Comparing Patency of Pulmonary Stent Implantation and Balloon Angioplasty in Pulmonary Vein Stenosis: A Systematic Review and Meta-Analysis.

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks.

Efficacy of Intravenous Versus Oral Administration of Levocarnitine in Maintenance Hemodialysis Patients: A Randomized Controlled Trial Investigating Therapeutic Approaches to Renal Anemia.

Background And Aim: Carnitine deficiency contributes to various comorbidities in maintenance hemodialysis (MHD) patients. This study aims to assess the impact of levocarnitine supplementation on hematological and serum iron profile parameters, comparing the efficacy of oral versus intravenous (IV) administration in these patients.

Materials And Methods: This was a multicenter, randomized controlled trial was conducted on patients undergoing MHD at the hemodialysis unit of our study center in Karachi, Pakistan.

Exploring medical educators' perspectives on teaching effectiveness and student learning.

Background: Medical education in resource-constrained settings such as Pakistan faces significant challenges, including large class sizes, limited resources, and reliance on traditional teacher-centered pedagogies. These factors hinder effective learning and fail to equip students with the critical thinking and practical skills essential for modern medical practice. Educators play a fundamental role in shaping student experiences but often struggle to adopt student-centred methodologies due to insufficient training, resource limitations, and institutional constraints.

RECONSTRUCTION OF SOFT TISSUE DEFECTS AROUND KNEE AND PROXIMAL LEG USING PROXIMAL BASED SURAL ARTERY FLAP.

Background: Soft tissue defects around the knee and proximal leg represent a challenging clinical scenario for plastic and reconstructive surgeons. These defects can arise from a variety of causes, including traumatic injuries, such as crush injuries and road traffic accidents, thermal injuries like burns, and surgical complications such as infection. Objective of the study was to evaluate the success of proximally based sural artery flap for soft tissue defects around the knee and proximal leg in patients presenting to our tertiary care hospital.

Sympathetic Ophthalmia Following an Evisceration Surgery-A Case Report.

Sympathetic ophthalmia (SO) is a rare, bilateral, granulomatous, panuveitis following perforating trauma or surgical intervention in one eye. Here, and to the best of knowledge, we report the first case of SO following an evisceration surgery in Pakistan. A 32-year-old, Pakistani, female presented with pain and decreased visual acuity in her right eye, at Civil Hospital, Karachi, 1 week after an evisceration surgery was performed on her left eye, following corneal perforation due to unresolved keratitis.

Reversible Cerebral Vasoconstriction Syndrome Following Blood Transfusion in a Patient With Chronic Anemia: A Case Report.

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare neurological disorder characterized by transient constriction and dilation of cerebral arteries, leading to severe headaches and neurological deficits. This case report describes a 41-year-old woman with chronic anemia, acute chronic kidney disease, type 2 diabetes mellitus, and rheumatoid arthritis who developed RCVS following transfusion of packed red blood cells (PRBCs). She experienced sudden-onset seizures and a thunderclap headache 5 days post-transfusion.

Soft Tissue Sarcoma in Sub-Saharan Africa: Surgical Management Outcomes, Gaps, and Future Prospects: A Narrative Review.

Background And Aims: The diagnosis and management of soft tissue sarcoma (STS) in sub-Saharan Africa (SSA) present significant challenges. Positive outcomes in STS treatment include achieving negative margins, improved quality of life, and reduced recurrence rates, while negative outcomes involve incomplete resection, local recurrence, and surgical complications. This review aims to examine the current state of STS management in SSA, identify key challenges, and propose potential solutions to improve patient outcomes.

Addressing abdominal trauma from conflict and warfare in under-resourced regions: A critical narrative review.

Introduction: The prevalence of abdominal injuries in war and conflict zones, particularly in low- and middle-income countries (LMICs), presents a significant healthcare challenge. These injuries, often resulting from explosive devices, firearms, and shrapnel, lead to high morbidity and mortality rates due to delayed diagnoses, inadequate medical infrastructure, and limited access to specialised care. This review aims to summarise the literature on conflict-related abdominal injuries in LMICs, highlighting the impact of such trauma on healthcare systems and patient outcomes, and suggesting strategies for improvement.

The rising tide of tuberculosis in Pakistan: Factors, impact, and multi-faceted approaches for prevention and control.

Background: Tuberculosis (TB) remains a major public health concern in Pakistan, which is ranked fifth among high-burden TB nations worldwide. The growing frequency of drug-resistant TB strains, particularly multidrug-resistant TB (MDR-TB), creates new obstacles. Socioeconomic factors, a lack of awareness, and inadequate healthcare infrastructure all contribute to the spread of the disease.

Retroperitoneal ancient schwannoma presenting as left flank pain and moderate unilateral hydronephrosis: A case report and literature review.

Key Clinical Message: Benign ancient retroperitoneal schwannomas (BARS) exhibit abdominal masses and flank pain to incidental findings at more advanced stages. Histopathological and immunohistochemical analysis is essential for confirmation of benign nature. Our patient was misdiagnosed as ureteric colic, highlighting the need to consider BARS in differential diagnosis to prevent complications like hydronephrosis.

BRAF mutations and the association of V600E with CD133 and CDX2 expression in a Pakistani colorectal carcinoma cohort.

Background: Despite a high incidence of colorectal carcinoma, data regarding genetic aberrations in colorectal carcinoma (CRC) patients in Pakistan is scarce. This study aimed to determine the frequency of BRAFV600E mutations in colorectal carcinoma tissue in the Pakistani population and to associate BRAFV600E expression with CD133, a marker of colorectal stem cells, and CDX2 marker of differentiation.

Methods: Sanger Sequencing of exon 15 (426 bp) including the hotspot V600E was performed on formalin-fixed-paraffin-embedded (FFPE) CRC tissue samples of 115 patients.

A rare case of primary signet-ring adenocarcinoma of anorectal region in a young patient: Diagnostic challenges and therapeutic outcomes.

Key Clinical Message: Primary signet-ring cell carcinoma of the anal canal and rectum is an extremely rare and aggressive malignancy. The present case underscores the importance of considering primary signet-ring cell carcinoma in differential diagnoses for young patients with chronic anorectal symptoms. It highlights the need for a multidisciplinary treatment approach (including surgery, chemotherapy, and radiotherapy) and comprehensive follow-up for managing this challenging condition and improving long-term patient outcomes.

Early onset of posterior reversible encephalopathy syndrome (PRES) following postpartum eclampsia-A case report.

Early screening and management of postpartum posterior reversible encephalopathy syndrome (PRES) can reduce hospital stay and complications. Obstetricians, gynecologists, ophthalmologists, and even general physicians should be aware of PRES since its presentation is variable.

Suspected large gall bladder mucocele extending from right hypochondrium up to right iliac region turned out to be gall bladder perforation in a patient with schizophrenia: A rare case report and literature review.

Key Clinical Message: This is a challenging case where the surgeon has initially thought it is a gallbladder (GB) mucocele. The surprise finding of a mucocele during an emergency laparotomy highlights the deceptive nature of certain clinical manifestations within the hepatobiliary domain. The intraoperative discovery of a 1×1 cm GB hole on the right lateral wall of the GB fundus revealed an unexpected and significant deviation from the hypothesized pathogenesis.

Seronegative celiac disease with transient protein-losing enteropathy and vitamin B12 deficiency in a pediatric patient: Case report.

Key Clinical Message: Early recognition and management of seronegative celiac disease, even in the absence of typical serological markers, can prevent complications and ensure better health outcomes in pediatric patients. Consideration of a gluten-free diet in similar cases can lead to significant clinical improvement.

Abstract: Celiac disease, characterized by its diverse clinical manifestations, often necessitates adherence to a gluten-free diet, particularly in pediatric patients for optimal growth and development.

Osteoprotegerin (OPG): A potential biomarker for adverse cardiovascular events in stable coronary artery disease.

Background: Osteoprotegerin (OPG) is a secretory glycoprotein known for its involvement in bone metabolism and immune regulation. Research has extended OPG's significance in cardiovascular diseases (CVDs). Elevated OPG levels have been associated with increased cardiovascular risks, prompting interest in its role as a potential biomarker.

Rupture of sinus of Valsalva in a young laborer: A rare case report.

Ruptured sinus of Valsalva (RSOV) upon physical exertion is rare but should be considered in differential in young adults. Symptoms of acute heart failure, hemodynamic instability, and continuous heart murmur raises suspicion for RSOV and requires emergent surgical repair of right ventricular outflow tract.

Infant and child mortality in Afghanistan: A scoping review.

Background And Aims: Since 1990, global child and infant mortality rates have typically stabilized or decreased due to improved healthcare, vaccination rollouts, and international funding. However, Afghanistan continues to face the highest child and infant mortality rates globally, with 43 deaths per 1000 live births. This study aims to examine the factors contributing to this high mortality rate and propose interventions to address the issue.

Single parenthood and depression: A thorough review of current understanding.

Background: Single parenthood is becoming increasingly common in today's society for various reasons such as divorce, the death of a spouse, or the choice of parenthood. Regrettably, there seems to be no significant concern among world leaders regarding depression arising from single parenting.

Aim: This article aimed to explore the prevalence of depression in single parents, the factors contributing to it, and its effects on their physical and emotional well-being.

Optimization of silver nanoparticles synthesis Plackett-Burman experimental design: assessment of their efficacy against oxidative stress-induced disorders.

Nanoparticles possess remarkable biological activities owing to their small size and large surface-to-volume ratio. Given the increasing adoption of environmentally sustainable practices in silver nanoparticle (AgNP) fabrication, this study presents a simple lab-scale green synthesis of AgNPs using banana peels. Large amounts of banana peels are disposed off in Pakistan every day.