Smokeless tobacco: knowledge, attitudes and usage in Pakistan.

Background: Smokeless tobacco (SLT) encompasses products that are not burnt but instead consumed orally or nasally. One-third of tobacco is consumed in the smokeless form in South Asia. Despite its widespread usage, there has been limited empirical research on the prevalence and factors influencing SLT consumption in Pakistan.

Outcomes of Reconstructive Surgery Using Vacuum-Assisted Closure in Patients With Complex Wounds.

This study aimed to assess the results of reconstructive surgery with vacuum-assisted closure (VAC) therapy in patients with complex wounds. The sample included 60 patients with a mean age of 53.03 years.

Clinical Outcomes with High- versus Low-Dose Tranexamic Acid Infusion in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.

Objectives:  Antifibrinolytics, such as tranexamic acid (TXA), are widely used in cardiac surgery to reduce bleeding risks; however, the optimal dosage for TXA infusion remains a subject of debate. Hence, this study aims to evaluate the safety and efficacy of high-dose compared with low-dose TXA infusion in cardiac surgery patients.

Methods:  PubMed, SCOPUS, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched until June 10, 2023, for studies assessing efficacy outcomes (e.

Professionalism and Ethics in Medical and Dental Education: A Survey of Student Perceptions and Experiences.

Background: Professionalism and ethical behavior are critical components of medical practice, yet gaps in ethical education among medical students remain a concern. This study addresses the need to assess perceptions and experiences regarding professionalism among medical students.

Objective: This study aims to evaluate medical students' awareness, perceptions, and experiences related to professionalism and ethical practices.

Behcet's disease in a tertiary eye hospital in Pakistan.

Behçet's disease is a kind of variable vessel vasculitis (VVV) and inflammatory systematic disease affecting various organs of the body. The cause of the disease is idiopathic but is most commonly genetic in origin. A positive skin prick test (dermatographia), genital sores, eye irritation, skin sores, and at least three episodes of mouth sores in a year confirm the diagnosis.

Pharmacist-led antibiotic interventions in infectious disease patients: a Pakistani tertiary care antimicrobial stewardship study.

Background: Antibiotics are widely used medications among infectious disease patients; therefore, proper monitoring and assessment are critical for ensuring rational use. Antimicrobial stewardship addresses the rational and appropriate use of antibiotics, which reinforces overall health outcomes. Ongoing antimicrobial resistance scenarios are an alarming condition for healthcare, necessitating continued practice of such assessments.

Role of HbA1c in Mortality Among Patients With a Medical History of Ischemic Stroke and Paroxysmal Atrial Fibrillation: A Systematic Review.

Elevated HbA1c, a marker of poor glycemic control, is associated with adverse cardiovascular outcomes and mortality. HbA1c influences outcomes through distinct mechanisms of vascular dysfunction and atherosclerosis in ischemic stroke, during atrial remodeling and thrombus formation in paroxysmal atrial fibrillation (PAF). Optimal HbA1c thresholds are generally below optimal levels, with levels above this being linked to higher mortality in both populations.

Outcomes of Direct-Acting Antivirals Versus Interferon-Based Therapy in Chronic Hepatitis C Infection.

This systematic review evaluates the outcomes of direct-acting antivirals (DAAs) compared to interferon-based therapies in patients with chronic hepatitis C infection. DAAs consistently demonstrate higher sustained virologic response (SVR) rates and better safety profiles across various patient populations, including those with cirrhosis and treatment-experienced individuals. The studies included highlight the superior efficacy of DAAs, with fewer adverse events such as anemia and fatigue, making them more tolerable and suitable for long-term treatment.

Efficacy and Safety of Total Body Irradiation Versus Chemotherapy Conditioning for Hematopoietic Stem Cell Transplant in Adult Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis.

Hematopoietic stem cell transplantation (HSCT) is a potentially curative option for adults with acute lymphoblastic leukemia (ALL) who have achieved remission. This systematic review and meta-analysis compare the efficacy of total body irradiation (TBI) versus chemotherapy (CHT) based regimens for conditioning in adult ALL patients being prepared for HSCT. A comprehensive literature search was conducted in MEDLINE, Embase, the Cochrane Library, and relevant trial registries from their inception to August 2024.

Frequency and Predictors of Diabetes Mellitus in Smear-Positive Pulmonary Tuberculosis Patients: A Cross-Sectional Study.

Introduction Tuberculosis (TB) is an infectious disease caused by . Various studies have established an association between diabetes mellitus (DM) and pulmonary TB. This study describes the prevalence of DM and its predictors in smear-positive TB patients.

Diagnostic value of CT scans in pediatric patients with acute non-traumatic altered mental status: a systematic review and meta-analysis.

Background: Computed tomography (CT) scans are widely used for evaluating children with acute atraumatic altered mental status (AMS) despite concerns about radiation exposure and limited diagnostic yield. This study aims to assess the efficacy of CT scans in this population and provide evidence-based recommendations.

Methods: A systematic review was conducted according to PRISMA guidelines.

Predictors of Mortality in Patients with Spontaneous Bacterial Peritonitis.

Introduction: Despite treatment with antibiotic therapy, spontaneous bacterial peritonitis (SBP) accounts for approximately 20-40% mortality in hospitalized patients. The data is scarce regarding mortality predictors in SBP. Recently, multiple factors have been studied for effectiveness in prognosis prediction in SBP.

Efficacy and Safety of Ileal Bile Acid Transport Inhibitors in Inherited Cholestatic Liver Disorders: A Meta-analysis of Randomized Controlled Trials.

Background: Inherited cholestatic liver disorders such as progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome result in significant pruritus and increased serum bile acids, necessitating liver transplantation. This study aims to evaluate the efficacy and safety of Ileal bile acid transport inhibitors (IBATIs) in children with PFIC and Alagille syndrome.

Methods: We conducted a comprehensive search across the databases to identify relevant randomized controlled trials (RCTs), and Covidence was used to screen eligible articles.

Efficacy and safety of polatuzumab-vedotin plus bendamustine and rituximab in patients with relapsed/refractory diffuse large B-cell lymphoma: A systematic review and meta-analysis.

Background: Diffuse large B-cell lymphoma (DLBCL), the most common non-Hodgkin's lymphoma subtype, relapses or becomes refractory (R/R) in 40 % of cases after initial treatment. Among the second-line treatments for these patients is CAR T-cell therapy, which is considered the gold standard and treatment better than SCT. For these patients, polatuzumab vedotin in combination with bendamustine and rituximab (Pola-BR) is a novel treatment.

Shifting temporal trends and disparities in sarcoidosis mortality in the United States: A retrospective analysis from 1999 to 2020.

Introduction: Sarcoidosis is an inflammatory disease characterized by granulomas, the etiology of which remains unclear. This study examines sarcoidosis-related mortality trends in the United States from 1999 to 2020, with a focus on disparities pertaining to patient sex, geographical location, and urbanization status.

Methods: We analyzed death certificate data from the CDC WONDER database, using ICD-10 code D86.

The Effectiveness and Safety of Beta Antagonists in Patients With Burns: An Updated Meta-Analysis.

Aims: The purpose of this systematic review was to assess the safety and effectiveness of beta antagonists for improving clinical care in burn patients, compared to placebo.

Methods: Articles from randomized-controlled trials were identified by a literature search on PubMed and Cochrane. We included relevant trials involving patients with burn.

Siblings With Berardinelli-Seip Congenital Lipodystrophy: Clinical Insights and Challenges.

Berardinelli-Seip congenital lipodystrophy (BSCL), also known as congenital generalized lipodystrophy (CGL), is an exceptionally rare autosomal recessive disorder marked by a significant deficiency of adipose tissue throughout the body. This lack of adipose tissue, normally found beneath the skin and between internal organs, leads to impaired adipocyte formation and fat storage, causing lipids to accumulate in atypical tissues such as muscles and the liver. The extent of adipose tissue loss directly influences the severity of symptoms, which can include a muscular appearance, increased appetite, bone cysts, marrow fat depletion, acromegalic features, severe insulin resistance, skeletal muscle hypertrophy, hypertrophic cardiomyopathy, hepatic steatosis, hepatomegaly, cirrhosis, and intellectual disability.

Trend of Representation of Women in Gastroenterology, Hepatology, and Endoscopy Conferences in Asia.

Objectives: Despite progress in promoting gender equality, gender bias remains a significant obstacle for women and hinders their academic advancement. We aim to survey and critically analyze women's representation in conferences and changes over time in various regions of Asian countries.

Methods: An international survey was conducted with representatives from East Asia (Hong Kong, China, and Japan), South Asia (India and Pakistan), and Southeast Asia (Vietnam and Thailand).

Screening for Alcohol Use Disorder Among Hospitalised Patients: Learning from a Retrospective Cohort Study in Secondary Care.

Excessive alcohol consumption is among the leading causes of hospitalisation in high-income countries and contributes to over 200 medical conditions. We aimed to determine the prevalence and characteristics of alcohol use disorder (AUD), describe the distribution of AUD in ICD-10 discharge diagnosis groups and ascertain any relationship between them in secondary care. The study group was a retrospective cohort of adult patients admitted to Nottingham University Hospital (NUH) between 4 April 2009 and 31 March 2020.

Comparison of Research Knowledge in Postgraduate Trainees of Clinical and Basic Health Sciences of a Tertiary Healthcare Setup: A Qualitative and Quantitative Assessment.

Background:  All recent advances in healthcare, including diagnostics, surveillance, management, and disease prevention, have depended on good-quality research that has brought new information to light. Therefore, in Pakistan, it is important to develop good research skills as, for many years, our physicians have relied on research knowledge from the Western world, which does not necessarily provide solutions to a developing country. Considering the gap in research knowledge among young doctors, the study was planned to compare the research knowledge of postgrad trainees of clinical and basic health sciences (BHS) of private tertiary care hospitals in Karachi.

Trends in Mortality Due to Inflammatory Bowel Disease in the United States: A CDC WONDER Database Analysis (1999-2020).

Introduction: Inflammatory bowel disease (IBD) is a global health issue profoundly impacting quality of life. The United States accounts for nearly a quarter of the world's IBD patients, with the highest prevalence rates. This study aims to identify the demographic and regional trends of IBD-related mortality in the U.

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.