Thyroid Functions and Cognitive Decline in the Elderly.

Background The maintenance of cognitive health depends on thyroid hormones, and it is becoming more widely acknowledged that thyroid hormone issues may be a factor in cognitive decline in the aged. Objective This study aimed to investigate the association between thyroid hormone levels and cognitive decline among elderly individuals, considering the influence of age-related factors and comorbidities. Methodology Over the course of two years, 218 adults 60 years of age and older with clinically diagnosed hypothyroidism or subclinical thyroid disease were included in a prospective observational research.

Peptide-Based Prodrug Approaches for Cancer Nanomedicine.

Peptide-based prodrugs, such as peptide-drug conjugates (PDCs), are currently being developed for cancer therapy. PDCs are considered single-component nanomedicines with various functionalities. The peptide moieties provide stability to the PDCs, which self-assemble into nanostructures in an aqueous medium.

Spindle cell lipoma, a rare entity affecting the larynx: A case report.

Spindle cell lipoma is a very rare occurrence in the larynx and can be cured by complete excision. In this case report we present the case of a 71-year-old female who presented to the otorhinolaryngology outpatient department of Northwest General Hospital and Research Centre, Peshawar, with complaints of occasional irritation and a foreign body sensation in the throat while swallowing, for the last three years. She had undergone a surgical procedure 30 years back for the same complaint and remained asymptomatic till three years back.

Apixaban versus low molecular weight heparin in patients with cancer-associated venous thromboembolism: a systematic review and meta-analysis.

Background: The optimal treatment regimen for patients with cancer-associated venous thromboembolism (CA-VTE) remains unclear. Therefore, the authors sought to compare the outcomes of (VKAs) versus direct apixaban and low molecular weight heparin (LMWH) in patients with CA-VTE.

Methods: MEDLINE, Embase, and Cochrane Central databases were searched for randomized controlled trials (RCTs) and observational studies comparing the efficacy and safety of apixaban and LMWH in patients with CA-VTE.

Evaluating the Efficacy and Accuracy of AI-Assisted Diagnostic Techniques in Endometrial Carcinoma: A Systematic Review.

Diagnosing endometrial carcinoma correctly is essential for appropriate treatment, as it is a major health risk. As machine learning (ML) and artificial intelligence (AI) have grown in popularity, so has interest in their potential to improve cancer diagnosis accuracy. In the context of endometrial cancer, this study attempts to examine the efficacy as well as the accuracy of AI-assisted diagnostic approaches.

Effects of Targeted Hypercapnia on Mortality and Length of Stay of Post-cardiac Arrest Patients: A Systematic Review and Meta-Analysis.

Therapeutic hypercapnia has been proposed as a potential strategy to enhance cerebral perfusion and improve outcomes in patients after cardiac arrest. However, the effects of targeted hypercapnia remain unclear. We conducted a systematic review and meta-analysis to evaluate the impact of hypercapnia compared to normocapnia on mortality and length of stay in post-cardiac arrest patients.

Prevalence of Aortic Root Pathologies in Platypnea-Orthodeoxia Syndrome Secondary to Intra-Cardiac Shunts.

Background: Atrial septal defects can allow right to left shunting of venous blood which presents clinically as platypnea-orthodeoxia syndrome. It is believed that concomitant presence of aortic root pathologies increases the likelihood of shunting.

Methods: The study included a review of 510 articles listed in PubMed of patients with platypnea-orthodeoxia syndrome.

Capacity building for pediatric neuro-oncology in Pakistan- a project by my child matters program of Foundation S.

Introduction: Initiated in June 2019, this collaborative effort involved 15 public and private sector hospitals in Pakistan. The primary objective was to enhance the capacity for pediatric neuro-oncology (PNO) care, supported by a My Child Matters/Foundation S grant.

Methods: We aimed to establish and operate Multidisciplinary Tumor Boards (MTBs) on a national scale, covering 76% of the population (185.

Role of granulocyte colony stimulating factor (G-CSF) in dengue patients with severe thrombocytopenia.

Objective: To determine the effects of granulocyte colony-stimulating factor in improving platelet count in patients with dengue fever.

Methods: The retrospective, cross-sectional study was conducted at Northwest General Hospital and Research Centre, Peshawar, Pakistan, between January 2021 and October 2022, and comprised dengue fever inpatients regardless of age and gender who received granulocyte colony-stimulating factor subcutaneously. The impact of colony-stimulating factor on platelet and white blood cell counts as well as any unfavourable consequences was assessed.

Association Between Venous Thromboembolism Prophylaxis and the Incidence of Thromboembolism Following Orthopedic Procedures: A Cross-Sectional Study.

Introduction: Venous thromboembolism (VTE) is a significant concern following orthopedic procedures, necessitating effective prophylactic measures. The rates of VTE prophylaxis, however, vary widely between institutions and nations, falling between 13% and 70% on average. In the absence of adequate thromboprophylaxis, pulmonary embolism, which accounts for 5% to 10% of mortality in hospitalized patients, is one of the leading causes of death.

Case report: A rare case of dual primary synchronous malignancies of the breast and kidney in a 70 year female.

Introduction: Multiple primary cancers (MPCs) have attracted attention in medical research due to their increasing incidence. The coexistence of invasive breast carcinoma and clear cell carcinoma of the kidney, alongside a family history of cancer, highlights the multifactorial origins of MPCs, particularly their potential association with genetic factors.

Case Presentation: A 70-year-old female initially sought medical attention for a two-year history of a right breast lump as her primary concerns centered on the long-standing lump.

COVID-19 Pandemic Lessons for Creating Effective Mental Health Safety Nets in Lower Middle-Income Countries.

The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to mental health globally, particularly in low- and middle-income countries (LMICs) such as Pakistan. This narrative review aims to synthesize the literature on the impact of the pandemic on mental health in LMICs, the challenges and opportunities for mental health system reform, and the role of safety nets in promoting mental health. A comprehensive search was conducted in several electronic databases, resulting in 35 articles being included for review.

Vitamin B12 Deficiency, a Rare Cause of Isolated Thrombocytopenia in Adults.

Isolated thrombocytopenia in adults is a common clinical problem, often caused by various hematological disorders. However, vitamin B12 deficiency as a rare cause of isolated thrombocytopenia has been rarely reported in the medical literature. This case report aims to highlight the diagnostic challenges associated with atypical presentations of thrombocytopenia and emphasizes the importance of considering nutritional deficiencies, such as vitamin B12 deficiency, in the diagnostic workup.

An Unfortunate Incident Of A Surgical Swab Left In The Sphenoid Sinus For Eight Years.

Retained foreign bodies are foreign materials which are left accidentally inside a patient's body after a procedure. In this report we present the case of a 57 year old man who presented to the ENT clinic with a history of symptoms stretching over 8 years back to when he underwent a hypophysectomy through the transsphenoidal approach. These symptoms included cacosmia, ageusia, altered taste at times, foul smelling discharge, nasal discharge and dizziness.

Psychiatric Illnesses, Somatic Complaints, and Treatments in a Tertiary Care Hospital in Khyber Pakhtunkhwa, Pakistan: A Cross-Sectional Study.

Background: Psychiatric disorders differ in frequency and symptoms based on the cultural and ethnic background of patients. This can make diagnosing and treating patients challenging globally. In Pakistan, most psychiatric patients report multiple somatic complaints.

The Spectrum of Heart Failure Management.

Heart failure, a complex cardiovascular condition, is a huge burden on patients, caregivers, and healthcare systems and it is prevalent worldwide. Heart failure is caused by a wide variety of underlying conditions that include both cardiac and non-cardiac pathologies. Identifying the underlying cause enables us to apply etiology-based interventions.

Sudden Cardiac Death in Athletes: Consensuses and Controversies.

Exercise is widely considered beneficial for cardiovascular health. However, on rare occasions, athletes experience sudden cardiac death without any preceding symptoms. The devastating nature of these events necessitates us to understand the underlying causes.

Toward Sustainable Healthcare Systems: A Low and Middle-Income Country's Case for Investing in Healthcare Reforms.

Pakistan, a low and middle-income country (LMIC), faces challenges in providing sustainable health care to its population due to inadequate financing, weak healthcare infrastructure, and insufficient health human resources. These challenges are not unique to Pakistan and are faced by many LMICs globally. In this paper, we aim to identify key strategies for achieving sustainable healthcare systems in Pakistan and to draw lessons for LMICs globally, keeping in view the healthcare reforms in Pakistan.

Prevalence and antimicrobial susceptibility of spp. in a tertiary care hospital in Peshawar: a cross-sectional study.

Unlabelled: spp. have been a primary cause of nosocomial infections worldwide, causing significant morbidity and mortality, especially in Pakistan. The purpose of this study was to investigate the trend of antimicrobial resistance over a 5-year period in a tertiary care hospital in Pakistan.

Frequency and Type of Thyroid Carcinoma in Patients With Multinodular Goiter.

Background This study aimed to investigate the incidence and subtype of thyroid cancer in multinodular goitre (MNG) patients who underwent total thyroidectomy. Methodology A cross-sectional study was conducted at the Khyber Teaching Hospital, screening 207 MNG patients who received complete thyroidectomies between July and December 2022. The senior consultant diagnosed thyroid cancer based on a complete history, physical examination, and laboratory and radiological studies.

A Survey of Traumatic Brain Injuries from Road Traffic Collisions in a Lower Middle-Income Country.

The burden of traumatic brain injury (TBI) from road traffic collisions (RTCs) is great in low-and middle-income countries (LMICs) due to shortfalls in preventative measures, and the lack of relevant, accurate data collection. To address this gap, we sought to study the epidemiology of TBI from RTCs in two LMIC neurosurgical centres in order to identify factors amenable to preventative strategies. A prospective survey of all adult and paediatric cases of TBI from RTCs admitted to Northwest General Hospital (NWGH) and Hayatabad Medical Complex (HMC) over a four-week period was carried out.

Association of Anemia with Parathyroid Hormone Levels and Other Factors in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Cross-Sectional, Real-World Data Study in Pakistan.

End-stage renal disease (ESRD) patients are mostly managed with maintenance hemodialysis (MHD). ESRD patients on MHD also present with many complications, such as anemia, hyperparathyroidism, and hepatitis prevalence. This study depicts the real-world scenario of anemia among MHD and end-stage renal disease patients in the Pakistani population.

Risk Assessment and Prophylaxis of Venous Thromboembolism in Patients of Medical Ward of Northwest General Hospital and Research Center, Peshawar, Pakistan: A Quality Improvement Project.

Background Venous thromboembolism (VTE) is a condition that occurs when a blood clot forms in veins. Hospitalization increases the risk of VTE so timely risk assessment and adequate prophylaxis for VTE should be done to prevent this potentially fatal complication. Local problem Data from developing countries regarding VTE prophylaxis is scarce.

Translation, Cross-Cultural Adaptation And Validation Of Polycystic Ovarian Syndrome Quality Of Life Scale In Pashto.

Background: Cross-cultural adaptation and validation are important for the reliable use of a scale. This study was conducted to translate and validate the polycystic ovarian syndrome quality of life scale (PCOSQOL) in Pashto.

Methods: This study was conducted in tertiary care teaching hospitals of Peshawar from August to December 2021 on 333 patients diagnosed with polycystic ovarian syndrome.