Doctors taking bribes from pharmaceutical companies is common and not substantially reduced by an educational intervention: a pragmatic randomised controlled trial in Pakistan.

Introduction: Incentive-linked prescribing, which is when healthcare providers accept incentives from pharmaceutical companies for prescribing promoted medicines, is a form of bribery that harms patients and health systems globally. We developed a novel method using data collectors posing as pharmaceutical company sales representatives to evaluate private doctors' engagement in incentive-linked prescribing and the impact of a multifaceted educational intervention on reducing this practice in Karachi, Pakistan.

Methods: We made a sampling frame of all doctors running for-profit, primary-care clinics and randomly allocated participants to control and intervention groups (1:1).

Risk Factors and Pharmacological Interventions Impacting Cerebrovascular Ischemic Events in Giant Cell Arteritis: A Narrative Review.

Introduction: Giant cell arteritis (GCA) is a common vasculitis predominantly affecting larger vessels, especially in individuals aged 70-79. Cerebrovascular ischemic events (CIE), such as stroke and transient ischemic attacks, are serious but rare complications of GCA, with a pooled prevalence of 4%. Some studies found that within 2 weeks of GCA diagnosis, 74% and 34% of patients experience transient or severe ischemic events, respectively.

Crafting Hollow Spheres via Bulk Ice Melting with ppb-Level Gas Sensing Performance.

Ice melting, a common yet complex phenomenon, remains incompletely understood. While theoretical studies suggest that preexisting defects in ice generate "off-lattice" water molecules, triggering bulk ice melting, direct experimental evidence of their form has been lacking as the transparent and transient nature of ice poses significant challenges for observation with current techniques. Here, we introduce an ice-melting-induced lyophilization (IMIL) technique that employs graphene-based nanoprobes to replicate and track liquid evolution within melting bulk ice.

Survival with Trastuzumab Emtansine in Residual HER2-Positive Breast Cancer.

Background: Patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer with residual invasive disease after neoadjuvant systemic therapy have a high risk of recurrence and death. The primary analysis of KATHERINE, a phase 3, open-label trial, showed that the risk of invasive breast cancer or death was 50% lower with adjuvant trastuzumab emtansine (T-DM1) than with trastuzumab alone.

Methods: We randomly assigned patients with HER2-positive early breast cancer with residual invasive disease in the breast or axilla after neoadjuvant systemic treatment with taxane-based chemotherapy and trastuzumab to receive T-DM1 or trastuzumab for 14 cycles.

Adolopment of Recommendations for Standardized Reporting of Protein Electrophoresis in Pakistan.

Introduction: The standardization of reporting in clinical laboratories, particularly regarding Serum Protein Electrophoresis (SPEP) and Urine Protein Electrophoresis (UPEP), is crucial for effective communication of findings to clinicians and optimal patient management. However, in countries like Pakistan with limited healthcare resources and a prevalent self-payment model, challenges arise in achieving standardized reporting practices. This manuscript addresses the need for standardized guidelines for protein electrophoresis reporting in Pakistan, aiming to enhance laboratory practices and patient care.