Exposure to post-transplant liver biopsies varies among pathology residencies and largely depends on the institution's training program, particularly if the hospital has a liver transplant program. The interpretation of biopsies from transplanted livers presents its own set of challenges, even for those with a solid understanding of non-transplant medical liver biopsies. In this review, we aim to provide a succinct, step-by-step approach to help you interpret liver transplant biopsies. This article may be beneficial for residents interested in liver pathology, gastrointestinal and liver pathology fellows in the early stages of training, clinical gastroenterology and hepatology fellows, hepatologists and general pathologists who are curious about this niche.

Exposure to post-transplant liver biopsies varies among pathology residencies and largely depends on the institution's training program, particularly if the hospital has a liver transplant program. The interpretation of biopsies from transplanted livers presents its own set of challenges, even for those with a solid understanding of non-transplant medical liver biopsies. In this review, we aim to provide a succinct, step-by-step approach to help you interpret liver transplant biopsies. This article may be beneficial for residents interested in liver pathology, gastrointestinal and liver pathology fellows in the early stages of training, clinical gastroenterology and hepatology fellows, hepatologists and general pathologists who are curious about this niche.

Background and Objectives: The timing of the reinstitution of warfarin after cesarean section (CS) delivery was not adequately addressed in the literature. This study aims to evaluate the risks of early versus late initiation of warfarin post-CS in patients with mechanical heart valves. Methods: This randomized, open-label cohort study included 114 pregnant women with mechanical heart valves planned to be delivered by CS at or after 28 weeks of gestation.Patients were randomly divided into two groups: Day-2-group, where warfarin was started on day 2, and Day-5-group, where warfarin was started on day 5 after CS. Maternal postoperative bleeding complications, mechanical valve thrombosis, need for blood transfusion or reoperation, and maternal mortality were identified. Results: Ten women (8.8%) had 11 bleeding complications, of whom 2 patients (20%) had intraperitoneal hemorrhage (none in Day-2-group and 2 in Day-5-group), 3 patients (30%) had subcutaneous hematoma (none in Day-2-group and 3 in Day-5-group), and 6 patients (60%) had sub-rectus hematoma (3 in Day-2-group and 3 in Day-5-group). No mechanical valve thrombosis, other thromboembolic events, or in-hospital maternal mortality were reported. Conclusion Despite the small number of events, the bleeding risk was lower in the group with early post-CS warfarin introduction than in the group with late warfarin introduction in patients with prosthetic heart valves.

The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (WHO). Climate change, biodiversity loss, and pollution negatively impact all life on earth. All populations are impacted but not equally; the most vulnerable are at highest risk, an inequity further exacerbated by differences in access to healthcare globally. The delivery of healthcare exacerbates the planetary health crisis through greenhouse gas emissions, largely due to combustion of fossil fuels for medical equipment production and operation, creation of medical and non-medical waste, and contamination of water supplies. As representatives of radiology societies from across the globe who work closely with industry, and both governmental and non-governmental leaders in multiple capacities, we advocate together for urgent, impactful, and measurable changes to the way we deliver care by further engaging our members, policymakers, industry partners, and our patients. Simultaneous challenges including global health disparities, resource allocation, and access to care must inform these efforts. Climate literacy should be increasingly added to radiology training programmes. More research is required to understand and measure the environmental impact of radiological services and inform mitigation, adaptation and monitoring efforts. Deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy utilization, and circular economy. Many solutions have been proposed and are already available, but we must understand and address barriers to implementation of current and future sustainable innovations.

Objectives: The objectives of this review and meta-analysis were twofold: first, to determine theprevalence of substance use among school-going children in Arab and African countries; andsecond, to highlight the considerable influence of variables such as the nation’s region and thetimeframe of the study on the prevalence of substance use. Methods: Research was sourced from Science Direct, Scopus, Web of Science, Google Scholar,and PubMed. Thirty-seven articles were incorporated in accordance with the PRISMA guidelines. This review included studies published from 2013 to 2023. The statistical meta-analysis was performed using Comprehensive Meta-Analysis ver. 3 software. Across 37 studies, the total number of study participants was 73,508. Results: The meta-analysis revealed that tobacco was the most commonly used substance, with a prevalence of 16% (95% confidence interval [CI], 12.7%–20.02%). This was closely followed by alcohol, which had a prevalence of 15% (95% CI, 10.5%–22.8%), stimulants at 11.4% (95% CI, 7.4%– 17%), khat at 10% (95% CI, 5.7%–15%), and cannabis at 8% (95% CI, 3.3%–18.4%). Notably, alcohol was the only substance that showed an increasing trend in prevalence from before to after 2019, rising from 13.3% (95% CI, 6.2%–26.1%) to 17% (95% CI, 10.2%–27%) (p < 0.001). Additionally, the prevalence of substance use varied significantly between Arab and African countries (p < 0.001). Conclusion Although the prevalence of substance use among school-going populations hassignificantly decreased over time, with the exception of alcohol, it is imperative that bothAfrican and Arab countries implement comprehensive measures and stringent laws to addressthe production and marketing of substances.

Purpose: Research proved the beneficial effect of Zinc on human health and Gastrointestinal tract inflammatory diseases. We propose that zinc would be of value in children with Hirschsprung’s disease (HD) undergoing elective pull-through surgery. This study was carried out to determine the influence of preoperative zinc intake on postoperative outcomes, especially the hospital length of stay in patients diagnosed with HD as a primary outcome.Other outcomes include identification of the nutritional and inflammatory status including the nutritional and inflammatory markers in children with HD with possible impacts on hospital outcomes. Methods: This is a randomized interventional control study that was applied to 50 children diagnosed with HD who underwent elective pull-through surgery. We randomly allocated 25 diagnosed with HD who underwent elective pull-through surgery. We randomly allocated 25 patients to zinc treatment. Results: The results demonstrated that the interventional group had a lower incidence of complications (20%) when compared to the control group (64%), with a significant p-value of 0.002. In addition, less incidence of Hirschsprung’s associated enterocolitis (HAEC) (12% vs. 40%) and skin excoriation (8% vs. 32%) were documented in the interventional group compared to the controls respectively. Conclusion Pre-operative zinc supplementation may have a beneficial impact on HD children undergoing elective pull-through surgery as regards outcomes such as HAEC and skin excoriation.