The purpose of this literature review and analysis report is to expose occupational exposure to sharp instrument injuries among registered nurses in public and private hospitals of Lahore Pakistan and associated factors related to sharp instrument injuries among nurses in public and private hospitals of Lahore Pakistan. Nurses are exposed to various risk factors and risky Behaviour that may seriously affect their health and ability to work. Despite recent technological advances such as safety-engineered devices (SEDs), these injuries continue to occur in healthcare facilities worldwide. The searches were restricted to papers published from 2015 to the present, those written in English, and those using the keywords exposure, hospital, doctor, nurse, and sharp injuries or needle stick injuries.

Background: Gastric cancer is a leading cause of cancer-related deaths. Surgery combined with adjuvant treatments improves survival. This meta-analysis compares the efficacy of chemoradiotherapy (CRT) vs. chemoimmunotherapy (CT) in resectable gastric cancer. Methods: A comprehensive search across five databases from inception to December 2024 identified studies on efficacy of CRT vs CT in adult patients with resectable gastric cancer. Data were pooled as odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CI). Analysis used Review Manager 5.4 with a random-effects model. Results: A total of 29 studies with 20 794 patients were included for further quantitative and qualitative analysis. CRT was associated with significantly higher recurrence-free survival (HR: 0.79; 95%CI: 0.69, 0.91; P = 0.004) and slightly improved overall survival (HR: 0.85; 95%CI: 0.73, 1; P = 0.05). The odds of locoregional metastases (OR: 0.60; 95%CI: 0.43, 0.82; P = 0.001) were significantly reduced following CRT. Adverse events between both treatments were comparable, although the risk of neutropenia (OR: 1.54; 95%CI: 1.29, 1.84; P<0.0001) and gastrointestinal side effects (OR: 1.30; 95%CI: 1.01, 1.69; P = 0.04) was significantly higher in the CRT arm. Conclusion: This meta-analysis concludes a higher efficacy of CRT over CT in improving survival and preventing recurrence, while limiting regional metastasis. Further studies are needed to assess modulation of radiotherapy dosage to reduce the adverse event while maintaining its efficacy.

Rationale: Adaptive deep brain stimulation (aDBS) represents a notable advancement in treating Parkinson’s disease (PD), as it offers enhanced therapeutic outcomes and personalized management by adjusting stimulation parameters in real-time according to individual neural signals. This approach minimizes adverse effects commonly associated with standard continuous deep brain stimulation (cDBS). This case report describes the progress of a 62-year-old man with severe PD who demonstrated notable enhancement in motor symptoms and quality of life throughout a 3-month trial period using aDBS. Patient concerns: A 62-year-old man who has been suffering from Parkinson’s disease. Diagnoses: The patient had been diagnosed with PD for 10 years. The patient’s motor symptoms, including dyskinesia during the on-state and akinesia during the off-state, progressively worsened over time. Interventions: The patient underwent bilateral subthalamic nuclei DBS surgery with cDBS. Following progressive worsening of motor symptoms, he was transitioned to aDBS. Outcomes: The aDBS system adaptively modified stimulation parameters by utilizing real-time neural feedback from beta band activity detected in the subthalamic nucleus, resulting in decreased dyskinesia and reduced reliance on medication. The customized strategy led to a significant improvement in motor symptoms, a reduction in dyskinesia, and an overall enhancement in quality of life during the 3-month trial period. Lessons: Existing evidence highlights the ability of aDBS to improve motor control and reduce problems associated with DBS, such as speech and gait abnormalities. Research findings have demonstrated significant improvements in motor scores and a reduction in stimulation time, highlighting the effectiveness of aDBS and its ability to prolong the lifespan of devices.