Trends and Disparities in Mortality Due to Gastric Malignancies the United States: A Nationwide Analysis from 1999 to 2020.

Purpose: Gastric malignancies remain a significant public health concern and a major contributor to cancer-related mortality worldwide. This study aimed to analyze trends and disparities in gastric malignancy mortality across socio-demographic and regional factors in the United States (US) from 1999 to 2020.

Methods: A retrospective analysis was conducted using CDC WONDER data from 1999 to 2020 for adults aged ≥ 25 years.

Effect of dexamethasone and lidocaine combination on incidence of post-operative sore throat: A meta-analysis and trial sequential analysis.

Background: Postoperative sore throat (POST) is a common complication after endotracheal intubation, occurring in 30-50 % of patients. While lidocaine (local anesthetic) and dexamethasone (anti-inflammatory) are used individually to prevent POST, their combined efficacy remains unclear. This meta-analysis synthesizes evidence from randomized controlled trials to determine whether Intravenous dexamethasone-lidocaine combination is more effective than dexamethasone alone in reducing POST incidence.

Radiation-Induced Cardiac Disease: Dilemma of Transcatheter Aortic Valve Replacement vs Surgical Aortic Valve Replacement and Pericardiectomy.

Background: Radiation-induced cardiovascular disease, a complication of mediastinal radiation, often results in valvular and pericardial disease. Management is challenging, especially in high-risk patients.

Case Summary: A 59-year-old man with a history of total body radiation presented with fatigue and dyspnea.

Comparative Efficacy and Safety of Colchicine and Anti-Interleukin-1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials.

Background: The management of recurrent pericarditis includes colchicine and anti-interleukin-1 agents, given the limited efficacy and adverse effects of NSAIDs and corticosteroids. We conducted a pairwise and network meta-analysis to evaluate the efficacy and safety of colchicine and anti-interleukin-1 agents in recurrent pericarditis.

Methods: We conducted a comprehensive search on various databases to retrieve relevant randomized controlled trials.

Efficacy and Safety of Clopidogrel Versus Aspirin Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Dual antiplatelet therapy is a standard treatment after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS), but the optimal monotherapy agent post-dual antiplatelet therapy remains unclear. Clopidogrel and aspirin are widely used, yet their comparative effectiveness and safety in this patient population have not been fully established. This systematic review and meta-analysis compared the efficacy and safety of clopidogrel and aspirin monotherapy following PCI in patients with ACS.

Anesthetic Management of a Patient With an Incidental Vallecular Cyst: A Case Report.

Vallecular cysts are rare, benign lesions of the epiglottis and adjacent structures, often asymptomatic but with the potential to cause airway obstruction during anesthesia. We report the case of a 50-year-old female undergoing elective laparoscopic hysterectomy, during which an incidental vallecular cyst was identified during intubation. This case highlights the challenges in airway management and the need for meticulous planning to ensure patient safety.

Running into trouble: exercise-exacerbated recurrent pericarditis-a case report.

Background: Recurrent pericarditis is an inflammatory condition characterized by symptom recurrence after an initial episode. Exercise-induced flares are underrecognized.

Case Summary: A 53-year-old male presented with recurrent pericarditis, initially diagnosed in June 2020 and inadequately treated with a three-month colchicine course.

Temporal Trends in Mortality Location Among Patients With Intrahepatic Cholangiocarcinoma in the USA: A Retrospective Observational Analysis of National Center for Health Statistics Mortality Data.

Objectives: Intrahepatic cholangiocarcinoma (ICC) is a malignancy with rising incidence and mortality in the United States. This study aimed to investigate temporal trends in the place of death among patients with ICC and assess demographic disparities.

Methods: We used the CDC WONDER database (2003-2020) for a retrospective study of patients who died from intrahepatic cholangiocarcinoma identified through death certificates.

Shifting US location patterns in leukaemia mortality: retrospective analysis.

Objectives: Leukaemia is a haematological malignancy with high mortality, yet end-of-life care patterns remain underexplored. This study analysed trends in the place of death among leukaemia decedents and assessed demographic disparities in end-of-life care.

Methods: A retrospective observational study was conducted using the Centres for Disease Control and Prevention's WONDER and National Center for Health Statistics mortality databases (2008-2020).

Anesthetic Challenges of Labor and Delivery in a Patient With Catecholaminergic Polymorphic Ventricular Tachycardia and Left Ventricular Non-Compaction Cardiomyopathy.

Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) and Left Ventricular Non-Compaction Cardiomyopathy (LVNC) are inherited disorders that pose significant challenges in the obstetric population due to the potential exacerbation of ventricular arrhythmias and potentially lethal cardiac compromise during pregnancy and labor. This case report aims to provide insights into the anesthetic management of CPVT and LVNC in obstetric patients. Goals of management should include careful optimization of anesthesia and analgesia, particularly during the birthing process.

Bronchial blocker placement for massive hemoptysis.

Massive hemoptysis is a life-threatening pathology requiring emergent intervention to prevent airway obstruction and hypovolemic shock. Intubation followed by lung isolation should be urgently performed. We elected to place Fuji Uniblocker (Fuji Systems Corporation, Tokyo, Japan) through an endotracheal tube to isolate a hemorrhage secondary to a cavitary lung lesion caused by a large pulmonary embolus.

Costoclavicular block for distal radius open reduction and internal fixation.

Interscalene and supraclavicular brachial plexus nerve blocks are routinely used for upper extremity surgeries, although they carry the risk of phrenic nerve involvement, which can lead to diaphragmatic paralysis. The costoclavicular block is a newer block that may mitigate the risk of this complication while providing similar coverage. Our case involves a patient who presented with a displaced distal radius fracture.

Vitamin B12 (hydroxocobalamin) administration in the management of persistent vasoplegic shock.

Vasoplegia, characterized by low systemic vascular resistance despite normal to high cardiac output, can result from various conditions, including cardiac surgery, and progress to vasoplegic shock if untreated. This case study involves a male in his 70s with multiple risk factors, including a left ventricular ejection fraction of 35%, who developed vasoplegia after taking lisinopril on the day of his elective coronary artery bypass graft (CABG) surgery. Despite initial management with vasopressors, the patient's condition necessitated postponing the CABG.

Vastus lateralis nerve block for knee hardware removal.

Effective pain management post-knee surgery is critical for recovery and minimizing opioid use. We present a case of a patient undergoing ORIF for a comminuted patellar fracture and subsequent hardware removal because of persistent medial knee pain from hardware prominence. Despite initial opioid administration under general anesthesia, severe postoperative pain necessitated rescue with peripheral nerve blocks.

Efficacy and safety of laquinimod versus placebo in relapsing-remitting multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.

Objective: To investigate the safety and efficacy of laquinimod in treating relapsing-remitting multiple sclerosis (RRMS).

Methods: An extensive electronic search was conducted across PubMed, Embase, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov to identify suitable studies.

Surgical Management of Ischemic Heart Disease Patients With Left Ventricular Dysfunction in Lower-Middle-Income Countries: Our Strategies and Experience at the Medical Teaching Institute-Hayatabad Medical Complex (MTI-HMC) Peshawar, Pakistan.

Introduction and objectives Severe left ventricular dysfunction (LVD) in coronary artery disease (CAD) is linked to high risks and limited outcomes. Coronary artery bypass grafting (CABG) remains a key surgical intervention for these patients. This study aimed to assess hospital and short-term outcomes in patients with severe LVD undergoing isolated CABG and identify predictors of adverse outcomes.

Outcomes of Coronary Artery Bypass Grafting in Patients With Impaired Left Ventricular Function and the Role of Preoperative Myocardial Viability.

Background Coronary artery bypass grafting (CABG) improves outcomes in patients with ischemic left ventricular (LV) dysfunction, but accurate patient selection remains critical. Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging aids in assessing myocardial viability, a key predictor of surgical outcomes. This study aimed to evaluate the impact of myocardial viability on postoperative outcomes in patients undergoing CABG.

Establishing Minimally Invasive Cardiac Surgery in a Developing Country: A Five-Year Experience at Hayatabad Medical Complex, Pakistan.

Background The adoption of minimally invasive cardiac surgery (MICS) has increased over the past 25 to 30 years, driven by advancements in technology and a growing understanding of its benefits. This study evaluates the outcomes of 144 elective MICS procedures performed between January 2019 and September 2024. Methods Patients underwent various surgical approaches, including upper mini-sternotomy, mini-thoracotomy, and sub-xiphoid access.

Short-Term Surgical Outcomes and Definitive Diagnosis in Patients With Congenital Cardiac Defects: A Single-Center Analysis.

Background With the rising number of children with congenital heart disease (CHD) reaching adulthood, surgical intervention has become a critical aspect of their long-term management. This study presents a six-year overview of early postoperative outcomes and mortality in CHD surgeries at a single center, underscoring advancements and challenges in treating this complex population. Objective As more children with CHD grow into adulthood, we are gaining critical insights from our extensive experience in performing cardiac surgery for this population.

Intraoperative Hemodynamic Instability in a Patient With Ebstein's Anomaly Complicated With Eisenmenger Syndrome.

Ebstein's anomaly is a rare congenital displacement of the tricuspid valve resulting in atrialization of the right ventricle. About half of the patients with Ebstein's anomaly also have atrial septal defects, which may lead to chronic shunting and development of Eisenmenger syndrome. We describe a case of a sexagenarian male patient with a history of Ebstein's anomaly complicated with Eisenmenger syndrome undergoing robotic laparoscopic adrenalectomy who presented hemodynamic instability, hypoxemia, and likely right-to-left shunting intraoperatively, as well as the actions taken to correct it and have a successful outcome.

Aortic Root Pathologies and Surgical Management: Insights From a Single Surgeon's Experience.

Introduction and objectives The Bentall procedure is a surgical technique designed to address aortic root abnormalities, including issues with the aortic valve, aortic root, and ascending aortic disease. This study aimed to assess the short-term outcomes of 39 patients who underwent the Bentall and concomitant procedures: aortic root enlargement, personalized external aortic root support (PEARS), and Mini-Bentall procedures at a single center. Methodology We conducted a retrospective study involving 39 patients who underwent surgery for aortic root pathologies such as dissection, Marfan syndrome (MFS), bicuspid aortic valve, degenerative disease, and atherosclerosis at our hospital between January 2019 and September 2024.

Vagal nerve stimulation for the management of long COVID symptoms.

This review investigates the therapeutic potential of vagal nerve stimulation (VNS) in managing long COVID, a condition marked by persistent symptoms following acute SARS-CoV-2 infection. Long COVID manifests as ongoing fatigue, cognitive impairment, and autonomic dysfunction, hypothesized to arise from sustained inflammatory and neurological dysregulation. The vagus nerve, central to modulating systemic inflammation and autonomic homeostasis, represents a promising therapeutic target for symptom alleviation through VNS.

Comparison of the Outcomes of Aortic Valve Replacements (AVRs) Performed via Conventional Full Sternotomy and Upper Mini Sternotomy: Our Experience at Hayatabad Medical Complex, Pakistan.

Introduction Aortic valve replacement (AVR) for severe symptomatic aortic stenosis is a commonly performed procedure, yielding excellent long-term outcomes. Comparing a mini sternotomy with a conventional sternotomy is essential to evaluate less invasive options that can improve patient recovery and reduce postoperative complications. This insight supports surgical decision-making for better AVR patient outcomes.