Effectiveness of Acetazolamide in Patients With Heart Failure: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis evaluated the efficacy and safety of acetazolamide as an adjunctive diuretic therapy in acute heart failure (AHF) patients. A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Embase, Cochrane Library, and Scopus, identifying seven studies (five randomized controlled trials and two observational studies) that met the eligibility criteria. The analysis revealed that acetazolamide significantly enhanced mean natriuresis (mean differences (MD) 52.

Efficacy of Amitriptyline in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis.

Background/aims: Amitriptyline is prescribed off-label for irritable bowel syndrome (IBS). We conducted a meta-analysis to assess its efficacy.

Methods: A systematic literature review was conducted until November 10, 2023, using MEDLINE, Embase, Cochrane Library, and Web of Science to study the efficacy of amitriptyline in patients with IBS.

CustOmized versus standard fundal-height measuREments for the detection of small-for-gestational age fetuses in low-risk women (CORE study): A randomized controlled trial.

Objective: To compare the proportion of small-for-gestational age (SGA) infants detected by routine care versus a growth assessment protocol using customized fundal-height charts in low-risk pregnancies of a developing country.

Methods: An open label randomized controlled trial was conducted at the Fatima Memorial Hospital (NUR International University, Pakistan). Low-risk pregnant women were randomly allocated to routine care (Mcdonald's rule for fundal height measurements followed by referral for scan with discrepancy of 3 cm from gestational age and a contingency third trimester scan) or the growth assessment protocol (GAP) developed by the Perinatal Institute (UK), which consists of the use of gestation-related optimal weight (GROW) customized charts, alongside management protocols for suspected SGA fetuses, audit tools and training.

The role of Intravitreal chemotherapy as an adjunctive treatment for retinoblastoma: a systematic review and single-arm meta-analysis.

Topic: evaluation of clinical outcomes of patients with retinoblastoma treated with intravitreal chemotherapy (IvitC).

Design: Systematic review and single-arm meta-analysis CLINICAL RELEVANCE: Clinical outcomes with IVitC vary across reports according to patient characteristics and concomitant treatment modalities, mainly intravenous chemotherapy (IVC) and intra-arterial chemotherapy (IAC). There are currently no large clinical trials or meta-analyses focusing on the topic.

The Relationship Between the Type of ST-Segment Elevation in Acute Anterior Wall Myocardial Infarction and Left Ventricular Ejection Function.

Introduction: Acute anterior wall myocardial infarction (AWMI), when presenting with ST-segment elevation on an electrocardiogram (ECG), represents a form of ST-elevation myocardial infarction (STEMI) caused by a significant reduction in coronary blood flow to the heart muscle. The shape of the ST-segment elevation, whether it is concave, convex, or straight, has been associated with different levels of left ventricular ejection fraction (LVEF), which is an important indicator of cardiac function and prognosis.

Objective: To investigate the relationship between the type of ST-segment elevation on ECG and LVEF measured 48 hours after the onset of myocardial infarction in patients with AWMI.

Congenital Insensitivity to Pain and Anhidrosis With Orthopedic and Self-Injury Complications in a 5-Year-Old Boy: A Case Report.

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disorder because of NTRK1 gene mutations, leading to an inability to perceive pain and temperature and lack of sweating. Its rarity and unique clinical challenges, such as severe injuries from the inability to sense pain, make reporting cases critical. A 5-year-old boy, the third child of consanguineous parents, was referred for a fractured femur.

Trends of HIV/AIDS in Pregnant Women Presenting to a Tertiary Care Setting.

According to WHO, there are around 35 million adults living with HIV/AIDs worldwide. Of these, around 1.5 million are pregnant women.

Recurrent Osteosarcoma Presenting as Hepatic Metastasis: A Case Report.

Osteosarcoma is a malignant tumor, derived from primitive bone-forming mesenchymal cells, and its aggressive nature often leads to significant morbidity and mortality, with amputation being routinely performed in localized cases. Post-amputation morbidity has a significant impact on the quality of life of the affected individuals. The tumor frequently metastasizes to the lungs and bones, and widespread disease remains the leading cause of most patient deaths.

VALIDITY OF LELLI'S TEST IN DIAGNOSING ACUTE ACL INJURY AND ITS COMPARISON WITH THE OTHER CONVENTIONAL CLINICAL EXAMS.

Background: The anterior cruciate ligament (ACL) is a vital structure in the knee responsible for preventing anterior translation; and countering rotational and valgus stress. The anteromedial and posterolateral bundles of the ACL, which are distinguished by their attachments at the tibia and femur, respectively, make up the ACL. The study is designed to evaluate the diagnostic parameters of lever sign in acute settings when compared against MRI as investigation of choice and compare them with the conventional tests.

Effect of Increased Level of Lipoprotein(a) on Cardiovascular Outcomes in Patients With Ischemic Heart Disease: A Systematic Review and Meta-Analysis.

Lipoprotein(a) (Lp(a)) has emerged as a significant cardiovascular risk factor, particularly in patients with ischemic heart disease (IHD). This systematic review and meta-analysis aimed to synthesize evidence on the impact of Lp(a) levels on cardiovascular outcomes in IHD patients. A comprehensive literature search was conducted across multiple databases, covering publications from January 2016 to October 2024.

COMPARING STRESS LEVELS AMONG MEDICAL EMERGENCY UNIT WORKERS IN TEACHING HOSPITALS ACROSS LAHORE: A QUANTITATIVE ANALYSIS OF PRECISION.

Background: Stress is characterized as a condition of anxiety or tension spurred on by challenging circumstances. Stress is a normal human reaction that motivates us to deal with obstacles and dangers in our lives. The study aimed to investigate the levels of stress that employees in the medical emergency unit (MEU) industry face and any possible relationship between work satisfaction, and perceived stress.

EFFECT OF COMPREHENSIVE DENTAL TREATMENT UNDER GENERAL ANAESTHESIA ON CHILDREN'S ORAL-HEALTH-RELATED QUALITY OF LIFE: A COMPARATIVE CROSS-SECTIONAL STUDY.

Background: Despite reductions in dental caries experience in developed countries, early childhood caries remains the most prevalent health problem in developing countries. This has a direct impact on the oral health-related quality of life of both children and parents. The objective of this study was to examine the impact of comprehensive dental treatment under general anaesthesia on oral health-related quality of life in children, using a parental and caregiver perception questionnaire.

Safety of Non-vitamin K Antagonist Oral Anticoagulants on Outcomes After Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.

The existing evidence on the use of non-vitamin K oral anticoagulants (NOACs) after transcatheter aortic valve replacement (TAVR) surgery is inconclusive and contradictory. Likewise, major society guidelines remain ambivalent about NOAC use around the time of TAVR. The objective of our meta-analysis was to assess the efficacy of NOACs in comparison to vitamin K antagonists (VKAs) in lowering complications following TAVR.

Optimizing surgical margins in oral cancer without frozen section: A single center retrospective study.

Purpose: Frozen section analysis has been a cornerstone in intraoperative pathological evaluation for oral cancer surgeries, aiding in achieving tumor-free margins. However, its utility and availability are subjects of ongoing debate and research. This study evaluates the efficacy of a guideline-based approach to surgical resection margins in the absence of frozen section analysis in a resource-constrained setting.

Salvage Stereotactic Radiotherapy for Nodal Oligo-Recurrent Prostate Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Prostate cancer has a high frequency of relapse, and the relapse is usually associated with a nodal recurrence pattern spreading predominantly to fewer pelvic or extra-pelvic lymph nodes. This meta-analysis sought to determine the safety and survival outcomes of salvage body stereotactic radiotherapy (SBRT) in oligo-recurrent nodal prostate cancer patients.

Methods: We searched the Cochrane Central Register of Controlled Trials, PubMed, ClinicalTrials.

Non-cirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and management.

Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy.

Evaluating the Effectiveness of Neuroprotective Strategies in Enhancing Post-stroke Recovery: A Systematic Review of Meta-Analyses and Clinical Trials.

This systematic review evaluates the effectiveness of various neuroprotective strategies in enhancing recovery following acute ischemic stroke, focusing on interventions such as normobaric oxygen (NBO), lithium, selective serotonin reuptake inhibitors (SSRIs), and Cerebrolysin. Drawing upon data from six primary studies, including randomized controlled trials (RCTs) and meta-analyses, we assessed these therapies' impact on functional outcomes, motor recovery, and neurological improvement. Normobaric oxygen, across 12 RCTs, demonstrated limited efficacy in improving recovery outcomes or reducing mortality.

A National Survey on Congenital Hypothyroidism Newborn Screening in Pakistan.

. Congenital hypothyroidism (CH) is a treatable condition with a good outcome if diagnosed promptly. However, neonatal screening programs are not routinely available in developing countries in Pakistan.

Efficacy and safety of norepinephrine versus phenylephrine for post-spinal hypotension in preeclamptic patients: A systematic review and meta-analysis.

Objective: We conducted a systematic review and meta-analysis to evaluate the fetomaternal outcomes after the administration of norepinephrine or phenylephrine for the treatment of post spinal hypotension in preeclamptic women undergoing a cesarean section.

Data Sources: We searched on PubMed, Embase, Scopus, Cochrane CENTRAL, and clinicaltrials.gov from inception till June 2024.

Intraoperative ketamine and pain after video-assisted thoracoscopic surgery (VATS): A systematic review and meta-analysis.

Background: Video-assisted thoracoscopic surgery (VATS) reduces postoperative discomfort and expedites recovery compared to open thoracotomy. Effective postoperative pain management is crucial to enhance recovery and reduce complications. Ketamine, an NMDA receptor antagonist, has shown promise, though its efficacy in VATS remains uncertain.