Dow Medical College is a public medical school located in the city of Karachi, Sindh. It was founded in 1945 and named after British civil servant Sir Hugh Dow, Governor of Sindh.In 2003, it became a constituent college of the newly formed Dow University of Health Sciences.
Both lung cancer and diabetes are the leading causes of death worldwide. These two conditions commonly coexist, especially in older patients, and result in worsening of prognosis and lower survival rates. Very limited scientific data are available about their correlation. Studying the mortality trends using data from Centers for Disease Control and Prevention Wide-Ranging Online Data of Epidemiologic Research (CDC WONDER) can help us in designing better health policies and treatment strategies. We analyzed the US mortality data from 1999 to 2023 using the CDC WONDER dataset. The ICD-10 codes were used. For lung cancer, it is C34, and for diabetes, they are E10-14. Temporal trends were analyzed by using joinpoint regression (V5.4.0) and a p value < 0.05 was considered statistically significant. From 1999 to 2023, a total of 174,418 deaths were reported in the United States. Most of them occurred at home (39.6
Venous thromboembolism (VTE) remains a leading cause of preventable morbidity and mortality among hospitalized patients. Although pharmacological thromboprophylaxis is well established in inpatient care, initiation is frequently delayed until after hospital admission. The emergency department represents the first point of contact for many high-risk patients and a potential opportunity for earlier prevention. This systematic review and meta-analysis evaluated the effectiveness of emergency department-initiated thromboprophylaxis protocols in preventing VTE among high-risk adult patients. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review was conducted using MEDLINE, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials from inception to the most recent update. Eligible studies included randomized controlled trials and observational or quasi-experimental studies evaluating thromboprophylaxis initiated in, or directly facilitated by, the emergency department. Outcomes of interest included incidence of VTE, bleeding complications, mortality, length of stay, and process measures such as prophylaxis utilization and timeliness. Risk of bias was assessed using the Risk of Bias 2 (RoB 2) tool for randomized trials and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-randomized studies. Due to substantial clinical and methodological heterogeneity, quantitative pooling was limited, and a structured narrative synthesis was performed. The review identified a heterogeneous body of evidence comprising prospective and retrospective cohorts, before-and-after implementation studies, and health information technology interventions. Emergency department-initiated or emergency department-facilitated protocols consistently increased appropriate thromboprophylaxis use and reduced delays to the first dose. In a subset of large protocol implementation studies, earlier initiation was associated with lower rates of symptomatic VTE without a corresponding increase in major bleeding. Mortality and length of stay outcomes were inconsistently reported, precluding definitive conclusions. The overall certainty of evidence was limited by observational designs, variability in patient populations, and inconsistent outcome definitions. Emergency department-initiated thromboprophylaxis protocols improve the timeliness and appropriateness of VTE prevention and may reduce symptomatic events without increasing bleeding risk in selected high-risk populations. These findings support the integration of structured thromboprophylaxis pathways into emergency care, while highlighting the need for high-quality prospective trials to define their impact on patient-centered outcomes.
Background:Mpox (formerly monkeypox) has emerged as a significant public health challenge in sub-Saharan Africa. The recent confirmation of Mpox cases in the Moyale region of Ethiopia highlights the urgent need for robust surveillance and response mechanisms in the Horn of Africa. Policy gaps:While Ethiopia has a strong history of epidemic control, specific gaps remain in diagnostic capacity for orthopoxviruses in remote border regions, and there is a need to adapt current strategies to resource-limited settings. Recommendations:This editorial advocates for integrating Mpox detection into Ethiopia's existing Polio and Measles surveillance networks to maximize cost-effectiveness. We recommend targeted vaccination strategies for high-risk healthcare workers rather than broad mandates, implementing community-based surveillance through Health Extension Workers, and ensuring ethical risk communication to prevent stigma. Conclusion:Immediate coordination between the Ethiopian Ministry of Health, Africa CDC, and WHO is required to contain the spread and prevent a broader regional outbreak.
Background:Hypertension and diabetes are among the most prevalent conditions in the world, which can severely affect the kidneys, especially when they occur together. This study analyzes mortality trends among the American population with hypertensive kidney disease (HKD) and diabetes. Methods:We carried out a retrospective analysis from 1999 to 2024 of nationwide mortality data obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. We included individuals with HKD diabetes (ICD-10 codes: I12, E10-E14) using a multiple cause of death approach (reporting any mention of the diagnosis as an underlying or contributing cause of death). We calculated the age-adjusted mortality rates (AAMR) per 100 000 population, and analysis based on year, gender, race/ethnicity, state, and urban/rural classification was performed. Joinpoint regression analysis was used to determine significant annual percent changes (APCs) in AAMR over the study period. Results:A total of 242 071 deaths among the patient population were reported, and analysis revealed a significant increase in the overall AAMR for mortality related to HKD and diabetes, rising from 1.1 per 100 000 in 1999 to 4.9 per 100 000 in 2024. Men consistently showed higher AAMRs (overall 2.4) compared to women (overall 2.0). Among racial and ethnic groups, the highest overall AAMR was observed in the non-Hispanic Black or African American population (6.9). States that showed the highest AAMR included California, South Carolina, Texas, Mississippi, and the District of Columbia. Additionally, nonmetropolitan areas demonstrated a generally higher AAMR (2.6) compared to metropolitan areas (2.5). Conclusions:HKD-related mortality among diabetic Americans surged between 1999 and 2024, with gender, race/ethnicity, and geographic location disparities, especially in nonmetropolitan areas. Targeted health strategies and interventions are vital to reducing mortality and addressing these disparities.
