Faisalabad Medical University

Glioblastoma (GBM) remains the most common and lethal primary central nervous system tumor, with a median survival of only 14.6 months under standard care. The tumor’s characteristic "Warburg effect"—a dependency on aerobic glycolysis for energy—creates a metabolic vulnerability. This review evaluates the efficacy and safety of the ketogenic diet (KD) as an adjunctive metabolic therapy aimed at exploiting this glucose dependency. This PRISMA-compliant systematic review updates clinical evidence by synthesizing data from databases from 2000 to September 2025. We searched PubMed, Embase, Cochrane, and Web of science for human studies assessing the ketogenic diet (KD) in glioblastoma and high-grade gliomas. Primary outcomes included overall survival (OS), progression-free survival (PFS), feasibility, and adverse events. Study quality was assessed using Joanna Briggs Institute tools. Prospero registration: CRD420251232650. Forty-one studies were included, ranging from randomized trials to case series and abstracts, utilizing interventions such as the classic 4:1 ketogenic diet, Modified Atkins Diet, and calorie restriction. Adherence was high (> 75

Endovascular options for infrapopliteal artery disease include plain balloon angioplasty (PTA), drug‑coated balloons (DCB), drug‑eluting and bare‑metal stents (DES), and atherectomy. Retrievable scaffold therapy (RST) has recently emerged as a temporary scaffolding strategy used with DCB, but its comparative effectiveness remains uncertain. A comprehensive literature search identified 21 randomized and 4 single‑arm trials (n = 3184). Eligible studies reported at least one prespecified outcome: 30‑day major adverse events (MAE), 12‑month all‑cause mortality, 6‑month clinically driven target lesion revascularization (CD‑TLR), or 6‑month major amputation. Random‑effects models generated odds ratios (ORs) with 95

Congenital sensorineural hearing loss (CSNHL) is a very common subtype of pediatric hearing loss disorders. Less severe deformities in CSNHL might not be recognized during a simple visual inspection in computed tomography (CT) of the temporal bone. Therefore, the present study aimed to compare the inner ear measurements between CSNHL patients with grossly normal CT appearance and the healthy population. Children with confirmed CSNHL were enrolled along with a control group of healthy children. Their CT scans of the temporal bone were retrospectively reviewed. Ten inner ear radiologic measurements, including cochlea height (CH) and width (CW), width of cochlear nerve bony canal (WCN), superior and lateral semicircular canals (SSCC and LSCC) bony island widths, posterior semicircular canal (PSCC) inferior limb length, vestibule height (VH) and width (VW), and vestibular aqueduct (VA) width at the midpoint and operculum were compared between the two groups. 62 children (30 CSNHL, 37 females, mean age: 7.1 ± 3.4 years) were included. The intra-observer repeatability was very good to excellent across all parameters (Intraclass correlation coefficient: 0.83–0.96). CH (P ≤ 0.001) and VA midpoint width (P ≤ 0.001) were significantly higher in CSNHL patients than healthy individuals, and WCN (P ≤ 0.001), SSCC bony island width (P ≤ 0.001) and LSCC bony island width (P = 0.01) were significantly lower. There was no statistically significant difference in terms of CW (P = 0.83), PSCC inferior limb length (P = 0.54), VH (P = 0.67), VW (P = 0.83), and VA operculum width (P = 0.15). WCN (ROC-AUC: 0.80, cut-off point = 1.9 mm, sensitivity = 60

Artificial intelligence (AI) is beginning to aid in several components of the intraoperative workflow, including navigation, instrument tracking, ultrasound analysis, video segmentation, and MRI reconstruction. Early studies demonstrate technical promise but are based on small, single-center datasets with limited heterogeneity and generalizability, and often lead to model overfitting. External validation is rare, and few trials measure the impact on decision-making, complications, or the extent of resection. Differences in annotation standards, imaging protocols and reporting also contribute to the slow speed of translation. Physical, ethical, and regulatory barriers add complexity, especially in settings with limited resources. Recent FDA, EU, and WHO guidance emphasizes lifecycle monitoring, transparency, and real-world evidence, raising the bar for clinical adoption. Progress will require shared databases, standardized reporting, and multicenter implementation studies that track workflow and patient outcomes. Intraoperative AI will definitely not replace a surgeon's judgment, but if carefully developed and rigorously tested, it may provide meaningful clinical value.

Introduction Placenta praevia is a recognized pregnancy complication characterized by the placenta implanting partially or completely within the lower uterine segment, and it is associated with significant maternal and perinatal morbidity. Antepartum hemorrhage is a cardinal sign of placenta praevia, and it is unusual for a woman with placenta praevia to reach the late third trimester without vaginal bleeding. Many risk factors, i.e., age >30 years, previous caesarean section, history of dilatation and curettage, history of assisted reproductive techniques (ARTs), multiple pregnancies, and history of placenta praevia in previous pregnancies, need to be addressed so that a confirmed diagnosis can be made in the antenatal period, and women who are at increased risk for this condition can be managed or referred to a setup where proper and vigilant care is provided to both mother and baby. This study aims to identify the risk factors unique to our population and to stratify antenatal patients into high-risk and lower-risk pregnancy groups.  Methods The study was conducted in the Obstetrical Department of Ayub Teaching Hospital, Abbottabad, Pakistan, after approval of the topic and completion of all prerequisites, for a period of three months from July 1, 2025, to September 30, 2025. Women diagnosed with placenta praevia, including low-lying placenta praevia, through ultrasound examinations after 32 completed weeks of gestation were included in the case group. A total of 30 patients were included in the case group. Similarly, 60 women with normal placental localization were included in the control group (case:control ratio, 1:2). Detailed history was taken and recorded in a predefined proforma. For qualitative data, the Chi-square test was used, and a p-value of <0.05 was considered significant. Results In our study, several factors were associated with placenta previa. Women older than 30 years were more likely to develop placenta previa, with nearly four times higher odds compared to younger women (odds ratio (OR) 3.92, 95% confidence interval (CI): 1.55-9.93; p = 0.0064). A history of previous cesarean section also increased the risk, with cases showing six times higher odds than controls (OR: 6.00, 95% CI: 2.28-15.77; p = 0.00037). Similarly, women who had previously undergone dilatation and curettage had over five times higher odds of placenta previa (OR: 5.20, 95% CI: 1.97-13.70; p = 0.00095), and those who conceived through ARTs were nearly four times more likely to develop the condition (OR: 3.80, 95% CI: 1.49-9.67; p = 0.0037). Notably, a previous history of placenta previa was the strongest predictor of recurrence, with affected women facing markedly higher odds of developing the condition again (OR: 11.0, 95% CI: 3.23-37.42; p = 0.0001).  Conclusion Our study highlights several key risk factors for placenta previa, including advanced maternal age, previous cesarean section, history of dilatation and curettage, ARTs, and prior placenta previa. Identifying these factors early can help clinicians recognize women at higher risk and implement careful monitoring to prevent complications. While our findings align with larger studies, they provide additional insight by examining these associations within a focused case-control setting. Overall, these results emphasize the importance of individualized risk assessment and proactive management to improve maternal and fetal outcomes in pregnancies complicated by placenta previa.