Andrographis paniculata is widely regarded as one of the most important medicinal plants due to its broad therapeutic value and global use in traditional medicine. Commonly known as Kalmegh, creat, or green chirayata, the plant has been an integral part of Ayurvedic, Siddha, Unani, and other traditional healing systems for centuries. It has traditionally been consumed to manage a variety of ailments, particularly those related to the liver, respiratory system, and immune health. Phytochemical investigations have revealed that Andrographis paniculata is rich in diverse bioactive constituents. Among these, andrographolide, neoandrographolide, and didehydroandrographolide are the most prominent diterpenoid lactones. Andrographolide, in particular, is recognized as the principal active compound and has been extensively studied for its wide pharmacological spectrum. Research indicates that andrographolide exhibits strong hepatoprotective, antioxidant, anti-inflammatory, immunomodulatory, antibacterial, antipyretic, anti-diabetic, and anti-cancer activities. These properties contribute to the plant’s reputation as a versatile therapeutic agent. In this review, we systematically searched and analyzed articles published in English from 2019 to 2025, using PubMed, ScienceDirect, Springer Link, and Google Scholar. Relevant search terms included “Andrographis paniculata”, pharmacology”, “clinical efficacy”, “safety”, etc. Given its chemical richness and diverse pharmacological actions, Andrographis paniculata continues to attract scientific attention. Numerous studies support its potential in managing chronic diseases, enhancing immune function, and mitigating oxidative stress. This review aims to provide a concise yet comprehensive overview of the plant’s therapeutic relevance, highlighting its major chemical constituents and summarizing key findings from pharmacological evaluations and clinical safety and efficacy reported in the scientific literature. By synthesizing existing knowledge, this review emphasises the significance of Andrographis paniculata as a promising natural resource in herbal medicine and modern pharmacotherapy.
Infertility is recognized as a major global health issue and has become one of the primary challenges in reproductive health; its prevalence and incidence are steadily increasing worldwide. Recent research has highlighted the critical role of epigenetic dysregulation as a direct factor affecting male infertility. The objective of this review is to investigate the relationship between epigenetic modifications (specifically 5-methylcytosine and 5-hydroxymethylcytosine) and essential male reproductive outcomes, including the spermatogenesis process, testicular function, and semen quality parameters. Furthermore, this study explores the influence of micronutrients such as vitamin B12, homocysteine metabolism, and antioxidant capacity on DNA methylation and genomic stability. Significantly, this review establishes a novel link between infertility and cellular hypoxia focusing on the modulation of hypoxia-inducible factor (HIF-1α and HIF-2α) as a potential therapeutic strategy. Additionally, this work introduces the overlooked association between HIF-2α and infertility, offering novel insights since current findings regarding HIF-2α in male infertility are remarkably limited. A literature search was conducted on PubMed, ScienceDirect, Springer Link, Oxford Academic and Nature databases for sources published in English from 2015 to 2025, using the following keywords: male infertility, DNA methylation, hypoxia, HIF-1α, and immunity. Our work investigates the interruption of inflammatory cytokines and immunological markers by linking them with molecular factors, micronutrients and hypoxia pathways. This approach provides an integrated foundation for advanced diagnostic and therapeutic strategies. Ultimately, understanding these molecular signatures provides ways to enhance reproductive outcomes and improve success rates of assisted reproductive techniques.
Background Post-stroke fatigue (PSF) is a multifactorial impairment characterized by persistent tiredness not relieved by rest, and affects nearly half of stroke survivors, leading to poor physical endurance which limits recovery and overall quality of life. Limited evidence suggests that combining cognitive and physical training might help in reducing fatigue. Brain endurance training (BET) involves both cognitive training and physical training, targeting PSF. The study aimed to evaluate the effect of BET on fatigue and physical endurance among stroke survivors. Methods A parallel group pilot randomized controlled trial was carried out in a private setting with 30 stroke survivors. Patients were randomized into two groups. Group A (n=15) received BET and group B (n=15) received conventional physiotherapy. Both groups underwent training for 65 minutes per day, thrice a week for eight weeks. Primary outcomes were Fatigue Severity Scale (FSS) and Six-Minute Walk Test (6MWT). Statistical analysis was performed using the chi-square test and independent t-test. Results At baseline, no significant differences were observed between groups for FSS and 6MWT (p>0.05). The BET group reported better reduction in fatigue (FSS: 5.39 ± 0.18 to 3.48 ± 0.16, p<0.001) and improvement in physical endurance (6MWT: 202.03 ± 4.35 to 273.35 ± 6.26, p<0.001) than the control group (FSS: 5.25 ± 0.10 to 4.19 ± 0.06) (6MWT: 200.53 ± 2.72 to 222.70 ± 3.64). Conclusion Brain endurance training is a feasible and safe approach for reducing fatigue and improving physical endurance among stroke survivors.
Background Dengue infection in children globally shows a significant increasing trend in incidence and remains a heavy public health burden. Dengue infection can progress rapidly to death, especially in children. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker that represents an immune response to the disease. This study investigated NLR as a risk factor of dengue infection severity in children. Methods A cross-sectional study was conducted involving 237 children, (110 girls and 127 boys) aged 1-18 years with dengue infection. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF) according to WHO 2011 criteria. Demographic characteristics, clinical manifestations, and hematological parameters, including hemoglobin (Hb), leukocyte count, thrombocyte count, hematocrit (HCT), and NLR, were extracted. Bivariate and multivariate logistic regression analysis were used to analyze the data. Results The study demonstrated that 59.9% of cases were classified as DF and 40.1% as DHF, with a mean age of 9.99 ± 4.84 years. The mean NLR was 0.99 ± 0.98 in DHF and 1.51 ± 1.38 in DF. Univariate regression analysis stated that NLR≥2 was associated with dengue severity. However, multivariate regression analysis stated that NLR was not a risk factor of dengue severity, adjusted from demographic characteristics and hematologic parameters. Hemoglobin and platelets are the independent factors of dengue severity. Conclusion Neutrophil-to-lymphocyte ratio is a simple biomarker but not a risk factor of dengue fever severity in children. There is evidence suggesting that the relationship between NLR and dengue fever severity is complex, with varying trends in different phases of the disease.
BACKGROUND Keloids are abnormal scars that present a therapeutic challenge. Various treatment modalities have been developed, including surgical excision. While cross-running intradermal sutures were previously created using absorbable polyglycolic acid, this study introduces a modification using a non-absorbable material. Therefore, this study aimed to evaluate the effect of the cross-running polypropylene intradermal suture (CR-PIS) technique compared to the simple interrupted suture technique on keloid repair. METHODS This was a randomized controlled trial with a post-test-only design involving 30 male and female keloid patients aged 20-50 years. Participants were randomized into the treatment group (n=15) and the control group (n=15). Wound assessment using the Vancouver Scar Scale (VSS), Manchester Scar Scale (MSS), and Patient and Observer Scar Assessment Scale (POSAS) was performed at 3, 6, and 9 months after surgery. Differences in VSS, MSS, and POSAS scores between the CR-PIS group and the simple knot group were analyzed using the Mann-Whitney U test. RESULTS Statistical analysis revealed a significant difference between the simple knot and CR-PIS groups (p<0.05). The median scores for each assessment (VSS, MSS, and POSAS) decreased significantly at 3, 6, and 9 months, with the control group's values being higher than those in the CR-PIS group (p<0.05). These results indicate that the control group developed moderate scars, whereas the treatment group exhibited good scars. CONCLUSIONS The CR-PIS is more effective than the simple knot technique in improving keloid scars, as shown by changes in wound appearance, morphological function, topography, and patient and evaluator assessments.
Background Urban lifestyles have become increasingly sedentary, contributing to reduced physical fitness. Muay Thai, a high-intensity martial art, has been proposed as an effective exercise modality to improve aerobic capacity and muscle endurance. This study aimed to evaluate the effects of different weekly Muay Thai training frequencies on VO₂ max and muscle endurance in non-athletic adults. Methods A randomized experimental study with a pre-test–post-test design was conducted involving 40 non-athletic adults (aged 20–25 years). Participants were randomly allocated into two groups: training twice weekly (MT2X) or four times weekly (MT4X) for eight weeks. Outcomes included VO₂ max and upper, abdominal, and lower body muscle endurance. Baseline characteristics were described descriptively. Between-group differences in post-intervention outcomes were analyzed using analysis of covariance (ANCOVA), with baseline values included as covariates. Results At baseline, VO₂ max, abdominal, and lower body muscle endurance were higher in the MT4X group. After adjustment for baseline values using ANCOVA, the MT4X group demonstrated significantly higher post-intervention VO₂ max compared with the MT2X group (adjusted mean difference, p<0.001). Significantly greater improvements favoring the MT4X group were also observed for upper body muscle endurance (push-ups, p<0.001), abdominal muscle endurance (sit-ups, p<0.001), and lower body muscle endurance (squats, p=0.018). Conclusion A higher frequency Muay Thai training program is effective in significantly improving participants' aerobic capacity and muscle endurance. Practitioners are able to choose their training frequency preference, since both frequencies provide similar adaptation.
BACKGROUND Toxoplasma gondii is a widespread zoonotic parasite that infects approximately one-third of the global population. Humans become infected mainly by consumption of undercooked meat or water or fruits and vegetables contaminated with oocysts. This study aimed to investigate the seroprevalence of toxoplasmosis and associated risk factors in adults from Duhok province, Iraq. Methods A cross-sectional study was conducted with 600 participants (ages 22–60 years, both genders) from Duhok. Variables included age, gender, occupation, interaction with cats, and hygiene practices were collected. Blood samples were analyzed for anti-Toxoplasma IgM and IgG antibodies, using ELISA. Multiple logistic regressions were used to identify risk factors for toxoplasmosis. Results The overall seroprevalence was 39.17% (IgG: 31.67%, IgM: 7.5%). Both IgM and IgG prevalence were significantly associated with gender (p<0.001). IgG was more prevalent in participants aged 31–40 years (p<0.001). Key risk factors included cat contact (aOR=4.50, 95% C.I.: [2.10, 9.50], p<0.001), drinking tap water (aOR=3.00, 95% C.I.: [1.50, 6.00], p=0.005), consuming undercooked meat (aOR=3.20, 95% C.I.: [2.00, 5.30], p<0.001), eating unwashed vegetables (aOR=2.50, 95% C.I.: [1.50, 4.30], p<0.001), eating outside home (aOR=2.50, 95% C.I.: [1.50, 4.00], p<0.001), and a history of arthritis (aOR=3.00, 95% C.I.: [2.00, 4.50], p<0.001), hygiene practices, such as handwashing (aOR=0.30, 95% C.I.: [0.15, 0.60], p=0.001) and hygienic measures (aOR=0.35, 95% C.I.: [0.20, 0.60], p<0.001), reduced risk former Covid-19 (aOR=7.00, 95% C.I.: [3.50, 14.00], p<0.001). Conclusions Toxoplasmosis in Duhok is associated with dietary habits, sanitation, and cat contact. Enhancing hygiene and food safety can reduce the disease burden, particularly in immunocompromised individuals.
BACKGROUND The Sudan war has severely disrupted healthcare services, particularly for patients with end-stage renal disease (ESRD) dependent on regular hemodialysis. Conflict-related displacement, damaged infrastructure, medication shortages, and financial hardship have compromised dialysis continuity and patient outcomes. This study assessed the impact of war-related displacement on dialysis care among Sudanese hemodialysis patients. METHODS This cross-sectional observational study included 101 displaced ESRD patients receiving maintenance hemodialysis. Data collection comprised demographic characteristics, causes of ESRD, dialysis access and adequacy, treatment interruptions, complications, medication availability, hospital admissions, and functional status before, during, and after the war. Comparisons of dialysis parameters and functional status before, during, and after the war were performed using Cochran’s Q test. RESULTS War-related displacement was associated with statistically significant worsening of dialysis care. Dialysis frequency decreased from two to 1.5 sessions per week, and session duration declined from four to three hours (both p<0.05). Patients missed a median of one dialysis session per week. Consequently, out-of-pocket payment for medications surged from 42 (41.6%) pre-war to 93 (92.1%) during the war and persisted at 89 (88.1% in the current period (p<0.0001). Erythropoietin use declined from 98 (97.1%) to 39 (38.6%) (both at p<0.001). Displacement was also associated with significantly increased complications, hospitalizations, reduced medication adherence, and marked fatigue (p < 0.05). CONCLUSION War-related displacement significantly reduced dialysis adequacy, medication access, and continuity of care, resulting in increased morbidity. Immediate humanitarian and health-system interventions are essential to prevent excess mortality among displaced hemodialysis patients.
Umbilical cord mesenchymal stem cells (UC-MSCs) have gained significant attention in regenerative medicine due to their unique biological properties, including high proliferation capacity, low immunogenicity, and potent immunomodulatory effects. These characteristics make UC-MSCs particularly promising for orthopedic applications, where the repair and regeneration of musculoskeletal tissues such as bone, cartilage, tendons, ligaments, and nerves are critical for restoring function. The secretome of UC-MSCs—comprising bioactive molecules such as exosomes, cytokines, and growth factors—offers a powerful, cell-free therapeutic option through paracrine signaling, further enhancing their therapeutic potential. A literature search was conducted in major databases (PubMed, ScienceDirect, SpringerLink, Google Scholar) for English articles from 2010–2025 using keywords related to UC‑MSCs and orthopedic regeneration. This review explores the role of UC-MSCs and their secretome in orthopedic tissue repair, focusing on their application in bone healing, cartilage regeneration, tendon-ligament repair, and nerve regeneration with their innovative delivery. Despite the promising potential of UC-MSC therapies, several challenges remain, including regulatory hurdles, long-term safety concerns, and the scalability of cell-based and secretome-based therapies for widespread clinical use. Although umbilical cord MSCs are not yet widely applied in clinical practice, increasing evidence suggests that they offer significant therapeutic potential, especially in the treatment of autoimmune and neurodegenerative diseases. The UC-MSCs and their secretome represent a transformative approach in orthopedics, offering new avenues for treating complex musculoskeletal injuries and degenerative diseases. Ongoing advancements in this field will likely unlock their full potential, making them viable options for clinical use in the near future.
INTRODUCTION Pituitary macroadenomas are benign pituitary tumors measuring more than 1 cm in diameter that constitute a substantial proportion of intracranial neoplasms. Despite their benign histology, these tumors may lead to significant morbidity due to local mass effects and endocrine dysfunction. Compression of the optic chiasm can result in progressive visual impairment and irreversible blindness if not promptly treated. Additionally, pituitary hormonal deficiencies may cause life-threatening metabolic and systemic complications. Early recognition and multidisciplinary management are therefore essential to prevent permanent sequelae and optimize functional recovery. Case Description A 40-year-old woman presented with a one-year history of recurrent headaches accompanied by progressive blurring of vision, diplopia, and visual field defects. She also reported irregular menstruation and unintended weight loss. Brain magnetic resonance imaging demonstrated a 2.13 × 2.28 × 3.05 cm pituitary macroadenoma with a characteristic “snowman appearance” compressing the optic chiasm. Hormonal evaluation revealed secondary adrenal insufficiency, hypogonadotropic hypogonadism, suppressed thyroid-stimulating hormone (TSH) with elevated free thyroxine (T4), and hyperprolactinemia attributed to the stalk effect, consistent with hypopituitarism and thyroid dysfunction. Initial stabilization with hydrocortisone and methimazole was performed prior to definitive management. The patient subsequently underwent transsphenoidal tumor resection with appropriate perioperative glucocorticoid coverage. Postoperatively, she remained clinically stable with improvement in headache and visual symptoms, and continued hormonal therapy under close endocrinological supervision. Conclusions This case underscores the importance of comprehensive hormonal assessment, timely neurosurgical intervention, and coordinated multidisciplinary care in managing pituitary macroadenomas complicated by optic chiasm compression and hypopituitarism to achieve favorable clinical outcomes.
BACKGROUND Identifying patients with intracerebral hemorrhagic (ICH) at high risk of mortality is crucial for timely intervention. Machine learning (ML) offers novel methodologies for precise predictive models for ICH. Therefore, the aim of this study was to develop an ML-based predictive model for 48-hour mortality in patients with acute hemorrhagic stroke. METHODS A cross-sectional study was conducted using secondary data from 657 patients diagnosed with acute ICH. Demographic, clinical, laboratory, and radiological variables were extracted from medical records. Data preprocessing included cleaning, normalization, and class balancing using the Synthetic Minority Oversampling Technique (SMOTE). Three supervised algorithms—Random Forest, Decision Tree, and Gaussian Naïve Bayes—were developed and evaluated using stratified 5-fold cross-validation. Model performance was assessed using accuracy, sensitivity, specificity, precision, recall, F1-score, and AUC. RESULTS Random Forest achieved the best overall performance for predicting 48-hour mortality, with an accuracy of 84.77%, F1-score of 84.63%, and AUC of 80.51, outperforming Decision Tree (AUC 61.12) and Gaussian Naïve Bayes (AUC 82.94). Random Forest most accurately identified >48-hour survival, with high sensitivity (93.5%) and PPV (92.9%), while Naïve Bayes provided the most reliable positive classification for this category (PPV 99.0; specificity 94.2%). For ≤24-hour mortality, Naïve Bayes showed the best detection performance (sensitivity 85.4%; NPV 98.7%). CONCLUSIONS Machine learning, particularly the Random Forest algorithm, enables reliable prediction of 48-hour mortality in patients with acute ICH using basic clinical and radiological data available at admission. The model offers practical potential for early risk stratification in emergency and critical care settings.
BACKGROUND Graves’ ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease and can significantly impair visual function and quality of life. High-dose intravenous methylprednisolone (IVMP) is recommended as first-line therapy for moderate-to-severe active GO due to its superior efficacy and tolerability compared with oral glucocorticoids. However, IVMP therapy may be associated with rare but potentially serious adverse effects, including suppression of the hypothalamic–pituitary–adrenal (HPA) axis leading to GI adrenal insufficiency (GI-AI). Case description We report the case of a 38-year-old man with Graves’ disease who developed AI following IVMP therapy for moderate-to-severe GO. The patient received five weekly doses of IVMP 500 mg (cumulative dose 2.5 g) for progressive ocular symptoms. He subsequently presented with fatigue, weight gain, moon face, and buffalo hump. Laboratory evaluation revealed a markedly low morning serum cortisol level of 1 mcg/dL, confirming adrenal insufficiency. Patient was diagnosed with GI-AI accompanied by features of iatrogenic Cushing’s syndrome. Management consisted of hydrocortisone replacement therapy at a dose of 20 mg/day along with ongoing antithyroid treatment using methimazole. Serial monitoring of cortisol levels demonstrated gradual recovery of HPA axis function, accompanied by clinical improvement. Conclusion This case highlights that glucocorticoid-induced adrenal insufficiency can occur on IVMP used for GO. Clinicians should maintain a high index of suspicion and perform appropriate adrenal function monitoring during and after IVMP therapy to ensure early detection and safe management of this potentially life-threatening complication.
Background Renal cell carcinoma (RCC) is a prevalent urologic malignancy with heterogeneous outcomes even after surgery. Conventional prognostic factors are insufficient to capture host-related influences on survival. The prognostic nutritional index (PNI), derived from serum albumin and lymphocyte count, reflects nutritional and immunological status and has emerged as a potential prognostic biomarker. The objective of this study was to determine preoperative PNI in predicting survival outcomes of RCC patients. Methods This was a retrospective cohort study involving 107 RCC patients who underwent radical or partial nephrectomy. Patients were categorized into normal and low PNI. Associations between PNI and clinicopathological features were assessed, while survival outcomes were evaluated using Kaplan–Meier analysis and Cox proportional hazards regression. Results Patients’ mean age was 53.1 ± 13.5 years, and 58.9% of the patients were male. Clear cell carcinoma was the most common histological type (69.2%). Low PNI was significantly associated with older age (p=0.04), metastatic disease (p<0.001), and advanced tumor stage (p=0.014). Kaplan–Meier analysis demonstrated significantly poorer survival in the low-PNI group (p<0.001). In the multivariate Cox model, PNI remained the strongest independent predictor of overall survival (HR = 0.29, 95% CI: 0.13–0.67, p=0.003), while metastasis also retained independent significance (HR = 2.04, 95% CI: 1.06–3.93, p=0.031). Conclusion The PNI is an independent, simple, and cost-effective prognostic factor for overall survival in RCC. Incorporating PNI into preoperative risk stratification may enhance clinical decision-making. Therefore, PNI could be used as an effective prognostic indicator in RCC.
BACKGROUND Type 2 Diabetes Mellitus (T2DM) is characterized by chronic inflammation and insulin resistance. These factors contribute to pancreatic β-cell apoptosis, reducing insulin production and impairing glucose homeostasis. This study aims to evaluate the protective effects of hypoxic mesenchymal stem cell-derived secretome (HMSCS) and alkaline water on inflammation, apoptosis, and insulin resistance in a T2DM rat model. METHODS An experimental study was conducted involving 24 male Wistar T2DM model rats (aged 6-8 weeks, 200-250g). They were randomized into four groups: T2DM rats only as negative control (K-), T2DM rats with metformin as positive control (K+), HMSCS treatment (P1), and HMSCS plus alkaline water group (P2). Caspase-3 expression was measured to assess apoptosis levels using RT-PCR, while homeostatic model assessment for insulin resistance (HOMA-IR) was measured using ELISA. One way ANOVA followed by a post hoc LSD test were used to analyse the data. RESULTS The P1 group (3.03 ± 1.26 a.u) and P2 group (2.93 ± 0.52 a.u.) had significantly lower caspase-3 expression compared to K- group (6.66 ± 2.76 a.u.) (p<0.05), but were not significantly different from K+ group (3.83 ± 1.61 a.u.) (p>0.05). Additionally, P2 group (6.76 ± 0.96) had a significantly lower HOMA-IR than K- group (18.92 ± 2.63) and K+ group (10.85 ± 1.39) (p<0.05), and similarly the P1 (7.71 ± 0.53) group also showed significant difference from K- and K+ groups (p<0.05). CONCLUSION Higher doses of HMSCS and alkaline water are associated with reduced pancreatic β-cell apoptosis and improved insulin sensitivity, highlighting its potential as a novel therapeutic approach for T2DM.
Background Brain metastases (BMs) most frequently originate from primary tumors of the lung and breast, and significantly impact cancer patient prognosis. Metastases can be detected synchronously along with the primary tumor or metachronously, following treatment of localized disease. The objective of this study was to identify key prognostic factors influencing survival in synchronous metastases (SM) and metachronous metastases (MM), focusing on metastatic duration, tumor volume response, and gamma knife radiosurgery. Methods A retrospective cohort study was conducted involving 100 patients with brain metastases (48 synchronous, 52 metachronous). Age, gender, primary tumor, gamma knife status, metastasis location, peritumoral index group, volume reduction, metastatic duration, metastasis characteristics, and intensity pattern based on MRI. A Cox proportional hazards regression was used to analyze the data. Based on the Cox regression coefficients, a prognostic index was constructed. Results Calculated HR comprised MM (HR=0.49;95% CI :0.24–0.97], gamma knife treatment (HR = 0.15;95% CI: 0.07–0.29], and volume response (HR=0.40;95% CI: 0.16–0.99), all indicating a significantly reduced mortality risk. A prognostic index was calculated for all patients; those with scores ≤–1.513 were classified as low risk. Kaplan-Meier analysis showed that the low-risk group had a significantly longer mean survival period (75.52 months) compared to the high-risk group (31.43 months) (p<0.001). Conclusion Metachronous presentation, gamma knife therapy, and greater tumor volume reduction independently predict better survival. The developed prognostic index provides a clinically useful tool for personalized risk assessment and treatment planning in patients with brain metastases.
Background Salat has been linked to physical, cognitive, emotional and psychological health benefits. This scoping review classifies the health benefits of salat based on the International Classification of Functioning, Disability, and Health (ICF) conceptual framework. The ICF illustrates how Salat may be used as a multi-modal and multidisciplinary framework to rehabilitate clients with different conditions tailored to their clinical, psychosocial and environmental contexts. Purpose To conduct a scoping review on the health benefits of salat (muslim prayer) based on the ICF conceptual framework. Methods A literature review was conducted from February to April 2023 using PubMed, EBSCO, and the Scopus Library databases. Articles published between 2012 and 2023 were retrieved using the following keywords: "impact" OR "effect" OR "health benefit" OR "functional outcome" AND "shalat" OR "Muslim prayer" OR "Salat”. Health benefits of salat were subsequently categorised into five domains of the ICF. Results A total of 596 articles were identified through PubMed (404), EBSCO (124), and Scopus (68). Thirty-one records met the predefined inclusion criteria: 21 original articles, two systematic reviews, five literature reviews, one case study, one case series, and one short report. Salat had positive benefits on the cardiorespiratory, haematological, immunological, mental and neuromuscular functions. Salat may serve as a coping mechanism to reduce stress and depression. The frequency and duration of salat had positive associations with maintaining employment, social support and better quality of life. Conclusion Salat is associated with many health benefits, which can be categorised systematically and summarised using the ICF conceptual framework.
Background Although uncommon, cavernous sinus thrombosis (CST) is a serious and potentially life-threatening condition that often presents with nonspecific signs and symptoms. Cavernous sinus thrombosis is associated with high morbidity and mortality, estimated at approximately 15% and 11% respectively. The complex diagnostic and treatment processes pose a challenge for healthcare providers, considering its elevated mortality and morbidity. We present four cases with varying clinical presentations and outcomes to provide valuable insights into the manifestations and management of CST. Case description Our case series explored CST across age groups, including a case involving a pregnant woman. The clinical manifestations, laboratory data, imaging findings, pathogens, medications, surgical treatment, and clinical outcomes were analyzed. All cases were associated with one or more ophthalmic symptoms. All patients exhibited eye symptoms, with proptosis occurring unilaterally or bilaterally. Etiologies ranged from infections stemming from pimples and tooth cavities to an initially non-septic cause. Of the four cases presented, two proved fatal: one due to severe sepsis in a young man and the other initially aseptic but later progressing into sepsis in a geriatric man. The remaining two cases exhibited septic complications with complete recovery after prompt treatment. Conclusion Severity and clinical courses of CST varied, emphasizing the need for careful consideration and tailored management strategies in CST cases. The prognosis of CST has improved with the advancement in treatment, but complications are not infrequent. Raising awareness regarding the potential for severe complications, such as cavernous sinus thrombosis, initiated by a common infection, is strongly encouraged.
Angiogenesis is the formation of new blood vessels from existing vessels. In rheumatoid arthritis (RA), new blood vessels maintain a chronic inflammatory state by transporting inflammatory cells to the site of inflammation. Rheumatoid arthritis is a chronic autoimmune disorder that affects approximately 1% of the global population, with a higher prevalence in women. It is characterized by synovial inflammation, hyperplasia, and angiogenesis, leading to joint destruction. Understanding the pathogenesis of RA, particularly the mechanisms driving synovial angiogenesis, is crucial for the development of targeted therapies. Fibroblast-like synoviocytes (FLS) and endothelial cells play key roles in RA pathogenesis by secreting pro-inflammatory cytokines and growth factors, such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1β, IL-6, and vascular endothelial growth factor (VEGF). These mediators activate multiple signaling pathways, including VEGF, nuclear factor kappa light chain enhancer of activated B cells (NF-κB), phosphatidylinositol-3 kinase (PI3K)/AKT, mitogen-activated protein kinase (MAPK), wingless-related integration site (Wnt), and the Janus kinase (JAK)/ signal transducer and activator of transcription (STAT), which contribute to synovial angiogenesis, inflammation, and joint damage. A literature search was conducted on PubMed, ScienceDirect, SpringerLink, and Google Scholar databases for sources published in English from 2015 to 2025, using the terms “nanotechnology rheumatoid arthritis,” “angiogenesis,” “synovial inflammation,” “pro-inflammatory cytokines,” “disease-modifying antirheumatic drugs,” and “signal transduction pathways”. Current treatments for RA include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs) (conventional synthetic, biological, and targeted synthetic). An informative overview of anti-angiogenic strategies for treating RA, which may provide new perspectives for developing nanoagents, is opening new horizons in the fight against RA. This review covers RA epidemiology, pathogenesis, and signal transduction, as well as current therapies and their limitations, highlighting the need to develop new treatment strategies that target angiogenesis in RA.
Life satisfaction is a subjective concept that reflects individuals’ overall evaluation of their life. It is closely associated with the physical and mental health of older adults. The sustainability of life satisfaction among the elderly is important for both individual happiness and societal well-being for public health. This literature study aims to provide a sustainable perspective by examining the factors influencing life satisfaction in old age through both physical and mental dimensions. This study, designed as a literature review, was prepared by scanning studies published in the last five years (2021-2025) in PubMed, Scopus and Science Direct databases. Older adults with high life satisfaction tend to form healthier relationships with their surroundings, access health services more consciously, and interact more actively with society. In this context, addressing life satisfaction in old age from a physical and mental health perspective contributes to achieving sustainable well-being at both the individual and societal levels. The literature demonstrates that life satisfaction in older adults is directly related to their physical and mental health status. The majority of participants reported that the presence of chronic diseases, mobility limitations, and loss of independence in daily activities negatively affected their life satisfaction. In terms of mental health, symptoms of depression, social isolation, and feelings of loneliness emerge as significant determinants of reduced life satisfaction. The review found that protective factors such as regular health check-ups, an active lifestyle, the presence of social support systems, and support for psychological well-being significantly enhance life satisfaction. Additionally, developing a positive attitude towards aging and having meaningful life goals play a vital role in ensuring sustainable life satisfaction. Based on the literature review, developing policies, practices, and supportive services aimed at improving life satisfaction in older adults is of great importance for promoting healthy and active aging.
