Gender Disparity in Leading Authorship of Critical Care Clinical Trials: A Systematic Review and Meta-Analysis.

In critical care medicine, research trials serve as crucial avenues for disseminating knowledge, influencing clinical practices, and fostering innovation. Notably, a significant gender imbalance exists within this field, potentially mirrored in the authorship of critical care research. This study aimed to investigate an exploration to ascertain the presence and extent of female representation in first and senior authorship roles within critical care literature. To this end, a systematic search was conducted across PubMed, Google Scholar, and Web of Science databases for original articles published up to February 2024, coupled with a methodological quality assessment via the Newcastle-Ottawa Scale (NOS) and statistical analyses through Review Manager software (RevMan, version 5.4.1, The Cochrane Collaboration, 2020). The study's findings, distilled from seven studies included in the final analysis, reveal a pronounced gender disparity. Specifically, in critical care literature examining mixed populations, female first authors were significantly less common than their male counterparts, with an odds ratio (OR) of 4.25 (95% confidence interval (CI): 3.18-5.68; p < 0.00001). Conversely, pediatric critical care studies did not show a significant difference in gender distribution among first authors (OR: 1.37; 95% CI: 0.31-6.10; p = 0.68). The investigation also highlighted a stark underrepresentation of female senior authors in critical care research across both mixed (OR: 11.67; 95% CI: 7.76-17.56; p < 0.00001) and pediatric populations (OR: 5.41; 95% CI: 1.88-15.56; p = 0.002). These findings underscore the persistent underrepresentation of women in critical care literature authorship and their slow progression into leadership roles, as evidenced by the disproportionately low number of female senior authors.

Empowering Patients Through Digital Health Literacy and Access to Electronic Medical Records (EMRs) in the Developing World.

This editorial discusses the transformative potential of digital health literacy and the critical role of electronic medical records (EMRs) in promoting patient empowerment in the healthcare landscape of developing countries. It examines the impact of digital media in healthcare, noting its ability to both democratize access to information and services and pose risks of misinformation among populations with limited health literacy. The discussion includes an overview of key literacy components critical for effectively navigating the digital healthcare ecosystem. Our article highlights the critical role of EMR in facilitating a patient-centered care (PCC) model, with a special emphasis on making EMR systems accessible and user-friendly for vulnerable groups in developing countries. The core aim of our study is twofold: First, it sheds light on the significant challenges - be they technical, financial, or infrastructural - that obstruct the adoption of sophisticated EMR systems in these areas. Second, it explores the essential aspect of digital health literacy, advocating for its improvement as a vital step toward enabling patients to effectively engage with their medical records. By addressing these key issues, our study seeks to illustrate how enhancing digital health literacy, alongside increasing the accessibility of EMR systems, can empower patients in the developing world to actively participate in their healthcare processes. This dual focus aims to contribute to the broader discourse on improving healthcare outcomes through more inclusive and patient-centered approaches, particularly in settings that are currently underserved by modern healthcare technologies. In conclusion, the editorial advocates for a concerted effort toward creating a more inclusive and empowered healthcare paradigm. It suggests integrating PCC principles, tailoring EMR systems to diverse needs, and enhancing digital health literacy as strategies to harness digital health innovations for better healthcare outcomes and equity. It emphasizes the importance of ongoing investment in education, technology, and policy to fully leverage digital health solutions in the developing world.

Neurosarcoidosis and Transverse Myelitis: Life-Threatening Manifestations of Sarcoidosis.

Sarcoidosis, a systemic granulomatous disorder, typically involves the lungs, skin, and lymph nodes. Neurological manifestations are diverse and may include longitudinally extensive transverse myelitis (LETM), an uncommon inflammatory disorder of the spinal cord. We present a case of a 62-year-old female with LETM as the initial manifestation of sarcoidosis. The patient exhibited progressive bilateral lower extremity weakness, urinary retention, and sensory disturbances. Diagnostic workup revealed characteristic findings on spinal magnetic resonance imaging (MRI), cerebrospinal fluid analysis, and thoracic biopsy. Treatment with high-dose corticosteroids and subsequent immunomodulatory therapy resulted in significant improvement. Our case highlights the importance of including sarcoidosis in the differentials of LETM, particularly in patients with no respiratory manifestations.

Type 1 Autoimmune Pancreatitis Masquerading as Pancreatic Head Carcinoma.

Obstructive jaundice is a joint clinical presentation with many etiologies, including pancreatic cancer and autoimmune pancreatitis (AIP). Differentiating between these two conditions is pivotal due to the divergent management approaches and prognoses. In this case report, we present a case of a 49-year-old female patient who presented with weight loss, intermittent chronic abdominal pain, and jaundice. She was initially suspected of having pancreatic cancer because of clinical presentation and imaging findings. However, she was ultimately diagnosed with Type 1 AIP due to histopathology findings and elevated immunoglobulin G4. This case highlights the complexities in diagnosis, the role of advanced imaging techniques and tissue sampling, and the lessons learned regarding managing this challenging clinical scenario.

Digital Pathology: Transforming Diagnosis in the Digital Age.

In the context of rapid technological advancements, the narrative review titled "Digital Pathology: Transforming Diagnosis in the Digital Age" explores the significant impact of digital pathology in reshaping diagnostic approaches. This review delves into the various effects of the field, including remote consultations and artificial intelligence (AI)-assisted analysis, revealing the ongoing transformation taking place. The investigation explores the process of digitizing traditional glass slides, which aims to improve accessibility and facilitate sharing. Additionally, it addresses the complexities associated with data security and standardization challenges. Incorporating AI enhances pathologists' diagnostic capabilities and accelerates analytical procedures. Furthermore, the review highlights the growing importance of collaborative networks facilitating global knowledge sharing. It also emphasizes the significant impact of this technology on medical education and patient care. This narrative review aims to provide an overview of digital pathology's transformative and innovative potential, highlighting its disruptive nature in reshaping diagnostic practices.

An Assessment and Management of Plexiform Schwannoma of the Third Webspace in a Female: A Case Report.

Schwannoma is a rare benign soft tissue tumor that appears like a neuroma based on its specific location and clinical features. We report a case of a plexiform schwannoma in a middle-aged woman who had a painful bump located in the third webspace on the dorsum of her right foot for the last four years. Initially, the swelling was thought to be Morton's neuroma based on location and clinical feature findings. The mass was resected and was sent for histopathological examination, revealing a plexiform schwannoma, most likely developing from the cutaneous nerves on the dorsum of the foot. She reported improvement in her symptoms after complete and careful excision without any neurological deficit. Investigation of any subcutaneous foot swelling should be coupled with a histopathological examination for comprehensive management.

Risk Factors Associated With Non-Respondence to Methotrexate in Rheumatoid Arthritis Patients.

INTRODUCTION: Oral methotrexate (MTX) is the first-line therapy for patients with rheumatoid arthritis (RA). However, not all RA patients respond to MTX. In this study, we will determine the risk factors associated with MTX failure. METHODS: This retrospective study was conducted in tertiary care hospital in Pakistan. Data of 612 patients who were diagnosed with RA from June 2019 to January 2021 were retrieved from the medical record room. After inclusion, patients were divided into two groups; respondent and non-respondent. Their characteristics and demographics were compared. RESULTS: Out of the total 612 patients, 112 (18.3%) were labelled as non-respondent to MTX. Non-respondents had a higher predominance of females (86.6% vs. 60.2%; p-value: 0.001), participants with body mass index (BMI) >25 kg/m2 (54.4% vs. 22.4%; p-value: <0.00001), smokers (34.8% vs. 18.2%; p-value: 0.0001), participants with diabetes (47.3% vs. 23.4%; p-value: <0.0001) and rheumatoid factor positivity (91.0% vs. 64.8%; p-value: <0.0001). CONCLUSION: Female gender, higher BMI, smoking, higher disease activity, and diabetes were associated with MTX failure. These easily available parameters can help predict the disease process and outcome of treatment. It is important to screen patients who are at risk of MTX failure, so a contingent treatment plan can be devised, in case patients do not respond to MTX.