Abstract: Cardiovascular disease (CVD) is an umbrella term for any condition affecting the circulatory system, which includes the heart that pumps blood and the blood vessels that transport it throughout the body. CVDs, which encompass conditions such as ischemic heart diseases, stroke, heart failure, peripheral arterial diseases, and other cardiac and vascular disorders, are the leading cause of morbidity and mortality globally and have a significant impact on quality of life. In 2017, CVDs were responsible for an estimated 17.8 million deaths worldwide, accounting for 330 million years of life lost (YLL) and 35.6 million years of disability. When paired with data on CVD and related risk factors, these health metrics provide critical information for cardiologists, doctors, and public health experts. They provide crucial population-level data that may be used to develop global, regional, national, and local policies for preventing, treating, and managing CVDs and risk factors. Digital health interventions (DHIs), which use information technology, electronic health records, and communication tools to accomplish health-related goals, are becoming increasingly important in patient management, research, and public health monitoring. Smartwatch monitoring systems, smartphone applications, text messaging, and telehealth programs have all been used to improve compliance with medical treatments, assist secondary preventive initiatives, assure follow-up, and increase community ties. Together, these patient-centered treatment techniques lead to improved CVD outcomes.
Abstract: Ectogenesis, defined as the gestation of a human fetus outside the maternal body using artificial womb technology, represents a significant emerging development in reproductive medicine and neonatal care. Although complete ectogenesis remains largely theoretical, advances in partial ectogenesis have demonstrated promising potential in the management of extremely preterm infants by simulating critical intrauterine physiological conditions. Apart from its clinical implications, ectogenesis also generates a number of ethical, legal, and social issues that challenge current understanding of pregnancy, parenthood, and human development. This review critically discusses the ethical issues raised by ectogenesis, particularly with regard to neonatal, reproductive, parental, fetal, and social issues. Some of the issues discussed include equity, commodification, gestational relationship, and legal frameworks on ex-uterine gestation. This review synthesizes current literature on ectogenesis, particularly from a medical, ethical, and legal perspective, to demonstrate that ectogenesis has a dual function: as a clinical tool and a moral challenge. The article emphasises the need for interdisciplinary discourse and the development of robust governance frameworks to ensure that future applications of ectogenesis proceed in an ethically responsible and socially equitable manner.
Abstract: Fine-needle aspiration cytology (FNAC) has recognized limitations in diagnosing infiltrative follicular variant papillary thyroid carcinoma (FVPTC), as follicular architecture obscures the nuclear features needed for cytological diagnosis. We report a 49-year-old euthyroid male who underwent right hemithyroidectomy for a Bethesda Category II nodule (TIRADS 3 on ultrasound, no suspicious nodes). Postoperative histopathology revealed infiltrative FVPTC with capsular and lymphovascular invasion, and an ipsilateral central nodal metastasis (1/1). Following the 2015 American Thyroid Association guidelines, the tumor board recommended completion of total thyroidectomy with bilateral modified radical neck dissection, performed after a 5-week financial delay. Final staging was pT2 pN1b cM0 (AJCC 8 th edition), with multifocal left-lobe disease and bilateral nodal metastases (right lateral 4/15, left lateral 4/5). We discuss FNAC limitations, the evidence for completion surgery and bilateral dissection, and the oncological and financial challenges unique to resource-limited settings.
Abstract: Artificial intelligence (AI) and machine learning (ML) are revolutionizing the field of pharmacology by providing innovative computational tools that enhance drug discovery, development, and therapeutic decision-making. These technologies facilitate the analysis of large and complex biological datasets, enabling the identification of novel drug targets, prediction of drug efficacy and toxicity, optimization of dosage regimens, detection of adverse drug reactions, and strengthening of Pharmacovigilance systems. This review summarizes recent advances in the application of AI and ML in pharmacology based on literature published over the past five years. Relevant information was collected from peer-reviewed national and international journals, scientific databases including PubMed, Google Scholar, and ResearchGate, as well as patents and book chapters. The review highlights the role of AI and ML in deciphering complex biological mechanisms, improving high-throughput drug screening, supporting personalized medicine, identifying meaningful data-driven patterns, and facilitating drug repurposing. The findings demonstrate that AI- and ML-based approaches significantly improve the efficiency, accuracy, and cost-effectiveness of pharmacological research by accelerating the identification of promising drug candidates, reducing development timelines, and enabling safer and more precise therapeutic interventions. These technologies also contribute to enhanced clinical decision-making and individualized treatment strategies through predictive analytics and risk assessment. Despite these advances, several challenges remain, including concerns regarding data quality, algorithm transparency, interpretability, regulatory compliance, and ethical management of patient information. Addressing these limitations through continued research, standardized frameworks, and responsible implementation will be essential to ensure the safe, reliable, and widespread integration of AI and ML into pharmacological research and clinical practice, ultimately advancing precision medicine and improving patient outcomes.
BACKGROUND: An age-related musculoskeletal disorder called sarcopenia is defined by a progressive loss of skeletal muscle mass, strength, and physical function. Functional limits, poor balance, a higher risk of falls, frailty, dependence on others for everyday tasks, and a lower quality of life are all significantly impacted by it for older persons. Given India’s increasing senior population and steadily increasing life expectancy, sarcopenia has emerged as a significant public health issue. Because pharmaceutical treatments for sarcopenia are few and frequently linked to unfavorable side effects, nonpharmacological approaches are crucial. Many people prescribe exercise therapy, especially resistance training, to increase strength and reverse muscle loss, and balance training is essential for improving postural control and lowering the risk of falls. The efficacy of balance training alone versus a combined resistance and balance training program in older adults with sarcopenia, however, is not well-established. Thus, the purpose of this study was to assess and contrast how balance training alone and resistance and balance training together affected the mobility, balance, muscular function, and functional independence of older adults with sarcopenia. METHODS: In a randomized control experiment, 50 elderly adults (60 years of age and older) who had been diagnosed with sarcopenia based on a SARC-CalF score of ≥11 were selected by simple random sampling. Two groups were randomly selected from among the participants. While Group B received a combined resistance and balance training program, Group A received an organized balance training program. Both groups received intervention for 8 weeks, both therapies were developed at low to moderate intensity and delivered under supervision. Among the outcome measures were the SARC-CalF questionnaire, which assessed muscle mass and function; the Berg Balance Scale (BBS), which assessed balance; the Timed Up and Go (TUG) test, which assessed mobility and fall risk; and the Barthel Index, which assessed functional independence in daily living activities. Every outcome measure was evaluated before, at week 2, 4, 6 and after the intervention, i.e., week 8. RESULTS: After the intervention, both groups’ muscle function, balance, mobility, and functional independence significantly improved, according to statistical analysis ( P < 0.05). Participants in both groups showed improved Barthel Index scores, decreased TUG duration, improved BBS scores, and improved SARC-CalF scores. Participants who received both resistance and balance training shown higher gains in balance, postural stability, mobility, and functional independence than those who only got balance training, according to a between-group comparison. In older persons with sarcopenia, the combination intervention was very successful in improving overall functional performance and lowering the risk of falls. CONCLUSION: For older persons with sarcopenia, balance training alone and resistance and balance training together are safe, non-pharmacological, and effective ways to improve muscle function and functional results. But when combined with resistance training, balance training offers greater advantages in terms of enhancing mobility, independence, and balance in day-to-day activities and lowering the risk of falls. To promote healthy aging and enhance the quality of life for older persons with sarcopenia, the results of this study encourage the integration of combined resistance and balance training programs into standard geriatric physiotherapy practice and community-based rehabilitation programs.
Anthracycline-derived antibiotics are prescribed frequently for treating patients diagnosed with acute myeloid leukemia (AML) and are notable for their association with mucositis and myelosuppressive properties; however, chemotherapy-induced oral hyperpigmentation resulting from the use of anthracycline antibiotics is rare and poorly documented, especially for idarubicin. A 29-year-old female presenting with fever and anemia along with bleeding manifestations was subsequently diagnosed with AML (FAB M4) based on laboratory findings of a hemoglobin level of 8.9 g/dL, a platelet count of 12 × 10 9 /L, and leukocytosis. The diagnosis was confirmed by bone marrow examination, which also identified FLT3-ITD and WT1 mutations through molecular studies, indicating that she had an European Leukemia Net 2017 risk classification of high risk. Induction chemotherapy was given using a 5 + 3 regimen (idarubicin + cytarabine). Day 19 after beginning therapy, the patient developed diffuse hyperpigmentation of the lesion, which was asymptomatic and showed no evidence of ulceration and infection. According to the Naranjo scale, the association between the drug and adverse reaction is possible. The patient was treated with topical triamcinolone but was allowed to continue the chemotherapy treatment without interruption. Idarubicin-associated tongue hyperpigmentation is a rare, benign, and reversible adverse effect. Recognition of this entity is important to avoid misdiagnosis and unnecessary modification of potentially life-saving chemotherapy.
Functional breathing disturbances represent a significant clinical overlap among respiratory physiology, autonomic regulation, and interoceptive processing. We report a 35-year-old healthy, athletic male with recurrent episodes of shallow, rapid breaths interrupted by forceful yet incomplete deep inspirations consistent with sigh syndrome. Episodes occurred once or twice a month for 2 years, lasted several hours, resolved with sleep, and produced substantial subjective distress. They were provoked by excess caffeine intake, intense anaerobic exercise, unfamiliar humid environments, and minor psychosocial stressors, each of which is known to influence respiratory drive, chemosensitivity, sympathetic arousal, airway resistance, and perceived breathing effort. Clinical examination, oxygen saturation monitoring, blood studies, electrocardiogram, and chest radiography were unremarkable. Mental status examination showed intact affect regulation in the absence of anxiety. Symptom resolution during sleep supports a cortically mediated disturbance in volitional respiratory modulation. Management consisted of breathing retraining, relaxation exercises, autonomic regulation strategies, strict stimulant avoidance, and intermittent low-dose benzodiazepines during acute episodes, leading to a significant diminution in symptom frequency. This case emphasizes the importance of recognizing functional breathing disturbances in the absence of psychiatric comorbidity. It highlights the need for an integrated biopsychophysiological model guiding diagnosis and intervention in unexplained dyspnea.
The 1 st month of life is critical in preventing complications in the neonatal stage and ensuring healthy growth of the young one. This paper compares the safety practices of parents, difficulties in newborn care, the effect of hospital-based prenatal education, emergency preparedness training, and family-centered neonatal care on the morbidity and mortality of the neonatal population. The key neonatal risks, namely, preterm births, birth asphyxia, infections, choking, hypothermia, and sepsis, have been considered with references to sociocultural factors causing them in India, as well as technological programs of the National Health Mission and infant care provision in case the mother has human immunodeficiency virus. The findings indicate that the evidence-based training in hospitals enhances knowledge, confidence, skills in responding in an emergency, and safety practices at home, as well as the involvement of the family in the care. Nevertheless, poor awareness, uneven service provision, and disparity of resources reduce the effectiveness of the programs. To enhance the neonatal survival rates, it is necessary to strengthen provider-parent communication and increase the number of structured education programs.
BACKGROUND: Chemotherapy-induced polyneuropathy (CIPN) is a frequent adverse effect in breast cancer patients, caused by neurotoxic agents that damage peripheral nerves. It manifests as sensory and motor deficits that impair balance, gait, and coordination, increasing the risk of falls. AIMS AND OBJECTIVES: The aims and objectives of this study were to determine the association of CIPN on balance and functional mobility in breast cancer patients using the Timed Up and Go (TUG) test. METHODOLOGY: A quantitative, prevalence-based study was conducted among 50 female breast cancer patients aged above 50 years from the oncology department. Participants who had completed 12 cycles of chemotherapy and presented with clinical symptoms suggestive of CIPN were included in the study. A simple random sampling was used. Participants with recent orthopedic surgery, spinal fractures, or uncontrolled diabetes or hypertension were excluded from the study. Ethical approval was obtained and informed consent was taken from participants before data collection. CIPN was identified based on presentation of sensory and motor symptoms; no standardized diagnostic grading scale was used. The TUG test, a reliable and widely used clinical tool, was administered to assess balance and functional mobility. RESULTS: As this was a descriptive study no inferential statistical analysis were performed. Among 50 participants, 13 (26%) demonstrated normal TUG scores (≤10 s), indicating preserved mobility and balance, whereas 37 (74%) showed abnormal scores (>10 s), reflecting reduced mobility and increased fall risk. The prevalence of abnormal TUG performance was 74%, indicating that most breast cancer patients with CIPN experience significant balance impairment. CONCLUSION: CIPN is associated with impaired mobility and balance in breast cancer, as indicated by the high prevalence of abnormal TUG scores. Early physiotherapy interventions emphasizing balance training, muscle strengthening, and gait rehabilitation are recommended to reduce fall risk and improve quality of life.
A single 37-year-old male patient, prediagnosed with generalized seizure disorder, had complaints of sleeplessness and headaches for the past 7 months and visited our hospital on May 12, 2023. The patient underwent integrated yoga and naturopathy therapies (IYNTs) for 3 weeks. Depression Anxiety Stress Score-21 (DASS-21), The Pittsburgh Sleep Quality Index (PSQI), and heart rate variability (HRV) were assessed before and after the intervention. Post-intervention results demonstrated a reduction in DASS-21 and PSQI scores, as well as decrease in low-frequency (LF) power and the LF/high frequency (HF) ratio. Concurrently, there were increase in heart rate variability parameters, including the standard deviation of R-R intervals (SDNN), root mean square of successive differences (RMSSD), and high-frequency power, compared to pre-intervention values. Three weeks of IYNT reduced stress, anxiety, and depression and improved quality of sleep and HRV, suggesting parasympathetic dominance in our patient with seizures. As this is a single case report, further clinical studies with larger sample sizes are necessary to validate these findings.
Adamantinomatous craniopharyngiomas are typically pediatric tumors, rarely encountered in older adults. Their presentation in the elderly is unusual and can easily be misdiagnosed due to clinical and radiological overlap with more common sellar pathologies in this age group. We report a case of a 64-year-old male who presented with visual impairment and persistent headaches. Imaging revealed a cystic suprasellar mass suggestive of a pituitary macroadenoma. Surgical excision followed by histopathological evaluation confirmed the diagnosis of adamantinomatous craniopharyngioma. This case highlights the importance of considering less common etiologies in atypical age groups and reinforces the indispensable role of histology in diagnostic confirmation, especially when clinical assumptions may be misleading.
BACKGROUND: Interdisciplinary integration serves as an umbrella domain within which the integration of digital technologies with the health sector plays a part. Although Ayurveda has roots in the ancient period, it continues to evolve through the efforts of policymakers and futuristic researchers, who embrace modern technologies. However, the fragmented landscape in this research, with limited insights into publication trends, highlights that the collaboration network must be collated and presented. OBJECTIVE: This study provides the first bibliometric mapping exclusively focused on the digital health–Ayurveda intersection to analyze publication trends, influential contributors, global collaborations, and thematic hotspots. MATERIALS AND METHODS: A comprehensive search was conducted in the Scopus database on September 23, 2025, using the selected keywords. A total of 37 publications (2014–2025) were retrieved and analyzed using VOSviewer (v1.6.19), Biblioshiny, and Datawrapper to visualize publication trends, co-authorship networks, keyword co-occurrence, and global research distribution. RESULTS: Research output demonstrated a compound annual growth rate of 18.4% since 2018, accumulating 227 total citations (average 6.14 per paper) by 2025. India dominated the landscape, contributing 86.5% of publications ( n = 32) and serving as a central hub of global collaboration, maintaining strong citation linkages with the United States ( n = 5), the United Kingdom ( n = 1), Germany ( n = 2), and Switzerland ( n = 3). Keyword analysis revealed technological convergence, with high-frequency terms including “Ayurveda” (25 occurrences), “Digital Technology” (5), “Telemedicine” (3), and “Artificial Intelligence” (3). CONCLUSION: Overall, this analysis reflects emerging India-centric leadership with expanding Western collaborations, transitioning from conceptual discussions to technology-enabled applications. Despite limited global volume, momentum is accelerating toward AI-assisted diagnostics, tele-Ayurveda services, and evidence translation for integrative digital health systems.
Hepatoblastoma is a rare malignant tumor which occurs in childhood. Most of the hepatoblastomas secrete large amounts of alpha-fetoprotein (AFP). Accurate measurement of AFP is crucial for the diagnosis and follow-up of hepatoblastoma. Hook effect is a well-recognized problem that occurs in the automated immunoassay methods for the measurement of tumor markers, especially in the case of AFP. We present a case of a 9-month-old baby, whose diagnosis was delayed because of an unrecognized hook effect, due to which a falsely low value was reported. In the subsequent sample, the test was performed in dilution, and the correct value was obtained. The laboratory staff and clinicians should be alert to the possibility of the Hook effect resulting in falsely low levels.
Primary renal parenchymal squamous cell carcinoma (SCC) is an uncommon condition with a poor prognosis. Here, we report a case of a male in his 70s who presented with a complaint of hematuria and left flank pain for 2 months. A computed tomography scan of the abdomen was done, which revealed left renal pelvic calculi with gross Hydronephrosis. Patient underwent left Nephrectomy for a nonfunctioning kidney. Histopathological examination of the left Nephrectomy specimen revealed primary SCC of the renal parenchyma, an incidental finding. Subsequently, it was confirmed by Immunohistochemistry (p40, CK 5/6). Following a radical nephrectomy, the patient didn’t receive any adjuvant chemotherapy and was alive for a year during follow-up. This case emphasizes the importance of considering a diagnosis of SCC in nephrectomy specimens from patients with chronic inflammation or renal calculi.
Abstract BACKGROUND: While global studies have examined the relationship between obesity and breast cancer, region-specific data from South India remain limited. Considering the unique genetic, metabolic, and lifestyle characteristics, this study investigates the association between obesity classified using Asian Indian body mass index (BMI) cutoffs and clinicopathological features, molecular subtypes, and hormone profiles in women with breast cancer. METHODOLOGY: A retrospective observational study was conducted involving 346 women diagnosed with breast cancer at a tertiary care center in South India. Participants were categorized by BMI and assessed for tumor characteristics, molecular subtype, and hormone receptor status. Statistical analysis was performed using Pearson’s Chi-squared test and one-way ANOVA, with significance set at P < 0.05. RESULTS: Among the cohort, 63.9% had obesity, and 67.1% were postmenopausal. Left-sided breast cancer was observed in 52.9% of women. Intermediate and poorly differentiated tumors were more common among women with obesity. Invasive ductal carcinoma was the predominant histologic type, with a higher frequency in obese women (57.75%). Luminal A was the most frequent molecular subtype, followed by the triple-negative subtype, in women with obesity. Of the 120 patients positive for Ki-67 expression, 81 (64.28%) were obese. A significant association was observed between Ki-67 and molecular subtype ( P = 0.042). Postmenopausal women with obesity had a 5.63-fold higher odds of developing breast cancer. CONCLUSION: This study demonstrates a strong association between obesity and aggressive tumor features in South Indian women. Findings underscore the prognostic value of Ki-67 and the importance of tailored lifestyle interventions in obese postmenopausal women to reduce breast cancer burden.
BACKGROUND: The growing burden of diabetes mellitus (DM), specifically among type II patients, is rising globally, regionally, and locally in many African countries, including Ethiopia. Hence, it is crucial to figure out the level of glycemic control, understand the contributing factors, and develop a framework to existing guidelines and systems in Ethiopia. This systematic review aimed to determine the prevalence and factors associated with glycemic control in Ethiopia. METHODS: PubMed, Google Scholar, Semantic Scholar, and Science Direct databases were used. All observational studies with eligibility criteria; 1) Only type II DM patients only (2) in adult patients, (3) reported the prevalence of glycemic control. (4) Studies conducted in Ethiopia from 2018 to 2023, and (4) only cross-sectional studies. Narrative review, studies conducted in type I patients and children, qualitative systematic reviews, and outside Ethiopia were excluded. Critical appraisal tool used to assess the quality of studies. Egger’s test and I 2 statistical analysis were used to check publication bias and heterogeneity of studies, respectively. Subgroup analysis across regions and sensitivity test were also conducted. All analysis was done using STATA v-17 software. International Prospective Register of Systematic Reviews (PROSPERO) registered this study with registration number CRD42023472999. RESULTS: A total of 26 studies, involving 9927 participants, were included. The pooled prevalence of poor glycemic control was 38% (95% confidence interval: 33%–44%). The prevalence ranged from 34% to 51% in Ethiopia. The glycemic level using glycated hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) was 38% and 39%, respectively. There is a significant change in glycemic control rate by year in the meta-regression. Factors associated with glycemic control were sociodemographic factors (age, sex, and residence), lifestyle factors (smoking, dietary practice, and physical activity), treatment-related factors, and clinical factors (presence of comorbidity/complications, diet adherence, duration of the disease, and physical activity). CONCLUSION: Poor glycemic control is prevalent among adult diabetes patients with type II in Ethiopia and poses a significant public health challenge. The existing healthcare system needs change in Ethiopia, warranting effective financing, design, and implementation of effective glycemic control strategies and enables the identification of effective interventions by considering associated factors.
Abstract: Cardiovascular diseases (CVDs) comprise a spectrum of noncommunicable diseases and conditions that cumulatively produce a significant burden on the healthcare delivery system. The objectives of the current article are to ascertain the role of occupational exposures in augmenting cardiovascular risks, identify different settings that have high cardiovascular risks, and propose public health interventions to minimize cardiovascular risks in these occupational settings. Occupational exposures have been identified as one of the key predisposing factors, either in isolation or due to their complex interplay in the causation of different CVDs. Multiple occupational settings have been identified that have specific cardiovascular risks, thereby reinforcing the need to adopt a holistic approach to reduce the involved CVD risks. Acknowledging the role of occupational exposures in the causation and progression of multiple CVDs, there is an immense need to implement targeted interventions to reduce the burden of these diseases. In conclusion, different occupational exposures play a crucial role in the development of CVDs. This calls for the need to understand the role of these predisposing factors and implement a holistic set of preventive interventions to reduce the magnitude of occupation-induced CVDs.
PURPOSE: This meta-analysis synthesized the evidence from randomized controlled trials and real-world data investigating the efficacy and safety of ocrelizumab in relapsing-remitting multiple sclerosis (RRMS), at various follow-up points. METHODS: A systematic search was performed on PubMed, Web of Science, and Scopus from inception to October 2024 using the search strategy: “Multiple sclerosis” AND “Relapsing remitting” AND “Ocrelizumab”. The mean difference (MD) was calculated for continuous variables, and the odds ratio (OR) was used for dichotomous variables, comparing baseline values and posttreatment outcomes. Meta-analysis was conducted using Review Manager version 5.4 software. RESULTS: Of 568 articles identified in the database search, 17 articles were included in this review. Ocrelizumab significantly decreased the annualized relapse rate (ARR: MD = −0.6, 95% CI: −0.73, −0.47; P < 0.00001) and reduced the risk of ARR (OR = 0.21, 95%CI: 0.1, 0.41; P < 0.00001). Sensitivity analysis (leave-one-out method) and subgroup analysis by measurement did not resolve heterogeneity. Ocrelizumab also reduced the number (MD = −0.26, 95% CI: −0.33, −0.2; P < 0.00001) and risk (OR = 0.11, 95%CI: 0.07, 0.16; P < 0.00001) of T1-weighted (T1) gadolinium (T1-Gd) enhancing lesions. In addition, ocrelizumab reduced the number of T2 lesions (MD = −1.23, 95% CI: −2.14, −0.32; P = 0.008). On the other hand, no significant effect was observed on the Expanded Disability Status Scale ( P = 0.58). CONCLUSION: This systematic review and meta-analysis of clinical and radiological outcomes demonstrated the effectiveness of ocrelizumab in reducing relapses and lesion counts associated with RRMS, while stopping disability progression. The associated side effects were minimal, with a low incidence of serious adverse events. Thus, ocrelizumab is an effective and well-tolerated treatment option for RRMS patients.
