http://www.nexusics.org/ Nexus of Integrated Clinical Science Journal (NICS) en daily 1 Sun, 12 Apr 2026 00:00:00 +0330 Sun, 12 Apr 2026 00:00:00 +0330 http://www.nexusics.org/article_242954.html Biomedical science is rapidly expanding, generating increasingly complex evidence across clinical research, diagnostics, therapeutics, and health systems science. However, this growth has not been accompanied by a proportional improvement in translating evidence into consistent, context-sensitive, and patient-centered care. This disconnect reflects not only implementation failure but also a structural limitation in how evidence is generated, interpreted, and integrated into clinical decision-making. Clinical practice occurs in heterogeneous, resource-constrained environments where evidence must be interpreted within real-world complexity. The Nexus of Integrated Clinical Science (NICS) addresses this gap by reframing the evidence–practice relationship as a continuous, integrated scientific process rather than a linear translational step. NICS emphasizes clinical relevance, methodological rigor, and real-world impact, positioning evidence as actionable knowledge embedded within clinical reasoning. By promoting integration across disciplines and aligning research with decision-making needs, NICS aims to improve patient outcomes and healthcare system performance through a unified model of evidence generation, interpretation, and application. http://www.nexusics.org/article_243499.html Postoperative pain following laparoscopic cholecystectomy remains a clinically important factor affecting recovery, patient satisfaction, and healthcare utilization. Despite being a minimally invasive procedure, pain is often multifactorial, involving incisional, visceral, and referred components, which makes single-agent analgesia insufficient. This review aimed to provide an updated and integrated overview of pharmacologic and non-pharmacologic strategies for postoperative pain management with an emphasis on multimodal and opioid-sparing approaches. Current evidence supports multimodal analgesia as the most effective strategy for pain control. Pharmacologic management typically includes acetaminophen combined with non-steroidal anti-inflammatory drugs or COX-2 inhibitors, supplemented by selective use of adjuvant agents and local or regional anesthesia techniques. Opioids should be reserved for breakthrough pain and used at the lowest effective dose to reduce the risk of adverse effects, including respiratory depression, nausea, and long-term dependence. Non-pharmacologic interventions such as early mobilization, breathing exercises, transcutaneous electrical nerve stimulation, and structured patient education further enhance recovery by reducing pain perception, anxiety, and functional limitations. Evidence also highlights the importance of individualized pain management based on patient-specific factors such as age, comorbidities, and surgical risk profile. Integration of these strategies within Enhanced Recovery After Surgery (ERAS) pathways improves clinical outcomes, shortens hospital stay, and enhances patient satisfaction. From a clinical perspective, postoperative pain management should shift toward a coordinated, multidisciplinary, and patient-centered approach that prioritizes opioid stewardship and functional recovery. The combination of pharmacologic and non-pharmacologic interventions represents the current standard of care and supports improved perioperative outcomes in laparoscopic cholecystectomy. http://www.nexusics.org/article_243699.html Background: Postmenopausal bleeding (PMB) is a clinically important symptom associated with a significant risk of endometrial malignancy. Although transvaginal ultrasonography (TVUS) is widely used for initial evaluation, its limited specificity highlights the need for additional biomarkers to improve diagnostic accuracy. This study aimed to evaluate the association between serum estradiol levels, endometrial thickness, and histopathological characteristics in postmenopausal women with PMB and confirmed endometrial malignancy.Methods: This retrospective cross-sectional study included 55 postmenopausal women with abnormal uterine bleeding and histopathologically confirmed endometrial cancer. Clinical, demographic, laboratory, hormonal, imaging, and pathological data were extracted from medical records. Serum estradiol levels were categorized as ≤54 pg/mL and >54 pg/mL. Endometrial thickness was assessed by transvaginal ultrasonography and classified as <4 mm or ≥4 mm. Statistical analysis was performed using SPSS version 26, and a p-value <0.05 was considered significant.Results: The majority of patients were aged 60–69 years and obese. Most cases were endometrioid adenocarcinoma grade 1. No significant associations were observed between serum estradiol levels and age, BMI, age at menopause, interval between menopause and diagnosis, or histopathological subtype. However, a significant association was found between serum estradiol levels and endometrial thickness (P = 0.022), with all patients in the elevated estradiol group demonstrating an endometrial thickness ≥4 mm.Conclusion: Serum estradiol levels were significantly associated with endometrial thickness but not with demographic or tumor-related characteristics. These findings suggest that estradiol may serve as a complementary biomarker alongside ultrasonographic evaluation in the risk stratification of postmenopausal women with abnormal uterine bleeding.Implications for Patient Care: Combining serum estradiol assessment with transvaginal ultrasonography may improve risk stratification in postmenopausal women with abnormal uterine bleeding. This approach can help identify higher-risk patients for endometrial pathology, guide appropriate use of biopsy, and support conservative management in low-risk cases, enhancing individualized clinical decision-making. http://www.nexusics.org/article_243709.html Background: Frozen section (FS) examination is a widely used intraoperative diagnostic technique that provides rapid histopathological assessment to guide surgical decision-making. However, its diagnostic performance across different tissue types remains an important clinical consideration. This study aimed to evaluate the diagnostic accuracy of FS in thyroid, breast, and ovarian specimens by comparing its results with permanent histopathological diagnoses.Methods: This analytical cross-sectional study included 199 pathology records of thyroid, breast, and ovarian specimens collected from 2021 to 2024 at Shahid Rahimi Hospital, Khorramabad, Iran. Cases were selected using stratified simple random sampling. Frozen section results were compared with permanent histopathology, which was considered the gold standard. Diagnostic performance indices including sensitivity, specificity, positive predictive value, and negative predictive value were calculated using SPSS version 22.Results: The mean age of patients was 47.35 ± 12.04 years, and most cases were female (96%). Breast specimens accounted for 67.8%, followed by thyroid (30.7%) and ovarian (1.5%) samples. FS showed complete concordance with permanent histopathology, with no false-positive or false-negative cases identified. Accordingly, sensitivity, specificity, PPV, and NPV were all 100% across all specimen types.Conclusion: Frozen section examination demonstrated high diagnostic accuracy and complete concordance with permanent histopathology in thyroid, breast, and ovarian specimens. FS remains a reliable intraoperative tool that supports surgical decision-making, although its limitations in specific tumor types highlight the continued importance of permanent section diagnosis.Implications for Patient Care: Frozen section (FS) examination may support intraoperative decision-making by providing rapid histopathological information, helping guide the extent of surgery and potentially reducing reoperations. FS results should be interpreted with clinical, radiological, and permanent histopathological findings, especially in challenging cases. Overall, FS may enhance surgical efficiency and support individualized patient care.