Optimizing sustainable agriculture: A comprehensive review of agronomic practices and their impacts on soil attributes.

This study explores agronomic management (AM) effects on soil parameters under diverse conditions. Investigating tillage practices (TP), nutrient management (NM), crop rotation (CR), organic matter (OM), irrigation management (IM), and mulching (MS), it aims to reveal impacts on soil productivity, nutrient availability, microbial activity, and overall health. Varied TP affect soil quality through compaction, porosity, and erosion risk. Proper NM is vital for nutrient cycling, preventing imbalances and acidification. CR disrupts pest cycles, reduces weed pressure, and boosts nutrient recycling. OM management enhances soil quality by influencing organic carbon, nutrient availability, pH, fertility, and water retention. Optimizing IM regulates soil water content without inducing waterlogging. MS contributes to OM content, nutrient retention, soil structure, and temperature-moisture regulation, benefiting soil biota, aggregation, soil health and agricultural productivity. The review emphasizes integrated nutrient, CR, and OM management's positive impact on fertility and microbial activity. Different TP and IM variations impact soil health and crop production. Judicious implementation of these practices is essential for sustainable agriculture. This synthesis identifies uncertainties and proposes research directions for optimizing productivity while ensuring environmental sustainability. Ongoing inquiry can guide a balanced approach between yields and resilient soil stewardship for future generations.

Entropy Analysis of the Peristaltic Flow of Hybrid Nanofluid Inside an Elliptic Duct with Sinusoidally Advancing Boundaries.

Peristaltic flow of hybrid nanofluid inside a duct having sinusoidally advancing boundaries and elliptic cross-section is mathematically investigated. The notable irreversibility effects are also examined in this mathematical research by considering a descriptive entropy analysis. In addition, this work provides a comparison analysis for two distinct nanofluid models: a hybrid model (Cu-Ag/water) and a phase flow model (Cu/water). A comprehensive graphical description is also provided to interpret the physical aspects of this mathematical analysis.

Role of low-level laser therapy in post-herpetic neuralgia: a pilot study.

The aim of the present study was to investigate the influence of low-level laser radiation at a wavelength of 650 nm for treating post-herpetic neuralgia, an extremely painful condition which frequently occurs severely in old age and may persist for years with no predictable course. In total, fifteen patients were included in the present study, out of which 8 were females and 7 were males aged between 42 and 82 years. All patients were treated through 16 sessions for 8 weeks, and pain scoring was done on a visual analogue scale and statistical analysis was made for comparison before and after treatments. The final pain score was 0 in 11 patients although their initial pain score was severe in 8 and moderate in 3 patients. In three patients, pain reduced to mild intensity (2-3), and in one, the final pain score was 4 on the visual analogue scale. Patients treated during the present study have not complained for recurrence of pain or any other abnormality even after many months since completion of the therapy. Overall, low-level laser therapy (LLLT) proved itself an excellent therapeutic modality for the relief of pain in post-herpetic neuralgia patients, which may replace pain management medicines in future.

Numerical Simulation of Entropy Generation for Power-Law Liquid Flow over a Permeable Exponential Stretched Surface with Variable Heat Source and Heat Flux.

This novel work explored the second law analysis and heat transfer in a magneto non-Newtonian power-law fluid model with the presence of an internal non-uniform heat source/sink. In this investigation, the motion of the studied fluid was induced by an exponentially stretching surface. The rheological behavior of the fluid model, including the shear thinning and shear thickening properties, are also considered as special case studies. The physical problem developed meaningfully with the imposed heat flux and the porosity of the stretched surface. Extensive numerical simulations were carried out for the present boundary layer flow, in order to study the influence of each control parameter on the boundary layer flow and heat transfer characteristics via various tabular and graphical illustrations. By employing the Shooting Runge-Kutta-Fehlberg Method (SRKFM), the resulting nonlinear ordinary differential equations were solved accurately. Based on this numerical procedure, the velocity and temperature fields are displayed graphically. By applying the second law of thermodynamics, and characterizing the entropy generation and Bejan number, the present physical problem was examined and discussed thoroughly in different situations. The attained results showed that the entropy generation can be improved significantly by raising the magnetic field strength and the group parameter. From an energetic point of view, it was found that the Reynolds number boosts the entropy generation of the fluidic medium and reduces the Bejan number. Also, it was observed that an amplification of the power-law index diminished the entropy generation near the stretched surface. As main results, it was proven that the heat transfer rate can be reduced with both the internal heat source intensity and the magnetic field strength.

SCHMIDT'S SYNDROME IN A 32 YEARS OLD FEMALE.

In polyglandular autoimmune (PGA) syndromes, there is immune dysfunction of two or more endocrine glands. Immunity mediated disorders of non-endocrine organs may also be seen. These syndromes are of two main types: type I and type II. We are reporting this case of a 32 years old lady who presented initially with hypothyroidism for many years and received thyroid replacement therapy. After that she was married and had children. After an interval of about seven years of the initial diagnosis of hypothyroidism, she was hospitalized in first trimester of pregnancy for severe vertigo, syncopal episodes and hypotension. She responded well to intravenous fluids and steroids. Further endocrine related, investigations revealed Addison's disease and the above episode were retrospectively diagnosed as Addisonian crisis. Thus the patient was diagnosed as Schmidt's Syndrome (Autoimmune polyendocrine syndrome type 2) since 2009.

Analysis of fractionalized Brinkman flow in the presence of diffusion effect.

A vertical plate experiences a dynamic flow of fractionalized Brinkman fluid governed by fluctuating magnetic forces. This study considers heat absorption and diffusion-thermo effects. The novelty of model is the fractionalized Fourier's and Fick's laws. The problem is solved using the constant proportional Caputo derivative and Laplace transform method. The resulting non-dimensional equations for temperature, mass, and velocity fields are solved and compared visually. We explore the influence of various parameters like the fractional order, heat absorption/generation (Q), chemical reaction rate (R), and magnetic field strength (M) through informative graphs. Additionally, we contrast the velocity fields of fractionalized and regular fluids. The visualizations reveal that diffusion-thermo and mass Grashof number enhance fluid velocity, while chemical reaction and magnetic field tend to suppress it. For the interest of engineering, physical quantities such as Sherwood number, skin friction, and Nusselt number are computed. The present study satisfying all initial and boundary condition can be reduced to to previous published work which shows the validity of present work.

Physicochemical and mineral properties of suspended sediments of the Tigris and Euphrates rivers in the Mesopotamian Plain.

Most of the suspended river load from the Tigris and Euphrates rivers is deposited in the Mesopotamian Plain in Iraq. This suspended river load comprises sediments consisting of minerals and organic particles generated from weathering, erosion, transport, and sedimentation. Therefore, it is crucial to analyze, either quantitative or qualitatively, the types of minerals in the sediment particles transported by the suspended river load, in addition to the potential value they may add to the agricultural lands irrigated by the Tigris and Euphrates rivers. Herein, samples of suspended sediments were collected from both rivers for physical, chemical, and mineral assessments. The results revealed the predominance of silt particles, followed by clay, and then sand. The presence of clay particles increased while that of silt and sand decreased with further travel into the rivers. The pH values ranged from 7.39 to 7.70 and the electrical conductivity ranged from 1.39 to 2.16 ds m-1. The values of the total and active calcium carbonate minerals were 352.87-336.12 and 172.64-194.56 g kg-1 for the Tigris and Euphrates rivers, respectively. The mineral analysis identified the presence of non-clay minerals at a rate of 83 %, including calcite, quartz, albite, dolomite, and gypsum. Clay minerals, including chlorite, illite, montmorillonite, palygorskite, vermiculite, and kaolinite, were found at a rate of 17 %. Both rivers exhibited distributions of clay and non-clay minerals that vary as they move along the rivers.

Heat Transfer of Magnetohydrodynamic Stratified Dusty Fluid Flow through an Inclined Irregular Porous Channel.

The primary objective of the study is to explore the phenomena of dusty fluid flow through an inclined irregular channel under the impact of the transversely applied magnetic field of fixed strength. The density and viscosity of the working fluid are assumed to vary along with the height of the channel as it behaves as a replica of many real world mechanisms. Hence, a stratified dusty fluid through a channel that tilts to an angle θ is the main objective of the present study. The prescribed flow is mathematically modeled and it is approached numerically under two distinct boundary conditions. The finite difference technique is employed to discretize the system of equations and solved using the Thomas algorithm. The velocity and temperature fields are discussed for different pertinent parameters which influence the flow. The friction factor and heat transfer rate are discussed as it has been a subject of interest in recent decades. The results show that the stratification decay parameter leads to enhancement in the momentum of the fluid flow. The temperature field is found to be higher in the convective boundary than the Navier slip boundary.

EMHD Nanofluid Flow with Radiation and Variable Heat Flux Effects along a Slandering Stretching Sheet.

Nanofluids have gained prominence due to their superior thermo-physical properties. The current paper deals with MHD nanofluid flow over a non-linear stretchable surface of varying thickness in the presence of an electric field. We investigated the effects of nanometer-sized copper (Cu) particles in water (base fluid) as a nanofluid, as well as non-linear thermal radiation, variable fluid viscosity, Joule heating, viscous dissipation, and non-uniform heat flux. The current study's aim is influenced by the immense applications in industry and machine building. It has been observed that linear stretching sheets have been extensively used in heat transfer research. Moreover, no effort has been made yet to model a non-linear stretching sheet with variable thickness. Furthermore, the effects of electromagnetohydrodynamics (EMHD) boundary-layer flow of a nanofluid with the cumulative impact of thermal radiation, variable viscosity, viscous dissipation, Joule heating, and variable heat flux have been investigated. Sheets with variable thicknesses are practically significant in real-life applications and are being used in metallurgical engineering, appliance structures and patterns, atomic reactor mechanization and paper production. To investigate the physical features of the problem, we first examined the model and identified all the physical properties of the problem. This problem has been formulated using basic laws and governing equations. The partial differential equations (PDEs) that govern the flow are converted into a system of non-dimensional ordinary differential equations (ODE's), using appropriate transformations. The Adam-Bashforth predictor-corrector technique and Mathematica software are utilized to numerically solve the resulting non-dimensionalized system. The interaction of various developing parameters with the flow is described graphically for temperature and velocity profiles. It is concluded that the velocity of nanoparticles declines as the intensity of the magnetic field increases. However, the temperature of the nanomaterials rises, as increasing the values of the electric field also increases the velocity distribution. The radiation parameter enhances the temperature field. The temperature of the fluid increases the occurrence of space- and time-dependent parameters for heat generation and absorption and radiation parameters.

Comparison of Continuous Thoracic Epidural With Erector Spinae Block for Postoperative Analgesia in Adult Living Donor Hepatectomy.

BACKGROUND: Thoracic epidural analgesia (TEA) is commonly used for pain management in donor hepatectomy. Erector spinae plane block (ESPB) is a newer ultrasound-guided block described for the management of thoracic and abdominal pain. There is limited literature available comparing the two techniques. The objective of this study was to compare the postoperative analgesic efficacy and adverse effects of continuous ESPB to continuous TEA in donor hepatectomy. METHODOLOGY: The randomized controlled trial (RCT) was registered on ClinicalTrials.gov (NCT04151511). A total of 82 patients undergoing donor hepatectomy between January 2020 and December 2020 were recruited, of whom 41 received TEA and 41 received ESPB. Randomization was done by the sealed opaque envelope method. RESULTS:  The mean visual analog scale (VAS) scores in donors who received TEA and ESPB in post-anesthesia care unit (PACU) (2.7 + 0.9 vs. 2.4 + 0.5; P = 0.02) at one hour (2.7 + 0.9 vs. 2.2 + 0.6; P = 0.008), six hours (1.8 + 0.9 vs. 0.8 + 0.5; P < 0.001), 12 hours (0.9 + 0.7 vs. 0.2 + 0.7; P < 0.001), and 24 hours (0.48 + 0.5 vs. 0.08 + 0.3; P < 0.001) were significantly different. Mean opioid consumption was 3.38 ± 6.24 mg in the ESPB group and 10.75 ± 9.64 mg in the TEA group (P < 0.001). Mean lung volume (MLV) at 24 hours in the TEA group and ESPB group was 1543 ml and 1815 ml (P < 0.001). MLV was 2545 ml in the TEA group and 2820 ml in the ESPB group at 48 hours (P < 0.001). Mean nausea and vomiting score at six hours was 0.1 vs. 0.03 (P = 0.02). CONCLUSION:  ESPB improves pain control after donor hepatectomy with an enhanced safety profile and reduced opioid consumption.

Modelling Entropy in Magnetized Flow of Eyring-Powell Nanofluid through Nonlinear Stretching Surface with Chemical Reaction: A Finite Element Method Approach.

The present paper explores the two-dimensional (2D) incompressible mixed-convection flow of magneto-hydrodynamic Eyring-Powell nanofluid through a nonlinear stretching surface in the occurrence of a chemical reaction, entropy generation, and Bejan number effects. The main focus is on the quantity of energy that is lost during any irreversible process of entropy generation. The system of entropy generation was examined with energy efficiency. The set of higher-order non-linear partial differential equations are transformed by utilizing non-dimensional parameters into a set of dimensionless ordinary differential equations. The set of ordinary differential equations are solved numerically with the help of the finite element method (FEM). The illustrative set of computational results of Eyring-Powell (E-P) flow on entropy generation, Bejan number, velocity, temperature, and concentration distributions, as well as physical quantities are influenced by several dimensionless physical parameters that are also presented graphically and in table-form and discussed in detail. It is shown that the Schemit number increases alongside an increase in temperature, but the opposite trend occurs in the Prandtl number. Bejan number and entropy generation decline with the effect of the concentration diffusion parameter, and the results are shown in graphs.

Mediastinal Lymphadenopathy As A Predictor Of Worse Outcome In Severe Covid-19 Cases.

BACKGROUND: This cross-sectional study is aimed at evaluating the association of mediastinal lymphadenopathy with COVID-19 prognosis in severe cases. Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Pakistan, from June to July 2020. METHODS: One hundred and fifty (150) laboratory-confirmed SARS CoV-2 infected, severe cases in Intensive Care Unit/ High Dependency Unit were included. These cases were divided into two categories, i.e., with and without mediastinal lymphadenopathy on High Resolution Computed Tomography chest. The two categories were compared on the basis of data obtained including age, gender, comorbid, White Blood Cell count, lymphocyte count, median days of hospitalization, need for invasive ventilation, Intensive Care Unit admission, clinical outcome and High-Resolution Computed Tomography chest findings. The data was compiled on a questionnaire and analysed on SPSS 24. RESULTS: Total 155 severe COVID-19 patients were reviewed, out of which 36 (23.2%) had mediastinal lymphadenopathy (category 1) and 119 (76.8%) had no mediastinal lymphadenopathy (category 2). Laboratory findings including median of white blood cells and lymphocyte percentage had no significant change in both categories. Intensive care unit admissions were 12 (33.3%) and 56 (47.1%) in category 1 and 2 respectively. Median days of hospitalization (8 days) and mortality rate (16%) were almost the same in both categories. CONCLUSIONS: Our study concludes that presence of mediastinal lymphadenopathy in severe COVID-19 cases is not associated with worse outcome. However, overall prevalence of mediastinal lymphadenopathy in severe cases is high (23.2%).

Recurrence Rate of Trigeminal Neuralgia With the Use of Percutaneous Stereotactic Continuous Radiofrequency Ablation at 80°C for 90 Seconds: A Single-Center Study.

Introduction With recent development in the treatment of trigeminal neuralgia (TN), percutaneous stereotactic rhizotomy is being widely used as an interventional technique. The purpose of this study was to find the recurrence rate of TN in patients who were treated with stereotactic rhizotomy at 80°C for 90 seconds, in a tertiary care set up in a developing country. Methodology A retrospective cohort study was conducted at Shifa International Hospital, Islamabad, Pakistan from September 2016 to August 31, 2021. A total of 57 patients (19 males and 38 females) aged 27-90 years old, whose MRI of the brain had ruled out organic or structural pathologies, and who fulfilled the International Classification of Headache Disorders, 3rd edition for TN were recruited for the study. Of these patients, 51 underwent radiofrequency ablation (RFA) of the trigeminal ganglion (one or more branches of the trigeminal nerve (cranial nerve V (CN V)) in the operation theater. Patients having concomitant comorbid conditions like brain tumors, vascular pathologies, or coagulopathies, those who had previously undergone trigeminal ganglion neurolysis with either alcohol or phenol, who were lost to follow-up before the completion of the six months or had not visited back after the procedure, and those on oral anticoagulants and the ones declared high risk or American Society of Anesthesiologists (ASA) 3 and above for general anesthesia were excluded. Ethical approval was obtained and data were collected from the medical records department. The pain was recorded using the Numeric Rating Scale and recurrence was recorded from the follow-up visits of the patient over at least 12 months. Results Out of 51 patients, three patients who underwent RFA reported recurrence of the same problem for which they had initially reported to the pain clinic and were treated again with RFA. Five patients came back with the neuralgia of a different but contiguous branch of the same Gasserian ganglion opted for the RFA and were treated with no subsequent recurrences. The initial pain relief rate was 84.31%. At the end of the five-year study period, 16 patients reported variable degrees of sensory deficit, and two patients experienced non-debilitating unilateral reversible motor weakness of the jaw. One patient experienced keratitis due to unintentional loss of corneal reflex and subsequent ipsilateral loss of vision. Conclusion RFA is one of the leading treatment options for TN, with lower recurrence at higher temperatures of the radiofrequency electrode, at the cost of more significant sensory and motor deficits.

Lack of impact of OCTN1 gene polymorphisms on clinical outcomes of gabapentinoids in Pakistani patients with neuropathic pain.

BACKGROUND AND OBJECTIVE: Gabapentinoids are the first-line drugs for neuropathic pain. These drugs are the substrate of organic cation transporter (OCTN1) for renal excretion and absorption across the intestinal epithelium. Gabapentinoids exhibit wide interindividual variability in daily dosage and therapeutic efficacy which makes titration regimens prolonged for optimal efficacy. The present study aimed to investigate the possible influence of the single nucleotide polymorphism (SNP) of OCTN1 on therapeutic efficacy and safety of gabapentinoids in neuropathic pain patients of the Pakistani population. METHODS: Four hundred and twenty-six patients were enrolled in the study. All participants were genotyped for OCTN1 rs1050152 and rs3792876 by PCR-RFLP method and followed up for eight weeks. The therapeutic outcomes of gabapentinoids, reduction in pain score, inadequate or complete lack of response, adverse events (AEs) in responders and discontinuation of treatment on account of AEs were recorded for all patients. RESULTS: There was no significant association of genotypes and alleles of both SNPs on the clinical response of gabapentinoids (P ˃ 0.05). Similarly, significant differences were not found in the reduction of pain scores and AEs among different genotypes in the responders. The present study has reported the association of OCTN1 rs1050152 and rs3792876 polymorphisms with clinical outcomes of gabapentinoids for the first time in the real-world clinical setting. CONCLUSION: Our results suggest a lack of influence of OCTN1 genetic variants in the determination of clinical response to gabapentinoids in patients with neuropathic pain in the Pakistani population. These findings signify the role of renal functions in predicting the interindividual variability to therapeutic responsiveness of gabapentinoids.

Comparison of the Efficacy of Continuous Femoral Nerve Block With Epidural Analgesia for Postoperative Pain Relief After Unilateral Total Knee Replacement.

Introduction With recent developments in postoperative pain management after total knee replacement (TKR), the continuous femoral nerve block is becoming a common practice. The purpose of this study was to compare a femoral nerve block with time-tested epidural analgesia in a tertiary care setup in a developing country. Methodology A randomized control trial took place at Shifa International Hospital (SIH), Islamabad, Pakistan. Sixty patients, aged 40 to 90 years old, 12 males and 48 females, who were undergoing unilateral TKR for osteoarthritis in American Society of Anesthesiologists (ASA) physical status classes I and II, weighing between 50 and 99 kg, and fully able to understand and respond to the numeric rating scale (NRS) were included in the study. While patients belonging to ASA physical status class ≥3, with chronic opiate therapy, having allergies to local anesthetics or equipment material, or with neuromuscular disease, were excluded from the study. Ethical approval was obtained, and patients were divided into two groups, with group A given epidural and group B given a femoral nerve block for pain management postop. Data were collected. The pain was recorded using the NRS at six, 12, and 24 hours postop. Results The results for six hours and 12 hours were found to be significant. Patients in group A had a lower NRS rating postop as compared to group B and required a lesser amount of additional boluses for pain management.  Conclusion The femoral nerve block is inferior to epidural analgesia for pain management after unilateral TKR in the first 24 hours, with a greater need for extra boluses to relieve pain.

Effects of temperature dependent viscosity and thermal conductivity on natural convection flow along a curved surface in the presence of exothermic catalytic chemical reaction.

The natural convection boundary layer flow of a viscous incompressible fluid with temperature dependent viscosity and thermal conductivity in the presence of exothermic catalytic chemical reaction along a curved surface has been investigated. The governing non dimensional form of equations is solved numerically by using finite difference scheme. The numerical results of velocity profile, temperature distribution and mass concentration as well as for skin friction, heat transfer rate and mass transfer rate are presented graphically and in tabular form for various values of dimensionless parameters those are generated in flow model during dimensionalization. From the obtained results, it is concluded that the exothermic catalytic chemical reactions is associated with temperature dependent viscosity and thermal conductivity. Further, it is concluded that the body shape parameter also plays an important quantitative role for change in velocity profile, temperature field and mass concentration behavior in the presence of exothermic catalytic chemical reaction.

Viscous flow between two sinusoidally deforming curved concentric tubes: advances in endoscopy.

Viscous flow between two sinusoidally deforming curved concentric tubes is mathematically investigated for the first time. Exact solutions are computed to analyse the flow between these two tubes and graphical outcomes are included for a thorough analysis of the solutions. The present article has prime applications in endoscopy as a novel peristaltic endoscope is introduced first time for a curved sinusoidal tube. This curved nature of outer sinusoidal tube with a flexible peristaltic endoscope placed inside it covers the topic of practical applications like endoscopy of human organs having curved shapes and the maintenance of complex machineries that involve complex curve structures. The usage of a flexible peristaltic endoscope inside a curved sinusoidal tube makes the process of catheterization more comfortable.

Mechanics of non-Newtonian blood flow in an artery having multiple stenosis and electroosmotic effects.

The electro-osmotically modulated hemodynamic across an artery with multiple stenosis is mathematically evaluated. The non-Newtonian behaviour of blood flow is tackled by utilizing Casson fluid model for this flow problem. The blood flow is confined in such arteries due to the presence of stenosis and this theoretical analysis provides the electro-osmotic effects for blood flow through such arteries. The mathematical equations that govern this flow problem are converted into their dimensionless form by using appropriate transformations and then exact mathematical computations are performed by utilizing Mathematica software. The range of the considered parameters is given as 0.03<δl<0.12,2

Convective heat transfer for Peristaltic flow of SWCNT inside a sinusoidal elliptic duct.

A mathematical model is presented to analyse the flow characteristics and heat transfer aspects of a heated Newtonian viscous fluid with single wall carbon nanotubes inside a vertical duct having elliptic cross section and sinusoidally fluctuating walls. Exact mathematical computations are performed to get temperature, velocity and pressure gradient expressions. A polynomial solution technique is utilized to obtain these mathematical solutions. Finally, these computational results are presented graphically and different characteristics of peristaltic flow phenomenon are examined in detail through these graphs. The velocity declines as the volume fraction of carbon nanotubes increases in the base fluid. Since the velocity of fluid is dependent on its temperature in this study case and temperature decreases with increasing volumetric fraction of carbon nanotubes. Thus velocity also declines for increasing volumetric fraction of nanoparticles.

Influence of single nucleotide polymorphism of LAT1 on therapeutic response to gabapentinoids in Pakistani patients with neuropathic pain.

Gabapentinoids are substrate of L-type amino acid transporter 1 (LAT1) for distribution across the blood-brain barrier. The present study aimed to evaluate the effect of LAT1 rs4240803 genetic polymorphism on the clinical efficacy and tolerability of gabapentinoids in Pakistani patients with neuropathic pain. Three-hundred and ninety-two patients were recruited, genotyped for SNP rs4240803, and followed up for eight weeks to evaluate the clinical response to gabapentinoids in terms of pain relief, inadequate response, and the emergence of adverse events. LAT1 rs4240803 GG, GA, and AA genotype frequency were 33.42%, 47.96% and 18.62%, respectively. Out of 392 patients, 323 responded to the treatment and 17.6% discontinued either due to insufficient response or intolerable adverse events (AEs). GA genotype was more frequent in non-responder group (P Ë‚ 0.001). Maximum pain responders (≥50%) in combination with the lowest incidence of AEs were observed in the GG group, whereas partial responders belonged to GA genotype and with the highest frequency of somnolence (83.6%) and dizziness (69.9%). Overall, 72.5% patients with GA genotype experienced AEs (P Ë‚ 0.001). In conclusion, clinical outcomes of gabapentinoids are influenced by LAT1 rs4240803 polymorphism and population pharmacogenetics should be considered to evaluate the maximum potential of gabapentinoids in the management of neuropathic pain.