Data mining in healthcare offers transformative insights yet surfaces multilayered ethical and governance challenges that extend beyond privacy alone. Privacy and consent concerns remain paramount when handling sensitive medical data, particularly as healthcare organizations increasingly share patient information with large digital platforms. The risks of data breaches and unauthorized access are stark: 725 reportable incidents in 2023 alone exposed more than 133 million patient records, and hacking-related breaches surged by 239% since 2018. Algorithmic bias further threatens equity; models trained on historically prejudiced data can reinforce health disparities across protected groups. Therefore, transparency must span three levels–dataset documentation, model interpretability, and post-deployment audit logging–to make algorithmic reasoning and failures traceable. Security vulnerabilities in the Internet of Medical Things (IoMT) and cloud-based health platforms amplify these risks, while corporate data-sharing deals complicate questions of data ownership and patient autonomy. A comprehensive response requires (i) dataset-level artifacts such as “datasheets,” (ii) model-cards that disclose fairness metrics, and (iii) continuous logging of predictions and LIME/SHAP explanations for independent audits. Technical safeguards must blend differential privacy (with empirically validated noise budgets), homomorphic encryption for high-value queries, and federated learning to maintain the locality of raw data. Governance frameworks must also mandate routine bias and robust audits and harmonized penalties for non-compliance. Regular reassessments, thorough documentation, and active engagement with clinicians, patients, and regulators are critical to accountability. This paper synthesizes current evidence, from a 2019 European re-identification study demonstrating 99.98% uniqueness with 15 quasi-identifiers to recent clinical audits that trimmed false-negative rates via threshold recalibration, and proposes an integrated set of fairness, privacy, and security controls aligned with SPIRIT-AI, CONSORT-AI, and emerging PROBAST-AI guidelines. Implementing these solutions will help healthcare systems harness the benefits of data mining while safeguarding patient rights and sustaining public trust.

Pediatric emergency care in low- and middle-income countries (LMICs) faces critical challenges, leading to preventable morbidity and mortality. Limited resources, inadequate infrastructure, workforce shortages, and socioeconomic disparities strain the healthcare system. This narrative review identifies key barriers, including insufficient healthcare infrastructure, a lack of trained professionals, and restricted access to essential medical supplies and emergency services. Financial constraints, caregiver health literacy gaps, and technological limitations, such as poor EMR systems and limited telemedicine, further hinder care. Geographical barriers delay interventions, especially in rural areas with poor transportation. Weak healthcare policies contribute to fragmented care, necessitating urgent reform. Solutions include strengthening infrastructure, expanding pediatric emergency training, leveraging digital health technologies, and reducing out-of-pocket expenses. Community engagement and caregiver education are crucial for timely access, whereas global collaboration is vital for resource mobilization and sustainable improvements in LMICs’ pediatric emergency care.

Background . Low- and middle-income countries (LMICs) face persistent challenges in reducing pediatric mortality, particularly in emergency settings. Simulation-based training (SBT) offers a practical solution to improve pediatric emergency care by enhancing healthcare providers’ skills and clinical decision-making. Objective . This narrative review explores the effectiveness, challenges, and implementation strategies of SBT for pediatric emergency care in LMICs. Methods . A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar databases and 36 selected articles were included. Results . Findings highlight significant improvements in clinical skills, teamwork, and decision-making through SBT, with low-fidelity and in-situ simulations emerging as cost-effective alternatives for these settings. Case studies from Ghana, India, and Uganda showcase innovative, affordable models, including task-trainers and homemade mannequins, which address local barriers. Despite its potential, further research is needed to evaluate long-term outcomes and establish standardized assessment metrics. Conclusion . SBT represents a scalable and impactful strategy to strengthen pediatric emergency care and reduce child mortality in LMICs.

Posterior reversible encephalopathy syndrome (PRES) is an acute neurological condition characterized by a spectrum of clinical and radiological features. I

Introduction: Dysphagia is a rare initial manifestation of primary hyperparathyroidism, which typically presents with gastrointestinal symptoms like anorexia and constipation. This case presentation aims to describe swallowing difficulty as a potential primary symptom of parathyroid hormone (PTH)-mediated hypercalcemia. Presentation of case: An elderly Palestinian female presented with a two-year history of progressive dysphagia, along with mood disturbances and increased urination. Her medical history included osteoporosis and hyperparathyroidism. Laboratory tests showed elevated PTH and calcium levels. Imaging, including neck ultrasound (US) and Tc99m sestamibi scan, identified a parathyroid adenoma. Despite normal findings on esophagogastroduodenoscopy, a focused single parathyroidectomy was performed. Post-surgery, the patient's dysphagia resolved completely, and her calcium and PTH levels normalized. Discussion: This case highlights an atypical presentation of PTH-mediated hypercalcemia where dysphagia was the primary symptom. Literature review shows similar cases where parathyroid adenomas presented with unusual symptoms, emphasizing the need for thorough diagnostic evaluation. The resolution of dysphagia following surgery suggests a likely correlation between hypercalcemia and dysphagia, implying a possible causative association. Conclusion: This case demonstrates dysphagia as a rare but significant symptom of hypercalcemia in a patient with a small parathyroid adenoma. Considering its size, it was unlikely to cause dysphagia through mechanical obstruction. Thus, a functional cause linked to hypercalcemia was likely to be the cause of dysphagia. Surgical removal of the adenoma resulted in resolution of symptoms. A literature review was performed, which revealed similar cases of dysphagia related to hypercalcemia, supporting the fact that in this patient, dysphagia was related to the hypercalcemia. Highlights:

Tailgut cysts (TGCs) are rare congenital lesions arising from incomplete regression of the embryonic hindgut, typically located in the presacral space and more common in females. Although often benign, these cysts carry a risk of malignant transformation. We report a case of a woman in her early 50s who presented with abdominal pain, urinary retention, and tenesmus. Initial imaging revealed a large presacral cystic lesion, and incomplete surgical excision confirmed benign histology. However, the patient returned 6 months later with recurrent symptoms and new-onset lower limb weakness. Repeat imaging showed a recurrent cystic lesion with liver and bony metastases. MRI showed peripheral nodular enhancement of the lesion and enhancing bone lesions. A liver biopsy confirmed mucinous adenocarcinoma. Despite chemotherapy, the disease progressed rapidly, and the patient passed away within 2 months. This case highlights the potential for malignant degeneration in TGCs, which, though rare, carries significant morbidity. Complete surgical resection and follow-up are critical to prevent recurrence and malignancy risk. Further research is needed to study the malignant transformation predictors of this rare entity.