Propranolol as a Novel Therapeutic Approach for Post-Stroke Anxiety: A Clinical Review and Future Directions.

Stroke remains a leading cause of death globally, with survivors facing both physical and psychological challenges. While acute stroke treatment has improved, many patients develop post-stroke anxiety (PSA), particularly generalized anxiety disorder. PSA represents a significant clinical challenge as most stroke survivors suffer from it.

Role of Artificial Intelligence in MRI-Based Rectal Cancer Staging: A Systematic Review.

Several studies explored the application of artificial intelligence (AI) in magnetic resonance imaging (MRI)-based rectal cancer (RC) staging, but a comprehensive evaluation remains lacking. This systematic review aims to review the performance of AI models in MRI-based RC staging. PubMed and Embase were searched from the inception of the database till October 2024 without any language and year restrictions.

Prevalence and Mitigation of Cardiovascular Disease Risk Factors Among the Corporate Workforce in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Cardiovascular disease (CVDs) is the leading cause of mortality worldwide. Corporate workplaces have been identified as important environmental factors that can increase the risk and severity of CVDs. Evidence indicates that the risk and severity of CVDs can be effectively reduced by mitigating modifiable behavioural and intermediate risk factors.

A Systematic Review and Meta-Analysis of Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitors and Their Impact on the Management of Heart Failure.

Heart failure (HF) is a life-threatening condition with severe incapacitating consequences. Many body organs and systems may be affected, which may also hinder the quality of life and finances at the individual and societal levels. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have also emerged as potentially useful drugs in the HF domain and other medical fields, in addition to their glucose-lowering effect.

Environmental impact of commonly used anaesthetic agents: systematic literature review with narrative synthesis.

Background: Increasing awareness of the potential environmental impact of volatile anaesthetic agents has stimulated increased use of total i.v. anaesthesia.

Integration of a specialist pharmacist-led multidisciplinary team in primary care: preventing strokes in people with atrial fibrillation across North East London.

Public Health England outlines a national ambition of anticoagulating 90% of eligible patients with atrial fibrillation (AF) by 2029. In 2019/2020, two out of three boroughs reviewed in this study were in the bottom 10% of boroughs compared with others within England. Stroke National Audit data for these three boroughs from 2019 to 2020 identified that in patients with known AF admitted to hospital with strokes, 37% were not anticoagulated.

Clinical Epidemiology, Etiology, and Outcomes of Upper Gastrointestinal Bleeding at a Tertiary Center in Bahrain: A Retrospective Study.

Background Upper gastrointestinal bleeding (UGIB) is one of the most common major medical emergencies. This study sought to determine the epidemiology, clinical characteristics, and outcomes of UGIB in the largest major tertiary care center in Bahrain, compared to regional and international cohorts. Methods We conducted a retrospective cohort study of all patients diagnosed with UGIB between April 2021 and April 2022 in Salmaniya Medical Complex, Bahrain's largest tertiary-level public hospital.

Small bowel lymphangioma: a multidisciplinary approach to diagnostic uncertainty.

Intra-abdominal lymphangioma, a rare benign lymphatic malformation resulting from an obstruction to lymphatic channels, often has non-specific clinical manifestations. Low incidence rates of this condition, paired with its unusual presentation and ambiguous radiological appearance, commonly lead to diagnostic uncertainty. This pathology can result in significant morbidity and mortality, emphasising the need to achieve early diagnosis and management despite these challenges.

PANORAMA: A 2021 Clinician Survey of Treatment Approaches for People With New Diagnoses of Relapsing-Remitting Multiple Sclerosis in the United Kingdom.

Background: The PANORAMA survey aimed to assess current treatment practice for individuals with new diagnoses of relapsing-remitting multiple sclerosis (RRMS) in the United Kingdom and to explore variations in treatment approaches with an emphasis on escalation vs early high-efficacy treatment (HET) and treatment goals.

Methods: Health care professionals (HCPs) from the UK treating patients with RRMS took part in interviews facilitated by a structured questionnaire. Data were analyzed descriptively using quantitative or qualitative methods, as appropriate.

Using the hospital frailty risk score to assess oesophago-gastric cancer patient outcomes: a retrospective cohort study.

Background: The inclusion of clinical frailty in the assessment of patients planned for major surgery has proven to be an independent predictor of outcome. Since approximately half of all patients in the UK diagnosed with oesophagogastric (OG) cancer are over 75 years of age, assessment of frailty may be important in selection for surgery.

Materials And Methods: This retrospective cohort study applied the Hospital Frailty Risk Score to data obtained from the NHS Secondary Uses Service electronic database for patients aged 75 years or older undergoing oesophagectomy and gastrectomy between April 2017 and March 2020.

Guide Extension-Facilitated Ostial Stenting (GEST) During Primary Coronary Angioplasty in a Patient With ST-Segment Elevation Myocardial Infarction: A Case Report.

The guide extension-facilitated ostial stenting (GEST) technique uses a guide extension catheter (GEC) to improve stent delivery during primary coronary angioplasty (PCI). GECs are used for stent delivery into the coronary arteries of patients with difficult anatomy due to tortuosity, calcification, or chronic total occlusion (CTO) vessels. Stent and balloon placement has become challenging in patients with increasing lesion complexity due to tortuosity, vessel morphology, length of the lesion, and respiratory movements.

A Case of Lumbosacral Radiculoplexus Neuropathy: A Rare Complication of Diabetes Mellitus.

Diabetic lumbosacral radiculoplexus neuropathy, also known as diabetic lumbosacral plexopathy or diabetic amyotrophy, is a rare complication of diabetes mellitus. Due to its varied clinical presentation and wide differential, it may pose a diagnostic quandary in assessing patients with proximal asymmetrical lower limb weakness. We present the case of a 74-year-old female patient with a recent onset of falls and aim to discuss the aetiology, differentials, and treatment modalities in diabetic plexopathy.

The Prevalence of Cardiovascular Risk Factors in Patients With Diabetes Mellitus in Yemen: A Systematic Review and Meta-Analysis.

Cardiovascular disease (CVD) is a major global health challenge, and its co-occurrence with diabetes mellitus (DM) contributes significantly to morbidity and mortality. Yemen, a nation facing unique healthcare complexities, necessitates an in-depth investigation into the prevalence of cardiovascular risk (CVR) factors among its population with DM. This systematic review and meta-analysis aimed to determine the prevalence of CVR factors among individuals with diabetes in Yemen, to understand and highlight the knowledge gap, and to influence targeted interventions and policies.

The Association Between Isometric Shoulder Strength and Sports Performances in University Soccer Players: A Cross-Sectional Study.

Background Soccer, a globally popular sport, demands a complex interplay between physical attributes, including speed, agility, power, and endurance. Although lower-body strength and power are often emphasized, the role of upper-body strength, particularly shoulder strength, remains less explored. Given the importance of upper-body movements in activities such as heading, shooting, and defending, understanding the relationship between shoulder strength and soccer performance is crucial.

Outcomes and Adverse Effects of Transcatheter Aortic Valve Replacement (TAVR) in Cancer Patients: A Meta-Analysis.

Aortic valve disease and cancer are significant causes of mortality, especially in older populations. This meta-analysis addresses a critical question in the management of patients with both aortic valve disease and cancer. As these two conditions are major contributors to mortality, determining the best course of treatment can be complex.

CBCT (Cone-Beam CT)-Based Online Adaptive Radiotherapy in the Post-operative Oesophageal Cancer Patient.

We present a case of a patient having cone-beam CT (CBCT)-based online adaptive radiotherapy (oART) on Ethos Therapy after oesophagectomy and gastric pull-up. This case report aims to demonstrate that daily oART is a viable treatment option for post-oesophagectomy patients. The patient's radiotherapy plan was generated on the Ethos system using an eight-field intensity-modulated radiation therapy (IMRT) plan imported from the Eclipse planning system.

Protocol club: a social learning framework for the research delivery workforce.

Background: 'Protocol club' is a learning activity underpinned by social learning theory that is designed 'by the research delivery workforce, for the research delivery workforce'. A protocol club meets regularly to critique the feasibility and deliverability of publicly available study protocols.

Aim: To describe a proof-of-concept protocol club aimed at addressing the training needs of a research delivery workforce at two NHS England trusts.

Assessment of Respiratory Health Implications of Vaping: A Systematic Review of Toxicity Mechanisms and Adverse Effects of Electronic Nicotine Delivery Systems.

E-cigarettes are thought to aid in tobacco smoking cessation, but there are concerns about their overall effectiveness and safety for the general population, particularly adults. This review aims to investigate the mechanisms of toxicity and adverse effects of e-cigarettes on the respiratory system, comparing these effects with those of conventional smoking. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

International expert consensus statement on physiological interpretation of cardiotocograph (CTG): First revision (2024).

The first international consensus guideline on physiological interpretation of cardiotocograph (CTG) produced by 44 CTG experts from 14 countries was published in 2018. This guideline ensured a paradigm shift from classifying CTG by arbitrarily grouping certain features of the fetal heart rate into different "categories", and then, randomly combining them to arrive at an overall classification of CTG traces into "Normal, Suspicious and Pathological" (or Category I, II and III) to a classification which is based on the understanding of fetal pathophysiology. The guideline recommended the recognition of different types of fetal hypoxia, and the determination of features of fetal compensatory responses as well as decompensation to ongoing hypoxic stress on the CTG trace.

Evaluating the effectiveness of simvastatin in slowing the progression of disability in secondary progressive multiple sclerosis (MS-STAT2): protocol for a multicentre, randomised controlled, double-blind, phase 3 clinical trial in the UK.

Introduction: There remains a high unmet need for disease-modifying therapies that can impact disability progression in secondary progressive multiple sclerosis (SPMS). Following positive results of the phase 2 MS-STAT study, the MS-STAT2 phase 3 trial will evaluate the efficacy and cost-effectiveness of repurposed high-dose simvastatin in slowing the progression of disability in SPMS.

Methods And Analysis: MS-STAT2 will be a multicentre, randomised, placebo-controlled, double-blind trial of participants aged between 25 and 65 (inclusive) who have SPMS with an Expanded Disability Status Scale (EDSS) score of 4.