Bridging the Vaccination Equity Gap: A Community-Driven Approach to Reduce Vaccine Inequities in Polio High-Risk Areas of Pakistan.

Immunization saves millions of lives, and globally, vaccines have significantly contributed to reducing mortality and morbidity due to more than 20 life-threatening illnesses. However, there are considerable disparities in vaccination coverage among countries and within populations. This study evaluates the reduction in disparities in vaccination coverage across various socio-economic groups by adopting an integrated community-engagement approach combined with maternal and child health services through mobile health camps.

Clinical Outcomes of Curettage Surgical Resection of Giant Cell Tumor of the Distal Radius - A Systematic Review and Meta-analysis.

 Surgical procedures of curettage and surgical resection are used to treat giant cell tumor (GCT) of the distal radius, but it is still controversial whether one provides better functional outcomes than the other. The present study aims to determine and compare both procedures regarding complications, local recurrence, and mobility.  A complete search of the applicable literature was done and independently assessed by three authors.

Zinc supplementation for acute and persistent watery diarrhoea in children: A systematic review and meta-analysis.

Background: Zinc is a micronutrient that plays a role in immune system strengthening and regulation of intestinal epithelial cells, and can reduce the duration and severity of diarrhoea. We conducted a systematic review of randomised controlled trials (RCTs) to assess the effectiveness of zinc compared to no zinc for the management of acute and persistent diarrhoea in children.

Methods: We searched PubMed, the Cochrane Library, Scopus, CINAHL, ClinicalTrials.

Low-osmolarity oral rehydration solution for childhood diarrhoea: A systematic review and meta-analysis.

Background: Oral rehydration solution (ORS) is crucial in the management of diarrhoea. Until the early 2000s, the standard formulation of glucose-based ORS with a total osmolarity of 311 mmol/L was being used for this purpose. However, due to concerns about sodium levels and cases of hypernatremia, a low-osmolarity ORS solution (LORS) with an osmolarity of 245mmol/L or less was developed to replace the standard ORS.

Antibiotics for acute watery or persistent with or without bloody diarrhoea in children: A systematic review and meta-analysis.

Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea.

Burden of congenital and hereditary anomalies and their epidemiological attributes in the pediatric and adult population of Peshawar valley, Pakistan.

Objectives: To elucidate the burden and clinico-epidemiological attributes of congenital and hereditary anomalies (CA) in the extended Peshawar Valley of Pakistan.

Method: This is a multicenter cross sectional study carried out in Buner, Charsadda, Mardan, Nowshera, Peshawar and Swabi districts, during 2017-2021. The pediatric and adult patients with CA were recruited from hospitals, public places and through door-to-door surveys.

A comparison of isolated limb infusion/perfusion, immune checkpoint inhibitors, and intralesional therapy as first-line treatment for patients with melanoma in-transit metastases.

Background: Isolated limb infusion and perfusion (ILI/ILP) has been a mainstay treatment for unresectable melanoma in-transit metastases (ITM), but increased use of immune checkpoint inhibitors (ICI) and intralesional therapy (talimogene laherparepvec [TVEC]) introduced several different management options. This study compares first-line ILI/ILP, ICI, and TVEC.

Methods: Retrospective review from 12 international institutions included patients treated from 1990 to 2022 with first-line ILI/ILP, ICI, or TVEC for unresectable melanoma ITM.

Real-world comparison of the efficacy and safety of atezolizumab versus durvalumab in extensive-stage small cell lung cancer.

Background: Small cell lung cancer (SCLC) is an aggressive disease associated with high relapse rates and limited treatment options. Current standard of care treatment for extensive-stage disease includes combination chemotherapy plus immunotherapy. Programmed death ligand-1 (PD-L1) immune checkpoint inhibitors (ICIs) are preferred first-line treatments in combination with chemotherapy with both atezolizumab and durvalumab being equivalent options.

Correlation of Air-Bone Gap on Pure Tone Audiometry with the Size of Perforation Assessed on Oto-Endoscopy.

Objective: To determine the correlation between the air-bone gap on pure tone audiometry with size of perforation oto-endoscopically.  Study Design: A descriptive study. Place and Duration of the Study: Department of ENT - Head and Neck Surgery, Dow University of Health Sciences (DUHS), from February 2020 to August 2021.

Middle Turbinate Angiofibroma in a Middle-Aged Female: A Case Report and Review of the Literature.

Unlabelled: Extra Nasopharyngeal Angiofibromas are rare benign vascular tumors typically affecting adolescent males. They have variable sites of origin. Only five cases of extra nasopharyngeal angiofibroma originating from the middle turbinate have been reported in the literature, here we present the sixth such case.

Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not: A systematic review and meta-analysis.

Background: Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. There is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 disease.

Aim: To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 patients.

Isolated Limb Infusion for Limb-Threatening Sarcomas.

Background: Isolated limb infusion (ILI) treats unresectable extremity malignancies with high-dose regional chemotherapy limited to the limb. This study assessed long-term outcomes after ILI for limb-threatening sarcomas.

Methods: A retrospective review analyzed patients with an extremity sarcoma who underwent ILI with melphalan and dactinomycin from 2008 to 2023 at a single institution.

Altered extracellular matrix and mechanotransduction gene expression in rat bone tissue following long-term estrogen deficiency.

Osteoporosis is primarily associated with bone loss, but changes in bone tissue matrix composition and osteocyte mechanotransduction have also been identified. However, the molecular mechanisms underlying these changes and their relation to bone loss are not fully understood. The objectives of this study were to (1) conduct comprehensive temporal gene expression analyses on cortical bone tissue from ovariectomized rats, with a specific focus on genes known to govern matrix degradation, matrix production, and mechanotransduction, and (2) correlate these findings with bone mass, trabecular and cortical microarchitecture, and mineral and matrix composition.

Effect modification of socioeconomic status in the association between contraception methods and couple's education: A secondary analysis of PDHS 2017-18.

Globally, the region of South Asia reports the highest number of women (87 million) with unmet needs of contraception. Amongst the lower-middle-income countries of South Asia, Pakistan has performed poorly in enhancing contraceptive prevalence, as evident by the Contraceptive Prevalence Rate (CPR) of 34%. Factors including restricted access to contraception, a restricted selection of techniques, cultural/religious resistance, gender-based hurdles, and societal factors, such as the couple's education level, are among the most important causes for this gap in desire and usage.

Environmental impacts and performance assessment of recycled fine aggregate concrete.

Natural disasters and human demolition create vast amounts of construction and demolition waste (CDW), with a substantial portion being concrete waste. Managing this concrete waste is a daunting challenge for developing countries with limited resources, aiming to mitigate its harmful environmental effects. Therefore, the proposed approach involves using recycled fine aggregates (RFA) instead of fresh fine aggregates (FFA) in concrete, which aligns closely with achieving sustainable environmental objectives.

Fannyhessea vaginae causing bacteraemia and vertebral osteomyelitis: first report of invasive disease in a male.

(formerly ) is an anaerobic organism commonly associated with female genital flora, with rare cases of invasive disease reported in females. We discuss the case of an 81-year-old male who presented with an acute history of back pain and signs of urinary tract infection in the context of intermittent self-urinary catheterisation. Multiple blood cultures grew with a later finding of lumbar vertebral osteomyelitis as the cause of back pain.

A mechanobiological model of bone metastasis reveals that mechanical stimulation inhibits the pro-osteolytic effects of breast cancer cells.

Bone is highly susceptible to cancer metastasis, and both tumor and bone cells enable tumor invasion through a "vicious cycle" of biochemical signaling. Tumor metastasis into bone also alters biophysical cues to both tumor and bone cells, which are highly sensitive to their mechanical environment. However, the mechanobiological feedback between these cells that perpetuate this cycle has not been studied.

Whole-of-school physical activity implementation in the context of the Dubai Fitness Challenge.

Introduction: Physical activity (PA) promotion among school-aged youth is a global health priority. Recommendations for such promotion include implementing whole-of-school approaches that maximize resources across the school environment. This study examined schools' participation in an annual, government-led, and emirate-wide initiative in Dubai, called the Dubai Fitness Challenge, in which the goal is to accrue 30 minutes of PA every day for 30 days (as such, the initiative is colloquially referred to as "Dubai 30x30").

Cost-utility of Initial Management of High-grade T1 Bladder Cancer With Intravesical BCG vs Immediate Radical Cystectomy.

Objective: To compare the cost-utility of initial management of high-grade T1 non-muscle invasive bladder cancer (HGT1 NMIBC) with intravesical BCG vs immediate radical cystectomy. High-risk NMIBC patients may climb a costly ladder of treatments, culminating in radical cystectomy for oncologic or symptomatic benefit in up to one-third. This high healthcare resource utilization presents a challenging dilemma in balancing sufficiently aggressive management with cost, toxicity, and quality-of-life.