Microvascular decompression: a contemporary update.

Background: Microvascular decompression (MVD) is the gold-standard surgical treatment for cranial nerve compression disorders, including trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN). This review synthesizes historical milestones, recent advances, and evolving techniques in MVD, with a primary focus on these conditions.

Methods: A comprehensive literature review was conducted using databases such as PubMed, SpringerLink, Google Scholar, BioMed Central, Scopus, and ScienceDirect.

THE EFFECT OF PRE-MEDICATION WITH ORAL STEROIDS ON INTRA-OPERATIVE BLEEDING IN PATIENTS WITH CHRONIC RHINOSINUSITIS UNDERGOING FUNCTIONAL ENDOSCOPIC SINUS SURGERY.

Background: An inflammation of the nasal and paranasal sinus mucosa that lasts longer than three months is known as chronic rhinosinusitis. When corticosteroids and other medicinal treatments fail to relieve a patient's symptoms, then functional endoscopic sinus surgery (FESS) is a commonly performed procedure to alleviate the symptoms. The aim of the study was to evaluate the impact of oral steroids given prior to surgery on intraoperative bleeding in patients having functional endoscopic sinus surgery for chronic rhinosinusitis.

Nucleophilic Sn Seeding and Interface Engineering for Highly Stable Sodium Metal Batteries.

Sodium metal is a promising anode material for energy storage beyond lithium-ion batteries due to its abundance and low cost. However, the uncontrolled growth of dendrites and associated safety concerns have limited the practical application of sodium metal batteries (SMBs). By embedding nucleophilic tin seeds in a free-standing carbon film (FSF), here, an effective solution is developed to stabilize the sodium metal anode.

Highly Solvating Electrolytes with Core-Shell Solvation Structure for Lean-Electrolyte Lithium-Sulfur Batteries.

The practical energy density of lithium-sulfur batteries is limited by the low sulfur utilization at lean electrolyte conditions. The highly solvating electrolytes (HSEs) promise to address the issue at harsh conditions, but the conflicting challenges of long-term stability of radical-mediated sulfur redox reactions (SRR) and the poor stability with lithium metal anode (LMA) have dimmed the efforts. We now present a unique core-shell solvation structured HSE formulated with classical ether-based solvents and phosphoramide co-solvent.

Hyponatremia Prevalence in Decompensated Chronic Liver Disease: Insights from a Tertiary Care Hospital.

Background: Liver cirrhosis is a prominent global contributor to mortality, and hyponatremia is a common complication in patients with decompensated chronic liver disease (DCLD). Hyponatremia is characterized by kidney impairment when eliminating solute-free water. The presence of contradictory findings in existing literature prompted this study.

The Evolving Role of Palliative Care in Older People with Glioblastoma.

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in older adults and has a poor prognosis and limited response to treatment. The growing impact of palliative care on older people undergoing neurosurgery is becoming increasingly important. Palliative care aims to improve the quality of life for people and their families by addressing their physical, psychosocial, and spiritual needs.

Geochemical insights of arsenic mobilization into the aquifers of Punjab, Pakistan.

It is well known that groundwater arsenic (As) contamination affects million(s) of people throughout the Indus flood plain, Pakistan. In this study, groundwater (n = 96) and drilled borehole samples (n = 87 sediments of 12 boreholes) were collected to investigate geochemical proxy-indicators for As release into groundwater across floodplains of the Indus Basin. The mean dissolved (μg/L) and sedimentary As concentrations (mg/kg) showed significant association in all studied areas viz.

Global Neurosurgical Challenges: A Focus on Central Asia.

Objective: To evaluate the current state of neurosurgical care in Central Asia, identify the challenges and advancements, and propose recommendations to improve neurosurgical capabilities and access in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan.

Methods: A comprehensive review of the neurosurgical infrastructure, availability of neurosurgeons, technological advancements, and healthcare policies in the five Central Asian countries. Analysis included published literature, healthcare reports, and expert opinions to assess the state of neurosurgical care and identify areas for improvement.

An unusual case of long-standing retained nasopharyngeal foreign body.

The nasopharynx is a rare anatomical location where a foreign body may become lodged after being ingested or inhaled. We are presenting a rare case of nasopharyngeal foreign body impaction in a two-and-a-half-year-old child that had been missed for almost a year. The child presented with a history of right-sided foul-smelling nasal discharge, snoring and mouth breathing.

Caroli's Syndrome: A Case Report and Literature Review.

Synonymous with congenital non-obstructive saccular or fusiform intra-hepatic duct dilatation and congenital communicating cavernous ectasia of the intra-hepatic biliary tract, Caroli's syndrome (CS) is an extremely rare fibro-polycystic liver disorder characterized by ductal plate malformation and consequent peri-portal fibrosis due to segmental intra-hepatic duct dilatation. No more than 200 cases of the syndrome have been reported since 1958. CS may affect one or both lobes of the liver, but more commonly it affects the left hepatic lobe.

Endoscopic Therapy of Gastric Varices: Safety and Efficacy of N-Butyl-2-Cyanoacrylate Injection.

Background Upper gastrointestinal bleeding (UGIB) is a common medical emergency that results in significant morbidity, mortality, and socioeconomic burden. Both types of cardio-fundal varices, gastro-esophageal varix 2 (GOV2) and isolated gastric varices type 1 (IGV1), can cause massive bleeding and often are difficult to treat compared to the other types of gastric varices. Endoscopic variceal band ligation (EVBL) is a less effective treatment modality for gastric varices than esophageal varices and is associated with high re-bleeding rates.

HepFREEPak: protocol for a multi-centre, prospective observational study examining efficacy and impact of current therapies for the treatment of hepatitis C in Pakistan and reporting resistance to antiviral drugs: study protocol.

Background: Pakistan has one of the highest burdens of Hepatitis C virus (HCV) infection globally. To achieve the World Health Organization's goals for HCV elimination, there is a need for substantial scale-up in testing, treatment, and a reduction in new infections. Data on the population impact of scaling up treatment is not available in Pakistan, nor is there reliable data on the incidence of infection/reinfection.

Association of Metabolic Dysfunction-Associated Steatotic Liver Disease/Non-alcoholic Fatty Liver Disease With Type 2 Diabetes Mellitus: A Case-Control Study in a Tertiary Care Hospital in Pakistan.

Background Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by high blood sugar levels, insulin resistance, and relative insulin deficiency. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the term used to describe fatty liver (steatosis) in individuals without a history of significant alcohol intake. MASLD is progressively known as the leading cause of chronic liver disease.

Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan.

Introduction: Tuberculosis (TB), a curable and preventable infectious disease, becomes difficult to treat if resistance against most effective and tolerable first line anti-TB drugs is developed. The objective of the present study was to evaluate the treatment outcomes and predictors of poor outcomes among drug-resistant tuberculosis (DR-TB) patients treated at a programmatic management unit of drug resistant tuberculosis (PMDT) unit, Punjab, Pakistan.

Methods: This prospective observational study was conducted at a a PMDT unit in Multan, Punjab, Pakistan.

A Coronary Cameral Fistula Associated With Incessant Ventricular Arrhythmias.

Coronary cameral fistula (CCF) is a rare congenital abnormality of abnormal communication between coronary arteries and cardiac chambers. Most patients are asymptomatic, while symptomatic patients are usually present in childhood. Adult patients can present with angina, heart failure, or arrhythmias.

Arsenic exposure induces urinary metabolome disruption in Pakistani male population.

Millions of people are at risk of consuming arsenic (As) contaminated drinking water in Pakistan. The current study aimed to investigate urinary arsenic species [iAs, iAs, dimethylarsinic acid (DMA), methylarsonic acid (MMA)] and their potential toxicity biomarkers (based on urinary metabolome) in order to characterize the health effects in general adult male participants (n = 588) exposed to various levels of arsenic in different floodplain areas of Pakistan. The total urinary arsenic concentration (mean; 161 μg/L) of studied participants was lower and/or comparable than those values reported from other highly contaminated regions, but exceeded the Agency for Toxic Substances and Disease Registry (ATSDR) limits.

Totally percutaneous endovascular repair for ruptured abdominal aortic aneurysms.

Purpose: The PEVAR Trial demonstrated that compared to open femoral exposure, elective percutaneous endovascular AAA repair (ePEVAR) is associated with decreased perioperative morbidity and access site complications. We hypothesized that PEVAR for ruptured AAA (rPEVAR) may also improve perioperative morbidity compared to open femoral exposure (rEVAR). There are currently no reports that evaluate the utility and outcomes of rPEVAR.

Highly Efficient Perfect Vortex Beams Generation Based on All-Dielectric Metasurface for Ultraviolet Light.

Featuring shorter wavelengths and high photon energy, ultraviolet (UV) light enables many exciting applications including photolithography, sensing, high-resolution imaging, and optical communication. The conventional methods of UV light manipulation through bulky optical components limit their integration in fast-growing on-chip systems. The advent of metasurfaces promised unprecedented control of electromagnetic waves from microwaves to visible spectrums.

Altered Peroxisome Proliferator-Activated Receptor Alpha Signaling in Variably Diseased Peripheral Arterial Segments.

Objective: Peripheral atherosclerosis that accumulates in the extracranial carotid and lower extremity arteries can lead to significant morbidity and mortality. However, atherosclerotic disease progression is often not homogenous and is accelerated by diabetes. We previously observed increased phospholipid content in minimally (Min)-diseased arterial segments compared to maximally (Max)-diseased segments.

Frequency and Management of Adverse Drug Reactions Among Drug-Resistant Tuberculosis Patients: Analysis From a Prospective Study.

Drug-resistant tuberculosis (DR-TB) management is often linked with a higher rate of adverse drug reactions (ADRs) needing effective and timely management of these ADRs, which, if left untreated, may result in a higher rate of loss to follow-up of drug-resistant patients. The study was aimed at prospectively identifying the nature, frequency, suspected drugs, and management approaches for ADRs along with risk factors of ADRs occurrence among DR-TB patients at Nishtar Medical University, Hospital, Multan, Pakistan. The prospective study included all the DR-TB patients enrolled for treatment from January 2016 to May 2017 at the study site Patients were evaluated for the treatment-induced ADRs as per standard criteria of the National Tuberculosis Program, Pakistan.