Global liver transplantation: emerging trends and ethical challenges.

Purpose: Liver transplant (LT) is the only definitive treatment for end-stage liver disease (ESLD). This review aims to explore current global LT practices, with an emphasis on challenges and disparities that limit access to LT in different regions of the world.

Methods: A detailed analysis was performed of present-day liver transplant practices throughout the world, including the etiology of liver disease, patient access to transplantation, surgical costs, and ongoing ethical concerns.

The Effect of Vitamin D3 Intervention on the Association Among Vitamin D3, Adiponectin, and Body Mass Index in Pregnant Women With Gestational Diabetes.

Introduction: Vitamin D3 (VD3) deficiency is a strong predictor of gestational diabetes. Therefore, VD3 supplementation during the antenatal period could prevent the development of gestational diabetes via its effects on insulin secretion, insulin sensitivity, body mass index (BMI), and adiponectin production.

Objectives: To observe the effect of VD3 supplementation on adiponectin and BMI and to explore the effect of VD3 supplementation on the association among VD3, adiponectin, and BMI in pregnant women with gestational diabetes.

Predictive biomarkers for colorectal cancer: a state-of-the-art systematic review.

Introduction: Colorectal cancer (CRC) poses a substantial health burden, with early detection paramount for improved prognosis. This study aims to evaluate potential CRC biomarkers and detection techniques.

Materials And Methods: This systematic review, reported in adherence to PRISMA Statement 2020 guidelines, collates the latest research on potential biomarkers and detection/prognosis methods for CRC, spanning the last decade.

Adjunct posterior wall isolation reduces the recurrence of atrial fibrillation in patients undergoing cryoballoon ablation: A systematic review and meta-analysis.

Background: Recurrence rates of atrial fibrillation (AF) remain high even after complete wide area circumferential pulmonary vein isolation (PVI). In recent years adjunct posterior wall isolation (PWI) has been performed in patients with more persistent forms of AF but the benefits remain unclear.

Aim: The objective of this meta-analysis was to evaluate the efficacy of adjunct posterior wall isolation in reducing recurrence rates of AF using cryoballoon ablation (CBA).

Virtual Reality: The Future of Invasive Procedure Training?

Invasive procedures are associated with adverse events that are both hazardous to patients and expensive to treat. A trainee is expected to perform complex sterile invasive procedures in a dynamic environment under time pressure while maintaining patient safety at the highest standard of care. For mastery in performing an invasive procedure, the automatism of the technical aspects is required, as well as the ability to adapt to patient conditions, anatomic variability, and environmental stressors.

Levofloxacin-Induced Toxic Epidermal Necrolysis.

Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a severe episodic mucocutaneous reaction that is usually brought on by oral medications and/or sporadically by infections. We report a case of a 19-year-old male with the presenting complaint of generalized skin blistering over the previous seven days at the dermatology outpatient clinic. The patient has had epilepsy since he was 10 years old.

Analyzing risky behaviors among different minority and majority race in teenagers in the USA using latent classes.

: This study is to ascertain any inconsistencies in the trend of co-occurrence by sex of teenage health risk behavior patterns such as smoking, behaviors contributing to deliberate and unintentional injuries, risky sexual behavior, and sedentary lifestyle. : The study's purpose was accomplished using Youth Risk Behavior Surveillance System (YRBSS) 2013 data. A Latent Class Analysis (LCA) was conducted for the entire sample of teenagers as well as separately for each sex.

Microsporidial Keratitis - First Case Series of a Rare Pathogen in the Wake of Flood Disasters of 2022 in Pakistan.

The recent monsoon rains in Pakistan were unprecedented and caused flooding all over Pakistan, especially in Sindh and Balochistan. Following this national disaster, various water-borne and contagious diseases started erupting all over the country. In such a calamity-struck city of Jacobabad, we started receiving cases with a peculiar set of ocular complaints mimicking viral keratoconjunctivitis.

A Multi-centre Experience of Trans-abdominal Chorionic Villus Sampling in Pakistan.

Objective: To determine the safety and outcomes of trans-abdominal chorionic villus sampling technique.

Study Design: Observational study.

Place And Duration Of Study: Departments of Obstetrics and Gynaecology, PNS Shifa Karachi, Pak-Emirates Military Hospital Rawalpindi and CMH Lahore, from 2005-2020.

Acute Limb Ischemia in a Patient With COVID-19 Pneumonia.

COVID-19, which is caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), is known to cause a myriad of complications along with the typical lower respiratory tract involvement. One of the emerging complications is a hypercoagulable state leading to venous or arterial thromboembolism. These complications are more common in those presenting with a severe disease with significantly elevated inflammatory markers.

A Rare Case of Homocysteinemia Presenting With Multiple Aneurysms in an Adolescent Boy.

Thoracoabdominal aortic aneurysm (TAAA) is primarily a disorder of the elderly; the condition, however, is rare in children, for whom the misdiagnosis is not uncommon. It is one of the leading causes of death in the older age group worldwide, with a 4:1 male to female ratio. There are no real data about the incidence of aortic aneurysms in childhood.

Effect of Buffered Local Anesthesia on Perioperative Pain During Arteriovenous Fistula Surgery: A Randomized Control Trial.

Objective: This prospective, pilot randomized double-blind study aimed to compare the effects of buffered and non-buffered xylocaine solutions on injection pain and anesthesia effectiveness in patients undergoing arteriovenous fistula surgery.

Material And Methods: A total of 100 adult patients meeting inclusion criteria undergoing arteriovenous fistula surgery were included in the study. They were split into two groups at random.

Physician Gender Preference Amongst Females Attending Obstetrics/Gynecology Clinics.

Introduction: The objective of our study was to explore the views and perceptions of female patients attending the obstetrics and gynecology (OB/GYN) outpatient department towards the gender of their healthcare provider, to look for any preference that might exist in this regard, and to highlight any discrimination towards male obstetricians/gynecologists.

Material And Methods: A cross-sectional study was conducted from November 2020 to March 2021 at Combined Military Hospital, Lahore. A total of 280 female patients were included in the study and interviewed consecutively.

Bilateral Thalamic Infarction Secondary to Thrombosis of Artery of Percheron.

The artery of Percheron (AOP) is a rare anatomical variation emerging from the posterior circulation and supplies both thalami in the brain. As per the literature, the AOP infarction constitutes less than 2% of all stroke cases. AOP infarctions are usually caused by a combination of risk factors and a predisposing vascular territory.

Comparison of Serum Brain-Derived Neurotrophic Factor Levels in Diabetic Patients With and Without Retinopathy.

Introduction Diabetes mellitus (DM) is a disease of carbohydrate, protein, and fats metabolism that results in hyperglycemia. It may also result from defects in the secretion of insulin from beta cells or in its action on target cells or both. Objective To determine the levels of brain-derived neurotrophic factor (BDNF) and glycated hemoglobulin (HbA1c) with the progression of retinopathy.

Relationship of Salivary Cortisol Level With Severe Depression and Family History.

Salivary cortisol level is considered a prominent depression biomarker, as saliva induces less stress as compared to blood. The study was performed in the physiology department, Sheikh Zayed Medical Institute Lahore from April 2015 to December 2015. Sixty participants, including 14 (46.

Do Patients With Osteoarthritis get Weight Loss Counseling?

Introduction: Osteoarthritis (OA) is a degenerative disease of joints which if untreated can lead to a permanent disability of joints. Obesity plays an important role in the morbidity of OA. Since there is no curative treatment for OA, several researches focusing on nonpharmacological intervention for OA have come forth.

Tocilizumab and COVID-19: a meta-analysis of 2120 patients with severe disease and implications for clinical trial methodologies.

Background/aim: Since the outbreak of the COVID-19, numerous therapies to counteract this severe disease have emerged. The benefits of Tocilizumab for severely infected COVID-19 patients and the methodologies of ongoing clinical trials are explored.

Materials And Methods: A systematic search adhering to PRISMA guidelines was conducted in PubMed, Cochrane Central, medRxiv, and bioRxiv using the following keywords: “Tocilizumab,” “Actemra,” “COVID-19.

Rare Association of Patent Foramen Ovale and Atrial Septal Aneurysm Leading to Branch Retinal Artery Occlusion in a Young Healthy Man.

Retinal artery occlusion (RAO) occurs in the elderly population above the age of 60 years due to carotid atherosclerosis as a consequence of long-standing hypertension, diabetes mellitus, smoking, and hyperlipidemia. It can also develop due to paradoxical emboli from patent foramen ovale (PFO), which can happen in a relatively younger population. Early diagnosis mandates prompt management; otherwise, it may lead to vision loss.

Possible Mode of Spread of Hepatitis B and Hepatitis C in Chronic Liver Disease Patients Presenting at CMH Lahore Medical College and Institute of Dentistry.

Introduction Chronic hepatitis B and C are the leading causes of chronic liver disease and a significant cause of mortality and morbidity worldwide. Hepatitis B is a preventable disease with vaccination, which is available worldwide. About 257 million people are affected worldwide with hepatitis B and around 71 million people with hepatitis C, and Pakistan is the second most prevalent country with hepatitis C.

Prevalence of Self-medication for Acid Peptic Disease amongst People of Manawa, Lahore.

Introduction Acid peptic disease is a common disorder, affecting millions of people worldwide. Its pharmacological management includes proton pump inhibitors, H blockers, antacids and mucosal protective agents. Multiple studies in Pakistan have shown increased tendency of population for self-medication.

Exploring Symptoms of Post-traumatic Stress Disorders and Perceived Social Support among Patients with Burn Injury.

Introduction Burns are a serious public health problem globally, causing an estimated 265,000 deaths per year. Although the association of burn injuries with mortality and morbidity rates has been well established, data on their psychological consequences are scarce. The present study explores the frequency of post-traumatic stress disorder (PTSD) and perceived social support among patients with burn injuries in Pakistan.