Use of large language models as artificial intelligence tools in academic research and publishing among global clinical researchers.

With breakthroughs in Natural Language Processing and Artificial Intelligence (AI), the usage of Large Language Models (LLMs) in academic research has increased tremendously. Models such as Generative Pre-trained Transformer (GPT) are used by researchers in literature review, abstract screening, and manuscript drafting. However, these models also present the attendant challenge of providing ethically questionable scientific information.

Prevalence and Clinical Features of Uterine Isthmocele Following Cesarean Sections: An Observational Study at Rabia Balkhi Hospital in Afghanistan.

Background Uterine isthmocele, a defect in the uterine wall at the cesarean scar, is increasingly recognized due to the rising rate of cesarean deliveries. Often asymptomatic, it may lead to complications such as abnormal bleeding, chronic pelvic pain, secondary infertility, or uterine rupture during subsequent pregnancies. Objective This study aimed to assess the prevalence, clinical features, and associated risk factors of uterine isthmocele among women with previous cesarean scars over four years (2019-2023) at Rabia Balkhi Hospital, Afghanistan.

Metabolite Biomarkers for Early Detection of Pancreatic Ductal Adenocarcinoma: A Systematic Review.

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, with a poor prognosis. This poor prognosis is largely attributed to a late-stage diagnosis. Recent advancements in metabolomics have emerged as a promising avenue for biomarker discovery in PDAC.

Comparing the Efficacy and Long-Term Outcomes of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors, Dipeptidyl Peptidase-4 (DPP-4) Inhibitors, Metformin, and Insulin in the Management of Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia, insulin resistance, and decreased insulin secretion. With its rising global prevalence, effective management strategies are critical to reducing morbidity and mortality. This systematic review compares the efficacy, safety, and long-term outcomes of four major pharmacological treatments for T2DM: sodium-glucose cotransporter-2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, metformin, and insulin.

Statins decrease the risk of hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease with a significant risk of developing hepatocellular carcinoma (HCC). Recent clinical evidence indicates the potential benefits of statins in cancer chemoprevention and therapeutics. However, it is still unclear if these drugs can lower the specific risk of HCC among patients with MASLD.

Enhanced recovery after surgery in Pakistan: a qualitative descriptive analysis of current practices and future directions.

Enhanced Recovery After Surgery (ERAS) is a cost-effective perioperative approach that has been shown to shorten patients' hospital length of stay, improve resource utilization, and reduce postoperative costs for both patients and hospitals. While ERAS has the potential to offer even greater benefits in low- and middle-income countries (LMICs) its successful long-term implementation remains incomplete in Pakistan. This study aimed to explore insights and identify opportunities for implementing ERAS within the local socio-environmental context.

Efficacy and safety of ensifentrine, a novel phosphodiesterase 3 and 4 inhibitor, in chronic obstructive pulmonary disease: A systematic review and meta-analysis.

Background: We evaluated the efficacy and safety of Ensifentrine in COPD via a systematic review and meta-analysis of randomized controlled trials (RCTs).

Methods: We performed a detailed literature search on Medline (via PubMed), Scopus, Google Scholar, and Cochrane on the basis of pre-specified eligibility criteria. We used Review Manager to calculate pooled mean differences (MD) and 95% Confidence Interval (CI) using a random effects model.

Rising mortality rates linked to type-2 diabetes and obesity in the United States: An observational analysis from 1999 to 2022.

Background: The prevalence of type 2 diabetes (T2D) and obesity are increasing in the United States. However, population-level data for mortality trends due to T2D and obesity are limited. This study aims to assess these death trends among adults in the United States categorized by sex, race, and geographical location.

The Management of Osteoporosis in Chronic Kidney Disease: A Review of Diagnostic and Therapeutic Approaches.

Chronic kidney disease (CKD) has shown a growing association with osteoporosis, comprising part of the broader CKD-mineral and bone disorder (CKD-MBD). CKD-MBD is marked by alterations in calcium, phosphorus, parathyroid hormone (PTH), and vitamin D metabolism, significantly elevating fracture risk. While traditional osteoporosis treatments such as bisphosphonates, denosumab, and teriparatide have been adapted for CKD patients, recent innovations have introduced agents aimed at enhancing bone mass and reducing fracture incidence.

Analgesic efficacy and safety of erector spinae plane block versus serratus anterior plane block in breast surgery-a meta-analysis and systematic review of randomized controlled trials.

Background: Mastectomy and breast-conserving surgery are key interventions for breast cancer, a leading cause of cancer-related mortality in women. Many undergoing breast surgery experience postoperative pain compromising their functionality and quality of life. While multiple pain management strategies are available, evidence comparing the erector spinae (ESPB) and serratus anterior plane blocks (SAPB) for improving post-surgical pain management in breast cancer surgery patients is limited.

Bidirectional Prime Editing: Combining Precision with Versatility for Genome Editing.

Genome editing techniques have potential to revolutionize the field of life sciences. Several limitations associated with traditional gene editing techniques have been resolved with the development of prime editors that precisely edit the DNA without double-strand breaks (DSBs). To further improve the efficiency, several modified versions of prime editing (PE) system have been introduced.

Comparative Efficacy of Endoscopic Versus Open Surgical Techniques in the Management of Gastric Outlet Obstruction: A Systematic Review.

Gastric outlet obstruction (GOO) is a clinical condition that can arise from both benign and malignant causes, requiring effective management strategies to ensure optimal patient outcomes. Traditionally, open surgical techniques like gastrojejunostomy (GJ) have been the standard treatment, but recent advances in minimally invasive procedures, such as endoscopic ultrasound-guided gastroenterostomy (EUS-GE), offer alternative approaches with potentially reduced morbidity. This systematic review compared the efficacy, safety, and clinical outcomes of endoscopic versus open surgical techniques in managing GOO.

Gallbladder Polyp-An Incidental Finding of a High-grade B-cell Lymphoma: A Case Report.

Unlabelled: Introduction and importance: High-grade B-cell lymphoma (HGBCL) is a highly aggressive form of B-cell non-Hodgkin lymphoma. Lymphoma involvement of the gallbladder is rare, with a reported incidence of 0.1-0.

Outcomes of Gallbladder Drainage Techniques in Acute Cholecystitis: Percutaneous Versus Endoscopic Methods.

Acute cholecystitis, often caused by gallstones obstructing the cystic duct, is a potentially life-threatening condition that requires timely intervention. High-risk patients, particularly those with significant comorbidities, may not be suitable candidates for laparoscopic cholecystectomy, necessitating alternative drainage techniques such as percutaneous cholecystostomy (PC) and endoscopic gallbladder drainage (EGD). This systematic review aims to compare the efficacy, safety, and outcomes of PC and EGD in managing acute cholecystitis in high-risk surgical patients.

Blurred vision: The ophthalmological effect of smog in Pakistan.

This article discusses the growing burden of smog in Pakistan, tracing its origins to vehicular emissions, industrial pollutants, and agricultural practices. It highlights current national initiatives and advocates for enhanced government interventions to mitigate smog's adverse effects on ocular health. It also emphasizes the need for collective action to safeguard ocular health amid rising smog pollution in Pakistan.

Mifepristone's Efficacy for Symptomatic Relief and Size Reduction in Uterine Fibroids: A 2023 Prospective Observational Study at Rabia Balkhi Hospital, Afghanistan.

Background Uterine fibroids (leiomyomas) are common benign tumors, affecting 70-80% of women by age 50, and can cause symptoms such as heavy bleeding, pelvic pain, and pressure, significantly impacting the quality of life. In severe cases, fibroids may lead to infertility or miscarriage, making their management a key healthcare challenge. Traditional treatments, including hysterectomy, may not be suitable for women wishing to preserve fertility or avoid surgery.

Zanubrutinib-Associated Recurrent Spontaneous Hemorrhagic Pleural Effusion in Chronic Lymphocytic Leukemia: Case Report.

Zanubrutinib is an orally administered second-generation covalent inhibitor of Bruton tyrosine kinase that was recently approved by the US Food and Drug Administration for the treatment of chronic lymphocytic leukemia and small lymphocytic leukemia. It has been associated with significant major and minor bleeding events, including intracranial and GI hemorrhage and hematuria, with or without concurrent antiplatelet or anticoagulation therapy. We report a case of a 65-year-old man with relapsing chronic lymphocytic leukemia.

Intravascular Ultrasound-Guided Versus Angiography-Guided Percutaneous Coronary Intervention: A Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Control Trials.

Background: Intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) allows better assessment of coronary artery lesion characteristics than angiography alone. This systematic review and meta-analysis aimed to comprehensively synthesize the available evidence regarding the efficacy of IVUS guidance compared to angiography-guided PCI.

Methods: A comprehensive literature search of major bibliographic databases from inception until April 2024 was conducted to identify randomized control trials (RCTs) comparing IVUS-guided PCI versus angiography-guided PCI.

Acute Onset Budd-Chiari Syndrome in the Postpartum Period: A Case of Missed Diagnosis Leading to Rapid Deterioration.

Budd-Chiari syndrome (BCS), a rare hepatic vein obstruction condition, poses significant risks during gestation and the postpartum period. We present the case of a 30-year-old primigravida at 32 weeks gestation admitted with weakness and lethargy, which was diagnosed with impending uterine rupture, HELLP syndrome, and intrauterine fetal demise. An emergency cesarean section was performed, delivering a stillborn baby and uncovering 700 milliliters of blood clots in her abdominal cavity.