Transfusion-associated graft-versus-host disease in an immunocompetent individual.

Transfusion-associated graft-versus-host disease (TA-GVHD) is a fatal complication that occurs in both immunocompromised and immunocompetent individuals following blood transfusion. It is characterised by donor lymphocyte attacks on recipient tissues. We present a case of TA-GVHD in an immunocompetent man in his 70s who developed fever, diarrhoea, rash and pancytopenia after non-irradiated blood transfusion from an unrelated donor.

Effect of probiotic toothpaste and regular toothpaste on gingival health and plaque levels of adult orthodontic patients - An open label randomized controlled trial.

Introduction: Probiotics are living micro-organisms that are likely to influence oral health by modulating the oral microbiota and offer a promising preventive approach to gum and dental disease. This approach is particularly relevant for orthodontic patients, who are more susceptible to gingival inflammation and plaque accumulation. The aim of this randomized controlled study was to compare the effects of a probiotic toothpaste versus a regular toothpaste on gingival health and plaque levels in orthodontic patients.

Blended learning: An innovative teaching strategy to teach dermatology to the family medicine residents of a teaching hospital.

Context: Medical educators face different challenges in this digital era with the pressure for clinical practice as well as teaching. In blended learning Internet technologies are used along with face-to-face teaching to deliver learning methodologies.

Objective: To assess the efficacy of the blended learning dermatology course on Family Medicine residents at a teaching hospital.

Optimal Strategies for Screening Common Birth Defects in Children of Low- and Middle-Income Countries: A Systematic Review.

Introduction: Congenital anomalies are one of the major causes of the global burden of diseases, and low- and middle-income countries (LMICs) are disproportionately affected. This review assesses the prenatal and postnatal screening methods and compares the prevalence of major congenital anomalies in LMICs.

Methodology: We conducted a systematic search in MEDLINE/PubMed, CINAHL, Cochrane databases of systematic reviews, clinical trials.

Bayesian Model Projecting Cardiovascular Disease Related Mortality Trends in the United States.

Background: As future cardiovascular disease mortality trends have public health implications, we aimed to project ischemic heart disease (IHD), cerebrovascular disease (CeVD), and heart failure (HF) mortality rates for adults (40-79 years).

Methods And Results: In this population-level study, we linked the yearly mortality rates (per 100 000 US residents) (2000-2019) with IHD, CeVD, or HF as the primary cause of death from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research with the midyear US population estimates (2000-2035) for adults (40-79 years). We calculated the observed age-standardized mortality rates (2000-2019) (per 100 000 residents) (aSMR) and fitted Bayesian age-period-cohort models to project aSMR for IHD, CeVD, and HF up to 2035 in the United States.

Impact of a Medication Reconciliation Improvement Package on Adherence to Medication Reconciliation Among Internal Medicine Physicians: A Quality Improvement Project in a Lower-Middle Income Country.

Medication reconciliation is one of the best measures to prevent medication-related errors at the time of admission and discharge of patients. We conducted a quasi-experimental study to evaluate the impact of a Medication reconciliation improvement package (intervention) on adherence to medication reconciliation at the time of admission in Department of Internal Medicine. The study included all adult patients admitted to internal medicine from August 2019 to December 2020.

The Boston Declaration 2025: Plan and Pledges for Progress in Global Neurosurgery.

Global Neurosurgery has been described as the clinical and public health practice of neurosurgery with the primary purpose of ensuring timely, safe, and affordable neurosurgical care to all who need it. Global Neurosurgery activities in the form of mission trips, educational partnerships, and research collaborations have been in place for decades. Still, there have been no central organizing efforts to improve the harmonization of these endeavors until recently.

A scoping review of substance use brief interventions in Africa.

Background: The burden of substance use in Africa is substantial. Brief interventions (BIs) are a recommended public health strategy for the prevention and early intervention for substance use problems. The objective of this scoping review was to map the literature on substance use BIs in Africa, identify gaps, and provide directions for future research.

The association between county-level premature cardiovascular mortality related to cardio-kidney-metabolic disease and the social determinants of health in the US.

Cardio-kidney-metabolic (CKM) syndrome is defined by the American Heart Association as the intersection between metabolic, renal and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality and recent trends in the US is essential for developing targeted public interventions. We collected state-level and county-level CKM-associated age-adjusted premature cardiovascular mortality (aaCVM) (2010-2019) rates from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER).

Health impact of urban green spaces: a systematic review of heat-related morbidity and mortality.

Objectives: The objective of this review was to scrutinise the impact of urban green spaces on heat-related morbidity and mortality.

Design: This systematic review was meticulously carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines DATA SOURCES: A comprehensive search was conducted across PubMed, Scopus and Google Scholar including studies from January 2000 to December 2022.

Eligibility Criteria: Studies that examined the influence of urban green spaces on heat-related morbidity and mortality, including randomised controlled trials, observational and modelling studies, were included.

Predictive Accuracy of Clinicians Estimates of Death and Recovery after Acute Intracerebral Hemorrhage: Pre-Specified Analysis in INTERACT3 Study.

Introduction: Accurately predicting a patient's prognosis is an important component of decision-making in intracerebral hemorrhage (ICH). We aimed to determine clinicians' ability to predict survival, functional recovery, and return to premorbid activities in patients with ICH.

Methods: Pre-specified secondary analysis of the third intensive care bundle with blood pressure reduction in acute cerebral hemorrhage trial (INTERACT3), an international, multicenter, stepped-wedge cluster randomized controlled trial.

Outcomes of first-line treatment and their association with pretreatment neutrophil-to-lymphocyte ratio in patients with advanced renal cell carcinoma: Insights from a tertiary care institute in Pakistan.

Background: Renal cell carcinomas (RCCs) are renal parenchymal neoplasms that contribute to <5% of cancer cases worldwide. Within the diverse group of renal tumours, clear cell carcinoma is the most common subtype. The recommended first-line treatment for metastatic disease is a tyrosine kinase inhibitor given either as monotherapy or in combination with an immune checkpoint inhibitor, based on improved survival outcomes.

Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism: A case report.

Background: With 4.9 to 35 instances per 100000 cases, hyperparathyroidism is one of the rarest causes of acute pancreatitis. The major cause of primary hyperparathyroidism is a parathyroid adenoma, which can manifest clinically in various ways.

Role of nurse informaticists in the implementation of Electronic Health Records (EHRs) at resource-limited settings.

Electronic health records (EHRs) play a critical role in the management of patient information and timely decision making in health facilities. In resource-limited settings, especially low- and middle-income countries (LMICs), nurse informaticists play a pivotal role in the implementation of EHRs. This article underscores their multifaceted responsibilities, emphasising critical contributions in vendor selection, system evaluation, workflow analysis, content development, end-user device assessment, training, and post-implementation stability support.

Development and testing of a videogame intervention for symptom management among 8-18 years old children with cancer: a study protocol.

Introduction: Evidence shows that cancer treatment-related symptoms could be managed effectively in 8-18 years old children through Digital Health Interventions (DHIs), consequently improving their health-related quality of life (HRQOL). However, limited research is available about digitally mediated educative health interventions for children with cancer from lower-middle income countries like Pakistan. This study aims to develop a videogame intervention for children with cancer and test the clinical efficacy of the videogame concerning HRQOL and cancer treatment-related symptoms.

Introduction of Simulation-Based Learning Strategy to Bridge the Theory-Practice Gap in Advanced Concepts in Community Health Nursing Course: Lens from Students' Perspective.

Simulation has proven to be one of the most powerful forms of enactive experience in medical sciences, which enhances the efficacy of both direct and vicarious learning. At the undergraduate level, community health nurses are expected to be inclusively knowledgeable about population-based nursing practices with diverse communities; so, they prepare well to establish partnership skills with stakeholders and make collaborative decisions that promote awareness and understanding of the community's health needs. Problem prioritisation is an essential step of the planning cycle.

Paediatric Early Warning Score to Detect Deterioration in Paediatric Patients at a Tertiary Care Hospital of a Developing Country: A Validation Study.

Objective: To test the validity of the paediatric early warning score (PEWS) and to identify the patients with deteriorating clinical conditions who were reviewed by a rapid response team (RRT) and were advised higher level of care.

Study Design: Observational study. Place and Duration of the Study: Paediatric ward and high dependency unit (HDU) of The Aga Khan University Hospital (AKUH), Karachi, Pakistan, from January 2021 to March 2022.

Detection of Hibernating Myocardium: A Gate Keeper in Decision Making in Patients with Left Ventricular Dysfunction.

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Investigating the use of peri-operative systemic steroid administration in anterior cervical discectomy and fusion (ACDF) - A systematic review.

Objective: The study aims to analyze the utility of peri-operative systemic intravenous (IV) steroids in mitigating postoperative complications and improving clinical outcomes following anterior cervical discectomy and fusion (ACDF) surgery.

Methods: A systematic review was conducted by searching PubMed, Scopus, Cochrane, Web of Science, and Embase databases for studies assessing the role of IV or systemic steroids in ACDF surgery. Data extraction and risk of bias assessment were conducted independently by two reviewers using Covidence, with a third reviewer finalizing the data and settling any conflicts.

Awareness and adoption of climate-resilient practices by smallholder farmers in central and upper Eastern Kenya.

Climate change and soil fertility decline are major hurdles to agricultural ecosystems. Despite the importance of climate-resilient practices (CRPs) in enhancing food security, poverty alleviation and nutritional security, awareness and adoption remain low in most developing countries, including Kenya. We assessed the determinants of simultaneous awareness and adoption of CRPs and their intensity in Central Highlands of Kenya.