Iftikhar Khan

Hip hemiarthroplasty for femoral neck fractures is often associated with substantial perioperative blood loss and transfusion requirements. Tranexamic acid (TXA) may reduce bleeding, but concerns remain regarding thromboembolic safety. This systematic review and meta-analysis evaluated the efficacy and safety of TXA in hip hemiarthroplasty. PubMed, Embase, and Cochrane were searched from inception to February 2026. Randomized controlled trials and cohort studies comparing TXA with no TXA or no TXA in patients undergoing hip hemiarthroplasty were included. Random-effects meta-analyses were performed to pool risk ratios (RRs) and mean differences (MDs), with subgroup and sensitivity analyses conducted to assess the robustness of the findings. The primary outcome was total blood loss. Secondary outcomes included postoperative haemoglobin, transfusion requirement, mortality, thromboembolic events, surgical site infection, stroke MI and length of hospital stay. Although total blood loss was the pre-specified primary outcome, transfusion requirement was also evaluated as an important secondary outcome because of its direct clinical relevance. Fourteen studies comprising 7,660 patients (3,271 TXA and 4,389 controls) were included. TXA significantly reduced allogeneic transfusion requirements (RR 0.48, 95% CI 0.38–0.61; P<0.001) and improved postoperative day-1 haemoglobin (MD 0.48 g/dL, 95% CI 0.14–0.83; P=0.011). A reduction in 30-day mortality (RR 0.69, 95% CI 0.49–0.96; P=0.029) and length of hospital stay (MD −1.57 days, 95% CI −3.12 to −0.03; P=0.047) was observed, although both findings were sensitive to individual studies and should be interpreted cautiously. Total blood loss was not significantly different between groups (MD −162.73 mL, 95% CI −346.49 to 21.02; P=0.076) because of extreme heterogeneity. TXA was not associated with an increased risk of DVT, PE, MI, stroke, or surgical site infection. No significant differences were observed between intravenous and intra-articular administration. TXA is an effective and safe adjunct in patients undergoing hip hemiarthroplasty. It significantly reduces transfusion requirements and preserves early postoperative haemoglobin without increasing major postoperative complications. Although reductions in 30-day mortality and length of hospital stay were observed, these findings require cautious interpretation because they were less robust and largely derived from observational evidence. Further high-quality randomized controlled trials are warranted to confirm these potential benefits.

Background and Aims: Colorectal cancer (CRC) and type 2 diabetes mellitus (T2DM) are significant contributors to global morbidity and mortality, with growing evidence suggesting a synergistic impact on disease outcomes. This research focused on analyzing trends in CRC‐related deaths among individuals with coexisting T2DM in the United States from 1999 to 2023, as well as exploring disparities among different demographic and geographic groups. Methods: Data were obtained from the CDC WONDER database for deaths among adults aged ≥ 45 years with CRC as the underlying cause and T2DM as a contributing cause. Age‐adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CI). A two‐sided p < 05 was considered statistically significant. Results: From 1999 to 2023, there were 22,392 recorded deaths. The overall age‐adjusted mortality rate (AAMR) increased from 0.55 to 1.04 per 100,000 people, with an average annual percentage change (AAPC) of 2.55% (95% CI: 2.18–3.06; p < 001). Men experienced higher mortality rates than women, and individuals aged ≥ 65 years had higher rates than those aged 45–64. Significant racial disparities were evident, with the highest AAMRs among Hispanic and non‐Hispanic Black groups. Geographically, the West had the highest AAMRs and the steepest increase over time. Rural areas consistently showed higher AAMRs compared to urban areas. Most deaths (44.06%) occurred at home. Conclusion: CRC‐related mortality in individuals with coexisting T2DM has risen sharply in the US over the past twenty years, showing significant demographic and geographic differences. These results highlight the importance of implementing targeted, integrated prevention and management approaches to decrease the combined impact of CRC and T2DM. The Detailed Visual Abstract is illustrated in the Central Illustration.

IUCD migration can cause severe complications like bladder and sigmoid perforation, even decades post‐insertion. Regular follow‐up, timely imaging, and thorough patient education are critical for early detection and multidisciplinary management to prevent long‐term adverse outcomes and ensure patient safety in reproductive health care.

Background: Peripheral neuropathies and other disorders of the peripheral nervous system carry a higher mortality risk due to respiratory failure, autonomic instability, and infections. The prevalence increases with age and due to other comorbid conditions. This study evaluates mortality trends in polyneuropathies and other disorders of the peripheral nervous system in the United States from 1999 to 2023. Methods: This study analyzed publicly available data from the CDC WONDER database (1999 to 2023) using ICD-10 codes for polyneuropathy and other disorders of the peripheral nervous system (G60-G64). Join point regression was used to compute annual percent changes and 95% CIs. Results: 70,080 deaths were reported among individuals aged ≥ 55 years. Most deaths occurred at decedents’ homes (33.0%). AAMR increased from 3.18 in 1999 to 4.96 in 2023 (AAPC: 2.31%; 95% CI: 1.89–2.74%). Males maintained consistently higher AAMR than females. The greatest average CMR was demonstrated by those aged 76–85 + years (average CMR: 8.79 per 100,000 over the study period). Most deaths were observed in NH White individuals (88.5%), while Hispanic or Latino individuals had the lowest deaths (3.90%). The West exhibited the highest AAMR (4.20), and the lowest was observed in the Northeast (2.63). Substantial disparities were observed between metropolitan and non-metropolitan areas and across various states. Conclusion: Polyneuropathy related mortality has demonstrated an upward trend among adults aged ≥ 55 years from 1999 to 2023. significant inconsistencies persist with higher mortality among older adults, males, non-Hispanic white individuals, with regional disparities favoring west. This highlights the necessity of focused public health initiatives and enhanced care accessibility for all populations and areas that are at risk.

The significance of mental health in athletes is acknowledged and valued. This review explores psychosocial triggers, evolving screening approaches, digital mood-tracking tools, and embedded mental health professionals in performance programs. Numerous studies have shown that the occurrence of depressive symptoms and anxiety is common among high performance athletes. Recent systematic reviews confirm anxiety, depression, and distress rates of 20–35%, especially around injury, deselection, or career change. In this article, we aim to focus on psychiatric issues faced by athletes and propose strategies that would help in improving mental health. Several reasons that affect the mental health of this population have been highlighted. The lack of proper mental health support, no access to sports psychologists in the training programs need urgent attention. A key point is that team support and self-confidence can also help buffer the negative effects of perfectionism on anxiety and performance.

Background: Immune thrombocytopenia (ITP) is an autoimmune condition often managed with corticosteroids, intravenous immunoglobulins, or thrombopoietin receptor agonists. In settings where these therapies are inaccessible or contraindicated, dapsone an older antimicrobial agent with immunomodulatory effects has been proposed as an alternative, though its comparative effectiveness and safety profile remain inadequately defined. Objectives: This study systematically reviews and synthesizes existing data to assess the efficacy and tolerability of dapsone in adult patients with ITP. Methods: Following PRISMA guidelines, a literature search across PubMed, Embase, and Cochrane databases identified observational studies and interventional trials evaluating dapsone in ITP, including comparisons with standard treatments. Primary outcomes included complete and overall response rates, hemoglobin variation, relapse frequency, and adverse effects. Risk of bias was evaluated using the Newcastle–Ottawa Scale and Cochrane tools. Meta-analysis was conducted using RevMan and R (meta/metafor). Results: Four eligible studies encompassing over 270 patients were analyzed. The pooled complete response rate was 28%, while the overall response rate reached 47%. Dapsone use was associated with a modest decline in hemoglobin levels with a mean decrease of 1.74 g/dL, and relapse occurred in approximately 21% of patients. Adverse effects most commonly hemolytic anemia and methemoglobinemia were reported in 18% of patients, though generally not severe. Heterogeneity was explored through leave-one-out sensitivity analyses. Conclusions: Dapsone demonstrates moderate efficacy and an acceptable safety profile in adult ITP patients, especially in resource-limited contexts. While it may not match thrombopoietin agonists in preventing relapse, its low cost and oral administration offer practical advantages. Further large-scale randomized trials are warranted to clarify its role in ITP management.

Traditional biomechanics research has long relied on lab-based systems, bulky, expensive, and often inaccessible to everyday athletes and coaches. This has limited its real-world impact, particularly in fast-paced and dynamic sports environments. However, the landscape is rapidly changing. Recent innovations in wearable technology, including smart textiles, graphene-printed sensors, and compact edge-AI chips, are bringing high-resolution motion analysis directly to the field. These systems can now track and analyse athletic movement in real-time, offering insights that were once only available in specialised labs. This review highlights key developments in sensor fusion, textile-integrated inertial measurement units (IMUs), and AI-driven form recognition. Together, these tools enable more precise monitoring of biomechanics during both training and rehabilitation. With multimodal data streams and machine learning algorithms, wearables can now provide individualised feedback on technique, workload, and recovery, without interrupting performance. The integration of artificial intelligence (AI) and smart fabrics represents a shift toward continuous and scalable biomechanical assessment. For coaches, physiotherapists, and athletes alike, these technologies present new opportunities for injury prevention, skill development, and personalized performance optimisation. As validation studies transition into real-world deployment, AI-powered wearables are poised to advance our ability to analyze and improve human movement in sport.