ASIDE Internal Medicine
type: channel
description: The ASIDE Internal Medicine Journal, a cornerstone publication of the American Society for Inclusion, Diversity, and Equity in Healthcare (ASIDE), is dedicated to advancing the fields of internal medicine and its subspecialties through a lens of diversity, equity, and inclusion. This peer-reviewed, open-access journal publishes a wide range of research articles, reviews, and clinical studies that focus on innovative healthcare solutions, the impact of social determinants on health outcomes, and strategies for enhancing accessibility to medical services for marginalized populations. With a commitment to fostering a more inclusive healthcare environment, the journal serves as a pivotal platform for medical professionals, researchers, and educators worldwide to share insights and discoveries that can lead to more equitable health practices and policies. ASIDE Internal Medicine: ISSN (Print) 3065-9671, ISSN (Online) 3065-968X Publication Frequency: Quarterly (4 issues per year)
publisher: American Society for Inclusion, Diversity, and Equity in Healthcare (ASIDE)
language: en
publication name: ASIDE Internal Medicine
issn: 3065-9671
copyright: Copyright and Licensing All articles published in ASIDE Internal Medicine are open access and freely available online immediately upon publication, without embargo. This journal applies the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license, anyone may copy, redistribute, remix, transform, and build upon the material for any purpose, even commercially, provided that proper credit is given to the original author(s), a link to the license is provided, and any changes made are indicated. License link: https://creativecommons.org/licenses/by/4.0/ Machine-readable license metadata is embedded in each article and its DOI record. Copyright Holder Copyright in all articles remains with the author(s). By submitting a manuscript, authors agree to grant the publisher (American Society for Inclusion, Diversity, and Equity in Healthcare – ASIDE) a non-exclusive license to publish and distribute the work under the terms of the CC BY 4.0 license. Third-party Material Any material (e.g., images, figures, or tables) not covered by CC BY 4.0 will be clearly indicated in the article. Users must obtain permission directly from the copyright holder for reuse of such third-party material. Author Rights and Self-Archiving Authors are permitted to deposit all versions of their work (preprint, author’s accepted manuscript, and version of record) in institutional or subject repositories of their choice immediately upon publication, without embargo, provided that the DOI and license information are included.
items: Posterior Reversible Encephalopathy Syndrome (PRES) Beyond Hypertension: Triggers, Pathophysiology, Management, and Outcomes
items: Dexmedetomidine as an Adjuvant to Ropivacaine in Thoracic Paravertebral Block: A Systematic Review with Meta-analysis
items: National-Level Outcomes of Diabetic Ketoacidosis with and without Coma: A Retrospective Analysis of 2.3 Million U.S. Hospitalizations
items: Twenty-Five Years of Angina–Related Mortality in Elderly Adults Aged ≥ 65 Years: A Retrospective Cohort Study Using Real-World Data from the USA
items: Disparities and Trends in Polycythemia Vera–Related Mortality in U.S. Adults Aged ≥45 Years from 1999 to 2023
items: A Pairwise and Network Meta-Analysis Comparing the Efficacy and Safety of Ribonucleic Acid Interference Therapeutics in the Management of Hypertension
items: Improving Inpatient Care for Acute Chronic Obstructive Pulmonary Disease Exacerbations: A Quality Improvement Initiative
items: Trends in Mortality from Leukemia and Ischemic Heart Disease: A 22-Year Analysis in the U.S. (1999-2020)
items: Probiotics: A Promising Ally in Burn Treatment
items: Prolonged Immunosuppressive Therapy in Immune Complex-Membranoproliferative Glomerulonephritis: A Case Report of Sustained Partial Remission Over Three Years
items: Migraine Headache in Patients with Allergic Rhinitis: A Systematic Review and Meta-Analysis of Observational Studies
items: Concurrent Diabetic Ketoacidosis and Acute Coronary Syndrome: A Systematic Review of Case Reports
items: Esophageal Stenting and Endoscopic Vacuum Therapy for Esophageal Defects: A Systematic Review and Meta-Analysis
items: A Comprehensive Review of Fluid Resuscitation Techniques in Sepsis in Patients with Heart Failure
items: Clinical Efficacy and Safety of Fluvoxamine in COVID-19 Patients: An Umbrella Review of Systematic Reviews and Meta-Analyses
items: Dual association of autoimmune encephalitis with anti-NMDAR and anti-GAD65 antibodies: A Case Report with Literature Review
items: Acute Myeloid Leukemia Presenting as Bilateral Proptosis: A Case Report with Literature Review
items: Human Readers versus AI-Based Systems in ASPECTS Scoring for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis with Region-Specific Guidance
items: Challenges and Infectious Complications in Living Donor Liver Transplantation in Egypt: A Comprehensive Review
items: Efficacy and Safety of Penehyclidine Hydrochloride in Postoperative Nausea and Vomiting Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
items: Antibiotic Knowledge, Perception, and Practice of Intern Doctors in Turkey: A Survey Study
items: TriNetX and Real-World Evidence: A Critical Review of Its Strengths, Limitations, and Bias Considerations in Clinical Research
items: Impact of Serum Adiponectin Level on Insulin and hs-CRP in Patients with Type 2 Diabetes: A Case-Control Study
items: Investigating the Impact of Primary Education on Birth Control Practices in Bangladesh: A Primary Study
items: Epidemiological Patterns of Diabetes Mellitus in The United States of America: An Observational Multicenter Analysis From 1990 to 2024
items: The Impact of Idiopathic Intracranial Hypertension on Cardiovascular Disease Risk Among UK Women: An Obesity-Adjusted Analysis
items: Safety and Efficacy of Metformin for Idiopathic Intracranial Hypertension: A U.S.-Based Real-World Data Retrospective Multicenter Cohort Study
items: Stroke-Like Migraine Attacks After Radiation Therapy (SMART) Syndrome: A Case Report With Vertigo, Dysmetria, And Impaired Tandem Gait
items: Epidemiological Assessment of Risk Factors for Inguinal Hernia Among Male Patients in Iraq: A Case-Control Study
items: Bridging the Gap: Addressing Language Barriers to Advance Equity in Internal Medicine

Posterior Reversible Encephalopathy Syndrome (PRES) Beyond Hypertension: Triggers, Pathophysiology, Management, and Outcomes
type: item
description: Section: Review Article Categories: Internal Medicine, Neurology Keywords: Posterior Reversible Encephalopathy Syndrome, PRES , Pathophysiology , Hypertension Subjects: Posterior Reversible Encephalopathy Syndrome, PRES, Hypertension, Eclampsia and Preeclampsia, Immunosuppressive Therapy, Autoimmune Diseases, Sepsis-associated Encephalopathy, Neuroimaging, Vasogenic Edema, Endothelial Dysfunction Disciplines: Neurology, Internal Medicine, Neuroradiology, Emergency Medicine, Critical Care Medicine, Obstetrics and Maternal-Fetal Medicine, Nephrology, Immunology, Neuroscience, Clinical Pharmacology Introduction: Posterior reversible encephalopathy syndrome (PRES) is a neurovascular disorder characterized by vasogenic edema, most often affecting the parieto-occipital lobes. Although typically reversible, some patients develop lasting neurological sequelae such as cognitive or visual impairment and epilepsy. This review summarizes the current understanding of PRES beyond its classical association with hypertension, emphasizing emerging triggers, mechanisms, and updates in management. Methods: A structured narrative review was conducted in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) framework. Literature was systematically searched in PubMed, Web of Science, and Google Scholar for studies published between January 1996 and June 2025. Fifty-nine relevant publications, including original studies and reviews, were synthesized to integrate evidence on presentation, imaging, pathophysiology, genetics, and management. Results: PRES can be triggered by a broad spectrum of hypertensive and non-hypertensive conditions, such as renal dysfunction, eclampsia, systemic lupus erythematosus, sepsis, and exposure to immunosuppressive agents (e.g., tacrolimus, cyclosporine, rituximab). The syndrome involves multifactorial mechanisms, including endothelial dysfunction, blood–brain barrier disruption, and dysregulated cerebral autoregulation. Emerging d…
subject: Review Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Neurology
  topic: category
subject: Posterior Reversible Encephalopathy Syndrome
  topic: keywords
subject: PRES
  topic: keywords
subject: Pathophysiology
  topic: keywords
subject: Hypertension
  topic: keywords
subject: Posterior Reversible Encephalopathy Syndrome
  topic: subjects
subject: PRES
  topic: subjects
subject: Hypertension
  topic: subjects
subject: Eclampsia and Preeclampsia
  topic: subjects
subject: Immunosuppressive Therapy
  topic: subjects
subject: Autoimmune Diseases
  topic: subjects
subject: Sepsis-associated Encephalopathy
  topic: subjects
subject: Neuroimaging
  topic: subjects
subject: Vasogenic Edema
  topic: subjects
subject: Endothelial Dysfunction
  topic: subjects
subject: Neurology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Neuroradiology
  topic: disciplines
subject: Emergency Medicine
  topic: disciplines
subject: Critical Care Medicine
  topic: disciplines
subject: Obstetrics and Maternal-Fetal Medicine
  topic: disciplines
subject: Nephrology
  topic: disciplines
subject: Immunology
  topic: disciplines
subject: Neuroscience
  topic: disciplines
subject: Clinical Pharmacology
  topic: disciplines
creator: Mohamed Fawzi Hemida
creator: Pranjal Kumar Singh
creator: Alyaa Ahmed Ibrahim
creator: Ahmed Harb
creator: Sai Lokesh Moraboina
creator: Geethanjali Prakash
creator: Esraa M. Soliman
creator: Arun Kumar Maloth
creator: Huda Adnan
creator: Ravi Virani
creator: Sanchit Shailendra Chouksey
rights: Copyright (c) 2025 Mohamed Fawzi Hemida, MD, Pranjal Kumar Singh, MBBS, Alyaa Ahmed Ibrahim, MD, Ahmed Harb, MD, Sai Lokesh Moraboina, MD, Geethanjali Prakash, MBBS, Esraa M. Soliman, MBBS, Arun Kumar Maloth, MBBS, Huda Adnan, MBBS, Ravi Virani, MBBS, Sanchit Shailendra Chouksey, MBBS, MD, DM https://creativecommons.org/licenses/by/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 9
ending page: 16
doi: 10.71079/ASIDE.IM.112825190

Dexmedetomidine as an Adjuvant to Ropivacaine in Thoracic Paravertebral Block: A Systematic Review with Meta-analysis
type: item
description: Section: Original Article Categories: Internal Medicine Keywords: Acute Appendix, Ropivacaine, Thoracic Surger, Paravertebral Block, Postoperative Pain, Meta-analysis Subjects: Dexmedetomidine, Ropivacaine, Thoracic Paravertebral Bloc, Video-Assisted Thoracoscopic Surgery (VATS), Postoperative Pain Management, Regional Anesthesia, Analgesic Adjuvants, Opioid-Sparing Techniques, Randomized Controlled Trials, Meta-Analysis Disciplines: Anesthesiology, Thoracic Surgery, Pain Medicine, Perioperative Care, Clinical Pharmacology, Evidence-Based Medicine, Critical Care, Surgical Anesthesia, Acute Pain Management, Internal Medicine (Thoracic/Perioperative Focus) Background: One of the ongoing challenges in thoracic surgeries, especially video-assisted thoracoscopic surgery (VATS), is effective postoperative pain management. The thoracic paravertebral block (TPVB) using ropivacaine provides targeted analgesia but suffers from a limited duration of effect. This meta-analysis aims to assess the safety of combining dexmedetomidine with ropivacaine in TPVB for thoracic procedures and to explore potential analgesic benefits suggested by individual trials. Method: A systematic review and meta-analysis of randomized controlled trials were conducted to compare the combination of dexmedetomidine and ropivacaine (PRD) with ropivacaine alone (PR) in thoracic procedures. Outcomes assessed included adverse effects (bradycardia, dizziness, hypotension, nausea, and vomiting). Analgesic and opioid-sparing effects were reported narratively, as data were heterogeneous and unsuitable for pooled analysis. Result: Five studies were included. No statistically significant differences were found between PRD and PR in the incidence of bradycardia (RR: 2.14; 95% CI: 0.71–6.40; p=0.1750), dizziness (RR: 1.52; 95% CI: 0.71–3.27; p=0.2833), hypotension (RR: 0.78; 95% CI: 0.40–1.53; p=0.4676), nausea (RR: 1.15; 95% CI: 0.65–2.03; p=0.6018), or vomiting (RR: 1.04; 95% CI: 0.54–2.02; p=0.9122). Some indivi…
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Acute Appendix
  topic: keywords
subject: Ropivacaine
  topic: keywords
subject: Thoracic Surger
  topic: keywords
subject: Paravertebral Block
  topic: keywords
subject: Postoperative Pain
  topic: keywords
subject: Meta-analysis
  topic: keywords
subject: Dexmedetomidine
  topic: subjects
subject: Ropivacaine
  topic: subjects
subject: Thoracic Paravertebral Bloc
  topic: subjects
subject: Video-Assisted Thoracoscopic Surgery (VATS)
  topic: subjects
subject: Postoperative Pain Management
  topic: subjects
subject: Regional Anesthesia
  topic: subjects
subject: Analgesic Adjuvants
  topic: subjects
subject: Opioid-Sparing Techniques
  topic: subjects
subject: Randomized Controlled Trials
  topic: subjects
subject: Meta-Analysis
  topic: subjects
subject: Anesthesiology
  topic: disciplines
subject: Thoracic Surgery
  topic: disciplines
subject: Pain Medicine
  topic: disciplines
subject: Perioperative Care
  topic: disciplines
subject: Clinical Pharmacology
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Critical Care
  topic: disciplines
subject: Surgical Anesthesia
  topic: disciplines
subject: Acute Pain Management
  topic: disciplines
subject: Internal Medicine (Thoracic/Perioperative Focus)
  topic: disciplines
creator: Mohamed Wagdy
creator: Abdelrahman Abdalla Mohamed
creator: Abdalla Ahmed Mohamed
creator: Ziad ElDosoky Farouk
creator: Mahmoud Abd El Nasser
creator: Abdelrahman A. Ebaid Ebaid
creator: Abdelrhman Waleed Kotb
creator: Mostafa AbdElmawla Mohamed
rights: Copyright (c) 2025 Mohamed Wagdy, Abdelrahman Abdalla Mohamed, Abdalla Ahmed Mohamed, Ziad ElDosoky Farouk, Mahmoud Abd El Nasser, Abdelrahman A. Ebaid Ebaid, Abdelrhman Waleed Kotb , Mostafa AbdElmawla Mohamed https://creativecommons.org/licenses/by/4.0
date: 2025-11-17
publication date: 2025-11-17
starting page: 1
ending page: 8
doi: 10.71079/ASIDE.IM.111725246

National-Level Outcomes of Diabetic Ketoacidosis with and without Coma: A Retrospective Analysis of 2.3 Million U.S. Hospitalizations
type: item
description: Section: Original Article Categories: Endocrinology Keywords: Diabetic ketoacidosis, Coma, Length of stay, Hospital charges, National Inpatient Sample, Mortality Subjects: Diabetic ketoacidosis (DKA), DKA mortality predictors, Consciousness level in DKA, Hospital outcomes, Type 1 diabetes complications, Type 2 diabetes complications, Healthcare resource utilization, Length of stay, In-hospital mortality, Hospital charges, National Inpatient Sample, Demographic factors in DKA, Coma in diabetes, Hospital characteristics, Age-related DKA outcomes, Gender differences in DKA, Racial/ethnic disparities in diabetes, Socioeconomic factors in DKA, Insurance status and DKA, Medicare outcomes, Critical care in diabetes Disciplines: Internal Medicine, Endocrinology, Critical Care Medicine, Emergency Medicine, Health Services Research, Epidemiology, Hospital Medicine, Public Health, Health Disparities Research, Medical Education, Healthcare Administration, Health Policy, Health Economics, Clinical Outcomes Research, Population Health, Diabetes Care, Metabolic Disorders, Healthcare Quality Improvement, Social Determinants of Health, Medical Informatics Background: Diabetic ketoacidosis (DKA) remains a significant complication of diabetes associated with substantial morbidity and mortality. We aimed to evaluate clinical outcomes among patients with DKA, both with and without coma, using a nationally representative database and to identify associated factors. Methods: We analyzed 2,381,619 DKA hospitalizations from the National Inpatient Sample (2016-2022), comparing outcomes between patients with (n=47,355, 1.99%) and without coma (n=2,334,264, 98.01%). Primary outcomes included length of stay (LOS), in-hospital mortality, and total hospital charges. Multivariable regression models adjusted for demographic, clinical, and hospital-level factors. Results: Patients with DKA-related coma had significantly worse outcomes: longer LOS (8.65 vs. 4.91 days), higher mortality (16.36% vs. 3.…
subject: Original Article
  topic: section
subject: Endocrinology
  topic: category
subject: Diabetic ketoacidosis
  topic: keywords
subject: Coma
  topic: keywords
subject: Length of stay
  topic: keywords
subject: Hospital charges
  topic: keywords
subject: National Inpatient Sample
  topic: keywords
subject: Mortality
  topic: keywords
subject: Diabetic ketoacidosis (DKA)
  topic: subjects
subject: DKA mortality predictors
  topic: subjects
subject: Consciousness level in DKA
  topic: subjects
subject: Hospital outcomes
  topic: subjects
subject: Type 1 diabetes complications
  topic: subjects
subject: Type 2 diabetes complications
  topic: subjects
subject: Healthcare resource utilization
  topic: subjects
subject: Length of stay
  topic: subjects
subject: In-hospital mortality
  topic: subjects
subject: Hospital charges
  topic: subjects
subject: National Inpatient Sample
  topic: subjects
subject: Demographic factors in DKA
  topic: subjects
subject: Coma in diabetes
  topic: subjects
subject: Hospital characteristics
  topic: subjects
subject: Age-related DKA outcomes
  topic: subjects
subject: Gender differences in DKA
  topic: subjects
subject: Racial/ethnic disparities in diabetes
  topic: subjects
subject: Socioeconomic factors in DKA
  topic: subjects
subject: Insurance status and DKA
  topic: subjects
subject: Medicare outcomes
  topic: subjects
subject: Critical care in diabetes
  topic: subjects
subject: Internal Medicine
  topic: disciplines
subject: Endocrinology
  topic: disciplines
subject: Critical Care Medicine
  topic: disciplines
subject: Emergency Medicine
  topic: disciplines
subject: Health Services Research
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Hospital Medicine
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Health Disparities Research
  topic: disciplines
subject: Medical Education
  topic: disciplines
subject: Healthcare Administration
  topic: disciplines
subject: Health Policy
  topic: disciplines
subject: Health Economics
  topic: disciplines
subject: Clinical Outcomes Research
  topic: disciplines
subject: Population Health
  topic: disciplines
subject: Diabetes Care
  topic: disciplines
subject: Metabolic Disorders
  topic: disciplines
subject: Healthcare Quality Improvement
  topic: disciplines
subject: Social Determinants of Health
  topic: disciplines
subject: Medical Informatics
  topic: disciplines
creator: Mahmoud Nassar
creator: Mohamed Hatem Ellabban
creator: Mohamed R. Murad
creator: Omar Nassar
creator: Nuha ElSayed
rights: Copyright (c) 2025 Mahmoud Nassar, Mohamed Hatem Ellabban, Mohamed R. Murad, Omar Nassar, Nuha ElSayed https://creativecommons.org/licenses/by/4.0
date: 2025-11-16
publication date: 2025-11-16
starting page: 43
ending page: 54
doi: 10.71079/ASIDE.IM.11162580

Twenty-Five Years of Angina–Related Mortality in Elderly Adults Aged ≥ 65 Years: A Retrospective Cohort Study Using Real-World Data from the USA
type: item
description: Section: Original Article Categories: Internal Medicine, Cardiology, Public Health Keywords: Angina, Trends, Mortality, Ischemic heart disease (IHD), Cardiovascular Subjects: Angina Pectoris, Ischemic Heart Disease, Cardiovascular Mortality, Elderly Population, Age-Adjusted Mortality Rate, Retrospective Cohort Study, Joinpoint Trend Analysis, CDC WONDER Database, Sex and Racial Disparities, United States Epidemiology Disciplines: Cardiology, Internal Medicine, Public health, Geriatric Medicine, Epidemiology, Preventive Cardiology, Health Disparities, Biostatistics, Population Health, Clinical Research Introduction: Angina is one of the ischemic heart diseases (IHD) that contributes to major cardiovascular complications up to death. We aim to assess angina-related mortality among adults aged ≥65 years in the U.S. Methods: Nationwide mortality records were obtained from the CDC-WONDER database from 1999 to 2023 among U.S. adults aged ≥65 with angina. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population. Joinpoint regression analysis was utilized to evaluate average annual percent changes (AAPCs). Results: From 1999 to 2023, a total of 36,544 deaths occurred among the elderly with angina in the U.S. The overall AAMR per 100,000 decreased from 7.52 in 1999 to 3.73 in 2023 (AAPC of -3.18; 95%CI: -3.79 to -2.75; p < 0.001). The AAMR for men decreased from 8.22 in 1999 to 4.75 in 2023 (AAPC of -2.53%; 95%CI: -3.02 to -2.09), and for women decreased from 6.95 in 1999 to 3.02 in 2023 (AAPC: -3.55%; 95%CI: -4.12 to -3.09). Across racial/ethnic groups, the highest overall rates were observed among NH-White individuals, 3.56. Overall, AAMRs were highest in the West, 4.00. The majority of deaths occurred in medical facilities (40.19%). Between 1999 and 2020, rural areas had a higher overall AAMR of 4.37 compared to urban areas, which had a rate of 3.02. Conclusion: Trends in angina-related mortality declined from 1999 to 2023. Higher mortality rates were o…
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Cardiology
  topic: category
subject: Public Health
  topic: category
subject: Angina
  topic: keywords
subject: Trends
  topic: keywords
subject: Mortality
  topic: keywords
subject: Ischemic heart disease (IHD)
  topic: keywords
subject: Cardiovascular
  topic: keywords
subject: Angina Pectoris
  topic: subjects
subject: Ischemic Heart Disease
  topic: subjects
subject: Cardiovascular Mortality
  topic: subjects
subject: Elderly Population
  topic: subjects
subject: Age-Adjusted Mortality Rate
  topic: subjects
subject: Retrospective Cohort Study
  topic: subjects
subject: Joinpoint Trend Analysis
  topic: subjects
subject: CDC WONDER Database
  topic: subjects
subject: Sex and Racial Disparities
  topic: subjects
subject: United States Epidemiology
  topic: subjects
subject: Cardiology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Public health
  topic: disciplines
subject: Geriatric Medicine
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Preventive Cardiology
  topic: disciplines
subject: Health Disparities
  topic: disciplines
subject: Biostatistics
  topic: disciplines
subject: Population Health
  topic: disciplines
subject: Clinical Research
  topic: disciplines
creator: Mohamed Fawzi Hemida
creator: Alyaa Ahmed Ibrahim
creator: Anika Goel
creator: Mirna Hussein
creator: Krish Patel
creator: Muhammad Raza Sarfraz
creator: Omar Y. Alkasabrah
creator: Maryam Saghir
creator: Komal Karmani
creator: Eshal Saghir
creator: Zahin Shahriar
creator: Safeya Fawzi
creator: Ahmed Bahnasy
creator: Muhammad Faizan Ali
creator: Amro Ali
creator: Ahmad M. Abdelkhalek
creator: Raheel Ahmed
rights: Copyright (c) 2025 Mohamed Fawzi Hemida, Alyaa Ahmed Ibrahim, Anika Goel, Mirna Hussein, Krish Patel, Muhammad Raza Sarfraz, Omar Y. Alkasabrah, MD, Maryam Saghir, Komal Karmani, Eshal Saghir, Zahin Shahriar, Safeya Fawzi, Ahmed Bahnasy, Muhammad Faizan Ali, Amro Ali, Ahmad M. Abdelkhalek, Raheel Ahmed, MBBS, MRCP, PhD https://creativecommons.org/licenses/by/4.0
date: 2025-11-09
publication date: 2025-11-09
starting page: 33
ending page: 42
doi: 10.71079/ASIDE.IM.110925248

Disparities and Trends in Polycythemia Vera–Related Mortality in U.S. Adults Aged ≥45 Years from 1999 to 2023
type: item
description: Section: Original Article Categories: Internal Medicine, Hematology, Public Health Keywords: Polycythemia Vera, Mortality, Trends, Myeloproliferative Neoplasms Subjects: Polycythemia Vera, Mortality Trends, Myeloproliferative Neoplasms, Hematologic Malignancies, Disparities in Health Outcomes, Age-specific Mortality, Gender Differences, Racial/Ethnic Disparities, Epidemiology, United States Population Disciplines: Hematology, Oncology, Internal Medicine, Public Health, Epidemiology, Biostatistics, Geriatrics, Health Disparities Research, Preventive Medicine, Medical Demography Background: Polycythemia vera (PV) is a rare myeloproliferative neoplasm characterized by excessive red blood cell production, leading to increased risk of thrombosis and other complications. Despite its clinical significance, trends in PV mortality across demographic groups in the US remain understudied. Methods: Nationwide mortality records were obtained from the CDC-WONDER database from 1999 to 2023 among U.S. adults aged ≥45 with PV. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated for variables. Joinpoint regression analysis was utilized to evaluate annual percent changes (APCs). Results: From 1999 to 2023, a total of 24,236 deaths occurred among adults with PV in the U.S. The overall AAMR decreased from 1.15 in 1999 to 0.73 in 2023 (AAPC: -1.96; 95% CI: -2.28 to -1.73; p < 0.001). The AAMR for men decreased from 1.38 in 1999 to 0.87 in 2023 (AAPC-1.88; 95% CI: -2.36 to -1.37; p < 0.001), and for women decreased from 1 in 1999 to 0.62 in 2023 (AAPC: -2.03; 95% CI: -2.66 to -1.43; p < 0.001). Across racial/ethnic groups, AAMR was highest in non-Hispanic White (0.93 per 100,000). Overall, AAMRs were highest in the Midwest (0.95). The majority of deaths occurred in medical facilities (39.36%). Rural areas had a higher overall AAMR (0.91) compared to urban areas (0.82). Conclusion: Trends in (PV) mortality declined overall from 1999 to 2023—higher trends observed in…
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Hematology
  topic: category
subject: Public Health
  topic: category
subject: Polycythemia Vera
  topic: keywords
subject: Mortality
  topic: keywords
subject: Trends
  topic: keywords
subject: Myeloproliferative Neoplasms
  topic: keywords
subject: Polycythemia Vera
  topic: subjects
subject: Mortality Trends
  topic: subjects
subject: Myeloproliferative Neoplasms
  topic: subjects
subject: Hematologic Malignancies
  topic: subjects
subject: Disparities in Health Outcomes
  topic: subjects
subject: Age-specific Mortality
  topic: subjects
subject: Gender Differences
  topic: subjects
subject: Racial/Ethnic Disparities
  topic: subjects
subject: Epidemiology
  topic: subjects
subject: United States Population
  topic: subjects
subject: Hematology
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Biostatistics
  topic: disciplines
subject: Geriatrics
  topic: disciplines
subject: Health Disparities Research
  topic: disciplines
subject: Preventive Medicine
  topic: disciplines
subject: Medical Demography
  topic: disciplines
creator: Alyaa Ahmed Ibrahim
creator: Mohamed Fawzi Hemida
creator: Mirna Hussein
creator: Maryam Saghir
creator: Mohammad Rayyan Faisal
creator: FNU Kritika
creator: Krish Patel
creator: Amro Ali
creator: Eshal Saghir
creator: Mahmoud Tablawy
creator: Abdelrhman H. Mohamed
creator: Amr Arafa
rights: Copyright (c) 2025 Alyaa Ahmed Ibrahim, Mohamed Fawzi Hemida, MD, Mirna Hussein, Maryam Saghir, Mohammad Rayyan Faisal, FNU Kritika, Krish Patel, Amro Ali, MD, Eshal Saghir, Mahmoud Tablawy, Abdelrhman H. Mohamed, Amr Arafa, MD https://creativecommons.org/licenses/by/4.0
date: 2025-09-27
publication date: 2025-09-27
starting page: 24
ending page: 32
doi: 10.71079/ASIDE.IM.092725233

A Pairwise and Network Meta-Analysis Comparing the Efficacy and Safety of Ribonucleic Acid Interference Therapeutics in the Management of Hypertension
type: item
description: Section: Review Article Categories: Cardiology Keywords: Hypertension, Ribonucleic acid interference therapeutics, Blood pressure management Subjects: Hypertension, Blood pressure management, Small interfering RNA (siRNA), RNA interference therapeutics, Zilebesiran, IONIS-AGT-LRx, Angiotensinogen (AGT), Renin-angiotensin-aldosterone system (RAAS), Ambulatory blood pressure, Network meta-analysis Disciplines: Cardiology, Systematic Reviews, Cardiovascular medicine, Internal medicine, Pharmacology, Molecular therapeutics, Genomic medicine, Evidence-based medicine, Clinical trials, Systematic review, Biostatistics, Translational medicine Background: Small interfering RNA (siRNA) and antisense agents targeting angiotensinogen are emerging antihypertensives. We synthesized their efficacy and safety. Methods: We searched PubMed, Web of Science, Scopus, and CENTRAL through 25 Nov 2024. Eligible studies were randomized controlled trials in adults with hypertension comparing RNA-interference therapeutics with placebo. Primary outcomes were the change in ambulatory and office systolic/diastolic blood pressure. We conducted random-effects pairwise meta-analyses and a network meta-analysis with SUCRA ranking, and appraised certainty with GRADE. Results: Four trials (n=486) met criteria. Versus placebo, RNA-interference therapy reduced ambulatory SBP (mean difference [MD] −15.46 mmHg; 95% CI −18.79 to −12.12) and DBP (MD −8.45 mmHg; −10.67 to −6.23), and lowered office SBP (MD −8.07 mmHg; −11.58 to −4.56) and DBP (MD −5.18 mmHg; −7.73 to −2.63). Injection-site reactions increased (risk ratio 5.26; 1.01–27.44); other adverse events, potassium, and eGFR were similar. In network analyses, zilebesiran 300 mg ranked highest for blood-pressure lowering; for AGT reduction, 800 mg ranked highest. GRADE certainty was high for blood-pressure outcomes and moderate for AGT, potassium, and eGFR. Few, short-term trials and sparse networks limit precision and generalizability; publication bias…
subject: Review Article
  topic: section
subject: Cardiology
  topic: category
subject: Hypertension
  topic: keywords
subject: Ribonucleic acid interference therapeutics
  topic: keywords
subject: Blood pressure management
  topic: keywords
subject: Hypertension
  topic: subjects
subject: Blood pressure management
  topic: subjects
subject: Small interfering RNA (siRNA)
  topic: subjects
subject: RNA interference therapeutics
  topic: subjects
subject: Zilebesiran
  topic: subjects
subject: IONIS-AGT-LRx
  topic: subjects
subject: Angiotensinogen (AGT)
  topic: subjects
subject: Renin-angiotensin-aldosterone system (RAAS)
  topic: subjects
subject: Ambulatory blood pressure
  topic: subjects
subject: Network meta-analysis
  topic: subjects
subject: Cardiology
  topic: disciplines
subject: Systematic Reviews
  topic: disciplines
subject: Cardiovascular medicine
  topic: disciplines
subject: Internal medicine
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Molecular therapeutics
  topic: disciplines
subject: Genomic medicine
  topic: disciplines
subject: Evidence-based medicine
  topic: disciplines
subject: Clinical trials
  topic: disciplines
subject: Systematic review
  topic: disciplines
subject: Biostatistics
  topic: disciplines
subject: Translational medicine
  topic: disciplines
creator: Mohamed E. Haseeb
creator: Zeyad Bady
creator: Hazem E. Mohammed
creator: George Hanen
creator: Mohamed Nasser
creator: Nada S. Jibril
creator: Mohamed Khalafalla Darwish
creator: Heba Aboeldahab
rights: Copyright (c) 2025 Mohamed E. Haseeb, Zeyad Bady, Hazem E. Mohammed, George Hanen, Mohamed Nasser, Nada S. Jibril, Mohamed Khalafalla Darwish, Heba Aboeldahab https://creativecommons.org/licenses/by/4.0
date: 2025-09-21
publication date: 2025-09-21
starting page: 11
ending page: 23
doi: 10.71079/ASIDE.IM.092125141

Improving Inpatient Care for Acute Chronic Obstructive Pulmonary Disease Exacerbations: A Quality Improvement Initiative
type: item
description: Section: Original Article Categories: Internal Medicine Keywords: Acute Exacerbation, Quality Improvement, Electronic Health Record, Pulmonary Rehabilitation, Smoking Cessation Subjects: Chronic Obstructive Pulmonary Disease (COPD), Acute Exacerbation of COPD (AECOPD), Inpatient Care, Pulmonary Rehabilitation, Oxygen Titration, Smoking Cessation, Electronic Health Records (EHR), Corticosteroid Therapy, Antibiotic Stewardship, Hospital Readmissions Disciplines: Internal Medicine, Respiratory Medicine, Pulmonology, Quality Improvement (QI), Clinical Decision Support Systems, Health Services Research, Patient Safety, Evidence-Based Medicine, Clinical Audit, Healthcare Quality and Equity Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) account for high hospital use; guideline-concordant diagnostics, oxygen titration, and discharge planning are often under-delivered. We aim to measure baseline compliance with eight AECOPD process standards and evaluate whether EHR-embedded prompts plus staff education were associated with observed improvements. Methods: We audited 50 consecutive adult admissions with primary AECOPD (ICD-10 J44.1 or clinician-documented diagnosis) between July and October 2024, implemented EHR prompts, an orderset, and targeted education (Nov–Dec 2024), then re-audited 50 consecutive admissions (Jan–Mar 2025) using identical methods. Primary process measures were pre-specified; analyses were descriptive with 95% Wilson confidence intervals (CIs) for proportions and two-sided Fisher exact tests for pre/post comparisons. This work was performed as a service evaluation/pilot. Results: After implementation, six of eight process standards showed observed increases. Pulmonary rehabilitation referrals rose from 32/50 (64.0%, 95% CI 50.1–75.9%) to 43/50 (86.0%, 95% CI 73.8–93.0%), p = 0.0198. Oxygen titration improved from 40/50 (80.0%, 95% CI 66.0–88.6%) to 46/50 (92.0%, 95% CI 78.6–95.7%), p = 0.148. Other measures (ABG timing, …
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Acute Exacerbation
  topic: keywords
subject: Quality Improvement
  topic: keywords
subject: Electronic Health Record
  topic: keywords
subject: Pulmonary Rehabilitation
  topic: keywords
subject: Smoking Cessation
  topic: keywords
subject: Chronic Obstructive Pulmonary Disease (COPD)
  topic: subjects
subject: Acute Exacerbation of COPD (AECOPD)
  topic: subjects
subject: Inpatient Care
  topic: subjects
subject: Pulmonary Rehabilitation
  topic: subjects
subject: Oxygen Titration
  topic: subjects
subject: Smoking Cessation
  topic: subjects
subject: Electronic Health Records (EHR)
  topic: subjects
subject: Corticosteroid Therapy
  topic: subjects
subject: Antibiotic Stewardship
  topic: subjects
subject: Hospital Readmissions
  topic: subjects
subject: Internal Medicine
  topic: disciplines
subject: Respiratory Medicine
  topic: disciplines
subject: Pulmonology
  topic: disciplines
subject: Quality Improvement (QI)
  topic: disciplines
subject: Clinical Decision Support Systems
  topic: disciplines
subject: Health Services Research
  topic: disciplines
subject: Patient Safety
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Clinical Audit
  topic: disciplines
subject: Healthcare Quality and Equity
  topic: disciplines
creator: Khaqan Ahmed
creator: Afaq Ahmad
creator: Muhammad Saqib
creator: Muhammad Iftikhar
creator: Humna Shahid
rights: Copyright (c) 2025 Khaqan Ahmed, Afaq Ahmad, Muhammad Saqib, Muhammad Iftikhar, Humna Shahid https://creativecommons.org/licenses/by/4.0
date: 2025-09-20
publication date: 2025-09-20
starting page: 1
ending page: 10
doi: 10.71079/ASIDE.IM.092025173

Trends in Mortality from Leukemia and Ischemic Heart Disease: A 22-Year Analysis in the U.S. (1999-2020)
type: item
description: Section: Original Article Categories: Internal Medicine, Cardiology, Hematology, Public Health Keywords: Ischemic heart disease, Leukemia, Mortality, Trends, Disparities Subjects: Leukemia, Ischemic Heart Disease (IHD), Mortality Trends, Cardiovascular Mortality, Cancer Mortality, United States Population, Time-Series Analysis, Epidemiology, Age-Adjusted Mortality Rates, Public Health Disciplines: Internal Medicine, Cardiology, Hematology, Oncology, Epidemiological Research, Health Statistics, Population Health, Chronic Disease Outcomes, Medical Data Analysis, Healthcare Policy Introduction: Leukemia and ischemic heart disease (IHD) are major U.S. mortality causes. This study analyzes national mortality trends from 1999 to 2020 to assess the impact of public health efforts in leukemia-associated IHD mortality rates. Methods: This retrospective study analyzed death certificate data from the CDC-WONDER database spanning 1999 to 2020, focusing on leukemia (ICD-10: C91–C95) and ischemic heart disease (ICD-10: I20–I25) as multiple causes of mortality in the U.S. population. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 100,000 population were calculated. JoinPoint analysis was performed to estimate annual percent change (APC) and average annual percent change (AAPC). Results: From 1999 to 2020, there were 53,603 deaths from combined leukemia and ischemic heart disease among U.S. adults aged 25+, with the AAMR declining from 1.39 to 1.09 per 100,000 (AAPC= -1.30%; 95% CI: -1.90 to -0.68; P= 0.000034). A significant decrease occurred from 1999 to 2018 (AAMR: 1.39 to 0.95; APC= -2.1894%; 95% CI: -2.3995 to -1.9788, P < 0.000001), followed by a period where the trend shifted upward which is statistically significant for the certain subgroups, except men and older adults. Men had higher AAMR than women (1.87 vs. 0.62). Regional AAMRs were highest in the Midwest (1.3). Non-Hispanic Whites had the highest AAMR (1.25). Adults 65+ had a CMR of 5.27 vs. 0…
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Cardiology
  topic: category
subject: Hematology
  topic: category
subject: Public Health
  topic: category
subject: Ischemic heart disease
  topic: keywords
subject: Leukemia
  topic: keywords
subject: Mortality
  topic: keywords
subject: Trends
  topic: keywords
subject: Disparities
  topic: keywords
subject: Leukemia
  topic: subjects
subject: Ischemic Heart Disease (IHD)
  topic: subjects
subject: Mortality Trends
  topic: subjects
subject: Cardiovascular Mortality
  topic: subjects
subject: Cancer Mortality
  topic: subjects
subject: United States Population
  topic: subjects
subject: Time-Series Analysis
  topic: subjects
subject: Epidemiology
  topic: subjects
subject: Age-Adjusted Mortality Rates
  topic: subjects
subject: Public Health
  topic: subjects
subject: Internal Medicine
  topic: disciplines
subject: Cardiology
  topic: disciplines
subject: Hematology
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Epidemiological Research
  topic: disciplines
subject: Health Statistics
  topic: disciplines
subject: Population Health
  topic: disciplines
subject: Chronic Disease Outcomes
  topic: disciplines
subject: Medical Data Analysis
  topic: disciplines
subject: Healthcare Policy
  topic: disciplines
creator: Mohamed Fawzi Hemida
creator: Ayesha Khan
creator: Alyaa Ahmed Ibrahim
creator: Anika Goel
creator: Krish Patel
creator: Zahin Shahriar
creator: Ahmed W. Hageen
creator: Mustafa Alsaadi
creator: Saif Ur Rahman
creator: Amr Arafa
creator: Zeyad Kholeif
creator: Ahmed Bahnasy
rights: Copyright (c) 2025 Mohamed Fawzi Hemida, Ayesha Khan, Alyaa Ahmed Ibrahim, Anika Goel, Krish Patel, Zahin Shahriar, Ahmed W. Hageen, Mustafa Alsaadi, Saif Ur Rahman, Amr Arafa, Zeyad Kholeif, Ahmed Bahnasy https://creativecommons.org/licenses/by/4.0
date: 2025-09-14
publication date: 2025-09-14
starting page: 21
ending page: 30
doi: 10.71079/ASIDE.IM.091425163

Probiotics: A Promising Ally in Burn Treatment
type: item
description: Section: Review Article Categories: Internal Medicine, Gastroenterology, Infectious Diseases, Public Health Keywords: Probiotics, Burns, Inflammation, microbiota Subjects: Probiotics and burns, Probiotics and Microbiome, Burn Injury and Wound Healing, Immunomodulation, Clinical Trials and Evidence-Based Medicine, Infectious Diseases and Antimicrobial Resistance, Skin and Gut Axis, Pediatric Burn Care, Inflammation and Immune Response, Nutrition in Critical Care, Regenerative Medicine and Tissue Engineering Disciplines: Medicine, Biology, Nursing, Pharmacy and Pharmacology, Public Health, Immunology, Microbiology, Nutrition and Dietetics, Biomedical Engineering, Surgery This review explores the potential therapeutic benefits of probiotics in the treatment of burn injuries, with the aim of addressing the limitations of traditional therapeutic approaches. It offers a comprehensive analysis of burn pathophysiology, including a wide range of burn forms and the biological reactions they induce, such as pain, inflammation, fluid imbalance, and metabolic alterations. It also specifically explains the mechanisms by which probiotics contribute to the improved healing of wounds and modified gut microbiota, as they are particularly effective in these two directions. This study looks at the ways probiotic treatment can facilitate the regeneration of the skin, which is crucial for accelerating burn recovery . Furthermore, it examines the barriers and limits of probiotic therapy, such as strain regularity and safety issues in immunocompromised patients, while emphasizing the interdependent benefits of probiotics and nutrition in promoting burn healing. This review highlights the advantages of probiotics in burn management and their potential as an adjuvant therapy for enhancing treatment results and patient well-being in the burn care context.
subject: Review Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Gastroenterology
  topic: category
subject: Infectious Diseases
  topic: category
subject: Public Health
  topic: category
subject: Probiotics
  topic: keywords
subject: Burns
  topic: keywords
subject: Inflammation
  topic: keywords
subject: microbiota
  topic: keywords
subject: Probiotics and burns
  topic: subjects
subject: Probiotics and Microbiome
  topic: subjects
subject: Burn Injury and Wound Healing
  topic: subjects
subject: Immunomodulation
  topic: subjects
subject: Clinical Trials and Evidence-Based Medicine
  topic: subjects
subject: Infectious Diseases and Antimicrobial Resistance
  topic: subjects
subject: Skin and Gut Axis
  topic: subjects
subject: Pediatric Burn Care
  topic: subjects
subject: Inflammation and Immune Response
  topic: subjects
subject: Nutrition in Critical Care
  topic: subjects
subject: Regenerative Medicine and Tissue Engineering
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Biology
  topic: disciplines
subject: Nursing
  topic: disciplines
subject: Pharmacy and Pharmacology
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Immunology
  topic: disciplines
subject: Microbiology
  topic: disciplines
subject: Nutrition and Dietetics
  topic: disciplines
subject: Biomedical Engineering
  topic: disciplines
subject: Surgery
  topic: disciplines
creator: Kholoud Al Jebawi
creator: Jobran Toami
creator: Adel Ayash
creator: Razan Salha
creator: Mira Al Shoufy
creator: Jamil Nasrallah
creator: Naseeb Danaf
creator: Lea El Ghawi
creator: Layal Msheik
creator: Hiba Hamdar
rights: Copyright (c) 2025 Kholoud Al Jebawi, Jobran Toami, Adel Ayash, Razan Salha, Mira Al Shoufy, Jamil Nasrallah , Naseeb Danaf, Lea El Ghawi, Layal Msheik, Hiba Hamdar https://creativecommons.org/licenses/by/4.0
date: 2025-06-02
publication date: 2025-06-02
starting page: 10
ending page: 17
doi: 10.71079/ASIDE.IM.06022554

Prolonged Immunosuppressive Therapy in Immune Complex-Membranoproliferative Glomerulonephritis: A Case Report of Sustained Partial Remission Over Three Years
type: item
description: Section: Case Report Categories: Internal Medicine Keywords: Membranoproliferative Glomerulonephritis , Mycophenolic acid, Remission induction Subjects: Glomerulonephritis, Idiopathic Glomerulonephritis, Immunosuppressive Therapy, Mycophenolate Mofetil (MMF), Prednisone Treatment, Chronic Kidney Disease (CKD), Proteinuria and Albuminuria, Renal Biopsy and Histopathology, Case Report – Nephrology, Membranoproliferative Glomerulonephritis (MPGN) Disciplines: Nephrology, Internal Medicine, Pathology, Clinical Medicine, Renal Pharmacology, Immunology, Histopathology, Evidence-Based Medicine, Chronic Disease Management, Clinical Case Studies The prevalence of membranoproliferative glomerulonephritis (MPGN) is very low among primary glomerulonephritis. Once MPGN is diagnosed, it is essential to classify the type of MPGN [immune complex (IC), complement-mediated, and without complement or IC deposition]. In cases of IC-MPGN, secondary causes should be thoroughly investigated. However, there are no randomised controlled prospective trials for the optimal treatment regime for primary IC-MPGN. Here, we present a report of primary IC-MPGN that achieved partial remission after 3 years of mycophenolate mofetil treatment, even though significant fibrosis was present in the kidney biopsy. This report may support consideration of prolonged immunosuppression in selected cases with primary IC-MPGN.
subject: Case Report
  topic: section
subject: Internal Medicine
  topic: category
subject: Membranoproliferative Glomerulonephritis
  topic: keywords
subject: Mycophenolic acid
  topic: keywords
subject: Remission induction
  topic: keywords
subject: Glomerulonephritis
  topic: subjects
subject: Idiopathic Glomerulonephritis
  topic: subjects
subject: Immunosuppressive Therapy
  topic: subjects
subject: Mycophenolate Mofetil (MMF)
  topic: subjects
subject: Prednisone Treatment
  topic: subjects
subject: Chronic Kidney Disease (CKD)
  topic: subjects
subject: Proteinuria and Albuminuria
  topic: subjects
subject: Renal Biopsy and Histopathology
  topic: subjects
subject: Case Report – Nephrology
  topic: subjects
subject: Membranoproliferative Glomerulonephritis (MPGN)
  topic: subjects
subject: Nephrology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Pathology
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Renal Pharmacology
  topic: disciplines
subject: Immunology
  topic: disciplines
subject: Histopathology
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Chronic Disease Management
  topic: disciplines
subject: Clinical Case Studies
  topic: disciplines
creator: Kubra Kaynar
creator: Yasin Dilek
creator: Mert Köse
creator: Sevdegül Aydın Mungan
rights: Copyright (c) 2025 Kubra Kaynar, Yasin Dilek, Mert Köse, Sevdegül Aydın Mungan https://creativecommons.org/licenses/by/4.0
date: 2025-09-04
publication date: 2025-09-04
starting page: 16
ending page: 20
doi: 10.71079/ASIDE.IM.090425144

Migraine Headache in Patients with Allergic Rhinitis: A Systematic Review and Meta-Analysis of Observational Studies
type: item
description: Section: Original Article Categories: Neurology Keywords: Migraine, Allergic Rhinitis, Meta-Analysis, Headache Subjects: Migraine, Allergic Rhinitis, Headache Disorders, Immunological Comorbidity, Meta-Analysis, Systematic Review, Atopic Conditions, IgE-Mediated Inflammation, Histamine Pathways, Comorbidity in Chronic Diseases Disciplines: Neurology, Allergy and Immunology, Epidemiology, Clinical Medicine, Otolaryngology (ENT), Public Health, Internal Medicine, Evidence-Based Medicine, Medical Statistics, Health Sciences Background: Migraine is a condition characterized by recurrent episodes of unilateral headache. Allergic rhinitis (AR) is an IgE-mediated inflammatory condition of the nasal mucosa that is triggered by exposure to allergens. Migraine and AR may share underlying immunological mechanisms, including histamine release and mast cell activation. Despite the growing interest in the immunological interplay between allergic conditions and neurological symptoms, the specific relationship between AR and migraine remains underexplored. Methods: PubMed, Scopus, and Web of Science were systematically searched to identify relevant studies. Pooled odds ratio (OR) and pooled risk ratio (RR) were calculated with 95% confidence intervals (CI) using a random-effects model. The Newcastle-Ottawa Scale (NOS) was used for quality assessment. Heterogeneity assessment and subgroup analysis were also performed. Results: Eleven studies involving 4,704,591 participants were included. The pooled OR for migraine in individuals with AR was 2.94 (95% CI: 2.02–4.29; p < 0.0001; I² = 95.62%). The pooled RR from two cohort studies was 2.27 (95% CI: 1.10–4.65; p = 0.026; I² = 99.72%). Subgroup analysis revealed significant differences in the pooled OR regarding the source of individuals with AR and the method of AR assessment, with a higher pooled OR in hospital patients (OR = 7.32) and when using skin tests (OR =6.93), respectively. Conclusion: Migraine headaches are significantly ass…
subject: Original Article
  topic: section
subject: Neurology
  topic: category
subject: Migraine
  topic: keywords
subject: Allergic Rhinitis
  topic: keywords
subject: Meta-Analysis
  topic: keywords
subject: Headache
  topic: keywords
subject: Migraine
  topic: subjects
subject: Allergic Rhinitis
  topic: subjects
subject: Headache Disorders
  topic: subjects
subject: Immunological Comorbidity
  topic: subjects
subject: Meta-Analysis
  topic: subjects
subject: Systematic Review
  topic: subjects
subject: Atopic Conditions
  topic: subjects
subject: IgE-Mediated Inflammation
  topic: subjects
subject: Histamine Pathways
  topic: subjects
subject: Comorbidity in Chronic Diseases
  topic: subjects
subject: Neurology
  topic: disciplines
subject: Allergy and Immunology
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Otolaryngology (ENT)
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Medical Statistics
  topic: disciplines
subject: Health Sciences
  topic: disciplines
creator: Ahmed Talaia
creator: Khaled Kettaneh
creator: Ayoub Ait lahcen
creator: Abdeljalil El Hilali
creator: Mohamed Magdi
creator: Marwa Amayem
creator: Mohamed Wagdy
creator: Shrouk Mahmoud Elghazaly
rights: Copyright (c) 2025 Ahmed Talaia, Khaled Kettaneh, Ayoub Ait lahcen, Abdeljalil El Hilali, Mohamed Magdi, Marwa Amayem, Mohamed Wagdy, Shrouk Mahmoud Elghazaly https://creativecommons.org/licenses/by/4.0
date: 2025-08-12
publication date: 2025-08-12
starting page: 33
ending page: 40
doi: 10.71079/ASIDE.IM.081225133

Concurrent Diabetic Ketoacidosis and Acute Coronary Syndrome: A Systematic Review of Case Reports
type: item
description: Section: Original Article Categories: Cardiology, Endocrinology Keywords: Diabetic Ketoacidosis, Acute coronary syndrome , Systematic Review , Case reports Subjects: Diabetic Ketoacidosis, Acute Coronary Syndrome, Myocardial Infarction, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Cardiovascular Complications, Systematic Review, Case Reports, SGLT2 Inhibitors, Cardiac Biomarkers Disciplines: Endocrinology, Cardiology, Internal Medicine, Emergency Medicine, Critical Care Medicine, Diabetes Research, Clinical Epidemiology, Pharmacology, Metabolic Disorders, Evidence-Based Medicine Background: Diabetic ketoacidosis (DKA) and acute coronary syndrome (ACS) represent serious medical emergencies with a complex bidirectional relationship. The clinical presentations and outcomes of these conditions when they co-occur remain incompletely characterized in the literature. We aim to investigate this correlation. Methods: We systematically searched the PubMed, Scopus, and Web of Science databases, using terms related to acute coronary syndrome (including myocardial infarction, unstable angina, STEMI, and NSTEMI) combined with diabetic ketoacidosis terms, from inception to April 2025, for case reports. The CARE checklist was applied to assess the risk of bias in the included reports. Results: Twenty-one case reports met inclusion criteria, describing 11 males and 9 females (one unspecified) with a mean age of 51 years. Patients had both type 1 (42.8%) and type 2 (57.1%) diabetes mellitus. Chest pain was the most common presenting symptom (52.3%), but was absent in nearly half of the cases. Six patients (28.5%) on sodium-glucose cotransporter-2 (SGLT2) inhibitors presented with euglycemic DKA. ST-segment elevation was observed in 61.9% of patients, while five patients had normal coronary arteries despite elevated troponin levels. All patients survived after receiving standard DKA management and appropriate cardiac interventions. Conclusion: This systematic review highlights …
subject: Original Article
  topic: section
subject: Cardiology
  topic: category
subject: Endocrinology
  topic: category
subject: Diabetic Ketoacidosis
  topic: keywords
subject: Acute coronary syndrome
  topic: keywords
subject: Systematic Review
  topic: keywords
subject: Case reports
  topic: keywords
subject: Diabetic Ketoacidosis
  topic: subjects
subject: Acute Coronary Syndrome
  topic: subjects
subject: Myocardial Infarction
  topic: subjects
subject: Type 1 Diabetes Mellitus
  topic: subjects
subject: Type 2 Diabetes Mellitus
  topic: subjects
subject: Cardiovascular Complications
  topic: subjects
subject: Systematic Review
  topic: subjects
subject: Case Reports
  topic: subjects
subject: SGLT2 Inhibitors
  topic: subjects
subject: Cardiac Biomarkers
  topic: subjects
subject: Endocrinology
  topic: disciplines
subject: Cardiology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Emergency Medicine
  topic: disciplines
subject: Critical Care Medicine
  topic: disciplines
subject: Diabetes Research
  topic: disciplines
subject: Clinical Epidemiology
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Metabolic Disorders
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
creator: Ahmed Elbataa Elbataa
creator: Ahmed Farid Gadelmawla
creator: Laila Mohamed Akr
creator: Mohamed Yasser Elnaggar
creator: Mohamed Mahmoud
creator: Omar Nassar
creator: Alaa Abdrabou Abouelmagd
creator: Ahmed Hassan
rights: Copyright (c) 2025 Ahmed Elbataa Elbataa, Ahmed Farid Gadelmawla, Laila Mohamed Akr, Mohamed Yasser Elnaggar, Mohamed Mahmoud, Omar Nassar, Alaa Abdrabou Abouelmagd, Ahmed Hassan https://creativecommons.org/licenses/by/4.0
date: 2025-07-19
publication date: 2025-07-19
starting page: 13
ending page: 22
doi: 10.71079/ASIDE.IM.071925107

Esophageal Stenting and Endoscopic Vacuum Therapy for Esophageal Defects: A Systematic Review and Meta-Analysis
type: item
description: Section: Review Article Categories: Internal Medicine, Gastroenterology Keywords: Esophageal Stenting, Endoscopic Vacuum Therapy, Esophageal Defects, Meta-analysis, Observational Studies Subjects: internal medicine, gastroenterology, endoscopy, meta-analysis, Esophageal Stenting, Boerhaave Syndrome, Esophageal Leak, Anastomotic Leak, Minimally Invasive Surgery, Gastrointestinal Endoscopy Disciplines: Gastroenterology, Medicine, Internal Medicine, Endoscopy, Thoracic Surgery, Emergency Medicine, Critical Care, Digestive Disease, Clinical Research Background: Spontaneous esophageal perforation, particularly Boerhaave syndrome, is a life-threatening condition associated with high morbidity and mortality. Traditional surgical management is increasingly being supplemented by minimally invasive approaches, including esophageal stenting and endoscopic vacuum therapy (EVT). However, the optimal treatment strategy remains debated due to variations in reported outcomes and the lack of randomized controlled trials. This systematic review and meta-analysis aim to evaluate the efficacy and safety of esophageal stenting and EVT in managing esophageal defects by specifically assessing sealing rates, failure rates, and mortality. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and the Cochrane Library up to March 24, 2025. Only observational studies and case series were included. The primary outcomes were the pooled sealing rate, failure rate, and mortality for esophageal stenting, and the closure rate for EVT. Data were analyzed using a random-effects model, and heterogeneity was assessed using the I² statistic. Results: Fourteen studies on esophageal stenting demonstrated a pooled sealing rate of 86.1% (95% CI: 80.2–92.0%) with a failure rate of 14.9% (95% CI: 8.5–21.3%). Mortality associated with stenting was 7.4% (95% CI: 3.5–11.4%). EVT studies reported a closure rate ranging from 80% to 94%. Conclusion: Both esophageal stenting and EVT show high ef…
subject: Review Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Gastroenterology
  topic: category
subject: Esophageal Stenting
  topic: keywords
subject: Endoscopic Vacuum Therapy
  topic: keywords
subject: Esophageal Defects
  topic: keywords
subject: Meta-analysis
  topic: keywords
subject: Observational Studies
  topic: keywords
subject: internal medicine
  topic: subjects
subject: gastroenterology
  topic: subjects
subject: endoscopy
  topic: subjects
subject: meta-analysis
  topic: subjects
subject: Esophageal Stenting
  topic: subjects
subject: Boerhaave Syndrome
  topic: subjects
subject: Esophageal Leak
  topic: subjects
subject: Anastomotic Leak
  topic: subjects
subject: Minimally Invasive Surgery
  topic: subjects
subject: Gastrointestinal Endoscopy
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Medicine
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Endoscopy
  topic: disciplines
subject: Thoracic Surgery
  topic: disciplines
subject: Emergency Medicine
  topic: disciplines
subject: Critical Care
  topic: disciplines
subject: Digestive Disease
  topic: disciplines
subject: Clinical Research
  topic: disciplines
creator: Muhammad Saqib
creator: Muhammad Iftikhar
creator: Khaqan Ahmed
creator: Humna Shahid
creator: Shehr I Yar Khan
creator: Muhammad Aamir Iqbal
creator: Hassan Mumtaz
rights: Copyright (c) 2025 Muhammad Saqib, Muhammad Iftikhar, Khaqan Ahmed, Humna Shahid, Shehr I Yar Khan, Muhammad Aamir Iqbal, Hassan Mumtaz https://creativecommons.org/licenses/by/4.0
date: 2025-07-26
publication date: 2025-07-26
starting page: 23
ending page: 32
doi: 10.71079/ASIDE.IM.07262576

A Comprehensive Review of Fluid Resuscitation Techniques in Sepsis in Patients with Heart Failure
type: item
description: Section: Review Article Categories: Cardiology, Infectious Diseases Keywords: Challenges in fluid resuscitation, Fluid Resuscitation, Heart failure, Sepsis Subjects: Fluid Resuscitation, Sepsis, Septic Shock, Hemodynamic Monitoring, Volume Overload, Critical Care, Intravenous Therapy, Ejection Fraction, Sepsis Management Guidelines Disciplines: Critical Care Medicine, Internal Medicine, Emergency Medicine, Cardiology, Infectious Diseases, Intensive Care, Clinical Pharmacology, Health Outcomes Research, Evidence-Based Medicine, Hospital Medicine Introduction: Fluid management in sepsis patients with pre-existing heart failure presents a complex clinical challenge, as these patients require adequate resuscitation while avoiding fluid overload that could worsen cardiac function. This article aims to explore optimal fluid resuscitation strategies for patients with pre-existing heart failure who develop sepsis, a group at high risk for fluid management complications. Methods: We conducted a narrative review of studies published between 2010 and 2024, utilizing PubMed, ScienceDirect, and Google Scholar. We employed Boolean formulas and search terms that evolved from broad to specific, refining the focus on fluid resuscitation in septic heart failure patients. Human studies focusing on fluid resuscitation, sepsis management, and outcomes in heart failure were included. Exclusion criteria included animal studies, non-English articles, and case reports. Results: Guideline-recommended fluid resuscitation (≥30 mL/kg within 3 hours) shows a neutral or positive effect on mortality in sepsis patients with pre-existing heart failure when monitored appropriately. Patients with reduced ejection fraction (HFrEF) and those with preserved ejection fraction (HFpEF) exhibit different tolerances to fluids. Advanced hemodynamic monitoring — including bedside echocardiography, lactate clearance, central venous pressure, and BNP levels — is essential for personalizing fluid therapy. Conclusi…
subject: Review Article
  topic: section
subject: Cardiology
  topic: category
subject: Infectious Diseases
  topic: category
subject: Challenges in fluid resuscitation
  topic: keywords
subject: Fluid Resuscitation
  topic: keywords
subject: Heart failure
  topic: keywords
subject: Sepsis
  topic: keywords
subject: Fluid Resuscitation
  topic: subjects
subject: Sepsis
  topic: subjects
subject: Septic Shock
  topic: subjects
subject: Hemodynamic Monitoring
  topic: subjects
subject: Volume Overload
  topic: subjects
subject: Critical Care
  topic: subjects
subject: Intravenous Therapy
  topic: subjects
subject: Ejection Fraction
  topic: subjects
subject: Sepsis Management Guidelines
  topic: subjects
subject: Critical Care Medicine
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Emergency Medicine
  topic: disciplines
subject: Cardiology
  topic: disciplines
subject: Infectious Diseases
  topic: disciplines
subject: Intensive Care
  topic: disciplines
subject: Clinical Pharmacology
  topic: disciplines
subject: Health Outcomes Research
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Hospital Medicine
  topic: disciplines
creator: Mallikarjuna Subramanyam Oruganti
creator: Sameena Tabassum
creator: Anushree Venkatesh Murthy
creator: Navya.Miriyala
creator: Nitasha
creator: Sunil Timislina
rights: Copyright (c) 2025 Mallikarjuna S. oruganti, Sameena Tabassum, Anushree V. Murthy, Navya.Miriyala, Nitasha, Sunil Timislina https://creativecommons.org/licenses/by/4.0
date: 2025-07-16
publication date: 2025-07-16
starting page: 1
ending page: 7
doi: 10.71079/ASIDE.IM.07162534

Clinical Efficacy and Safety of Fluvoxamine in COVID-19 Patients: An Umbrella Review of Systematic Reviews and Meta-Analyses
type: item
description: Section: Original Article Categories: Infectious Diseases, Public Health Keywords: Fluvoxamine, COVID-19, Cytokine storm, IL-6, Hospitalization, Disease progression Subjects: Fluvoxamine, COVID-19, Cytokine storm, IL-6, Hospitalization, Disease progression, Selective Serotonin Reuptake Inhibitor (SSRI), Antiviral Therapy, Inflammatory Response, Meta-Analysis Disciplines: Infectious Diseases, Public Health, Internal Medicine, Pharmacology, Epidemiology, Pulmonary Medicine, Critical Care Medicine, Clinical Trials, Psychiatry, Translational Medicine Introduction: Fluvoxamine is an agonist for the sigma-1 receptor, through which it controls inflammation. It helps reduce the cytokine storm associated with the COVID-19 virus by regulating the production of IL-6 and gene expression. This review of systematic reviews (SRs) aims to summarize the effects of fluvoxamine in treatment of COVID-19. Methods: This umbrella review (CRD42025592203) of SRs and meta-analyses investigated the safety and efficacy of fluvoxamine for treatment in COVID-19 patients, irrespective of disease severity and age. Comprehensive searches were conducted from inception to December 12, 2024, covering PubMed, Cochrane CENTRAL, Google Scholar, and Cochrane COVID-19 resources. A qualitative synthesis of evidence was performed. The AMSTAR2 tool was used to assess the methodological quality of the included SRs. Results: Eleven reviews published in 12 publications that reported the use of fluvoxamine in COVID-19 patients were finally included as part of the synthesis. The studies reported a lower mortality rate with fluvoxamine than with placebo, but only four studies reported statistical significance. Five reported a statistically significant reduction in hospitalization risk for patients treated with fluvoxamine compared to controls. Only one review evaluated COVID-19 progression, reporting a non-significant decrease in the risk of disease progression with fluvoxamine compared to placebo. Higher dosages o…
subject: Original Article
  topic: section
subject: Infectious Diseases
  topic: category
subject: Public Health
  topic: category
subject: Fluvoxamine
  topic: keywords
subject: COVID-19
  topic: keywords
subject: Cytokine storm
  topic: keywords
subject: IL-6
  topic: keywords
subject: Hospitalization
  topic: keywords
subject: Disease progression
  topic: keywords
subject: Fluvoxamine
  topic: subjects
subject: COVID-19
  topic: subjects
subject: Cytokine storm
  topic: subjects
subject: IL-6
  topic: subjects
subject: Hospitalization
  topic: subjects
subject: Disease progression
  topic: subjects
subject: Selective Serotonin Reuptake Inhibitor (SSRI)
  topic: subjects
subject: Antiviral Therapy
  topic: subjects
subject: Inflammatory Response
  topic: subjects
subject: Meta-Analysis
  topic: subjects
subject: Infectious Diseases
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Pulmonary Medicine
  topic: disciplines
subject: Critical Care Medicine
  topic: disciplines
subject: Clinical Trials
  topic: disciplines
subject: Psychiatry
  topic: disciplines
subject: Translational Medicine
  topic: disciplines
creator: Omar Irfan
creator: Muhammad Jansher
creator: Wania Moeen
creator: Muhammad Sohaib Khan
creator: Muhammad Bin Hammad
creator: Rubaid Dhillon
creator: Nabira Khan
creator: Abia Abdullah
creator: Mohammad Aadil Qamar
creator: Ayesha Rashid
creator: Javaid Ahmed Khan
creator: Ali Bin Sarwar Zubairi
rights: Copyright (c) 2025 Omar Irfan, Muhammad Jansher, Wania Moeen, Muhammad Sohaib Khan, Muhammad Bin Hammad, Rubaid Dhillon, Nabira Khan, Abia Abdullah, Mohammad Aadil Qamar, Ayesha Rashid, Javaid Ahmed Khan, Ali Bin Sarwar Zubairi https://creativecommons.org/licenses/by/4.0
date: 2025-07-17
publication date: 2025-07-17
starting page: 31
ending page: 41
doi: 10.71079/ASIDE.IM.07172586

Dual association of autoimmune encephalitis with anti-NMDAR and anti-GAD65 antibodies: A Case Report with Literature Review
type: item
description: Section: Case Report Categories: Neurology Keywords: Anti-GAD65, Anti-NMDAR, Autoimmune encephalitis, Immunotherapy, Case report Subjects: Anti-GAD65, Anti-NMDAR, Autoimmune encephalitis, Immunotherapy, Autoimmune Diseases, Infectious Diseases, Neurology, Endocrinology, Immunology, Hematology Disciplines: Neurology, Internal Medicine, Critical Care Medicine, Clinical Research, Translational Medicine, Molecular Biology, Medical Education Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis, whereas anti-glutamic acid decarboxylase 65 (antiGAD65) encephalitis is a rare autoimmune condition. The coexistence of these two conditions has been rarely reported. In this article, we will discuss this rare association through a case report and attempt to determine its main characteristics. We report the case of an 18-year-old male with no medical history, admitted to the medical Intensive Care Unit (ICU) with a decreased level of consciousness, bizarre behavior, and abnormal movements for one week. These symptoms followed the progression of initial signs such as delirium, which had begun two months earlier. Laboratory analysis revealed an inflammatory syndrome with rhabdomyolysis. Cerebral angio-MRI findings were unremarkable. The electroencephalogram (EEG) showed slow, non-reactive activity. Cerebrospinal fluid (CSF) analysis and infectious studies were normal. However, immunological testing using the immunofluorescence technique revealed the presence of anti-NMDAR antibodies in both serum and CSF, as well as anti-GAD65 antibodies in the serum. The positron emission tomography (PET) scan screening for neoplasm was negative. Therapeutically, the patient was treated with anticonvulsants, antipsychotics, intravenous immunoglobulins, corticosteroids, plasma exchanges, cyclophosphamide, and rituximab. Consequently, he demonstrated a remarkable gradual clinical improvement. This case highlights an aspect of autoimmune dysre…
subject: Case Report
  topic: section
subject: Neurology
  topic: category
subject: Anti-GAD65
  topic: keywords
subject: Anti-NMDAR
  topic: keywords
subject: Autoimmune encephalitis
  topic: keywords
subject: Immunotherapy
  topic: keywords
subject: Case report
  topic: keywords
subject: Anti-GAD65
  topic: subjects
subject: Anti-NMDAR
  topic: subjects
subject: Autoimmune encephalitis
  topic: subjects
subject: Immunotherapy
  topic: subjects
subject: Autoimmune Diseases
  topic: subjects
subject: Infectious Diseases
  topic: subjects
subject: Neurology
  topic: subjects
subject: Endocrinology
  topic: subjects
subject: Immunology
  topic: subjects
subject: Hematology
  topic: subjects
subject: Neurology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Critical Care Medicine
  topic: disciplines
subject: Clinical Research
  topic: disciplines
subject: Translational Medicine
  topic: disciplines
subject: Molecular Biology
  topic: disciplines
subject: Medical Education
  topic: disciplines
creator: Oumaima Rian
creator: Wafa Ammouri
creator: Latifa Oualili
creator: Mouna Maamer
creator: Tarek Dendane
creator: Hicham Harmouche
creator: Khalid Abidi
rights: Copyright (c) 2025 Oumaima Rian, Wafa Ammouri, Latifa Oualili, Mouna Maamer, Tarek Dendane, Hicham Harmouche, Khalid Abidi https://creativecommons.org/licenses/by/4.0
date: 2025-06-21
publication date: 2025-06-21
starting page: 18
ending page: 22
doi: 10.71079/ASIDE.IM.062125105

Acute Myeloid Leukemia Presenting as Bilateral Proptosis: A Case Report with Literature Review
type: item
description: Section: Case Report Categories: Internal Medicine, Hematology Keywords: Acute Myeloid Leukemia, Myeloid Sarcoma, Bilateral proptosis, M6 subtype, RUNX1-RUNX1T1, Di Guglielmo syndrome Subjects: Oncology, Lukemia, case report, Hematologic Disciplines: hematology, Oncology Introduction: Acute myeloid leukemia (AML), constituting 30% of pediatric malignancies, is the most common childhood cancer. This paper explores the rare presentation of AML with extramedullary involvement, specifically bilateral proptosis, in a 15-year-old boy. Case report: The patient initially presented with worsening shortness of breath, palpitations, extreme fatigue, and bruising. Examination revealed bilateral proptosis, watery discharge from the right eye, and petechial rash. Blood investigations revealed low hemoglobin, severe thrombocytopenia, and high WBC count. Computed tomography (CT) revealed bilateral orbital infiltrative soft tissue lesions. Leukemia fusion gene screening identified RUNX1-RUNX1T1 later. The patient was admitted, received transfusions, and started on antibiotics. Despite initial improvement, he later developed sepsis, septic shock, and severe pancytopenia, necessitating intensive care and specific AML M2 targeting therapy. Conclusion: Bilateral proptosis in AML, termed myeloid sarcoma (MS), is rare but responsive to chemotherapy. Orbital MS has higher responsiveness and survival rates in pediatric cases. The case highlights the importance of identifying AML subtypes, like RUNX1-RUNX1T1-positive AML, for tailored treatment strategies. This case underscores the challenges in diagnosing and treating pediatric AML with extramedullary involvement. Early recognition of AML subtypes is crucial for prognosis prediction and treatment tailoring.
subject: Case Report
  topic: section
subject: Internal Medicine
  topic: category
subject: Hematology
  topic: category
subject: Acute Myeloid Leukemia
  topic: keywords
subject: Myeloid Sarcoma
  topic: keywords
subject: Bilateral proptosis
  topic: keywords
subject: M6 subtype
  topic: keywords
subject: RUNX1-RUNX1T1
  topic: keywords
subject: Di Guglielmo syndrome
  topic: keywords
subject: Oncology
  topic: subjects
subject: Lukemia
  topic: subjects
subject: case report
  topic: subjects
subject: Hematologic
  topic: subjects
subject: hematology
  topic: disciplines
subject: Oncology
  topic: disciplines
creator: Ahmed Youssef
creator: Mohamad Assker
creator: Farah Alkhaleefa
creator: Mahasin Shaheen
rights: Copyright (c) 2025 Ahmed Mostafa Youssef , Mohamad Monif Assker, Farah Alkhaleefa , Mahasin Shaheen https://creativecommons.org/licenses/by/4.0
date: 2025-05-12
publication date: 2025-05-12
starting page: 28
ending page: 33
doi: 10.71079/ASIDE.IM.05122559

Human Readers versus AI-Based Systems in ASPECTS Scoring for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis with Region-Specific Guidance
type: item
description: Section: Original Article Categories: Neurology Keywords: Ischemic Stroke, Artificial Intelligence, ASPECTS, Machine Learning, Imaging Subjects: Stroke, Machine Learning, Imaging, Acute Ischemic Stroke, Artificial Intelligence in Medicine, Computed Tomography (CT), Radiology, Diagnostic Imaging, ASPECTS Scoring, Thrombectomy, Interobserver Variability, Neuroimaging, Systematic Review, Meta-Analysis, Clinical Decision Support Systems, Health Informatics Disciplines: Neurology, Radiology and Diagnostic Imaging, Emergency Medicine, Health Technology Assessment, Internal Medicine, Medical Informatics, Evidence-Based Medicine, Neurosurgery, Clinical Epidemiology Introduction: The Alberta Stroke Program Early CT Score (ASPECTS) is widely used to evaluate early ischemic changes and guide thrombectomy decisions in acute stroke patients. However, significant interobserver variability in manual ASPECTS assessment presents a challenge. Recent advances in artificial intelligence have enabled the development of automated ASPECTS scoring systems; however, their comparative performance against expert interpretation remains insufficiently studied. Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. We searched multiple scientific databases for studies comparing automated and manual ASPECTS on Non-Contrast Computed Tomography (NCCT). Interobserver reliability was assessed using pooled interclass correlation coefficients (ICCs). Subgroup analyses were made using software types, reference standards, time windows, and computed tomography-based factors. Results: Eleven studies with a total of 1,976 patients were included. Automated ASPECTS demonstrated good reliability against reference standards (ICC: 0.72), comparable to expert readings (ICC: 0.62). RAPID ASPECTS performed highest (ICC: 0.86), especially for high-stakes decision-making. AI advantages were most significant with thin-slice CT (≤2.5mm; +0.16), intermediate time windows (120-240mi…
subject: Original Article
  topic: section
subject: Neurology
  topic: category
subject: Ischemic Stroke
  topic: keywords
subject: Artificial Intelligence
  topic: keywords
subject: ASPECTS
  topic: keywords
subject: Machine Learning
  topic: keywords
subject: Imaging
  topic: keywords
subject: Stroke
  topic: subjects
subject: Machine Learning
  topic: subjects
subject: Imaging
  topic: subjects
subject: Acute Ischemic Stroke
  topic: subjects
subject: Artificial Intelligence in Medicine
  topic: subjects
subject: Computed Tomography (CT)
  topic: subjects
subject: Radiology
  topic: subjects
subject: Diagnostic Imaging
  topic: subjects
subject: ASPECTS Scoring
  topic: subjects
subject: Thrombectomy
  topic: subjects
subject: Interobserver Variability
  topic: subjects
subject: Neuroimaging
  topic: subjects
subject: Systematic Review
  topic: subjects
subject: Meta-Analysis
  topic: subjects
subject: Clinical Decision Support Systems
  topic: subjects
subject: Health Informatics
  topic: subjects
subject: Neurology
  topic: disciplines
subject: Radiology and Diagnostic Imaging
  topic: disciplines
subject: Emergency Medicine
  topic: disciplines
subject: Health Technology Assessment
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Medical Informatics
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Neurosurgery
  topic: disciplines
subject: Clinical Epidemiology
  topic: disciplines
creator: Ahmed Y Azzam
creator: Ibrahim Hadadi
creator: Leen M. Al-Shahrani
creator: Ummkulthum A. Shanqeeti
creator: Noor A. Alqurqush
creator: Mohammed A. Alsehli
creator: Rudaynah S. Alali
creator: Rahaf S. Tammar
creator: Mahmoud M. Morsy
creator: Muhammed Amir Essibayi
rights: Copyright (c) 2025 Ahmed Y Azzam, Ibrahim Hadadi, Leen M. Al-Shahrani, Ummkulthum A. Shanqeeti, Noor A. Alqurqush, Mohammed A. Alsehli, Rudaynah S. Alali, Rahaf S. Tammar, Mahmoud M. Morsy, Muhammed Amir Essibayi https://creativecommons.org/licenses/by/4.0
date: 2025-05-17
publication date: 2025-05-17
starting page: 1
ending page: 9
doi: 10.71079/ASIDE.IM.05172573

Challenges and Infectious Complications in Living Donor Liver Transplantation in Egypt: A Comprehensive Review
type: item
description: Section: Review Article Categories: Internal Medicine, Gastroenterology Keywords: Living donor liver transplantation, Infectious complications, Hepatitis C virus, Donor selection, Organ donation awareness Subjects: Living Donor Liver Transplantation (LDLT), Infectious Complications, Hepatitis C Virus (HCV), Donor Selection, Organ Donation Awareness, End-Stage Liver Disease (ESLD), Liver Transplantation in Egypt, Deceased Donor Liver Transplantation (DDLT), Pediatric Liver Transplantation, Healthcare Providers' Knowledge, Liver Transplantation Challenges, Post-Transplant Infections, Bacterial Infections in Transplant Recipients, COVID-19 and Liver Transplantation, Sepsis in Transplant Patients, Hospital-Acquired Infections (HAIs), Donor Morbidity and Mortality, Public Awareness and Media Coverage, Religious and Cultural Attitudes Toward Organ Donation, Quality of Life After Transplantation, Medical Education and Organ Donation, Liver Transplantation in Low-Resource Settings, Transplant Tourism, Multi-Drug Resistant Bacteria in Transplant Recipients, Cytomegalovirus (CMV) Infections in Transplantation Disciplines: Hepatology , Gastroenterology , Transplant Surgery , Epidemiology , Infectious Diseases, Public Health , Critical Care Medicine, Pediatrics , Immunology , Microbiology , Virology , Medical Ethics, Sociology of Health, Psychology , Health Policy and Systems Research, Global Health Background: Living donor liver transplantation (LDLT) is a crucial therapeutic option for patients with end-stage liver disease in Egypt, where deceased donor grafts are scarce. This study aims to investigate the challenges and infectious complications associated with LDLT in Egypt. Methods: A comprehensive review of relevant literature was conducted, focusing on factors affecting donor selection, the prevalence of infections in recipients, and the impact of healthcare providers' knowledge on organ donation. The study included data on complications affecting donors and recipients in…
subject: Review Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Gastroenterology
  topic: category
subject: Living donor liver transplantation
  topic: keywords
subject: Infectious complications
  topic: keywords
subject: Hepatitis C virus
  topic: keywords
subject: Donor selection
  topic: keywords
subject: Organ donation awareness
  topic: keywords
subject: Living Donor Liver Transplantation (LDLT)
  topic: subjects
subject: Infectious Complications
  topic: subjects
subject: Hepatitis C Virus (HCV)
  topic: subjects
subject: Donor Selection
  topic: subjects
subject: Organ Donation Awareness
  topic: subjects
subject: End-Stage Liver Disease (ESLD)
  topic: subjects
subject: Liver Transplantation in Egypt
  topic: subjects
subject: Deceased Donor Liver Transplantation (DDLT)
  topic: subjects
subject: Pediatric Liver Transplantation
  topic: subjects
subject: Healthcare Providers' Knowledge
  topic: subjects
subject: Liver Transplantation Challenges
  topic: subjects
subject: Post-Transplant Infections
  topic: subjects
subject: Bacterial Infections in Transplant Recipients
  topic: subjects
subject: COVID-19 and Liver Transplantation
  topic: subjects
subject: Sepsis in Transplant Patients
  topic: subjects
subject: Hospital-Acquired Infections (HAIs)
  topic: subjects
subject: Donor Morbidity and Mortality
  topic: subjects
subject: Public Awareness and Media Coverage
  topic: subjects
subject: Religious and Cultural Attitudes Toward Organ Donation
  topic: subjects
subject: Quality of Life After Transplantation
  topic: subjects
subject: Medical Education and Organ Donation
  topic: subjects
subject: Liver Transplantation in Low-Resource Settings
  topic: subjects
subject: Transplant Tourism
  topic: subjects
subject: Multi-Drug Resistant Bacteria in Transplant Recipients
  topic: subjects
subject: Cytomegalovirus (CMV) Infections in Transplantation
  topic: subjects
subject: Hepatology
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Transplant Surgery
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Infectious Diseases
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Critical Care Medicine
  topic: disciplines
subject: Pediatrics
  topic: disciplines
subject: Immunology
  topic: disciplines
subject: Microbiology
  topic: disciplines
subject: Virology
  topic: disciplines
subject: Medical Ethics
  topic: disciplines
subject: Sociology of Health
  topic: disciplines
subject: Psychology
  topic: disciplines
subject: Health Policy and Systems Research
  topic: disciplines
subject: Global Health
  topic: disciplines
creator: Ahmed Mohamed Ali Aref
creator: Ahmed H. Abdelwahed
creator: Abdelrahman Nassar
creator: Mohamed Elshennawy
creator: Maryam Massoud
creator: Nada Madkour
creator: Esraa Awad
creator: Fatma Aljalawy
creator: Mohamed Akram Abdelwahab Hassan Khalil
creator: Mohammed Y. Youssef
creator: Omar Nassar
creator: Mostafa Alfishawy
rights: Copyright (c) 2025 Ahmed Mohamed Ali Aref, Ahmed H. Abdelwahed, Abdelrahman Nassar, Mohamed Elshennawy, Maryam Massoud , Nada Madkour, Esraa Awad, Fatma Aljalawy, Mohamed Akram Abdelwahab Hassan Khalil, Mohammed Y. Youssef, Omar Nassar, Mostafa Alfishawy https://creativecommons.org/licenses/by/4.0
date: 2025-05-11
publication date: 2025-05-11
starting page: 22
ending page: 27
doi: 10.71079/ASIDE.IM.05112553

Efficacy and Safety of Penehyclidine Hydrochloride in Postoperative Nausea and Vomiting Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
type: item
description: Section: Original Article Categories: Internal Medicine Keywords: Penehyclidine hydrochloride, Postoperative nausea and vomiting, Systematic Review, Meta-analysis Subjects: Postoperative nausea and vomiting, Internal Medicine, Anesthesiology, Pharmacology, Surgery, Systematic Reviews and Meta-Analyses, Postoperative Care Disciplines: Medicine and Health Sciences, Internal Medicine, Anesthesiology and Pain Medicine, Surgery, Pharmacology and Toxicology, Evidence-Based Medicine, Systematic Reviews Introduction: Postoperative nausea and vomiting (PONV) is a common complication following anesthesia. Penehyclidine hydrochloride (PHC), an anticholinergic medication, selectively inhibits the M1 Muscarinic and M3 Muscarinic receptors involved in the nausea and vomiting pathways. This study aims to evaluate the efficacy of PHC in preventing PONV and its potential advantages over existing treatments. Methods: This study investigated the efficacy and safety of PHC in preventing PONV by analyzing randomized controlled trials (RCTs) identified through a comprehensive search of the PubMed, Scopus, Web of Science, and Cochrane Library databases up to December 2024. Results: Five RCTs involving 979 patients were included. Compared to the control group, PHC reduced the incidence of PONV in the first 24-72 hours after surgery (RR: 0.64, 95% CI [0.50, 0.82], p = 0.0004) and the requirement of rescue antiemetics (RR: 0.46, 95% CI [0.22, 0.96], p = 0.04). However, PHC significantly increased the incidence of dry mouth (RR: 2.64, 95% CI [1.98, 3.5], p < 0.00001). No significant differences were observed between the two groups regarding other secondary outcomes. Risk of bias assessment was done using RoB2. Conclusions: PHC shows promising efficacy in reducing PONV and the need for antiemetic medications. Further large-scale RCTs are necessary to verify these results and determine the optimal dose.
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Penehyclidine hydrochloride
  topic: keywords
subject: Postoperative nausea and vomiting
  topic: keywords
subject: Systematic Review
  topic: keywords
subject: Meta-analysis
  topic: keywords
subject: Postoperative nausea and vomiting
  topic: subjects
subject: Internal Medicine
  topic: subjects
subject: Anesthesiology
  topic: subjects
subject: Pharmacology
  topic: subjects
subject: Surgery
  topic: subjects
subject: Systematic Reviews and Meta-Analyses
  topic: subjects
subject: Postoperative Care
  topic: subjects
subject: Medicine and Health Sciences
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Anesthesiology and Pain Medicine
  topic: disciplines
subject: Surgery
  topic: disciplines
subject: Pharmacology and Toxicology
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Systematic Reviews
  topic: disciplines
creator: Ahmed Magdy
creator: Eithar Alqady
creator: Mohamed Wagdy
creator: Ahmed T.shalby
creator: Mahmoud Abdelkader
creator: Karim Osamy
creator: Alaa Anter
creator: IhabTarik
creator: Manar Samy
creator: Sherif Eltawansy
creator: Ahmed Hassan
rights: Copyright (c) 2025 Ahmed Magdy, Eithar Alqady, Mohamed Wagdy, Ahmed T.shalby, Mahmoud Abdelkader, Karim Osamy, Alaa Anter, IhabTarik, Manar Samy, Sherif Eltawansy, Ahmed Hassan https://creativecommons.org/licenses/by/4.0
date: 2025-04-27
publication date: 2025-04-27
starting page: 15
ending page: 21
doi: 10.71079/ASIDE.IM.04272547

Antibiotic Knowledge, Perception, and Practice of Intern Doctors in Turkey: A Survey Study
type: item
description: Section: Original Article Categories: Infectious Diseases Keywords: Antibiotic knowledge, Antibiotic resistance, Antibiotic stewardship, Intern doctors, Survey study, Turkey Subjects: Antibiotic Resistance, Clinical Surveys, Medical Education, Antibiotic Stewardship, Healthcare Policy, Public Health, Infectious Disease Management, Pharmaceutical Practices, Clinical Decision-Making, Antimicrobial Consumption Disciplines: Medicine, Pharmacology, Public Health, Epidemiology, Health Policy, Medical Education, Clinical Sociology, Behavioral Science Background: This study aimed to measure intern doctors' knowledge, attitudes, and perceptions about antibiotic treatment and determine the situation on the subject. Methods: A 34-question questionnaire was prepared for the study, and volunteers were administered the questionnaire face-to-face or via a Google form on a mobile WhatsApp application. Prospectively, 221 volunteer physicians participated in the survey, which was conducted between March 15-22, 2024 in Turkey. Results: Of the participants, 118 (53.4%) were male and 103 (46.6%) were female. The mean age (mean ± SD) was 24 years (24.46±1.83). Many participants had good antibiotic knowledge but a poor antibiotic use percentage. The knowledge that misuse of antibiotics causes resistance was quite high, and there were deficiencies in the mechanisms of resistance. The misconceptions identified were stopping treatment when the clinical condition improved, regardless of the duration, or giving treatment every time the fever was high. There was a significant and positive correlation between age level-antibiotic knowledge and age-level-resistance awareness (rs=0.190, p=0.002 and rs=0.152, p=0.007, respectively). A significant difference was also found between gender-attitude scores (p=0.004). There was a significant (rs=0.247, p=0.003) and positive correlation between antibiotic knowledge and resistance awareness, and a significant (rs=0.610, p<0.001) and positive correlation b…
subject: Original Article
  topic: section
subject: Infectious Diseases
  topic: category
subject: Antibiotic knowledge
  topic: keywords
subject: Antibiotic resistance
  topic: keywords
subject: Antibiotic stewardship
  topic: keywords
subject: Intern doctors
  topic: keywords
subject: Survey study
  topic: keywords
subject: Turkey
  topic: keywords
subject: Antibiotic Resistance
  topic: subjects
subject: Clinical Surveys
  topic: subjects
subject: Medical Education
  topic: subjects
subject: Antibiotic Stewardship
  topic: subjects
subject: Healthcare Policy
  topic: subjects
subject: Public Health
  topic: subjects
subject: Infectious Disease Management
  topic: subjects
subject: Pharmaceutical Practices
  topic: subjects
subject: Clinical Decision-Making
  topic: subjects
subject: Antimicrobial Consumption
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Health Policy
  topic: disciplines
subject: Medical Education
  topic: disciplines
subject: Clinical Sociology
  topic: disciplines
subject: Behavioral Science
  topic: disciplines
creator: AHMET DOĞAN
creator: Azra SÖNMEZ
creator: Beyza DİŞLİ
creator: Hasan Şamil ÇELİK
creator: Chingiz RUSTAMLİ
creator: Ecem Berra NAZLIOĞLU
creator: Zuhat ABDULKERİMOĞLU
creator: Mustafa Talha ALTUNBAŞ
creator: Rumeysa ÖZER
rights: Copyright (c) 2025 AHMET DOĞAN, Azra SÖNMEZ, Beyza DİŞLİ, Hasan Şamil ÇELİK, Chingiz RUSTAMLİ, Ecem Berra NAZLIOĞLU, Zuhat ABDULKERİMOĞLU, Mustafa Talha ALTUNBAŞ, Rumeysa ÖZER https://creativecommons.org/licenses/by/4.0
date: 2025-04-14
publication date: 2025-04-14
starting page: 1
ending page: 6
doi: 10.71079/ASIDE.IM.1442541

TriNetX and Real-World Evidence: A Critical Review of Its Strengths, Limitations, and Bias Considerations in Clinical Research
type: item
description: Section: Review Article Categories: Internal Medicine Keywords: TriNetX, Clinical Research, Medical Research, Research Database, Real-World Evidence Subjects: Real-World Evidence, TriNetX, Observational Studies, Clinical Research, Data Quality, Coding , EHR Coding Accuracy, Bias in Research, Research Methodology, Healthcare Disparities Disciplines: Medical Informatics, Clinical Research, Epidemiology, Public Health, Health Services Research, Biomedical Informatics, Data Science Introduction: The increasing utilization of real-world data platforms in medical research necessitates a comprehensive understanding of their methodological strengths and limitations. TriNetX has emerged as a significant platform for exploring large healthcare datasets. This review aims to critically evaluate the methodological framework and limitations of TriNetX, assess the impact of electronic health record coding accuracy on data reliability, and analyze the platform's capacity for generating generalizable real-world evidence in clinical research. Methods: We conducted a comprehensive review examining TriNetX's data architecture, quality metrics, and research applications, focusing on data integrity, platform architecture, and the external validity of research findings. Results: The analysis reveals significant methodological considerations. TriNetX's reliance on retrospective data introduces biases such as selection bias and confounding variables. The coding accuracy of electronic health records, which have not been independently validated, is a critical determinant of data reliability. The demographic representation is limited, affecting the generalizability of results. Discussion: Despite its extensive use, TriNetX's effective utilization requires careful consideration of its inherent limitations. The platform's data, predominantly from insured populations in academic and acute care settings, may not fully represent broader demographic groups. Addressing these methodological constraint…
subject: Review Article
  topic: section
subject: Internal Medicine
  topic: category
subject: TriNetX
  topic: keywords
subject: Clinical Research
  topic: keywords
subject: Medical Research
  topic: keywords
subject: Research Database
  topic: keywords
subject: Real-World Evidence
  topic: keywords
subject: Real-World Evidence
  topic: subjects
subject: TriNetX
  topic: subjects
subject: Observational Studies
  topic: subjects
subject: Clinical Research
  topic: subjects
subject: Data Quality
  topic: subjects
subject: Coding
  topic: subjects
subject: EHR Coding Accuracy
  topic: subjects
subject: Bias in Research
  topic: subjects
subject: Research Methodology
  topic: subjects
subject: Healthcare Disparities
  topic: subjects
subject: Medical Informatics
  topic: disciplines
subject: Clinical Research
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Health Services Research
  topic: disciplines
subject: Biomedical Informatics
  topic: disciplines
subject: Data Science
  topic: disciplines
creator: Mahmoud Nassar
creator: Hazem Abosheaishaa
creator: Khaled Elfert
creator: Azizullah Beran
creator: Abdellatif Ismail
creator: Mouhand Mohamed
creator: Anoop Misra
creator: Muhammed Amir Essibayi
creator: David J. Altschul
creator: Ahmed Y. Azzam
rights: Copyright (c) 2025 Mahmoud Nassar, Hazem Abosheaishaa, Khaled Elfert, Azizullah Beran, Abdellatif Ismail, Mouhand Mohamed, Anoop Misra, Muhammed Amir Essibayi, David J. Altschul, Ahmed Y. Azzam https://creativecommons.org/licenses/by/4.0
date: 2025-03-22
publication date: 2025-03-22
starting page: 24
ending page: 32
doi: 10.71079/ASIDE.IM.03222516

Impact of Serum Adiponectin Level on Insulin and hs-CRP in Patients with Type 2 Diabetes: A Case-Control Study
type: item
description: Section: Original Article Categories: Internal Medicine, Endocrinology Keywords: Adiponectin, Insulin, hs-CRP, Type 2 Diabetes Mellitus (T2D), HOMA-IR, Fasting Serum Glucose, Overweight Subjects: Adiponectin, Insulin Sensitivity and Resistance, Inflammatory Markers, Serum Markers, Case-Control Study, Epidemiological Data on Diabetes Disciplines: Endocrinology, Biochemistry, Epidemiology, Diabetology, Biostatistics, Public Health Introduction: Type 2 diabetes mellitus (T2DM) is marked by insulin resistance, hyperglycemia, and systemic inflammation. Adiponectin—a hormone produced mainly by adipose tissue—enhances insulin sensitivity and exhibits anti‐inflammatory properties. This study evaluated serum adiponectin and related metabolic markers in Iraqi patients with T2DM versus healthy controls. Methods: In a case-control design, 84 Iraqi subjects were recruited (45 patients with T2DM and 39 controls). Fasting blood samples were obtained to measure adiponectin, insulin, high-sensitivity C-reactive protein (hs-CRP), fasting serum glucose (FSG), and Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) using standardized ELISA and biochemical assays. Correlations between adiponectin and anthropometric parameters were also analyzed. Results: Controls showed significantly higher serum adiponectin and insulin levels (p < 0.05) compared to patients with T2DM. In contrast, hs-CRP, FSG, and HOMA-IR were significantly elevated in the diabetic group (p < 0.05). Moreover, adiponectin demonstrated significant negative correlations with both height and weight among controls, with their lower body weight suggesting enhanced fatty acid oxidation. Conclusions: These findings indicate that elevated adiponectin is associated with improved insulin sensitivity and reduced inflammatory markers. The data support the potential role of adiponectin in mitigating insulin resistance, hyperglycemia, and overweight risks in T2DM, warranting further investigation into its therapeutic utility.
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Endocrinology
  topic: category
subject: Adiponectin
  topic: keywords
subject: Insulin
  topic: keywords
subject: hs-CRP
  topic: keywords
subject: Type 2 Diabetes Mellitus (T2D)
  topic: keywords
subject: HOMA-IR
  topic: keywords
subject: Fasting Serum Glucose
  topic: keywords
subject: Overweight
  topic: keywords
subject: Adiponectin
  topic: subjects
subject: Insulin Sensitivity and Resistance
  topic: subjects
subject: Inflammatory Markers
  topic: subjects
subject: Serum Markers
  topic: subjects
subject: Case-Control Study
  topic: subjects
subject: Epidemiological Data on Diabetes
  topic: subjects
subject: Endocrinology
  topic: disciplines
subject: Biochemistry
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Diabetology
  topic: disciplines
subject: Biostatistics
  topic: disciplines
subject: Public Health
  topic: disciplines
creator: Hind Jawad
creator: Shatha Ali
creator: Mustafa Jawad
rights: Copyright (c) 2025 Hind F Jawad, Shatha H Ali, Mustafa S Jawad https://creativecommons.org/licenses/by/4.0
date: 2025-03-28
publication date: 2025-03-28
starting page: 20
ending page: 23
doi: 10.71079/ASIDE.IM.03182550

Investigating the Impact of Primary Education on Birth Control Practices in Bangladesh: A Primary Study
type: item
description: Section: Original Article Categories: Internal Medicine Keywords: Birth Control, Contraceptive Methods, Primary Education, Socio-economic Factors, Primary study, Survey, Bangladesh Subjects: Public Health, Family Medicine Disciplines: Internal Medicine, Public Health, Reproductive Health Introduction: Bangladesh faces significant challenges due to overpopulation, impacting essential resources such as healthcare, employment, and education. This study investigates the role of primary education in influencing contraceptive adoption and examines the socio-economic and educational factors affecting birth control practices in Bangladesh. Methods: A cross-sectional study was conducted in four districts (Sylhet, Habiganj, Sunamganj, and Moulvibazar). These areas were selected to provide a diverse representation of both urban and rural populations. A stratified random sampling technique was used to select 160 service recipients. A validated questionnaire was administered face-to-face by trained data collectors. Statistical methods included Chi-square tests, logistic regression modeling, and sensitivity analysis to control for confounding variables. Results: Higher education levels were significantly associated with increased contraceptive use (OR = 2.31, 95% CI: 1.58-3.47, p < 0.01). Multivariate analysis confirmed that income, religion, and geographic location were significant predictors of contraceptive adoption. Specifically, 41% of service recipients had secondary education, and 56% earned between 4000-5000 Taka per month. Discussion: This study underscores the importance of primary education in contraceptive adoption and identifies key socio-economic determinants affecting family planning choices. Despite methodological limitations, such as sample size constraints, the findings suggest a need for targeted interventions to enhance educational access and contraceptive awareness, particularly among lower-income groups. Conclusion: Expanding primary education is a critical …
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Birth Control
  topic: keywords
subject: Contraceptive Methods
  topic: keywords
subject: Primary Education
  topic: keywords
subject: Socio-economic Factors
  topic: keywords
subject: Primary study
  topic: keywords
subject: Survey
  topic: keywords
subject: Bangladesh
  topic: keywords
subject: Public Health
  topic: subjects
subject: Family Medicine
  topic: subjects
subject: Internal Medicine
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Reproductive Health
  topic: disciplines
creator: Md Rakibul Hasan
creator: Kanij Fatema Rabu
creator: Moryom Akter Muna
creator: Sajid Hassan
creator: Saifur Rahman
rights: Copyright (c) 2025 Md Rakibul Hasan, Kanij Fatema Rabu, Moryom Akter Muna, Sajid Hassan, Saifur Rahman https://creativecommons.org/licenses/by/4.0
date: 2025-02-23
publication date: 2025-02-23
starting page: 13
ending page: 19
doi: 10.71079/ASIDE.IM.02232529

Epidemiological Patterns of Diabetes Mellitus in The United States of America: An Observational Multicenter Analysis From 1990 to 2024
type: item
description: Section: Original Article Categories: Endocrinology Keywords: Diabetes Mellitus, Epidemiology, United States, Disparities, Healthcare, TriNetX Subjects: Diabetes Mellitus , Type 2 Diabetes Mellitus (T2D), Public health Disciplines: Endocrinology, Epidemiology, Internal Medicine Introduction: Diabetes mellitus represents a significant public health challenge, however, the current trends in its epidemiology remain incompletely characterized. This study aimed to analyze epidemiological changes and demographic patterns in diabetes incidence and prevalence across the United States from 1990 to 2024. Methods: We conducted a retrospective cohort study utilizing the TriNetX Global Health Research Network, analyzing de-identified electronic health records from 52,922,301 patients across 92 U.S. healthcare organizations. Time-based changes in disease trends regarding diabetes incidence and prevalence were targeted, and stratified by age, sex, race, and diabetes type. Results: Combined diabetes incidence increased from 3.98 per 1,000 in 1990-1994 to 60.98 per 1,000 in 2020-2024, while prevalence doubled from 6.26% to 12.00%. T2DM showed a twenty-fold increase in incidence (3.52 to 59.30 per 1,000), while T1DM peaked at 7.46 per 1,000 in 2010-2014 before declining to 4.59 per 1,000. Significant disparities were observed across demographic groups, with the highest rates among Native Hawaiians/Pacific Islanders (incidence: 94.75 per 1,000; prevalence: 20.65%) and consistent male predominance (incidence: 69.40 vs 54.07 per 1,000). Conclusions: These findings reveal concerning trends in diabetes epidemiology, characterized by a prominent and significant elevation in disease burden and persistent demographic disparities. The results call for the urgent need for optimized preventive strategies, targeted interventions for high-risk populations, and systematic changes in healthcare delivery to address this growing public health challenge effectively.
subject: Original Article
  topic: section
subject: Endocrinology
  topic: category
subject: Diabetes Mellitus
  topic: keywords
subject: Epidemiology
  topic: keywords
subject: United States
  topic: keywords
subject: Disparities
  topic: keywords
subject: Healthcare
  topic: keywords
subject: TriNetX
  topic: keywords
subject: Diabetes Mellitus
  topic: subjects
subject: Type 2 Diabetes Mellitus (T2D)
  topic: subjects
subject: Public health
  topic: subjects
subject: Endocrinology
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
creator: Ahmed Y Azzam
creator: Luis Medina Mora
creator: Mahmoud M. Morsy
creator: Muhammed Amir Essibayi
creator: David J. Altschul
creator: Mahmoud Nassar
rights: Copyright (c) 2025 Ahmed Y Azzam, Luis Medina Mora, Mahmoud M. Morsy, Muhammed Amir Essibayi, David J. Altschul, Mahmoud Nassar https://creativecommons.org/licenses/by/4.0
date: 2025-02-20
publication date: 2025-02-20
starting page: 1
ending page: 7
doi: 10.71079/ASIDE.IM.02202517

The Impact of Idiopathic Intracranial Hypertension on Cardiovascular Disease Risk Among UK Women: An Obesity-Adjusted Analysis
type: item
description: Section: Original Article Categories: Internal Medicine, Neurology Keywords: Idiopathic Intracranial Hypertension, Pseudotumor Cerebri, Stroke, Ischemic Stroke, Cardiovascular Disease Subjects: neurology, Epidemiology Disciplines: neurology Introduction: Idiopathic intracranial hypertension (IIH) is known to elevate cardiovascular disease (CVD) risk, but the extent to which obesity and IIH-specific factors contribute to this risk is not well understood. WE aim to separate the effects of obesity from IIH-specific factors on the risk of stroke and CVD, building on previous findings that indicate a two-fold increase in cardiovascular events in women with IIH compared to BMI-matched controls. Methods: An obesity-adjusted risk analysis was conducted using Indirect Standardization based on data from a cohort study by Adderley et al., which included 2,760 women with IIH and 27,125 matched healthy controls from The Health Improvement Network (THIN). Advanced statistical models were employed to adjust for confounding effects of obesity and determine the risk contributions of IIH to ischemic stroke and CVD, independent of obesity. Four distinct models explored the interactions between IIH, obesity, and CVD risk. Results: The analysis showed that IIH independently contributes to increased cardiovascular risk beyond obesity alone. Risk ratios for cardiovascular outcomes were significantly higher in IIH patients compared to controls within similar obesity categories. Notably, a synergistic effect was observed in obese IIH patients, with a composite CVD risk ratio of 6.19 (95% CI: 4.58-8.36, p<0.001) compared to non-obese controls. Conclusions: This study underscores a significant, independent cardiovascular risk from IIH beyond obesity. The findings advocate for a shift in managing IIH to include comprehensive cardiovascular risk assessment and mitigation. Further research is required to understand the mechanisms and develop specific interventions for this group.
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Neurology
  topic: category
subject: Idiopathic Intracranial Hypertension
  topic: keywords
subject: Pseudotumor Cerebri
  topic: keywords
subject: Stroke
  topic: keywords
subject: Ischemic Stroke
  topic: keywords
subject: Cardiovascular Disease
  topic: keywords
subject: neurology
  topic: subjects
subject: Epidemiology
  topic: subjects
subject: neurology
  topic: disciplines
creator: Ahmed Y. Azzam
creator: Mahmoud M. Morsy
creator: Mohamed Hatem Ellabban
creator: Ahmed M. Morsy
creator: Adham Adel Zahran
creator: Mahmoud Nassar
creator: Omar S. Elsayed
creator: Adam Elswedy
creator: Osman Elamin
creator: Ahmed Saad Al Zomia
creator: Hana J. Abukhadijah Abukhadijah
creator: Hammam A. Alotaibi Alotaibi
creator: Oday Atallah
creator: Mohammed A. Azab
creator: Muhammed Amir Essibayi
creator: Adam A. Dmytirw
creator: Mohamed D. Morsy
creator: David J. Altschul
rights: Copyright (c) 2024 Ahmed Y. Azzam, Mahmoud M. Morsy, Mohamed Hatem Ellabban, Ahmed M. Morsy, Adham Adel Zahran, Mahmoud Nassar, Omar S. Elsayed, Adam Elswedy, Osman Elamin, Ahmed Saad Al Zomia, Hana J. Abukhadijah, Hammam A. Alotaibi, Oday Atallah, Mohammed A. Azab, Muhammed Amir Essibayi, Adam A. Dmytirw, Mohamed D. Morsy, David J. Altschul https://creativecommons.org/licenses/by/4.0
date: 2024-11-27
publication date: 2024-11-27
starting page: 1
ending page: 10
doi: 10.71079/h1fr8h68

Safety and Efficacy of Metformin for Idiopathic Intracranial Hypertension: A U.S.-Based Real-World Data Retrospective Multicenter Cohort Study
type: item
description: Section: Original Article Categories: Internal Medicine, Neurology Keywords: Idiopathic Intracranial Hypertension, Pseudotumor Cerebri, Intracranial Pressure, Metformin, Metabolic Syndrome Subjects: neurology Disciplines: Neurology Introduction: Managing idiopathic intracranial hypertension (IIH) is challenging due to limited treatment options. This study evaluates metformin as a potential therapy for IIH, examining its impact on disease outcomes and safety. Methods: We performed a retrospective cohort study using the TriNetX database, covering data from 2009 to August 2024. The study included IIH patients, excluding those with other causes of raised intracranial pressure or pre-existing diabetes. Propensity score matching adjusted for age, sex, race, ethnicity, Hemoglobin A1C, and baseline BMI at metformin initiation. We assessed outcomes up to 24 months. Results: Initially, 1,268 patients received metformin and 49,262 served as controls, showing disparities in various parameters. After matching, both groups consisted of 1,267 patients each. Metformin users had significantly lower risks of papilledema, headache, and refractory IIH at all follow-ups (p<0.0001). They also had fewer spinal punctures and reduced acetazolamide use. BMI reductions were more significant in the metformin group from 6 months onward (p<0.0001), with benefits persisting regardless of BMI changes. Metformin’s safety profile was comparable to the control group. Conclusions: The study indicates metformin’s potential as a disease-modifying treatment in IIH, with improvements across multiple outcomes independent of weight loss. This suggests complex mechanisms at play, supporting further research through prospective clinical trials to confirm metformin’s role in IIH management and its mechanisms of action.
subject: Original Article
  topic: section
subject: Internal Medicine
  topic: category
subject: Neurology
  topic: category
subject: Idiopathic Intracranial Hypertension
  topic: keywords
subject: Pseudotumor Cerebri
  topic: keywords
subject: Intracranial Pressure
  topic: keywords
subject: Metformin
  topic: keywords
subject: Metabolic Syndrome
  topic: keywords
subject: neurology
  topic: subjects
subject: Neurology
  topic: disciplines
creator: Ahmed Y. Azzam
creator: Mahmoud Nassar
creator: Ahmed Saad Al Zomia
creator: Adam Elswedy
creator: Mahmoud M. Morsy
creator: Adham A. Mohamed
creator: Osman Elamin
creator: Omar S. Elsayed
creator: Mohammed A. Azab
creator: Muhammed Amir Essibayi
creator: Jin Wu
creator: Adam A. Dmytirw
creator: David J. Altschul
rights: Copyright (c) 2024 Ahmed Y. Azzam, Mahmoud Nassar, Ahmed Saad Al Zomia, Adam Elswedy, Mahmoud M. Morsy, Adham A. Mohamed, Osman Elamin, Omar S. Elsayed, Mohammed A. Azab, Muhammed Amir Essibayi, Jin Wu, Adam A. Dmytirw, David J. Altschul https://creativecommons.org/licenses/by/4.0
date: 2024-11-27
publication date: 2024-11-27
starting page: 11
ending page: 17
doi: 10.71079/2024001001

Stroke-Like Migraine Attacks After Radiation Therapy (SMART) Syndrome: A Case Report With Vertigo, Dysmetria, And Impaired Tandem Gait
type: item
description: Section: Case Report Categories: Internal Medicine, Neurology Keywords: SMART syndrome, Radiotherapy, Migraine, subcortical enhancement, cortical laminar necrosis Subjects: SMART syndrome, Stroke-like migraine attacks, Radiation-induced complications, Proton beam radiotherapy, Cortical laminar necrosis, Craniopharyngioma, Subcortical hyperintensity, Vertigo, Dysmetria, Impaired tandem gait Disciplines: Neurology, Neuroradiology, Radiation oncology, Pediatric oncology, Neuro-oncology, Clinical case reports, Neuroimaging, Headache medicine, Neurovascular disorders, Medical diagnostics SMART syndrome is a rare, delayed complication of brain radiation. The acronym SMART stands for stroke-like migraine attacks following radiation therapy. This case is one of the first to describe episodic vertigo, dysmetria, and impaired tandem gait following proton beam radiotherapy for a craniopharyngioma. An 18-year-old male presented with migraine headaches, upper and lower limb weakness, episodic vertigo, and dysmetria with impaired tandem gait. This occurred following proton-beam radiotherapy, which was completed at around 11 years of age for recurrent craniopharyngioma. Magnetic resonance imaging (MRI) of the brain demonstrated a T1 hyperintense signal in the cortex of the right parietal and temporal lobes consistent with SMART syndrome. In addition, a subcortical hyperintense signal was seen in the right parietal, temporal, and frontal lobes. Atypical presentations of SMART syndrome are out there, and it is essential to recognize them in patients presenting with neurological symptoms following radiation therapy so that diagnosis and treatment can be done.
subject: Case Report
  topic: section
subject: Internal Medicine
  topic: category
subject: Neurology
  topic: category
subject: SMART syndrome
  topic: keywords
subject: Radiotherapy
  topic: keywords
subject: Migraine
  topic: keywords
subject: subcortical enhancement
  topic: keywords
subject: cortical laminar necrosis
  topic: keywords
subject: SMART syndrome
  topic: subjects
subject: Stroke-like migraine attacks
  topic: subjects
subject: Radiation-induced complications
  topic: subjects
subject: Proton beam radiotherapy
  topic: subjects
subject: Cortical laminar necrosis
  topic: subjects
subject: Craniopharyngioma
  topic: subjects
subject: Subcortical hyperintensity
  topic: subjects
subject: Vertigo
  topic: subjects
subject: Dysmetria
  topic: subjects
subject: Impaired tandem gait
  topic: subjects
subject: Neurology
  topic: disciplines
subject: Neuroradiology
  topic: disciplines
subject: Radiation oncology
  topic: disciplines
subject: Pediatric oncology
  topic: disciplines
subject: Neuro-oncology
  topic: disciplines
subject: Clinical case reports
  topic: disciplines
subject: Neuroimaging
  topic: disciplines
subject: Headache medicine
  topic: disciplines
subject: Neurovascular disorders
  topic: disciplines
subject: Medical diagnostics
  topic: disciplines
creator: Ali Al Yasari
creator: Mahdia Alhaidar
creator: Mohamad Assker
rights: Copyright (c) 2025 Ali Al Yasari, Mahdia Alhaidar, Mohamad Assker https://creativecommons.org/licenses/by/4.0
date: 2025-08-29
publication date: 2025-08-29
starting page: 12
ending page: 15
doi: 10.71079/ASIDE.IM.08292567

Epidemiological Assessment of Risk Factors for Inguinal Hernia Among Male Patients in Iraq: A Case-Control Study
type: item
description: Section: Original Article Categories: Public Health Keywords: Epidemiology, Inguinal hernia, Iraq, Males, Risk factors Subjects: Epidemiology, Preventive Medicine, Inguinal Hernia, Risk Factors, Heavy Lifting, Chronic Cough, Smoking, Male Health, Family History, Body Mass Index (BMI) Disciplines: Epidemiology, Public Health, General Surgery, Internal Medicine, Family Medicine, Community Medicine, Preventive Medicine, Urology, Health Sciences, Clinical Research Introduction: Inguinal hernia is one of the most common surgical conditions, particularly among males. Despite its prevalence, limited regional data exist on the associated risk factors in Iraq. This study aimed to identify socio-demographic, lifestyle, and clinical risk factors contributing to inguinal hernia among male patients. Methods: A case-control study was conducted on 250 male patients diagnosed with inguinal hernia at multiple public hospitals and surgical clinics across three major cities in Iraq: Wasit, Baghdad, and Basra. Compared with a 250-member control group. Data were collected using structured questionnaires covering socio-demographic details, occupational exposure, lifestyle habits, medical history, and family history. Univariate and logistic regression analyses were performed to identify significant risk factors. Results: Most patients (57.5%) were between 41 and 60 years old. Heavy lifting (63.6%), smoking(62.0%), chronic cough (38.6%), and constipation (32.4%) were frequently reported. A positive family history was noted in 22.4% of cases. Univariate analysis revealed significant associations between inguinal hernia and heavy lifting (p < 0.001), smoking (p < 0.001), chronic cough (p = 0.002), constipation (p = 0.020), and a family history of inguinal hernia (p = 0.001). Logistic regression confirmed heavy lifting (OR=2.78), family history (OR=2.46), smoking (OR=1.69), and chronic cough (OR=1.54) as independent risk factors. Conclusion: Heavy lifting, smoking, chronic cough, and family h…
subject: Original Article
  topic: section
subject: Public Health
  topic: category
subject: Epidemiology
  topic: keywords
subject: Inguinal hernia
  topic: keywords
subject: Iraq
  topic: keywords
subject: Males
  topic: keywords
subject: Risk factors
  topic: keywords
subject: Epidemiology
  topic: subjects
subject: Preventive Medicine
  topic: subjects
subject: Inguinal Hernia
  topic: subjects
subject: Risk Factors
  topic: subjects
subject: Heavy Lifting
  topic: subjects
subject: Chronic Cough
  topic: subjects
subject: Smoking
  topic: subjects
subject: Male Health
  topic: subjects
subject: Family History
  topic: subjects
subject: Body Mass Index (BMI)
  topic: subjects
subject: Epidemiology
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: General Surgery
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Family Medicine
  topic: disciplines
subject: Community Medicine
  topic: disciplines
subject: Preventive Medicine
  topic: disciplines
subject: Urology
  topic: disciplines
subject: Health Sciences
  topic: disciplines
subject: Clinical Research
  topic: disciplines
creator: Ali Abdul Jabbar Mahdi
creator: Taqi Mohammed Jwad Taher
creator: Rami Bahaa Saadi
rights: Copyright (c) 2025 Ali Abdul Jabbar Mahdi, Taqi Mohammed Jwad Taher, Rami Bahaa Saadi https://creativecommons.org/licenses/by/4.0
date: 2025-07-15
publication date: 2025-07-15
starting page: 8
ending page: 12
doi: 10.71079/ASIDE.IM.071525132

Bridging the Gap: Addressing Language Barriers to Advance Equity in Internal Medicine
type: item
description: Section: Review Article Categories: Public Health Keywords: Public health impact, equity, language barriers, cultural competence Subjects: Language barriers in healthcare, Health equity, Communication in internal medicine, Diversity and inclusion, Limited English proficiency (LEP) Disciplines: Internal Medicine , Health Communication , Public Health, Health Policy and Systems, Medical Humanities Language barriers in healthcare are a persistent challenge that disproportionately affect patients with limited English proficiency (LEP), contributing to disparities in care, poor health outcomes, and patient dissatisfaction. In internal medicine, where effective communication is essential for diagnosis, management, and chronic disease follow-up, these barriers hinder quality and equity. This review synthesizes the current evidence on the impact of language discordance in internal medicine, explores effective mitigation strategies including interpreter services, culturally competent care, and technological tools and offers policy and practice recommendations to promote equitable healthcare delivery.
subject: Review Article
  topic: section
subject: Public Health
  topic: category
subject: Public health impact
  topic: keywords
subject: equity
  topic: keywords
subject: language barriers
  topic: keywords
subject: cultural competence
  topic: keywords
subject: Language barriers in healthcare
  topic: subjects
subject: Health equity
  topic: subjects
subject: Communication in internal medicine
  topic: subjects
subject: Diversity and inclusion
  topic: subjects
subject: Limited English proficiency (LEP)
  topic: subjects
subject: Internal Medicine
  topic: disciplines
subject: Health Communication
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Health Policy and Systems
  topic: disciplines
subject: Medical Humanities
  topic: disciplines
creator: Jayashree Ravikumar
creator: Divya Ravikumar
rights: Copyright (c) 2025 Jayashree Ravikumar, Divya Ravikumar https://creativecommons.org/licenses/by/4.0
date: 2025-07-01
publication date: 2025-07-01
starting page: 23
ending page: 30
doi: 10.71079/ASIDE.IM.070125117