Africa bears the largest burden of communicable and non-communicable diseases globally, yet it contributes only about 1 % of global research output, partly because of inaccessibility and low maintenance of medical data. Data is widely recognized as a crucial tool for improvement of population health. Despite the introduction of electronic health data systems in low-and middle-income countries (LMICs) to improve data quality, some LMICs still lack an efficient system to collect and archive data. This study aims to examine the underlying causes of data archive inaccessibility and poor maintenance in LMICS, and to highlight sustainable mitigation measures. Authors conducted a comprehensive search on PubMed, Google scholar, organization websites using the search string "data archive" or "medical data" or "public health statistics" AND "challenges" AND "maintenance" AND "Low Middle Income Countries" or "LMIC". to Identify relevant studies and reports to be included in our review. All articles related data archive in low and middle income countries were considered without restrictions due to scarcity of data. Medical data archives in LMICs face challenges impacting data quality. Insufficient training, organizational constraints, and limited infrastructure hinder archive maintenance. To improve, support for public datasets, digital literacy, and technology infrastructure is needed. Standardization, cloud solutions, and advanced technologies can enhance data management, while capacity building and training programs are crucial. The creation and maintenance of data archives to facilitate the storage of retrospective datasets is critical to create reliable and consistent data to better equip the development of resilient health systems and surveillance of diseases in LMICs.

Congenital heart defects (CHDs) are birth abnormalities that may drastically alter the structure and functionality of the heart. For 70% of infants with congenital disorders to survive or maintain a better quality of life, surgery is necessary. Over 500 000 of the 1.5 million CHD cases reported annually, or 1% of all live births, occur in Africa, according to the WHO. A surmounted 90% of these patients are from Africa, and as a consequence, 300 000 infants die annually as a result of poor care or difficulty accessing adequate healthcare. However, the high prevalence of CHDs, precipitated by a plethora of aetiologies worldwide, is particularly pronounced in Africa due to maternal infectious diseases like syphilis and rubella amongst the pregnant populace. In low- and middle-income countries, especially in Africa, where foreign missions and organizations care for the majority of complicated cardiac surgical patients, access to secure and affordable cardiac surgical therapy is a substantial issue. Interventions for CHDs are very expensive in Africa as many of the continent’s domiciles possess low expenditures and funding, thereby cannot afford the costs indicated by associated surgical treatments. Access to management and healthcare for CHDs is further hampered by a lack of trained surgical personnel, specialized tools, infrastructure, and diagnostic facilities in Africa.

Breast cancer (BC) continues to be a significant global challenge due to drug resistance and severe side effects. The increasing prevalence is alarming, requiring new therapeutic approaches to address these challenges. At this point, Extracellular vesicles (EVs), specifically small endosome-released nanometer-sized EVs (SEVs) or exosomes, have been explored by literature as potential theranostics. Therefore, this review aims to highlight the therapeutic potential of exosomes in BC, focusing on their advantages in drug delivery and their ability to mitigate metastasis. Following the review, we identified exosomes' potential in combination therapies, serving as miRNA carriers and contributing to improved anti-tumor effects. This is evident in clinical trials investigating exosomes in BC, which have shown their ability to boost chemotherapy efficacy by delivering drugs like paclitaxel (PTX) and doxorubicin (DOX). However, the translation of EVs into BC therapy is hindered by various challenges. These challenges include the heterogeneity of EVs, the selection of the appropriate parent cell, the loading procedures, and determining the optimal administration routes. Despite the promising therapeutic potential of EVs, these obstacles must be addressed to realize their benefits in BC treatment.

Objective: To compare the ability of a deep-learning platform (the MACSSwin-T model) with health care professionals in detecting cerebral aneurysms from operative videos. Secondly, we aimed to compare health care professionals' ability to detect cerebral aneurysms with and without artificial intelligence (AI) assistance. Background: Modern microscopic surgery enables the capture of operative video data on an unforeseen scale. Advances in computer vision, a branch of AI, have enabled automated analysis of operative video. These advances are likely to benefit clinicians, health care systems, and patients alike, yet such benefits are yet to be realized. Methods: In a cross-sectional comparative study, neurosurgeons, anesthetists, and operating room nurses, all at varying stages of training and experience, reviewed still frames of aneurysm clipping operations and labeled frames as “aneurysm not in frame” or “aneurysm in frame.” Frames then underwent analysis by the AI platform. A second round of data collection was performed, whereby the neurosurgical team had AI assistance. The accuracy of aneurysm detection was calculated for human-only, AI-only, and AI-assisted human groups. Results: A total of 5154 individual frame reviews were collated from 338 health care professionals. Health care professionals correctly labeled 70% of frames without AI assistance, compared with 78% with AI assistance (odds ratio: 1.77, P < 0.001). Neurosurgical Attendings showed the greatest improvement, from 77% to 92% correct predictions with AI assistance (odds ratio: 4.24, P = 0.003). Conclusions: AI-assisted human performance surpassed both human and AI alone. Notably, across health care professionals surveyed, frame accuracy improved across all subspecialties and experience levels, particularly among the most experienced health care professionals. These results challenge the prevailing notion that AI primarily benefits junior clinicians, highlighting its crucial role throughout the surgical hierarchy as an essential component of modern surgical practice.

Dysfunction in the epithelium, breakdown of the blood–brain barrier, and consequent leukocyte and T-cell infiltration into the central nervous system define Vascular Multiple Sclerosis. Multiple sclerosis (MS) affects around 2.5 million individuals worldwide, is the leading cause of neurological impairment in young adults, and can have a variety of progressions and consequences. Despite significant discoveries in immunology and molecular biology, the root cause of MS is still not fully understood, as do the immunological triggers and causative pathways. Recent research into vascular anomalies associated with MS suggests that a vascular component may be pivotal to the etiology of MS, and there can be actually a completely new entity in the already available classification of MS, which can be called ‘vascular multiple sclerosis’. Unlike the usual other causes of MS, vascular MS is not dependent on autoimmune pathophysiologic mechanisms, instead, it is caused due to the blood vessels pathology. This review aims to thoroughly analyze existing information and updates about the scattered available findings of genetics, pro-angiogenetic factors, and vascular abnormalities in this important spectrum, the vascular facets of MS.

Lumbar disk herniation (LDH) is a common condition affecting millions worldwide. The management of LDH has evolved over the years, with the development of newer surgical techniques that aim to provide better outcomes with minimal invasiveness. One promising emerging technique is biportal endoscopic spinal surgery (BESS), which utilizes specialized endoscopic equipment to treat LDH through two small incisions. This review aims to assess the effectiveness of BESS as a management option for LDH by analyzing the available literature on surgical outcomes and potential complications associated with the technique. Our review shows that BESS is associated with favorable postoperative results as judged by clinical scoring systems, such as visual analog scale, Oswestry disability index, and MacNab criteria. BESS has several advantages over traditional open surgery, including minimized blood loss, a shorter duration of hospitalization, and an expedited healing process. However, the technique has limitations, such as a steep learning curve and practical challenges for surgeons. Our review offers recommendations for the optimal use of BESS in clinical practice, and provides a foundation for future research and development in this field, aiming to improve patient outcomes and quality of life.