Safety and efficacy of index admission cholecystectomy in severity-stratified acute cholangitis hospitalizations.

Introduction: Cholecystectomy (CCY) is generally advocated for patients presenting with acute cholangitis (AC) to ensure definitive management and prevent recurrence. The optimal timing for cholecystectomy (CCY), however, remains to be determined. This study aims to comprehend the clinical outcomes and financial implications of performing a CCY during index admission.

Ketamine to enhance methadone treatment retention in patients with opioid use disorder and co-morbid depression.

Opioid use disorder (OUD) is a chronic relapsing condition with a high mortality rate. While medications such as methadone are valuable first-line therapies, retention is poor, with the highest dropout rates early in a treatment attempt. Poor outcomes are due in part to the very high rates of co-morbid depression in people with OUD, as depression can drive opioid use.

Endoscopic treatment modalities for colonic diverticular bleeding: A systematic review with direct and network meta-analyses.

Background: Colonic diverticular bleeding (CDB) is a leading cause of lower gastrointestinal hemorrhage that has a high risk of recurrence. The endoscopic clipping and endoscopic band ligation (EBL) methods are widely used for hemostasis in patients with CDB. Endoscopic detachable snare ligation (EDSL) has also become an increasingly common treatment option.

Weight Loss That Lasts: Reviewing the Long-Term Impact of GLP-1 Receptor Agonists.

This systematic review evaluates the long-term efficacy and safety of GLP-1 receptor agonists in the management of obesity, focusing on data from high-quality randomized controlled trials published between 2018 and 2025. This review synthesizes findings from studies assessing agents such as semaglutide, liraglutide, tirzepatide, and exenatide in diverse populations, including adults with and without type 2 diabetes and adolescents with severe obesity. Most studies demonstrated sustained weight loss and favorable glycemic control over treatment durations of 40-120 weeks.

Choosing the Right Vasoactive Agent in Acute Variceal Bleeding in Cirrhotic Patients: A Review of Terlipressin vs. Octreotide Outcomes.

This systematic review evaluates and compares the clinical effectiveness of terlipressin and octreotide in the management of acute gastroesophageal variceal bleeding among cirrhotic patients. A comprehensive literature search was conducted across PubMed, Google Scholar, and clinical trial registries, identifying five randomized controlled trials that met predefined inclusion criteria. These studies assessed key outcomes, including bleeding control, mortality, hepatic venous pressure gradient (HVPG) reduction, hemodynamic stability, and safety profiles.

Citrulline enhances salinity tolerance via photosynthesis, redox balance, osmotic and hormonal regulation, and nutrient assimilation in sunflower ( L.).

Unlabelled: Citrulline (CITR) is a strong osmolyte and hydroxyl radical scavenger. However, no previous study has reported the ameliorative role of CITR under salinity stress. We found a significant decrease in growth, chlorophyll content, SPAD value, photosynthesis, leaf relative water content, and nutrient acquisition in sunflower plants exposed to salinity (15 dS m).

Therapeutic Duel of Rifaximin Versus Lactulose in Hepatic Encephalopathy: A Systematic Review.

This systematic review aimed to compare the clinical efficacy of rifaximin versus lactulose in the management of hepatic encephalopathy (HE) by analyzing evidence from randomized controlled trials (RCTs). A comprehensive search across major databases identified seven eligible RCTs encompassing 693 adult patients diagnosed with overt or minimal HE. Findings demonstrated that rifaximin is at least as effective as lactulose in reversing HE symptoms, with some studies reporting significantly higher HE reversal rates when rifaximin was used in combination with lactulose (e.

Efficient removal of Sr²⁺, V⁵⁺, and Rb⁺ ions from groundwater using a hybrid Mg-MCM-41/Talc composite; Siwa Oasis in Egypt as case study.

This study presents the development and application of a hybrid inorganic adsorbent composed of mesoporous Mg-MCM-41 integrated with exfoliated talc nanosheets (MCM/talc composite)-for the efficient removal of Sr²⁺, V⁵⁺, and Rb⁺ ions from contaminated water sources. The composite exhibited a mesoporous architecture (9.6 nm) and a specific surface area of 123.

Prognostic Utility of N-terminal Pro-B-type Natriuretic Peptide (NT-proBNP) for Predicting Hospital Readmissions in Patients With Heart Failure: A Systematic Review of Clinical Evidence.

This systematic review examines the prognostic utility of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for predicting hospital readmissions in patients with heart failure (HF). HF remains a leading cause of recurrent hospitalizations, contributing to increased morbidity and healthcare burden. While NT-proBNP is widely established for diagnosis and mortality prediction in HF, its role in forecasting hospital readmission risk-particularly at varying time frames-remains unclear.

Idiopathic Cervical Transverse Myelitis Presenting Predominantly With Lower Limb Weakness and Autonomic Dysfunction: A Report of a Rare Case.

Transverse myelitis (TM) is a rare neuroinflammatory disorder that can lead to significant morbidity if not promptly diagnosed and treated. We report the case of a 40-year-old female who presented with progressive bilateral lower limb weakness and urinary incontinence over a two-month period. Neurological examination revealed upper motor neuron signs and a defined sensory level, raising suspicion of a spinal cord pathology.

Exploring the Role of Laryngopharyngeal Reflux in Eustachian Tube Dysfunction: Therapeutic Potential of Proton Pump Inhibitors in a Resource-Constrained Setting.

Background Eustachian tube dysfunction (ETD) and laryngopharyngeal reflux disease (LPRD) are under-recognized conditions that significantly impact quality of life. LPRD may contribute to ETD via gastric refluxate-induced mucosal damage. While proton pump inhibitors (PPIs) are commonly used for reflux management, their role in alleviating ETD symptoms remains controversial.

Frequency of Stroke in Patients With Chronic Obstructive Pulmonary Disease: A Retrospective Study.

Background Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder associated with several comorbidities, including cardiovascular diseases. Objective This study aims to assess the frequency of stroke in patients presenting with COPD, explore associated risk factors, and examine the clinical outcomes of stroke in this population. Methods This retrospective cohort study was conducted using medical records from a tertiary care hospital.

Frailty Predicts Mortality and Procedural Performance in Patients With Non-Variceal Upper Gastrointestinal Bleeding.

Introduction: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a common cause of hospitalization in the United States, with approximately 400 000 admissions annually and a 5%-10% mortality rate. This study aimed to evaluate frailty's impact on NVUGIB outcomes.

Methods: We utilized the 2019 National Readmission Database (NRD) to identify adult patients (≥ 18 years) admitted with a principal diagnosis of NVUGIB using ICD-10-CM codes.

Role of Proton Pump Inhibitors in Prevention of Upper Gastrointestinal Bleeding in Patients on Dual Antiplatelet Therapy: Systematic Review and Meta-Analysis.

Background: Dual antiplatelet therapy (DAPT) with oral P2Y12 inhibitors and aspirin is crucial for patients with acute coronary syndrome (ACS) and postpercutaneous coronary interventions (PCI). Concomitant proton pump inhibitor (PPI) therapy with DAPT can potentially reduce the risk of upper gastrointestinal bleeding (UGIB).

Aim: We conducted a meta-analysis of randomized controlled trials to evaluate the prevention of UGIB with concomitant use of PPI with DAPT.

Navigating Thyroid Crises: A Nationwide Analysis of the Weekend Effect and Mortality Trends in Myxedema Coma (2016-2020).

Our objective was to utilize the National Inpatient Sample (NIS) database for analyzing the outcomes of myxedema coma based on the day of admission and explore five-year mortality trends. This retrospective cohort study examined in-patient mortality and secondary outcomes of patients with myxedema coma from 2016 to 2020 using the NIS database. Patients were selected using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and divided into weekday and weekend admission groups.

Influence of Obesity Class on Clinical Outcomes in Alcoholic Hepatitis: A National Cohort Study of Mortality, Complications, and Resource Use.

Background & Aims: Alcoholic hepatitis (AH) is a severe manifestation of alcoholic liver disease with high morbidity and mortality. This study used the 2016-2020 National Readmission Database to investigate how obesity influences AH outcomes.

Methods: Adult hospitalizations were categorized as those without obesity, Class 1 obesity (BMI 30-34.

Machine learning-based detection and quantification of red blood cells in Cholistani cattle: A pilot study.

This study presents the first account of using machine learning to detect and count normal and abnormal red blood cells (RBCs), including tear-drop cells and schistocytes, in Cholistani cattle from Pakistan. A Support Vector Machine (SVM) model was applied and compared with manual counting methods. Pre-annotated blood smear images were preprocessed using contrast stretching transformation, followed by segmentation and resizing.

Evidence Report on the Safety of Gastrointestinal Endoscopy in Patients on Glucagon-like Peptide-1 Receptor Agonists: A Systematic Review and Meta-Analysis.

: Glucagon-like peptide-1 receptor agonists are increasingly used worldwide for weight and hyperglycemia management. There is an ongoing debate on the presence of increased gastric residue, leading to complications such as aspiration and overall safety in patients receiving upper gastrointestinal endoscopy. We aimed to study the effect of GLP-RAs on endoscopy outcomes.

Taurine priming improves redox balance, osmotic adjustment, and nutrient acquisition to lessen phytotoxic effects of neutral and alkaline salts on pea ( L.).

Taurine (TAR) intricately mediates a plethora of physiological processes. This investigation aimed to elucidate the impact of TAR (50, 100, 150, and 200 mg L) seed priming on redox homeostasis, glutathione metabolism, photosynthetic efficiency, osmotic adjustment and nutrient acquisition in pea plants subjected to 100 mm salinity of neutral (NaCl and NaSO) and alkaline (NaCO) salts. Salinity diminished growth, chlorophyll, and photosynthetic efficiency alongside a concurrent rise in reactive oxygen species (ROS), lipid peroxidation, and relative membrane permeability.

Genome-wide identification and characterization of stress-responsive genes in Chlorella vulgaris.

Background: Chlorella vulgaris is a significant green alga that has a role in the bioremediation of environmental pollutants, especially heavy metals. Therefore, to meet the emerging needs of sustainable bioremediation, it is the need of the hour to improve the bioremediation potential of Chlorella vulgaris. Stress-related genes play significant roles in homeostasis and stress management in algal species, including C.

The impact of inter-hospital transfer on outcomes in lower gastrointestinal bleeding: a retrospective cohort analysis.

Background: This study investigates the role of interhospital transfer (IHT) in lower gastrointestinal bleeding (LGIB) management and its impact on patient outcomes, focusing on mortality rates, complication occurrences, procedural performance, and resource utilization in patients diagnosed with LGIB.

Methods: This retrospective cohort study used data from the National Inpatient Sample database from 2017 to 2020. It included adult patients diagnosed with LGIB, assessing the impact of IHT on outcomes such as mortality, complication rates, procedural performance, and resource utilization.

A preliminary study on digital quantification of ocular attributes in cattle as potential non-invasive indicators of anemia.

Background: Various non-invasive indicators such as ocular attributes have been tested and validated for the assessment of anemia and vitamin A deficiency in human medical sciences with promising results. However, regarding veterinary diagnostics/prognostics, there is limited literature for photometric assessment of anemia in cattle. The present preliminary study is the first account of digital quantification of various ocular attributes in cattle (n = 36) carried out with an objective to unearth the potential of these attributes (RGB analysis and morphometry of eyeballs, and color of palpebral conjunctiva) as non-invasive predictors of RBC count, hemoglobin (Hb) and packed cell volume (PCV).

A preliminary study on physiological dynamism of various serum cardiac biomarkers in apparently healthy Sipli sheep of Pakistan.

Background: For sheep in tropical/subtropical areas of the world, the reported mortality and morbidity rate regarding cardiomyopathies is quite low (1%-2%), yet it has been elucidated that many sheep slaughtered for meat purposes in Pakistan have enlarged hearts with underlying cardiac abnormalities.

Aim: The present preliminary work is the first record of deducing normal reference intervals (RIs) for various serum cardiac biomarkers namely cardiac troponin I (cTnI), alanine transaminase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH), creatine kinase-myocardial band (CK-MB), sodium (Na), potassium (K), and total protein (TP), and their interrelationship in apparently healthy indigenous Sipli breed of sheep ( = 141) from Pakistan.

Methods: Apropos to aseptic blood collection and serum extraction, the attributes were deduced using commercially available kits.

Performance evaluation of Rayto RT-7600Vet hematology analyzer in side-by-side comparison with manual hematological methods for apparently healthy Cholistani cattle blood.

The present study is the first from Pakistan being reported with an objective to assess performance of Rayto RT-7600Vet hematology analyzer (HA) for Cholistani cattle blood (n = 134), in comparison to the manual hematological methods. The four hematological attributes viz. total erythrocyte count (TEC), hemoglobin (Hb), packed cell volume (PCV) and platelet count (PLT) were deduced through HA (A) and manual (M) methods.