Esophageal Stenting and Endoscopic Vacuum Therapy for Esophageal Defects: A Systematic Review and Meta-Analysis

Background: Spontaneous esophageal perforation, particularly Boerhaave syndrome, is a life-threatening condition associated with high morbidity and mortality. Traditional surgical management is increasingly being supplemented by minimally invasive approaches, including esophageal stenting and endoscopic vacuum therapy (EVT). However, the optimal treatment strategy remains debated due to variations in reported outcomes and the lack of randomized controlled trials. This systematic review and meta-analysis aim to evaluate the efficacy and safety of esophageal stenting and EVT in managing esophageal defects by specifically assessing sealing rates, failure rates, and mortality. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and the Cochrane Library up to March 24, 2025. Only observational studies and case series were included. The primary outcomes were the pooled sealing rate, failure rate, and mortality for esophageal stenting, and the closure rate for EVT. Data were analyzed using a random-effects model, and heterogeneity was assessed using the I² statistic. Results: Fourteen studies on esophageal stenting demonstrated a pooled sealing rate of 86.1% (95% CI: 80.2–92.0%) with a failure rate of 14.9% (95% CI: 8.5–21.3%). Mortality associated with stenting was 7.4% (95% CI: 3.5–11.4%). EVT studies reported a closure rate ranging from 80% to 94%. Conclusion: Both esophageal stenting and EVT show high efficacy in sealing esophageal defects. Although EVT exhibits promising closure rates, further comparative studies are needed to establish definitive treatment guidelines

Evidence-based analysis of the situation with tuberculosis in Kyrgyzstan and Pakistan

The target of this work is to implement an evidence-based approach in a comparative analyzing of the current tuberculosis situation in the Kyrgyz Republic and the Islamic Republic of Pakistan. Such analysis is of particular interest for assessing the so-called “country” contribution to the implementation of strategies to stop tuberculosis, proclaimed by the World Health Organization. Two-factor linear regression models are presented for both countries. Models take into account how state budget expenditures on health care and the level of poverty impact onto the tuberculosis incidence. The latter circumstance is due to the significant difference between the National Statistical Services in considered countries, as well as the lack of initial data and their heterogeneity. The estimated quality characteristics of the models show them to use in prediction values of the tuberculosis incidence until 2024-2025. The modeling results show that if the established trend of strengthening of the state role continues, then we can talk about the successful implementation of the WHO strategy to decrease and stop tuberculosis in the Kyrgyz Republic and the desired annual reduction in incidence to 10% by 2025. For Pakistan, the same parameter will be no more than 1.5%. The novelty of the presented work lies in the very formulation of the problem of monitoring the current outcomes of the implementation of WHO recommendations in different countries and the methodological development of appropriate situational tasks for learning and teaching medical students the methods of evidence-based medicine/health care.</jats:p

Development of Yoghurt Spread from Goat Milk and its Qualitative Valorization Using Chia Seed Oil

Aim Present study was conducted with a theme to develop yoghurt spread from goat milk owing to its therapeutic significance and ameliorate nutritional value and quality of the finished product via supplementation of chia seed oil. Methodology Four treatments (T0, T1, T2 and T3) possessing varying concentrations of chia seed oil (0, 2, 4 and 6%) were formulated and the first was opted as control. Samples were evaluated on 0th, 10th and 20th day for physicochemical (pH, acidity, TSS, total protein, fat), microbiological (total plate count) and sensory acceptance. Results Significant changes (increasing or decreasing trends) were perceived in all physicochemical parameters as the storage span progressed however minute differences were observed among different treatments except moisture content which varied significantly among different formulations. Total microbial count also increased with increase in storage days however decreased with increase in concentration of chia seed oil. Sensorial attributes particularly product acceptability was considerably reduced at the end of storage period. Conclusion Generally, addition of chia seed oil at different concentration to yoghurt spread improves the sensory properties and overall acceptability, extends the shelf life and enhances nutrition values. Goat milk is preferable to cow milk owing to essential nutrients it provides to infants and substantial therapeutic significance.</jats:p