Regional and demographic variations in diabetes mellitus and myocardial infarction mortality among US adults: A retrospective observational analysis from 1999 to 2023.

Background: Individuals with diabetes mellitus (DM) are at an increased risk of having myocardial infarction (MI). We aim to identify the trends in the mortality rates from DM and MI among US adults stratified by demographic and geographical parameters.

Methods: The CDC-WONDER database was used to extract death certificate data for adults aged ≥25 years.

Barriers to Renal Transplant in Pakistan.

Background Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD), offering better survival and quality of life compared to dialysis. However, in Pakistan, multiple socio-economic, legal, and healthcare-related barriers limit the accessibility of kidney transplants. The objective of the current study is to evaluate the barriers to kidney transplant among ESRD patients in Pakistan.

Quality of Life Among Attendants/Caregivers of Dialysis Patients.

Aim And Background: Caregivers of dialysis patients often face substantial physical, psychological, and social challenges impacting their quality of life. This study aimed to evaluate caregivers' quality of life across multiple domains using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) assessment tool.

Methods: A hospital-based cross-sectional study was conducted at the Dialysis Center of Services Hospital Lahore from March to August 2024.

10 degree C static storage of porcine donation after circulatory death livers improves biliary viability and mitigates ischemia-reperfusion injury.

Optimized static cold storage has the potential to improve the preservation of organs most vulnerable to ischemia-reperfusion injury. Data from lung transplantation suggest that storage at 10 °C improves mitochondrial preservation and subsequent allograft function compared with conventional storage on ice. Using a porcine model of donation after circulatory death, we compared static storage of livers at 10 °C to ice.

Evaluating Drug-Eluting Balloons Versus Stenting for Provisional Bifurcation Lesions: Short-Term Outcomes and Future Directions.

Background This prospective cohort study aimed to evaluate the short-term clinical outcomes of drug-eluting balloons (DEBs) versus stenting in provisional bifurcation lesions, focusing on procedural success, safety, and major adverse cardiac events (MACE). The study specifically assessed key adverse outcomes, including restenosis, target lesion revascularization (TLR), myocardial infarction (MI), stent thrombosis, and mortality. Bifurcation lesions present significant challenges in interventional cardiology due to their complex anatomy, which contributes to a higher risk of restenosis, side-branch occlusion, and thrombotic events.

Evaluating the Safety and Efficacy of Ticagrelor vs. Clopidogrel Following Percutaneous Coronary Intervention in Chronic Coronary Disease.

Objective This study aimed to compare the safety and efficacy of ticagrelor and clopidogrel in reducing major adverse cardiovascular events (MACE) among patients undergoing percutaneous coronary intervention (PCI) for chronic coronary disease. Additionally, secondary endpoints, including adverse events such as major bleeding, minor bleeding, and dyspnea, were assessed to evaluate the overall safety profile of both antiplatelet therapies. Methodology A prospective cohort study was conducted at Kuwait Teaching Hospital, Peshawar, Pakistan, enrolling 300 patients (150 receiving ticagrelor and 150 receiving clopidogrel) from July 2023 to June 2024.

Extensive Myocardial Calcification Rapidly Progressing After Orthotopic Liver Transplantation.

Orthotopic liver transplantation has been rarely associated with myocardial calcification; no prior cases of asymptomatic calcification have been documented. We present the unique finding of asymptomatic myocardial calcification following orthotopic liver transplantation.

Toward robust and privacy-enhanced facial recognition: A decentralized blockchain-based approach with GANs and deep learning.

In recent years, the extensive use of facial recognition technology has raised concerns about data privacy and security for various applications, such as improving security and streamlining attendance systems and smartphone access. In this study, a blockchain-based decentralized facial recognition system (DFRS) that has been designed to overcome the complexities of technology. The DFRS takes a trailblazing approach, focusing on finding a critical balance between the benefits of facial recognition and the protection of individuals' private rights in an era of increasing monitoring.

A cost effective communication model for requirements elicitation in global software development.

Requirement elicitation stands as a pivotal activity within requirement engineering, gaining even greater significance in the context of global software development. Effective communication among stakeholders assumes paramount importance in this arena. Factors such as time zone disparities, cultural variations, and language differences exert a formidable impact on communication within the sphere of global software development.

Reducing diagnostic delay in hypophosphatasia: a case series of 14 patients presenting to general rheumatology.

Objectives: Hypophosphatasia (HPP) is a rare genetic metabolic bone disease that can cause chronic pain and fractures. Its hallmark is a persistently low serum ALP. HPP is now recognised by many osteoporosis specialists, but other specialists, such as rheumatologists and primary care physicians, may be less aware of this condition, causing diagnostic delay and possible harm to these patients.

Successful Catheter Ablation of Ventricular Tachycardia Precipitated by Cardiac Resynchronization Therapy.

A patient with ischemic cardiomyopathy and an implantable cardioverter-defibrillator underwent an upgrade with an epicardial left ventricular lead, which precipitated recurrent ventricular tachycardia (VT). An electrophysiological study with electroanatomic mapping showed the site of the left ventricular lead to be part of the re-entrant circuit, and substrate modification of an endocardial channel led to the resolution of VT and an improvement in symptoms.

Adult Combined Heart-Liver Transplantation: The United States Experience.

We aimed to review the indications and outcomes of adults undergoing combined heart-liver transplantation (CHLT) in the US using national registry data. Adult (≥18 years) CHLT recipients in the United Network for Organ Sharing database were included (09/1987-09/2020; era 1 = 1989-2000, era 2 = 2001-2010, era 3 = 2011-2020). Survival analysis was conducted by means of Kaplan-Meier method, log-rank test, and Cox regression.

Impact of COVID-19 in hematopoietic stem cell transplant recipients: A systematic review and meta-analysis.

Background: Hematopoietic stem cell transplant (HSCT) recipients are at increased risk of mortality and morbidity with coronavirus disease 2019 (COVID-19) due to severe immune dysfunction.

Methods: A literature search was performed on PubMed, Cochrane, and Clinical trials.gov from the date of inception to 12/08/2021.

Pancreatic adenocarcinoma in liver transplant recipients: a case series.

Background: Malignancy is one of the known leading causes of death among long-term liver transplantation (LT) survivors. Pancreatic cancer has an incidence of 7.6/100,000 in North America and constitutes a diagnostic challenge post-LT.

Liver Transplantation for Cholangiocarcinoma: Charting a Path With Lessons Learned From Center Experience.

Background: While liver transplantation (LT) with neoadjuvant chemoradiation is increasingly utilized for the management of unresectable cholangiocarcinoma (CCA), data on post-LT survival are limited.

Methods: We identified 844 patients who underwent LT (2002-2019) for nonincidental (CCA listing) or incidental (CCA on explant, not at listing) CCA in the Scientific Registry of Transplant Recipients. Kaplan-Meier and multivariable proportional hazards regression methods evaluated the effects of patient characteristics, donor type, transplant era (before/after 2010), and center volume (center-level CCALTs/active year) on the risk of graft failure and patient mortality.

Effect of Donor Transaminase Levels on Graft Survival Following Liver Transplant: An Analysis of the Organ Procurement and Transplantation Network Database.

Objectives: Despite data showing equivalent outcomes between grafts from marginal versus standard criteria deceased liver donors, elevated donor transaminases constitute a frequent reason to decline potential livers. We assessed the effect of donor transaminase levels and other characteristics on graft survival.

Materials And Methods: We performed a retrospective cohort analysis of adult first deceased donor liver transplant recipients with available transaminase levels registered in the Organ Procurement and Transplantation Network database (2008-2018).

Management of hepatoblastoma in the United States: Can we do better?

Background: Hepatoblastoma is the most common type of liver cancer in children. Refined therapeutic approaches combining risk-adapted chemotherapy along with complete tumor resection has led to improved survival. We aimed to evaluate the current state of management and outcomes for hepatoblastoma in the United States.

Hepatectomy for Breast Cancer Metastasis and Sarcoma are more likely to have Adverse Outcomes than Hepatectomy for Primary Hepatocellular Cancer or for Colorectal Metastasis.

Introduction: Outcomes for hepatectomy for breast cancer metastasis and sarcomatous disease processes are not well defined in literature. We sought to use a national database to identify outcomes in these patients compared to subset of patients more well studied in literature - primary Hepatocellular cancer patients and patients with colorectal metastasis.

Methods: We identified patients undergoing major hepatectomy (≥ 3 segments) for primary hepatocellular cancer (HCC), sarcoma metastasis, breast cancer metastasis, and colorectal metastasis using NSQIP database.

Feasibility of Serial Ultrasound Measurements of the Rectus Femoris Muscle Area to Assess Muscle Loss in Patients Awaiting Liver Transplantation in the Intensive Care Unit.

Unlabelled: End-stage liver disease (ESLD) patients requiring intensive care unit (ICU) care before liver transplantation (LT) often experience significant muscle mass loss, which has been associated with mortality. In this exploratory study, we primarily aimed to assess the feasibility of serial ultrasound (US) rectus femoris muscle area (RFMA) measurements for the evaluation of progressive muscle loss in ICU-bound potential LT candidates and describe the rate of muscle loss as assessed by sequential US RFMA measurements. Secondarily, we sought to identify patient characteristics associated with muscle loss and determine how muscle loss is associated with survival.

Applicants' Interview Experience of Family Medicine Residency Match: Reflections from a Quality Improvement Initiative at a Community Hospital.

Background and objective Both family medicine applicants and programs dedicate significant resources to the interview process, a time for both parties to make an impression on the other in an attempt to find their best match. Despite the importance of this process, little research has been completed to ensure the process efficiently addresses applicant preferences on interview day and the surrounding process. This study aimed to determine the factors influencing the family medicine applicant preferences regarding the pre-interview, interview, and post-interview ranking process.

Mortality Determinants in Children with Biliary Atresia Awaiting Liver Transplantation.

Objective: To determine risk factors for waitlist mortality in children with biliary atresia listed for liver transplantation.

Study Design: There were 2704 children with biliary atresia (<12 years of age) listed for a first liver transplant (2002-2018) in the United Network for Organ Sharing database. Fine-Gray regression models for competing risks analysis (main risk = waitlist mortality/delisting owing to too sick; competing risk = liver transplantation) were implemented to identify risk factors for waitlist mortality.

The role of imaging and other diagnostic approaches in COVID-19.

As the COVID 19 pandemic develops across the globe, a large amount of literature has been written about the different ways in which we can diagnose and investigate someone suspected of being infected with the new coronavirus. Many approaches highlight the importance of using reverse transcriptase polymerase chain reaction (RT-PCR) used in conjunction with computed tomography (CT) scans. Whilst CT scans have been shown to be useful, there are multiple risks associated with them, for example radiation exposure and the transmission risk associated with repeated use of a CT suite.

Extracorporeal Membrane Oxygenation in Pediatric Liver Transplantation: A Multicenter Linked Database Analysis and Systematic Review of the Literature.

Background: Extracorporeal membrane oxygenation (ECMO) can be used to maintain oxygen delivery and provide hemodynamic support in case of circulatory and respiratory failure. Although the role of ECMO has emerged in the setting of adult liver transplantation (LT), data in children are limited. We aimed to describe the characteristics and outcomes of children receiving ECMO support at the time of or following LT.

Surgical management of pediatric hepatocellular carcinoma: An analysis of the National Cancer Database.

Purpose: This study evaluates overall survival (OS) between liver transplantation (LT) and liver resection (LR), while assessing the effect of margin status, in children with hepatocellular carcinoma (HCC).

Methods: The National Cancer Database was queried (2004-2015) for children (<18 years) with non-metastatic HCC undergoing surgery.

Results: One hundred six children with HCC treated surgically (LT 34, LR 72) were identified.

Subclinical Hypothyroidism among local adult obese population.

Objective: To determine the frequency of subclinical hypothyroidism in local adult obese population.

Methods: The study was conducted at Hayatabad Medical Complex, Peshawar, from March, 2017 to August, 2017. All patients aged between 18 and 60 years with BMI of more than 29kg/m were included in the study.