Annals of Medicine and Surgery最新文献

{"title":"Factors associated with perioperative anxiety among patients undergoing coronary angiography or angioplasty: a cross-sectional study.","authors":"Hoa Tran, Dat Minh Nguyen, Nhut Quang Le, Tan Minh Nguyen, Khuong Dang Tran","doi":"10.1097/MS9.0000000000003265","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003265","url":null,"abstract":"<p><strong>Background: </strong>Anxiety is commonly encountered in patients undergoing medical procedures or surgeries and contributes to adverse outcomes including physiological damage, prolonged postoperative care, and rehabilitation. This study aimed to identify factors related to anxiety among patients undergoing coronary procedures.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at a tertiary hospital in Vietnam. Patients were included in our study if they were scheduled for coronary angiography or angioplasty. Pre-operative Intrusive Thought Inventory was employed to assess the patient's anxiety level.</p><p><strong>Result: </strong>Three hundred six patients scheduled for coronary procedure met inclusion criteria. High perioperative anxiety was reported by 56.2% of patients undergoing coronary angiography/angioplasty. Multivariable analysis showed that factors independently associated with high perioperative anxiety were no previous coronary angiography/angioplasty (odd ratio [OR]: 2.69 [1.44-5.01]), lack of pre-procedural anesthesia information (OR: 5.12 [2.54-10.31]) and prolonged indication-to-procedure duration (OR: 1.08 [1.05-1.11]).</p><p><strong>Conclusion: </strong>Although coronary angiography or angioplasty were minimally invasive procedures, high perioperative anxiety was significant among patients scheduled for these procedures. Extended waiting time, no procedural experience, and inadequate anesthesia information were associated with increased levels of anxiety.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2668-2673"},"PeriodicalIF":1.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring neonatal brain tumors: a narrative review about epidemiology, classification, and management.","authors":"Mira Al Shoufy, Gabi Kafa, Bana Ibrahim, Hazem Ibrahem, Aya Dakour, Ali Haidar, Zuheir Alshehabi","doi":"10.1097/MS9.0000000000003229","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003229","url":null,"abstract":"<p><p>Neonatal brain tumors (NBTs) are rare, with specific characteristics distinguishing them from tumors in older children. NBTs occur in the first 28 days of life with a low incidence rate. They present unique histological features, with teratomas and gliomas being the most relevant types of NBTs. The most common clinical finding is macrocephaly and hydrocephaly, but non-specific symptoms can also occur. Researchers illustrated multiple risk factors predominantly carcinogens and genetic factors. Managing these tumors is challenging, with surgery being the gold standard for treatment whereas the use of chemotherapy and radiotherapy is risky with this age group. Thus, balancing between aggressive intervention and adverse effects is crucial. This review will be relevant to clinicians and researchers interested in understanding the epidemiology, classification, clinical features, diagnostic features, and management options of NBTs.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2838-2846"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of giant epithelial splenic cyst causing abdominal pain and anemia in a 10-year-old girl.","authors":"Mohammed A Barakat, Hamza A Abdul-Hafez, Anas S I Sayed, Islam M Fahed, Mahmoud Alawneh, Baraa A Qarmash","doi":"10.1097/MS9.0000000000003238","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003238","url":null,"abstract":"<p><strong>Background: </strong>Splenic cystic lesions are rare, especially in children, and are often discovered incidentally. These lesions can present with abdominal pain, swelling, or complications such as intra-cystic bleeding, rupture, or infection. Epithelial cysts, a subtype of non-parasitic splenic cysts, account for approximately 20% of cases and are managed based on size and symptoms.</p><p><strong>Case presentation: </strong>A 10-year-old female presented with vague abdominal pain lasting two days, accompanied by pallor, due to anemia caused by intra-cystic hemorrhage, decreased appetite, shortness of breath with exertion, and significant weight loss over six months. Examination revealed a 15-cm immobile mass in the left upper abdomen, and laboratory tests showed anemia. Imaging identified a 17-cm splenic cyst replacing most of the splenic parenchyma. Hydatid serology and tumor markers were negative. Due to the cyst's size, mass effect, and adherence to the diaphragm, an open splenectomy was performed. Postoperative recovery was uneventful, and histopathological examination confirmed an epithelial splenic cyst with hemorrhage.</p><p><strong>Discussion: </strong>Epithelial splenic cysts are rare, with varied presentations depending on their size. Larger cysts can compress adjacent structures or present with complications. Imaging modalities such as ultrasound and CT are crucial for diagnosis, but histopathological examination is essential for definitive classification. Treatment is generally indicated for symptomatic or large cysts, with options ranging from partial splenectomy to total splenectomy.</p><p><strong>Conclusion: </strong>This case highlights the importance of a multidisciplinary approach in managing large splenic cysts in pediatric patients. Surgical intervention remains the treatment of choice for symptomatic or complicated cysts.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"3027-3031"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic aneurysm rupture in a postpartum patient with antiphospholipid syndrome: a case report.","authors":"Bita Badehnoosh, Maryam Hashemnejad, Banafsheh Mashak, Mahya Khoddami-Khosroshahi, Zatollah Asemi","doi":"10.1097/MS9.0000000000003231","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003231","url":null,"abstract":"<p><strong>Introduction and importance: </strong>An abdominal aortic aneurysm (AAA) is a localized dilatation of the infrarenal Aorta. The antiphospholipid syndrome (APS) is defined by the persistent presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism or pregnancy morbidity.</p><p><strong>Case presentation: </strong>A 38-year-old woman, with a known case of APS, was referred to the emergency department three days after undergoing her second cesarean section. She presented with a 3-day history of fatigue and weakness with tachycardia and decreased blood pressure. Because of unstable hemodynamics, portable ultrasonography was performed and revealed intra-abdominal massive hematoma and free fluid with debris in the abdominal and pelvic spaces, the surgical team performed an exploratory laparotomy to assess the extent of the internal bleeding and to address the identified hematomas. A midline incision was performed for exploratory laparotomy, revealing a massive extraperitoneal hematoma in Zone 1 which ruptured immediately, not allowing the origin of the hematoma to be identified. Then cardiovascular collapse happened. Despite resuscitative efforts, including prolonged cardiopulmonary resuscitation for 30 minutes, the patient did not respond and was pronounced dead.</p><p><strong>Clinical discussion: </strong>In this case, early detection of an AAA and prompt investigation might have enabled safer management of the pregnancy and cesarean section complications.</p><p><strong>Conclusion: </strong>In this case, early detection of an AAA and prompt investigation might have enabled safer management of the pregnancy and cesarean section complications.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"3012-3015"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alteration in oxidative/nitrosative disparity and nephroprotective effect of hydroethanolic extract of <i>Ocimum tenuiflorum</i> L. in gentamicin-induced acute kidney injury.","authors":"Neeraj Thakur, S K Shukla, Mahesh Kumar, G E Chethan, Alok Singh, Radhika, Anand Kumar Singh, Kruti Debnath Mandal, M Saminathan, Priyanka Choudhary, U K De, Kalyan Sarma","doi":"10.1097/MS9.0000000000003230","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003230","url":null,"abstract":"<p><strong>Background: </strong>Antibacterial, antioxidant, and antilipidemic properties of <i>Ocimum tenuiflorum</i> are well known from previous studies. This study was designed to study the phytochemical constituents, antioxidant efficacy, <i>in vivo</i> nephroprotective activity, and immunomodulatory potential of <i>Ocimum tenuiflorum</i> hydroethanolic extract in gentamicin-induced acute kidney injury (AKI) rat model.</p><p><strong>Methods: </strong><i>Ocimum tenuiflorum</i> extract was given for 8 days to gentamicin-induced toxicity (100 mg/kg) in rats. Nephroprotective and immunomodulatory efficacy of <i>O. tenuiflorum</i> extract was evaluated based on urine and serum biochemistry, blood and tissue oxidative stress indices, cytokine levels, kidney injury biomarkers, and histopathology.</p><p><strong>Results: </strong>Gentamicin toxicity resulted in a reduction in catalase, glutathione reductase, superoxide dismutase, and interleukin-10 levels in blood and tissue homogenates, while an increase in serum creatinine, blood urea nitrogen, lipid peroxide, tumor necrosis factor-alpha, cystatin C, kidney injury molecule-1, and gamma-glutamyl transpeptidase levels. Treatment with <i>O. tenuiflorum</i> ameliorated oxidative stress, cytokine imbalance, and kidney injury; however, the results were almost similar to standard drug. Furthermore, histopathological analysis of kidney, liver, and heart tissues confirmed the organoprotective efficacy of <i>O. tenuiflorum</i> extract.</p><p><strong>Conclusion: </strong>The present findings demonstrate the curative efficacy of <i>O. tenuiflorum</i> in gentamicin-induced AKI, probably mediated through phenolic and flavonoid phytoconstituents, antioxidant properties, and down-regulation of inflammatory cytokines. Therefore, future studies may be established to evaluate its efficacy and safety for clinical trials.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2674-2688"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the role of metformin in urogenital malignancies.","authors":"Xu Cheng, Zebin Deng, Yijian Li, Yinhuai Wang","doi":"10.1097/MS9.0000000000003216","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003216","url":null,"abstract":"<p><p>Metformin has shown great potential for anti-tumor therapy according to laboratory results, but there is currently no consensus on the role it playing in the pathogenesis of urogenital malignancies. Initially, a systematic review was conducted on clinical research examining the association between the use of metformin and the incidence and prognosis of prevalent urogenital malignancies. Then, a retrospective analysis of the participants in NHANES was performed to strengthen the study. Given the distinct methodological advantages of Mendelian randomization (MR) in research design, whereby genetic variations influencing the exposure of interest are independent of potential confounders, available GWAS data were thoroughly collected and utilized in a two-sample MR analysis to assess the causal relationships between metformin use and various urogenital malignancies. The review of literature demonstrated inconsistencies and ambiguities in clinical findings. The retrospective analysis of 20,527 participants in the NHANES did not reveal strong evidence in the four urogenital malignancies. The current MR study indicates that metformin use is unlikely to be a causal factor in the development of five urogenital malignancies (<i>P</i> > 0.05), either does the reverse MR analysis (<i>P</i> > 0.05). Nevertheless, the results were reliable to some extent since neither heterogeneity nor pleiotropy was detected in most cases. This study suggests that metformin use does not demonstrate a protective effect on the studied urogenital malignancies, contradicting the positive results observed in laboratory settings. Additional evidence from clinical studies is required to validate this conclusion.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2582-2588"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of transjugular intrahepatic portosystemic shunt versus endoscopic variceal ligation for variceal rebleeding: a systematic review and meta-analysis.","authors":"Abdelaziz A Awad, Alaa Ramadan, Abdelrahman M Elettreby, Yousef Radwan Alnomani, Ahmed Hamdy Zabady, Esraa Abdelhafz, Yousef Ahmed Elamin, Mahmoud Ali, Merna R Roshdy, Omar Abdelrahim, Moustafa S Mohamed, Mohamed Elmasry, Naji Al-Bawah, Mohamed Fakhry","doi":"10.1097/MS9.0000000000003215","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003215","url":null,"abstract":"<p><strong>Background: </strong>Variceal bleeding is a significant cause of morbidity and mortality among patients with cirrhosis. While both transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic variceal ligation (EVL) are utilized for variceal rebleeding prevention, their comparative efficacy and safety remain debated.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted to compare TIPS with EVL for variceal rebleeding prevention. A comprehensive search of electronic databases on PubMed, Embase, Scopus, and Web of Science identified 16 studies meeting inclusion criteria. Data on outcomes including gastrointestinal bleeding, variceal rebleeding, hepatic encephalopathy, treatment failure, and mortality were extracted and analyzed.</p><p><strong>Results: </strong>TIPS was associated with significantly lower rates of gastrointestinal bleeding (RR = -0.69, 95% CI [-0.92, -0.47], <i>P</i> < 0.001), variceal rebleeding (RR: -0.99, 95% CI [-1.2, -0.79], <i>P</i> < 0.001), and bleeding from banding ulcers (RR: -1.51, 95% CI [-2.75, -0.27], <i>P</i> = 0.02) compared to EVL. However, TIPS was linked to higher rates of hepatic encephalopathy (RR: 0.44, 95% CI [0.18, 0.71], <i>P</i> < 0.001) and treatment failure (RR: -1.29, 95% CI [-2.01, -0.57], <i>P</i> < 0.001). No significant differences were found in mortality, liver failure, hepatocellular carcinoma, or other clinical outcomes between the two interventions.</p><p><strong>Conclusion: </strong>TIPS demonstrates superiority over EVL in reducing variceal rebleeding and gastrointestinal bleeding. However, it is associated with higher rates of hepatic encephalopathy and treatment failure. Individualized treatment decisions should consider patient characteristics and treatment goals to optimize outcomes in variceal bleeding management. Further research is warranted to refine treatment strategies and minimize adverse events associated with both interventions.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2936-2947"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A diagnostic journey started with yellow nail syndrome (YNS) ended with the Kartagener's syndrome: a rare case report of coexistence of YNS and Kartagener's syndrome.","authors":"Mishaim Khan, Noor Ul Ain Saleem, Waseem Sajjad, Javed Iqbal","doi":"10.1097/MS9.0000000000002878","DOIUrl":"https://doi.org/10.1097/MS9.0000000000002878","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Yellow nail syndrome (YNS) is a rare disorder diagnosed by a triad of yellowish-green discoloration of the nails, respiratory manifestations, and lymphedema. Kartagener's syndrome (KS) is an autosomal recessive syndrome characterized by chronic sinusitis, bronchiectasis, infertility, and situs inversus. In this case we report the rare coexistence of these solitary occurring disorders.</p><p><strong>Case presentation: </strong>This report details an interesting case wherein the clinical manifestation of YNS in a 54-year-old male patient not only led to its diagnosis but also revealed the coexistence of another distinctive underlying genetic disorder - KS.</p><p><strong>Clinical discussion: </strong>KS is an autosomal recessive syndrome characterized by chronic sinusitis, bronchiectasis, infertility, and situs inversus. While KS and YNS are two discernibly unique syndromes, the simultaneous clinical manifestation of their pathologies within a single patient, as presented in our patient, is notably infrequent and rare.</p><p><strong>Conclusion: </strong>While there is significant documented evidence of YNS co-occurring with only bronchiectasis, we present this case due to the rarity of the amalgamation of YNS with the complete spectrum of pathologies associated with KS. This may help in early diagnosis of either disorder via investigation on the basis of their coexistence as presented in this case and may result in better health outcomes in clinical practice.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2970-2976"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ataxia in Africa: current efforts and recommendations.","authors":"Anano Nebieridze, Olivier Uwishema, Yusuf Jaafer Al Tarawneh, Amir I Abdelsamea, Nancy Zrara, Mugabekazi Albright Belise, Sarah Mshaymesh","doi":"10.1097/MS9.0000000000003220","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003220","url":null,"abstract":"<p><p>Ataxia which is a disorder of the nervous system with the primary symptom being unsteady mobility is becoming more prevalent especially within the African continent. Nonetheless, it is suggested that there may be more cases of ataxia that are still undiagnosed roughly and this has to do with very few health care facilities offering genetic testing. This disease is most commonly associated with a variety of neurological illnesses, including stroke and brain damage leading to the uncontrollable moving of the limbs. However, in Africa, the primary contributors to the increase in ataxia are infectious diseases and food scarcity caused by drought. In our article, we analyze the different types of ataxia according to their epidemiology and describe how sociological factors aggravate the situation. We detail existing national strategies and programs aimed at solving this problem, particularly increasing funding for the infrastructure necessary for genetic testing, imagining and brain studies. Even with these measures, there remain a number of gaps with regard to epidemiology studies that need painting so as aid in accurating in the diagnosis. Awareness of the problem regarding patient education and active healthcare personnel has to be raised too. We advocate working on various fronts, including nutritional intervention, support groups for the patients, or modifying occupation therapy programs. Such measures are necessary to increase the effectiveness of ataxia treatment and improve the quality of life of patients.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2800-2803"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety considerations and risk mitigation strategies for ketamine use: a comprehensive review.","authors":"Reem Sayad, Ahmed Saad Elsaeidy, Amna M Anis, Mohamed Atef, Eslam A Hawash, Hager Adel Saad, Khadijah Ali Abdalrahman Hamad, Neveen A Kohaf","doi":"10.1097/MS9.0000000000003232","DOIUrl":"https://doi.org/10.1097/MS9.0000000000003232","url":null,"abstract":"<p><p>Ketamine, a dissociative anesthetic, has gained widespread use in various medical contexts, including anesthesia, pain management, and treatment-resistant depression. Despite its therapeutic potential, concerns regarding its safety profile have prompted ongoing research and regulatory guidance. This comprehensive literature review explores the current safety considerations of ketamine, summarizing its adverse effects, particularly on cardiovascular, neuropsychiatric, and dependency effects. Evidence-based guidelines for its administration, dosing, and monitoring are discussed, emphasizing the importance of risk-benefit assessments in clinical practice. The review also delves into current guidelines and proposes future directions for ketamine research and clinical implementation, including enhanced safety protocols, long-term patient outcomes, and the development of individualized safe dosing protocols.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2829-2837"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}