Correlation between selenium levels and selenoproteins expression in idiopathic generalized epilepsy: a study from Karachi.

Background: Oxidative damage has been implicated in multiple neurodegenerative diseases, including epilepsy. Selenium, in the form of selenoproteins is an integral part of the human antioxidant defense system. Though a relationship between the altered selenium levels and epilepsy has been reported, limited evidence is available about the expression pattern of selenoproteins in epileptic patients.

Giant Baker Cyst Extending Up to the Gastrocnemius: A Case Report.

Baker cyst is an abnormal enlargement of the gastrocnemius-semimembranous bursa behind the knee joint due to an exit of joint fluid. We herein report a rare case of giant Baker cyst in a rheumatic arthritic female patient. An MRI scan showed a complex, multiloculated cyst measuring 11.

The Hasson Versus Veress Trocar Wars: Determining the Safety Index of Laparoscopic Surgical Entry Techniques.

Background: Classically, there are two techniques for establishing pneumoperitoneum in laparoscopic and robotic surgeries: the closed Veress needle technique and Hasson's technique for open placement of laparoscopic ports. Most surgeons prefer the open Hasson technique, even though it is not the gold standard. Some surgeons still favour the Veress needle technique despite literature linking it to visceral and vascular damage.

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.

Inflammatory bowel disease in Pakistan: Low prevalence or underdiagnosis?

Inflammatory bowel disease (IBD) has a low prevalence in the Global South, including Pakistan. While genetics and gut flora, influenced by diet and the environment, can contribute to this, we are exploring the possibility of underdiagnosis. Lack of facilities trained in IBD, scarcity of medications, limited health insurance for specialist referral and the current epidemic of abdominal tuberculosis could be the cause.

Anatomical Variation of the Olfactory Fossa According to Keros and Yenigun Classifications in Karachi, Pakistan.

Aim: The goal of our research is to assess the olfactory fossa anatomical variation through Keros and Yenigun classification by computed tomography (CT) scan of paranasal sinuses (PNS), as in order for surgeons to prevent major complications, they must be familiar with its variations in anatomy during functional endoscopic sinus surgery (FESS) related to anterior ethmoidal artery injury, as its course varies with depth and length of the olfactory fossa.

Methods: At Karachi's Dow University of Health Sciences (DUHS), retrospective research was carried out. From anterior to posterior, sequential coronal and axial pictures were examined, and the existence and location of further anatomical characteristics were documented.

Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis in chronic Hepatitis B: Unraveling the immune puzzle - a rare case report with review of literature.

Background: Hepatitis B virus (HBV) infection affects millions worldwide, predominantly targeting the liver, leading to conditions like cirrhosis and hepatocellular cancer. However, HBV can also cause extrahepatic complications, including autoimmune-mediated vasculitis. Small vessel vasculitis, often associated with antineutrophil cytoplasmic antibodies (ANCA), can occur in chronic infections like HBV.

A rare case of glanzmann thrombasthenia with concomitant factor VII deficiency.

Glanzmann thrombasthenia and clotting factor VII deficiency are rare autosomal recessive bleeding disorders. But the occurrence of both in the same person is an extremely rare phenomenon. Here, we present the case of a young female from Sindh, Pakistan that got diagnosed with Glanzmann thrombasthenia and concomitant moderate factor VII deficiency, a combination not previously reported in the country.

Percutaneous Versus Surgical Cutdown Access for Transfemoral Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis Focusing on Propensity-Score Matched Studies.

Background: Transcatheter aortic valve implantation (TAVI) has emerged as a potential alternative for aortic valve surgery to treat aortic valve stenosis. There is limited evidence on the comparative outcomes of TAVI access approaches, specifically the percutaneous (PC) vs surgical cutdown (SC) approach. This study aimed to assess the short-term outcomes in patients undergoing PC vs SC access for transfemoral transcatheter aortic valve replacement.

Undiagnosed vertebral fragility fractures in patients with distal radius fragility fractures: an opportunity for prevention of morbimortality in osteoporotic patients in developing countries.

Unlabelled: Our study investigates vertebral fractures in individuals with distal radius fractures. Among 512 patients, 41.21% had vertebral fractures, predominantly in the lumbar spine.

Point-of-care ultrasonography spotlight: Could venous excess ultrasound serve as a shared language for internists and intensivists?

Point-of-care ultrasonography (POCUS), particularly venous excess ultrasound (VExUS) is emerging as a valuable bedside tool to gain real-time hemodynamic insights. This modality, derived from hepatic vein, portal vein, and intrarenal vessel Doppler patterns, offers a scoring system for dynamic venous congestion assessment. Such an assessment can be crucial in effective management of patients with heart failure exacerbation.

Pathological Hip Dislocation in a Neurofibromatosis Patient Secondary to Capsular Hemangioma.

Neurofibromatosis is an autosomal-dominant multi-system disease affecting the nervous, integumentary, ocular, and musculoskeletal systems. In the small number of reported cases, the cause was either atraumatic or an intra-articular neurofibroma. Only a couple of articles in medical literature have reported synovial and capsular hemangioma originating within the hip joint.

Validation of a Predictive Model of Vaginal Birth after Caesarean Section in Pakistani Women.

Objective: To determine the frequency of successful trials of vaginal birth after Caesarean section (VBAC) using the Flamm and Geiger model.

Study Design: Observational study. Place and Duration of the Study: Obstetrics and Gynaecology Unit II of Dr.

Brain Calcifications Secondary to Idiopathic Hyperthyroidism and Hypoparathyroidism.

Thyroid and parathyroid hormones are essential components of the metabolic system and its regulation. Concurrent hyperthyroidism with hypoparathyroidism is an extremely rare finding and is not considered a common etiology of brain calcifications seen on imaging. Brain calcifications can cause a range of neurologic symptoms, including movement disorders, cognitive impairment, and seizures.

Correction: Real-World Evidence to Evaluate the Efficacy and Safety of Vonoprazan in Gastrointestinal Disorders in the Pakistani Population.

[This corrects the article DOI: 10.7759/cureus.48994.

Steroid efficacy in Meralgia Paresthetica: A systematic review and meta-analysis.

Objective: To determine the efficacy of steroid injections for pain relief in patients with meralgia paresthetica (MP).

Methods: All the literature published until March 2023 was explored from several databases, including EBSCO, PubMed, EMBASE, Cochrane Library, Google Scholar, and Scopus. Articles investigating the change in pain status of MP patients after steroid injection were included.

Tuberculosis Presenting as Ruptured Liver Abscess and Inferior Vena Cava Thrombosis in a Pediatric Patient.

Tuberculosis is a leading cause of mortality and morbidity in many countries across the world, including Pakistan. While systemic tuberculosis can involve any organ of the body, tubercular liver abscess is a rare presentation. We report the case of an 8-year-old female from a developing country where tuberculosis poses a significant burden on the health care system.

Real-World Evidence to Evaluate the Efficacy and Safety of Vonoprazan in Gastrointestinal Disorders in the Pakistani Population.

Background And Aim: While proton pump inhibitor (PPI) therapy has proven to be effective in managing gastroesophageal reflux disease (GERD), a notable portion of patients who experience GERD symptoms may not respond to this treatment. Research suggests that roughly 30% of individuals with a presumed GERD diagnosis may continue to experience symptoms, whether partially or completely, even when receiving PPI therapy. The aim of this study was to assess the treatment of gastrointestinal diseases with a novel potassium-competitive acid blocker (P-CAB), vonoprazan, in terms of its effectiveness and safety in the Pakistani population.

Revascularization Modalities in Acute Coronary Syndrome: A Review of the Current State of Evidence.

Acute coronary syndrome (ACS) stands as a leading global cause of mortality, underscoring the importance of effective prevention, early diagnosis, and timely intervention. While medications offer benefits to many patients, revascularization procedures such as coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and emerging hybrid approaches remain pivotal for ACS management. This review delves into the 2018 ESC/EACTS guidelines alongside an analysis of existing literature to shed light on the spectrum of revascularization methods.

Neurofibroma: Case Series with Clinical Features and Recommendations.

Neurofibroma is an autosomal benign disorder. It can be localized, diffuse or invasive like plexiform neurofibroma that involves the nerves, muscle, tissues, skeleton. It represents itself as a destructive variant of neurofibroma, mostly present as orbital or periorbital neurofibroma or may be associated with autosomal dominant disease.