Efficacy of Bisphosphonates in Reducing Fracture Risk Among Postmenopausal Women With Osteoporosis.

Background: Postmenopausal women are often affected by osteoporosis, a disorder that lowers bone density, increases the risk of fractures, and has a major negative influence on quality of life.

Objective: This study aimed to assess the efficacy of bisphosphonates in reducing fracture risk among postmenopausal women with osteoporosis by analyzing their impact across various fracture sites, treatment durations, and patient subgroups.

Methodology: A retrospective cohort research was conducted between January 2021 and December 2022 at Hayatabad Medical Complex (HMC), Peshawar.

Assessing Standardisation in Platelet-Rich Plasma (PRP) Injections for the Management of Greater Trochanteric Pain Syndrome (GTPS): A Systematic Review of the Available Literature.

Greater trochanteric pain syndrome (GTPS) is a prevalent musculoskeletal condition characterised by lateral hip pain and reduced function. Platelet-rich plasma (PRP) injections have gained attention as a potential treatment due to their regenerative properties. However, variability in PRP preparation methods and insufficient standardisation in the literature complicate the evaluation of its efficacy and reproducibility.

Safety, tolerability, and efficacy of an in-class combination therapy switch from bosentan plus sildenafil to ambrisentan plus tadalafil in children with pulmonary arterial hypertension.

The aim of this single-centre retrospective observational study was to evaluate the safety, tolerability, and efficacy of an in-class combination therapy switch from bosentan plus sildenafil to ambrisentan plus tadalafil in children with pulmonary arterial hypertension. Children aged over 5 years who were established on sildenafil plus bosentan were offered to undergo a therapy switch from May 2014 to May 2021 and, if remaining in the service, followed up to May 2024. Children with Eisenmenger syndrome, open intra or extra-cardiac shunt, or with pulmonary hypertension-associated lung disease were excluded.

Self-Reported Penicillin Allergy and antibiotic use in critical care: An observational, retrospective study.

Background: Patients with Self-Reported Penicillin Allergy (SRPA) receive alternative antibiotics, which increase the length of stay and hospital costs, but the impact of SRPA on mortality in critically ill patients is not well described.

Methods: This was a single-center, retrospective analysis of routinely gathered clinical data for all intensive care unit (ICU) admissions over nine years. The primary outcome was 28-day mortality, which was analyzed using a time-to-event approach with multivariable models to adjust for confounding factors, including age, comorbidities, sex, and admission SOFA score (as a measure of organ dysfunction).

Structured Polymers Enable the Sustained Delivery of Glucocorticoids within the Intra-Articular Space.

Intra-articular glucocorticoid injections are effective in controlling inflammation and pain in arthritides but restricted by short duration of action and risk of joint degeneration. Controlled drug release using biocompatible hydrogels offers a unique solution, but limitations of in situ gelation restrict their application. Gellan sheared hydrogels (GSHs) retain the advantages of hydrogels, however their unique microstructures lend themselves to intra-articular application - capable of shear thinning under force but restructuring at rest to enhance residence.

The Outcome of the Use of Continuous Action Compression Device for the First Metatarsophalangeal Joint Fusion.

Introduction: First metatarsophalangeal (MTP) joint fusion is a widely accepted surgical intervention for treating severe arthritis, deformities, and instability of the first MTP joint. This paper provides a review of a single surgeon's experience with continuous compression implants (CCI), which offer a notable advantage by providing uniform compression across a larger surface area of the fusion site compared to plate and screw constructs. This design potentially reduces soft tissue irritation and, consequently, the need for subsequent implant removal.

Cardiac catheterization in pulmonary arterial hypertension: Tips and tricks to enhance diagnosis and guide therapy.

Cardiac catheterization (CC) is essential for the diagnosis of pulmonary hypertension (PH), and for its characterisation. It allows distinction between pre- and post-capillary PH which, when integrated with other non-invasive data, facilitates classification into one of the 5 diagnostic groups defined by international PH guidelines. CC also provides valuable information for the risk stratification of patients with PH, guiding management and the type and intensity of treatment.

Diagnostic interobserver variability of atypia assessment in columnar cell lesions among a group of expert breast pathologists in the United Kingdom and the Republic of Ireland, on behalf of the UK national coordinating committee for breast pathology.

Aims: Atypical ductal hyperplasia and flat epithelial atypia (FEA) have defined diagnostic criteria, yet there is variation in the interpretation of these criteria, particularly when the atypia is present in a background of columnar cell lesions (CCLs). This study focuses upon cases which are especially challenging or difficult to classify reproducibly according to existing criteria.

Methods And Results: Thirteen breast pathology experts were asked to classify 10 challenging cases with CLLs as atypical or non-atypical.

Functional Outcomes of the Management of Acromioclavicular Joint Dislocation With a Clavicle Hook Plate: A Retrospective Study.

Background: Dislocation of the acromioclavicular joint (ACJ), accounting for 9%-12% of all shoulder injuries, is a frequent shoulder problem. Clavicular hook plates have proven to be a successful implant choice for surgical management. The benefit of this method is that it preserves the diarthrosis of the ACJ while reducing dislocation.

The Influence of Timing of Surgery on Postoperative Length of Hospital Stay in Closed Ankle Fractures.

Background Ankle fractures are prevalent lower limb injuries that often necessitate surgical intervention to restore joint stability and functionality. Delays in surgical management can extend hospital stays and elevate the risk of complications. This study aims to evaluate the effect of surgical timing on the postoperative length of hospital stay in patients with closed ankle fractures managed through open reduction and internal fixation (ORIF).

Efficacy of Local Intralesional Steroid Injection for Pain Relief in De Quervain's Tenosynovitis.

Introduction: Conservative treatment options, such as rest, massage, cold and heat packs, wrist splints, braces, physical therapy, thumb spica casts, and local steroid injections, have been used with mixed results to treat De Quervain's tenosynovitis. Surgical treatment, like releasing the first dorsal wrist compartment, is the last resort for resistant cases of De Quervain's tenosynovitis, exhibiting an efficacy of 91%. However, complications and increased expenses have limited the use of surgical interventions.

A Five-Year Retrospective Study on the Clinical Outcomes of Sacral Nerve Stimulation for Neuromodulation of the Lower Urinary Tract in a Tertiary Hospital.

Aim: To assess clinical outcomes in terms of first to second-stage conversion rates, revision rates, and complications for all patients undergoing sacral neuromodulation of the lower urinary tract for the past five years at the Queen Elizabeth Hospital Birmingham.

Method: This is a retrospective observational study. Only patients with the first stage of sacral neuromodulation between January 2017 and January 2023 were included in the study.

Comparing Urethral Stricture Rates Following Bipolar and Monopolar Transurethral Resection of the Prostate: A Retrospective Study.

Aim The aim is to compare the incidence of urethral strictures and other complications following monopolar and bipolar transurethral resection of the prostate (TURP). Method We conducted a retrospective study to compare patients who underwent bipolar TURP with those who underwent monopolar TURP between 2017 and 2023. The collected data included demographics, age, history of urethral stricture, prostate size, operation duration, and postoperative complications, such as blood transfusion, transurethral resection (TUR) syndrome, and other relevant data points.

Metabolic Characterization of Deceased Donor Kidneys Undergoing Hypothermic Machine Perfusion Before Transplantation Using C-enriched Glucose.

Background: The provision of a metabolic substrate is one mechanism by which hypothermic machine perfusion (HMP) of kidneys provides clinical benefit. This study aimed to describe metabolism in ex vivo human kidneys undergoing HMP before transplantation using C-labeled glucose as a metabolic tracer.

Methods: Cadaveric human kidneys were perfused with modified clinical-grade perfusion fluid (kidney perfusion solution [KPS-1], Organ Recovery Systems), in which glucose was uniformly enriched with the stable isotope C ([U-C] glucose).

Intravascular Ultrasound-Guided Versus Angiography-Guided Percutaneous Coronary Intervention: A Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Control Trials.

Background: Intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) allows better assessment of coronary artery lesion characteristics than angiography alone. This systematic review and meta-analysis aimed to comprehensively synthesize the available evidence regarding the efficacy of IVUS guidance compared to angiography-guided PCI.

Methods: A comprehensive literature search of major bibliographic databases from inception until April 2024 was conducted to identify randomized control trials (RCTs) comparing IVUS-guided PCI versus angiography-guided PCI.

Anti-Ro-Positive Dermatomyositis Presenting as a Clinical Mimic of Guillain-Barré Syndrome: A Case Report.

Dermatomyositis is a multi-system, connective tissue immune-mediated inflammatory condition characterised by myositis and distinct skin manifestations, with a higher prevalence in women. Symptoms typically appear in adulthood, though a juvenile form exists. Early signs may include Gottron's papules and heliotrope rash, with proximal muscle weakness as the second most common initial symptom.

Penoscrotal Extension and Fistulation From Urothelial Carcinoma of the Bladder.

The commonest malignancy of the urinary tract is bladder cancer, with the commonest presentation being painless visible haematuria. Just like other malignancies, it can spread, commonly to surrounding tissues like the prostate, seminal vesicles, and vagina, distantly to lymph nodes, lungs, liver, and bone, and less commonly to the skin and subcutaneous tissues. This is a case of a man with muscle-invasive bladder cancer who underwent radical radiotherapy.

Functional analysis of fibroblasts and macrophages in head and neck paragangliomas.

Background And Aim: Head and neck paragangliomas (HNPGN) are tumours that carry significant morbidity The role of the stroma in the pathogenesis of HNPGN is not completely understood. This study explores the profile of fibroblasts and macrophages in HNPGN.

Methods: Ten patients undergoing HNPGN surgery were recruited.

Mortality in septic patients treated with short-acting betablockers: a comprehensive meta-analysis of randomized controlled trials.

Background: Treatment with short-acting betablockers in septic patients remains controversial. Two recent large multicenter trials have provided additional evidence on this therapeutic approach. We thus performed a meta-analysis, including the most recent data, to evaluate the potential impacts of treatment with short-acting betablockers on mortality in adult septic patients.

Efficacy of Platelet-Rich Plasma (PRP) in Treating Plantar Fasciitis.

Background: Platelet-rich plasma (PRP) is an autologous blood derivative with an enhanced platelet concentration and can enhance the tissue-healing process naturally. Plasma with a higher concentration of platelets on activation leads to the release of various growth factors that in turn augment tissue repair and jump-start the healing process. The aim of this study was to determine the efficacy of PRP in reducing pain and improving functional outcomes in patients with plantar fasciitis who had failed to respond to conservative treatment.

Clinical and Metabolic Characteristics and Follow-Up Results of Adrenal Incidentalomas: A 10-Year Experience.

Objective: In this retrospective study, we aimed to investigate the clinical, hormonal, and radiological characteristics of patients with adrenal incidentalomas (AIs), to assess the prevalence of metabolic syndrome components in patients with AIs, and to determine whether changes in tumor size or hormonal activity occur during long-term follow-up in patients with AIs.

Methods:  We retrospectively analyzed data from 384 patients diagnosed with AI between 2010 and 2020. Data regarding radiological, hormonal, and metabolic investigations in diagnosis and also during follow-ups were collected.

Enhancing wellbeing in medical practice: Exploring interventions and effectiveness for improving the work lives of resident (junior) doctors: A systematic review and narrative synthesis.

Introduction: Globally, resident doctors face challenges like long work hours, critical decision-making stress, and exposure to death and distress, prompting concern for their wellbeing. This study addresses the need for interventions to improve their working conditions, vital for enhancing quality of life, patient care and retaining a skilled workforce.

Methods: Following PRISMA guidelines, a systematic literature review until 3 January 2024 explored interventions for resident Ddoctors pre- and post-COVID-19.

Assessment of the BODE Index and Its Association With Inflammatory Mediators in Chronic Obstructive Pulmonary Disease (COPD) Patients.

Background Chronic obstructive pulmonary disease (COPD) is a respiratory condition impacting daily activities of susceptible individuals and increasing the risk of respiratory infections and cardiovascular disease. Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index is applied clinically to measure the survival of COPD patients. Inflammatory mediators, including cytokines and chemokines, significantly contribute to the COPD pathology.