Impact of 18FDG PET/CT on Clinical Management, Cost Effectiveness, and Radiation Exposure in Newly Diagnosed Breast Cancer Patients.

Background: For the initial staging of breast cancer (BC), 18FDG PET/CT is recommended by professional guidelines in stage III (except T3N1) and inflammatory BC (T4d) and optional when conventional imaging is equivocal or suspicious. However, growing evidence also supports its role in the staging of intermediate-risk groups (IIA, IIB, T3N1 of IA). This study aimed to compare the impact of 18FDG PET/CT with conventional imaging (CT-chest+abdomen+pelvis and bone scan; CT-CAP+BS) in staging, cost-effectiveness, and radiation exposure in the initial staging of BC.

Blended learning: An innovative teaching strategy to teach dermatology to the family medicine residents of a teaching hospital.

Context: Medical educators face different challenges in this digital era with the pressure for clinical practice as well as teaching. In blended learning Internet technologies are used along with face-to-face teaching to deliver learning methodologies.

Objective: To assess the efficacy of the blended learning dermatology course on Family Medicine residents at a teaching hospital.

Mental health and quality of life following breast cancer diagnosis in patients seen at a tertiary care hospital in Nairobi, Kenya: A qualitative study.

Mental health challenges are common following cancer diagnosis, negatively impacting treatment and quality of life for breast cancer (BC) patients. This pilot study provides an understanding of the impacts of BC diagnosis and care experiences on the mental health of patients seen at the Aga Khan University Hospital in Nairobi, Kenya. We conducted 40 in-depth interviews, including 10 women with newly diagnosed BC, 10 women with metastatic BC, 10 family members and 10 healthcare professionals.

Angiosarcoma Arising in a Vagal Schwannoma - Report and Literature Review.

Schwannoma and angiosarcoma are rare occurrences. Angiosarcoma's occurrence in a preexisting schwannoma is a very rare event with only fifteen cases reported in the literature. We report the sixteenth case of angiosarcoma arising in a schwannoma, a 30-year-old male patient with a long-standing (15 years) history of right neck lump.

Normative values and factors affecting saphenous nerve responses in a south Asian population: a cross-sectional neurophysiological study at a tertiary care hospital in Pakistan.

Background: The saphenous nerve, a sensory branch of the femoral nerve, is not commonly included in routine lower extremity nerve conduction studies due to a high frequency of non-recordable responses in healthy subjects. However, saphenous nerve conduction studies are sometimes utilized for the diagnostic assessment of isolated lumbosacral plexus, femoral, or saphenous mononeuropathies. Our study aims to determine normative saphenous nerve response values in a healthy Pakistani population and to investigate their associations with patient body mass index, age, and gender.

Mutational analysis of cytoplasmic domain of integrin subunit alpha-1 and its association with periapical wound healing after surgical endodontic treatment.

Background: Numerous studies reported that the healing after surgical endodontic retreatment is influenced by multiple factors which include the genetic profile of the patient, epigenetics, and immune responses. The genes which are primarily responsible for the healing potential in different individuals are those which are involved in the regulation of the cytoskeleton and cellular adhesion which subsequently affects bone deposition and healing. Integrins are cell-surface molecules, possess a key role in the cytoskeleton and cellular adhesion.

A scoping review of substance use brief interventions in Africa.

Background: The burden of substance use in Africa is substantial. Brief interventions (BIs) are a recommended public health strategy for the prevention and early intervention for substance use problems. The objective of this scoping review was to map the literature on substance use BIs in Africa, identify gaps, and provide directions for future research.

Inflammatory myofibroblastic tumor: A rare cause of intestinal obstruction: Case report.

Introduction And Importance: Inflammatory myofibroblastic tumor IMT is a rare neoplasm with diverse clinical presentations, needing histological confirmation for diagnosis. The tumor often mimics malignant conditions, making accurate diagnosis challenging.

Case Presentation: We report a case of a 29-year-old male presenting with long standing recurrent abdominal pain, with more recent increasing frequency and associated weight loss.

Anesthesia and its environmental impact: approaches to minimize exposure to anesthetic gases and reduce waste.

In today's era of modern healthcare, the intersection between medical practices and environmental responsibility has gained significant attention. One such area of focus is the practice of anesthesia, which plays a crucial role in various surgical procedures. Anesthetics such as nitrous oxide and volatile halogenated ethers (desflurane, isoflurane, sevoflurane) are examples of medical gases that are strong greenhouse gases that contribute to global warming.

Clinical outcomes in metastatic prostate adenocarcinoma treated with abiraterone and enzalutamide.

Aim: The management of metastatic prostate cancer has progressed immensely in the last decade. This study aims to investigate the real-world clinical outcomes of metastatic prostate adenocarcinoma treated with abiraterone and enzalutamide. The findings will assist healthcare providers in making more informed decisions when choosing between these two drugs for treating these patients.

Surgical management of Rhodococcus induced anterior mediastinal mass: A case report.

Introduction: Rhodococcus is an extremely rare, gram positive, aerobic, coccobacillary organism, usually found in the soil or in dairy and livestock animals. It is most commonly affecting the immunocompromised. Only 15 % of cases have been reported in immunocompetent hosts.

Esophageal squamous cell carcinoma in a patient with mutation: a rare association.

Background: Esophageal neoplasms rank as the 7th most common cancers in the world. Squamous cell carcinomas of esophagus (SCCE) are the predominant subset, linked to a number of genetic alterations. Gene-driven tumour pathways are being increasingly identified with the emerging role of next-generation sequencing.

Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism: A case report.

Background: With 4.9 to 35 instances per 100000 cases, hyperparathyroidism is one of the rarest causes of acute pancreatitis. The major cause of primary hyperparathyroidism is a parathyroid adenoma, which can manifest clinically in various ways.

Discovering down's syndrome: An account from A low middle income country.

Objective: This study aims to establish the frequency of Down's syndrome which will enhance the knowledge of our local population as well to understand our genotypic patterns and variations.

Methods: Electronic Medical Records of inborn babies at the Department of Neonatology, Sheikh Saeed Memorial Campus of The Indus Hospital Karachi during the study period from 1 January 2021 to 31 December 2022 were retrieved. Chromosomal karyotyping was done for all babies with suspicious clinical features identified on routine new born examination by consultant neonatologists, trainee doctors and experienced nurses.

Role of nurse informaticists in the implementation of Electronic Health Records (EHRs) at resource-limited settings.

Electronic health records (EHRs) play a critical role in the management of patient information and timely decision making in health facilities. In resource-limited settings, especially low- and middle-income countries (LMICs), nurse informaticists play a pivotal role in the implementation of EHRs. This article underscores their multifaceted responsibilities, emphasising critical contributions in vendor selection, system evaluation, workflow analysis, content development, end-user device assessment, training, and post-implementation stability support.

Paediatric Early Warning Score to Detect Deterioration in Paediatric Patients at a Tertiary Care Hospital of a Developing Country: A Validation Study.

Objective: To test the validity of the paediatric early warning score (PEWS) and to identify the patients with deteriorating clinical conditions who were reviewed by a rapid response team (RRT) and were advised higher level of care.

Study Design: Observational study. Place and Duration of the Study: Paediatric ward and high dependency unit (HDU) of The Aga Khan University Hospital (AKUH), Karachi, Pakistan, from January 2021 to March 2022.

Detection of Hibernating Myocardium: A Gate Keeper in Decision Making in Patients with Left Ventricular Dysfunction.

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Role of Surgery in Vestibular Schwannoma following prior Stereotactic Radiosurgery.

Stereotactic radiosurgery (SRS) is widely used for treating vestibular schwannoma (VS), offering high tumour control rates, especially in small to medium-sized tumours. However, a subset of patients experiences SRS failure, requiring subsequent salvage microsurgery (MS). The primary reason for salvage surgery is continued tumour growth, but other causes include symptom progression and cystic enlargement.

Skull base osteomyelitis (SBO): a dreaded clinical entity.

Objectives: To identify the risk factors and clinical manifestations associated with skull base osteomyelitis.

Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from July 2013 to October 2020 related to adult patients of either who presented with base osteomyelitis. All relevant data was retrieved from hospital records.