Comparative bioavailability study of supplemental oral Sucrosomial vs. oral conventional vitamin B12 in enhancing circulatory B12 levels in healthy deficient adults: a multicentre, double-blind randomized clinical trial.

Background: Vitamin B12 is essential for neurological function, red blood cell formation, and DNA synthesis. Deficiency can lead to diverse health conditions, including megaloblastic anemia and neurological issues. Oral supplementation is a standard treatment for B12 deficiency.

Effectiveness of early pharmaceutical interventions in symptomatic COVID-19 patients: A randomized clinical trial.

Objective: We assessed the effectiveness of oral Hydroxychloroquine (HC), Azithromycin (AZ) and Oseltamivir (OS), alone or combined, among patients hospitalized with mildly symptomatic coronavirus infectious disease (COVID-19).

Methods: Following the approval of the National Bioethics Committee and prospective registration (clinicaltrials.gov NCT04338698), a multicenter randomized clinical trial of adaptive design was conducted at 10 multispecialty hospitals in Pakistan.

Percutaneous thermal radiofrequency rhizotomy of L2-S1 spinal nerve roots in children with cerebral palsy.

Objective: This study presents the results of an evaluation of the effectiveness of percutaneous thermal radiofrequency (RF) ablation of spinal nerve roots to reduce spasticity and improve motor function in children with cerebral palsy (CP).

Methods: A retrospective analysis was conducted on the surgical treatment outcomes of 26 pediatric patients with severe CP (Gross Motor Function Classification System levels IV-V). The assessment protocol included muscle tone assessment using the modified Ashworth scale (MAS), evaluation of passive and active range of motion, gait video recording, and locomotor status evaluation using the Gross Motor Function Measure (GMFM)-88 scale.

Investigating awareness of artificial intelligence in healthcare among medical students and professionals in Pakistan: a cross-sectional study.

Objective: The purpose of this study is to find out the level of awareness and acceptance of artificial intelligence (AI) in Pakistan's medical community so as to comment on its future in our healthcare system.

Methods: A survey consisting of 15 close-ended questions was conducted. The questions inquired about awareness about AI and discovered the opinions of healthcare professionals regarding its benefits and expected problems.

Comparison of Laparoscopic Intraperitoneal Onlay Mesh (IPOM) Hernioplasty With Laparoscopic IPOM-Plus: Our Initial Experience in Pakistan.

Objectives Laparoscopic intraperitoneal onlay mesh hernioplasty (IPOM) for ventral hernias has been used for a long time. However, there have been some issues associated with it, thereby leading to the introduction of a new technique that involves laparoscopic closure of the fascial defect with suture followed by intraperitoneal onlay mesh placement (IPOM-Plus). We carried out this study to compare the outcome of laparoscopic IPOM with fascial defect closure versus without defect closure in midline ventral hernia repair in terms of recurrence.

Comparative Efficacy of Anti-vascular Endothelial Growth Factor (Anti-VEGF) Agents and Corticosteroids in Managing Diabetic Retinopathy-Associated Diabetic Macular Edema: A Meta-Analysis and Comprehensive Systematic Review.

Diabetic macular edema (DME) is a significant condition linked to diabetes that can result in visual loss. In recent times, there has been a notable change in the desire for treatment, with a shift toward anti-vascular endothelial growth factor (anti-VEGF) therapy and intravitreal steroids while moving away from conventional laser therapies. This comprehensive meta-analysis explicitly compares the efficacy of two therapies for DME: anti-VEGF therapy and corticosteroid.

Anatomical Justification of Extradural Resection of the Anterior Clinoid Process.

 The study aimed to provide neuroanatomical justification of the extradural resection of the anterior clinoid process (ACP).  Using a cross-sectional study design, 47 cranial computed tomography (CT) scans were examined. There were 31 (65.

Efficacy of Terbinafine and Itraconazole Combination Therapy Versus Terbinafine or Itraconazole Monotherapy in the Management of Fungal Diseases: A Systematic Review and Meta-Analysis.

Fungal infections constitute a common dermatological illness rampant in underdeveloped countries. Combination drug therapy is becoming increasingly well-established owing to drug resistance because of monotherapy. Different studies have been conducted previously to compare the medical regimens for the treatment of fungal infections.

A Case of Angiotensin-Converting Enzyme (ACE) Inhibitor-Induced Small Bowel Angioedema.

Angioedema is a rare but known side effect of angiotensin-converting enzyme (ACE) inhibitor therapy. The most common presentations of ACE inhibitor-induced angioedema describe swellings in the oropharyngeal and periorbital regions. We describe a rare case of a 58-year-old female with a history of type 2 diabetes and hypertension taking lisinopril for the past three years and presented with recurrent episodes of abdominal pain, nausea, and vomiting around the same time she started taking the drug.

Clinical Outcomes of Ustekinumab in Inflammatory Bowel Disease.

Inflammatory bowel diseases including Crohn's disease (CD) and ulcerative colitis (UC) are characterized by abdominal pain, diarrhea, blood in stools, weight loss, and fatigue. It presents in patients with varying severity from mild to severe depending on the inflammation. Detailed analysis and guidelines are required for the safe usage of biological therapies in the treatment of inflammatory bowel diseases as surgery is reserved for more complex cases.

Advancements in the Management of Endocrine System Disorders and Arrhythmias: A Comprehensive Narrative Review.

In recent years, notable advancements have been made in managing endocrine system disorders and arrhythmias. These advancements have brought about significant changes in healthcare providers' approach towards these complex medical conditions. Endocrine system disorders encompass a diverse range of conditions, including but not limited to diabetes mellitus, thyroid dysfunction, and adrenal disorders.

Respiratory Dysfunction in Epileptic Encephalopathies: Insights and Challenges.

Epileptic encephalopathies constitute a group of severe epileptic disorders characterized by intractable seizures and cognitive regression. Beyond the hallmark neurological manifestations, these disorders frequently exhibit associated respiratory dysfunction, which is increasingly recognized as a critical aspect of their pathophysiology. Respiratory abnormalities in epileptic encephalopathies encompass a spectrum of manifestations, ranging from subtle alterations in breathing patterns to life-threatening events such as apneas and hypoventilation.

Cardiac Rehabilitation in the Modern Era: Optimizing Recovery and Reducing Recurrence.

Cardiovascular diseases (CVDs) continue to be a prominent issue in global health, emphasizing the necessity for efficient cardiac rehabilitation programs. This narrative review provides a detailed analysis of the current state of cardiac rehabilitation, focusing on maximizing recovery and minimizing the likelihood of recurrence. This paper examines the historical progression of cardiac rehabilitation, explores the epidemiological background of cardiovascular disease (CVD), and provides an overview of the many stages of the rehabilitation process.

A Treatment Dilemma: Bentall vs Transcatheter Paravalvular Leak Closure with Aortic Aneurysm Repair in a High Surgical Risk Patient.

This case presentation involves an 80-year-old male with a history of surgically repaired patent ductus arteriosus and surgical aortic valve replacement due to infective endocarditis, who presented with progressive heart failure symptoms and was found to have a severe aortic paravalvular leak (PVL) and ascending thoracic aortic aneurysm. Due to complex surgical anatomy and multiple chronic comorbidities, he was considered a poor candidate for traditional valve replacement surgery including the Bentall procedure. Instead, a multidisciplinary team opted for transcatheter paravalvular leak closure (TPLC) with an Amplatzer plug followed by planned endovascular aortic aneurysm repair.

Neuropathy following intramuscular injections: a clinical and neurophysiological study from a tertiary care centre in Pakistan.

Objective: To assess the clinical and neurophysiological profile of peripheral nerve injuries in patients following intramuscular injections.

Methods: The descriptive, cross-sectional study was conducted at the Department of Neurology, Mayo Hospital, Lahore, Pakistan, from July 2019 to January 2021, and comprised adult patients of either gender with isolated peripheral nerve injuries following intramuscular injections. Nerve conduction studies were performed for each patient.

Towards survival prediction of cancer patients using medical images.

Survival prediction of a patient is a critical task in clinical medicine for physicians and patients to make an informed decision. Several survival and risk scoring methods have been developed to estimate the survival score of patients using clinical information. For instance, the Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores are developed for the survival prediction of heart patients.

Machine learning models to predict neuropsychiatric disorders in various brain tumors.

Objective: Neuropsychiatric disorders in brain tumor patients are commonly observed. It is difficult to anticipate these disorders in different types of brain tumors. The goal of the study was to see how well machine learning (ML)-based decision algorithms might predict neuropsychiatric problems in different types of brain tumors.

Clinical and biochemical indicators of disease severity and neurological findings in COVID-19: A study of King Edward Medical University (KEMU), Pakistan.

This study investigated the significance of difference between presence and absence of different neurological findings in COVID-19, in relation with the biochemistry. Various significant correlations in connection with the disease severity and clinical factors were also identified. 351 COVID-19 patients were included.

Assessment and prediction of restless leg syndrome (RLS) in patients with diabetes mellitus type II through artificial intelligence (AI).

This study aimed to diagnose the incidence of restless leg syndrome (RLS) in patients with diabetes mellitus (DM) type-2, thorough artificial intelligence based multilayer perceptron (MLP). 300 cases of diabetes mellitus type-2, of age between 18-80 years were included. Point-biserial correlation/Pearson Chi-Square correlations were conducted between RLS and risk factors.

Sensory symptoms on admission as a predictor of respiratory insufficiency in patients of Guillain-Barre Syndrome (GBS).

Objective: To assess sensory symptoms on presentation as a predictor of respiratory insufficiency in patients of Guillain-Barre Syndrome.

Methods: The descriptive cross-sectional study was conducted from November 2018 to March 2019 at the Neurology Department of King Edward Medical University, Lahore, Pakistan, and comprised patients aged 18-60 years suffering from Guillain-Barre Syndrome as per Brighton criteria. All patients were monitored for respiratory insufficiency by single breath count and arterial blood gases.

COVID-19 and Its Psychological Impacts on Healthcare Staff - A Multi-Centric Comparative Cross-Sectional Study.

Background Since the first case of coronavirus disease-19 (COVID-19) in Pakistan was reported in February 2020, the medical and paramedical staff has been working on the frontlines to deal with this disease. They have been facing significant strain and stress due to the pandemic, affecting their social, mental, and personal life. The purpose of this study is to investigate the psychological effects of the COVID-19 pandemic, etiology, personal coping mechanisms, and the strategies that are being adopted to reduce stress by the healthcare workers (HCWs) working in COVID-19 dedicated wards (group 2) and compare it with staff working in other departments but not in COVID-19 wards amid this pandemic (group 1) in various hospitals of Lahore, Pakistan.

Renal Infiltration as a Primary Presentation of Burkitt Lymphoma Secondary to Systemic Lupus Erythematosus: A Rarity Unto a Rarity.

Burkitt lymphoma (BL) is a highly aggressive non-Hodgkin B-cell lymphoma characterized by the translocation and deregulation of the MYC (MyeloCytomatosis) gene on chromosome 8. Three distinct clinical forms of BL are recognized: endemic (African), sporadic (non-endemic), and immunodeficiency-associated. Bilateral renal infiltration leading to acute kidney injury (AKI) is a rare initial presentation of BL.

Supervisor's Feedback on Progress of E-Logbook System of CPSP: A Cross-sectional Survey.

Objective: To determine the feedback of supervisors regarding role of e-logbook in monitoring of training, strengthening supervisor-supervisee relationship and improving overall environment of postgraduate training at College of Physicians and Surgeons Pakistan (CPSP).

Study Design: Cross-sectional survey.

Place And Duration Of Study: College of Physicians and Surgeons Pakistan (CPSP) from July to December, 2017.

Primary Cutaneous Nocardiosis: A Rare Presentation of Nocardiosis.

Nocardia is an uncommon gram-positive, weakly acid-fast bacterium that causes systemic or localized suppurative disease in humans and animals. Nocardiosis is typically regarded as an opportunistic infection, but approximately one-third of the patients are immunocompetent. The most common presentation is pulmonary disease (39%) followed by systemic involvement, defined as involvement of more than two sites; cutaneous presentation constitutes only 8% of the cases.