Bolan Medical College

Accurate tissue acquisition (TA) of solid pancreatic lesions is essential for guiding treatment with endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) being the preferred method. Among FNB designs, the three-pronged Franseen-tip needle demonstrates strong diagnostic performance, though direct head-to-head comparisons with other FNB designs remain limited. This meta-analysis was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251123856). Eligible studies enrolled patients with solid pancreatic lesions who underwent EUS-guided FNB, directly compared the Franseen-tip with other FNB needles. Six databases were systematically searched through July 2025, and study selection, data extraction, and risk of bias assessment (QUADAS-2 tool) were performed independently by two reviewers. Pooled estimates were generated using random-effects and bivariate hierarchical models. Sixteen studies (2,010 Franseen vs. 2,811 comparator) were included. Bivariate analysis showed that sensitivity and specificity of the Franseen needle were comparable to newer-generation comparator needles (sensitivity 91.3

Emergence delirium (ED) is a frequent postoperative complication in children, marked by confusion, disorientation, and agitation following general anesthesia. Electroencephalogram (EEG)-guided anesthesia offers a promising approach to optimize anesthetic dosing, reduces sevoflurane exposure, and potentially lowers the incidence of ED. This systematic review and meta-analysis evaluates the impact of EEG-guided anesthesia on key outcomes in pediatric patients, including ED incidence, PACU stay duration, and PAED scores. This systematic review and meta-analysis followed PRISMA guidelines and was registered on PROSPERO (CRD420251121848). A comprehensive search of PubMed, Embase, Scopus, and Cochrane Library was conducted up to July 2025. Only randomized controlled trials comparing EEG-guided anesthesia with standard care in pediatric patients undergoing sevoflurane-based general anesthesia were included. Primary outcomes were PAED scores and incidence of emergence delirium; secondary outcomes included sevoflurane exposure, PACU stay duration, extubation time, FLACC scores, and burst suppression. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated using GRADE. Statistical analysis was performed using a random effects model. Our analysis demonstrated that EEG-guided anesthesia significantly reduced PAED scores at 10 min post-extubation (MD: − 0.94; 95

Background: Postpartum depressive symptoms are frequently under-recognised in resource-constrained settings, and their geographic and socioeconomic distribution within Pakistani hospital populations remains insufficiently characterised. Objective: To identify hospital-city and socioeconomic predictors of postpartum depressive symptom severity using conventional regression and random forest analysis. Methods: This multicentre retrospective record-based analytical study included 336 postpartum women aged 18–45 years receiving care at tertiary hospitals in Karachi, Lahore, and Rawalpindi between January 2021 and December 2023. The primary outcome was the continuous Edinburgh Postnatal Depression Scale score. Geographic and socioeconomic predictors were examined using analysis of variance, multivariable linear regression, and random forest regression. Results: The mean EPDS score was 11.2 ± 5.8, and 187 women (55.7%) screened positive at an EPDS threshold of ≥10. Mean scores were highest in Rawalpindi (13.4 ± 5.9), followed by Lahore (11.1 ± 5.6) and Karachi (9.1 ± 5.2). Compared with the respective reference categories, Rawalpindi hospital-city site was associated with a 3.9-point higher score, household income below PKR 30,000 with a 5.8-point increase, no formal education with a 4.9-point increase, and overcrowding with a 3.2-point increase. The random forest model achieved a test-set R² of 0.51. Conclusion: Socioeconomic disadvantage and hospital-city context were associated with greater postpartum depressive symptom severity. Targeted screening may be warranted among women from low-income, poorly educated, and overcrowded households