Effectiveness of Distal Sodium Channel Blocks in Managing Cervical Radiculopathy.

Objective: To find the effectiveness of distal sodium channel blocks (DSCB) in managing cervical radiculopathy.

Study Design: Open-labelled single-group pilot study. Place and Duration of the Study: Pain Clinic of the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan, from January to June 2022.

Residency robotic biotissue curriculum: the next frontier in robotic surgical training.

Introduction: Virtual reality has been shown to be a strong introduction to the robot. However, we hypothesized that a biotissue curriculum including common surgical anastomoses can further enhance robotic technical skills in surgical residents.

Methods: Post-graduate-year three (PGY-3) general surgery residents completed a two-week robotic simulation rotation.

Multimodal Therapy May be Key to Improving Survival for Octogenarians Undergoing Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma: An American Multicenter Analysis.

Background: As the population ages, the number of octogenarians with pancreatic ductal adenocarcinoma (PDAC) continues to rise. Morbidity and mortality following pancreatectomy have improved owing to safer surgery and better chemoradiation regimens. This study compares the outcomes and multimodality utilization in octogenarians (≥80 years) who underwent pancreaticoduodenectomy (PD) for PDAC, with a younger cohort.

Endocrine and metabolic alterations in response to systemic inflammation and sepsis: a review article.

Severe sepsis is cognate with life threatening multi-organ dysfunction. There is a disturbance in endocrine functions with alterations in several hormonal pathways. It has frequently been linked with dysfunction in the hypothalamic pituitary-adrenal axis (HPA).

Mural Cells Initiate Endothelial-to-Mesenchymal Transition in Adjacent Endothelial Cells in Extracranial AVMs.

Extracranial arteriovenous malformations (eAVMs) are complex vascular lesions characterized by anomalous arteriovenous connections, vascular instability, and disruptions in endothelial cell (EC)-to-mural cell (MC) interactions. This study sought to determine whether eAVM-MCs could induce endothelial-to-mesenchymal transition (EndMT), a process known to disrupt vascular integrity, in the eAVM microenvironment. eAVM and paired control tissues were analyzed using RT-PCR for EC (, , and ) and EndMT-specific markers (, , , /.

The HECT ubiquitin-protein ligases UPL1 and UPL2 are involved in degradation of Arabidopsis thaliana ACC synthase 7.

Ethylene is an important plant hormone whose production relies on the action of key enzymes, one of which is 1-aminocyclopropane-1-carboxylate synthase (ACS). There are three classes of ACS, which are all partially regulated by degradation through the ubiquitin-proteasome system (UPS), which regulates ethylene production. Arabidopsis has a single class III ACS, ACS7, but although it is known to be degraded by the 26S proteasome, the UPS proteins involved are poorly characterised.

Video Review Can Measure Surgical Robotic Skill Development in a Resident Robotic Hernia Curriculum: A Retrospective Cohort Study.

Background: Hernia repairs are one of the most common general surgery procedures and an essential part of training for general surgery residents. The widespread incorporation of robotic hernia repairs warrants the development of a procedure-specific robotic curriculum to assist novice surgeons in improving technical skills.

Objective: To evaluate a robotic hernia simulation-based curriculum for general surgery residents using video review.

A Case Report of Atypical Presentation of Metastatic Breast Cancer as Peri-Bronchial Mediastinal Lesion.

Breast cancer is the most prevalent cancer among women worldwide. Despite significant advancements in breast cancer treatments over the past decade, late recurrence, a hallmark of breast cancer, remains a major challenge for oncologists. In this case report, we present an atypical presentation of late breast cancer recurrence as a peri-bronchial lesion manifesting as dysphagia 14 years after completing treatment for primary breast cancer.

1D MXenes: Synthesis, Properties, and Applications.

The fascinating properties and versatile nature of 2D MXenes have generated significant interest in the scientific community. This has led to extensive research on expanding these materials into 1D and 0D forms. This review investigates the synthesis, properties, and applications of 1D MXenes, elucidating their potential across various fields.

Neuromuscular Polytrauma Pain is Resolved by Macrophage COX-2 Nanoimmunomodulation.

Soft tissue injuries often involve muscle and peripheral nerves and are qualitatively distinct from single-tissue injuries. Prior research suggests that damaged innervation compromises wound healing. To test this in a traumatic injury context, we developed a novel mouse model of nerve and lower limb polytrauma, which features greater pain hypersensitivity and more sustained macrophage infiltration than either injury in isolation.

Infantile Colic: A Survey of Physicians in Pakistan.

Purpose: Infantile colic diagnostic criteria were established by Rome IV. A universally accepted management remains to be established. We aimed to evaluate diagnostic criteria, management strategies, and perceived regional prevalence of infantile colic in Pakistan, as well as its effect on physicians and parents.

Path tracking control of a steerable catheter in transcatheter cardiology interventions.

Purpose: Intracardiac transcatheter interventions allow for reducing trauma and hospitalization stays as compared to standard surgery. In the treatment of mitral regurgitation, the most widely adopted transcatheter approach consists in deploying a clip on the mitral valve leaflets by means of a catheter that is run through veins from a peripheral access to the left atrium. However, precise manipulation of the catheter from outside the body while copying with the path constraints imposed by the vessels remains challenging.

Challenging diagnosis of IgM multiple myeloma.

IgM monoclonal gammopathies such as IgM myeloma and Waldenström macroglobulinaemia are distinct haematological conditions; however, differentiating between these entities can often present as a challenge.In this review, we explore the challenging diagnosis and treatment of IgM myeloma in a patient presenting with unexplained macrocytic anaemia, elevated serum protein and IgM levels in the absence of t(11;14) and lytic bone lesions that are classically associated with the diagnosis of IgM myeloma. The diagnosis was established based on 40% monoclonal plasma cell population on a bone marrow biopsy, gain of 1q21 on fluorescence in situ hybridisation, cyclin D1 positivity and absence of MYD88 mutation.

Prince and princesses: The current status of robotic surgery in surgical oncology.

Robotic surgery has experienced a dramatic increase in utilization across general surgery over the last two decades, including in surgical oncology. Although urologists and gynecologists were the first to show that this technology could be utilized in cancer surgery, the robot is now a powerful tool in the treatment of gastrointestinal, hepato-pancreatico-biliary, colorectal, endocrine, and soft tissue malignancies. While long-term outcomes are still pending, short-term outcomes have showed promise for this technologic advancement of cancer surgery.

Sustained pain and macrophage infiltration in a mouse muscle contusion model.

Introduction/aims: Prior studies have emphasized the role of inflammation in the response to injury and muscle regeneration, but little emphasis has been placed on characterizing the relationship between innate inflammation, pain, and functional impairment. The aim of our study was to determine the contribution of innate immunity to prolonged pain following muscle contusion.

Methods: We developed a closed-impact mouse model of muscle contusion and a macrophage-targeted near-infrared fluorescent nanoemulsion.

Bifunctional Inhibitor Reveals NEK2 as a Therapeutic Target and Regulator of Oncogenic Pathways in Lymphoma.

Expression of the serine/threonine kinase never in mitosis gene A (NIMA)-related kinase 2 (NEK2) is essential for entry into mitosis via its role in facilitating centrosome separation. Its overactivity can lead to tumorigenesis and drug resistance through the activation of several oncogenic pathways, including AKT. Although the cancer-enabling activities of NEK2 are documented in many malignancies, including correlations with poor survival in myeloma, breast, and non-small cell lung cancer, little is known about the role of NEK2 in lymphoma.

EDNRA-Expressing Mesenchymal Cells Are Expanded in Myeloma Interstitial Bone Marrow and Associated with Disease Progression.

Multiple myeloma (MM) induces dysfunctional bone marrow (BM) mesenchymal cells and neoangiogenesis. Pericytes and smooth muscle cells (SMCs) could detach from vessels and become cancer-associated fibroblasts. We found that the pericyte and SMC marker endothelin receptor type A (EDNRA) is overexpressed in whole MM bone biopsies; we sought to characterize its expression.

A Novel Experience Of Ultrasound-Guided Erector Spinae Plane Block With Sedation In Breast Cancer Surgery: A Case Report.

We report the anaesthetic management of a breast cancer patient, at a high risk for undergoing general anaesthesia, using a single-shot ultrasound-guided Erector Spinae Plane Block (ESPB) with monitored sedation. Targetted at T4, 20 mL of 0.375% bupivacaine provided complete surgical anaesthesia in 15 minutes.

A pattern of antibiotic drug resistance of Salmonella Typhi and Salmonella Paratyphi among children with enteric fever in a tertiary care hospital in Lahore, Pakistan.

Aim: To establish the pattern of antibiotic resistance and assess the frequency of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Salmonella Typhi and Salmonella Paratyphi among children with enteric fever.

Methods: This cross-sectional study was carried out in the Department of Pediatrics, Sharif Medical City Hospital, Lahore, from July 2020 to January 2021. The study involved patients aged between 0 to 15 years who attended our outpatient department or were admitted to the ward with the suspicion of typhoid fever.

Wedge resection versus lobectomy in T1 lung cancer patients: a propensity matched analysis.

Objectives: Performing wedge resection rather than lobectomy for primary lung cancer remains controversial. Recent studies demonstrate no survival advantage for non-anatomical resection compared to lobectomy in patients with early-stage lung cancer. The objective of this study was to investigate whether in patients with T1 tumours, non-anatomical wedge resection is associated with equivalent survival to lobectomy.

Growth and dormancy control of myeloma cells by mesenchymal stem cells.

Bone marrow mesenchymal stem cells (MSCs) may have contrasting impacts on the progression of multiple myeloma (MM). Priming normal MSCs, by culturing them with MM cells, mimics the MSC-induced MM growth. We studied the contrasting effects of conditioned medium (CM) from unprimed or primed MSCs on growth of MM cells from newly diagnosed cases.

Nicotine exacerbates diabetic nephropathy through upregulation of Grem1 expression.

Background: Diabetic nephropathy (DN) is a major complication of diabetes mellitus. Clinical reports indicate that smoking is a significant risk factor for chronic kidney disease, and the tobacco epidemic exacerbates kidney damage in patients with DN. However, the underlying molecular mechanisms remain unclear.