First-World Care at Third-World Rates: Pakistan, an Attractive Destination for Bariatric Tourism.

Introduction Obesity, a complex and multifactorial disease, is defined by a body mass index (BMI) greater than 30 kg/m². When the BMI exceeds 40 kg/m², it is classified as morbid obesity. This condition leads to excessive fat accumulation, which impairs normal body function and metabolism.

A 31-Year-Old Female With Postcoital Hemoptysis.

Hemoptysis is a common presenting symptom in the clinical setting. The most frequent causes of non-life-threatening hemoptysis, which usually originates from the pulmonary arterial circulation, include pulmonary pathologies such as infections, inflammatory airway diseases, and bronchial neoplasms. Hemoptysis occurring only after sexual intercourse, however, is a rare phenomenon.

Empyema necessitans (EN) as a rare complication of tuberculosis - A case report.

Introduction: Empyema necessitans (EN) is an uncommon condition where an intrathoracic empyema extends into surrounding extra-thoracic tissues. This case report presents a rare instance of tuberculous EN in an immunocompetent individual.

Presentation Of Case: We present a case of a healthy young male with complaints of weight loss and a chest wall swelling, initially treated as a subcutaneous abscess.

Outcome of pediatric living donor liver transplant: Experience from Pakistan; a resource limited setting.

Introduction: Liver transplantation (LT) has emerged as a lifesaving modality for many liver diseases in children. Pediatric LT is an established treatment in the Western world but is relatively a new procedure in resource-limited countries like Pakistan. The study aims to highlight the outcomes and survival of pediatric recipients from the first pediatric liver transplant center in Pakistan.

The WATCHMAN Device Review: A New Era for Stroke Prophylaxis.

Atrial fibrillation (AF) is a major risk factor for ischemic stroke, accounting for more than 37 million cases worldwide. In AF, the left atrial appendage (LAA) is the most common site of thrombus formation, and its ligation/closure with the WATCHMAN device is a good alternative to long-term oral anticoagulation, especially in patients with contraindications to warfarin. However, the implantation procedure is associated with various risks and complications.

Lupus Podocytopathy: A Rare Cause of Nephrotic Syndrome in Patients with Systemic Lupus Erythematosus.

Lupus podocytopathy, a unique form of lupus nephritis, mimics minimal change disease (MCD) or primary focal segmental glomerulosclerosis (FSGS) and represents approximately 1% of lupus nephritis biopsies. Lupus podocytopathy is characterized by diffuse epithelial cell foot process effacement without immune complex deposition or with only mesangial immune complex deposition. We present the case of a young woman with systemic lupus erythematosus (SLE) who presented with nephrotic syndrome and acute kidney injury (AKI) and was subsequently diagnosed with lupus podocytopathy.

Dietary habits and physical activity patterns in relation to nutritional status among school-aged children in Pakistan: A cross-sectional study.

Background: Childhood malnutrition remains a significant public health problem impacting the physical and mental growth if school aged children, particularly in limited-resource countries.

Objective: The study objective was to assess levels of physical activity, patterns of screen time (S.T.

Beyond the norm: A rare case of cardiac and extracardiac metastatic urothelial carcinoma.

Screening echocardiography aids in identifying cardiac emboli causes and asymptomatic cardiac metastases in high-grade neoplasms. Conversely, cardiac MRI provides advanced tissue characterization and broader extracardiac assessment.

A Comparison of the Effects of Empagliflozin and Sitagliptin, When Combined With Metformin, on Lipid Levels in Patients with Type 2 Diabetes: A Clinical Investigation.

Introduction Type 2 diabetes (T2D) is emerging as a major global health concern. An associated condition, dyslipidemia, which acts as a significant modifiable risk factor for T2D, exhibits variations across different ethnicities and socioeconomic backgrounds. While many patients rely on metformin as their primary treatment, it does not always effectively control hyperglycemia.

Safety and Efficacy of Ferric Carboxymaltose in Heart Failure With Preserved Ejection Fraction and Iron Deficiency.

Heart Failure with Preserved Ejection Fraction (HFpEF) is a prevalent cardiovascular condition characterized by a complex pathophysiology and limited therapeutic options. Coinciding iron deficiency often compounds the clinical picture, contributing to symptom burden and adverse outcomes. The review underscores the urgency for effective treatments in light of its increasing incidence and considerable healthcare burden.

ChatGPT and the Future of Medical Education: Opportunities and Challenges.

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A cognitive task analysis of expert surgeons performing the robotic roux-en-y gastric bypass.

Background: The safe and effective performance of a robotic roux-en-y gastric bypass (RRNY) requires the application of a complex body of knowledge and skills. This qualitative study aims to: (1) define the tasks, subtasks, decision points, and pitfalls in a RRNY; (2) create a framework upon which training and objective evaluation of a RRNY can be based.

Methods: Hierarchical and cognitive task analyses for a RRNY were performed using semi-structured interviews of expert bariatric surgeons to describe the thoughts and behaviors that exemplify optimal performance.

An Atypical Presentation of Fibrodysplasia Ossificans Progressiva and the Imperative for Multidisciplinary Care: A Case Report.

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterized by the gradual heterotopic ossification of soft tissues, leading to abnormal bone growth within muscles, tendons, and ligaments, due to a mutation in the ACVR1 gene. This specific case report highlights an unusual occurrence of FOP, emphasizing the diagnostic challenges and the importance of quick identification and appropriate intervention to mitigate its debilitating effects. The report also underscores the need for comprehensive genetic counseling and a multidisciplinary treatment approach, involving experts, such as orthopedic specialists, geneticists, and physical therapists, to improve the prognosis and overall well-being of those affected by FOP.

Revolutionizing Inflammatory Bowel Disease Management: A Comprehensive Narrative Review of Innovative Dietary Strategies and Future Directions.

This comprehensive narrative review delves into the intricate interplay between diet and inflammatory bowel disease (IBD), shedding light on the potential impact of dietary interventions in disease management. By analyzing nutritional interventions, risks, challenges, and future perspectives, this review serves as a vital resource for clinicians, researchers, and patients alike. The amalgamation of evidence underscores the significance of customizing dietary strategies for individual patients, considering disease phenotype and cultural factors.

The Global Otolaryngology-Head and Neck Surgery Workforce.

Importance: A core component of delivering care of head and neck diseases is an adequate workforce. The World Health Organization report, Multi-Country Assessment of National Capacity to Provide Hearing Care, captured primary workforce estimates from 68 member states in 2012, noting that response rates were a limitation and that updated more comprehensive data are needed.

Objective: To establish comprehensive workforce metrics for global otolaryngology-head and neck surgery (OHNS) with updated data from more countries/territories.

Myocarditis and Myocardial Injury in Long COVID Syndrome: A Comprehensive Review of the Literature.

The repercussions of coronavirus disease 2019 (COVID-19) have been devastating on a global scale. Long COVID, which affects patients for weeks or even months after their initial infection, is not limited to individuals with severe symptoms and can affect people of all ages. The condition can impact various physiological systems, leading to chronic health conditions and long-term disabilities that present significant challenges for healthcare systems worldwide.

Effect of Dapagliflozin in Patients with Heart Failure: A Systematic Review and Meta-Analysis.

Background: Heart failure (HF) is a major cause of recurrent hospitalization and death worldwide. Sodium-glucose cotransporter-2 inhibitors including dapagliflozin are anti-diabetic drugs with promising cardiovascular (CV) effects. We performed systematic review and meta-analysis of randomized controlled trials investigating the effects of dapagliflozin in heart failure patients.

Shrapnel in carotid sheath: A rare penetrating neck injury.

Injuries deeper than the platysma are considered as penetrating neck injuries, constituting approximately 5% - 10% of all trauma. Many vital organs are at risk from a penetrating neck injury. These injuries in zone 1 have the highest mortality, because the injuries are close to the vital organs and difficult to access surgically.

Role of Positive Emotions in Takotsubo Cardiomyopathy.

Takotsubo Cardiomyopathy, also known as "broken heart syndrome," is a transient cardiac condition characterized by sudden left ventricular dysfunction, often triggered by emotional stress or significant life events. While research has predominantly focused on the impact of negative emotions and emotional stressors, there is a growing interest in understanding the role of positive emotions in this unique cardiac syndrome. This narrative review explores the emerging research on positive emotions and Takotsubo Cardiomyopathy.

Clinical Outcomes With Furosemide Versus Torsemide in Patients With Heart Failure: An Updated Systematic Review and Meta-Analysis.

Despite potential advantages of torsemide over furosemide, <10% of the patients with heart failure (HF) are on torsemide in clinical practice. Prior studies comparing furosemide to torsemide in patients with HF have shown conflicting findings, regarding hospitalizations and mortality. We aimed to pool all the studies conducted to date and provide the most updated and comprehensive evidence, regarding the effect of furosemide vs torsemide in reducing mortality and hospitalizations in patients with HF.

Primary retroperitoneal teratoma in a young woman: a case report.

Teratomas are usually seen in gonads but they do occur in other extra gonadal regions such as sacrococcygeal region, mediastinum, head and neck, and retroperitoneum. Rarely in the retroperitoneal area, such tumours mostly develop in the pararenal area and usually on the left side. They have bimodal presentation at the age of six months and then in early adulthood.