Direct Oral Anticoagulants Versus Vitamin K Antagonists in Patients with Atrial Fibrillation and Bioprosthetic Valve Replacement: An Umbrella Review.

Atrial fibrillation (AF) is a major sequela after bioprosthetic valve replacement (BPVR) in patients with valvular heart disease. This study evaluates the data compiled from different meta-analyses in an umbrella review. We investigated the anticoagulation efficacy of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients with AF and BPVR.

The efficacy of antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease (GERD) by 24-h pH monitoring: systematic review and meta-analysis.

Background: Gastroesophageal reflux disease (GERD) is a prevalent and chronic disorder impacting a significant proportion of the global population, approximately 15%. Most GERD patients show improvement with medical treatment, including proton pump inhibitors (PPIs); however, around 40% continue to experience symptoms despite ongoing PPI use. Antireflux mucosal ablation (ARMA) and antireflux mucosectomy (ARMS) are minimally invasive endoscopic procedures for treating GERD.

Prospective, Matched Case-Control Study of Endoscopic Sleeve Gastroplasty and Semaglutide in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease at One Year.

Purpose: Endoscopic sleeve gastroplasty (ESG) and GLP-1RA are proven obesity interventions with potential to aid patients who have MASLD. However, their comparative effectiveness remains unclear. This study aimed to compare ESG and semaglutide in MASLD patients regarding weight loss and improvements in metabolic parameters, including liver enzymes, and FIB-4 scores.

Comparing Weight Loss and Metabolic Outcomes of Virtual Versus In-Person Follow-Up Care in Bariatrics: A Propensity-Matched Analysis at 12 and 36 Months Post-ESG.

Introduction: The rising prevalence of obesity and demand for minimally invasive treatments has led to increased adoption of endoscopic sleeve gastroplasty (ESG). As telemedicine expands in bariatrics, understanding the role of virtual follow-up care is crucial. This study aims to use propensity-matching to compare weight loss and metabolic outcomes between virtual and in-person follow-up modalities post-ESG.

Systematic review of technical factors associated with persistent fistula after EUS-directed transgastric ERCP in patients with Roux-en-Y gastric bypass.

Background And Aims: An important unintended consequence of EUS-directed transgastric ERCP (EDGE) in patients with Roux-en-Y gastric bypass is persistent fistula (PF) formation after stent removal. To better inform procedural decision-making, we wanted to elucidate the technical factors associated with PF after EDGE.

Methods: We performed a systematic literature search of EMBASE, Scopus, and PubMed databases from inception until November 2024.

Endoscopic Sleeve Gastroplasty for the Treatment of Metabolic Syndrome: A Systematic Review and Meta-analysis.

Background: Endoscopic sleeve gastroplasty (ESG) is an incisionless weight loss procedure that has been demonstrated to be safe and effective for the treatment of obesity; however, the efficacy of ESG for the treatment of comorbid type 2 diabetes mellitus (T2DM) and other components of metabolic syndrome (MetS) has been less well studied. We aimed to conduct a systematic review and meta-analysis of available literature to evaluate the outcomes of ESG on T2DM and MetS.

Methods: Bibliographic databases were systematically searched for studies assessing the outcomes of ESG on T2DM and MetS.

Metal versus plastic stents for EUS-guided walled-off necrosis drainage: a systematic review and meta-analysis of randomized controlled trials.

Background & Objective: The endoscopic step-up approach is the mainstay of walled-off necrosis management (WON). However, using metal stents versus plastic stents during WON drainage is debatable, with limited high-quality evidence. Therefore, we aim to investigate the comparative safety and efficacy of metal versus plastic stents for endoscopic ultrasound (EUS) guided WON drainage.

Phase I Study of Vorinostat and Temsirolimus in Newly Diagnosed or Progressive Diffuse Intrinsic Pontine Glioma.

Background: Diffuse intrinsic pontine glioma (DIPG) carries a poor prognosis with a median survival of less than 12 months. Key molecular features include histone H3 mutation (K27M) and AKT pathway dysregulation. There is currently no curative treatment.

Glucagon-like peptide-1 receptor agonist use and the risk of residual gastric contents and aspiration in patients undergoing GI endoscopy: a systematic review and a meta-analysis.

Background And Aims: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used for type 2 diabetes mellitus and obesity, but safety concerns have been raised for users undergoing GI endoscopy because of retained food and aspiration events. We compared the risk of adverse events for GLP-1RA users and nonusers undergoing endoscopy.

Methods: We conducted a systematic review and meta-analysis (PROSPERO registration: CRD42024556732).

Improvement in obesity-related comorbidities 5 years after endoscopic sleeve gastroplasty: a prospective cohort study.

Background And Aims: Endoscopic sleeve gastroplasty (ESG) is a minimally invasive bariatric procedure of the gastric cavity to facilitate weight loss. We aimed to evaluate the long-term effects of ESG as a monotherapy on obesity-related comorbidities over 5 years.

Methods: This prospective study analyzed data from 404 consecutive patients (aged 45 ± 11.

Late-onset pulmonary complications among survivors of coronavirus Disease 2019.

Objectives: To assess the late-onset pulmonary complications among survivors of coronavirus disease 2019.

Methods: The cross-sectional analytical study was conducted in the department of Pulmonology, Sir Ganga Ram Hospital Lahore between October 2020 and March 2021. Total 288 patients visiting the hospital 12-week after recovery from COVID-19 enrolled using convenience sampling.

A generalized framework for the quantum Zeno and anti-Zeno effects in the strong coupling regime.

It is well known that repeated projective measurements can either slow down (the Zeno effect) or speed up (the anti-Zeno effect) quantum evolution. Until now, studies of these effects for a two-level system interacting with its environment have focused on repeatedly preparing the excited state via projective measurements. In this paper, we consider the repeated preparation of an arbitrary state of a two-level system that is interacting strongly with an environment of harmonic oscillators.

Sleep Disturbance and Its Association With Sluggish Cognitive Tempo and Attention in Pediatric Brain Tumor Survivors.

Background: Pediatric brain tumor (PBT) survivors are at risk for developing sleep disturbances. While in other pediatric populations sleep disturbance has been associated with worse cognitive functioning, it is unclear to what extent this relationship generalizes to PBT survivors. The aim of the current study was to assess the relationship between sleep disturbance and aspects of cognition, including sluggish cognitive tempo (SCT) as well as attention and working memory.

Hyponatremia with Antidepressant: A Rare Side Effect from Duloxetine in a Child with Acute Leukemia.

Duloxetine is indicated for the treatment of chemotherapy-induced neuropathic pain in adults. It is also indicated for anxiety, depression, and fibromyalgia in children. A rare side effect of syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been reported in adults, but not in pediatrics or pediatric oncology patients.

Venetoclax and Decitabine in Pediatric Refractory T-cell Lymphoblastic Lymphoma.

Background: Overall survival of adolescents with relapsed T-cell lymphoblastic lymphoma (T-LL) remains poor with limited options for salvage therapy. The BCL-2 inhibitor venetoclax combined with hypomethylating agents like decitabine, has shown favorable responses in elderly patients with acute myeloid leukemia.

Observation: We present the case of a 19-year-old adolescent with stage III relapsed and refractory T-LL who did not respond to 3 lines of salvage therapy.

Adequacy of Completion of Computed Tomography Scan Request Forms at a Tertiary Care Center in Pakistan: A Clinical Audit.

Introduction A lot of radiation exposure to a population comes from medical sources. Clinicians must justify the need for radiology procedures on a request form to prevent unnecessary scans and radiation exposure. Moreover, the properly-filled form will help to identify the patient correctly and provide clinical details to make a radiological diagnosis.

The Spectrum of Beta-thalassemia Mutations in Couples Referred for Chorionic Villus Sampling at Bahawal Victoria Hospital, Bahawalpur.

Introduction The prevalence of beta-thalassemia mutations is different in various castes, regions, and ethnic groups. By knowing this prevalence, we can conduct a targeted screening of only the high-risk population and only for the specific mutations that are prevalent in each group. Objective The purpose of this study was to determine the regional, caste-wise, and ethnic spectrum of beta-thalassemia mutations in couples referred for a prenatal diagnosis.

The Frequency of Hepatitis C and its Risk Factors Among Health Care Providers at Tehsil Headquarter Hospital, Hasilpur, Pakistan.

Introduction Hepatitis C has emerged as a big challenge for Pakistan. Health care providers are at increased risk of being infected due to tremendous exposure. Aim The purpose of this study was to find the prevalence of hepatitis C, its risk factors especially its occupational risk factors and preventive measures practiced by health care providers of Tehsil Head Quarter Hospital, Hasilpur, Pakistan.

Bisphosphonate-induced Atypical Femoral Shaft Fracture.

Bisphosphonates are used to treat postmenopausal and glucocorticoid-induced osteoporosis, Paget's disease of bone, and malignant hypercalcemia. They have been related to atypical femur fractures. We describe an 83-year-old woman on long-term bisphosphonates presenting with an atypical femur fracture.