Lung cancer remains the leading cause of cancer-related deaths globally, often detected in advanced stages with poor prognosis. While surgical resection is the mainstay of curative treatment, early detection remains a significant challenge. Advances in personalized medicine, including genomic profiling and low-dose CT scans, have led to more tailored therapies, offering improved outcomes. Integrating artificial intelligence (AI) and machine learning (ML) into oncology has the potential to revolutionize lung cancer management by enhancing early detection, improving treatment precision, and supporting surgical decision-making. AI-driven technologies, such as deep learning algorithms and predictive models, have demonstrated effectiveness in identifying lung nodules, predicting immunotherapy response, and reducing diagnostic errors. Additionally, AI-powered robotics have contributed to improved surgical precision and better patient recovery. However, the widespread adoption of AI in clinical practice faces challenges, including data standardization, ethical concerns, and the need for robust validation. This study explores the question: How can AI and ML optimize thoracic surgical oncology by improving early detection, enhancing surgical precision, and enabling personalized care? This review highlights the significance of AI and ML in thoracic surgery and oncology, discussing their current applications, limitations, and future potential to advance personalized cancer care and improve patient outcomes.

Background: Chronic pain affects over 30% of the global population, imposing significant physical, psychological, and economic burdens. It is classified into nociceptive, neuropathic, and nociplastic pain, each with distinct mechanisms and management challenges. Despite advancements, the complexity of chronic pain necessitates a comprehensive understanding of its types, mechanisms, and emerging treatment strategies. Methods: A narrative review was conducted using six electronic databases, including Medline, Embase, and PubMed. Studies examining the biological, psychological, socio-economic, and cultural factors influencing chronic pain were included without date or geographic restrictions. Systematic reviews and key research articles were prioritized. Results: Nociceptive pain arises from tissue damage, as seen in arthritis and myofascial pain syndrome. Neuropathic pain originates from nerve injury or dysfunction, with examples like diabetic neuropathy and trigeminal neuralgia. Nociplastic pain, exemplified by fibromyalgia, involves altered central pain processing. Recent advancements in molecular and genetic research have uncovered potential therapeutic targets, while non-pharmacological interventions like physical therapy and mindfulness have demonstrated efficacy. However, diagnostic challenges and variability in treatment response highlight the need for individualized, multidisciplinary approaches. Conclusion: This review underscores the importance of understanding chronic pain classifications and mechanisms to develop targeted and effective management strategies. Future directions should focus on integrating innovative diagnostic tools, enhancing patient education, and implementing personalized multimodal therapies to reduce the burden of chronic pain.

Background: Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disorder characterized by unexplained left ventricular hypertrophy, affecting approximately 0.2% of the global population. Around 40% of HCM cases are linked to mutations in sarcomeric protein genes such as β-myosin heavy chain and myosin-binding protein C, which impair calcium signaling and myocardial contractility. Objective: This review aims to explore the therapeutic potential of cardiac myosin inhibitors (CMIs) by assessing their effects on the underlying pathophysiology of HCM, specifically targeting sarcomere function and hypercontractility. Methods: A literature search from 2013 to 2024 using PubMed and Google Scholar identified studies on CMIs in HCM. Relevant trials and reviews were selected based on strict criteria. Two reviewers screened studies, and findings on mechanisms, efficacy, safety, and outcomes were narratively synthesized for analysis. Results: Recent studies have highlighted the role of cardiac fibroblasts and transforming growth factor-β signaling in the development of myocardial fibrosis in HCM. CMIs have shown effectiveness in reducing left ventricular outflow tract gradients, improving exercise tolerance, and lowering biomarkers such as N-terminal pro-b-type natriuretic peptide, without significantly affecting left ventricular ejection fraction (LVEF). Compared to beta-blockers and calcium channel blockers, CMIs offer a targeted approach by modulating sarcomere activity. Conclusion: CMIs represent a promising and mechanism-based treatment for HCM. Their potential to reduce the need for invasive procedures and improve patient outcomes highlights the importance of their integration into clinical practice. Further large-scale trials are needed to establish long-term safety, cost-effectiveness, and broader clinical applicability.

Background and Objectives: Balamuthia mandrillaris granulomatous amoebic encephalitis (GAE) is a rare, frequently fatal central nervous system infection in which delayed recognition remains a major determinant of outcome. The increasing use of metagenomic next-generation sequencing (mNGS), plasma microbial cell-free DNA sequencing and targeted sequencing has changed the diagnostic pathway for unexplained encephalitis, but the survival implications of earlier molecular diagnosis remain unclear. Materials and Methods: A systematic review of peer-reviewed reports published from January 2015 to June 2026 was designed according to PRISMA 2020. Eligible records reported human B. mandrillaris GAE, encephalitis, meningoencephalitis or encephalomyelitis with extractable patient-level diagnostic, treatment or outcome information. Data were narratively synthesised because case definitions, sample types, timing of testing and follow-up were heterogeneous. Results: The evidence base consisted mainly of case reports, small case series and retrospective clinical summaries. Across recent reports, B. mandrillaris GAE commonly mimicked malignancy, tuberculosis, fungal infection, autoimmune encephalitis or bacterial brain abscess. Diagnostic delay was driven by nonspecific symptoms, ring-enhancing lesions, negative routine cultures and limited clinician familiarity with free-living amoebae. Molecular methods, particularly mNGS/NGS applied to cerebrospinal fluid, plasma, blood, brain tissue or bronchoalveolar lavage fluid, repeatedly enabled antemortem diagnosis when routine tests were unrevealing. Survival reports shared a pattern of earlier tissue diagnosis or molecular identification, neurosurgical intervention when feasible, and prolonged multidrug therapy, sometimes including miltefosine or nitroxoline. Conclusions: B. mandrillaris GAE should be considered in subacute encephalitis with mass-like or multifocal enhancing lesions and negative conventional investigations. Early biopsy or non-invasive sequencing, followed by confirmatory testing and expert-guided combination therapy, represents the most actionable strategy to reduce diagnostic delay.

OBJECTIVE:The study aims to highlight the trend of cesarean deliveries and sociodemographic and pregnancy-related factors associated with the change in trend from 1990 to 2019, as reported by demographic health surveys.METHOD:Data were extracted from the Pakistan Demographic Health Survey report from 1990 to 2019. Sociodemographic and pregnancy-related independent variables were considered. Weighting was done to generalize the findings across all Pakistani women. Descriptive statistics for maternal group variables are depicted in frequency and percentage obtained from the original report.RESULT:The study highlights significant shifts in Pakistan’s childbearing demographics and cesarean delivery trends. Teenage pregnancies decreased from 40.5% (1990–1991) to 26.8% (2018), while maternal illiteracy rates dropped from 76.7% to 51.7% in the same period. Cesarean deliveries rose due to increased pregnancy complications (from 17.9% in 2006–2007 to 46.38% in 2019) and higher antenatal care attendance (8.5% to 52.4% for four or more visits). Both public and private healthcare facilities saw a surge in cesarean rates, particularly among multiparous women and those with terminated pregnancies.CONCLUSION:This study sheds light on the changing landscape of cesarean deliveries across Pakistan among females of reproductive age. It also highlights a notable increase in the maternal demographic aspects, complexities of pregnancies, and antenatal care practices. Through collaborative efforts focusing on evidence-based practices, policymakers and health care providers can work toward enhancing maternal and neonatal health outcomes, ultimately striving for equitable and accessible maternal health care for all the women of Pakistan.