Abstract Background Synovial sarcoma is a rare and aggressive subtype of soft tissue sarcoma that predominantly affects adolescents and young adults and poses significant therapeutic challenges when tumors are large or located near critical neurovascular structures. While surgery combined with radiotherapy represents the standard approach for local control, the optimal dose, fractionation, and timing of preoperative radiotherapy remain under investigation, particularly with the increasing use of hypofractionated and stereotactic techniques. Case presentation We report the case of a 19-year-old female with a large biphasic synovial sarcoma of the proximal lower limb. Induction chemotherapy with doxorubicin and ifosfamide resulted in volumetric tumor progression with only minimal metabolic response on 18F-FDG PET-CT, indicating inadequate local disease control. A salvage neoadjuvant strategy using preoperative stereotactic ablative radiotherapy (SABR) was therefore adopted. The patient received 35 Gy in five fractions, followed by limb-sparing surgical resection 58 days later. Histopathological analysis demonstrated extensive treatment-related changes, with near-complete tumor necrosis and approximately 5% residual viable tumor, and all surgical margins were negative. At approximately 4.5 years of post-surgical follow-up, the patient remains free of local recurrence and distant metastasis, with preserved limb function and no severe acute or late radiation-related toxicity. Conclusions This case highlights the potential role of intermediate dose-escalated preoperative SABR as a salvage neoadjuvant strategy in biphasic synovial sarcoma refractory to chemotherapy, supporting its consideration within individualized multimodal treatment planning for selected high-risk soft tissue sarcomas.
Foot-and-Mouth Disease (FMD) remains a major transboundary threat to livestock production and food security in Bangladesh. This study investigated the epidemiological characteristics and genetic diversity of FMD virus (FMDV) associated with two outbreaks affecting 24 cattle farms in Bogura and Mymensingh districts during June, and September and October 2024, respectively. Epidemiological data and clinical samples were collected, and FMDV was confirmed and serotyped using quantitative RT-PCR. Whole-genome sequencing was performed on the Ion Torrent PGM platform, and sequence analyses were conducted using MEGA12 and BioEdit software. Epidemic curve analysis classified both outbreaks as propagated. The introduction of newly purchased cattle into the herd without prior quarantine was identified as the likely source of infection. FMDV serotype O was detected in both outbreaks. The overall attack risk and case fatality were 65.8
Pediatric formulations are challenging to design due to considerations of convenience. Many children are suffering from an epileptic condition at an early age. Continuing anti-epileptic treatment can influence bone metabolism in children. The research was undertaken to design a pediatric and industry approachable smart stable dosage form of carbamazepine (CBZ) supplemented with Vitamin D (Vit D). Smart Oro-solid Carbamazepine Dry Suspension (SOS-CDS) was formulated using a liquorice-based suspending agent. DSC and FTIR were performed to observe interactions among CBZ, Vit D, and other excipients. Screening of various variables was performed using Failure Mode and Effects Analysis (FMEA), and the results were further optimized using a Central Composite Design (CCD) with two independent variables (suspending agent and mixing speed) and three dependent variables (sedimentation volume, blend uniformity, and
Abstract Background Diabetic foot ulcers (DFUs) are a significant worldwide health burden, worsened by biofilms that encourage chronicity and resistance to antibiotics. To improve the outcomes of diabetic infections, it is important to know how biofilms work, how they interact with each other, how they spread, and what problems they cause in therapy. Methods A narrative literature search was conducted in PubMed, Scopus, Google Scholar, and Web of Science to investigate biofilm formation pathways (e.g., the icaADBC operon in Staphylococcus aureus and quorum sensing genes such as las / rhl , and pelA in Pseudomonas aeruginosa ), polymicrobial interactions, global prevalence, and associated therapeutic challenges. We reviewed recent primary studies and influential review articles (2020–2026). Results Biofilms, predominantly polymicrobial (60–80% of DFUs), often comprise Staphylococcus aureus (34.34% in sub-Saharan Africa, over 30% in Western countries), P. aeruginosa (11.1–18.5%), and Escherichia coli (21.16%). Hyperglycemia and advanced glycation end products enhance biofilm formation via σB overexpression and metabolic cooperation, hence promoting virulence and the progression of Wagner grade. Extracellular polymeric substance (EPS), and efflux pumps impede the efficacy of antibiotics such as vancomycin and linezolid. Surgical interventions (such as debridement and osteotomies) and novel therapies (including nisin, silver sulfadiazine, and rhamnolipid-coated nanoparticles) possess potential in combating resistance and promoting recovery. Conclusion In conclusion, biofilm development significantly contributes to the chronicity and treatment resistance of DFUs, shaped by complex host-pathogen and polymicrobial interactions. Combining novel antibiofilm medicines with traditional wound care in a multimodal strategy offers promise for improved healing outcomes, but further clinical trials are needed to be certain. Clinical trial number Not applicable.
Diabetic kidney injury is associated with renal bioenergetic disturbance, redox imbalance and impaired mitochondrial biogenesis signalling. This study evaluated whether papain supplementation attenuates renal bioenergetic, redox and inflammatory alterations and modulates Ppargc1a/PGC-1α mRNA expression in fructose/streptozotocin-induced diabetic rats. Twenty-five male Wistar rats (n = 5/group) were assigned to five groups: non-diabetic control, diabetic only, high-dose papain (800 mg/kg/day), low-dose papain (400 mg/kg/day) and metformin (100 mg/kg/day), the last three on a diabetic background. After 28 days, renal tissue was analysed for injury-associated analytes, bioenergetic and antioxidant markers, inflammatory cytokines and Ppargc1a/PGC-1α mRNA expression. Data were analysed by one-way ANOVA with Bonferroni post hoc test (p < 0.05). In the oral glucose tolerance test, both papain doses restored the glycaemic excursion and area under the curve to near-control values, with no clear dose separation and with tighter control than metformin; both papain groups were also protected from the progressive body-weight gain and hyperphagia of the untreated diabetic group. At the renal level, diabetes significantly increased creatinine, urea, lactate, pyruvate and tumour necrosis factor alpha and reduced succinate dehydrogenase, glutathione, interleukin 10 and Ppargc1a/PGC-1α mRNA, while high-dose papain significantly improved these endpoints relative to the diabetic group; low-dose papain produced a weaker response, and metformin showed similar recovery. Papain supplementation improved renal bioenergetic and antioxidant markers, rebalanced inflammatory cytokines and up-regulated Ppargc1a/PGC-1α mRNA expression, performing comparably to or better than metformin and supporting papain as a promising renoprotective candidate in diabetic kidney disease.
