Post-Traumatic Hip Osteoarthritis after Pelvic Ring Injuries.

Objectives: While rates of post-traumatic osteoarthritis after acetabulum fracture have been thoroughly studied, there has been less emphasis on hip osteoarthritis after pelvic ring injuries. The objective of this study was to determine the frequency of post-traumatic hip osteoarthritis in pelvic ring injury patients. It was hypothesized that more severe pelvic ring injuries would be associated with greater rates of post-traumatic hip osteoarthritis.

Change in management for digital subtraction angiography-identified false-positive traumatic vertebral artery injury.

Background: For patients with suspected traumatic vertebral artery injury (TVAI), CT angiography (CTA) is the first-line screening modality. Digital subtraction angiography (DSA) serves as the confirmatory diagnostic imaging, and is the gold standard for cerebrovascular injury assessment, due to its higher sensitivity and specificity. Among patients with TVAI based on CTA who have undergone follow-up DSA, this study aims to investigate how diagnostic information with additional imaging affects clinical management.

Outcomes of mechanical thrombectomy for medium vessel occlusion in acute ischemic stroke patients with ASPECTS 4-5 vs. 6-7: a retrospective, multicenter, and multinational study.

Introduction: Mechanical thrombectomy (MT) efficacy in medium vessel occlusion (MeVO) stroke, particularly in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS), remains less explored.

Methods: This retrospective study analyzed data from 443 AIS patients treated with MT for MeVO and low ASPECTS (4-7) at 37 centers across North America, Asia, and Europe, from September 2017 to July 2021. Patients were categorized into ASPECTS of 4-5 and 6-7.

Injury Patterns and Surgical Approaches.

Effective management of bony and cartilaginous thoracic injury is a vital part of the care of the polytraumatized patient. Commonly because of high-energy accidents including motor vehicle collisions and falls, these patients routinely require multidisciplinary care and surgical intervention. As our understanding of unstable chest wall injuries and pulmonary sequelae of the injury grows, it is imperative that injury patterns and surgical approaches become familiar to the orthopaedic trauma-trained surgeon.

Anatomy of the Ribs, Sternum, and Costal Margin.

The ribs, sternum, and costal margin provide a rigid, but flexible chest wall that functions to provide protection to the vital cardiothoracic organs, while also allowing for varying levels of respiration based on physiologic need. The latter function is accomplished through various muscular attachments and rib articulations with both the axial spine posteriorly and the sternum anteriorly. The accessory muscles of inspiration rely on the downward slope and outward curve of each rib, which when contracted move the ribs upward and outward, in turn forcing the sternum anterior and increasing the thoracic volume.

Emergence of fungal hybrids - Potential threat to humans.

Fungal hybrids arise through the interbreeding of distinct species. This hybridization process fosters increased genetic diversity and the emergence of new traits. Mechanisms driving hybridization include the loss of heterozygosity, copy number variations, and horizontal gene transfer.

Microscopic Techniques for Nanomaterials Characterization: A Concise Review.

Nanomaterials have been gaining interest due to their remarkable properties at the nanoscale. The surface area of particles becomes high at the nanoscale because of this virtue, they have been used in a bundle of applications like electronics, biomedical, agriculture, wastewater treatment, semiconductor industry, cosmetics, drug delivery, paints, and so forth. The morphology (size and shape) of nanomaterials plays an important role because each application requires the appropriate morphology for better performance.

Occult Breast Cancer in High-Risk Gene-Positive Pakistani Women Undergoing Contralateral Prophylactic Mastectomy/Prophylactic Mastectomy: Implications for Sentinel Lymph Node Biopsy.

Introduction: Sentinel lymph node biopsy (SLNB) of the axilla is standard in breast cancer (BC) management; however, its role in prophylactic/contralateral prophylactic mastectomy (CPM) is still questioned. To avoid future consequences on surgical morbidity and socioeconomic aspects in low and middle-income countries (LMICs), we intend to determine the prevalence of occult breast cancer (OBC) among CPM cases.

Objective: To determine the prevalence of OBC in patients undergoing prophylactic mastectomy (PM).

Analysis of gene variants in familial and non-familial primary open angle glaucoma Pakistani patients.

Aim: To find out the association of secreted protein acidic and rich in cysteine (SPARC)-related modular calcium binding 2 () gene variants rs2255680 and rs13208776 with genotypic and phenotypic characteristics in both familial and non-familial primary open angle glaucoma (POAG) patients.

Methods: A total of 212 POAG patients, comprising 124 familial and 88 non-familial, were enrolled. For genotyping the variant rs2255680, amplification refractory mutation system (ARMS)-polymerase chain reaction (PCR) method and PCR-restriction fragment length polymorphism (PCR-RFLP) were utilized for analyzing rs13208776 variant.

Elective outpatient middle meningeal artery embolization for chronic subdural hematoma is safe.

Background: Middle meningeal artery embolization (MMAE) is a safe and effective treatment for chronic subdural hematoma (cSDH); however, the appropriate level of postoperative care is unknown.

Objective: To evaluate whether elective MMAE for cSDH could be safely performed in an outpatient setting.

Methods: This was a multicenter, retrospective study of patients with cSDH who underwent elective MMAE.

Predictive value of neutrophil-lymphocyte ratio in assessing the outcomes of diabetic foot ulcer.

Objectives: To assess the correlation of neutrophil-lymphocyte ratio with clinical outcomes in diabetic foot ulcer cases.

Methods: The retrospective, cross-sectional, single-centre study was conducted at Section of Vascular Surgery, Aga Khan University Hospital, Karachi (Pakistan), and comprised data from January 2019 to January 2022 of diabetic foot inpatients of either gender aged at least 18 years. Hospital complications and outcomes were noted along with other data on a self-designed proforma.

Minimally invasive treatment with radiofrequency ablation and kyphoplasty for avascular necrosis of the spine in sickle cell disease: illustrative case.

Background: Avascular necrosis (AVN) of the spine is a rare sequela of chronic sickle cell disease (SCD) in which the shape of the sickled red blood cells interfere with the normal vascular supply of vertebral bodies. In this report, the authors describe a case of progressive spinal AVN treated with radiofrequency ablation (RFA) and kyphoplasty for the patient's persistent lower back pain.

Observations: A 38-year-old male with long-standing spinal AVN due to SCD had been managed conservatively with hydroxyurea and oral opioid analgesics for several years until breakthrough episodes of low-back pain began to occur with an inability to perform activities of daily life.

Association of OAS1 and MxA variants with COVID-19 in Pakistani patients.

Introduction: Coronaviruses, a family of enveloped RNA viruses, have been implicated in various clinical disorders including coronavirus disease 2019 (COVID-19). Host genetic factors, including the OAS1 and MxA gene variants may have a role in determining susceptibility to viral infections. Understanding the genetic factors involved in unraveling COVID-19`s diverse clinical outcomes is critical for disease management.

"Chopperlysis": The effect of helicopter transport on reperfusion and outcomes in large vessel occlusion strokes.

Background: In large vessel occlusion (LVO) stroke patients transferred to a comprehensive stroke center for thrombectomy, spontaneous reperfusion may occur during transport, and anecdotally more frequently in patients transferred via helicopter than by ground. This pattern has been more often observed in conjunction with tenecteplase (TNK) treatment prior to helicopter transport. We aim to explore the "chopperlysis" effect-how helicopter transport, particularly with thrombolytics, may affect reperfusion and clinical outcomes.

Hyperacute thrombosis of a vertebral artery stent with a single missed dose of a P2Y12 inhibitor and poor stent wall apposition: illustrative case.

Background: Iatrogenic vertebral artery injury during surgery can cause pseudoaneurysm, hemorrhage, thrombosis, ischemia, or death. Strategies to prevent cerebrovascular embolic complications include surgical ligation, endovascular stenting, and/or antiplatelet therapy.

Observations: A 73-year-old female with a known right vertebral artery occlusion underwent a C2-3 laminectomy, complicated by left vertebral artery injury and occlusion with subsequent posterior circulation ischemia.

Endovascular therapy versus medical management in isolated posterior cerebral artery acute ischemic stroke: A multinational multicenter propensity score-weighted study.

Background: Despite the proven effectiveness of endovascular therapy (EVT) in acute ischemic strokes (AIS) involving anterior circulation large vessel occlusions, isolated posterior cerebral artery (PCA) occlusions (iPCAo) remain underexplored in clinical trials. This study investigates the comparative effectiveness and safety of EVT against medical management (MM) in patients with iPCAo.

Methods: This multinational, multicenter propensity score-weighted study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, involving 37 centers across North America, Asia, and Europe.

A 360-degree evaluation of the professionalism and communication skills of technologists working in the radiology department of a public sector tertiary care hospital in Karachi, Pakistan.

Background: Radiologic technologists (RTs) are at the forefront of radiology departments and require optimal skills to demonstrate professionalism and effective provider-patient communication. Hence, the objective of this study was to determine the reliability of 360-degree evaluation as a feedback tool to improve competencies in this crucial workforce.

Methods: A planned 360-degree evaluation was conducted using a 10-item tool to evaluate communication skills and professionalism among radiological technologists working at Dow University Hospital, Karachi.

Fabrication of poly (quinine--itaconic acid) incorporated reduced graphene oxide nanocomposite and its application for electrochemical sensing and photocatalysis of hydroquinone.

In this work, we report the synthesis of poly (quinine--itaconic acid) incorporated graphene oxide composite that is electro-active and photo-active simultaneously. The poly (quinine--itaconic acid)@rGO composite was successfully utilized for electrochemical detection and photocatalytic degradation of hydroquinone (HQ). HQ is recognized as an environmental pollutant because of its high toxicity to human health even at low concentrations.