Gynecomastia Surgery: Liposuction Alone versus Liposuction with Endoscope-Assisted Glandular Excision-A Comparative Study.

Background: Gynecomastia, affecting around 30% of young males, has seen evolving surgical treatments, transitioning from traditional excision methods to contemporary techniques like liposuction. Emotional distress persists when glandular tissue is inadequately addressed, prompting exploration of combined liposuction and glandular excision procedures.

Materials And Methods: Patients undergoing gynecomastia surgery over a period of 2 years were assessed, considering their demographics, medical history, and gynecomastia grade.

Introducing "Delta Angle" of Posterior Tibial Slope and Its Impact on ACL Reconstruction Failures: A Regression Analysis of 1174 Patients.

Background: Anterior cruciate ligament reconstruction (ACLR) failures are linked to various risk factors, including an increased posterior tibial slope (PTS). Recent studies have indicated that both the medial PTS (MPTS) and lateral PTS (LPTS) contribute to ACLR outcomes, but the clinical importance of their difference-delta angle-has not been previously explored.

Hypothesis: The delta angle, or the difference between the lateral and medial PTSs, is a more significant predictor of ACLR rerupture than either slope considered individually.

Content oriented 3D-CNN sequence learning architecture for academic activities recognition using a realistic CAD dataset.

In computer vision, video analytic researchers have been developing techniques for human activity recognition in several application domains. Academic institutions are in possession of rich video repository generated by the surveillance system in respective campuses. One major requirement is to develop lightweight adaptable models capable of recognizing academic activities, enabling effective decision making in various application domains.

Fatty Liver Disease in the Diabetic Population: A Cross-Sectional Study From Pakistan.

Introduction Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disorder, particularly among patients with type 2 diabetes mellitus (T2DM). The association between NAFLD and diabetes is bidirectional, with NAFLD increasing the risk of diabetes and vice versa. Therefore, this study aimed to determine the prevalence of NAFLD in diabetic individuals and evaluate the impact of metabolic and cardiovascular factors, along with the role of anti-diabetic medications in NAFLD progression.

Frequency of Gallstones in Patients With Non-alcoholic Fatty Liver Disease.

Introduction Non-alcoholic fatty liver disease (NAFLD) is a metabolically related liver disease that is becoming increasingly prevalent globally, due to rising obesity, diabetes, and sedentary lifestyles. Concurrently, gallstone disease is a prevalent biliary disease and shares similar risk factors to NAFLD, such as dyslipidemia, insulin resistance, and obesity. In Pakistan, due to a paradigm shift toward urbanization and sedentary lifestyles in recent times, the data are scarce regarding the coexistence of gallstones in the NAFLD population.

Impact assessment of Benazir Nashonuma Programme (BNP) on maternal, child health and nutritional status in Pakistan: a quasi-experimental study protocol.

Introduction: Maternal and child malnutrition is a significant public health concern in Pakistan, with 40% of children under five being stunted. In response, the Government of Pakistan initiated the Benazir Nashonuma Programme (BNP), a nutritional supplementation programme for pregnant women, mothers of children aged 0 to 23 months and children aged 6 to 24 months. This study aims to evaluate the effectiveness of the BNP in reducing childhood stunting and improving maternal and child health outcomes.

Assessment prior to liver tumor resection: what a radiologist needs to know.

Liver tumor resection remains the mainstay of treatment for patients with primary and secondary hepatic malignancies and can potentially be a curative option. With advances in surgical techniques, systemic therapies, and perioperative management, resectability criteria have expanded over time yet operative planning must still be carefully weighed between oncologic benefit and surgical risks along with residual liver function. While tumor detection is critical, radiologists also have an essential role in assessing tumor resectability, evaluating background liver disease, identifying surgically relevant vascular and biliary anatomy, and estimating future liver remnant adequacy.

Helicobacter pylori as a Cause of Dyspepsia in Patients With End-Stage Renal Disease.

Introduction Dyspepsia is a frequent complaint in patients with end-stage renal disease (ESRD). () is a well-established etiological factor for dyspepsia in the general population; however, its role in ESRD patients remains to be determined. Therefore, this study aimed to determine the frequency of infection among ESRD patients presenting with dyspeptic symptoms.

The recovery trajectory of people undergoing treatment for knee articular cartilage damage: A systematic review and meta-analysis.

Background: Knowledge of recovery trajectories helps interpret studies, manage patient expectations and plan future trials. The purpose of this review was to summarise the recovery trajectory of participants undergoing the main treatments of full-thickness knee articular cartilage defects: microfracture, scaffold-based repair, cell expansion therapy or non-operative treatment.

Methods: The search included Medline, Embase, Web of Science and the Cochrane Central Register of Controlled trials until April 2024.

A cross-sectional analysis of the impact of lady health worker visits in the prenatal and postnatal period on the uptake of continuum of care interventions and childhood mortality in Pakistan.

Background: Community health workers are crucial in bridging the gap between health care facilities and the general population. In Pakistan, the lady health worker (LHW) program was launched in 1994 to enhance access to essential health care services. However, the overall quality of care provided by LHWs and its impact on population-level coverage of key maternal, newborn, and child health (MNCH) interventions and mortality remain insufficiently understood.

Comparison of Different Non-invasive Indices in Predicting High-Risk Esophageal Varices in a Pakistani Population.

Introduction Esophageal varices (EV) generally develop as a complication of portal hypertension, whereas high-risk esophageal varices (HRV) are associated with significant morbidity and mortality. Although endoscopic surveillance is widely recommended in recent guidelines, its invasiveness and cost are important concerns, particularly in resource-poor countries such as Pakistan. The aim of this study was to compare the diagnostic performance of the PMS index ((platelet count (×10/L)) / (monocyte fraction (%) × segmented neutrophil fraction (%)), the EVendo score, the international normalized ratio (INR) to platelet ratio (INPR), and splenic stiffness for predicting HRV in a Pakistani population.

A Phase I Trial to Determine the Safety and Tolerability of Autophagy Inhibition Using Chloroquine or Hydroxychloroquine in Combination with Carboplatin and Gemcitabine in Patients with Advanced Solid Tumorsced solid tumors.

Background: Autophagy is a catabolic process triggered in cells during periods of metabolic or hypoxic stress to enable their survival that may also impart advantages to tumors. Inhibition of early stage autophagy can rescue cancer cells, while inhibition of late stage autophagy leads to cell death due to accumulation of damaged organelles.  Chloroquine (CQ) and hydroxychloroquine (HCQ) inhibit late phase autophagy.

Identification and quantification of muscular cocontraction for ankle rehabilitation through variational mode decomposition in surface electromyography.

The ankle joint plays important role in performing fundamental activities such as walking and other essential daily tasks. Ankle stabilization and muscle co-contraction are crucial for rehabilitating gait abnormalities, as impaired ankle function disrupts gait, causes pain and inflammation, and hampers recovery. Accurate assessment of muscle co-contraction is crucial for developing effective non-pharmacological interventions.

Social sector drivers and stunting reduction in Pakistan: A subnational analysis.

Background: Poor nutrition remains a problem in Pakistan, and despite economic growth, stunting reduction is slow with subnational variations. Generally, stunting prevalence is lower in Khyber Pakhtunkhwa (KP) and Northern Punjab than in Sindh and Balochistan.

Objectives: Our study aimed to identify and explore key drivers and barriers underlying subnational changes in stunting between 2011 and 2018.

Outcome and management of children with chest indrawing pneumonia at primary health care settings in Pakistan: an observational cohort study.

Background: Pneumonia is a major cause of childhood mortality in Pakistan. In 2019, the Government of Pakistan revised the national Integrated Management of Childhood Illness (IMCI) chart booklet, following the World Health Organization's recommendation for outpatient management with oral antibiotics of children aged 2-59 months with chest indrawing pneumonia. We aimed to assess the outcomes of children aged 2-59 months with chest indrawing pneumonia in programme setting of Pakistan.

The recovery trajectory of anterior cruciate ligament ruptures in randomised controlled trials: A systematic review and meta-analysis of operative and nonoperative treatments.

Purpose: The purpose of this research was to understand the trajectory of recovery following anterior cruciate ligament (ACL) reconstruction compared to nonoperative treatments.

Methods: A systematic review and meta-analysis approach was used to evaluate randomised controlled trials (RCTs). A comprehensive search was conducted on databases including Medline, Embase, Web of Science and The Cochrane Central Register of Controlled Trials up until 18 May 2023.

Imaging the Female Urethra: US and MRI in Cystic and Solid Pathologic Conditions.

The female urethra can be affected by numerous pathologic conditions, many of which are infrequent and often underdiagnosed, particularly before the introduction of MRI. Diagnosing urethral pathologic conditions is challenging due to ambiguous signs and symptoms, nonspecific physical examinations, atypical presentations (such as benign conditions mimicking malignant disorders), and large lesions. Various imaging techniques, including transperineal or transvaginal US and MRI, are essential for accurate anatomic and tissue characterization.

Gaussian process latent variable models-ANN based method for automatic features selection and dimensionality reduction for control of EMG-driven systems.

Electromyography (EMG) signals have gained significant attention due to their potential applications in prosthetics, rehabilitation, and human-computer interfaces. However, the dimensionality of EMG signal features poses challenges in achieving accurate classification and reducing computational complexity. To overcome such issues, this paper proposes a novel approach that integrates feature reduction techniques with an artificial neural network (ANN) classifier to enhance the accuracy of high-dimensional EMG classification.

The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries.

Background: Understanding the effects of balanced energy and protein (BEP) supplements on gestational weight gain (GWG) and how the effects differ depending on maternal characteristics and the nutritional composition of the supplements will inform the implementation of prenatal BEP interventions.

Methods And Findings: Individual participant data from 11 randomized controlled trials of prenatal BEP supplements (N = 12,549, with 5,693 in the BEP arm and 6,856 in the comparison arm) in low- and middle-income countries were used. The primary outcomes included GWG adequacy (%) and the estimated total GWG at delivery as continuous outcomes, and severely inadequate (<70% adequacy), inadequate GWG (<90% adequacy), and excessive GWG (>125% adequacy) as binary outcomes; all variables were calculated based on the Institute of Medicine recommendations.

Diagnostic Performance of Shear-Wave Elastography in Autoimmune Hepatitis: Evaluating Baseline Characteristics and Accuracy Across Fibrosis Stages.

Background Autoimmune hepatitis (AIH) is a chronic inflammatory condition affecting the liver, ultimately leading to fibrosis, followed by cirrhosis and liver failure. Although liver biopsy is necessary to confirm the disease and outline different stages of liver fibrosis, it is associated with several risks due to its invasiveness. Shear-wave elastography (SWE) has recently emerged as a non-invasive imaging modality, representing liver stiffness and providing additional fibrosis assessment.

Helicobacter pylori Infection as a Cause of Dyspepsia in the Pakistani Population: An Experience From a Large Tertiary Care Center.

Background Dyspepsia is one of the most common worldwide gastrointestinal disorders, more prevalent in developing countries like Pakistan. One of the most common causes of dyspepsia is . Therefore, this study aimed to determine the frequency of infection among dyspeptic patients presenting to a tertiary care hospital in Karachi, Pakistan.

Early life adverse environmental, nutrition and infection factors are associated with lower developmental scores in Pakistani children at 5 years: a cohort study.

Background: The effects of multiple early adverse psychosocial and biological factors on child development at preschool age in deprived settings are not fully understood.

Methods: The 'Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development' (MAL-ED) project followed children from eight countries, recording sociodemographic, nutritional, illness, enteroinfection biomarkers and scores for quality of home environment (Home Observation for Measurement of the Environment (HOME)), development (Bayley) and maternal depression during the first year of life. In the Pakistan cohort, we investigated associations of these early factors with Z-scores (derived from the eight participating countries) of three developmental outcomes at 5 years: Executive Functions (Z-EF), the Wechsler Preschool and Primary Scale for Intelligence (Z-WPPSI) and the externalising behaviours component of the Strength and Difficulties test (Z-externalising behaviours).

Frequency of viral etiology in community-acquired pneumonia.

The identification of etiology is very important when managing patients with community-acquired pneumonia (CAP). In Pakistan, studies regarding the viral etiology in CAP are scarce. The main objective of this study was to evaluate the frequency of viral etiology in CAP patients and analyze the clinical features and their impact on prognosis.

'Obviously, because it's a tear it won't necessarily mend itself': a qualitative study of patient experiences and expectations of treatment for a meniscal tear.

Objectives: There is a paucity of qualitative research exploring the patient experience of living with a meniscal tear, vital to effective patient management. The aim of this study was to explore the experiences and expectations of treatment of patients aged 18-55 years with a meniscal tear of the knee.

Design: Qualitative study involving semistructured interviews.