline demographics were similar between treatment groups. A numerically higher proportion of patients receiving etrasimod vs placebo achieved the primary efficacy endpoint (Figure). Similar patterns were observed for all key secondary endpoints (Table). TEAEs occurred in 84.4% (27/32) and 62.5% (10/16) of patients receiving etrasimod vs placebo, respectively. The safety of etrasimod was similar between Japanese and global UC populations. Conclusion In this Japanese population, numerically higher proportions of patients achieved all efficacy endpoints with etrasimod vs placebo. Efficacy and safety findings were consistent with the global ELEVATE UC population.1 Reference 1. Sandborn WJ et al. Lancet 2023; 401: 1159–1171.

Detention of children and adolescents under mental health legislation: a scoping review of prevalence, risk factors, and legal frameworks

BackgroundFor individuals with severe mental illness, involuntary assessment and/or treatment (hereafter detention) can be a necessary intervention to support recovery and may even be lifesaving. Despite this, little is known about how often these interventions are used for children and adolescents.MethodsThis global scoping review set out to: (1) map the current evidence around mental health detentions of children and adolescents (< 18 years); (2) identify the clinical, sociodemographic, and behavioural factors associated with detention; and (3) document the views of professionals and young people on the implementation of mental health legislation.ResultsAfter searching databases of peer-reviewed literature and citation chaining, 42 articles from 15 jurisdictions were included. About one fifth of psychiatric admissions in national register data were detentions, however trends were only available for a few high-income Western countries. The circumstances justifying detention and the criteria authorising detention varied between studies, with a mix of clinical factors and observed behaviours reported as the reason(s) warranting/precipitating a detention. Particular groups were more likely to experience detention, such as children and adolescents from minority ethnic communities and those with a documented history of abuse. There was a notable absence of qualitative research exploring the views of professionals or children and adolescents on detention.ConclusionFurther research is needed to explore the impact of detention on those aged < 18 years, including national register-based studies and qualitative studies. This is particularly relevant in nations currently undergoing legislative reform.

The genome of the black-footed cat: Revealing a rich natural history and urgent conservation priorities for small felids.

Habitat degradation and loss of genetic diversity are common threats faced by almost all of today's wild cats. Big cats, such as tigers and lions, are of great concern and have received considerable conservation attention through policies and international actions. However, knowledge of and conservation actions for small wild cats are lagging considerably behind. The black-footed cat, Felis nigripes, one of the smallest felid species, is experiencing increasing threats with a rapid reduction in population size. However, there is a lack of genetic information to assist in developing effective conservation actions. A de novo assembly of a high-quality chromosome-level reference genome of the black-footed cat was made, and comparative genomics and population genomics analyses were carried out. These analyses revealed that the most significant genetic changes in the evolution of the black-footed cat are the rapid evolution of sensory and metabolic-related genes, reflecting genetic adaptations to its characteristic nocturnal hunting and a high metabolic rate. Genomes of the black-footed cat exhibit a high level of inbreeding, especially for signals of recent inbreeding events, which suggest that they may have experienced severe genetic isolation caused by habitat fragmentation. More importantly, inbreeding associated with two deleterious mutated genes may exacerbate the risk of amyloidosis, the dominant disease that causes mortality of about 70% of captive individuals. Our research provides comprehensive documentation of the evolutionary history of the black-footed cat and suggests that there is an urgent need to investigate genomic variations of small felids worldwide to support effective conservation actions.

Black Radio’s Contribution to Collective and Cultural Memory: Personnel Perspectives of Black Radio History in the United States

ABSTRACT This interdisciplinary research investigates the significance of the community connection between Black radio personnel and their audiences through the lens of collective and cultural memory narratives. The study addresses two key research questions. First, how do Black radio personnel’s collective and cultural memories contribute to the Black public sphere? Second, what are the defining characteristics in developing parasocial relationships and interactions between Black radio personalities and their audiences? The qualitative research employs an autoethnographic methodology and a questionnaire, utilizing insights gained from the author’s experiences working at a Black-owned radio network and station. The questionnaire, distributed to key informants in the field, explores narratives related to Black radio station engagement, memorable moments, and public service programming. The findings reveal diverse stories, including community mobilization around social issues and the unique role of Black radio in shaping local and national events. The exploration of parasocial relationships among Black radio personnel demonstrates positive connections with listeners, ranging from on-air interactions to long-term friendships. Despite occasional challenges and boundary issues, the study highlights the deep emotional impact of these relationships and their role in fostering loyalty and engagement within the Black community. The research contributes to the documentation of Black radio history, emphasizing its role as a cultural memory maker and underscoring the need for expanded archival efforts in this area.

The association between serum testosterone level and congestive heart failure in US male adults: data from National Health and Nutrition Examination Survey (NHANES) 2011-2016.

This study aimed to investigate the relationship between serum testosterone levels and the risk of congestive heart failure (CHF) in adult males. Previous research has suggested a potential link between serum testosterone and cardiovascular health, but the findings have been inconclusive. This study was cross-sectional, and the data were obtained from the 2011-2016 cycle of the National Health and Nutrition Examination Survey (NHANES), which included a sample of 6,841 male participants. Serum testosterone levels were measured using a standardized assay, and CHF status was assessed through self-reporting. Covariates such as age, ethnicity, lifestyle factors, and health conditions were considered in the analysis. Among the participants, 242 individuals had a documented history of CHF. We observed a linear correlation between serum testosterone levels and CHF occurrence, with higher serum testosterone levels associated with a decreased risk of CHF (Q4 vs. Q1, OR = 0.29, 95% CI: 0.19-0.47, P < 0.001). After adjusting for confounding variables, multivariate analysis revealed that high serum testosterone levels remained significantly associated with a lower risk of CHF (OR: 0.47, 95% CI: 0.27-0.80, P = 0.01). Subgroup analysis indicated a significant association between high serum testosterone levels and reduced CHF risk in individuals over 50 years old. Our findings suggest that the serum testosterone level was positively associated with CHF in adult males. This study highlights the potential role of serum testosterone in cardiovascular health, particularly in older individuals. Further research is needed to elucidate the underlying mechanisms and explore the clinical implications of these findings.

Characteristics and Outcomes of Cardiac Rehabilitation Patients With and Without Cancer: Insights From Western Sydney

Increased cardiovascular events are common in cancer survivors and contribute to an emerging cardio-oncology patient group requiring secondary prevention strategies including cardiac rehabilitation (CR). This study aimed to compare characteristics and outcomes for patients participating in CR with and without an existing cancer diagnosis. Observational cohort study including consecutive patients enrolled in a single-centre outpatient CR program in Western Sydney between 2018-2022. Clinical history, demographics and CR outcome data were collected as part of standard care at program enrolment and completion. Patients with and without a cancer diagnosis were compared at enrolment and outcomes were analysed in both groups. A total of 1,792 patients enrolled in CR, 191 (11%) had a documented history of cancer; prostate (18%), skin (12%), colon (9%) and breast (8%) malignancies were most prevalent. The most common treatments were surgical resection (80%) and chemotherapy or radiotherapy (37%). Cardio-oncology patients were older (68.8±10.6 vs 59.8±13.7yrs, p<0.001), more likely female (33% vs 21%, p<0.001), born in Australia (46% vs 35%, p=0.004), non-partnered (34% vs 25%, p=0.002) and had a prior history of hypertension (65% vs 56%, p=0.010) or stroke (8% vs 5%, p=0.045). After adjusting for age and sex, the overall cohort improved their mean peak exercise capacity and waist circumference after CR, however there were no differences between groups. There were also no between-group differences for adherence and completion of CR program or any other cardiovascular risk factors. Sub-analyses revealed a clinically meaningful improvement in waist circumference for cancer patients with a history of radiation therapy and a blunted peak exercise capacity adaptation for those with a history of chemotherapy treatment. Despite differences in demographic and clinical characteristics of CR patients with and without cancer, all patients showed significant and clinically relevant improvements in peak exercise capacity and waist circumference after CR. Results also highlighted potential associations between specific cancer treatments and changes in fitness outcomes, which warrants further evaluation.

Relationship Between Cognitive Impairment and Depression Among Middle Aged and Older Adults in Primary Care.

Objectives: To determine rates of previously undetected cognitive impairment among patients with depression in primary care. Methods: Patients ages 55 and older with no documented history of dementia or mild cognitive impairment were recruited from primary care practices in New York City, NY and Chicago, IL (n = 855). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and depression with the Patient Health Questionnaire-8. Results: The mean age was 66.8 (8.0) years, 45.3% were male, 32.7% Black, and 29.2% Latinx. Cognitive impairment increased with severity of depression: 22.9% in persons with mild depression, 27.4% in moderate depression and 41.8% in severe depression (p = .0002). Severe depression was significantly associated with cognitive impairment in multivariable analysis (standardized β = -.11, SE = 0.33, p < .0001). Discussion: Depression was strongly associated with previously undetected cognitive impairment. Primary care clinicians should consider screening, or expand their screening, for both conditions.

Evolving Trends in Modern History Writing: A Comprehensive Overview

History is the study of human civilization across various cultures, geographical locations, and historical eras. It covers various occurrences, movements, conflicts, discoveries, and relationships that have contributed to the development of the modern world. The practice of writing history has undergone significant transformations over the years, shaped by evolving methodologies, technological advancements, and changing perspectives. Modern history writing is a dynamic field that encompasses a wide range of approaches, from traditional narrative histories to the incorporation of interdisciplinary methods. This article explores the key trends in modern history writing, highlighting the diverse methodologies employed by historians and the impact of technological innovations on the field focusing on the need for accurate documentation and transmission of history. The paper uses qualitative methods, including in-depth interviews, conversations with historians, academicians, university professors, and library research.

Are Medical Records Truly Prepared for Malpractice Liability in Cases of Suicide?

The most common reason for a malpractice claim is suicide or attempted suicide. It is argued that suicide can be prevented if the danger is recognized and proper and timely treatment is provided. Failure to make an informed decision as to whether to admit an individual to a psychiatric unit generally constitutes the initial breach in a claim of negligence. The present study was designed to identify exactly what essential data was missing from files of completed suicides, using 39 medical case records of the risk-management files of the state-owned malpractice insurance company between 2004 and 2022 in Israel. We found that a great deal of important information was missing from those files (e.g., records of previous suicide attempts, documentation of disagreement between the emergency department and the patient as to whether the individual should be hospitalized, and information regarding a history or lack thereof of suicidal tendencies in the individuals immediate family). Our study demonstrates that lacking the proper documentation of vital patient history, allegations of negligence would be very difficult to disprove.

Pattern of Coronary Artery Disease in Young Patients with Acute Coronary Syndrome

Background: Coronary artery disease (CAD), historically considered a malady of the elderly, has increasingly emerged as a significant health concern among young adults, including individuals in their third or fourth decade of life. Objective: The primary aim of the study is to identify the pattern of coronary artery disease in young patients with acute coronary syndrome (ACS). Methods: This retrospective observational study was conducted at a tertiary cardiac care center in Rawalpindi from July 2023 to November 2023. The study included a cohort of 180 young patients aged less than 45 years who were diagnosed with ACS. These patients were identified from medical records and databases over a defined time period. Detailed demographic data, including age, gender, and pertinent medical history, were extracted from the medical records of each patient. This information facilitated a comprehensive understanding of the patient population under investigation. Results: Data were collected from 180 patients. The analysis of clinical profiles and demographics revealed a diverse patient population. The study cohort comprised individuals with a mean age of 39 years. Male patients predominated, constituting approximately 65% of the cohort. Among the study participants, 40% had a documented history of smoking, while 20% reported a family history of CAD. Hypertension was the most prevalent risk factor, affecting nearly 50% of the patients, followed by hyperlipidemia (30%) and diabetes (20%). Conclusion: It is concluded that coronary artery disease (CAD) is not confined to older age groups but can significantly impact young individuals aged less than 45 years presenting with acute coronary syndrome (ACS). The prevalence of traditional risk factors and genetic predisposition among these patients underscores the multifactorial nature of CAD in this demographic.

Revolutionizing Breast Cancer Care: AI-Enhanced Diagnosis and Patient History

Breast cancer poses a significant global health challenge, demanding enhanced diagnostic accuracy and streamlined medical history documentation. This study presents a holistic approach that harnesses the power of artificial intelligence (AI) and machine learning (ML) to address these pressing needs. This study presents a comprehensive methodology for breast cancer diagnosis and medical history generation, integrating data collection, feature extraction, machine learning, and AI-driven history-taking. The research employs a systematic approach to ensure accurate diagnosis and efficient history collection. Data preprocessing merges similar attributes to streamline analysis. Three key algorithms, Support Vector Machine (SVM), K-Nearest Neighbours (KNN), and Fuzzy Logic, are applied. Fuzzy Logic shows exceptional accuracy in handling uncertain data. Deep learning models enhance predictive accuracy, emphasizing the synergy between traditional and deep learning approaches. The AI-driven history collection simplifies the patient history-taking process, adapting questions dynamically based on patient responses. Comprehensive medical history reports summarize patient data, facilitating informed healthcare decisions. The research prioritizes ethical compliance and data privacy. OpenAI has integrated GPT-3.5 to generate automated patient reports, offering structured overviews of patient health history. The study’s results indicate the potential for enhanced disease prediction accuracy and streamlined medical history collection, contributing to more reliable healthcare assessments and patient care. Machine learning, deep learning, and AI-driven approaches hold promise for a wide range of applications, particularly in healthcare and beyond.