INTRODUCTION:The present case of oral tuberculosis represents an uncommon manifestation of Mycobacterium tuberculosis infection. Primary oral Tuberculosis is often easily overlooked during routine evaluation, because its clinical appearance overlaps with more frequently encountered reactive or benign lesions. CASE PRESENTATION:A seventy-two-year-old woman of poor socio-economic status presented with a small, firm swelling on the right buccal mucosa near tooth 18. Clinically, the lesion resembled a typical irritational fibroma. Histopathological examination revealed well-formed epithelioid granulomas with Langhans-type multinucleated giant cells. Ziehl-Neelsen staining demonstrated acid-fast bacilli within the lesion, supporting the diagnosis of tuberculous granuloma. Both Mantoux testing and chest radiography were unremarkable. The patient underwent standard antitubercular therapy and experienced complete resolution without recurrence at the six-month review. Persistent or atypical oral mucosal lesions should prompt consideration of Tuberculosis, especially in endemic regions. CONCLUSION:This case is unusual because the lesion clinically resembles a benign reactive growth in the absence of pulmonary involvement or systemic manifestations. The report highlights the diagnostic value of histopathological examination and emphasizes the importance of considering Tuberculosis in the differential diagnosis of persistent oral lesions. Early biopsy facilitates accurate diagnosis and appropriate therapy, minimizing morbidity.
The transformative role of artificial intelligence (AI) in the pharmaceutical industry is examined, with a focus on its significant contributions to drug discovery, development, and clinical trial processes. It highlights the inefficiencies and high costs associated with traditional drug development and explores how AI and machine learning (ML) can enhance these processes by analyzing extensive biological datasets. The historical context of AI in pharmaceutical development is examined, noting how advances in computational power and data accessibility have facilitated innovative methodologies, such as predictive analytics and natural language processing. Contemporary trends reveal the integration of AI technologies in drug design, repurposing, and patient response forecasting. This study also addresses the challenges of participant recruitment for clinical trials and proposes AI-driven solutions to optimize patient selection and data management. Furthermore, it discusses AI's role in tailored medicine, emphasizing its potential for advancing precision therapy through targeted drug development and personalized treatment strategies. The importance of digital tools, genomic data analysis, and AI-driven imaging technologies for customizing therapeutic approaches is underscored, along with the regulatory and ethical challenges posed by AI deployment in healthcare. This study illustrates the complexities of AI applications in the pharmaceutical sector, offering insights into both successful and unsuccessful initiatives. The findings suggest that the digitalization of the pharmaceutical industry and enhanced AI integration hold promise for developing safer and more effective therapeutic strategies, while also identifying obstacles to their widespread adoption and optimal functionality.
Novel chemotherapeutic drugs that can fight multidrug-resistant bacteria are desperately needed due to the fast growth of antimicrobial resistance (AMR). As a favoured scaffold in medicinal chemistry, the naturally produced indole derivative isatin (1H-indole-2,3-dione) is found in microorganisms, plants, and the metabolic pathways of mammals, has garnered significant interest. Isatin is a crucial pharmacophore for the creation of broad-spectrum antibacterial medicines because of its adaptable chemical structure and ease of structural alteration at several reactive locations. The therapeutic potential of isatin and its derivatives against bacterial, fungal, viral, and microbacterial diseases is well highlighted in this study. Schiff bases, Mannich bases, thiosemicarbazones, azole, furan, sulfonamide, fluoroquinolone, chalcone, and coumarin conjugates are among the many isatinbased hybrids and analogs that show strong and specific antimicrobial action. According to mechanistic investigations, these compounds function via a variety of mechanisms, including biofilm suppression, membrane disruption, interference with DNA gyrase and topoisomerase IV, inhibition of cell-wall production, and targeting vital enzymes like FtsZ and CrtM. To enhance biological potency and overcome drug resistance, electronic substituents, linker flexibility, and hybridization techniques are crucial, according to structure-activity relationship (SAR) studies. The clinical approval of numerous isatin-based drugs, including sunitinib and nintedanib, for the treatment of cancer, as well as the evaluation of other drugs, like TD-1792 and Ro 23-9424, for the treatment of infectious diseases, demonstrate the translational success of this scaffold. This review focuses on significant advancements, procedures, and potential treatments in isatin-based antimicrobial research.
Introduction: Tuberculosis (TB), induced by Mycobacterium tuberculosis (Mtb), constitutes a significant global public health issue, particularly for immunocompromised individuals who have HIV or cancer and are susceptible to latent tuberculosis. The Directly Observed Treatment Short (DOTS) course comprises isoniazid, rifampin, pyrazinamide, and ethambutol, which are administered to treat tuberculosis. Intentional or unintentional missed doses or inferior formulations have resulted in MDR-TB. Prompt and correct diagnosis is urgent to initiate treatment. The present study attempts to explore patient demographics, prompt TB diagnosis, and anti-tubercular medications under surveillance. Methods: A comprehensive literature search was performed to identify relevant studies published between 2018 and 2025, using electronic databases including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar. Search terms were applied using combinations of controlled vocabulary and free-text keywords, including Mycobacterium tuberculosis, MDR and XDR-TB, antitubercular drugs, clinical trials, and patents on fast detection of tuberculosis and easy diagnosis of Mtb. Studies not focused on the said area were excluded. Results: Traditional diagnostic methods, while relatively affordable, were found to be timeconsuming and limited in sensitivity, particularly in HIV-positive TB patients to whom conventional immune-based tests may yield false-negative results. The present study reviewed novel diagnostic technologies, including advanced molecular techniques such as RT-qPCR and RNA sequencing, which offered rapid, highly specific identification of drug-resistant strains. Point-of-care platforms and immunological assays showed strong potential for deployment in resource-limited settings, addressing critical gaps in diagnostic access. Gene expression profiling further enabled distinguishing active TB from latent infection and predicting treatment response, providing a foundation for more personalized therapeutic strategies. Discussion: Rapid diagnosis of the specific disease can initiate appropriate treatment, which can save the patient's life. Conclusion: Timely and accurate diagnosis of TB, particularly drug-resistant forms, is essential for guiding appropriate treatment and preventing the further spread of MDR-TB and XDR-TB. Early TB detection helps make the right choice of specific current antitubercular chemotherapeutics, as strongly recommended in the present scoping review for the global effort to eradicate drug-resistant tuberculosis.
Autoimmune diseases such as rheumatoid arthritis represent major clinical challenges due to the complexity of immune system dysfunction and the limitations of current treatment strategies. Combination therapies involving JAK inhibitors, methotrexate, and natural compounds such as quercetin can target multiple disease pathways and improve therapeutic outcomes. Previous studies have shown that the concurrent administration of multiple medications may result in reduced patient adherence, systemic adverse effects, and suboptimal tissue targeting. Hydrogel-Forming Microneedles (HFMNs) enable controlled transdermal drug delivery, offering a minimally invasive approach that may improve patient acceptability and facilitate the administration of multiple therapeutic agents. This review examines the design principles of HFMNs, including polymer selection, crosslinking strategies, swelling behavior, and drug-loading approaches, and compares them with other microneedle platforms. Recent advances have focused on the co-encapsulation of multiple therapeutic agents, including synthetic drugs, Disease-Modifying Antirheumatic Drugs (DMARDs), and phytochemicals, enabling their controlled and sequential release for enhanced therapeutic efficacy. Recent studies have investigated drug-material interactions, in vitro and in vivo release profiles, and the synergistic effects of co-delivered therapeutic agents. Particular emphasis is placed on the application of combination therapy in rheumatoid arthritis through modulation of the JAK/STAT, NF-κB, and oxidative stress pathways, while HFMN-mediated delivery may improve therapeutic outcomes and reduce systemic adverse effects. Ongoing studies have evaluated the development of these systems, including their mechanical strength, transdermal penetration performance, and therapeutic efficacy in animal models of inflammatory joint disease using relevant biomarker analyses. The review also discusses regulatory considerations, including scale-up manufacturing and sterilization, and highlights future directions involving smart hydrogels and integrated diagnostic technologies to facilitate clinical translation. HFMNs provide a versatile platform for advancing combination therapies for autoimmune and inflammatory diseases. This platform has the potential to improve tissue targeting, patient adherence, and therapeutic outcomes.
Introduction:: Upper respiratory tract infections (URTIs) affect millions globally, with cough being one of the most bothersome symptoms. While various treatments exist, their comparative effectiveness remains unclear. This study aims to evaluate and compare three commonly used treatments for acute cough in adults with upper respiratory tract infections: Levodropropizine, Codeine (with Pseudoephedrine and chlorphenamine), and Hedera Helix extract. Methods:: We will conduct a double-blind, parallel-group randomized clinical trial with 136 adults aged 18-65 with acute upper respiratory tract infection and moderate to severe cough. Participants will be randomized to receive Levodropropizine, Codeine + Pseudoephedrine + Chlorphenamine, Hedera Helix Extract, or Placebo three times a day for 4 days. Outcomes:: The primary outcome will be cough severity at 48 hours, measured by a cough numerical rating scale. Secondary outcomes will include cough severity and duration at 4- and 10-day intervals. Discussion:: We will conduct a rigorous clinical trial addressing several methodological challenges of previous studies and conduct the first direct head-to-head comparison of three commonly used medications to treat acute cough in adults with URTIs. Conclusion:: This trial will provide high-quality evidence comparing the effectiveness of three widely used antitussive medications in primary care settings. The results would help establish evidencebased guidelines for treating acute cough in upper respiratory infections. Clinical Trial Registration Number:: ClinicalTrials.gov NCT06907355.
This review examined the prevalence and implications of Conflicts of Interest (COI) in biomedical research. It involved an analysis of high-profile cases, including the Troglitazone safety controversy, Dr. Baselga’s undisclosed pharmaceutical payments, National Institute of Health’s (NIH) financial COIs, the COI involving COX-2 inhibitors, the 2008-2009 COI involving Harvard pediatric psychiatrists, and the UK University collaboration with “health-harming” industries. It also examined regulatory and ethical frameworks of COI management. The study’s results show that COIs can threaten the quality of biomedical research and endanger patient health. In extreme cases, they might even lead to patient deaths. The evidence links this problem to the inconsistency of COI management policies, especially COI disclosure requirements. The findings of this research demonstrate the vague wording and poor enforcement of these requirements. To prevent the negative effects of COIs on research outcomes, consistent COI across relevant fields must be developed. For instance, leading academic journals must adopt the same COI disclosure approach to reduce ambiguity. Moreover, COI policies must address previously overlooked areas, such as the financial interests of authors’ family members. The results of the study can be a good starting point for future research on addressing COIs through self-regulation. They illustrate the need for a customized COI management strategy rather than the one-size-fits-all approach.
INTRODUCTION:Arsenic is a ubiquitous environmental metalloid with dual characteristics-acting as both a potent toxin and an effective therapeutic agent. Chronic exposure to inorganic arsenic species, arsenite [As(III)] and arsenate [As(V)], is associated with multiple cancers and systemic diseases, whereas Arsenic Trioxide (ATO) demonstrates strong anticancer efficacy, particularly in Acute Promyelocytic Leukemia (APL). METHODS:A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar to review epidemiological, experimental, and clinical studies. Inclusion criteria focused on works addressing arsenic-induced genotoxicity, proteotoxicity, and therapeutic applications. Data were extracted regarding molecular mechanisms, biomarkers, and mitigation strategies. RESULTS:Arsenic induces oxidative stress, DNA damage, and epigenetic alterations, leading to genomic and proteomic instability. Clinical evidence indicates ATO achieves remission rates exceeding 90% in APL by degrading the PML-RARα oncoprotein. Emerging nanotechnology and precision medicine approaches enhance drug delivery, reduce systemic toxicity, and support targeted therapy. DISCUSSION:Arsenic's paradoxical behavior is dose- and context-dependent. While chronic lowlevel exposure drives carcinogenesis, controlled pharmacologic use offers therapeutic benefit. Integration of omics technologies and nanocarriers can refine their safety and clinical applicability. CONCLUSION:Arsenic exemplifies the intersection of toxicity and therapy. Understanding its genotoxic and proteotoxic mechanisms supports the development of safer, precision-based interventions and expands its potential as a therapeutic agent in modern oncology.
INTRODUCTION/OBJECTIVE:Cefepime, a fourth-generation cephalosporin, is commonly prescribed in clinical practice for the treatment of moderate to severe infections and is primarily eliminated by renal clearance. PBPK modeling, a mechanistic and innovative approach with substantial implications for decision-making and drug development. The current study aimed to develop and validate a PBPK model of cefepime in healthy, CKD, geriatric, and pregnant populations to support dose optimization and promote personalized, safer treatment strategies. METHODS:The model was first developed in a healthy adult population using different intravenous doses of cefepime, and its performance was evaluated using observed-to-predicted ratios of pharmacokinetic parameters. A virtual cohort of 100 subjects was then created in PK-Sim, and cefepime pharmacokinetics in CKD, geriatric, and pregnant populations was simulated after incorporating the relevant pathophysiological alterations. RESULTS:The cefepime PBPK model accurately predicted drug disposition across healthy, geriatric, CKD, and pregnant populations, aligning with reported clinical data. DISCUSSION:The findings underscore the effectiveness of PBPK modeling in forecasting cefepime pharmacokinetics across diverse populations, particularly where conducting clinical trials may be difficult. This predictive accuracy highlights its importance in guiding dose adjustments and advancing individualized therapy. CONCLUSION:Approximately 95% of observed versus predicted cefepime concentrations fell within a two-fold error margin, demonstrating the robustness of the PBPK model. This PBPK model is intended to complement, not replace, therapeutic drug monitoring by supporting initial dose selection and pharmacokinetic risk stratification in special populations, particularly in clinical settings where routine monitoring or population-specific pharmacokinetic data are limited.
Introduction: Urinary lithiasis is one of the most common diseases in Western countries. Although there is evidence that kidney stones may be related to upper urinary tract tumors, the mechanisms that link the origin of urinary stones to the development of these tumors remain largely unclear. In this article, we present a rare case of a giant tumor of the renal pelvis associated with chronic lithiasis and discuss the association between these two conditions. Case presentation and review of the literature: A 69-year-old woman was admitted to the hospital because of a high fever, pain in the left flank, and gross haematuria. She had a history of recurrent renal infection and untreated kidney stones, diagnosed 30 years ago. Imaging studies showed staghorn calculi in both kidneys and two large cystic formations within the pelvis of the left kidney. The patient underwent salvage nephrectomy. Histologic examination diagnosed high-grade urothelial carcinoma and chronic inflammation. A systematic search was performed in electronic libraries (PubMed) using the terms: “transitional cell carcinoma”, “renal cancer”, “urothelial carcinoma” along with the term “staghorn calculi”, “nephrolithiasis”, “urinary tract infection” and “chronic inflammation”. There was no restriction on publication date. Results and conclusion: According to the literature, untreated nephrolithiasis can cause both anatomical and functional damage, leading to an increased risk of developing urothelial carcinoma in the renal pelvis. Clinicians should consider the risk of developing urothelial carcinoma in patients with chronic nephrolithiasis, large stones, frequent urinary tract infections, and abnormalities observed during radiological investigations.
Dietary fibers, and more specifically water-soluble fibers, beneficially affect human health. Guar gum and its enzymatic product, partially hydrolyzed guar gum (PHGG), are among the most studied dietary fibers in humans. Altogether, they can be described as "guar fiber". We performed a narrative review of the literature on guar fiber, namely guar gum and its partially hydrolyzed product, and their impact on human health, with a special focus on the gastrointestinal tract, gut microbiota, gut-brain axis, and liver steatosis. Accordingly, a literature search was conducted using the following keywords and combinations: guar fiber, guar gum, partially hydrolyzed guar gum, disorders of gut-brain interaction, gut-liver axis, and gut microbiota. Guar gum and its derivative, PHGG, show promising effects in gastrointestinal disorders, such as constipation and diarrhea. Interestingly, they can modulate the gut microbiota, with promising implications for the gut-brain axis and disorders of gut-brain interaction, such as irritable bowel syndrome. There are also interesting, albeit preliminary, results regarding their use in fatty liver disease. Thus, dietary fibers such as guar gum and, more importantly, its hydrolyzed product, show promising and better-documented effects on the health of the gastrointestinal tract and other organs and systems of the human body. However, the latter evidence still requires clinical confirmation of preclinical findings. Overall, the reviewed data vary in quality and maturity across different outcome domains.
Cardiovascular diseases (CVD) are still among the main causes of illness and death worldwide. In recent years, research has started to look beyond the classic risk factors and has shown growing interest in the gut microbiota, which plays an important role in cardiovascular health. This review highlights how the intestinal microbiota acts as a link between diet, the immune system, and cardiovascular disease, focusing on underlying molecular mechanisms, new potential biomarkers, and clinical relevance. Many bioactive compounds, such as trimethylamine-N-oxide (TMAO) and short-chain fatty acids (SCFAs), are produced by the gut microbiota and can influence inflammation, endothelial function, and lipid metabolism. Chronic low-grade inflammatory state (due to bacterial endotoxins entrance in bloodstream when intestinal permeability increases) contributes to the development of atherosclerosis. Multi-omics technologies have helped to understand the functional role of the microbiota better and to identify dynamic biomarkers. These include plasma TMAO levels, the Firmicutes/Bacteroidetes ratio, SCFA patterns, and the presence of microbial species with pro- or anti-inflammatory effects. Such biomarkers may be useful for risk assessment, therapeutic monitoring, and the design of personalized dietary strategies. Overall, analyzing the gut microbiota and monitoring its changes through specific biomarkers supports a preventive medicine approach based on lifestyle interventions. This strategy has strong potential to improve public health outcomes while also contributing to more sustainable healthcare systems.
INTRODUCTION:Spontaneous rupture of the renal pelvis with urinary extravasation due to ureteral lithiasis is an uncommon entity, and it presents both diagnostic and therapeutic challenges, necessitating a systematic approach for diagnosis confirmation, treatment, and follow-up. Case Presentation and Review of the Literature: This article concerns a case of a 45-year-old male with acute left renal pain. Computed Tomography revealed renal pelvis rupture with perirenal urinary extravasation due to a 3 mm calculus located at the right ureterovesical junction. The patient was successfully managed with the insertion of a percutaneous nephrostomy and a drainage tube in the urinoma. A follow-up CT nephrostomography demonstrated complete healing of the renal pelvis, with no residual extravasation, while no evidence of the obstructing calculus was identified. RESULTS AND CONCLUSION:The incidence of renal pelvis rupture due to urolithiasis is rare and warrants heightened suspicion by the urologist for prompt diagnosis and appropriate management.
INTRODUCTION:Acromioclavicular joint (ACJ) dislocations are common, particularly in athletes. Surgical treatments, including tightrope (TR) and hook plate (HP) techniques, are frequently used, yet no consensus exists on the most effective approach. This study aimed to compare TR and HP methods for managing ACJ dislocations. METHODS:Following PRISMA guidelines, we conducted a systematic review of PubMed, Scopus, and Web of Science databases, including randomized controlled trials, cohort, and case-control studies. Statistical analysis was performed using RevMan software. RESULTS:A total of 10 studies with 285 patients in the TR group and 355 in the HP group were analyzed. The TR technique showed a significant reduction in pain (MD=-0.3, p =0.04) and lower blood loss (MD=-36.14, p <0.00001) compared to the HP method. No significant differences were noted in shoulder function (Constant-Murley score: MD=-0.14, p =0.95), joint stability (coracoclavicular distance: MD=0.47, p =0.41), or patient satisfaction (ASES: MD=-2.28, p =0.67). DISCUSSION:Both techniques offered similar functional and stability outcomes, yet TR presented clear benefits in pain management and reduced blood loss. These advantages suggest that TR may be a better option for minimizing complications and improving recovery. The comparable results in shoulder function and stability implied that surgeon preference and patient-specific factors should guide the choice of technique. CONCLUSION:TR provided superior pain relief, less intraoperative blood loss, and fewer implantrelated complications compared to HP, while both methods offered similar outcomes in functional recovery and satisfaction.
INTRODUCTION/BACKGROUND:Cerebral air embolism (CAE) is a rare but potentially fatal complication, characterized by the entry of air bubbles into the arterial circulation, subsequently obstructing cerebral blood flow and causing ischemic injury. While CAE is a recognized risk in cardiovascular surgery, barotrauma, trauma of the chest or head, it remains an extremely rare complication of pleural procedures, which is even more exceptional when occurring during chest tube placement. To our knowledge, we report the first case of CAE induced by insertion of a small-bore (12 Fr) chest tube via a safety Verres needle technique in a patient with hydropneumothorax. CASE PRESENTATION:The patient was admitted with cough, confusion, fever, and dyspnea. Diagnostic imaging, including a chest x-ray (CXR) and chest Computed Tomography (CT), detected a rightsided hydropneumothorax, which was also identified by thoracic ultrasound. During the 12 Fr chest tube insertion with the patient in the supine position, a sudden loss of consciousness and convulsions occurred. The patient was administered the Trendelenburg position and high-flow oxygen therapy, recovering consciousness within minutes, with residual neurologic deficits. A subsequent head CT scan revealed CAE. CONCLUSION:This case highlights an exceptionally rare but potentially devastating complication of pleural drainage insertion, underscoring the need for heightened clinical vigilance during all pleural procedures, regardless of procedural complexity or drainage size. Although thoracic ultrasound is fundamental for guiding chest tube placement, a thickened pleura is associated with increased procedural risk due to increased resistance. Clinicians should promptly recognize acute neurological deterioration during chest tube placement as a possible manifestation of CAE, performing an early neuroimaging and immediate management.
Primary Amoebic Meningoencephalitis (PAM), caused by Naegleria fowleri, is a rare but highly devastating infection with a mortality rate exceeding 98%. Although historically sporadic, recent emerging cases and localized outbreaks have raised global concern. The disease's rapid progression and diagnostic complexity demand immediate and precise therapeutic intervention, as even minor medication errors can critically impact patient survival. Such medication errors, ranging from incorrect dosing to delayed administration,Primary Amoebic Meningoencephalitis (PAM), caused by Naegleria fowleri, is a rare but devastating infection with a mortality rate exceeding 98%. Although historically sporadic, recent emerging cases and localized outbreaks have heightened global concern. The disease's rapid progression and diagnostic complexity necessitate immediate, precise therapeutic intervention, where even minor medication discrepancies can critically affect survival outcomes. Medication errors ranging from incorrect dosing to delayed administration pose significant clinical and economic challenges, underscoring the need for robust strategic safeguards. Within this context, clinical pharmacists emerge as pivotal agents of patient safety. Their expertise in pharmacotherapy, drug interactions, and adherence to treatment protocols enables them to implement strategic solutions such as: Standardized treatment algorithms for anti-amoebic therapy to minimize dosing errors. Real-time medication reconciliation systems to prevent delays and ensure timely administration. Multidisciplinary coordination frameworks integrating pharmacists with physicians, microbiologists, and intensivists for rapid decision-making. Continuous training and simulation exercises to prepare healthcare teams for rare but high-stakes infections. Digital monitoring and AI-driven alerts to detect potential drug interactions or deviations from protocol. This article synthesizes case reports from the United States, Pakistan, and India, highlighting both historical and recent PAM instances. These narratives emphasize the evolving role of clinical pharmacists in identifying, preventing, and correcting medication-related issues. By bridging clinical insight with pharmaceutical precision, pharmacists not only enhance therapeutic accuracy but also strengthen institutional preparedness against rare infections. As global awareness grows, embedding clinical pharmacy into multidisciplinary care models represents a strategic solution essential not only for PAM but also for other emerging infectious threats where survival hinges on therapeutic precision.
Artificial intelligence (AI) and machine learning (ML) are transforming healthcare, particularly in drug delivery, development, and therapeutics. These technologies offer unprecedented potential to address complex diseases and improve patient outcomes. AI-powered drug delivery systems optimize drug release, target specific tissues, and enhance treatment efficacy, thereby minimizing side effects and maximizing therapeutic effectiveness. ML algorithms accelerate drug development by identifying promising candidates and streamlining clinical trials, which reduces both development time and costs. Another significant application is personalized therapeutics, which are tailored to individual patient profiles. AI analyzes genomic and medical history data to predict drug responses and generate optimized treatment plans. This personalized approach increases treatment effectiveness and reduces adverse reactions. AI and ML are also being applied to the management of neurodegenerative disorders, antimicrobial resistance, and ocular diseases, providing tools for early diagnosis and disease management. Ethical considerations such as data privacy, algorithmic transparency, and robust pharmacovigilance are essential for responsible advancement. The integration of AI and ML in drug delivery and therapeutics is poised to significantly improve patient outcomes.
BACKGROUND:Urethral bleeding resulting from a urethral injury is usually easily controlled with conservative management (placement of a catheter and pressure). The case of uncontrolled urethral bleeding is rare, and only a small number of uncontrolled urethral bleeding case reports after urological procedures have been reported in the literature. CASE REPORT:Herein, we present an unusual case of a 67-year-old male with uncontrolled urethral bleeding after a transurethral resection of the prostate (TUR-P) for benign prostatic hyperplasia, who underwent a successfully, hyper-selective embolization of the bulbar artery with micro coils. Hyperselective embolization of the bulbar artery with micro coils was successfully. The patient was discharged home within 76 hours. At the regular follow-up, the patient was asymptomatic, his laboratory studies were stable, while no tissue ischemia with subsequent urethral strictures and erectile dysfunction was noticed. CONCLUSION:Although urethral bleeding after transurethral procedures is common, the urologist should be aware of the management options for massive bleeding. End-vessel vascular embolization, such as the bulbar urethral artery with permanent metal coils, is an option in case of uncontrolled urethral bleeding when conservative treatment has failed.
BACKGROUND:Postoperative Gastrointestinal Dysfunction (PGD), a common surgical complication closely linked to anaesthetic agents and techniques, has garnered increasing research attention under the framework of Enhanced Recovery After Surgery (ERAS), driving significant progress in both basic and clinical understanding. This review aims to summarise the latest advances in anaesthesia-induced PGD, with a focus on its mechanisms, anaesthetic drug effects, and clinical management strategies, to provide evidence-based references for optimising perioperative care. METHODS:A comprehensive narrative review of recent literature from PubMed was conducted. The search terms included "anaesthetic drugs," "postoperative gastrointestinal dysfunction," "ERAS," and "multimodal analgesia." Both preclinical and clinical studies were included to synthesize current evidence. RESULTS:Anaesthetic drugs, especially opioids, significantly inhibit gastrointestinal motility and contribute to PGD. Inhalational anaesthetics such as sevoflurane may increase the risk of intestinal paralysis, while propofol demonstrates protective effects through anti-inflammatory and antioxidant mechanisms. Regional anaesthesia and multimodal analgesia reduce opioid exposure and improve gastrointestinal recovery. Emerging strategies, including novel opioid formulations, modulation of the gut microbiota, and non-pharmacological interventions (e.g., early enteral nutrition, electroacupuncture), show promising potential for mitigating PGD. CONCLUSION:Preventing and managing PGD requires optimizing anesthetic protocols, reducing opioid reliance, and integrating multimodal interventions, while future research should prioritize personalized anesthesia, modulation of the gut-brain axis, and AI-enhanced perioperative care to improve outcomes.
INTRODUCTION:Hepatitis C virus (HCV) is believed to cause 130-170 million infections worldwide, or roughly 3% population worldwide, and poses a serious risk to global health. Hepatitis C is an enveloped +ve RNA virus belonging to the family Flaviviridae. All around the world, HCV infection is the main cause of serious liver diseases such as cirrhosis and hepatocellular carcinoma. Even though drugs have been around for a while, only a small number of them have been proven to be effective against every HCV genotype because of their genetic diversity and complexity. The objective of the paper to understand various protein targets of HCV and study various inhibitors from different sources and their scope in the treatment of HCV infection. METHODS:The terms "core proteins," "structural and non-structural HCV proteins," "treatment strategies of HCV," and "hepatitis C virus" were used to search the scientific database for relevant publications. A selection of reports from PubMed, MEDLINE, Scopus, Web of Science, followed by Science Direct, and Google Scholar that were searched through 2024 are included in this review. In this work, the findings were evaluated, collected, and presented. There were 218 papers in all, and the number of articles published between 2010 and 2024 increased exponentially. RESULTS:This study provides an overview of what is currently known about the virology, transmission, diagnosis, and treatment of HCV. Additionally, it offers a thorough examination of HCV proteins as potential targets for the creation of vaccines and antiviral medications. The NS5B polymerase, NS3/4A protease, entrance receptors, including CD81, and core proteins are among the specific HCV proteins that have been suggested as possible therapeutic targets. Additionally, the potential uses of HCV proteins as prognostic and diagnostic biomarkers. Although successful, the current direct- acting antiviral treatments have drawbacks related to resistance, genotype specificity, and cost. In order to guide future research on better preventive, diagnostic, and therapeutic approaches against this worldwide infectious disease threat, this review attempts to compile crucial knowledge on HCV biology and pathogenesis. DISCUSSION:The findings of the review indicate the importance of understanding various protein targets of HCV and studying various inhibitors from different sources and their scope in the treatment of HCV infection. In support of the review, an in-silico based meta-analysis study is included to infer the complete antiviral potential of Hepatitis C Virus- Drug Resistance and different proteinsbased therapeutic targets. CONCLUSION:We intended to highlight the advances gained in managing and preventing HCV infection, as well as the ongoing challenges to HCV prevention. The primary goal was to connect with global health objectives in order to reduce the burden of chronic hepatitis, ultimately eliminating it as a public health hazard in the near future. The PROSPERO registration number for systematic review is 1080028.
