Pak J Med Sci
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To investigate the impact of combining lenvatinib with transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC). ⋯ TACE combined with lenvatinib have a high clinical effective rate, with reduced AFP and VEGF levels, higher two year survival rate, and acceptable incidence of adverse events.
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This study aimed to determine the incidence of extra pulmonary complications among critically ill COVID-19 patients requiring invasive mechanical ventilation and association of these complications with various inflammatory markers and degree of hypoxia. ⋯ Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most common extra pulmonary complications among mechanically ventilated COVID-19 patients with ARDS. Higher serum d-dimer levels were associated with acute liver injury, NSTEMI, ICU stay longer >3 days and invasive mechanical ventilation >2 days. Higher serum ferritin levels are associated with male sex and serve as an important predictor of ICU as well as hospital mortality.
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To explore the independent risk factors of poor wound healing after craniocerebral surgery, and to generate a risk prediction model. ⋯ Long operation duration, surgical site infection, duration of drainage tube, ALB <35g/L, and abnormal HGB were risk factors for poor wound healing. The nomograph model based on these factors showed good discrimination, calibration, and clinical effectiveness in predicting poor wound healing.
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To develop and validate Digital Medical Education Environment (Digi-MEE) Instrument for measuring online learning environment in medical education. ⋯ Digi-MEE is a promising valid and reliable instrument to evaluate online education environment in medical education. Content, response-process, factorial structure, and internal consistency evidence support the validity of Digi-MEE. Medical schools can use Digi-MEE as an evaluation tool for the continuous quality improvement of online learning environments.
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The International Cardio-Metabolic Forum held a plenary session to establish a multinational consensus on the challenges faced in diabetes management within lower-middle-income countries (LMICs) and their potential solutions. Stakeholders, including patients, family/caretakers, healthcare professionals, and healthcare policymakers & organizations, participated in discussions. The audience of 280 doctors from 15 different countries (Pakistan, Qatar, Sri Lanka, Kenya, Myanmar, Georgia, Nigeria, Philippines, Uzbekistan, Iraq, Tanzania, Cambodia, Kazakhstan, South Sudan and Libya) was divided into 4 groups led by Group Leaders to represent each stakeholder group. ⋯ Healthcare professionals emphasized the challenges posed by cultural beliefs and health awareness, underscoring the importance of teamwork and early referral for managing comorbidities. Healthcare policymakers need to focus on disease education, awareness programs, screening guidelines, and advocacy for community and clinical screening. By addressing these challenges, a more comprehensive and effective approach to diabetes management can be achieved in LMICs, ultimately improving outcomes for individuals with diabetes.