Randomised controlled trials of dual antiplatelet therapy versus aspirin in patients with stroke or transient ischaemic attack: an updated meta-analysis.

Introduction: We explored the efficacy and safety of dual antiplatelet therapy (DAPT) for individuals diagnosed with stroke or transient ischaemic attack (TIA), incorporating the latest insights from randomised controlled trials (RCTs). The emerging evidence surrounding DAPT in stroke and TIA plays a pivotal role in guiding clinical decisions.

Methods: Our study included five RCTs (INSPIRES, THALES, POINT, CHANCE, FASTER) on DAPT (aspirin + P2Y12 inhibitor) initiated within 72 hours of acute stroke or TIA, which evaluated DAPT efficacy and safety over 21-90 days, focusing on new strokes and major bleeding.

Optimizing population mean estimation in stratified sampling using linear cost: A simulation study.

Improving efficiency has long been a focal challenge in sampling literature. However, simultaneously enhancing estimator efficacy and optimizing survey costs is a practical necessity across various fields such as medicine, agriculture, and transportation. In this study, we present a comprehensive family of generalized exponential estimators specifically designed for estimating population means within stratified sampling frameworks.

Reference Intervals for Venous Blood Gas in Healthy Adults: A One-Year Prospective Study.

Background Venous blood gas (VBG) investigation is a widespread option for arterial blood gas analysis because it is easier to draw and has a lower risk of complications during phlebotomy. This study aimed to establish reference intervals for the accurate analysis of VBG results as there is a lack of published data. Method Dr.

Diffuse Maculopapular Rash: An Uncommon Cutaneous Presentation of Secondary Syphilis.

Syphilis is a sexually acquired disease that can affect multiple organ systems. Secondary syphilis can cause a wide range of skin manifestations, leading to misdiagnoses. Herein, we present a patient who developed a diffuse maculopapular rash concerning for a drug reaction leading to a dermatology consult.

Twelve-month follow-up of a controlled trial of a brief behavioural intervention to reduce psychological distress in young adolescent Syrian refugees.

Aims: The majority of studies of mental health interventions for young adolescents have only evaluated short-term benefits. This study evaluated the longer-term effectiveness of a non-specialist delivered group-based intervention (Early Adolescent Skills for Emotions; EASE) to improve young adolescents' mental health.

Methods: In this single-blind, parallel, controlled trial, Syrian refugees aged 10-14 years in Jordan who screened positive for psychological distress were randomised to receive either EASE or enhanced usual care (EUC).

Interventions to reduce social isolation and loneliness among minority ethnic populations in OECD countries: A scoping review.

Background: Social isolation and loneliness (SIL) are complex issues that impact mental and physical wellbeing and are significant public health concerns. People from minority ethnic backgrounds living in Organisation for Economic Cooperation and Development (OECD) member states may be particularly vulnerable to experiencing SIL. This is due to various challenges associated with life in foreign countries, including cultural differences, settlement issues, low incomes, and discrimination.

Salvianolic acid B prevents the amyloid transformation of A53T mutant of α-synuclein.

Parkinson's disease (PD) is a neurodegenerative disorder involving the progressive loss of dopaminergic neurons in the substantia nigra pars compacta triggered by the accumulation of amyloid aggregates of α-synuclein protein. This study investigates the potential of Salvianolic Acid B (SalB), a water-soluble polyphenol derived from Salvia miltiorrhiza Bunge, in modulating the aggregation of the A53T mutant of α-synuclein (A53T Syn). This mutation is associated with rapid aggregation and a higher rate of protofibril formation in early-onset familial PD.

Labor market marginalization in individuals with bipolar disorder: a Swedish nationwide register-based sibling comparison study.

Background: There is a lack of large-scale studies exploring labor market marginalization (LMM) among individuals diagnosed with bipolar disorder (BD). We aimed to investigate the association of BD with subsequent LMM in Sweden, and the effect of sex on LMM in BD.

Methods: Individuals aged 19-60 years living in Sweden with a first-time BD diagnosis between 2007 and 2016 ( = 25 231) were followed from the date of diagnosis for a maximum of 14 years.

Identification of gastric cancer biomarkers through analysis of microarray based datasets.

Gastric cancer is among the most prevalent cancers worldwide including in Pakistan. Late diagnosis of gastric cancer leads to reduced survival. The present study aimed to investigate biomarkers for early diagnosis and prognosis of gastric cancer.

Integrative Network Pharmacology, Molecular Docking, and Dynamics Simulations Reveal the Mechanisms of in Diabetic Nephropathy Treatment: An In Silico Study.

Diabetic nephropathy (DN) is a serious diabetes-related complication leading to kidney damage. (CT), traditionally used in managing diabetes and kidney disorders, has shown potential in treating DN, although its active compounds and mechanisms are not fully understood. This study aims to identify CT's bioactive compounds and explore their therapeutic mechanisms in DN.

Scalable Technology for Adolescents and Youth to Reduce Stress in the Treatment of Common Mental Disorders in Jordan: Protocol for a Randomized Controlled Trial.

Background: Young people in low- and middle-income countries encounter significant barriers to accessing mental health support due to various factors, including a substantial treatment gap and limited health care budgets allocated to mental health. Using innovative strategies, such as scalable digital self-help psychological interventions, offers a potential solution for improving access to mental health support. However, digital mental health interventions come with their own set of challenges, including issues related to low user engagement.

Prescriber Adherence to Antihypertensive Prescription Guidelines and the Impact of Patient Socioeconomic Factors: A Cross-Sectional Study Using Data From the Irish Longitudinal Study on Ageing.

Purpose: Uncontrolled hypertension causes significant morbidity and mortality worldwide. Several prescribing guidelines have been created to address this, however, prescriber adherence to guidelines is influenced by various sociodemographic patient factors. This study aims to determine the effects of these patient factors on prescriber adherence to antihypertensive prescription guidelines.

Morphology of the First Tarsometatarsal Joint and the Incidence of Arthritis and Post-operative Complications.

Introduction The first tarsometatarsal joint (TMTJ) is often overlooked regarding foot pathology or a secondary measure in most studies, despite its heavy involvement in surgical procedures and foot stability. The primary aim of this study is to assess the effect of the first TMTJ morphology on the incidence of arthritis and post-operative complications following a Lapidus procedure. Materials and methods A total of 39 feet/subjects (19 left and 20 right) were assessed by two independent reviewers.

Addressing challenges faced by young refugees in the Netherlands: Adapting problem management plus (PM+) with an emotional processing module.

Young refugees face numerous challenges before, during, and after their journey, leading to higher rates of mental health issues such as depression, anxiety, and posttraumatic stress disorder. These problems often remain untreated due to barriers like limited services, stigma, and varied distress expressions. One effective scalable intervention that bridges this treatment gap is problem management plus (PM+), a transdiagnostic program delivered by trained nonspecialists.

Smartphone-driven centrifugal microfluidics for diagnostics in resource limited settings.

The broad availability of smartphones has provided new opportunities to develop less expensive, portable, and integrated point-of-care (POC) platforms. Here, a platform that consists of three main components is introduced: a portable housing, a centrifugal microfluidic disc, and a mobile phone. The mobile phone supplies the electrical power and serves as an analysing system.

Blockchain Based Auditable Access Control For Business Processes With Event Driven Policies.

The use of blockchain technology has been proposed to provide auditable access control for individual resources. Unlike the case where all resources are owned by a single organization, this work focuses on distributed applications such as business processes and distributed workflows. These applications are often composed of multiple resources/services that are subject to the security and access control policies of different organizational domains.

Forecasting the Pharmacological Mechanisms of and in Diabetic Retinopathy Treatment: A Network Pharmacology, Molecular Docking, and Molecular Dynamics Simulation Study.

(1) Background: Diabetic retinopathy (DR) is a major complication of diabetes, marked by abnormal angiogenesis, microaneurysms, and retinal hemorrhages. Traditional Ayurvedic medicine advocates multi-target strategies for DR management. However, the mechanisms by which (SX) and (PZ) exert therapeutic effects are not well understood; (2) Methods: To investigate these mechanisms, we employed network pharmacology and molecular docking techniques.

Exploring the Impact of Cognitive Dysfunction During Recurrent Depression in a Sample of Mid-to-Older Age British South Asians: A Qualitative Study.

Introduction: Depression is a major public health issue, increasing the risk of comorbidities. Some people with depression experience cognitive dysfunction, which can persist even after symptomatic recovery. British South Asians are at greater risk of developing depression and are less likely to seek treatment.

Retrospective Comparison of Influenza and COVID-19-Associated Acute Respiratory Distress Syndrome (ARDS): An Experience From a Tertiary Care Hospital.

Background The COVID-19 pandemic has had a profound impact on global healthcare systems, often compared to seasonal influenza due to similarities in clinical presentation. This study aims to compare the clinical characteristics, comorbidities, and outcomes of critically ill patients with COVID-19 and those with influenza admitted to a tertiary care hospital in Islamabad, Pakistan. Methods This retrospective cohort study included 120 patients, 60 with confirmed COVID-19 and 60 with confirmed influenza, all of whom required ICU admission and mechanical ventilation between January 1, 2021, and January 1, 2024.

With What Should We Replace Nonhuman Animals in Biomedical Research Protocols?

Historically, most discussions about nonhuman animal experimentation consider what has become known as the 3 R's: refinement, reduction, and replacement. Refinement and reduction receive the most attention, but recent modeling advances suggest that suitable replacement of nonhuman animal testing would bolster human research and increase translatability to human health outcomes. This article discusses these modeling advances and advocates their use, especially as replacements to nonpredictive nonhuman animal protocols, and discusses growing momentum in biomedical research communities and federal agencies that favors replacement of animal testing.

Risk factors for mortality in hospitalized COVID-19 patients across five waves in Pakistan.

This retrospective cohort study aims to describe the clinical characteristics and outcomes and assess risk factors for mortality across the epidemic waves in hospitalized COVID-19 patients in a major tertiary-care center in Pakistan. A total of 5368 patients with COVID-19, hospitalized between March 2020 and April 2022 were included. The median age was 58 years (IQR: 44-69), 41% were females, and the overall mortality was 12%.