Background: Diagnosing pancreatic lesions, including chronic pancreatitis, autoimmune pancreatitis, and pancreatic cancer, poses a challenge and, as a result, is time-consuming. To tackle this issue, artificial intelligence (AI) has been increasingly utilized over the years. AI can analyze large data sets with heightened accuracy, reduce interobserver variability, and can standardize the interpretation of radiologic and histopathologic lesions. Therefore, this study aims to review the use of AI in the detection and differentiation of pancreatic space-occupying lesions and to compare AI-assisted endoscopic ultrasound (EUS) with conventional EUS in terms of their detection capabilities. Methods: Literature searches were conducted through PubMed/Medline, SCOPUS, and Embase to identify studies eligible for inclusion. Original articles, including observational studies, randomized control trials, systematic reviews, meta-analyses, and case series specifically focused on AI-assisted EUS in adults, were included. Data were extracted and pooled, and a meta-analysis was conducted using Meta-xl. For results exhibiting significant heterogeneity, a random-effects model was employed; otherwise, a fixed-effects model was utilized. Results: A total of 21 studies were included in the review with four studies pooled for a meta-analysis. A pooled accuracy of 93.6% (CI 90.4–96.8%) was found using the random-effects model on four studies that showed significant heterogeneity (P<0.05) in the Cochrane’s Q test. Further, a pooled sensitivity of 93.9% (CI 92.4–95.3%) was found using a fixed-effects model on seven studies that showed no significant heterogeneity in the Cochrane’s Q test. When it came to pooled specificity, a fixed-effects model was utilized in six studies that showed no significant heterogeneity in the Cochrane’s Q test and determined as 93.1% (CI 90.7–95.4%). The pooled positive predictive value which was done using the random-effects model on six studies that showed significant heterogeneity was 91.6% (CI 87.3–95.8%). The pooled negative predictive value which was done using the random-effects model on six studies that showed significant heterogeneity was 93.6% (CI 90.4–96.8%). Conclusion: AI-assisted EUS shows a high degree of accuracy in the detection and differentiation of pancreatic space-occupying lesions over conventional EUS. Its application may promote prompt and accurate diagnosis of pancreatic pathologies.

BACKGROUND The rising global burden of liver diseases, such as non-alcoholic fatty liver disease and liver fibrosis, has necessitated innovative therapeutic approaches. Plant-based therapies, recognized for their anti-inflammatory and antioxidant properties, have shown promising effects. However, poor bioavailability limits their clinical application. AIM To map global research trends, key contributors, and emerging themes in plant-based therapies combined with advanced drug delivery systems for liver health. METHODS Using the Scopus database, 645 documents were retrieved and analyzed using bibliometric tools Biblioshiny and VOSviewer. Analysis focused on publication trends, geographical contributions, and advancements in drug delivery technologies, including nanoparticles, liposomes, and polymeric micelles. Metrics such as publication growth rate, authorship collaboration, and thematic clustering were assessed. RESULTS The dataset spans 43 years (1981-2024), with an annual growth rate of 11.09% in the number of publications. Research output is dominated by China (33%), followed by the United States (24%) and India (18%). Collaborative studies accounted for 24.34% of publications, with an average of 5.81 co-authors per document. Key innovations include nanoparticle encapsulation of curcumin and silymarin, improving bioavailability by up to 85%. Highly cited studies demonstrated the antioxidant, anti-inflammatory, and anti-fibrotic properties of these compounds. For instance, curcumin nanoparticles showed a 70% improvement in solubility, and silymarin liposomal formulations enhanced therapeutic efficiency by 62%. Thematic analysis revealed a transition from basic clinical observations to molecular and pharmacokinetic research, with a focus on oxidative stress mitigation and hepatoprotection. CONCLUSION This study highlights the growing synergy between plant-based therapies and advanced drug delivery systems, with significant contributions from Asian and Western countries. Future efforts should prioritize clinical trials, standardization of plant extract formulations, and interdisciplinary approaches to maximize therapeutic outcomes. The findings provide a foundation for integrating plant-derived compounds into evidence-based hepatological therapies, addressing critical challenges in bioavailability and safety.

Neurotropic viruses are a threat to human populations due to ongoing zoonosis. A wide array of neurological manifestations can occur most often including parkinsonism, encephalitis/encephalopathy, flaccid myelitis, and Guillain-Barré syndrome. Neuroinvasion occurs through: transneural transmission, blood brain barrier (BBB) dysfunction, and ‘trojan horse’ mechanism or infected immune cell trafficking into the central nervous system (CNS). Transneural transmission occurs through virus mediated hijacking of intracellular transport proteins allowing retrograde viral transport. BBB dysfunction occurs through cytokine storm increasing membrane permissibility. Increased chemokine expression allows leukocyte trafficking to the BBB. Virally infected leukocytes may successfully pass through the BBB allowing the pathogen to infect microglia and other CNS cell types. We define cerebrospinal fluid (CSF) nondetection as a virus’ ability to evade direct CSF detection but still causing significant neurological symptoms and disease. Mechanisms of CSF nondetection include: transneuronal propagation through trans-synaptic transmission, and synaptic microfusion, as well as intrathecal antibody synthesis and virus neutralization. Direct virus detection in CSF is associated with an increased neurological disease burden. However, the lack of CSF detection does not exclude CNS involvement due to possible neuroevasive mechanisms.

Background: Malaria remains a major public health burden in Africa, particularly among children under five years of age. By consolidating findings across randomized controlled trials on the RTS,S and R21 malaria vaccines, this study seeks to provide an evidence based guide. Methods: We conducted a systematic review and meta-analysis of studies of randomized controlled trials evaluating the RTS,S and R21 malaria vaccines in African children under five. Data sources included PubMed, Scopus, and Embase. Primary outcomes were the vaccine efficacies against first/only episodes of malaria, multiple episodes and severe malaria; and the incidence of severe adverse events following vaccination. Pooled effect estimates were calculated using random-effects models. Results: Eleven studies enrolling 27,178 participants (RTS,S: 21,589; R21: 5589) were included. For RTS,S, pooled efficacy against first clinical malaria episode was 32% (HR 0.68, 95% CI 0.61–0.76; I ² = 0%), against multiple episodes was 29% (IRR 0.71, 95% CI 0.55–0.91; I ² = 11.3%), and against severe malaria was 17–22% (RR 0.78–0.83). The R21 vaccine demonstrated 68% efficacy against first episodes (HR 0.32, 95% CI 0.26–0.39) and 67% against multiple episodes (IRR 0.33, 95% CI 0.27–0.41) in a single phase 3 trial. Pooled SAE incidence was 11.2% (95% CI 6.6–18.6%; I ² = 96.2%) for RTS,S and 3% (95% CI 1–6%; I ² = 80.6%) for R21, with no vaccine-attributable deaths. Both vaccines showed acceptable reactogenicity profiles. Conclusion: Both RTS,S and R21 vaccines demonstrate protective efficacy against clinical malaria in African children under five, with R21 showing higher efficacy in initial trials. RTS,S provides moderate, reproducible protection in clinical trials. Both vaccines have acceptable safety profiles, though continued pharmacovigilance is essential.

Background: Doxorubicin is an anti-neoplastic agent widely indicated for a variety of cancers. One of its adverse effects is hepatotoxicity which presents with hepatocyte necrosis, sinusoidal dilation, and fibrosis. However, there remains a dearth in the quantification and zonal distribution of this damage. Methods: Twenty-three adult female Wister albino rats were placed into baseline, control, and experimental group receiving 2.5mg/kg bodyweight Doxorubicin intra-peritoneally thrice weekly for 3-weeks. Rats were sacrificed on days 0, 7, 14 and 21 and livers harvested for processing. Masson’s Trichrome was used in staining 7 µm thick sections. Images were taken and analyzed via STEPanizer, and data entered into SPSS for analysis. Results: Rats treated with Doxorubicin had increased liver to body weight ratios from 5.00% at baseline to 6.15%, 6.69% and 7.56% on days 7, 14 and 21 (p=0.090). There was a decrease in hepatocyte densities from 51.88/mm2 to 48.61/mm2, 46.65/mm2 and 42.24/mm2 on day 7, 14 and 21 (p=0.779). Collagen fiber deposition increased from 0.12±0.06 cm3 to 0.47±0.55 cm3, 1.64±0.11 cm3 and 1.88±0.24 cm3 on days 7, 14 and 21 (p=0.009). Deposition was greatest periportally and least pericentrally. Volume of sinusoidal spaces increased from 5.46±0.50 cm3 to 5.49±0.15 cm3, 5.53±0.24 cm3 and 5.50±0.17 cm3 on days 7, 14 and 21 respectively (p=0.827). Sinusoids were larger pericentrally than periportally. Conclusion: Doxorubicin administration is associated with an increase in volume density of fibrotic tissue and sinusoidal spaces but decrease in hepatocytes. The quantitative changes presented may facilitate histopathological grading of Doxorubicin-induced hepatotoxicity.

Background: Transverse foramina are canals in cervical transverse processes transmitting the vertebral vessels and the accompanying sympathetic plexus. These foramina exhibit side, sex and population specific variations such as those of size, shape and number. Knowledge of these variations is important for cervical surgical procedures and prediction of vertebral artery variations. Objective: To describe the morphology and morphometry of cervical transverse foramina in an adult Kenyan population. Methods: Ninety-four neck CT scan images of 2 mm slice thickness in axial view were used to assess presence, number, completeness and shape of transverse foramina. Antero-posterior and transverse lengths were measured using NeusoftTM software. Paired and independent t-tests were used to compare morphometric parameters for side and sex respectively. One-way ANOVA was used to determine differences in foramina down the cervical spine. A p-value of ≤ 0.05 was considered significant. Results: Transverse foramina had a prevalence of 98.78% with 3.64% being duplicated. They were identified as type 1 (circular), type 2 (elongated antero-posteriorly), type 3 (elongated transversely), type 4 (oblique left-right elongation) and type 5 (oblique right-left elongation) in 69.62%, 3.62%, 13.38%, 7.23% and 6.15% respectively. 0.46% foramina were incomplete and 3.19% constricted. Diameters on the right were larger than left. C1 foramina were the largest and C7 smallest. The diameters decreased from C2 to C3 then increased to C6. Conclusion: Transverse foramina display side and level dependent variations. This is of clinical importance to spine surgeons to prevent intraoperative damage of vertebral vessels when operating in the cervical region. Keywords: Morphology and morphometry; transverse foramina; cervical vertebrae; in Kenyan Population; a radiological study.