Maryam Saeed - Academia.edu (original) (raw)

Papers by Maryam Saeed

Research paper thumbnail of End-stage renal disease: incidence and prediction by coronary heart disease, and educational level. Follow-up from diagnosis of childhood-onset type 1 diabetes throughout Norway 1973–2017

Annals of Epidemiology

To investigate incidence of end-stage renal disease (ESRD), and the association of education and ... more To investigate incidence of end-stage renal disease (ESRD), and the association of education and coronary heart disease (CHD) with ESRD, in subjects throughout Norway followed from the diagnosis of childhood-onset type 1 diabetes. Methods: All new onset cases of type 1 diabetes 1973-2016 were followed for CHD and ESRD in nationwide registries through 2017. Ten matched controls per case were selected from the National Population Register. Cox regression was used to estimate hazard ratios, and probabilities were estimated by the cumulative incidence function accounting for competing risk. Results: Among 9311 patients with type 1 diabetes, 130 developed ESRD with a probability of ESRD after 40 years of 5.5%. The rate was 35-fold higher than in controls (aHR = 35.5, 95% CI 23.1-54.6). Higher education was associated with lower risk of ESRD compared to low education (aHR = 0.14, 95% CI 0.07-0.27). Diagnosed CHD was associated with 14-fold increased rate of ESRD (aHR = 14.3, 95% CI 9.2-22.2). Conclusions: The hazard rate of ESRD was 35-fold higher in cases compared to controls. CHD was associated with a 14-fold increased rate of subsequent ESRD, while higher education was associated with substantially lower rate of ESRD.

Research paper thumbnail of Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study

Diabetes Care, 2021

OBJECTIVE To study whether serum galectin-3 and other biomarkers of inflammation predict coronary... more OBJECTIVE To study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS A population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973–1982 was examined in 2002–2003 at a mean age of 33 years (range 21–44), with mean diabetes duration of 24 years (range 19–30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression. RESULTS Of 295 subjects, 40 (...

Research paper thumbnail of Low Incidence of End-Stage Renal Disease in Childhood-Onset Type 1 Diabetes Followed for Up to 42 Years

Diabetes care, Mar 12, 2017

End-stage renal disease (ESRD) is one of the most severe complications in type 1 diabetes. We aim... more End-stage renal disease (ESRD) is one of the most severe complications in type 1 diabetes. We aimed to estimate the cumulative incidence of ESRD in individuals with childhood-onset type 1 diabetes followed for up to 42 years. Data were based on the nationwide, population-based Norwegian Childhood Diabetes Registry and included case patients with new-onset type 1 diabetes (age <15 years) who had received a diagnosis during the periods 1973-1982 and 1989-2012. Follow-up took place until the development of ESRD, death, emigration, or 30 November 2015. We estimated the cumulative incidence of ESRD by linking to the Norwegian Renal Registry. Among the 7,871 patients, representing 147,714 person-years of follow-up, ESRD developed in 103 individuals (1.3%). The mean time from the diagnosis of diabetes to the development of ESRD was 25.9 years (range 12.7-39.1). The cumulative incidence of ESRD was 0.7% (95% CI 0.4-1.0) at 20 years diabetes duration, 2.9% (2.3-3.7) at 30 years duration, ...

Research paper thumbnail of Nine-fold higher risk of acute myocardial infarction in subjects with type 1 diabetes compared to controls in Norway 1973–2017

Cardiovascular Diabetology

Background We aimed to study the cumulative incidence and risk factors (sex, age, calendar year o... more Background We aimed to study the cumulative incidence and risk factors (sex, age, calendar year of diabetes onset, country of origin and educational level) of acute myocardial infarction (AMI) in subjects with type 1 diabetes and matched controls. Methods A nationwide cohort of subjects with type 1 diabetes diagnosed at age < 15 years in Norway during 1973–2000 was followed until the first AMI event, emigration, death or 31st of December 2017. The Norwegian Childhood Diabetes Registry was linked to five nationwide registries, and up to ten sex- and age-matched controls per case were included. Results Among 7086 subjects with type 1 diabetes, 170 (2.4%) were identified with incident AMI, compared to 193 (0.3%) of 69,356 controls. Mean age and diabetes duration at first AMI was 40.8 years and 30.6 years, respectively. The probability of AMI after 40 years of follow-up was 8.0% in subjects with type 1 diabetes and 1.1% in controls, aHR 9.05 (95% CI 7.18–11.41). In type 1 diabetes, m...

Research paper thumbnail of Fact versus Conjecture: Exploring Levels of Evidence in the Context of Patient Safety and Care Quality

Vignettes in Patient Safety - Volume 3, 2018

Evidence-based medicine (EBM) can be defined as the integration of optimized clinical judgment, p... more Evidence-based medicine (EBM) can be defined as the integration of optimized clinical judgment, patient values, and available evidence. It is a philosophical approach to making the best possible clinical decisions for individual patients. Based on objective evaluation and categorization of methodological design and data quality, all existing literature can be organized according to a hierarchy of "evidence quality" that helps determine the applicability and value of scientific findings in terms of clinical implementation and the potential to change existing patterns of practice. In terms of general categorization of scientific impact, randomized controlled trials (RCTs) are placed on top of the hierarchy, followed by systematic reviews of randomized controlled trials (RCTs), quasi-randomized designs, observational studies including retrospective case series, and finally case reports and expert opinion. Each study design is susceptible to certain limitations and biases, highlighting the importance of both clinical and scientific acumen of the interpreting provider. Such approach is critical to determining the value and the applicability of study recommendations in everyday practice. Evidence-based practice (EBP) has become one of the fundamental components of modern medicine and plays an indispensible role in the development (and improvement) of patient care and safety worldwide. Furthermore, organizations that create guidelines and policies for the management of specific conditions, often base the content and strength of their recommendations on the quality of evidence available to expert decision-makers. Therefore, understanding the "state of the science" upon which those recommendations are based will help guide the medical practitioner on "if, when and how" to apply evidence-based guidelines in his or her everyday medical or surgical practice. This chapter focuses on clinically relevant application of levels of scientific evidence (LSE) and the corresponding levels of clinical recommendation (LCR) in the context of care quality and safety.

Research paper thumbnail of Avoiding Fire in the Operating Suite: An Intersection of Prevention and Common Sense

Vignettes in Patient Safety - Volume 3, 2018

The operating room (OR) is a complex environment that involves large teams and multiple competing... more The operating room (OR) is a complex environment that involves large teams and multiple competing priorities, dynamically interacting throughout the entire course of a surgical procedure. The simultaneous presence of flammable substances, volatile gases, and the frequent use of electrical current results in a potentially dangerous combination. Operating room fire (ORF) is a rare but potentially devastating occurrence. To prevent this "never event", it is critical for institutions to establish and follow proper fire safety protocols. Adherence to proven prevention strategies and awareness of associated risk factors will help reduce the incidence of this dreaded safety event. When ORF does occur despite strict adherence to established safety protocols, the entire OR team should know the steps required to contain and extinguish the fire as well as essential measures to minimize or avoid thermal injury. If injury does occur, it is important to recognize and treat it promptly. Appropriate and honest disclosure to all injured persons and their families should be made without delay. As with all serious patient safety events, regulatory reporting and root cause determinations must take place in accordance with applicable laws and regulations. The goal of patient safety champions at each institution should be the attainment of zero incidence of ORF.

Research paper thumbnail of Perceptions regarding helmet use: a cross-sectional survey of female pillions in Karachi, Pakistan

Journal of Surgical Research, 2017

Cockroaches live in close proximity to human beings. Due to filthy breeding sites i.e. sewer syst... more Cockroaches live in close proximity to human beings. Due to filthy breeding sites i.e. sewer systems they carry up to 40 pathogenic bacteria. Typhoid is a notorious disease known to be transmitted by cockroaches worldwide. Human thought, perception and behavior vary according to the traditions, vicinity and knowledge. This study was carried out to understand the awareness of community about typhoid and its vector and the way they manage them. For this purpose a questionnaire was developed and data regarding typhoid and its vector were collected from 500 people belonging to 5 localities i.e. Multan, Shujabad, Muzaffargarh, KotAddu and Dera Ghazi Khan of southern Punjab. Results revealed that 44.6% of peoples were affected by typhoid at least once in their life. For season of prevalence, 57.0% of persons said that typhoid problem is more during summer season as compared to other seasons. In southern Punjab 92.2% interviewed persons said that cockroaches create more problem in houses and 84.2% of persons said that annoyance of cockroaches occur in night time but data regarding about insect vector or responsible insect of typhoid only 20.2% person have information that cockroaches spread the typhoid. Present survey in Southern Punjab showed that cockroaches create most problems in food commodities and person need to control it properly and very little person identify the insect vector of typhoid. This survey highlights the Southern Punjab people practices in control of cockroaches.

Research paper thumbnail of Direct Molecular Detection and Genotyping of Borrelia burgdorferi from Whole Blood of Patients with Early Lyme Disease

PLoS ONE, 2012

Direct molecular tests in blood for early Lyme disease can be insensitive due to low amount of ci... more Direct molecular tests in blood for early Lyme disease can be insensitive due to low amount of circulating Borrelia burgdorferi DNA. To address this challenge, we have developed a sensitive strategy to both detect and genotype B. burgdorferi directly from whole blood collected during the initial patient visit. This strategy improved sensitivity by employing 1.25 mL of whole blood, a novel pre-enrichment of the entire specimen extract for Borrelia DNA prior to a multilocus PCR and electrospray ionization mass spectrometry detection assay. We evaluated the assay on blood collected at the initial presentation from 21 endemic area patients who had both physician-diagnosed erythema migrans (EM) and positive two-tiered serology either at the initial visit or at a follow-up visit after three weeks of antibiotic therapy. Results of this DNA analysis showed detection of B. burgdorferi in 13 of 21 patients (62%). In most cases the new assay also provided the B. burgdorferi genotype. The combined results of our direct detection assay with initial physician visit serology resulted in the detection of early Lyme disease in 19 of 21 (90%) of patients at the initial visit. In 5 of 21 cases we demonstrate the ability to detect B. burgdorferi in early Lyme disease directly from whole blood specimens prior to seroconversion.

Research paper thumbnail of End-stage renal disease: incidence and prediction by coronary heart disease, and educational level. Follow-up from diagnosis of childhood-onset type 1 diabetes throughout Norway 1973–2017

Annals of Epidemiology

To investigate incidence of end-stage renal disease (ESRD), and the association of education and ... more To investigate incidence of end-stage renal disease (ESRD), and the association of education and coronary heart disease (CHD) with ESRD, in subjects throughout Norway followed from the diagnosis of childhood-onset type 1 diabetes. Methods: All new onset cases of type 1 diabetes 1973-2016 were followed for CHD and ESRD in nationwide registries through 2017. Ten matched controls per case were selected from the National Population Register. Cox regression was used to estimate hazard ratios, and probabilities were estimated by the cumulative incidence function accounting for competing risk. Results: Among 9311 patients with type 1 diabetes, 130 developed ESRD with a probability of ESRD after 40 years of 5.5%. The rate was 35-fold higher than in controls (aHR = 35.5, 95% CI 23.1-54.6). Higher education was associated with lower risk of ESRD compared to low education (aHR = 0.14, 95% CI 0.07-0.27). Diagnosed CHD was associated with 14-fold increased rate of ESRD (aHR = 14.3, 95% CI 9.2-22.2). Conclusions: The hazard rate of ESRD was 35-fold higher in cases compared to controls. CHD was associated with a 14-fold increased rate of subsequent ESRD, while higher education was associated with substantially lower rate of ESRD.

Research paper thumbnail of Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study

Diabetes Care, 2021

OBJECTIVE To study whether serum galectin-3 and other biomarkers of inflammation predict coronary... more OBJECTIVE To study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS A population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973–1982 was examined in 2002–2003 at a mean age of 33 years (range 21–44), with mean diabetes duration of 24 years (range 19–30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression. RESULTS Of 295 subjects, 40 (...

Research paper thumbnail of Low Incidence of End-Stage Renal Disease in Childhood-Onset Type 1 Diabetes Followed for Up to 42 Years

Diabetes care, Mar 12, 2017

End-stage renal disease (ESRD) is one of the most severe complications in type 1 diabetes. We aim... more End-stage renal disease (ESRD) is one of the most severe complications in type 1 diabetes. We aimed to estimate the cumulative incidence of ESRD in individuals with childhood-onset type 1 diabetes followed for up to 42 years. Data were based on the nationwide, population-based Norwegian Childhood Diabetes Registry and included case patients with new-onset type 1 diabetes (age <15 years) who had received a diagnosis during the periods 1973-1982 and 1989-2012. Follow-up took place until the development of ESRD, death, emigration, or 30 November 2015. We estimated the cumulative incidence of ESRD by linking to the Norwegian Renal Registry. Among the 7,871 patients, representing 147,714 person-years of follow-up, ESRD developed in 103 individuals (1.3%). The mean time from the diagnosis of diabetes to the development of ESRD was 25.9 years (range 12.7-39.1). The cumulative incidence of ESRD was 0.7% (95% CI 0.4-1.0) at 20 years diabetes duration, 2.9% (2.3-3.7) at 30 years duration, ...

Research paper thumbnail of Nine-fold higher risk of acute myocardial infarction in subjects with type 1 diabetes compared to controls in Norway 1973–2017

Cardiovascular Diabetology

Background We aimed to study the cumulative incidence and risk factors (sex, age, calendar year o... more Background We aimed to study the cumulative incidence and risk factors (sex, age, calendar year of diabetes onset, country of origin and educational level) of acute myocardial infarction (AMI) in subjects with type 1 diabetes and matched controls. Methods A nationwide cohort of subjects with type 1 diabetes diagnosed at age < 15 years in Norway during 1973–2000 was followed until the first AMI event, emigration, death or 31st of December 2017. The Norwegian Childhood Diabetes Registry was linked to five nationwide registries, and up to ten sex- and age-matched controls per case were included. Results Among 7086 subjects with type 1 diabetes, 170 (2.4%) were identified with incident AMI, compared to 193 (0.3%) of 69,356 controls. Mean age and diabetes duration at first AMI was 40.8 years and 30.6 years, respectively. The probability of AMI after 40 years of follow-up was 8.0% in subjects with type 1 diabetes and 1.1% in controls, aHR 9.05 (95% CI 7.18–11.41). In type 1 diabetes, m...

Research paper thumbnail of Fact versus Conjecture: Exploring Levels of Evidence in the Context of Patient Safety and Care Quality

Vignettes in Patient Safety - Volume 3, 2018

Evidence-based medicine (EBM) can be defined as the integration of optimized clinical judgment, p... more Evidence-based medicine (EBM) can be defined as the integration of optimized clinical judgment, patient values, and available evidence. It is a philosophical approach to making the best possible clinical decisions for individual patients. Based on objective evaluation and categorization of methodological design and data quality, all existing literature can be organized according to a hierarchy of "evidence quality" that helps determine the applicability and value of scientific findings in terms of clinical implementation and the potential to change existing patterns of practice. In terms of general categorization of scientific impact, randomized controlled trials (RCTs) are placed on top of the hierarchy, followed by systematic reviews of randomized controlled trials (RCTs), quasi-randomized designs, observational studies including retrospective case series, and finally case reports and expert opinion. Each study design is susceptible to certain limitations and biases, highlighting the importance of both clinical and scientific acumen of the interpreting provider. Such approach is critical to determining the value and the applicability of study recommendations in everyday practice. Evidence-based practice (EBP) has become one of the fundamental components of modern medicine and plays an indispensible role in the development (and improvement) of patient care and safety worldwide. Furthermore, organizations that create guidelines and policies for the management of specific conditions, often base the content and strength of their recommendations on the quality of evidence available to expert decision-makers. Therefore, understanding the "state of the science" upon which those recommendations are based will help guide the medical practitioner on "if, when and how" to apply evidence-based guidelines in his or her everyday medical or surgical practice. This chapter focuses on clinically relevant application of levels of scientific evidence (LSE) and the corresponding levels of clinical recommendation (LCR) in the context of care quality and safety.

Research paper thumbnail of Avoiding Fire in the Operating Suite: An Intersection of Prevention and Common Sense

Vignettes in Patient Safety - Volume 3, 2018

The operating room (OR) is a complex environment that involves large teams and multiple competing... more The operating room (OR) is a complex environment that involves large teams and multiple competing priorities, dynamically interacting throughout the entire course of a surgical procedure. The simultaneous presence of flammable substances, volatile gases, and the frequent use of electrical current results in a potentially dangerous combination. Operating room fire (ORF) is a rare but potentially devastating occurrence. To prevent this "never event", it is critical for institutions to establish and follow proper fire safety protocols. Adherence to proven prevention strategies and awareness of associated risk factors will help reduce the incidence of this dreaded safety event. When ORF does occur despite strict adherence to established safety protocols, the entire OR team should know the steps required to contain and extinguish the fire as well as essential measures to minimize or avoid thermal injury. If injury does occur, it is important to recognize and treat it promptly. Appropriate and honest disclosure to all injured persons and their families should be made without delay. As with all serious patient safety events, regulatory reporting and root cause determinations must take place in accordance with applicable laws and regulations. The goal of patient safety champions at each institution should be the attainment of zero incidence of ORF.

Research paper thumbnail of Perceptions regarding helmet use: a cross-sectional survey of female pillions in Karachi, Pakistan

Journal of Surgical Research, 2017

Cockroaches live in close proximity to human beings. Due to filthy breeding sites i.e. sewer syst... more Cockroaches live in close proximity to human beings. Due to filthy breeding sites i.e. sewer systems they carry up to 40 pathogenic bacteria. Typhoid is a notorious disease known to be transmitted by cockroaches worldwide. Human thought, perception and behavior vary according to the traditions, vicinity and knowledge. This study was carried out to understand the awareness of community about typhoid and its vector and the way they manage them. For this purpose a questionnaire was developed and data regarding typhoid and its vector were collected from 500 people belonging to 5 localities i.e. Multan, Shujabad, Muzaffargarh, KotAddu and Dera Ghazi Khan of southern Punjab. Results revealed that 44.6% of peoples were affected by typhoid at least once in their life. For season of prevalence, 57.0% of persons said that typhoid problem is more during summer season as compared to other seasons. In southern Punjab 92.2% interviewed persons said that cockroaches create more problem in houses and 84.2% of persons said that annoyance of cockroaches occur in night time but data regarding about insect vector or responsible insect of typhoid only 20.2% person have information that cockroaches spread the typhoid. Present survey in Southern Punjab showed that cockroaches create most problems in food commodities and person need to control it properly and very little person identify the insect vector of typhoid. This survey highlights the Southern Punjab people practices in control of cockroaches.

Research paper thumbnail of Direct Molecular Detection and Genotyping of Borrelia burgdorferi from Whole Blood of Patients with Early Lyme Disease

PLoS ONE, 2012

Direct molecular tests in blood for early Lyme disease can be insensitive due to low amount of ci... more Direct molecular tests in blood for early Lyme disease can be insensitive due to low amount of circulating Borrelia burgdorferi DNA. To address this challenge, we have developed a sensitive strategy to both detect and genotype B. burgdorferi directly from whole blood collected during the initial patient visit. This strategy improved sensitivity by employing 1.25 mL of whole blood, a novel pre-enrichment of the entire specimen extract for Borrelia DNA prior to a multilocus PCR and electrospray ionization mass spectrometry detection assay. We evaluated the assay on blood collected at the initial presentation from 21 endemic area patients who had both physician-diagnosed erythema migrans (EM) and positive two-tiered serology either at the initial visit or at a follow-up visit after three weeks of antibiotic therapy. Results of this DNA analysis showed detection of B. burgdorferi in 13 of 21 patients (62%). In most cases the new assay also provided the B. burgdorferi genotype. The combined results of our direct detection assay with initial physician visit serology resulted in the detection of early Lyme disease in 19 of 21 (90%) of patients at the initial visit. In 5 of 21 cases we demonstrate the ability to detect B. burgdorferi in early Lyme disease directly from whole blood specimens prior to seroconversion.