A Systematic Review of modern endovascular techniques compared to surgery for acute limb ischaemia.

Introduction: Acute limb ischemia (ALI) represents a critical vascular emergency, conventionally managed with surgical intervention in cases of threatened limbs. However, the increasing application of modern endovascular techniques, such as percutaneous thrombectomy, has emerged as an alternative treatment approach for ALI. This systematic review evaluates the contemporary management of ALI.

The Effects of Bariatric Surgery on the Requirement for Antihypertensive Treatment in Type 2 Diabetes: Insights from a Long-Term Follow-Up Study.

Introduction: Bariatric surgery (BS) has emerged an effective intervention in achieving significant and sustained weight loss in patients with type 2 diabetes (T2D). However, comprehensive data on the long-term impact of BS on hypertension is scarce. We aimed to investigate the long-term impact of BS on blood pressure management in individuals within a T2D cohort.

Covariates in population pharmacokinetic studies of critically ill adults receiving β-lactam antimicrobials: a systematic review and narrative synthesis.

Introduction: Population pharmacokinetic studies of β-lactam antimicrobials in critically ill patients derive models that inform their dosing. In non-linear mixed-effects modelling, covariates are often used to improve model fit and explain variability. We aimed to investigate which covariates are most commonly assessed and which are found to be significant, along with global patterns of publication.

Number of CAG repeats and mortality in middle aged and older men.

Design: The androgen receptor (AR) mediates peripheral effects of testosterone. Previous data suggests an association between the number of CAG repeats in exon-1 of the AR gene and AR transcriptional activity. The aim of this analysis was to determine the association between the number of AR CAG repeats and all-cause mortality in men and the influence of testosterone level on the association.

Failure to control conventional cardiovascular risk factors in women with type 2 diabetes might explain worse mortality.

Introduction: The standardised mortality rate (SMR) for people with diabetes in England is 1.5-1.7, with differences in outcomes between sexes.

Automatic Detection of Cognitive Impairment with Virtual Reality.

Cognitive impairment features in neuropsychiatric conditions and when undiagnosed can have a severe impact on the affected individual's safety and ability to perform daily tasks. Virtual Reality (VR) systems are increasingly being explored for the recognition, diagnosis and treatment of cognitive impairment. In this paper, we describe novel VR-derived measures of cognitive performance and show their correspondence with clinically-validated cognitive performance measures.

Impact of QRS Duration on Non-ST-Segment Elevation Myocardial Infarction (from a National Registry).

QRS duration (QRSd) is ill-defined and under-researched as a prognosticator in patients with non-ST-segment myocardial infarction (NSTEMI). We analyzed 240,866 adult (≥18 years) hospitalizations with non-ST-segment elevation myocardial infarction using data from the United Kingdom Myocardial Infarction National Audit Project. Clinical characteristics and all-cause in-hospital mortality were analyzed according to QRSd, with 38,023 patients presenting with a QRSd >120 ms and 202,842 patients with a QRSd <120 ms.

Early Childhood Educators as COVID Warriors: Adaptations and Responsiveness to the Pandemic Across Five Countries.

The ongoing COVID-19 pandemic has seriously impacted countries across the globe. The pandemic has created a completely new teaching-learning environment of interaction for early childhood educators. In many countries, face-to-face teaching has been replaced by remote teaching, while in others, there have been intermittent lockdowns and limited interruptions to regular teaching norms.

COVID-19 pandemic: An analysis of the healthcare, social and economic challenges in Bangladesh.

Bangladesh is one of the worst hit countries in South Asia for COVID-19 outbreak. The objective of this article is to analyse healthcare, social and economic challenges faced by the country. Quantitative data and qualitative information from different sources have been used.

Investigating the utility of COVID-19 antibody testing in end-stage renal disease patients receiving haemodialysis: a cohort study in the United Kingdom.

Background: End-stage renal disease (ESRD) patients receiving haemodialysis (HD) are a vulnerable group of patients with increased mortality from COVID-19. Despite improved understanding, the duration of host immunity following COVID-19 infection and role of serological testing alone or in addition to real-time reverse transcription polymerase chain reaction (rRT-PCR) testing in the HD population is not fully understood, which this study aimed to investigate.

Methods: There were two parts to this study.

Acute necrotizing pancreatitis: Has conservative management replaced surgery? Perspective from a tertiary care centre in Pakistan: A cross-sectional study.

Background: The main purpose of this study was to review the trends in management of patients presenting with acute necrotizing pancreatitis (ANP) over the last seven years and its effect on morbidity and mortality.

Methods: A cross-sectional study was conducted on all patients presenting with the diagnosis of acute necrotizing pancreatitis to the Aga Khan University Hospital in between the year 2008-2015. The study population was broadly categorized in to two groups based on the way these were managed.

Assessing the Adherence of Operative Notes for Laparoscopic Appendectomy with the Royal College of Surgeons Guidelines.

Unlabelled:  Objective: To determine the frequency of adherence of laparoscopic appendectomy operative notes with the Royal College of Surgeons (RCS) guidelines at the tertiary care centre.  Study Design: A clinical audit report.

Place And Duration Of Study: The Aga Khan University Hospital, Karachi between January and June 2018.

Early versus delayed (interval) appendicectomy for the management of appendicular abscess and phlegmon: a systematic review and meta-analysis.

Objective: The safety and role of emergency (EA) versus interval appendicectomy (IA) for appendicular abscess and phlegmon remains debatable with no optimal strategy identified. The aim of this systematic review and meta-analysis is to evaluate outcomes of managing appendicular abscesses and phlegmon with emergency or interval appendicectomy.

Methods: We conducted a systematic search of electronic databases using key terms including 'appendicular abscess', 'appendicular phlegmon' and 'interval appendicectomy'.

COVID-19 Pandemic: How is Bangladesh coping with the rapid spread of coronavirus infection?

The novel coronavirus has become a global risk because of its massive transmission and high rates of mutation. Efficient clinical management remains a challenge in combatting the severe acute respiratory syndrome caused by this virulent strain. This contagious disease is new to the people of Bangladesh.

Minimal model of the hydrodynamical coupling of flagella on a spherical body with application to Volvox.

Flagella are hairlike appendages attached to microorganisms that allow the organisms to traverse their fluid environment. The algae Volvox are spherical swimmers with thousands of individual flagella on their surface, and their coordination is not fully understood. In this work, a previously developed minimal model of flagella synchronization is extended to the outer surface of a sphere submerged in a fluid.

A Model to Determine Value of Care Delivered at the Level of Individual Providers in an Organization.

Introduction: Value in health care has been defined as health outcomes achieved per dollar spent. The concept of value is a shift from the traditional volume-based health delivery system. The implementation of value-based health care has generally been at an institutional level.

Transient Musical Hallucinations in a Young Adult Male Associated with Alcohol Withdrawal.

We present the case of a 25-year-old male who presented to A&E with isolated musical hallucinations, in the absence of audiological or neurological disease. The patient had a history of recreational drug use and a family history of psychosis. Hallucinations, which were preceded by discontinuation of alcohol and reinitiation of citalopram for depression, resolved spontaneously after three days.

Characteristics of Prescription-Opioid-Impaired and Other Substance-Impaired Drivers in Rural Appalachian Kentucky.

Previous studies have highlighted the prescription opioid epidemic in rural Appalachia and its associated risk behaviors; however, no studies have examined prescription-opioid-impaired driving as a consequence of this epidemic. The purpose of the present study was to describe prescription-opioid-impaired drivers in rural Appalachian Kentucky and examine how they are similar to and different from other substance-impaired drivers from the region. A sample of convicted DUI offenders from rural Appalachian Kentucky completed a confidential research interview focused on their substance use, mental health, and criminal activity.

Research Outputs of England's Hospital Episode Statistics (HES) Database: Bibliometric Analysis.

Background: Hospital administrative data, such as those provided by the Hospital Episode Statistics (HES) database in England, are increasingly being used for research and quality improvement. To date, no study has tried to quantify and examine trends in the use of HES for research purposes.

Objective: To examine trends in the use of HES data for research.

Outputs and Growth of Primary Care Databases in the United Kingdom: Bibliometric Analysis.

Background: Electronic health database (EHD) data is increasingly used by researchers. The major United Kingdom EHDs are the 'Clinical Practice Research Datalink' (CPRD), 'The Health Improvement Network' (THIN) and 'QResearch'. Over time, outputs from these databases have increased, but have not been evaluated.

T-tube placement as a method for treating penetrating oesophageal injuries.

Introduction: Penetrating oesophageal injuries are extremely rare. Their timely recognition can be difficult and optimal treatment remains controversial. Early recognition of injury is possible with the help of a high index of suspicion and early radiological and endoscopic examinations.

Perforated sub-hepatic appendix; rare presentation of a common disease.

An elderly gentleman presented to our emergency with a 10-day history of right upper quadrant pain and nausea with associated tenderness on examination. His white cell counts were raised with predominant neutrophils with ultrasound evidence of a heterogeneous sub-hepatic collection, not associated with fever, diarrhoea or vomiting. He had a similar episode 3 weeks ago, which resolved with antibiotics.

Quality of care in university hospitals in Saudi Arabia: a systematic review.

Objectives: To identify the key issues, problems, barriers and challenges particularly in relation to the quality of care in university hospitals in the Kingdom of Saudi Arabia (KSA), and to provide recommendations for improvement.

Methods: A systematic search was carried out using five electronic databases, for articles published between January 2004 and January 2015. We included studies conducted in university hospitals in KSA that focused on the quality of healthcare.

Assessment of Natural Radioactivity Levels and Potential Radiological Risks of Common Building Materials Used in Bangladeshi Dwellings.

The concentrations of primordial radionuclides (226Ra, 232Th and 40K) in commonly used building materials (brick, cement and sand), the raw materials of cement and the by-products of coal-fired power plants (fly ash) collected from various manufacturers and suppliers in Bangladesh were determined via gamma-ray spectrometry using an HPGe detector. The results showed that the mean concentrations of 226Ra, 232Th and 40K in all studied samples slightly exceeded the typical world average values of 50 Bq kg(-1), 50 Bq kg(-1) and 500 Bq kg(-1), respectively. The activity concentrations (especially 226Ra) of fly-ash-containing cement in this study were found to be higher than those of fly-ash-free cement.