Significant association of miRNA 34a with BRCA1 expression in pancreatic ductal adenocarcinoma: an insight on miRNA regulatory pathways in the Pakistani population.

Background: Pancreatic Ductal Adenocarcinoma (PDAC) is among the most aggressive cancers, characterized by high mortality rates. Studies on various cancers across the globe indicate that regulatory miRNAs play a vital role in cellular signaling. However, the expression and interactions of these miRNAs in the Pakistani patients with PDAC is yet to be explored.

Clinical and genetic characterization of a progressive RBL2-associated neurodevelopmental disorder.

Retinoblastoma (RB) proteins are highly conserved transcriptional regulators that play important roles during development by regulating cell-cycle gene expression. RBL2 dysfunction has been linked to a severe neurodevelopmental disorder. However, to date, clinical features have only been described in six individuals carrying five biallelic predicted loss of function (pLOF) variants.

Feasibility and Cost-Effectiveness of Daycare Anterior Cruciate Ligament Reconstruction - A Retrospective Case Series.

Introduction: Multiple reviews of the applicability, cost-effectiveness, and safety of daycare reconstruction of anterior cruciate ligament have been published in French, American, and British setups, but have not been described in our population.

Materials And Methods: In this study, 25 patients who underwent Anterior Cruciate Ligament Reconstruction (ACLR) as a daycare surgery in our setup were assessed retrospectively. Post-operatively patients were reviewed for pain, complications, conversion from daycare to inpatients, readmission within two weeks post ACLR and cost-effectiveness.

From Harmless to Harmful: A Case Series of Hepatic Abscess Induced by Gut Microbiota Due to Fish Bone.

Accidental ingestion of fish bones can lead to serious complications, such as gastrointestinal perforation and hepatic abscesses. This case series presents three instances where fish bone ingestion led to secondary GI tract perforation and the development of hepatic abscesses. It also emphasizes the importance of prompt diagnosis and intervention to prevent serious consequences.

Marketing Strategies and Consumer and Sellers Perception About Oral Nicotine Pouches in Karachi, Pakistan.

The availability of novel nicotine products like oral nicotine pouches (ONP) has been rising in South Asian countries, including Pakistan. We aimed to assess ONP marketing strategies at point-of-sale (POS) and understand the perceptions among consumers and sellers regarding its use in Karachi, Pakistan. We conducted a mixed-methods study in low, middle, and high socioeconomic neighborhoods of District East Karachi.

Orthopantomogram teeth segmentation and numbering dataset.

With the digitization of radiographs, vast amounts of data have become accessible, enabling the curation and development of extensive datasets. Among radiographic modalities, Orthopantomograms (OPGs) are widely utilized in clinical practice. The integration of automated diagnostic processes into routine clinical practice holds great potential as an adjunct for dentists.

Social Determinants of Health in Cerebral Palsy.

: To describe social and psychological needs, such as poverty, early trauma, or adverse childhood events, of caregivers with a child newly diagnosed with cerebral palsy (CP) or receiving a designation of high-risk for cerebral palsy (HRCP). : Caregiver self-report questionnaires screening for unmet social needs, adverse childhood experiences (ACEs), depression symptoms, and trauma were collected from 97 caregivers of children with CP/HRCP seen in a high-risk infant follow-up clinic (adjusted age range 1-24 months). We compared their responses to those of 97 caregivers of age-matched controls seen in the same clinic with similar risk factors over the equivalent time period.

The Effects of Tirzepatide on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Tirzepatide is a novel dual glucose-dependent insulinotropic peptide (GIP)-glucagon-like peptide 1 (GLP-1) receptor agonist being evaluated for the treatment of various metabolic disorders. We performed a meta-analysis of randomized data on the effects of tirzepatide on serum lipid levels.

Methods: We systematically searched the PubMed and ClinicalTrials.

Capacity of Anesthesiology Residency Programs in Four East African Countries: Can Supply Meet the Demand?

Background: By 2015, 4 East African countries (Kenya, Uganda, Rwanda, and Burundi) had identified a deficit in the number of anesthesiologists, with a mean density of 0.30 physician anesthesia providers (PAP) per 100,000 population, which was significantly lower than the World Federation of Societies of Anaesthesiologists (WFSA) recommended minimum of 5.0/100,000 population.

Temporal Trends in Mortality Related to Stroke and Atrial Fibrillation in the United States: A 21-Year Retrospective Analysis of CDC-WONDER Database.

Aims: Atrial Fibrillation (AF) is one of the most strongly associated risk factors for stroke. Our study aims to analyze changes in mortality from 1999 to 2020 in patients with AF and stroke.

Methods: Using the Centre for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER), we retrospectively analyzed annual age-adjusted mortality rates (AAMR) per million from 1999 to 2020 in stroke patients with AF.

Efficacy of nonmedicated middle meatal packing after endoscopic sinus surgery: A systematic review.

Objectives: This review aims to evaluate the utility of nonmedicated middle meatal packing compared to no packing on synechia formation up to 12 weeks after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).

Methods: We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was performed on Medline (PubMed), EBSCO CINAHL plus, CENTRAL, and Clinicaltrials.

A Decade of Achievements: International Society of Paediatric Oncology Baseline Nursing Standards.

The six International Society of Paediatric Oncology (SIOP) Baseline Nursing Standards provide the first evidence-based framework for assessing and improving pediatric oncology nursing practice settings in low-, middle-, and high-income countries. Over the past 10 years, the standards have been translated to six languages, endorsed by 13 organizations, surveyed at 101 hospitals in 54 countries, and initiatives have been documented at over 63 institutions in 31 countries. Going forward, the SIOP Nursing Network's Baseline Standards Special Interest Group has established a 5-year strategic plan to guide advocacy, research, and standards implementation through global multidisciplinary collaboration.

Effect of high-efficiency particulate air filter on children with asthma: a systematic review protocol of RCTs.

Introduction: Asthma has been classified as a major non-communicable disease by the WHO. With the worsening air quality index worldwide, the burden of asthma has increased specifically in children. The focus of the management strategy of asthma has shifted from traditional pharmacological treatments towards non-pharmacological preventive and control therapy in recent decades.

Contextual factors influencing bubble continuous positive airway pressure implementation for paediatric respiratory distress in low-income and middle-income countries: a realist review.

Background: Bubble continuous positive airway pressure (bCPAP) is a low-cost, non-invasive respiratory support therapy for children with respiratory distress, but its effectiveness is dependent on the context. We aimed to understand contextual factors influencing bCPAP implementation for children aged 1-59 months in low-income and middle-income countries (LMICs) and to develop a theory explaining how these factors influence implementation outcomes.

Methods: In this realist review, we generated an initial programme theory comprising candidate context-mechanism-outcome configurations (CMOCs) via review of key references and team discussion.

Interdisciplinary perspectives on the co-management of metabolic dysfunction-associated steatotic liver disease and coronary artery disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a public health threat as it affects approximately 38% of the adult population worldwide, with its prevalence rising in step with that of obesity and type 2 diabetes. Beyond the implications of MASLD for liver health, it is also associated with cardiovascular and vascular dysfunction. Although the many shared risk factors and common metabolic milieu might indicate that cardiovascular disease and MASLD are discrete outcomes from common systemic pathogeneses, a growing body of evidence has identified a potential causal relationship between MASLD and coronary artery disease, which is the leading cause of morbidity and mortality in people with MASLD and all-cause mortality worldwide.

Brain health is essential for smooth economic transitions: towards socio-economic sustainability, productivity and well-being.

Optimal brain health is essential to smoothing major global skill-intensive economic transitions, such as the bioeconomy, green, care economy and digital transitions. Good brain health is vital to socio-economic sustainability, productivity and well-being. The care transition focuses on recognizing and investing in care services and care work as essential for economic growth and social well-being.

Addressing inequities in research for early to mid-career women scientists in low- and middle-income countries: "Supporting Women in Science" programme.

Introduction: The gender disparities and inequities faced by women in academia are widespread, especially in low- and middle-income countries (LMICs). The scholarly output of women scientists remains significantly lower than that of men due to limited opportunities. This widening gap has significant implications for policy-making and prioritizing agendas.

GLP-1 Receptor Agonist in Non-obese Patients with Type-2 Diabetes Mellitus and Heart Failure with Preserved Ejection Fraction.

Background: Glucagon like peptide-1 receptor agonists (GLP-1RA) promote weight loss and improve heart failure-related symptoms, quality of life, and functional capacity in patients with obesity and heart failure with preserved ejection fraction (HFpEF). However, their clinical effectiveness in non-obese patients with diabetes and HFpEF is understudied.

Methods: The TriNetX research network was used to identify adult patients (≥18 years) with type 2 diabetes mellitus (T2DM), Heart failure with preserved ejection fraction ((Left ventricular ejection fraction ≥45%), elevated brain natriuretic peptide (≥150pg/mL) or N-terminal pro-B-type natriuretic peptide(≥450pg/mL) and a body mass index (BMI) <30 kg/m2 on or before August 31, 2022.

Mortality Among Severely Injured Adolescents Admitted to Pediatric vs Adult Trauma Centers.

Importance: Care in a pediatric (vs adult) trauma center improves outcomes for injured children aged 0 to 12 years, but whether pediatric care benefits injured adolescents is unclear.

Objective: To evaluate the association of pediatric vs adult trauma center care with mortality among severely injured adolescents.

Design, Setting, And Participants: This retrospective cohort study was conducted between April 1, 2012, and March 31, 2020, among adolescents aged 12 to 16 years who were admitted to level I or level II adult trauma centers or a level I pediatric trauma center in British Columbia, Canada.

Sociodemographic and clinical predictors of quality-of-life outcome in children and young people with primary brain tumour in Karachi, Pakistan: a prospective cohort study.

Background: Children and young people (CYP) with primary brain tumour (PBT) are at high risk for developing late effects, potentially affecting long-term quality of life (QoL). In low-income and middle-income countries, QoL has not been studied in depth in CYP. In the present study, CYP treated for PBTs in Pakistan were evaluated regarding (A) mean change in QoL scores pretreatment and 12 months post-treatment and (B) predictors of change in QoL scores 12 months post-treatment.

Perceived barriers and facilitators of implementing a sustained smartphone-based telemonitoring program for pregnant women at high-risk for pre-eclampsia in the public and private sectors in Pakistan.

Background: In Pakistan, a smartphone-based telemonitoring (TM) program (Raabta) has been designed to support pregnant women with high risk for preeclampsia (HRPE) in Pakistan. However, implementing TM interventions is often challenging, particularly in low-resource settings, given the complexity of healthcare environments and variations in public and private health sectors. This study explores the potential barriers and facilitators for a sustained implementation of the Raabta program in public and private sector hospitals in Pakistan.