Assessment of Abrasive Containing Irritants on the Bond Strength of Gutta-Percha to Radicular Dentine
Background: Recently, nanoparticles have introduced in endodontic treatment as successful irrigants due to their ultra-small size and high surface area enabled them to penetrate deeply into the dentinal tubules and optimize root canal treatment. Objective: This study aimed to evaluate the effect of silver nanoparticles and graphene oxide irrigants on apical debris extrusion and push-out bond strength of gutta-percha to radicular dentin, compared to conventional saline and EDTA. Methods: Forty extracted human maxillary first molars with straight palatal canals were instrumented using ProTaper NEXT rotary files. Samples were randomly assigned to four groups: Group A (saline), Group B (silver nanoparticles), Group C (graphene oxide), and Group D (17% EDTA). Nano-irrigants were ultrasonically activated for five minutes. Debris extrusion was measured using precision weighing of filter discs. Push-out bond strength was assessed in apical, middle, and coronal root sections using a universal testing machine. Statistical analysis of debris extrusion was performed using one-way ANOVA and posthoc Tuckey’s tests, while for the overall mean push-out bond strength Kruskal Wallis and Mann-Whitney U tests were performed (p<0.05) Results: Graphene oxide and silver nanoparticle groups exhibited significantly lower apical debris extrusion compared to EDTA (p < 0.05). Push-out bond strength was highest in the apical third across all groups, with graphene oxide showing the greatest overall adhesion, followed by silver nanoparticles, saline, and EDTA. Conclusion: Silver nanoparticles and graphene oxide irrigants enhanced root canal cleanliness while limiting apical extrusion and increased bonding of gutta-percha. These findings support the ability of nano-irrigants to effectively alternate conventional solutions in endodontic therapy.
Copyright (c) 2026 Al-alaa J. Mowlood https://creativecommons.org/licenses/by/4.0
Towards Strengthening HIV Case Detection and Management: A Review of The Role of Oral Healthcare and Enhanced Laboratory Diagnostics
An estimated 84.2 million people have suffered the disease since its discovery. Although the number of new cases decreased by 32% since 2010, it is most prevalent in Africa 68% [25.7 million], resulting in approximately 470,000 AIDS-related deaths with Nigeria having the highest number of people living with HIV/AIDS (PLWHA) in the region and the second highest globally. Rapid diagnostic tests (RDTs) have emerged as indispensable tools for point-of-care testing, providing quick results with minimal infrastructure requirements. Dentists play a critical role in the early detection of HIV, as they are in a unique position to identify oral manifestations associated with the infection. The oral cavity is frequently the first site where symptoms of HIV appear, often even before individuals are aware of their serostatus. Dentists have a responsibility to be aware of the oral manifestations of HIV and to consider HIV infection in the differential diagnosis of these conditions. Additionally, dentists can play a proactive role in HIV screening by offering rapid HIV testing services in their dental. With recent findings demonstrating the high transmissibility of HIV early in infection, and the potential benefit of early initiation of treatment, it is essential to identify as many infected individuals as possible. HIV testing is the key part of diagnosis and prevention efforts hence the need for synergy between oral health practitioners and laboratory diagnostic experts in bridging the gap of diagnosis and prevention among healthcare professionals.
Copyright (c) 2026 Promise Udohchukwu Okereke (BDS), Chukwuma Franklin Ozioma, Obumneme Wisdom Okereke (BDS), Emmanuel Elebesunu (BMLS), Babatunde Ismail Bale (DOpt), Chimeremeze Offurum (BDS), Immanuel Azubuike (BMLS), Ogechi Grace Okoli (MBBS), Obinna Ikegwuonu, Anthony Chukwuebuka Okeke (MBBS), Obidike Ezije Chidiogo (BDS), Mmesoma F. Umeh (B.Pharm), Chukwuemeka Victor Umeh, Perfectus C. Obodo (BDS) https://creativecommons.org/licenses/by/4.0
Eradicating the Enemy Within: A Narrative Review of Malaria Elimination Strategies and Future Pathways in Nigeria
Despite decades of coordinated national and international effort, the elimination targets embedded in the National Malaria Strategic Plan 2021 to 2025 remain substantially unmet, exposing a persistent and deeply rooted gap between the demonstrated efficacy of available tools and their real-world programmatic impact. This narrative review critically synthesises current evidence on both established and emerging malaria elimination strategies in Nigeria, examining the implementation landscape across six interrelated domains: vector control, case management and chemoprevention, diagnostic accuracy, malaria vaccination, mobile health surveillance, and genetic vector control. A comprehensive literature search was conducted across PubMed, Google Scholar, Web of Science, and EMBASE, supplemented by grey literature from the World Health Organization, the National Malaria Elimination Programme, and Gavi, with priority given to publications from 2015 to 2025. The review finds that existing tools, including long-lasting insecticide treated nets, artemisinin-based combination therapies, seasonal malaria chemoprevention, and indoor residual spraying, have produced measurable but insufficient reductions in burden, constrained by insecticide resistance, low utilisation rates, supply chain fragility, and weak diagnostic infrastructure. Inaccuracies in rapid diagnostic test performance substantially drive misdiagnosis and fuel antimalarial resistance in Nigeria, with deletions in the hrp2 and hrp3 genes of Plasmodium falciparum emerging as a particularly consequential threat to the reliability of frontline testing. The December 2024 rollout of the R21/Matrix-M vaccine in Bayelsa and Kebbi States represents a historic national milestone, though implementation barriers encompassing vaccine hesitancy, cold chain limitations, health workforce gaps, and the complexity of the four-dose schedule demand systematic and urgent responses. The overarching finding of this review is that no single intervention, however efficacious in trial settings, is sufficient to achieve malaria elimination in Nigeria, and that what is required is a systems-level, integrated strategy aligning biological innovation with health system strengthening, equitable financing, digital infrastructure, and genuine community partnership.
Copyright (c) 2026 Promise U. OKEREKE, Dorcas A. ADENIYI, Mulikat T. ADEDEJI, Sheriff O. AKINOLA, Wisdom O. OKEREKE, Chukwuma F. OZIOMA, Ogechi G. OKOLI, Chikamso O. Chibueze, Nzubechukwu OGAMBA, Collins U. UCHE https://creativecommons.org/licenses/by/4.0
The Effect of Platelet-Rich Plasma on Orthodontic Tooth Movement: A Systematic Review
Background: Prolonged orthodontic treatments pose risks like root resorption and periodontal issues. Platelet-rich plasma (PRP), rich in growth factors, has been proposed as a non-invasive adjunct to accelerate orthodontic tooth movement (OTM). Objectives: The objective of this systematic review was to evaluate existing research on the impact of platelet-rich plasma (PRP) in the field of orthodontics Material and Methods A systematic review was conducted following PRISMA guidelines (PROSPERO ID: CRD42024535223). Databases searched included PubMed, Embase, CENTRAL, and others. Studies involving PRP use in orthodontics were included. Risk of bias was assessed using RoB 2 and SYRCLE tools. Due to study heterogeneity, only qualitative synthesis was performed. Results Human trials consistently reported an increased rate of canine retraction or space closure on the PRP-treated side, with acceleration ranging from 1.2 to 1.7 times compared to controls. Animal studies, while supporting PRP’s stimulatory effects on bone resorption and osteoclastic activity, revealed variability based on species, PRP preparation methods, and study design. Despite promising histological and clinical findings, heterogeneity across studies limited the ability to draw definitive conclusions Conclusion Eight human and six animal studies were analysed. While some reported increased OTM with PRP, findings were inconsistent due to varied protocols and outcome measures. More standardized clinical trials are needed to validate PRP’s role in orthodontics.
Copyright (c) 2026 Arushi Malhotra, Sanjay Mittal, Isha Aggarwal, Merry, Pallavi Vishavkarma, Shaina Goyal https://creativecommons.org/licenses/by/4.0
Placenta Accreta Spectrum: A Narrative Review of Clinical Management, Contemporary Innovations, And Global Challenges
Background: Placenta accreta spectrum (PAS) is a severe obstetric complication characterized by abnormal placental adherence or invasion into the uterine wall, posing significant global reproductive health challenges. While clinical guidelines for PAS exist, a critical knowledge gap remains regarding how to successfully translate high-resource diagnostic innovations and multidisciplinary frameworks into resource-limited settings. Furthermore, there is a lack of synthesized literature evaluating how emerging technologies, such as machine learning models and real-time intraoperative flow assessments, can be integrated with traditional imaging to optimise surgical outcomes. Objectives: This narrative review comprehensively evaluates the evolving clinical landscape of PAS, examining its epidemiology, pathophysiology, risk factors, and diagnostic advancements, while critically appraising multidisciplinary management frameworks across diverse healthcare resource settings. Methods: A descriptive narrative approach was utilised to synthesise peer-reviewed publications, consensus guidelines, and clinical studies from PubMed, SCOPUS, Web of Science, and Google Scholar up to June 2026. Data synthesis focused on key parameters including study characteristics, diagnostic modalities (ultrasound, magnetic resonance imaging, and emerging imaging mordalities), and clinical management outcomes, with additional context integrated from regional low- and middle-income country (LMIC) reports. Results: The incidence of PAS has escalated globally, driven primarily by rising primary and recurrent caesarean section rates. Emerging evidence confirms that the condition arises from an endometrial–myometrial interface defect characterised by thinned or absent decidua basalis, accompanied by molecularly driven hypervascularity and altered tissue adhesion. Modern diagnostic signs, such as intracervical lakes (ICL) and the "rail sign," significantly enhance prenatal identification and predict severe peripartum morbidity. Multidisciplinary care, specialized surgical planning, and intraoperative adjuncts (such as transvaginal ultrasound [TVUS] and machine learning models) improve maternal outcomes, although severe postpartum haemorrhage and maternal mortality remain pronounced in resource-limited systems. Conclusion: Optimising PAS outcomes requires timely prenatal detection and structured, coordinated care. Advances in ultrasound techniques, combined imaging scores, and real-time intraoperative flow assessments facilitate better risk stratification and surgical optimisation. Addressing current limitations through standardised reporting frameworks and expanding access to subspecialty multidisciplinary care, especially in low-resource settings, remains mandatory to reduce severe maternal morbidity and optimise reproductive health preservation.
Copyright (c) 2026 Chijioke Ogomegbunam Ezeigwe, George Uchenna Eleje, Uchenna Paschaline Eze, Gerald Tochukwu Igwemadu, Emmanuel Onyebuchi Ugwu, Emmanuel Chukwubuikem Egwuatu, Chigozie Geoffrey Okafor, Chukwuemeka Chukwubuikem Okoro, Chukwudubem Chinagorom Onyejiaka, Obinna Kenneth Nnabuchi, Princeston Chukwuemeka Okam, Adanna Vivian Egwim, Charlotte Blanche Oguejiofor, Malarchy Ekwunife Nwankwo, Chukwunwendu Aloysius Okeke, Chisom God’swill Chigbo, Gerald Okanandu Udigwe, Joseph Ifeanyichukwu Ikechebelu, Akaninyene Eseme Ubom, Kingsley Chidiebere Nwaogu, Ahizechukwu Chigoziem Eke https://creativecommons.org/licenses/by/4.0
Oral Immediate-Release Nifedipine Versus Intravenous Hydralazine for Controlling Severe Hypertension in Pregnancy: A Double-Blind Randomised Controlled Trial
Background: A significant gap exists in understanding the efficacy and safety of oral immediate-release nifedipine and intravenous hydralazine in the control of severe hypertension in pregnancy within the context of randomised control trials. Objectives: To compare the efficacy and safety of oral immediate-release nifedipine and intravenous hydralazine for controlling severe hypertension in pregnancy. Methods: Randomised, double-blind, 2-arm, single center non-inferiority trial in pregnant women with confirmed severe hypertension in pregnancy who were randomised in a 1:1 ratio to receive oral immediate-release Nifedipine (n=35) or intravenous hydralazine (n=35) was done from 20th June 2019 to 20th December, 2019. The primary outcome was the mean time required to achieve target blood pressure. Secondary outcomes included the mean number of anti-hypertensive doses needed, proportions requiring crossover or rescue therapy, frequency of maternal side effects, fetal heart rate abnormalities, maternal complications, neonatal birth asphyxia, and mode of delivery. Results: The baseline socio-demographic parameters were similar between the two groups. The mean durations taken to reach the target blood pressure for patients that received oral immediate-release nifedipine versus intravenous hydralazine were 48.29min±31.95 and 41.20min±26.98 respectively (P=0.320). The mean dose used before target blood pressure was reached, the proportion of participants that crossed over to another treatment allocation, and the proportion that required a rescue anti-hypertensive (labetalol) to achieve the target blood pressure were similar between the two groups (P >0.05). None of the participants that received oral immediate-release nifedipine had maternal or neonatal side effect while one participant (2.9%) that received intravenous hydralazine had nausea and vomiting. Conclusion: Oral immediate-release nifedipine is as effective as intravenous hydralazine in controlling severe hypertension in pregnancy. Both have remarkable materno-fetal safety profile and its non-invasive nature makes it an appealing modality especially in resource poor countries. More robust studies are encouraged to increase the evidence for its use as first line anti-hypertensives, especially in low and middle-income countries. Trial Registration: Pan African Clinical Trial registry, PACTR201906662822573, registration date: 19th June, 2019.
Copyright (c) 2026 Ayodele Obianuju Okwuosa, George Uchenna Eleje, Okechukwu Christian Ikpeze, Emmanuel Onyebuchi Ugwu, Boniface Chukwuneme Okpala, Golibe Christian Ikpeze, Ifeanyi Ogochukwu Okonkwo, Hillary Ikechukwu Obiagwu, Odigonma Zinobia Ikpeze, Ifeanyichukwu Jude Ofor, Emeka Philip Igbodike, Joseph Odirichukwu Ugboaja, Kingsley Emeka Ekwuazi, Chukwuemeka Chukwubuikem Okoro, Chigozie Geoffrey Okafor, Onyecherelam Monday Ogelle, Chukwunonso Isaiah Enechukwu, Lazarus Ugochukwu Okafor, Osita Samuel Umeononihu, Zebulon Chiawolamoke Okechukwu, Chukwudubem Chinagorom Onyejiaka, Chijioke Ogomegbunam Ezeigwe, Adanna Vivian Egwim, Chukwunwendu Aloysius Okeke, Johnbosco Emmanuel Mamah, Joseph Ifeanyichukwu Ikechebelu, Ahizechukwu Chigoziem Eke https://creativecommons.org/licenses/by/4.0
Traumatic Ulcerative Granuloma with Stromal Eosinophilia of The Lateral Border of Tongue Mimicking Oral Squamous Cell Carcinoma: A Case Report
Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an uncommon benign inflammatory lesion of the oral mucosa characterized by persistent ulceration accompanied by a dense eosinophil-rich inflammatory infiltrate within the connective tissue. Clinically, the lesion often presents as a chronic indurated ulcer and may closely resemble oral squamous cell carcinoma, creating diagnostic uncertainty. Histopathologically, it typically shows ulcerated stratified squamous epithelium with a polymorphous inflammatory infiltrate predominantly composed of eosinophils extending into deeper connective tissue and skeletal muscle bundles. We report a case of a 75-year-old female presenting with a persistent ulcer on the right lateral border of the tongue associated with chronic mechanical irritation. The clinical, histopathological and follow-up findings were consistent with traumatic ulcerative granuloma with stromal eosinophilia, and the lesion resolved completely after elimination of the traumatic factor.
Copyright (c) 2026 Dr. Pramit Sen, Dr. Swagata Gayen, Dr. Sanjeet Kumar Das, Dr. Mousumi Pal https://creativecommons.org/licenses/by/4.0
Consealing Amputation- A Case Report on Finger Prosthesis
Fingertip amputations, particularly involving the distal phalanges, represent a common yet debilitating form of hand injury that severely impacts manual function, aesthetics, and psychosocial well-being. One growing cause of such injuries is trauma from motorcycle spoke wheels during improper cleaning practices. This case report outlines the prosthetic rehabilitation of a 23-year-old male patient with an Allen’s Level IV partial amputation of the left index finger. A novel approach tired hereby incorporating fiber reinforced glass tape during the prosthesis fabrication process to enhance structural strength, achieve aesthetic realism, and ensure functional retention post-insertion. This highlights the value of customized silicone finger prostheses as a viable non-invasive solution for restoring aesthetics and basic hand function in patients averse to surgical options.
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
Investigation of Multidrug-Resistant Klebsiella pneumoniae and Acinetobacter baumannii Isolated from Inpatients at Al-Nasiriyah Teaching Hospital
This study aimed to determine the prevalence, phenotypic characteristics, molecular identification, and antibiotic resistance pattern of both of A. baumannii and K. pneumoniae in inpatients at Al-Nasiriyah Teaching Hospital, Iraq. A total of 150 clinical specimens were obtained and processed for A. baumannii and K. pneumoniae isolation using typical microbiological, PCR and DNA sequencing techniques. The antimicrobial susceptibility testing was conducted by using VITEK-2. The results revealed a 23% (35/150) prevalence of A. baumannii, and the same ratio for K. pneumoniae was identified and diagnosed; however, the remaining gram-negative isolates represented 54%. PCR confirmed these isolates as A. baumannii and K. pneumoniae using specific primers. The antibiogram profile revealed high susceptibility to tigecycline (94.3%) by all of our tested isolates. There was a high prevalence of multidrug resistance among both species, with A. baumannii demonstrating complete resistance to several key antibiotics. Sample-type-specific patterns were also identified. Both bacterial species can be classified as MDR. The significant burden of MDR and XDR profiles among A. baumannii and K. pneumoniae in these inpatient samples emphasizes the need for optimized experimental therapy and rigorous administration in Thi-Qar.
Effects of Alcoholic Extract Nigella Sativa on Blood Clotting Markers in Male Rats Models with F2 G20210A Mutation
Despite its well-documented antioxidant and anti-inflammatory activities, there are no sufficient data exists regarding duration of Nigella sativa effects on blood coagulation. This experiment observed the effects of a sixty-day oral intoxication of alcoholic Nigella sativa extract on four key hemostatic indicators—prothrombin time, fibrinogen, D-dimer and platelet count—with respect to the veins of normal male rats treated or otherwise and rats carrying the F2 G20210A mutation as a model of increased thrombotic risk. Thirty mature male rats were divided into three groups: control, normal rats treated with N. sativa extract, and rats crossing the G20210A mutation into their genome and therefore in theory at higher risk of thrombosis. After 60 days of treatment, blood was taken for coagulant analysis. The treated normotensive rats displayed a significant prolongation of PT and reductions in fibrinogen and D-dimer levels, pointing to an anticoagulant action of the extract. However, the group disadvantaged by the mutation presented with smaller PT, greater fibrinogen, higher D-dimer and peaked platelet levels, thus manifesting a hypercoagulative profile. The results generally indicate that long-term exposure to alcoholic Nigella sativa may to some extent influence coagulation in such a way as to lessen the tendency toward clot formation and that when there is a prothrombin gene mutation present, a strong prothrombotic condition still prevails. Altogether, these results emphasize the potential of Nigella sativa to act as a natural modulator of coagulation, particularly in the absence of genetically derived hypercoagulable circumstances.
The Biochemistry, Physiology, And Clinical Significance of Haptoglobin: A Review
Haptoglobin is a plasma glycoprotein and one of the major acute phase proteins, which is involved in physiological homeostasis, especially in inflammatory states and during haemolysis. Haptoglobin is highly polymorphic at the genetic level in biochemical terms, and for this reason it displays structural and functional variations, which impact on its antioxidant potential and haemoglobin (Hb)-binding capability. In the physiological perspective, haptoglobin prevents tissues from hemoglobin-induced oxidative injury by stably binding to free hemoglobin and aiding its clearance via macrophage scavenger receptors. Furthermore, it is involved in iron homeostasis, vessel integrity and modulation of innate and adaptive immune responses. Clinically, haptoglobin is commonly used as a marker for intravascular hemolysis and systemic inflammation, but there is increasing evidence that it also has significance in cardiovascular disease, metabolic syndrome, hepatic insufficiency and cancer. Changes in haptoglobin levels and glycosylation varieties have been correlated with disease severity and prognosis, indicating its potential value in diagnosis and prognostication. Although it is not disease specific, the interpretation of measurements of haptoglobin processing clinically have improved with modern molecular biology and proteomic techniques. This review describes the biochemistry, physiology and pathophysiological relevance of haptoglobin in health and disease, highlighting its diverse roles: focusing on new areas that it has found applications, particularly in biomedical research and clinical care.
Integrative Role of Yoga Prana Vidya (YPV) Healing in Post-Surgical Recovery of Hip Fracture: A Case Report
Background: Hip fractures are a major cause of morbidity and mortality in elderly populations, often requiring surgical intervention and prolonged rehabilitation. Integrative approaches, including energy-based healing systems such as Yoga Prana Vidya (YPV), have shown promise in enhancing recovery outcomes. Objective: To document the recovery of a 78-year-old female patient with a left neck of femur fracture following 3 falls on 7 November 2025, and started receiving YPV healing alongside conventional medical management. Methods: The patient, diagnosed on 8 November 2025, underwent hip surgery on 10 November 2025. No neurological causes of falls were observed during investigations. On patient’s request, YPV healing sessions were initiated by a Certified Healer immediately after fallings on 7 November and continued until 10 December 2025. Healing protocols included psychotherapy, cleansing and energizing specific affected chakras, strengthening the spine, and daily affirmations. Sessions were frequent in the initial phase (every three hours for three days), gradually tapering as recovery progressed. Results: Post-surgery, the patient reported reduced pain, improved mobility, and faster-than-expected rehabilitation. By 5 December 2025, i.e., within 25 days after surgery, she was walking without support, and by 15 December 2025, she resumed normal activities including attending social functions. Physiotherapy outcomes were positive, with enhanced mobility and reduced dependence on assistive devices. Conclusions: The integration of YPV healing with conventional medical care facilitated smooth recovery, improved patient confidence, and accelerated functional independence. This case highlights the potential of YPV as a complementary therapy in orthopaedic rehabilitation.
Pathogenicity and Antimicrobial Resistance of Mycobacterium Tuberculosis: A Review Article
Mycobacterium tuberculosis (Mtb) induced tuberculosis (TB), is a severe public health problem world widely because of its intricate pathobiology and increasing antimicrobial resistance. Mtb possess a repertoire of virulence factors that can enable it to remain alive within cells, escape the immune system to form granulomas (multi-cellular aggregates), establish latency, and reactivate disease, which complicates the control and elimination of this disease. Concurrently, the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB has made conventional antimicrobial therapy dramatically less effective, with prolonged treatment durations and worse clinical outcomes. Resistance arises through chromosomal mutations, efflux pump-- mediated resistance, and by phenotypic drug tolerance as well as due to limited penetration of drugs across the hydrophobic mycobacterial cell wall. Advances in molecular diagnostics, whole genome surveillance and development of new therapies such as a few host-directed therapies and also the experimental anti-virulence strategies have lead to an improved understanding about TB pathogenesis and resistance dynamics too. This review highlights the emerging disease-causing of Mycobacterium tuberculosis and offers an overview of currently growing sources of antimicrobial resistance and treatment management issues, seeking to steer possible future direction for TB control and management.
Physical, Chemical, and Industrial Properties of Copper Nanoparticles: A Review
Copper nanoparticles (CuNPs) have attracted attention as versatile nanomaterials because of their unique physical, chemical and therapeutic properties quite different to those of bulk copper. Copper at the nanoscale possesses improved surface reactivity, redox activity and tunable optical and electrical properties that enable various technological and biomedical applications. This review includes a comprehensive summary of the physical aspects of CuNPs: size- and shape-dependent properties, crystallinity, optical response and thermal/electrical conductivities. Furthermore, the chemical properties of CuNPs including oxidation property, surface chemistry, catalytic activity and mechanisms associated with ROS generation and ion release were also reviewed in detail. Special consideration is given to the therapeutic role of CuNPs, including their anti-microbial/anti-viral activities, wound-healing properties, anti-cancer effects and drug-release applications. Tendencies and challenges for toxicology, biocompatibility and translation are also explored. In general, this review describes the most recent progress in CuNP research and provides future directions for the development of safe and effective therapeutic systems using CuNPs.
Effectiveness of Dietary Control on The Severity and Frequency of Asthmatic Attacks
Background: Bronchial asthma is a chronic inflammatory airway disease with episodic, reversible airway obstruction leading to wheezing, breathlessness and cough that significantly affects quality of life and use of health care resources. Although medical therapy has improved, many patients have uncontrolled asthma. In recent years, lifestyle-related factors especially nutrition have been emerged as possible modifiable contributors to airway inflammation and asthma. Nevertheless, data on structured dietary management of asthma severity and frequency of attack are insufficient. Objectives: To assess the impact of dietary management on severity and frequency of asthmatic attacks among adult patients with bronchial asthma, and to determine strength of association between post-intervention outcomes and selected demographic variables. Methods: A quasi-experimental study with a pre-test-post-test control group design was conducted in a respiratory clinic. Three dozen adult patients with confirmed diagnosis of bronchial asthma were included in the study and divided into the study group (n = 30) and control group (n = 30). The study group underwent a preset dietary control intervention combined with medical practice, while the control group received only medical care. The severity of asthma was evaluated based on ACT (a validated tool) to measure the number of asthmatic attacks in 1 month pre-test and post-test. Results: Asthma severity was significantly less and the number of asthmatic attacks were numerically fewer for the study group at post-test than pretest relative to BM adults (p 0.05). In addition, we found n association between post-test asthma severity and frequency with age and sex; but no correlation was detected with BMI. Conclusion: Diet control is effective in addition to the traditional asthma therapy for controlling asthma and most adults with asthma can get benefit from it. Including nutritional counseling as part of asthma standard treatment seems to improve disease control and the patients' health status. More prospective and randomized trials are needed to verify these effects, in order to provide evidence-based dietary recommendations in the control of asthma.
A Review on The Glymphatic System and Meningeal Lymphatics
The maintenance of neuronal homeostasis within the central nervous system (CNS) requires the efficient removal of metabolic waste products and neurotoxic proteins. Historically, the CNS was considered devoid of a conventional lymphatic system, relying solely on passive diffusion for solute clearance. This paradigm shifted with the identification of the glymphatic system, a macro-scale waste clearance pathway dependent on glial cells, and the subsequent rediscovery of meningeal lymphatic vessels lining the dural sinuses. Cerebrospinal fluid (CSF) enters the brain parenchyma via peri-arterial spaces, exchanging with interstitial fluid (ISF) mediated by aquaporin-4 (AQP4) water channels localized on astrocytic endfeet. This convective flux facilitates the washout of soluble proteins, including amyloid-beta and tau, directing them toward the meningeal lymphatic network for drainage into deep cervical lymph nodes. Physiological factors, primarily sleep and arterial pulsation, critically regulate this fluid transport, while aging and traumatic injury impair its efficacy. Disruption of this dual-component clearance axis contributes significantly to the pathophysiology of neurodegenerative proteinopathies. Delineating the molecular and anatomical architecture of these systems offers novel therapeutic targets for conditions characterized by accumulation of misfolded proteins and metabolic stagnation.
Physical, Chemical, And Therapeutic Applications of Silver Nanoparticles: A Review
Since their physical, chemical and therapeutic properties of noble nanometal deviate markedly from those at bulk scale, silver nanoparticles (AgNPs) have become promising nano-substances. At the nanoscale, silver displays high surface reactivity, strongly plasmonic properties and modulable bio-, electro- and optical properties, thereby finding several applications in biomedicine and technology. The physical properties of AgNPs are reviewed in a well-documented science encompassing size- and shape-controlled effects, crystallinity, as surface plasmon resonance (SPR) and thermal and electrical conductivity. Moreover, the chemical properties of AgNPs (ion release, redox activity, surface chemistry, and catalytic activity) and mechanisms linked to the generation of ROS are thoroughly addressed. Special attention is given to the therapeutic uses of AgNPs, such as antimicrobial, antiviral action and wound-healing activity especially those related to cancer treatment and drug-delivery. Issues concerning the toxicity, biocompatibility, environmental impact and clinical transfer to human are also discussed. Accordingly, this review focuses on the recent progression of AgNP studies and summarizes prospective for designing safe, effective, and clinically viable silver nanoparticle-related therapeutic systems.
Association Between IL-6 And Oral Tissue Responses in Patients Wearing Dental Prostheses
The oral mucosa of the dental prosthesis bearing areas are subjected to permanent stresses and it is a chronic infection which may lead to inflammatory conditions produced by pro-inflammatory cytokines. Interleukin-6 (IL-6) is an important mediator of inflammation that participates in regulation and damage of mucosal immune, but little is known about its relevance to prosthesis-induced oral tissue changes. The objective of the current case–control study was to measure salivary levels of IL-6 in patients who wore dental prostheses and healthy controls and seek possible associations between IL-6 concentrations and clinical responses in oral tissues as mucosal erythema, mucosal edema, ulceration, or gingival inflammation. This cross-sectional study was performed in the Dental Clinics of Al-Najaf Center for Dentistry, Al-Najaf, Iraq from April 2024 to February 2025. A total of 120 subjects were included, which consisted of 66 denture wearers and 54 healthy systemically control individuals that were age and sex matched. Full-mouth clinical examinations were conducted to evaluate tissue alterations that were graded by the degree of severity. Whole unstimulated saliva samples were collected in the morning under standardized conditions and analyzed with a commercial enzyme-linked immunosorbent (ELISA) for IL-6 concentrations. Results Statistical analysis was conducted with SPSS version 25, which included chi-square tests for categorical variables, independent-samples t-tests to compare the groups, one-way ANOVA (F-test) for subgroup comparisons and Pearson’s correlation in order to test the association between IL-6 levels and tissue response indices. It was also found that mean salivary IL-6 level of the prosthesis-wearing group was significantly higher than that of the controls (p = 0.013). Statistically, a significant difference in mucosal erythema, ulcers, mucosa edema and the degree of gingival inflammation between patients and controls was found (p < 0.05). IL-6 levels were progressively higher with the severity of tissue alterations, and differed significantly between subgroups for mucosal erythema, edema, ulceration and gingival index (p < 0.05). The correlation analysis showed a significant positive relationship between IL-6 levels and mucosal erythema (p = 0.002), mucosal edema (p = 0.003) and gingival inflammation (p = 0.04), but not with ulceration. In summary, salivary IL-6 levels are significantly connected with local inflammatory responses in oral tissue of patients using dental prostheses. These results reveal the important role of IL-6 as a mediator of prosthesis-induced mucosal inflammation and its potential use as a non-invasive biomarker for monitoring oral tissue response in prosthodontic patients.
The Synergistic Role Of IL-8 And Serum C-Reactive Protein Levels in The Diagnosis of Helicobacter Pylori Infection
Helicobacter pylori infection is one of the most frequently and globally emerged chronic bacterial infections and is strongly correlation with , peptic ulcer, gastritis, and gastric malignancies. The host inflammatory response plays a pivotal role in disease pathogenesis, highlighting the need for reliable non-invasive biomarkers to aid diagnosis. This study aims to investigate the diagnostic power of serum interleukin-8 (IL-8) and C-reactive protein (CRP) levels, individually and in combination, for the detection of H. pylori infection. A case–control study was conducted including 78 patients with confirmed H. pylori infection and 62 apparently healthy controls. Serum IL-8 levels were determined using enzyme-linked immunosorbent assay (ELISA), while CRP concentrations were determined by standard immunoturbidimetric methods. Differences between groups were assessed using independent samples t-tests, and the relationship between IL-8 and CRP was evaluated using Pearson correlation analysis. Receiver operating characteristic (ROC) curve analysis was conducted to investigate the diagnostic performance of each biomarker. Patients with H. pylori infection exhibited significantly higher serum IL-8 levels (72.4 ± 18.6 pg/mL) compared with controls (58.1 ± 15.2 pg/mL; P < 0.02). Similarly, CRP concentrations were significantly elevated in patients (4.8 ± 1.6 pg/mL) relative to controls (3.6 ± 1.3 pg/mL; P < 0.04). A moderate positive correlation was observed between IL-8 and CRP levels (r = 0.49, P < 0.001). ROC analysis revealed that IL-8 demonstrated superior diagnostic accuracy (AUC = 0.78) compared to CRP (AUC = 0.71). At an optimal cut-off value of 65.0 pg/mL, IL-8 yielded a sensitivity of 74.4% and specificity of 71.0%. These findings indicate that both IL-8 and CRP are significantly associated with H. pylori infection and that their combined assessment may enhance diagnostic accuracy. The results support the potential role of IL-8 and CRP as complementary, non-invasive biomarkers for the diagnosis of H. pylori-associated inflammation.
The Biochemical, Physiological, And Clinical Importance of Ceruloplasmin: A Review
Ceruloplasmin is a glycoprotein multicopper oxidase and the main copper transport protein in humans. It is responsible for metal homeostasis, redox equilibrium, and inflammatory response in human plasma. It is produced mainly in the liver and acts as a ferroxidase enzyme that catalyzes the oxidation of ferrous iron to ferric iron, enabling the transport of iron while reducing free radical formation from iron. In this way, ceruloplasmin participates in control of systemic iron homeostasis, antioxidant defense and tissue protection against oxidative damage. Furthermore, as a positive APPs itself, ceruloplasmin is considered the regulator of innate immune response and its circulating levels have been shown to raise during inflammation, infection and tissue injury. The clinical utility of ceruloplasmin testing is well established in the diagnosis and monitoring of disorders of copper metabolism, including Wilson’s disease, with emerging applications in cardiovascular disease and metabolic syndrome, neurodegenerative diseases as well as chronic inflammatory diseases. Changes in the concentration, enzymatic activity and molecular structure of ceruloplasmin correlate with disease severity and prognosis. The aim of this review is to summarize the biochemistry, physiology and clinical implications of ceruloplasmin in view of recent developments and new perspectives relevant to its function as a biomarker and mediator in health a disease.
Speedy Recovery from Transverse Myelitis through Yoga Prana Vidya (YPV) Healing as Complementary Therapy: A Case Study
Background: Transverse myelitis (TM) is a rare neuroinflammatory disorder of the spinal cord, often leading to severe motor and sensory deficits. Conventional treatment involves corticosteroids, plasma exchange, and rehabilitation, with recovery timelines ranging from months to years. Objective: To document the clinical recovery of a 34-year-old female patient diagnosed with TM following integrative Yoga Prana Vidya (YPV) healing interventions. Methods: The patient underwent 89 YPV healing sessions over three months, including psychotherapy, internal organ cleansing, and energy-based spinal regeneration techniques. Clinical progress was tracked through patient feedback and functional recovery milestones. Results: Within one month, the patient regained sensory functions and balance. By the third month, she achieved independent ambulation, normalized menstrual cycles, and resumed daily activities. Recovery was significantly faster than the medical prognosis of 1–2 years. Conclusion: This case highlights the potential role of YPV healing as a complementary modality in accelerating recovery from TM, warranting further controlled studies.
Influence of Individual Factors on The Utilization of Dental Services Among Patients Attending Public Health Facilities in Nairobi City County, Kenya
Background: Approximately 3.5 billion people of all ages and races globally are affected by dental diseases. Overall human health, well-being and quality of life can fundamentally be measure by an individual dental health. Despite the wide distribution of dental diseases, few individuals seek dental care services mostly for treatment. To tackle this problem, the populace requires to utilize health facilities to receive basic preventive services. Objective: This study was carried out to examine the influence of individual factors on the utilization of dental services among patients attending public health facilities in Nairobi City County, Kenya. Methods: A cross-sectional analytical study was conducted among 384 randomly selected respondents using structured questionnaires, and the data were analyzed using the Statistical Package for the Social Sciences (SPSS) and spreadsheet software. Results: Findings indicated sociodemographic factors have no significant impact on the utilization of dental services in public facilities, P-values greater than 0.05 across all variables. Individual preferences, awareness, time availability, perceptions, psychological factors, and health needs are critical determinants in seeking dental services with p-value of 0.001. Individual perceptions significantly guide decision-making in dental care p = 0.001. Individuals’ awareness of dental services offered in county health facilities significantly influence dental service utilization, p=0.001. Statistically significant relationship p=0.045 was observed that general health conditions influence dental care-seeking behaviors. Necessity-driven utilization was significant p=0.001 but barriers like high costs and patients’ busy schedules hamper individuals from seeking timely dental services. Conclusion: Individual preferences, awareness, time availability, perceptions, psychological factors, and health needs are critical determinants in seeking of dental services. Recommendations: Focus should be placed on the key determinants of utilization of dental services – proximity to health facilities, awareness, affordability, and patient satisfaction to enhance utilization. Further Nairobi City County government should prioritize integration of primary dental care into primary health care.
Clinical and Radiographic Assessment of Direct Pulp-Capping Materials: A Comparison of Calcium Silicate-Based and Calcium Hydroxide Based Approaches (A Review)
Background: Direct pulp capping is a critical procedure in endodontics aimed at preserving pulp vitality following exposure due to carious lesions or trauma. The choice of pulp-capping materials significantly influences treatment outcomes, with calcium silicate-based materials, such as mineral trioxide aggregate (MTA) and Biodentine, emerging as promising alternatives to traditional calcium hydroxide. This systematic review aims to evaluate the clinical and radiographic effectiveness of these materials, addressing the need for updated evidence to guide clinical practice. Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library, from January 2000 to October 2023. Inclusion criteria encompassed randomized controlled trials, cohort studies, and systematic reviews that compared calcium silicate-based materials with calcium hydroxide in direct pulp capping. Exclusion criteria included studies not published in English, animal studies, and those lacking relevant clinical outcomes. Data extraction and analysis were performed following PRISMA guidelines, with a focus on clinical success rates, radiographic outcomes, and biocompatibility. Results: A total of 25 studies met the inclusion criteria, comprising 15 randomized controlled trials and 10 cohort studies. The review revealed that calcium silicate-based materials demonstrated a significantly higher clinical success rate (average 83.33%) compared to calcium hydroxide (average 72.5%). Radiographic assessments indicated superior dentin bridge formation and reduced inflammation associated with calcium silicate materials. Notably, gaps in long-term follow-up data were identified, highlighting the need for further research in this area. Conclusion: This systematic review underscores the clinical superiority of calcium silicate-based materials over traditional calcium hydroxide in direct pulp capping procedures. The findings contribute to the growing body of evidence advocating for the adoption of advanced materials in endodontic practice, emphasizing the importance of material selection in enhancing patient outcomes. Future research should focus on long-term efficacy and the integration of advanced imaging techniques to further substantiate these findings.
Evaluation Of IL-6 And IL-8 In the Saliva of Patients with Type II Diabetes Mellitus After Tooth Extraction
Type II diabetes mellitus (T2DM) is characterized by chronic low-grade inflammation and impaired wound healing, which may have undesirable effects on the outcomes of oral surgery. The expression of proinflammatory cytokines, including IL-6 and IL-8, is fundamental in immune regulation and for tissue damage or recovery. The purpose of the present investigation was to measure salivary IL-6 and IL-8 in patients with type II diabetes mellitus before and after undergoing tooth extraction, as well as in a control group of systemically healthy individuals. This was an observational case–control study that was performed at the college of dentistry university of Kufa, Al-Najaf, Iraq from April 2025 to December 2025. Sixty individuals participated in the study, including 30 T2DM patients and 30 gender- and age-matched healthy controls. Unstimulated whole saliva was collected one hour before extraction and two days after extraction. Enzyme linked immunosorbent assay (ELISA) was used to determine the levels of IL-6 and IL-8 in saliva. The statistical analysis between the two groups was analyzed by independent-samples and paired t-test with P < 0.05 considered as significant. At baseline, the concentrations of salivary IL-6 and IL-8 was significantly higher in patients with T2DM compared to controls (P < 0.05). Both cytokines were significantly elevated (P < 0.001) when compared with the basal values in diabetics on day 2 following tooth extraction; this difference was still statistically significant from that observed in controls (P < 0.05). Type II diabetes mellitus patients have a high salivary level of IL-6 and IL-8 at the baseline and an exaggerated response to inflammation after tooth extraction. These results indicate that diabetic patients have a chronic inflammatory phase, which might affect the ability to heal wounds. Salivary IL-6 and IL-8 can be potentially useful, non-invasive biomarkers for monitoring POI in T2DM patients.
Clinical Advantages and Negative Consequences of Dental Veneers: A Review
Despite the widespread use of dental veneers within contemporary esthetic dentistry as a restorative treatment option capable of masking imperfections of the dental appearance with little tooth structure loss, there has not been an attempt to identify and evaluate dental veneers within the dental literature along the lines of evidence-based benefits and harms with a clear clinical focus. Clinical benefits of veneers consist of superior aesthetic results, superior tp color stability, optimal tooth form and ideal patient acceptance especially if conservative preparation designs are used in conjunction with contemporary ceramic materials. A classic illustration of the strengths of these materials would be lithium disilicate or feldspathic ceramics; they retain excellent optical properties and demonstrate the best long-term survival when bonded appropriately to enamel. However, dental veneers have their complications. Adverse effects may include irreversible loss of enamel, dentine hypersensitivity, marginal staining, fracture of the ceramic, debonding, and inflammatory reaction of the periodontal tissues, especially in case of inadequate case selection or over-preparation. Based on this, biological risks such as pulp irritation or long-term restorative dependence should also be evaluated, especially in young patients with an intact dentition. Introduction Occlusal overload, parafunctional habits, and inadequate bonding protocols are frequently implicated in mechanical and technical failures of fixed partial dentures (FPDs). Conservative treatment planning, an accurate diagnosis, and a patient-centered approach play an important role in achieving favorable clinical outcomes and preventing adverse effects, as summarized in this review. Dentists need to be mindful of both the pros and cons of dental veneers to ensure reliable esthetic results while still protecting healthy teeth for years to come.
Vaccination and Its Effects on Long COVID-19 Prevalence, Severity, and Clinical Outcomes: A Literature Review
Long COVID is a heterogeneous condition characterized by persistent symptoms following SARS-CoV-2 infection and represents an important public health concern. COVID-19 vaccination has been widely implemented, yet its association with long-term post-COVID outcomes remains incompletely understood. This narrative review summarizes current evidence on the relationship between COVID-19 vaccination and Long COVID, focusing on prevalence, symptom severity, and clinical outcomes. Available studies suggest that vaccination may be associated with a lower risk of Long COVID and reduced symptom burden in breakthrough infections, although findings are variable across populations and study designs. Age and pre-existing comorbidities consistently emerge as relevant factors that may influence observed associations. Overall, existing evidence supports a potential protective association of vaccination with Long COVID outcomes, while emphasizing the need for further longitudinal studies with standardized definitions and outcome measures.
The Impact of Sex Hormones on Physiological Alterations and Severity of Asthma
Sex hormones, including estradiol, progesterone and testosterone recently have been recognized as modulators of airway inflammation and immune responses, but currently it remains a poorly defined association between sex hormones and severity of asthma. The objective of this study was to investigate the serum levels of estradiol, progesterone and testosterone in asthmatic patients and their association with disease severity. A cross-sectional case–control study was carried out on 88 asthmatic patients, diagnosed according to the Global Initiative for Asthma (GINA) and 62 healthy controls of similar age and sex. Patients who had endocrine disease or chronic systemic disease were excluded. Serum estradiol, progesterone and testosterone levels were assessed by enzyme-linked immunosorbent assay (ELISA). Serum estradiol levels were higher in asthmatic patients than in controls (72.4 ± 18.6 vs. 58.1 ± 14.3 pg/mL, P < 0.002). Patients also had increased levels of progesterone (1.89 ± 0.54 vs 1.32 ± 0.41 ng/mL, P < 0.003), and decreased testosterone (392.6 ± 110.8 vs 465.3 ± 124.5 ng/dL, P < 0.04). Stratification by disease severity showed significant differences in estradiol (P =0.033) and testosterone (P =0.001), both were highest in severe asthma and the lowest for testosterone was found in severe asthma. There was no difference in progesterone concentrations by severity (P = 0.075). There was a strong negative correlation between testosterone and estradiol (r = −0.41, P<0.01). Changes in sex hormone profiles are related to the prevalence of asthma and severity of its clinical expression, implying a causative role in the pathophysiology of asthma. These results indicate a need for further longitudinal and mechanism-based studies on sex hormones as candidate biomarkers in the pathophysiology of asthma.
Association Between Stress Hormones and Menopausal Symptoms in Iraqi Postmenopausal Women
There is increasing evidence that dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis may play a role in the etiology and severity of symptoms of menopause but the data are scarce regarding stress hormones in postmenopausal women with limited data from Middle Eastern population. The aim of this study was to examine serum levels of cortisol, ACTH, and DHEA and their associations with menopausal symptoms in postmenopausal women in Iraq. We used a cross-sectional comparative design including 68 postmenopausal women and 42 age-matched premenopausal controls. The information regarding menopausal symptoms was obtained via structured questionnaires, meanwhile, serum cortisol, ACTH, and DHEA concentrations were measured by enzyme-linked immuno-sorbent assay (ELISA). Cortisol in postmenopausal women had significantly higher concentrations of cortisol (18.6 ± 4.2 µg/dL vs. 13.9 ± 3.6 µg/dL, P < 0.02) and ACTH (46.3 ± 10.8 pg/mL vs. 38.1 ± 9.4 pg/mL, P < 0.03), along with significantly lower concentrations of DHEA (88.21 ± 12.3 µg/dL vs. 95.4 ± 18.9 µg/dL, P < 0.017), compared with premenopausal women. Postmenopausal participants experienced significantly higher prevalence of menopausal symptoms, especially hot flashes (78.0%), sleep disturbances (69.1%), and mood disturbances (64.7%). Hot flashes (P=0.02; P=0.01), sleep disturbance (P=0.03; P=0.04), and mood disturbances (P=0.04; P=0.02) were significantly associated with elevated cortisol and ACTH levels, respectively. By contrast, lower DHEA was independently associated with lack of libido (P = 0.001) and vaginal dryness (P = 0.03). Such stress hormone imbalance is associated with menopausal symptomatology, which suggests that stress-related hormonal assessment should be included to the bedside evaluation of postmenopausal women.
Bacterial Biofilm Virulence on Hospital Plastic Surfaces: Mechanistic Insights, Persistence Drivers, and Infection Control Challenges
The establishment of bacterial biofilms on plastic surfaces has become increasingly recognized as an important, yet understudied, contributor to the persistence of pathogens in clinical and community settings. The wide use of polymers, like polyethylene and polypropylene, in the manufacturing of medical devices and high-contact surfaces inside hospitals creates physicochemical interfaces that promote bacterial adhesion and biofilm development. In contrast to metals or glass, however, plastics contribute to hydrophobic and electrostatic deposition, rapid accumulation of host-derived proteins, and metabolic zonation in biofilm depth with an increased tolerance against antimicrobials while supporting long-term survival in the environment. Surface sensing of polymers is also a heterotypic signal that activates bacterial virulence programs and induces expression of toxins, proteases, hemolysins, siderophores, and motility determinants, which are in turn correlated with phenotypes for chronic infection. Biofilms aged on plastics serve as pathogen dissemination reservoirs by active dispersion, which leads to secondary infections and adds difficulty in infection control. Conventional disinfection modalities are mainly ineffective owing to the inadequate penetration of antimicrobials into EPS matrices and fast resurface recolonization. New developments illustrate the possibility of biofilm-aware interventions such as anti-adhesive materials designs, enzyme/peptide-coated surfaces, quorum-sensing inhibitors, phage-based therapies, UV-C exposure, and plasma treatments, as well as the manufacture of inherently antimicrobial/biocompatible/sustainable polymer alternatives. This review integrates existing mechanisms, clinical risk, and emergent infection preventive technologies, proposing that the next-generation biosafety guideline should ultimately center on the polymer–microbe–altitude of virulence axis to constrain biofilm resilience and inhibit pathogenic switching event upon plastic medical device surfaces.
Histological Changes of Skin Induced with Psoriasis and Treated with Aloe Vera Gel in Rats
Psoriasis is a common chronic immune-mediated inflammatory skin disease with features of epidermal hyperproliferation and infiltration of leukocytes. The current work was performed to assess the histopathological changes of imiquimod (IMQ) induced psoriatic skin lesions and investigate the beneficial therapeutic targets after topical application of Aloe vera (AV) gel in experimental rats. A total of 24 male Wistar albino rats were divided into four groups: G1 (healthy control), G2 (psoriasis-induced control), G3 (psoriasis + AV gel treatment), and G4 (psoriasis + Tazarotene treatment). Histological analysis revealed that AV gel significantly reduced keratosis, acanthosis, and perivascular inflammation, comparable to the standard Tazarotene treatment. The stratum corneum thickness was significantly decreased in treated groups. These findings suggest that AV gel holds promise as a natural therapeutic option for psoriasis management.
A Case Series of Different Dermatological Adverse Drug Reactions Attending the Medical Oncology Clinic of a Tertiary Care Hospital Eastern India
Background: Cutaneous adverse drug reactions (CADRs) are among the most frequent complications of anticancer therapy, affecting the skin, hair, nails, and mucosa. Both conventional cytotoxic chemotherapies and newer targeted agents are associated with a wide spectrum of dermatological toxicities that may impair quality of life and lead to dose modification or treatment discontinuation. Continuous pharmacovigilance is essential for early detection and appropriate management of these reactions as the safeguard of health by ensuring that the benefits of the use of the anticancer drugs outweigh the risk associated with its use. Objectives: To document and analyze the spectrum of dermatological adverse drug reactions in cancer patients receiving chemotherapy and targeted therapies at a tertiary care hospital in Eastern India, and to emphasize the role of pharmacovigilance in improving patient outcomes. Methods: This case series included ten patients who developed cutaneous adverse drug reactions while attending the Medical Oncology Clinic of a tertiary care hospital in Kolkata. Clinical details, suspected drugs, temporal association and dermatological manifestations were recorded. Causality assessment of the adverse events was performed based on clinical correlation and temporal relationship with drug administration. Results: Among the ten cases, females predominated (n=6). Five patients were above 40 years of age, while five were in the pediatric age group. Frequently implicated drugs included Paclitaxel, Capecitabine, L-asparaginase, Vincristine, Docetaxel, Doxorubicin, Cyclophosphamide, Daunorubicin, and Azacitidine. The observed CADRs comprised nail hyperpigmentation, palmoplantar hyperpigmentation, alopecia, oral ulcers, hyperpigmented plaques, skin nodules, acanthosis. Most reactions were non-life-threatening but contributed to patient distress and potential treatment interruptions. Conclusion: Cutaneous adverse drug reactions represent a significant proportion of adverse events associated with anticancer therapy. Early recognition, timely intervention, and close collaboration between oncologists and dermatologists are crucial to minimize morbidity and ensure treatment adherence. Strengthening Pharmacovigilance systems and maintaining robust ADR databases will enhance detection of emerging drug safety signals and optimize cancer patient care.
Laboratory Investigations in Patients with Hypothyroidism and Compared with Healthy Control Group in Baquba Teaching Hospital
Background: One of the utmost prevalent endocrine disorders is hypothyroidism, which can reason moderate symptoms like depression, cold sensitivity, fatigue, and weight gain, as well as further severe one’s alike myxedema and mortality. Objective: To assess the laboratory investigations in patients with hypothyroidism and compared with healthy control group in Baquba Teaching Hospital. Method: Cross sectional study was fixed amongst 90 individuals (60 patients with hypothyroidism and 30 healthy control) from Baquba Teaching Hospital, Diyala. The study was finished in the dated from December 2024 to February 2025. We estimated thyroid function (T3, T4, TSH) and hematological analysis (WBC, RBC, and platelets count) to find the relationship between them and compared with healthy control. Results: The results exhibited count of WBC in patients’ group was statistically non-significant lessened as associated with control group. The RBC count displayed enlarged level in control group as associated to patients with statistically exposed no significant connection. The platelets count presented enlarged level in control group as related to patients with statistically exhibited no significant connection. The results illustration Mean ±SE of platelets counts in patient’s male more than in female with statistically significant relationship. The patients were separated into three age groups, (<40 years), (40-50 years) and (>50 years) and all hematological analysis were divided into the age groups. It was shown through the statistical results that age does not affect the results of the hematological test. Conclusion: The study found that thyroid issues affect women more often than they do men. It is crucial for hematological testing on hypothyroid patients.
The Classification of Carbapenemase Genes and Their Role in Bacterial Antimicrobial Resistance: A Review
Antimicrobial resistance (AMR) is a significant worldwide health problem caused by antimicrobial overuse and misuse in different sectors, resulting in the appearance of resistant microbes. Other concerning is the concurrent emergence of dual carbapenem-colistin resistance, defined as no efficacy by both antibiotics that are reserved to treat life-threatening infections due to multidrug-resistant enterobacteriaceae. Carbapenemase genes encode β-lactamase enzymes capable of hydrolyzing carbapenems and other β-lactam antibiotics, offering high-level resistance and promoting treatment failure. This review focuses on molecular features, classification and pathogenic significance of the main carbapenemase genes in clinically important bacteria through data until October 2023. Carbapenemases are mainly classified into Ambler classes A, B, and D including major enzymatic family like KPC, OXA, IMP, VIM, and NDM type carbapenemases. the genes that encode carbapenemases often reside on mobile genetic elements that can be transferred horizontally at a high rate between bacterial species and are responsible for spreading carbapenem resistance globally. Besides their well-characterized links to antimicrobial resistance, emerging data suggest that carbapenemase genes can also influence bacterial pathogenesis through increased survival in the presence of antibiotic selective pressure, biofilm formation and co-transfer of virulence-associated determinants. It also emphasizes the clinical manifestations of infections with carbapenemase-producing pathogens, which are linked with increased morbidity and mortality, prolonged length of stay and greater healthcare costs. In line with observations made in some bacterial lineages, the co-existence of resistance and virulence traits highlights an urgent need to improve molecular surveillance, rapid diagnostic tools and efficient strategies for infection prevention. In addition, understanding the complex interactions between carbapenemase gene expression and bacterial fitness and host–pathogen dynamics is important for developing new therapeutic and preventive measures. There are many factors that facilitate the pathogenesis and antibiotic resistance of these organisms. To overcome this escalating public health challenge, it will then require integrated approaches between molecular epidemiology, antimicrobial stewardship and novel therapeutic strategies that together will alleviate the burden of carbapenemase-producing organisms on global health.
Detection of Blandm And Blaoxa-23 Genes in Acinetobacter Baumannii Isolated from Sputum Samples of Iraqi Patients
Acinetobacter baumannii is a pivotal pathogenic bacterium causing hospital-acquired respiratory infections, particularly in critically ill patients, and its prevalence of multidrug-resistant strains has increased globally. Two of the most relevant carbapenemase genes from a clinical standpoint is blaOXA-23 and blaNDM which are highly involved in conferring resistance to carbapenems in A. baumannii. The aim of this study was to investigate the prevalence of the blaOXA-23 and blaNDM genes in A. baumannii isolates isolated from sputum samples obtained from Iraqi patients, and whether these genes were associated with patterns of resistance to specific antibiotics. This is a cross-sectional study performed in the Teaching Hospital in Al-Diwaniyah City, Iraq during March 2025 to August 2025. A total of 48 patients with a clinically suspected lower RTI were recruited. Sputum aspirates were obtained under aseptic conditions and processed by standard microbiological procedures. A. baumannii was identified by colony morphology, Gram staining and standard biochemical testing. The susceptibility testing for imipenem, meropenem, amikacin gentamicin ciprofloxacin ceftazidime and piperacillin–tazobactam (p-t) were performed by the Kirby–Bauer disk diffusion according to the CLSI. Molecular identification of blaOXA-23 and blaNDM genes was done by conventional polymerase chain reaction (PCR). High resistance rates were also noted for carbapenems, imipenem (87.5%) and meropenem (85.4%). Resistance was also high for ceftazidime (81.3%) and piperacillin/tazobactam (79.2%), which were much lower in case of aminoglycosides. Molecular investigation indicated that blaOXA-23 and blaNDM genes were observed in 83.3% and 37.5% of the isolates, respectively. The link between resistance to carbapenems and the simultaneous presence of blaOXA-23 and blaNDM genes was strongly significant. These observations show high rates of blaOXA-23 but still considerable rates of blaNDM enzymes among CRAB isolates in Al-Diwaniyah, and highlight the necessity for regular molecular surveillance, proper infection control measures and improved antimicrobial stewardship policies to prevent expansion of MDR A. baumannii strains.
Treatment and Incidence Rate of Tuberculosis in Diyala Province
Background: Tuberculosis (TB), a chronic granulomatous infection produced by the obligate aerobe, slow-growing, acid-fast bacillus (AFB) Mycobacterium tuberculosis, owns a lipid-rich cell wall (mycolic acids, lipoarabinomannan) that delivers resistance to antibiotics and phagocytosis. Objectives: To evaluate the Incidence rate of tuberculosis in Diyala province Patients and methods: The study is a cross-sectional analysis directed in Diyala province, Iraq, between November 2024, and February 2025, concerning 713 TB patients (69 males and 71 females). The study fixated on gender distribution, TB types (pulmonary and extrapulmonary), and treatment consequences, with 691 patients recovering, 17 deaths, and 5 treatment failures. Statistical analysis was accomplished using Microsoft Excel and SPSS, applying descriptive statistics to analyze patterns in the data. Results: The study results designate a higher prevalence of tuberculosis (TB) amongst females (58%) associated to males (42%). The primary causes of TB cases were the general healthcare sector (381 cases), followed by the private sector (208 cases), direct reporting (111 cases), and prisons (13 cases). In relations of treatment regimens, most patients (657) usual Cut 1, which comprised isoniazid, rifampin, pyrazinamide, and ethambutol, while only 56 patients usual Cut 2, which involved of the same drugs with the addition of streptomycin. Conclusion: This study describes the trends of tuberculosis (TB) incidence, treatment distribution and patient outcome in the province of Diyala. The results show that TB is predominantly pulmonary; with the males having a higher prevalence of TB, and TAC is influenced by the male population
Histological Alterations, Diagnosis and Therapeutic Approaches of Colorectal Cancer: A Review Article
Colorectal cancer (CRC) is one of the most common cancers and a major public health burden leading to cancer-related morbidity and mortality throughout the world. Its induction is a multistaged process which includes genetic and epigenetic mutations, and complicated environmental/lifestyle interactions. Histologically, CRC is mainly adenocarcinoma that develops from dysplastic transformation of the colonic epithelium and has known variants which affect prognosis and response to treatment. The cumulative effect of architectural distortion, cellular irregularities, invasive extension beyond muscularis mucosae and through the surrounding lymphovascular channels to form metastases describes disease progression. Early diagnosis is paramount for survival. Diagnostic work up includes screening tools, including fecal occult blood test and colonoscopy, followed by histo-pathological diagnosis and radiologic staging. Molecular diagnostics for mutation analysis and microsatellite instabilty status have provided additional clarification to categorization and treatment strategy in recent years. Therapies for CRC are dependent on the stage, as local disease is resected surgically and treatment there-after administered. The introduction of adjuvant and neo-adjuvant systemic chemotherapy, radiotherapy (especially for rectal cancer), new targeted biologic agents, and as of late immune therapy have transformed the management of both metastatic and locally advanced disease. Identification of target therapy according to the molecular tumor profile is essential to patients who respond to this treatment. In conclusion, the histopathological features of CRC and early diagnosis options and modern therapeutic opportunities should be combined to best control colorectal cancer as well as additional new research approaches in response to worldwide diseases.
Prevalence and Risk Indicators of Orofacial Trauma and Mouthguard Awareness Among Youth Water Polo Players
Background: Sports-related orofacial injuries are common among young athletes, and water polo carries a moderate risk for dental trauma. However, awareness of emergency management and mouthguard use remains limited. Objectives: This study evaluated the prevalence of dental and orofacial trauma, avulsion management awareness, and attitudes toward mouthguard use among junior male water polo players in Istanbul. Methods: A cross-sectional survey was conducted among 80 male athletes (8–18 years) from three youth water polo clubs in Istanbul using a structured 19-item questionnaire. The survey evaluated trauma history, avulsion management awareness, and mouthguard use. Data were analyzed using chi-square tests (p<0.05). Results: Eighty athletes were included (response rate: 94.1%). The most common orofacial injury was bruising (81.3%), followed by lip/tongue injuries (48.8%), with no reported avulsion cases. Dental trauma occurred more frequently during training (45%) than matches (13.8%) and contact with other players (52.5%) was the leading cause. Injury type was significantly associated with age group (p=0.0056) and weekly training time (p=0.00795), but not with years of experience (p=0.352). Awareness of avulsion management was low, and although 67.5% were aware of mouthguards, none reported using one. Conclusions: Junior water polo players in Istanbul demonstrated limited awareness of dental trauma management and no reported use of mouthguards. Greater exposure time was associated with trauma risk, while the absence of mouthguard use despite existing awareness indicates a substantial preventive gap.
Comparative Study of frozen Section with Histopathology of Primary Site in OSCC
Background: Oral squamous cell carcinoma (OSCC) is largely a disease of older adults, occurring most commonly in patients older than age 45. Surgery was a principal modality of treatment and gaining microscopically negative resected margins are possible the most significant prognostic factor for a patient with a head and neck squamous cell carcinoma (HNSCC) and accordingly Frozen section (FS) evaluation was used to confirm negative margins. Aim of study: To compare the accuracy of frozen section FS with permanent histological examination of the same primary site margins and to improve the validity of FS during intra-operative operations. Methods: The researchers reviewed frozen section examination of the resection surfaces of 13 patients surgically treated for oral squamous cell carcinoma during the period October 2020 to October 2021 when close or positive margins was present at the resection surface, re-resection 0.5 cm was performed. Then after final histopathological study obtained, we compare it with FS result to evaluate the accuracy of FS. Results: A total of 39 margins were evaluated from 13 individuals. With a p value of 0.001, all margins exhibited highly significant concordance with the permanent section of the same tissue sample. Conclusion: Frozen section histopathological study data, sensitivity, specificity and accuracy, showed highly significant p value result which improve its validity intraoperatively this result was confirmed by permanent histopathological study.
Lung Cancer Detection and Diagnosis in Babylon Governorate by Gender and Age Group
Lung cancer is one of the global health problems that has a high incidence and mortality rate. Particularly, it is one cancer that comes under strong effect of age, sex and lifestyle. This study included lung cancer as Babylon Governorate in terms of age groups and sex of the study, and the most important risk factors and methods of diagnosis are seen. Abstract This study has cross sectional design, this study was done in some of the hospitals of Babylon Governorate. Results: The results of the present study showed that the study population consisted of 160 lung cancer patients (120 males, 40 females) with mean age of 62.3 years. The risk factors and clinical symptoms were examined after stratifying the cases according to age and sex. The results showed that the rate of lung cancer was higher in males than females and significantly increased with increasing age. Smoking was the most common risk factor followed by being around chemicals at work and pollution in the environment. The main symptoms found were persistent cough and respiratory problems and chest pain, which resulted in late-stage medical consultations. Diagnosis was accomplished using a combination of methods ranging from chest radiography to computed tomography (CT) imaging to tissue biopsies. The results of the study highlight the importance of detecting lung cancer early, especially among older people and smokers, due to the significant influence of this on the efficacy of the therapeutics and the reduction of adverse effects. Furthermore, the research calls for the improvement of health education programs and the adoption of wider screening programs to help reduce the impact of this disease on society.
Epigenetic Regulation and Metabolic Adaptation in the Emergence of Multidrug Resistance Among Clinically Significant Gram-Negative Pathogen
The swift development of multidrug-resistant (MDR) Gram-negative microbes has emerged as a key health problem in the world, greatly reducing the efficacy of the available antimicrobial treatments. Among the most designable effective pathogens that cause severe healthcare-associated and community-acquired infections, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii can be named. Historically, genetic processes, such as horizontal gene transfer, chromosomal mutation, enzymatic inactivation of antibiotics, and overexpression of efflux pumps, have been recognized as the major causes of antibiotic resistance in these organisms. Nevertheless, there is increasingly strong evidence of a significant role of non-genetic regulatory mechanisms in controlling adaptation and survival of bacteria to antimicrobial pressure. In the recent past, research on epigenetic regulation and metabolic adaptation has been noted as critical factors in the development and maintenance of MDR in Gram-negative pathogens. Flexible gene expression in bacteria is made possible through epigenetic processes, such as DNA methylation, phase variation, and nucleoid-associated protein activity, but does not change the genome sequence. These processes bring about simple and reversible phenotypic alterations in bacteria, which enables the populations to produce phenotypic diversity and increase their ability to endure the environmental exposure as a consequence of antibiotic exposure. Simultaneously, metabolic adjustment has also been much more highly appreciated as a pivotal determinant in bacterial tolerance and resistance towards antibiotics. When exposed to antimicrobial agents, significant changes are commonly induced on the central metabolic pathways, such as carbon metabolism, energy production, and oxidative stress responses. Such metabolic changes may affect the growth rate of bacteria, the cellular dynamics, and the membrane dynamics, which have an eventual impact on antibiotic susceptibility. Moreover, the metabolic reprogramming can also enhance the development of persister cells, subpopulations with a transient antibiotic tolerance, which can lead to the long-term expansion of stable resistance in the form of long-term mechanisms. Critically, metabolic processes and epigenetic regulation are thought to be very linked. The expressions of genes in metabolic pathways can be regulated by epigenetic modifications and intracellular metabolic states may affect epigenetic regulation systems via the provision of important metabolites. This bidirectional interaction creates a complicated regulatory network that increases the adaptability of bacteria to the antibiotic pressure and is favorable to the emergence of multidrug resistance. The purpose of the review is to obtain a complete picture of the present-day knowledge on epigenetic regulation and metabolic adaptation of clinically significant Gram-negative bacteria and their contributions to the development of multidrug resistance. Besides, the therapeutic implications that have been discussed in the review with regard to targeting these regulatory systems and emerging strategies that could play a role in the development of novel antimicrobial interventions are discussed. Better insight into these processes can possibly be used to discover new methods to address MDR infection and enhance the efficacy of future antimicrobial treatment.
Adequacy of Radiographic Reportage in Endodontic Treatment: A Retrospective Review from a Teaching Hospital in Southwest Nigeria
Background: Understanding the patterns of documentation among endodontic caregivers, ranging from students and registrars to consultants, can provide valuable insights into systemic strengths and weaknesses within dental service delivery frameworks. Objective: This study evaluated the adequacy of radiographic documentation in endodontic treatment, assessing the frequency of preoperative, intraoperative, and postoperative radiographs, and determining factors associated with adequate reportage. Methods: A retrospective review was conducted on 357 patient records treated for endodontic conditions at a tertiary dental hospital. Data extracted included demographic variables, designation of the attending caregiver, radiographic documentation, diagnosis, and treatment type. Adequacy of radiographic reportage was defined by inclusion of the coronal surface, apical structures, periodontal ligament space, and canal patency in the recorded findings. Descriptive and inferential statistics, including chi-square tests, were performed at a 5% significance level. Results: Patients were predominantly aged 20–29 years (25.2%) and female (56.0%). Most treatments were rendered by registrars (88.2%). Although 96.9% of cases had preoperative radiographs, and 88.5% and 85.7% had master cone and obturation radiographs respectively, only 16.2% of records met the criteria for adequate documentation. Acute apical periodontitis (36.4%) was the most common diagnosis, and conventional root canal therapy accounted for 86.8% of treatments. The association between caregiver designation and adequacy of radiographic documentation was not statistically significant (p = 0.287). Conclusion: While radiographs were widely utilized in endodontic care, comprehensive documentation was suboptimal. Structured training and adherence to documentation protocols are essential to improve radiographic reporting standards and ensure medico-legal accountability in clinical practice.
Evaluation of Erosive Durability in Dental Microchannels Sealed Using Various Sensitivity-Reducing Agents
Dentin hypersensitivity remains a prevalent clinical condition characterized by short, sharp pain arising from exposed dentinal surfaces in response to external stimuli. The occlusion of dentinal microchannels has emerged as a primary therapeutic strategy for mitigating hypersensitivity. However, the long-term effectiveness of such treatments is challenged by erosive conditions within the oral environment, particularly exposure to acidic agents. This study evaluates the erosive durability of dental microchannels sealed using different sensitivity-reducing agents, with a focus on their resistance to acid-mediated degradation. A comprehensive in vitro experimental design was developed to simulate clinical conditions, incorporating widely used desensitizing agents including bioactive glass formulations, potassium nitrate-based compounds, oxalate-based agents, and nanohydroxyapatite systems. The treated dentin samples were subjected to controlled acidic challenges to assess the integrity of microchannel occlusion. Scanning electron microscopy (SEM) and quantitative image analysis were employed to evaluate structural changes, degree of occlusion, and resistance to erosive dissolution. Findings indicate significant variation in erosive durability among the tested materials. Bioactive glass and nanohydroxyapatite-based agents demonstrated superior resistance due to their remineralization potential and ability to form stable mineral deposits within dentinal microchannels. In contrast, potassium nitrate-based formulations exhibited limited structural stability under acidic exposure. Oxalate-containing compounds showed moderate resistance but were susceptible to gradual dissolution. The study underscores the importance of material composition and mechanism of action in determining long-term clinical efficacy. It highlights the need for developing advanced desensitizing systems with enhanced resistance to erosive challenges. The findings contribute to evidence-based clinical decision-making and provide a foundation for future research in improving therapeutic outcomes for dentin hypersensitivity.
Knowledge Levels Regarding Urgent Health Situations and Readiness Among Predoctoral Oral Health Trainees at an Advanced Care Center in West Africa
Medical emergencies in dental settings, though relatively infrequent, pose significant risks to patient safety and require immediate, competent intervention. Predoctoral oral health trainees represent a critical workforce segment within teaching institutions, where clinical exposure increases the likelihood of encountering urgent health situations. This study investigates knowledge levels and preparedness among undergraduate clinical dental students in a tertiary care institution in West Africa, with a focus on cognitive understanding, practical readiness, and systemic training adequacy. A structured analytical framework was employed to evaluate theoretical knowledge, clinical competence, and perceived confidence using insights synthesized from existing empirical studies. The study integrates findings from cross-sectional surveys, observational analyses, and educational assessments documented across diverse geographical contexts, including Nigeria, Brazil, India, and the United States. Key variables include recognition of medical emergencies, decision-making capacity, response protocols, and prior training exposure. Findings reveal a persistent gap between theoretical awareness and practical preparedness. While most trainees demonstrate basic recognition of common emergencies such as syncope, hypoglycemia, and cardiac arrest, their ability to implement appropriate interventions remains inconsistent. Training deficiencies, limited hands-on simulation exposure, and lack of standardized emergency protocols contribute significantly to these gaps. Comparative analysis suggests that structured training programs and recurrent simulation exercises are positively associated with higher preparedness levels. The study underscores the need for curriculum reform emphasizing competency-based emergency management training. It further highlights institutional responsibilities in equipping students with both cognitive and procedural readiness. The implications extend to patient safety, healthcare quality, and professional competency development. This research contributes to the growing discourse on clinical preparedness in dental education and offers evidence-based recommendations for enhancing emergency management training frameworks in developing healthcare systems.
The Utility of Serum CD152 Concentration as a Differential Biomarker in Hashimoto's Thyroiditis
Background: Hashimoto's disease is an autoimmune disorder that affects the thyroid gland. The thyroid gland, shaped like a butterfly, is located at the base of the neck, directly beneath the Adam's apple. The thyroid produces hormones that help to regulate a variety of body processes. An autoimmune illness occurs when the immune system attacks healthy tissues. In Hashimoto's disease, immune system cells cause the death of thyroid hormone-producing cells. Hypothyroidism is a common consequence of the condition. Objectives: Aim of study is to investigating the levels of CD152 and its correlation TSH, T3 and T4 to provide the reference for the diagnosis of Hashimoto's. Materials and Methods: This study included (80 patients “40 males and 40 females” with Hashimoto's and 40 healthy persons as control group). Five ml of blood were taken from all to assess T3, T4, TSH, Vitamin D and CD152 according to procedures that provide with kits. By SPSS v.29, all data were analyzed at P value equal or less than 0.5. Results: The level of CD152 is higher in female group when compare with male group P- value 0.05, the ROC carve show the CD152 is greater than vitamin D and TSH and more specific to distinguish between the groups, In Hashimoto's thyroiditis patients, there was a link between CD152 and thyroid function tests. Conclusion: It was concluding CD152 is depend alone is a novel biomarker to HT diagnosis, in addition there is correlation between CD152 and TSH, T3, T4.
Incidence of Injuries in Inferior Alveolar Nerve After Surgical Removal of Mandibular Third Molar. Prospective Study
Background and objective: Inferior dental alveolar nerve injury is a recognized complication of mandibular third molar surgery, potentially resulting in sensory disturbances such as paresthesia and numbness in the lower lip and chin. Our study is aimed of to evaluate the incidence of IAN injury following surgical removal of third molar and to assess its management and outcomes. Material and Method; Our study was involved surgical extraction of lower wisdom tooth for hundred patients. Preoperative assessments radiographically & clinically were accomplished. Around six months postoperative follow up period for any changes in neurosensory feeling for patients, with recording duration and management of I. A. N. injury. Results; Factors of endanger represented in near proximity and deep impaction that making the roots in or around the mandibular canal, were resulted in permanent harm or damage persist after six months in four percent ((4%)) among the total number of 100 patients involved in the study. Transient effect or symptom of postoperative nerve harm/injury was clear in eight percent ((8%)) of patients among 100 case, were the symptom was solved and disappear within 3 months. Conclusion; Surgery of the lower wisdom tooth stay accompanied with nerve harm or injury of inferior alveolar nerve. Effects could be temporary ((transient)) or permanent deficit which involve small ratio among patients. The essential keys for decreasing the incidence of nerve deficit/injury beside enhancing sequelae, were achieved by focusing on early/premature intervention, preoperative radiograph, and congruent surgical procedure.
Epitranscriptomic Remodeling of N6-Methyladenosine (m6A) RNA Marks in CRISPR-Edited Genomes: Emerging Implications for Off-Target Genetic Instability and Precision Gene Therapy
With the advent of epitranscriptomics, there is the addition of a regulatory layer of control over gene expression which goes beyond DNA sequence and chromatin-based regulation and encompasses dynamic chemical RNA modification. Of these N6-methyladenosine (m6A) is the most common interior modification of eukaryotic messenger RNA (mRNA) and is crucial in maintaining RNA stability, splicing, nuclear export, and translational efficiency. M6A deposition, removal and functional interpretation are regulated by an extensive system of methyltransferases (writers), demethylases (erasers) and RNA-binding proteins (readers), which allow a rapid and reversible regulation of gene expression in response to cellular signals. Simultaneously, the emergence of CRISPR-Cas genome editing technologies has transformed the field of molecular biology and provided a new opportunity in the field of precision gene therapy. Although significant focus has been placed on the conceptualization of off-target DNA mutation and genomic instability, the consequences of genome editing on RNA layers of control, and especially, the epitranscriptomic changes have not been fully investigated. Recent data indicate that, following the formation of CRISPR-induced DNA double-strand breaks and the ensuing activation of DNA damage response pathways, the global state of cells can be changed, with a potential impact on m6A deposition patterns, including: chromatin remodeling, transcriptional reprogramming, and stress signaling. This review offers the highest possible idea of the m6A epitranscriptomic environment and its regulatory apparatus, and then a deeper discussion of CRISPR-Cas systems and the cellular reactions related to it. We make the mechanistic case of the interaction between genome editing and m6A remodelling, and how the transcriptional dynamics and RNA-binding protein activity perturbation can cause transcriptome-wide changes in m6A distribution. We also compare the existing methods of m6A modifications detection, their advantages, and shortcomings, and address their possibilities of use in CRISPR-based research. Notably, we discuss the consequences of the CRISPR-based epitranscriptomic variability to precise gene therapy, in which unintended RNA-level regulatory alterations can influence treatment safety, efficacy and reproducibility. Combining the findings of RNA biology, genome engineering, and high-throughput sequencing technologies, this review highlights the importance of taking into consideration epitranscriptomic measurements in genome editing models. The interaction between the CRISPR systems and m6A regulation will need a better insight, as it will be the key to more precise and safer therapeutic approaches.
Efficiency and Stability of Gummy Smile Correction Using a Minimally Invasive Technique
Background: Excessive gingival display (gummy smile) represents a common esthetic concern and a therapeutic challenge in oral and maxillofacial surgery. Its etiology may include vertical maxillary excess, dentoalveolar extrusion, short upper lip, hyperactivity of the upper lip elevator muscles, or altered passive eruption. Various surgical and non-surgical treatment modalities have been described. An evaluation of a minimally invasive surgical approach based on selective myotomy and detachment of the upper lip elevator muscles is presented. Objective: To assess the efficiency and stability of gummy smile correction using selective myotomy of the upper lip elevator muscles (levator labii superioris, zygomaticus major, and zygomaticus minor) with repositioning of muscle fibers near the anterior nasal spine. Materials and Methods: This prospective clinical work was conducted between January and September 2023 at the Department of Oral and Maxillofacial Surgery, Al-Wasity Hospital, Baghdad. Fifteen female patients (mean age: 28 years) with excessive gingival display of mixed soft- and hard-tissue etiology were treated under local anesthesia. Gingival display was assessed preoperatively and during follow-up for up to 9 months, and pre- and postoperative outcomes were statistically analyzed. Results: A significant reduction in gingival display was observed in 14 patients, while one patient demonstrated partial relapse during the follow-up period between 1 and 9 months. Statistical analysis revealed a highly significant reduction in gingival display at 9 months compared with preoperative measurements (t = −4.10, df = 21.23, p = 0.0005). Conclusion: Selective myotomy and detachment of the upper lip elevator muscles is a simple, minimally invasive, and effective technique for the correction of gummy smile. The procedure offers satisfactory esthetic outcomes with minimal morbidity, preservation of neuromuscular function, and good short-term stability.
Association of Hormonal Profiles with Menopausal Symptoms in Women Following Hysterectomy
Background: Hysterectomy is one of the most frequently performed surgical operations in gynecology, with a potential impact on ovarian function and an increase in hormonal changes causing menopausal symptoms. Changes in important hormones like Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), and Inhibin B could be major contributors to the onset and severity of these symptoms. Objective: This study aimed to explore the relationship of hormonal profiles with menopausal symptoms among postmenopausal women after hysterectomy. Methods: We performed a case–control study at Al-Zahra Teaching Hospital, Al-Najaf, Iraq from June 2025 to December 2025. The study involved 48 women with a history of hysterectomy, compared to 62 age-matched healthy controls. A structured questionnaire was used to collect demographic and clinical data, including menopausal symptoms. FSH, LH and inhibin B serum levels were determined by enzyme-linked immunosorbent assay (ELISA). Statistical analyses: independent t-test, Chi-square test and correlation analysis, P < 0.05. Results: FSH (46.80 ± 8.75 mIU/mL) and LH (28.50 ± 6.20 mIU/mL) levels in women with hysterectomy were significantly higher than controls (P < 0.05), but inhibin B secretion was significantly lower at this stage (18.30 ± 5.10 pg/mL). Patients reported significantly more menopausal symptoms than the controls, such as hot flashes, vaginal dryness, sleep disturbances and night sweats (p < 0.05). High levels of FSH and LH were significantly associated with vasomotor and psychological symptoms, whereas low inhibin B was significantly linked to vaginal dryness and lack of libido. Conclusion: Hysterectomy is related with hormonal imbalance and increased menopausal symptoms. Hormonal profiling may prove particularly valuable in the assessment and management of post-hysterectomy.
The Association of rs1042522 and rs3088440 Polymorphisms with CA125, IFN-γ, and IL-10 Levels in Cervical Cancer and Genital Warts Patients
Introduction: Variants in tumor suppressor genes may affect susceptibility to HPV-related diseases and alter immune responses by modifying cytokine production. Thus, in the current study, we sought to examine how rs1042522 (TP53 codon 72) and rs3088440 (INK4a 540 C>T) variants correlate with serum CA125, IFN-γ, and IL-10 levels in Iraqi women with cervical cancer, genital warts, or no disease. Methods: We enrolled 106 participants from four Iraqi hospitals (October 2024-January 2025): 26 with cervical cancer, 30 with genital warts, and 50 healthy individuals. Genetic variants were identified through PCR-RFLP, and ELISA was used to measure CA125, IFN-γ, and IL-10 in serum. We applied Chi-square tests for genotype frequencies and Kruskal-Wallis followed by Mann-Whitney U tests for biomarker analysis. Results: For rs1042522, controls had higher GG genotype frequency (46.0%) than genital warts patients (23.3%; P=0.03), whereas genital warts patients showed increased CC genotype (43.3%). Among genital warts patients, IL-10 concentrations varied by rs1042522 genotype (P=0.025): CC carriers had elevated levels (0.76 pg/mL) versus GG carriers (0.60 pg/mL; P=0.006). The rs3088440 variant showed no meaningful associations with disease or biomarkers. Conclusion: Our findings link rs1042522 to genital warts risk and IL-10 regulation in affected patients, indicating a genetic basis for immune responses in HPV-associated conditions. This variant may serve as a useful marker for identifying at-risk individuals.
Nutritional Rickets in Ekiti, Southwestern Nigeria: Investigating the Roles of Calcium and Vitamin D
Background: Nutritional rickets remains a common cause of skeletal deformities among children in developing countries. While vitamin D deficiency is traditionally implicated, evidence from tropical regions with abundant sunlight suggests calcium deficiency may be more prominent. Objectives: This study evaluated the relative roles of calcium and vitamin D in children with rickets in Ekiti, Southwestern Nigeria. Methods: A descriptive comparative study was conducted involving 32 children with clinical features of rickets and 32 age- and sex-matched controls without rickets at Ekiti State University Teaching Hospital, Ado-Ekiti. Sociodemographic and clinical data were collected, and biochemical analyses included serum calcium, phosphate, alkaline phosphatase (ALP), vitamin D, total protein, albumin, and renal function tests. Radiographs of wrists and knees were obtained for affected children. Independent sample t-tests compared mean biochemical values, while Chi-square tests assessed associations between variables. Statistical significance was set at p < 0.05. Results: The mean age of affected children was 3.06 ± 0.13 years (range 2–5 years). Bilateral genu varum was the most common presentation (31.3%). Hypocalcaemia was observed in 87.5% of cases and elevated ALP in 75.0%, whereas 87.5% had normal serum vitamin D levels. Significant differences between cases and controls were found for serum calcium (p = 0.02) and ALP (p = 0.01), but not for vitamin D or protein levels. Renal parameters were largely normal. Conclusion: Calcium deficiency appears to be the predominant biochemical abnormality in children with rickets in this tropical setting, despite adequate sunlight exposure and largely normal vitamin D levels. Emphasis on calcium assessment and supplementation is essential for effective management and prevention.
The Biochemical Features, Physiological Actions, And Clinical Importance of Procalcitonin: A Review
Procalcitonin (PCT), a peptide precursor of calcitonin, has emerged as an important biomarker (biomarker) clinically that can be used for diagnosis and subsequent management of bacterial infection. This review summarizes the biosynthesis, biochemical characteristics, physiological functions and clinical relevance of procalcitonin. PCT is produced by thyroid C cells under physiological conditions, and almost immediately converted to calcitonin giving rise to extremely low levels in circulation. In contrast, during systemic bacterial infections it is produced in relatively high states in various tissues with a corresponding increase in serum concentrations. From a biochemical perspective, PCT is representative of a “hormokine,” bridging the immune and endocrine responses. On a physiological level, it helps to regulate inflammation and immune responses. Clinically, PCT has been used as a sensitive and specific biomarker for bacterial infections and sepsis, making it a valuable tool in differentiating disease causing by viral infection from that of bacterial origin. Moreover, antibiotic therapy based on PCT reduces unnecessary antibiotic therapy and improves treatment outcome. Procalcitonin is an important supporting diagnostic and prognostic biomarker, which undoubtedly has limitations but supports appropriate clinical decision-making and patient care in different medical contexts.
Evaluation of New Biomarkers in The Diagnosis of Herpes Zoster Infections
Background: Herpes Zoster is a neurotropic viral disease with notable inflammatory and neurological complications. And early diagnosis and treatment is still the way to go. Aims: This study was designed to investigate the diagnostic value of new biomarkers such as procalcitonin, neuron-specific enolase (NSE), and miR-155 among Herpes Zoster infection patients. Methods: The study was a case–control cross-sectional study involving 44 patients diagnosed with Herpes Zoster and 66 healthy controls. Serum levels of procalcitonin and NSE were detected by ELISA, and expression levels of miR-155 was analyzed using qRT-PCR. Statistical analysis was performed to assess differences between groups, correlations and diagnostic performance using ROC curve analysis. Results: The study identified significantly higher concentrations of procalcitonin (PC), NSE and miR-155 levels in patients, than controls (P < 0.01). All biomarkers performed well to excellent in diagnostic performance, with miR-155 having the highest sensitivity and specificity. In addition, the biomarkers studied displayed several significant positive correlations with each other indicating their biological role in disease pathophysiology. Conclusion: Procalcitonin, NSE and miR-155 are all potential diagnostic biomarkers of Herpes Zoster infection. A composite biomarker panel, especially including miR-155, may facilitate early diagnosis and a better understanding of disease mechanisms.
Engineering-Based Technological Transformation in Dentistry and Endodontics and its Impact on Türkiye's Competitiveness in the Health Tourism Market
Technological advancements driven by engineering have become key factors in elevating Türkiye's global standing in health tourism, greatly strengthening its competitiveness and attracting a growing number of international patients. Emin Taner Elmas is not a dentist or endodontist, but a Mechanical Engineer and academic. His work focuses not directly on classical dental clinical practice or endodontics, but rather on interdisciplinary fields such as thermodynamics, energy transfer, fluid mechanics, and biomedical engineering. However, Elmas's engineering approach has the potential to contribute to the medical field, including dentistry, indirectly through biomedical and health technologies: Biomedical Approach: Treating the human body as a "bio-machine," Elmas develops theories on the natural vibration frequencies of organs and tissues. This "bio-robotic resonance" theory can inspire the design of next-generation devices for tissue healing or disease diagnosis at a theoretical level. Medical Device Modeling: His expertise in thermodynamics and fluid mechanics is used in the design and simulation of medical devices (e.g., hemodialysis machines or drug delivery algorithms). The mechanical strength of surgical instruments used in dentistry or the thermal effects of dental lasers are engineering problems that fall within Elmas's area of ​​expertise. Interdisciplinary Technologies: He has studies on machine learning and artificial intelligence-supported diagnostic systems. These technologies are increasingly used in the field of endodontics today, such as caries detection and root canal anatomy analysis. In summary, Emin Taner Elmas is not a dentist, therefore he does not develop clinical endodontic procedures. However, his work applying engineering principles to the biomedical field has the potential to contribute to the scientific infrastructure of future dental technologies (device design, diagnostic algorithms, etc.). The "Bio-robotic Resonance and Thermodynamic Interaction" theory and medical technology models developed by Emin Taner Elmas can be indirectly adapted to the fields of dentistry and endodontics. The potential contributions of Elmas's work to dental technologies can be evaluated under the following headings: Bio-robotic Resonance and Diagnosis: Elmas views the body as a "bio-machine," arguing that each tissue has its own unique natural vibration frequency. This approach could form the basis for the development of next-generation diagnostic devices that can detect the condition of tooth canals or microcracks in the tooth root using acoustic signal analysis and Fourier transforms in endodontics. Smart Drug Algorithms: His work focuses on smart drug algorithms and simulations via "Frequency Modulation". This modeling can be used to optimize the thermodynamic interaction of disinfectants or drugs applied into the root canal with the tissue in endodontic treatments. Medical Device Modeling: As a thermodynamics and fluid mechanics specialist, Elmas works on the prototype design and simulation of medical devices (such as hemodialysis machines). This engineering knowledge can directly address specific engineering problems in dentistry, such as controlling the thermal effects of dental lasers or increasing the mechanical efficiency of surgical instruments. Interdisciplinary Approach: His work generally focuses on "Medical Technology," combining mechanical engineering and medical sciences. This perspective contributes to the development of the mechanical and software infrastructure of advanced technologies such as digital intraoral scanners and robotic surgical support systems, which are becoming increasingly common in dentistry today. In summary, Elmas's contribution focuses on the engineering design and theoretical physics of smart devices and diagnostic systems used in dentistry, rather than a clinical application.[1-73]
Cyclic Fatigue of Nickel-Titanium Rotary Instruments in Single Curvature Canals
Aim: the aim of current research was to evaluate and compare cyclic rotations required to fracture different rotary nickel titanium (NiTi) endodontic files in single curvature canals. Methods: Four different NiTi rotary instruments were selected for the present study: F6 SkyTaper, EndoSequence ESR, Endosequence CM, and Ordeka plex-v file of ISO 25, 0.06 instrument taper and 25 mm instrument length. All files were subjected to cyclic fatigue test inside custom-made simulated canals with 60° curvature. Time required to fracture rotary files (in seconds) while being rotated in a steel block canal was determined to calculate cyclic fatigue. Data was statistically evaluated ANOVA test at 5% level of significance. Results: EndoSequence ESR instrument reported the highest cyclic fatigue resistance among all other tested rotary instruments. Endosequence CM expressed the lowest fatigue resistance. One-way ANOVA test expressed a statistically significant difference between all four groups regarding number of cycles to fracture (NCF) and non-statical significant difference relating to length of fracture segment (FL). Conclusion: EndoSequence ESR and Ordeka plex-v files demonstrated dominance over Endosequence CM and F6 SkyTaper files in cyclic fatigue resistance.
Suboptimal Antenatal Care in Resource – limited Settings and Quality Improvement Strategies as Perceived by midwives in Awka – South LGA in Anambra State Nigeria.
Identifying the opportunities for quality improvement is essential to maximize the impact of midwife – led antenatal care. The aim of this study was to determine suboptimal antenatal care and the quality improvement strategies as perceived by midwives in resource – limited settings in Awka – south Local Government Area (LGA), Anambra state, Nigeria. The objectives of the study were to; determine areas of suboptimal antenatal care in resource – limited settings, in Awka –south LGA, Anambra state, Nigeria, and the areas of quality improvement as perceived by midwives. The design for the study was cross – sectional research. It was a facility study which constituted 31Primary Health Centres, 1 Secondary Health Facility, 1 Tertiary Health Facility, plus 112 midwives and 165 pregnant women. Multistage sampling technique was used for the study. Two (2) Questionnaires and one (1) Checklist were adopted for data collection in the study. Data generated from the study were analyzed using descriptive and inferential statistics. The hypotheses were tested at significant level of 0.05. The result indicated resource adequacy in the secondary and tertiary health facilities (100% and 63.1% respectively) and inadequacy in primary health facilities (38.7%). Across all the health facility levels, 75% of service delivery practices among midwives during antenatal care of pregnant women were rated as poor while 25% were categorized as good. Secondary health facility lacked presence of midwives officially on call at all times. The quality of antenatal care provided by midwives had significant association with ANC Screening training update, p – value 0.02. Antenatal care provided by midwives in resource – limited settings did not significantly differ from areas of sub –optimal antenatal care, overall p – value 0.40. Antenatal care provided by midwives had no significant association with the perceived quality improvement strategies, over all p – value 0.42. Conclusively, the study revealed a substantial disparity in resource availability across facility levels. Recommendations included that Primary health facilities need to be adequately equipped and there should be regular supervision of midwives’ practices by quality improvement team in order to identify areas of deficiencies to be properly addressed.
Comparative Evaluation of Minimally Invasive and Conventional Access on The Biofilm Elimination of Enterococcus Faecalis From the Root Canal System
Background: The access cavity is a fundamental step in endodontic treatment. Traditionally, it is performed by completely removing the pulp chamber and all its contents. Recently, the introduction of technologies such as the operating microscope, ultrasound, and Ni-Ti instrumentation systems has allowed this phase to be performed conservatively through minimal invasive access. However, further evidence is needed to determine whether these techniques allow complete elimination of microorganisms within the root canal system. Objectives: The aim of this study was to evaluate the effects of minimally invasive access (MIA) compared with conventional access (CA) on the disinfection and elimination of biofilm Enterococcus faecalis in root canal therapy. Methods: Forty-four first molars were selected and randomly divided in groups: MIA and CA (n= 15 each), positive control (n= 8), negative control (n= 6). After access cavity, the root canals were contaminated with E. faecalis for 30 days. Bacterial sampling was performed with sterile paper points before (S1) and after (S2) instrumentation with the TruNatomy system to quantify the bacterial load. Colony-forming units per milliliter (CFU/mL) and scanning electron microscopy (SEM) were used for bacterial reduction assessment and elimination of biofilm. Statistical comparisons were conducted using Student’s t-test or Mann–Whitney U test, with significance set at 5%. Results: Significant reductions in E. faecalis were observed in all groups, regardless of cavity design. However, the lowest bacterial reduction was found in the MIA group, while the CA group achieved the highest reduction. Conclusions: Conventional access resulted in significantly better disinfection compared with minimally invasive access. These findings suggest that the design of the access cavity influences bacterial load reduction and biofilm elimination within root canals.
Yoga Prana Vidya (YPV) Healing in Post-Bypass Surgery Recovery with Complications of Epiglottis Flap Dysfunction and Infected Vein-Harvest Wound: A Case Report
Background: Post-bypass surgery complications such as epiglottis flap dysfunction and infected vein-harvest wounds severely impair recovery, especially in elderly patients. Conventional rehabilitation often struggles to address multidimensional recovery needs. Integrative approaches like Yoga Prana Vidya (YPV) healing may offer complementary benefits. Case Presentation: A 73-year-old male with hypertension, prior cardiac stenting (2018), brain tumor (2022), paralysis (2023), and recent bypass surgery (January 2026) developed severe complications: epiglottis dysfunction causing loss of speech and feeding tube dependence, pus formation in the leg wound from vein harvesting, immobility, and depression. YPV healing was initiated on 10 February 2026, using protocols such as soaking, cleansing & energising, psychotherapy, blood strengthening, internal organ healing, and group blessings. Sessions were conducted twice daily for 30 minutes over 30 days. Results: Speech clarity improved within 48 hours. Oral feeding resumed by day 10, and the feeding tube was removed by day 20. The infected leg wound showed progressive healing, with reduced pus and improved strength. By day 15, the patient began assisted walking, and by day 24, walker-supported ambulation was possible. Psychological well-being improved, with reduced depression and increased positivity. Conclusion: YPV healing facilitated rapid recovery in swallowing, speech, wound healing, mobility, and emotional health. This case highlights the potential of integrative energy healing in complex post-surgical recovery. Further research with controlled studies is recommended.
Contact Angle Measurement and Wettability of TiO2 and ZrO2 Nano Composite Coated on cpTi
Background: Dental implants have become one of the most reliable treatment options for replacing missing teeth due to their high success rates and long-term stability. Commercially pure titanium (cpTi) is widely used as an implant material because of its excellent biocompatibility, corrosion resistance, and its ability to achieve osseointegration with the surrounding bone. However, the biological performance of titanium implants is greatly influenced by surface characteristics such as surface roughness, surface energy, and wettability, which play an important role in protein adsorption, cell adhesion, and bone healing. Aim: The aim of this study was to evaluate the effect of a TiO2- ZrO2 nano-composite coating on the wettability of commercially pure titanium surfaces by measuring the contact angle. Materials and Methods: Commercially pure titanium discs were prepared and divided into two groups: a control group with uncoated titanium surfaces and an experimental group coated with TiO2- ZrO2 nano- composite. Surface wettability was evaluated using contact angle measurement by placing a droplet of distilled water on the surface and recording the angle using a goniometer. Results: The coated titanium surfaces showed a lower contact angle compared with the uncoated surfaces, indicating improved wettability and a more hydrophilic surface. Conclusion: TiO2- ZrO2 nano-composite coating enhances the wettability of titanium surfaces by reducing the contact angle, which may improve protein adsorption, cell attachment, and potentially enhance the osseointegration of dental implants.
The Biochemistry, Physiological Actions and Clinical Importance of Dopamine: A Review
Dopamine (DA) have been an essential catecholamine neurotransmitter that mediates many biochemical, physiological and pathological functions. This review summarizes what we currently know about the biochemistry, physiology and clinical significance of dopamine, with special emphasis placed on new insights. Dopamine is synthesized from tyrosine via a two-step enzymatic conversion catalyzed by tyrosine hydroxylase first followed by aromatic L-amino acid decarboxylase. Its life-cycle—vesicular storage, exocytosis, reuptake and degradation though monoamine oxidase and catechol-O-methyltransferase—is under precise control. As a neurophysiological neurotransmitter, dopamine have been essential for controlling movement, processes of thought, reward pathways and hormonal balance through different neural circuits and specific receptor subtype. It also plays a role in cardiovascular, renal, and immune system function outside the brain. Clinically, weakened dopaminergic signaling has been related with many disorders such as Parkinson's disease, schizophrenia depression and ADHD; therefore it is a target of drug development. These recent advances are substantially enhancing our knowledge towards dopamine contributions to disease, especially its involvement in immune regulation and oxidative stress. Nevertheless, the complete organizational complexity of dopaminergic networks and their cross-biological system interactions remain incompletely characterized, a challenge that survives even decades of research. Dopamine is, in conclusion, integrator of many physiological system and further studies on dopamine will lead to new treatment strategies with improved effectiveness and specificity (even on many different disease).
Assessment of Structural and Functional Variability in Successive Autologous Platelet Formulations
Autologous platelet formulations have become integral to regenerative medicine due to their capacity to deliver a concentrated pool of growth factors, cytokines, and cellular mediators essential for tissue repair and regeneration. Over time, advancements in preparation techniques have resulted in successive generations of platelet-based biomaterials, each exhibiting distinct structural and functional characteristics. This study provides a comprehensive assessment of variability across these formulations, focusing on differences in composition, fibrin architecture, cellular distribution, and biological activity. By synthesizing findings from established literature, the paper examines how preparation protocols—including centrifugation speed, activation methods, and leukocyte inclusion—affect the release kinetics of bioactive molecules and clinical outcomes. Comparative analysis reveals that first-generation formulations are characterized by rapid growth factor release, whereas later formulations demonstrate sustained release and enhanced scaffold properties. Furthermore, the presence of leukocytes and modifications in fibrin structure significantly influence inflammatory responses and tissue remodeling. The study identifies critical factors contributing to variability and highlights the absence of standardized protocols as a major challenge. The findings suggest that optimal formulation selection should be tailored to specific clinical applications rather than adopting a universal approach. This research contributes to a deeper understanding of platelet-based therapies and provides a framework for future optimization and innovation in regenerative medicine.
Application of Bacillus Subtilis Antimicrobial Peptides to Control Pseudomonas Aeruginosa in Water Systems
Pseudomonas aeruginosa is an opportunistic waterborne pathogen that has pronounced ecological and public health significance due to its ability to survive, risks biofilm formation when exposed to many therapeutic agents or natural resistance mechanisms and disinfectants. The increasing prevalence of antimicrobial resistance (AMR) in P. aeruginosa strains present in water systems has led to increased interest in technologically sustainable approaches especially those derived from biological sources but there is still limited understanding of their full potential as effective antimicrobial agents. The present is to evaluate and characterize the antimicrobial peptides of Bacillus subtilis that have specifically antibacterial activity against P. aeruginosa under simulated conditions of the water system in which both organisms are grown together. MethodologyA laboratory-controlled, randomized experimental study was conducted in the time period from summer 2024 to late autumn/early winter 2025. The negative control, positive control and treatment (crude and partially purified antimicrobial peptide extracts) groups were assigned randomly to P. aeruginosa ATCC 27853 inoculated sterile water. Antimicrobial activity was measured (viable bacterial count determination, agar well diffusion assay, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)). Treatment with antimicrobial peptides derived from B. subtilis reduced bacterial growth compared to untreated controls (p < 0.001). Results: The viable bacterial count was decreased by decreasing from 8.74 × 10⁵ CFU/mL in positive control to 3.42 × 10⁵ CFU/mL after crude peptide treatment, and again down to 1.18 × 10⁵ CFU/mL with the partially purified peptide treatment. Concurrently, the inhibition zone diameters increased significantly from 14.82 mm (crude extract) to 22.46 mm at partial purified peptides level, with respective MIC and MBC values in prepared purifications at lower levels presenting higher antibacterial potency. These results demonstrate that the water-soluble antimicrobial peptides of B. subtilis have strong inhibitory and bactericidal effects on P. aeruginosa with improved activity after partial purification, which support microbial product safety while also diminishing occurrence of resistant bacterial contaminants in water systems.
Relationship Between Resilience and Quality of Life in Parents of Children with Cleft Lip and Palate in Ilam City in 2026
Introduction: One of the important and practical topics in psychology that is closely related to the concept of resilience is quality of life. the present study was conducted to determine the relationship between resilience and quality of life among parents of children with cleft lip and palate in Ilam city. Methods: In this cross‑sectional study conducted in 2026 in Ilam city, parents of patients with cleft lip and palate were examined. The sample consisted of parents of children with cleft lip and palate, and a total of 117 fathers and mothers participated in the study. The instruments used included the Connor–Davidson Resilience Scale (CD‑RISC), the SF‑36 Quality of Life Questionnaire, and a demographic information form for the participants. After entering all data into SPSS version 18, descriptive and analytical statistical analyses were performed to report the findings. Results: Result showed, 55.6% of the participants were mothers and 44.4% were fathers. The mean (SD) age of the parents was 47.58 (7.82) years. The mean (SD) resilience score was 88.84 (12.94) among fathers and 59.66 (11.69) among mothers, indicating that fathers had higher resilience levels compared with mothers. The overall mean resilience score among parents was 72.63 (19), suggesting a moderate to relatively high level of resilience in the studied sample. The mean (SD) quality of life score was 76.30 (8.12) for fathers and 59.27 (8.66) for mothers, indicating a better quality of life among fathers compared with mothers. The overall mean quality of life score among parents was 66.84 ± 11.94, reflecting a moderate level of quality of life in the study population. The correlation coefficient R = 0.931 indicates a very strong positive relationship between parental resilience and quality of life. Conclusion: The correlation results showed that resilience plays a very important role in determining quality of life, and more than 86% of the variance in quality of life can be explained by resilience. These findings highlight the importance of strengthening parents’ resilience—especially that of mothers—as a key strategy for improving their quality of life.
Spectrum of Clinical Presentation of Cervical Spinal Cord Injury in Ado-Ekiti
Background: Cervical spinal cord injury (CSCI) is a devastating condition associated with significant morbidity and mortality, particularly in low- and middle-income settings where pre-hospital care and trauma systems are often suboptimal. Understanding the clinical spectrum and determinants of outcome is essential for improving management strategies. Objective: To evaluate the spectrum of clinical presentation and identify predictors of mortality among adult patients with cervical spinal cord injury in Ado-Ekiti. Methods: This was a hospital-based prospective descriptive and analytical study conducted over an 18-month period between July 2024 and December 2025 and involved 43 adult patients with confirmed cervical spinal cord injury. Data were collected using a structured proforma for capturing socio-demographic characteristics, injury mechanisms, clinical presentation, radiological findings, management, complications, and outcomes. Neurological status was assessed using the ASIA impairment scale. Data were analyzed using descriptive statistics and multivariate logistic regression to identify predictors of mortality, with statistical significance set at p < 0.05. Results: The majority of patients were males (72.1%), with the peak age group being 18–30 years (27.9%). Road traffic accidents were the leading cause of injury (65.1%), with motorcycle-related incidents predominating. Most patients presented late, with over half presenting after 24 hours, and 67.4% received no pre-hospital care. Clinically, neck pain (81.4%), limb weakness, and severe neurological deficits such as quadriparesis (46.5%) and quadriplegia (41.9%) were common. Complete spinal cord injury (ASIA A) was observed in 32.5% of patients. The mortality rate was 18.6%, while only 23.2% achieved functional independence at discharge. Independent predictors of mortality included complete injury (aOR = 6.85, p = 0.006), upper cervical level involvement (aOR = 4.92, p = 0.019), respiratory difficulty (aOR = 5.63, p = 0.014), and delayed presentation beyond 24 hours (aOR = 3.76, p = 0.048). Conclusion: Cervical spinal cord injury in Ado-Ekiti predominantly affects young males and is largely due to preventable causes such as road traffic accidents. The clinical presentation is often severe, with a high burden of neurological deficits and complications. Mortality is significantly associated with injury severity, higher cervical involvement, delayed presentation, and respiratory compromise. Strengthening pre-hospital care, promoting early presentation, and improving acute management may enhance outcomes.
Surgical Management of Temporomandibular Joint Disorder Clinical Outcomes and Patient Satisfaction
TMJ disorders are widespread compounds that could lead to pain, poor mouth openings, poor mastication, and low quality of life. The objective was to determine how well the surgical management of temporomandibular disorders of the joint is done, using clinical outcome and patient satisfaction in a hospital-based sample in Baghdad. It gave a prospective study of arthrocentesis, arthroscopy, open joint surgery or a combination of both studies on 40 patients who had undergone all the professional therapies yet failed to respond to the conservative therapy. Pain score, maximal interincisal opening, functional limitation, and locking joints were assessed clinically, but also patient satisfaction at the end of the treatment. The results indicated evident postoperative pain, mouth opening, and jaw-function improvements, and a significant decrease in joint-locking and overall high patient-satisfaction rates. Arthroscopy demonstrated the quickest functional recovery and arthrocentesis demonstrated an advantageous recovery with reduced invasion. In a few advanced cases, open surgery was still viable. The researchers conclude that surgical treatment can offer substantial clinical benefit and acceptable patient-reported outcomes in the appropriate cases of temporomandibular joint disorder.
Impact of Daily Screen Time on Headache Patterns and Musculoskeletal Pain in Patients with Temporomandibular Disorders: A Pilot Cross-Sectional Study
Background and Objective: Temporomandibular disorders (TMD) are a prevalent source of chronic orofacial pain. Increased digital device usage has raised concerns regarding its contribution to musculoskeletal complaints. This study assessed the association between daily screen time exposure and the prevalence of headache and widespread musculoskeletal pain among patients with TMD in Navi Mumbai. Methods: A cross-sectional analytical study was conducted among 20 patients diagnosed with TMD based on DC/TMD criteria. Data were collected using a validated structured questionnaire and standardized clinical examination. Statistical analysis was performed using SPSS v21.0. Associations were evaluated using Chi-square test and Pearson’s correlation, with statistical significance set at p < 0.05. Results: Frequent episodic TTH was observed in 40% of participants, new daily persistent headache in 25%, and migraine without aura in 15%. Widespread musculoskeletal pain was reported by 75% of the cohort. Screen time exceeding four hours per day demonstrated a statistically significant association with headache occurrence and widespread pain, with a moderate positive correlation noted between screen duration and WPI scores (r = 0.41). Conclusion: Higher daily screen exposure was significantly associated with increased headache prevalence and musculoskeletal symptom burden among TMD patients. Incorporating ergonomic counselling and digital-use assessment into routine orofacial pain management may assist in mitigating symptom severity. Larger multi-centre studies are recommended to validate these findings.
Evaluation of Interleukin-27 as a Cytokine Marker in Type 2 Diabetes Mellitus Associated with Toxoplasmosis in Karbala Governorate
Background and Objective: Type 2 Diabetes Mellitus (T2DM) is characterized by a state of chronic inflammation and increased risk for certain infections like Toxoplasma gondii. This study set out to investigate the role of interleukin-27 (IL-27), a regulatory cytokine, in this dual-disease milieu. Methodology: 184 participants (diabetic patients with toxoplasmosis and healthy control) were analyzed. Serum measurement of IL-27, Hs-CRP and lipids were done using ELISA and automated systems respectively. Data were analyzed using SPSS (Version 26.0) through t-test, ANOVA and linear regression. Results: All lipid parameters and Hs-CRP were significantly higher in diabetic patients (P < 0.001). IL-27 levels were lower than controls (46.63 ± 21.44 ng/ml vs. 50.59 ± 8.50ng/ml), which was not statistically significant (P = 0.074). No significant correlation was found between IL-27 and HbA1c (P = 0.305), age (P = 0.917), or lipids (P > 0.05). Also, 50.75% of patients with high Hs-CRP (>3mg/L) had abnormally elevated IL-27 levels. Conclusion: IL-27 may be acting as an independent regulatory mediator across the immune-metabolic axis in diabetic patients with toxoplasmosis. The lack of association of IL-27 with metabolic parameters further alludes to its production being favoured along complex immune-regulatory pathways instead of by the glycaemic state.
Phosphate-Buffered RMGIC Liner Under Pediatric Class II Composites: Clinical Sensitivity & Inflammatory Biomarkers
Background: Post-operative sensitivity after pediatric Class II composites is frequent and relates to polymerization stress and transient inflammation. A phosphate-buffered resin-modified glass ionomer (RMGIC) liner may stabilize pH, limit inflammation, and improve comfort. Objective: To compare a phosphate-buffered RMGIC liner with a conventional RMGIC liner under Class II composites in primary molars. Methods: Randomized, controlled clinical study of fifty children, each contributing one tooth per group (buffered vs conventional). Standardized isolation, preparation, selective-etch bonding, and incremental composite placement were used. Outcomes: pain by 0–10 Numeric Rating Scale (NRS) and Wong–Baker FACES at 1 and 4 weeks; electric pulp testing (EPT) at baseline and 4 weeks; gingival crevicular fluid interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and prostaglandin E₂ (PGE₂) at baseline, 1 and 4 weeks; 1-week chewing function; 48-hour analgesic use; and 3-month marginal staining. Per table footnotes, between-group comparisons used independent samples t-tests for continuous outcomes and chi-square tests for proportions/categories. Results: Baseline demographics were comparable. NRS pain favored buffering at 1 week (1.83±1.33 vs 3.78±1.80; p<0.001) and 4 weeks (0.69±0.71 vs 1.93±1.03; p<0.001); Wong–Baker differences were nonsignificant. EPT thresholds were higher with buffering at 4 weeks (32.60±5.43 vs 27.58±4.54; p=0.001). IL-6 was lower with buffering at 1 week (8.58±3.42 vs 12.00±4.76; p=0.005) and 4 weeks (6.78±2.29 vs 10.21±5.21; p=0.004); TNF-α was lower at 4 weeks (8.13±3.28 vs 14.48±5.40; p<0.001). PGE₂ differences were nonsignificant. Chewing function was better at 1 week (7.68±2.06 vs 11.80±3.98; p<0.001). Fewer children required analgesics within 48 hours (20% vs 40%; p=0.039) and fewer doses were taken (0.27±0.56 vs 0.96±1.08; p=0.006). At 3 months, marginal staining distributions were similar (p=0.538). Conclusions: Compared with a conventional RMGIC, the phosphate-buffered RMGIC liner reduced early pain, attenuated inflammatory biomarkers, improved pulpal sensibility, and enhanced short-term function without compromising restoration integrity. These child-centered benefits support biologically informed liner selection and justify longer follow-up to confirm clinical long-term durability and survival.
Isolation and Identification of Bacteria Associated with Irritable Bowel Syndrome
Background: Irritable bowel syndrome (IBS) represents a multifactorial functional gastrointestinal disorder which affects approximately 10-15% of the world's population. It has been demonstrated that microbial disturbances are a crucial part of its etiology and sustainment. Unfortunately, a lack of complete bacteriological profiling of stool specimens of patients from some geographic locations exists. Objective: The objective of the work is isolation and identification of bacterial species from stool specimens of patients diagnosed with irritable bowel syndrome and the comparison of their profiles with those of healthy control subjects as well as the determination of the resistance of the isolated strains to various antimicrobial drugs. Methods: Stool specimens were taken from 80 patients who met the Rome IV Irritable bowel syndrome diagnostic criteria and 40 healthy age- and sex-matched control subjects. Traditional bacteriological cultures were followed by sequencing of the 16S RNA gene in order to definitively establish the species of isolates. Antibiotic susceptibilities were measured according to CLSI criteria via the Kirby-Bauer disk diffusion test. Results: In total, 248 bacterial isolates have been identified in stool specimens of IBS patients, while only 98 isolates have been found in controls. Among isolates obtained from IBS patients, the most frequent included E. coli (31.5%), K. pneumoniae (18.1%), E. faecalis (14.1%), B. fragilis (11.3%), lactobacilli (9.3%), bifidobacteria (7.7%), along with other lesser represented bacterial strains A decrease in the number that is statistically significant of lactobacilli and bifidobacteria (p<0.01) was found in IBS patients. Regarding antibiotic resistance, Enterobacteriaceae showed significant resistance to ampicillin (58.4%) and tetracycline (47.6%). Conclusions: It has been found that IBS patients have significant dysbiosis in terms of reduced numbers of beneficial bacteria with concomitant colonization by pathogenic bacteria.
Cervical Cerclage in Combination with Oral Progesterone and Vaginal Ring Pessary for Preventing Recurrent Previable Births in Women with Prior Failed Cervical Cerclage: An Exploratory Prospective Case Series
Background: Recurrent previable births due to cervical insufficiency pose significant challenges, particularly after failed cerclage procedures. Objectives: This case study evaluates a novel triple approach combining transvaginal cerclage, oral progesterone, and vaginal ring pessary in high-risk women with prior failed cerclage. Methods: We conducted a prospective case series involving four women with recurrent previable births and previously failed cerclage at a tertiary centre in Nigeria between January 2024 and April 2025. Participants received transvaginal cervical cerclage between 10-13 weeks, followed by vaginal ring pessary (‘Donut type’) insertion two weeks later, and oral progesterone (dydrogesterone 10mg three times daily) until 28 weeks. The primary outcome was delivery beyond 34 weeks of gestation. Secondary outcomes included neonatal survival, birth weight, and maternal complications. Results: Among the four participants (mean age 30.8 years, range 26-36), three (75%) delivered beyond 34 weeks of gestation (mean 35.2 weeks among those who delivered). Three had live births at term or late preterm (34weeks 1 day, 36weeks 3 days, and 37weeks 2 days) with favourable neonatal outcomes (birth weights 2.4kg, 3.1kg, and 2.7kg; APGAR scores 6/1, 9/1 and 9/1), while one experienced a previable birth at 26 weeks 1 day resulting in neonatal death. One maternal complication (cervical laceration) occurred that was successfully repaired. Conclusion: This combined triplex approach appears feasible and potentially effective for high-risk women with recurrent previable births following failed cerclage. It may offer a less invasive alternative to open abdominal or laparoscopic cerclage, particularly valuable in resource-limited settings. These preliminary findings warrant validation through larger prospective or randomised controlled trials.
Association Between Neopterin And Oxidative Stress in Patients with Psoriasis
Background: Recent literature has focused on the oxidative stress and inflammatory biomarkers to play an important role in the pathogenesis and clinical course of psoriasis. Objectives: The study was designed to evaluate serum levels of neopterin and selected oxidative stress biomarkers (lactate dehydrogenase (LDH), malondialdehyde (MDA) and thiobarbituric acid reactive substances (TBARS)) in psoriasis patients and their correlation with disease severity and interrelationships in the context of the role of oxidative stress in psoriasis pathophysiology. Methods: This case–control cross-sectional study was conducted on 62 patients with clinically diagnosed psoriasis and 48 apparently healthy persons as a control group recruited from the Central Laboratory of Al-Sadr Medical City, Al-Najaf, Iraq during the period from June 2025 to January 2026. Patients were categorized into mild, moderate and severe psoriasis groups according to disease severity evaluated by the Psoriasis Area and Severity Index (PASI). Results: The levels of serum neopterin, LDH, MDA and TBARS in patients with psoriasis were significantly higher than those in healthy controls (p < 0.01). A statistically significant trend for increasing biomarker levels according to disease severity was noted, with maximum values being recorded in patients with severe psoriasis. Pearson correlation analysis showed that neopterin was significantly positively correlated with both LDH (r = 0.341, p = 0.002) and MDA (r = 0.487, p = 0.008). On the other hand, neopterin showed a positive, although non-significant, correlation with TBARS (r = 0.168, p = 0.121). Conclusion: Serum neopterin and biomarkers of oxidative stress were significantly increased in patients with psoriasis and the levels progressively elevated according to disease severity. The observed positive peaks between neopterin and oxidative stress markers suggest that the immune activation do trigger the oxidative damage synergistic and mutual with each other in psoriasis pathogenic versus.
Apically Extruded Debris Following Root Canal Instrumentation Using Three File Systems: A Comparative In-Vitro Study
Background: Apically extruded debris induced during root canal instrumentation is of clinical importance associated with postoperative pain and flare-ups. Different file systems with different kinematics and designs may influence the amount of extruded debris. Objective: This in-vitro study aimed to assess and compare the quantity of apically extruded debris after root canal instrumentation by three different endodontic file systems: EdgeFile X7, 2-Shape, and WaveOne Gold. Methods: A total of thirty single-rooted extracted human mandibular premolars were collected and randomly allocated into three groups (n = 10). Group A was instrumented with the EdgeFile X7 rotary system, Group B with the 2-Shape rotary system, and Group C with the WaveOne Gold reciprocating system. Debris were collected in known-weighted glass vials following the Myers and Montgomery method. After instrumentation, the vials were dried at 68°C in an incubator for five days. The dry debris weight was calculated using a high-precision digital balance. Statistical analysis for the collected data was performed with one-way ANOVA and Duncan’s post-hoc tests (p < 0.05). Results: All file systems resulted in extrusion of apical debris. The WaveOne Gold system led to significantly higher mean amount of debris comparing with the other two systems (p < 0.05). The EdgeFile X7 system induced the lowest mean amount of debris, followed by the 2-Shape system, with no statistically significant difference between them (p > 0.05). Conclusion: Within this study's limitations, file systems with rotation motion (EdgeFile X7 and 2-Shape) were related to less extrusion of apical debris comparable to the reciprocating system (WaveOne Gold). The file design and motion kinematics were significantly related to amount of debris extruded beyond the apical foramen.
Impact of COVID-19 Vaccination on Pregnancy Outcomes among Women in Babylon City, Iraq: A Prospective Cohort Study
Background: Maternal COVID-19 infection was associated with increased severity of adverse outcomes for birth, such as poor birth outcomes. These risks were significantly lowered by vaccination, but information on these vaccines from low- and middle-income countries such as Iraq is sparse. Objective: To assess the impact of the maternal vaccination against COVID-19 on pregnancy outcomes in Babylon city, Iraq. Methods: Prospective cohort study was done in Al Hashimiya General Hospital and private maternity clinics from January 2023 to December 2024. 400 pregnant women aged 18-40 were registered, 200 of whom were vaccinated (Pfizer-BioNTech or Oxford-AstraZeneca during pregnancy) and 200 of whom were not. We gathered information on demographics, obstetric history, time of vaccination, and maternal and neonatal complications. The data was analyzed using SPSS version 26. Results: Vaccinated women had lower COVID-19 infection rates during pregnancy (8.5% vs. 34.5%; OR 0.19, 95% CI 0.11-0.33; P < 0.001). Preterm birth was also less common (9.0% vs. 16.5%; OR 0.50, 95% CI 0.28-0.89; P = 0.018). Mean gestational age was higher in vaccinated women (38.6 ± 1.4 vs. 37.8 ± 2.1 weeks; P = 0.003). Birth weight, Apgar scores, NICU admission and congenital anomalies did not differ significantly. The rates of preterm birth differed between the 3 groups of women, with the lowest rate observed among those who received second trimester vaccination (6.8%) (P = 0.04). Conclusion: COVID-19 vaccination during pregnancy reduces maternal infection and preterm birth without increasing neonatal risks in this Iraqi population. These findings support adding COVID-19 vaccination to routine antenatal care.
Knowledge, Attitudes and Practices of Secondary School Teachers in Ekiti State Regarding Hospital Referral for Sports-Related Head Injuries among Students
Background: Sports-related head injuries among students are common and require timely recognition and hospital referral to prevent complications. Teachers often serve as first responders in school settings, especially in low-resource environments. Objective: To assess the knowledge, attitudes, and practices of secondary school teachers in Ekiti State regarding hospital referral for sports-related head injuries. Methods: A descriptive cross-sectional study was conducted among 342 teachers using a structured questionnaire. Knowledge, attitude, and practices (KAP) were assessed using predefined scoring systems. Data were analyzed using SPSS version 25.0, with logistic regression used to identify predictors of good referral practice. Results: Most respondents demonstrated good knowledge of key concussion signs, including recognition of red flag symptoms (85.4%) and appropriate emergency response (88.9%). Overall, 69.6% had a positive attitude toward referral. However, only 52.0% reported frequent hospital referral practices (always/often). Common barriers included lack of training (66.7%), absence of school policy (62.0%), and transport challenges (57.3%). Predictors of good referral practice included good knowledge (AOR 2.34, p=0.001), positive attitude (AOR 1.96, p=0.005), and formal training (AOR 2.88, p<0.001). Conclusion: While teachers demonstrated relatively good knowledge and attitudes, referral practices remain suboptimal due to systemic and training-related barriers. Targeted training and institutional support are essential to improve outcomes.
The Role of Anti-Müllerian Hormone (Amh) In the Pathophysiology and Therapeutic Approaches in Female Infertility: A Review
Anti-Müllerian Hormone (AMH) is a hormone that belongs to the transforming growth factor beta (TGF-β) superfamily. It is involved in the development and functioning of the reproductive tract and is used as a marker for ovarian reserve. This review aims to outline the current knowledge of the physiology, pathophysiology, and therapeutic applications of AMH in females with infertility focusing on recent molecular and clinical developments. AMH plays a central role in regulation of folliculogenesis, inhibiting primordial follicle recruitment and thereby modifying the sensitivity of reduced number large growing follicles to FSH stimulation. However, as AMH levels are relatively stable throughout the menstrual cycle, it is currently considered one of best reproductive aging biomarkers of ovarian reserve and consequently reproductive lifespan. At physiological levels, AMH plays a major role in ovarian homeostasis, follicular maturation and the maintenance of the ovarian follicular reserve. Changes in AMH synthesis or action are related with multiple reproductive disorders, including polycystic ovary syndrome (PCOS), diminished ovarian reserve (DOR), premature ovarian insufficiency (POI), endometriosis, and granulosa cell tumors. Women with PCOS having increased AMH levels exhibit both follicular arrest and anovulatory infertility while women undergoing ovarian aging have less AMH production with consequent impaired fecundity. In addition, recent advances also postulated possible utilization of AMH in clinical settings ranging from being an ovarian protector during chemotherapy (due to the effects on chemoresistance), to modulating specific pathways linked with reproductive disorders. Despite notable advances, several issues regarding AMH assay standardization, age-dependent reference ranges and the link between circulating AMH concentrations and reproductive health outcomes remain to be resolved. Additionally, the molecular mechanisms of AMH action in endocrine ovarian dysfunction are still poorly understood. Final remarks AMH is a major regulator of the female reproductive system and an important infertility biomarker. Ongoing studies of the physiology and signaling pathways for AMH may help to micro-focus diagnostic and therapeutic strategies in female infertility, as well as improve personalized reproductive medicine.
Histological Alterations and Biochemical Markers of Skin Cancer: A Review
Skin cancer is a broad range of malignant and benign neoplasms that are common worldwide and more prevalent than many other cancer types. This condition involves the neoplastic proliferation of cells and tissues within the skin and can be associated with significant morbidity and mortality. This review summarizes the most recent advances regarding histopathologic changes and management of skin malignancy, which are classified by three types-Melanoma (MM), Basal Cell Carcinoma (BCC) Squamous Cell Carcinoma (SCC). They also show certain patterns of atypia, invasion and proliferative activity which is vital for histopathological diagnosis as well as prognostic stratification. Molecular changes demonstrate that mutations in BRAF (v-raf murine sarcoma viral oncogene homolog B1) or NRAS (neuroblastoma RAS viral oncogene homolog) in the RAS signaling pathway, Hedgehog family of proteins and β-catenin may underlie differences in clinical outcome as they affect tumor progression and response to therapy, particularly in skin cancers. In recent years, encouraging results have been observed in the treatment of HCC through targeted therapies and immune checkpoint inhibitors as first- or second-line treatment objectives, resulting in improvement in the clinical outcomes of patients with HCC. However, these strategies are also faced with formidable challenges for clinical translation due to cancer-relapsing therapeutic resistance and tumor heterogeneity. Tumor microenvironmental [practices] like Ti [tumor infiltrating] immune cells, interaction with (the)extracellular matrix are also key to the tumor development and progression. High throughput technologies like molecular profiling and precision medicine provide new treatment markers as well as the means to individualize therapy. However, skin cancer represents one of the most heavily treated malignancies, especially with advanced disease. This would, in turn, integrate lithologic, molecular and therapeutic data into the diagnostic inferences standardized for patients—improving understanding & rational of treatment thereby enabling better reporting of outcomes.
Association Between Stress Hormones and Sperm DNA Fragmentation in Men with Unexplained Infertility
Background: Psychological and physiological stress has been an emerging interest as a likely contributor to male infertility by influencing endocrine regulation and sperm quality. Hormonal changes due to stress may induce a background of oxidative damage that could influence sperm DNA damage and thus affect fertility potential. Purpose: The purpose of this study was to explore the relationship between stress hormones and sperm DNA fragmentation in men with idiopathic infertility. Methods: A case–control study of 120 men aged 20–45. The subject group consisted of 60 men with unexplained infertility and 60 healthy fertile men as controls. Overnight fasting venous blood samples were taken for the measurement of serum cortisol (µg/dL), adrenocorticotropic hormone (ACTH; pg/mL) and dehydroepiandrosterone (DHEA; µg/dL) by enzyme-linked immunosorbent assay ELISA. Semen was collected from the infertile participants, who they were analyzed by using the staining method (Toluidin Blue TB). Results: Serum cortisol (20.84 ± 4.92 vs 16.73 ± 3.85 µg/dL; P = 0.004) and ACTH levels (42.61 ±8.34 vs 34-18±6-79 pg/mL; P =0-002) were significantly higher in the infertile men than healthy controls, respectively In contrast, levels of DHEA were significantly lower in infertile men than those of fertile ones (178.45 ± 38.72 vs. 221.36 ± 42.15 µg/dL; P =0.005). Cortisol (23.41 ± 4.83 vs. 18.47 ± 3.95 µg/dL; P = 0.006) and ACTH levels (46.28 ± 7.91 vs.39,15±6,84 pg/mL;P=0,007) were significantly elevated in men with damaged sperm DNA compared to those without impaired DNA integrity among infertile men. Conclusions: Unexplained infertile men have demonstrable evidence for stress-induced endocrine dysfunction characterized by elevated cortisol (and ACTH) levels combined with low DHEA concentrations.
Clinical Complexities in Vulnerable Populations: A Comprehensive Review of Hemophagocytic Lymphohistiocytosis Diagnostics and the Long-Term Neurodevelopmental Sequelae of Preterm Birth
Background: Modern medicine faces distinct challenges in managing acute hyperinflammatory syndromes and chronic developmental sequelae. This article synthesizes evidence regarding Hemophagocytic Lymphohistiocytosis (HLH), a life-threatening immune dysregulation, and the long-term neurocognitive outcomes of preterm birth, representing two critical ends of the patient vulnerability spectrum. Methods: We reviewed recent literature regarding HLH diagnostic criteria, specifically focusing on bone marrow histomorphology and the HScore, alongside meta-analyses of executive function (EF) in children born preterm. Efficacy data on etoposide regimens and global preterm birth statistics were analyzed to provide a holistic view of patient outcomes. Results: Diagnostic precision in HLH remains difficult; bone marrow hemophagocytosis is sensitive but lacks specificity without the HScore. Malignancy-associated HLH, particularly T-cell lymphoma, carries the highest mortality. In the pediatric domain, survivors of preterm birth exhibit persistent deficits in executive functions—specifically working memory and inhibition—which significantly hinder academic performance at school age. Conclusions: Effective management of vulnerable populations requires a dual focus: rapid, accurate diagnosis for acute crises like HLH using improved indices, and sustained neurodevelopmental support for preterm survivors. The intersection of inflammatory susceptibility and developmental fragility warrants further investigation to optimize long-term quality of life.
Spatial Clustering Analysis of Mortality Tuberculosis in The Iraq, 2018 To 2022
Back ground: Iraq's Environmental Statistics and Health Indicators published annual mortality rates for tuberculosis from 2018 to 2022. However, this publication does not assess whether the patterns are merely the result of chance or whether they accurately reflect regional variations in disease risk or treatment methods. To formally test for geographical clustering of disease, we used global spatial autocorrelation to analyze Iraq's annual TB mortality rates from 2018 to 2022. The spatial scan statistic, the Anselin Local Moran's I, and Getis-Ord Gi* were used to determine the spatial variations of TB mortality rates. Geographic clustering was statistically significant across all age and gender groups, according to all tests. The spatial scan statistic indicated that the most likely cluster of high mortality was in parts of Dha qar, Maysan, Basrah, Diwaniyah, Muthanna, Wasit, Babil, Najaf, and Karbala, (LLR= 4.71, P > 0.05). Secondary clusters were found in Ninawa, Dahuk, Karbala, Arbil, Tam’mim, Salah ad din, Sulaymaniyah, Diyala, and Anbar (LLR= 0.88, P < 0.05). For 25% maximum window size, the statistically significant most likely was found around Diwaniyah, Babil, Wasit, Karbala, Dha qar, and Najaf (LLR= 3.65, P > 0.05), with secondary clusters in Ninawa, Dahuk, Karbala, Arbil, Tam’mim, Salah ad din, Sulaymaniyah, Diyala, and Anbar (LLR= 0.88, P < 0.05).
Evaluation of Growth Indicators and Quality of Life in Children with Cleft Lip/Palate After Surgery
Introduction: Oral clefts are a group of relatively common congenital anomalies, among which cleft lip and cleft palate (CLP) represent one of the major forms. Methods: This study was conducted among patients with CLP. A total of 70 patients who had undergone CLP-related surgery were enrolled in the study. The study instrument consisted of several sections assessing demographic characteristics and Oral Health Impact Profile-14 (OHIP-14) questionnaire The collected data were then analyzed and compared using SPSS software, version 18. Result: Based on the findings, 70 patients were enrolled in the study. Sixty percent of the participants were male, and the largest age group was 6–9 years (36.7%). Regarding parental education, 38.3% of fathers had a secondary education level, while 43.3% of mothers had completed primary education. The mean (SD) of the total OHIP-14 score before surgery was 45.60 (2.30). Post-operatively, this score significantly decreased to 30.21 (8.33), indicating a substantial improvement in the patients’ quality of life following the surgical procedure. Findings revealed a reduction in scores across all seven domains of the OHIP-14 questionnaire post-surgery, reflecting a significant enhancement in the patients’ OHRQoL. This improvement was statistically significant in all dimensions (P < 0.001). Conclusion: Given the significant post-surgical improvement in OHRQoL, it is highly recommended that reconstructive surgeries and associated rehabilitative care be prioritized to optimize the quality of life for patients with CLPA.
Evaluation of The Diagnostic Power of New Biochemical Biomarkers in The Early Detection of Sinusoidal Adenocarcinoma
Background: One objective of this study was to analyze the diagnostic potential of selected serum biochemical markers, such as interleukin-6 (IL-6) and carbohydrate antigen 19-9 (CA 19-9), as well as molecular markers including microRNA-21 (miR-21) and caudal type homeobox transcription factor CDX2 in patients with adenocarcinoma. Materials and Methods: This was a case-control study conducted at the Oncology Center Thi-Qar, Iraq during the period from March 2025 to December. We enrolled 138 subjects, including 72 patients with confirming diagnosis of adenocarcinoma, and controls that were apparently healthy in the number of 66. Cytokine concentrations of IL-6 and CA 19-9 were obtained using enzyme-linked immunosorbent assay (ELISA) kits. Quantification of miR-21 and CDX2 Expression Levels by qRT-PCR Results: Serum levels of IL-6 and CA 19-9 in adenocarcinoma patients were significantly higher than the normal controls (38.72 ± 12.45 vs 8.64 ± 3.18 pg/mL, p < 0.001; 87.46 ± 35.18 vs, p <0ofU/mL U(mL)]< u) In summary, miR-21 expression was significantly increased and CDX2 expression decreased in patients compared to controls (all p < 0.001). CDX2 expression was positive in 40.3% of patients and 90.9% of controls. Using multiple linear regression, we found that miR-21 was the most significant predictor of disease severity (β = 0.412, p < 0.001; IL6 β = 0.331, p = 0.002; CA19-9 β =0.286,p=0.013; CDX2 β=− 0.274,p=0.004). Conclusions: IL-6, CA 19-9, miR-21 and CDX2 were markedly dysregulated in the adenocarcinoma patients. These biomarkers were all significantly associated with disease presence and severity, suggesting the validity of these new findings as reliable non-invasive diagnostic tools for early diagnosis and clinical appraisal of this chronic disease in the future.
The Role of Serum IL-10 And IL-17 Levels in The Progression and Severity of Bacterial Pneumonia
Background: Bacterial pneumonia is still a leading cause of global morbidity and mortality. Interleukin-10(IL-10) and interleukin-17(IL-17), two major cytokines participating in the anti-inflammatory and pro-inflammatory pathways. The objective of the study was to determine whether serum IL-10 and IL-17 acts as a noninvasive marker for bacterial pneumonia staging and severity. Methods: A case-control study was carried out at Al-Sadr Medical City, Al-Najaf, Iraq. This study enrolled 60 patients diagnosed as bacterial pneumonia (cases) and 40 apparently healthy controls. Serum IL-10 and IL-17 using Enzyme-linked immunosorbent assays (ELISA). According to the severity of illness, patients were divided into groups with mild, moderate and severe pneumonia. Results: Serum IL-10 and IL-17 levels in bacterial pneumonia patients were also significantly elevated when compared with healthy controls (P < 0.001). The average IL-10 level was 32.84 ± 8.71 pg/mL in patients vs. 12.63 ± 4.25 pg/mL in controls and the average IL-17 level was 48.57 ± 11.36 pg/mL vs. 18.92 ± 6.14 pg/mL, respectively. Moreover, both cytokines increased significantly with disease severity. Among the three groups, patients with severe pneumonia had the highest concentrations of IL-10 and IL-17 (P = 0.002 and P < 0.001, respectively). Conclusions: High serum IL-10 and IL-17 levels associated with bacterial pneumonia can be used as a significant correlate with severity of disease. Therefore, these results indicate that both cytokines should be helpful for predicting or evaluating the disease severity and disease course of patients with bacterial pneumonia.
Sexual Dimorphism in Micronutrient Homeostasis and Cluster Depletion Patterns in Type 2 Diabetes Mellitus Patients with Hair Loss: Development and Validation of a Phenotype-Based Risk Stratification Tool
Background: It is clear that there are gender differences in micronutrient body handling; however, there is a lack of systematic research on micronutrient gender differences in Type 2 Diabetes Mellitus (T2DM) patients also experiencing hair loss. The notion that several micronutrients may be depleted simultaneously (so called "cluster deficiency") has not been studied in this specific type of patients; and there is no validated instrument for clinicians to determine who should be more extensively tested. Hypothesis: We hypothesized that zinc, ferritin and vitamin D status would be different in men and women with T2DM and hair loss, that multiple deficiencies would be clustered and that a simple risk score could be constructed based on these results that would enable clinicians to predict at the bedside which patients are likely to have the most severe deficiency pattern. Methods: involved in recruiting 150 patients with T2DM who suffered from active hair loss (80 patients from females and 70 patients from males) were carried out at the Imam Al-Sadiq Hospital in Babil, Iraq in the period between January and April 2026. Serum zinc, ferritin, vitamin D, and HbA1c was measured by atomic absorption spectrophotometry, CMIA, CLIA, and HPLC, respectively. Independent samples t-tests were used to compare groups, Pearson's was used to explore correlations and hierarchical cluster analysis was used to identify natural groupings of deficiency patterns. We then constructed a logistic regression model and transformed it into a simple integer risk score, and tested the model against 1000 bootstrap resamples. Results: Women had far lower ferritin than men (30.6 vs 113.3 ng/mL, p < 0.001, Cohen's d = 2.89), lower zinc (66.6 vs 85.4 µg/dL, p = 0.001, d = 1.38), and lower vitamin D (13.6 vs 21.3 ng/mL, p = 0.015, d = 0.96). Zinc and ferritin had strong positive correlation (r = 0.72) and zinc and vitamin D (r = 0.68) but there was no correlation between the micronutrients and HbA1c. The cluster analysis divided the patients into three groups: (i) isolated vitamin D deficiency (53 %); (ii) dual or triple vitamin D deficiency (33 %); and (iii) triple vitamin D deficiency (14 %). Logistic regression analysis revealed that female sex (OR 8.4), age > 55 years (OR 3.2) and diabetes duration > 10 years (OR 2.9) were independently associated with triple deficiency, with AUC value of 0.84. The 4 point risk score (0–3 low, 4–6 moderate, 7–9 high) identified triple-deficient patients with an AUC of 0.83 (95% CI 0.75–0.91) and 86% sensitivity and 92% specificity in the bootstrap validation. Summary: This is the first validated bedside instrument for the prediction of cluster deficiency phenotypes in T2DM patients with hair loss. The score enables the efficient triaging of patients for unnecessary testing of low-risk patients as well as for prompt and targeted multi-nutrient replacement of high-risk patients.
Evaluation of The Diagnostic Power of New Urinary Molecular Biomarkers in The Early Diagnosis of Urinary Bladder Cancer
Background: Urinary molecular biomarkers attracting interests as potential tools for early detection and prognosis of urinary bladder cancer (UBC). This study was performed to assess the diagnostic ability of Nuclear Matrix Protein 22 (NMP22), Bladder Tumor Antigen (BTA), microRNA-21 (miR-21) and survivin (BIRC5) in urinary bladder cancer patients. Methods: A case–control study conducted at Al-Forat A-Awsat Oncology Center, Najaf, Iraq during July 2025 to February 2026. A total 110 subjects were included: 62 patients with histopathological confirm of urinary bladder malignancy, and 48 healthy controls. Standardized collection of fresh urine samples NMP22 and BTA were measured in urine using enzyme-linked immunosorbent assay (ELISA) kits. Methods qRT-PCR was used to measure the expression levels of miR-21 and survivin (BIRC5). Results: The urinary levels of NMP22 (24.85 ± 8.37 U/mL vs. 9.42 ± 3.18 U/mL), BTA (42.71 ± 12.65 U/mL vs. 18.53 ± 6.27 U/mL), and miR-21 expression (3 Standardized DNA tests for the diagnosis of bladder carcinoma on urine) were significantly higher in patients compared with healthy controls (p <0 001). As a result, survivin had the highest diagnostic with an area under the operating curve (AUC) of 0.945 (sensitivity and specificity: 93.5% and 89.6%), and it was followed by miR-21 AUC = 0.927(91.9% sensitivity,87.5% specificity). AUC value was good for NMP22 (0.841) and BTA 0.812 also, which showed that these two diagnostic tests are doing important role in diagnosis of bladder cancer. Conclusions: NMP22, BTA, miR-21 and survivin were differentially dysregulated in UCB patients and associated with disease progression. Both survivin and miR-21 displayed better diagnostic and prognostic ability in all biomarkers.
Awareness and Practice of Orthodontic Record-Keeping and Radiographic Documentation among Iraqi Orthodontists: A Cross-Sectional Study
Background: Accurate and comprehensive orthodontic records are essential for precise diagnosis, effective treatment planning, treatment monitoring, medico-legal protection, and long-term patient care. Recent technological advancements have improved the methods of recording, storing, and managing orthodontic records; however, the extent to which these practices are consistently implemented in routine clinical settings remains uncertain. Aim of the Study: to evaluate the level of awareness and clinical practices related to orthodontic record-keeping among Iraqi orthodontists and to investigate age-related differences in awareness and record-management practices. Materials and Methods: A cross-sectional online survey was conducted among Iraqi orthodontists from January to March 2026 using a structured questionnaire. The questionnaire assessed demographic characteristics, awareness of essential orthodontic records, and practices related to record storage, retention, and disposal. A total of 71 valid responses were included in the statistical analysis. Data were analyzed using descriptive statistics, Pearson’s Chi-square test, or Fisher’s Exact test when appropriate, with statistical significance set at p < 0.05. Results: Most participants demonstrated high awareness regarding the importance of documenting patient details, medical history, radiographs, and pre- and post-treatment photographs. Orthopantomograms were routinely used, whereas lateral cephalometric radiographs were obtained selectively according to clinical requirements. Conventional handwritten record systems remained the predominant method of documentation, while digital dental models were infrequently used. Significant associations were observed between age groups and specific aspects of record documentation and organization, whereas record retention and disposal practices showed no significant age-related differences. Conclusion: Iraqi orthodontists demonstrated adequate awareness regarding orthodontic record-keeping; however, a noticeable gap persists between awareness and consistent clinical implementation. The development of standardized protocols, wider adoption of digital record systems, and continuous professional education may improve the quality, efficiency, and legal reliability of orthodontic record-keeping practices.
Liquid Biopsy Biomarkers in Thyroid Cancer: Current Evidence and Future Directions
Background: Thyroid cancer (TC) incidence has risen globally, yet the diagnostic and management paradigms remain heavily reliant on invasive tissue biopsies and ultrasonography, plagued by high rates of indeterminate cytology and overtreatment. Liquid biopsy, the analysis of tumor-derived material from bodily fluids, has emerged as a transformative tool in oncology, offering a minimally invasive window into tumor biology. This systematic review synthesizes the evidence from 2020 to 2026 on liquid biopsy biomarkers in TC, including circulating tumor cells (CTCs), cell-free DNA (cfDNA), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and extracellular vesicles (EVs). Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for articles published between January 1, 2020, and January 1, 2026, using PRISMA guidelines. Studies investigating the diagnostic, prognostic, or predictive utility of blood-based liquid biopsy biomarkers in differentiated thyroid cancer (DTC), medullary thyroid cancer (MTC), and anaplastic thyroid cancer (ATC) were included. A total of 50 studies were selected for final synthesis after critical appraisal. Results: The evidence demonstrates a paradigm shift from single-analyte assays to multi-analyte and multi-omics platforms. ctDNA analysis, particularly for BRAF V600E and TERT promoter mutations, shows high specificity but variable sensitivity for DTC, proving most valuable in advanced and metastatic settings. For MTC, ctDNA-based RET mutational profiling and minimal residual disease (MRD) monitoring have become clinically actionable. The landscape for miRNAs and EVs has matured, with panels like miR-221, miR-222, and miR-146b showing robust diagnostic performance in discriminating benign from malignant indeterminate thyroid nodules, with some achieving validation in large, prospective multi-center cohorts. Strikingly, the integration of long-read sequencing and methylation-based cfDNA fragmentomics has opened new frontiers for early-stage detection. Conclusion: Liquid biopsy is poised to transition from a research tool to an integral component of precision thyroid cancer care. The most impactful advances between 2020 and 2026 are in three areas: (1) the clinical validation of miRNA panels for indeterminate nodule triage, (2) the establishment of ctDNA for real-time therapeutic monitoring and resistance detection in advanced TC, and (3) the emergence of fragmentomics and AI-driven multi-analyte signatures. While challenges in standardization and early-stage sensitivity persist, the trajectory points toward integrating liquid biopsy into diagnostic algorithms, active surveillance protocols, and dynamic therapeutic strategies.
Integrated Prediction and Management of Protein Energy Wasting in Pediatric Chronic Kidney Disease: A Prospective Cohort Study at The Children's National Medical Center
Background: Protein‑energy wasting (PEW) is a multifactorial complication in children with chronic kidney disease (CKD), leading to growth failure, poor quality of life, and increased mortality. However, routine nutritional assessment often lacks predictive tools and integrated management strategies. Objective: To develop a predictive model for nutritional deterioration in children with CKD stages 3‑5D and to evaluate the efficacy of a targeted, multi‑component nutritional intervention protocol at the Children's National Medical Center. Methods: A prospective cohort study (January 2022 – December 2025) enrolled 154 children with CKD (7‑17 years, stages 3‑5D). Comprehensive assessment included anthropometry, bioelectrical impedance analysis (BIA), dietary records, and serum biomarkers. A multivariate logistic regression model was developed to predict weight‑for‑height decline (≥0.5 SD over 12 months). High-risk patients (n=72) were allocated to either the intervention or standard care group based on consent and logistical feasibility.” to a 12‑month intensive Nutritional Optimization Protocol (NOP) or standard care. Results: “The baseline prevalence of PEW was 38.3%.” The final predictive model included dialysis vintage >12 months (OR=4.21), low phase angle (PhA<5°) (OR=3.84), energy intake <80% (OR=3.52), low leptin (OR=2.93), and frequent hospitalizations (OR=2.71); AUC‑ROC=0.89. After 12 months, the NOP group showed significant improvements vs. controls: weight‑for‑height Z‑score (+0.42 vs. −0.11, p<0.001), mid‑upper arm circumference (+1.8 vs. +0.3 cm, p<0.001), serum albumin (+0.35 vs. +0.05 g/dL, p=0.003), and a 32% reduction in hospitalization days. Phase angle <4.5° predicted low prealbumin with 85% sensitivity and 78% specificity. Conclusion: A validated predictive model using clinical, dietary, and BIA parameters enables early identification of children at risk for PEW. A multi‑modal, individualized nutritional intervention significantly improves nutritional status and reduces hospitalizations, supporting its integration into routine care at the Children's National Medical Center
Apoptosis and Cancer Progression: Balancing Tumor Suppression and Disease Advancement
Background: Apoptosis is a tightly regulated form of programmed cell death that is essential for tissue homeostasis, normal development, and tumour suppression. Although defective apoptotic signalling is a hallmark of cancer, accumulating evidence indicates that apoptosis may also paradoxically promote tumour progression through its effects on the tumour microenvironment (TME), giving rise to the concept of the "apoptosis paradox." Objectives: To critically review the dual role of apoptosis in cancer progression, with particular emphasis on its immunomodulatory, regenerative, and pro-tumorigenic functions within the TME, and to discuss the therapeutic implications of targeting apoptosis-associated pathways. Methods: A comprehensive narrative review of the contemporary literature was conducted using peer-reviewed studies addressing the molecular mechanisms of apoptosis, apoptosis-mediated remodelling of the TME, immune regulation, autophagy, angiogenesis, metastasis, therapeutic resistance, and emerging apoptosis-targeted cancer therapies. Results: Current evidence demonstrates that, beyond eliminating damaged or transformed cells, apoptotic tumour cells actively influence the TME by releasing bioactive mediators that regulate immune responses, promote pro-tumorigenic macrophage polarization, stimulate angiogenesis and tissue regeneration, and facilitate tumour growth, metastatic dissemination, and resistance to therapy. Furthermore, the intricate interplay between apoptosis, autophagy, and immune signalling highlights the context-dependent nature of programmed cell death in cancer biology, challenging the traditional view of apoptosis as solely tumour suppressive. Conclusions: Apoptosis exhibits a dualistic role in cancer, functioning as both a tumour-suppressive and tumour-promoting process depending on the biological context. A deeper understanding of apoptosis-mediated interactions within the TME may uncover novel therapeutic targets and support the development of precision-based strategies that improve treatment efficacy and clinical outcomes in patients with cancer.
The Role of Fecal Calprotectin in The Diagnosis and Severity of Ulcerative Colitis
Background: The neutrophil-derived protein fecal calprotectin has emerged over the last decade as a novel non-invasive biomarker for the diagnosis and follow-up of intestinal inflammation. Objectives The objective of this study was to assess the diagnostic power and role of severity of fecal calprotectin in patients with ulcerative colitis. Methods: A case-control study was performed in Al-Najaf City in Iraq at Al-Sadr Medical City, from August 2025 to March 2026. A total of 150 subjects were recruited, comprising 63 patients with clinicopathologically proved ulcerative colitis (UC) and 87 apparently healthy controls. The severity of disease was characterized according to the Mayo scoring system into mild, moderate and severe. All subjects were asked to provide fresh stool samples, and fecal calprotectin concentrations were assessed via a commercially available ELISA. Results: Fecal calprotectin concentrations in patients with ulcerative colitis were significantly greater than those of healthy controls (412.68 ± 136.45 μg/g vs.38.74 ± 14.62 μg/g; p <0.002). Similarly, fecal calprotectin concentration showed stepwise elevation according to disease severity: 218.54 ± 64.27μg/g, 431.86 ± 95.48μg/g and 732.45 ± 128.91μg/g in patients with mild, moderate and severe disease respectively (F =58·73, p <0·001). In the diagnosis of ulcerative colitis, fecal calprotectin showed a sensitivity of 90.5% and specificity of 87.4% at a cut-off value of 85.5 μg/g. Conclusions: Fecal calprotectin stands as a non-invasive biomarker with high sensibility and specificity in the diagnosis of ulcerative colitis, also correlating highly with severity of illness. The sequential accumulation of high fecal calprotectin concentrations with severe disease activity is a further indication of its useful e ness as an indicator of inflammatory burden, which is directly related to treatment choices.
Detection of The Psla And Pela Genes in Multidrug-Resistant Pseudomonas Aeruginosa Isolated from Respiratory Infections
Background: Pseudomonas aeruginosa is a leading opportunistic pathogen that have the ability to produce biofilms using secreted extracellular polymeric substances are typically controlled by the pslA and pelA genes. The current study was undertaken to determine the prevalence of pslA and pelA genes in MDR P. aeruginosa isolated from respiratory infections, and to assess its correlation with antibiotic resistance profile. Methods: Cross-sectional study carried in Hilla Teaching Hospital, Babylon Province-Iraq during the period from July 2024 to January 2025. Methods: 87 patients who presented with clinically suspected respiratory tract infections. Antimicrobial susceptibility tests were conducted using the Kirby–Bauer disk diffusion method according to CLSI guidelines as follows: ceftazidime, imipenem, meropenem, ciprofloxacin, levofloxacin, gentamicin and amikacin. Molecular Detection of pslA and pelA GenesMultidrug-resistant isolates were selected to be used for the molecular detectionof the pslA genes by conventional PCR. Results: Ciprofloxacin (85.0%) and levofloxacin (82.5%) had the highest resistance rates, followed by ceftazidime (77.5%), meropenem (75.0%), and imipenem (70.0%); however, amikacin had the lowest resistance rate at 45%. In molecular analysis, the pslA gene was identified in 95.0% of MDR isolates and pelA gene was found in 87.5%. The presence of pslA and pelA genes is significantly associated with resistance to β-lactams, carbapenems and fluoroquinolones (p < 0.05; however, aminoglycosides showed no significant correlation. Conclusion: The Pseudomonas aeruginosa Respiratory Isolates of Multidrug Resistant Bacteria (MDR) exhibited high frequency of pslA and pelA genes which imply that biofilm formation took a major part in bacterial persistence and MDR. The major correlation with biofilm-associated genes and antimicrobial resistance indicates the emergence of pathogenic clones which are well adapted and higher virulent.
The Benzoxazole Pharmacophore in Precision Oncology: A Critical Narrative Review of its Potential and Pitfalls in the Treatment of Lung Cancer
Lung cancer remains the preeminent cause of cancer-related mortality globally, a grim statistic that persists despite significant advancements in molecular diagnostics and targeted therapeutics. The paradigm shift towards precision medicine has intensified the search for novel molecular entities capable of selectively ablating the heterogeneous oncogenic drivers of this complex disease. The benzoxazole scaffold has emerged as a privileged structure in medicinal chemistry, garnering significant interest due to its structural versatility, favorable drug-like properties, and broad-spectrum biological activities. This narrative review critically evaluates the contemporary evidence base concerning the advantages and limitations of positioning benzoxazole derivatives as viable candidates for the precision treatment of lung cancer. We systematically synthesize available preclinical data demonstrating that benzoxazole-based compounds possess a remarkable capacity to modulate a diverse array of oncogenic pathways integral to lung cancer pathogenesis, including the epidermal growth factor receptor (EGFR), the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) axis, the mitogen-activated protein kinase (MAPK) cascade, vascular endothelial growth factor (VEGF)-mediated angiogenesis, and key apoptosis and cell-cycle checkpoints. Numerous derivatives exhibit promising antiproliferative, antiangiogenic, antimetastatic, and chemosensitizing activities in vitro and in vivo. Concurrently, structure-activity relationship (SAR) studies and rational drug design have facilitated improvements in target selectivity and pharmacokinetic (PK) profiles. Furthermore, the integration of computational chemistry, artificial intelligence (AI)-driven molecular discovery, and biomarker-guided patient stratification offers a fertile ground for the future development of tailored benzoxazole-based therapeutics for genetically defined lung cancer subtypes. However, the path to clinical translation is beset with substantial challenges. This review identifies critical bottlenecks, including limited validation in clinically relevant in vivo models, incomplete toxicity and pharmacokinetic characterization, uncertain long-term safety profiles, the potential for off-target effects, the confounding issue of tumor heterogeneity, the inevitable emergence of acquired drug resistance, and the conspicuous absence of clinical trial data for benzoxazole derivatives in lung cancer patients. Developmental complexities related to manufacturing, formulation, and regulatory approval further impede progress. By critically synthesizing the current medicinal chemistry, pharmacological, and translational evidence, this review offers a balanced perspective on both the promise and the limitations of benzoxazoles within the precision oncology armamentarium. We conclude that future multidisciplinary efforts—integrating structure-based drug design, predictive biomarker discovery, nanotechnology-enabled delivery systems, and rational combination therapeutic strategies—may facilitate the successful incorporation of benzoxazole-based agents into personalized treatment paradigms for lung cancer, provided that robust preclinical and clinical evidence unequivocally confirms their efficacy and safety.
Effectiveness of Differentiated Treatment Strategies and Quality-of-Life Assessment in Patients with Trigeminal Neuralgia
Background and objective. Trigeminal neuralgia (TN) is a severe paroxysmal facial pain disorder for which treatment must be individualized. This study aimed to improve treatment outcomes in patients with TN through a differentiated approach that accounts for disease severity, somatic status and quality of life (QoL). Methods. A 【retrospective / prospective — specify】 observational study of 171 patients with TN treated in the inpatient neurosurgery department of the multidisciplinary clinic of the Tashkent Medical Academy (2019–2023). Patients were allocated to three groups by treatment modality, disease severity and somatic status: conservative treatment plus peripheral trigeminal branch blocks (Group 1, n = 55); Gasserian ganglion blocks plus trigeminal branch exeresis (Group 2, n = 57); and microvascular decompression (MVD; Group 3, n = 59). Diagnosis was based on clinical criteria, high-resolution magnetic resonance imaging (MRI) and electroneuromyography (ENMG). Pain and QoL were assessed before and after treatment using institutional questionnaires. Results. Positive outcomes were achieved in 163 of 171 patients (95.0%). The best results were obtained in Group 3 (MVD), where 87% of patients achieved significant improvement and none showed no change. Pain and QoL scores improved significantly in all groups after treatment (P < 0.001), most markedly after MVD. Conclusion. A differentiated, severity- and comorbidity-based treatment strategy yields high rates of pain relief and QoL improvement in TN. MVD provides the most durable outcomes in surgically fit patients, while destructive and conservative approaches remain valuable for patients with contraindications to MVD.
Association Between Respiratory Symptoms and Indoor Air Quality in Small Workshops in Babil City in Iraq
Background: Poor indoor air quality in occupational settings is a significant public health issue as the small workshop’s workers are continuously exposed to airborne pollutants. Aim: This study was aimed to identify the relationship between the indoor air and respiratory symptomatic that affect workers in small workshops in Babylon City-Iraq. Methods: Cross-sectional analytical study conducted from September 2025 till March 2026 among the workers of 40 small workshops in Babylon City, Iraq. The detectors of various physical and chemical factors impulses are the portable calibrated instruments that were used to assess indoor air quality, measuring particulate matter (PM₂.₅, and PM₁₀). Respiratory symptoms such as persistent cough, sputum production, wheezing, dyspnea, chest tightness, nasal and throat irritation were evaluated using a semi-structured questionnaire adapted from the American Thoracic Society (ATS). Results: Overall, 63.0% of workers had at least one respiratory symptom: Persistent cough (41.0%), and nasal irritation (38.0%) were the most commonly reported complaints. Higher levels of PM₂. Relationship between respiratory symptoms and concentrations of particulate matter, PM₂₅ (χ² = 24.86, P < 0.001), PM₁₀ (χ² = 18.79, P < 0.001), CO₂ (χ² = 6.47, P = 0.011) and VOCs (χ² = 7.95, P = 0.005). Respiratory symptoms related to exposure to carbon monoxide were not statistically significant (P = 0.576). Conclusion: The poor indoor air quality was strongly related to the presence of respiratory symptoms among workers in small workshops located in Babylon City. Higher levels of particulate matter, carbon dioxide, and volatile organic compounds are key occupational health risks.