Adult-onset Still’s disease is a rare multisystem autoinflammatory disorder of unknown etiology, the pathogenesis of which is primarily associated with dysregulation of the innate immune response and excessive production of proinflammatory cytokines. Its clinical phenotype is highly heterogeneous; however, in most patients the disease is characterized by a combination of high spiking fever, arthritis or arthralgia, an evanescent maculopapular rash, and neutrophilic leukocytosis. Common associated manifestations include pharyngitis, lymphadenopathy, hepatosplenomegaly, serositis, and marked laboratory evidence of inflammatory activity with hyperferritinemia. The diagnosis of adult-onset Still’s disease remains clinical and is established by integrating symptoms, findings of ancillary investigations, and exclusion of alternative causes of systemic inflammation, since no pathognomonic diagnostic test is available. In clinical practice, classification criteria, systemic manifestations, hematologic abnormalities, and inflammatory biomarkers are of particular value. Treatment is considered a stepwise process, ranging from symptomatic anti-inflammatory therapy and glucocorticoids to immunosuppressive treatment and targeted biologic agents, primarily inhibitors of key cytokines. This article summarizes current concepts of the etiopathogenesis of adult-onset Still’s disease, presents a practice-oriented approach to differential diagnosis, and describes an original clinical case illustrating typical diagnostic challenges and the rationale for a therapeutic strategy that resulted in sustained remission.
Osteoporosis is a systemic skeletal disorder characterized by reduced bone strength and increased fracture risk. Although dual-energy X-ray absorptiometry (DEXA) remains central to the diagnosis of osteoporosis, bone mineral density alone does not fully capture the dynamic biological processes that determine skeletal strength. Biochemical bone turnover markers provide information on bone formation and resorption and may complement imaging-based assessment, particularly for monitoring treatment response and adherence. Ayurveda describes skeletal health through concepts such as Asthi Dhatu, Asthi Dhatwagni, Vata Dosha and Asthi Dhatu Kshaya. These classical constructs should not be treated as direct equivalents of modern biochemical markers; however, bone turnover markers may provide a measurable framework to study selected aspects of bone metabolism in relation to Ayurvedic assessment. This review summarizes the modern understanding of bone remodeling, describes clinically relevant bone formation and resorption markers, and proposes a cautious integrative framework linking Asthi Dhatu and Asthi Dhatwagni with objective parameters of bone turnover. The review emphasizes that such correlations require systematic validation through well-designed clinical studies incorporating Ayurvedic clinical assessment, DEXA, fracture risk evaluation and standardized biomarker measurement.
Background: Chronic non-specific neck pain (CNSNP) is associated with postural misalignments and sensorimotor deficits, which can influence the function of the upper limbs. The relationship between the severity of pain, the position of the cervical spine, and the strength of the hands is not well understood. This study investigated the connections between pain severity, cervical alignment, and both grip and pinch strength in individuals suffering from CNSNP. Materials and Methods: This cross-sectional study included 84 individuals with CNSNP (mean age: 37.90 ± 3.55 years). Pain intensity was assessed using the Visual Analogue Scale (VAS). Cervical posture was evaluated using digital photogrammetry by measuring the craniovertebral angle (CVA), sagittal head tilt (SHT), and shoulder angle (SA). Bilateral grip and pinch strength were measured using standardized dynamometric protocols. Pearson correlation analyses were performed to examine associations among pain severity, cervical posture, and hand strength variables. Results: Participants reported a mean pain intensity of 6.61 ± 0.70 cm and a mean CVA of 44.21 ± 2.00°. Pain severity demonstrated significant negative correlations with CVA (r = −0.524, p < 0.001), right and left grip strength (r = −0.558 and −0.524, respectively; p < 0.001), and right and left pinch strength (r = −0.459 and −0.393, respectively; p < 0.001). CVA showed significant positive correlations with right and left grip strength (r = 0.457 and 0.406, respectively; p < 0.001) and weaker positive correlations with pinch strength (r = 0.231–0.220; p < 0.05). Conclusions: Individuals with CNSNP who experienced more intense pain and had a decreased CVA exhibited weaker grip and pinch strength. Among postural variables, CVA was the most clinically significant in relation to hand function. Evaluating chronic neck pain should encompass both hand strength and cervical posture to detect impairments that extend beyond localized symptoms.
Digital device use and inactive lifestyles have become some of the common causes of cervical pain as a musculoskeletal condition. Conventional evaluation procedures are based on manual clinical testing and self-reported symptoms, which do not always have objectivity, scale, and the ability to monitor some things in real time. This paper will also attempt to overcome these pitfalls by suggesting a quantum-enhanced cervical pain assessment framework that relies on neck motion analysis using a webcam. The suggested system makes use of a typical web camera that records live video of the neck motions, which are analyzed through the use of computer vision algorithms that determine poses and keypoints. Biomechanical characteristics are obtained like neck tilt, rotation, flexion and motion velocity and are rendered in the form of time-series data. The model is based on quantum-inspired learning that includes feature mapping using the kernel as well as variational optimization to classify cervical pain levels into four categories, including no pain, mild, moderate, and severe. The experimental analysis of a curated data set illustrates that the proposed model provides an accuracy of 92.8 and is better than the traditional models like Support Vector Machines, Random Forest and Convolutional Neural Networks. The findings show enhanced classification strength and the management of the complicated motion patterns. The presented framework can provide a non-invasive and cost-effective and scalable approach to cervical pain measurement in real-time. Its innovation that integrates web camera technology based surveillance with quantum inspired intelligence is a new input to accessible and intelligent telehealth technology.
In recent years, processing daily real-life applications in the health care supply chain, business, manufacturing and other sectors has benefited greatly from optimization methodologies. This article discusses the inventory model for a linear function with inflation. This study uses time-dependent linear demand, shortage allowance, and deterioration rate data to demonstrate the positive reflectivity of an inventory model. The holding cost fluctuates, and the demand rate for the good should be linear. The sensitivity of the model is analyzed using a numerical example, and for each possible scenario, the convexity of the total inventory cost function is graphically observed.
Background: Pyoderma gangrenosum represents a rare neutrophilic dermatosis, characterized by rapidly evolving and highly painful skin ulcers. This pathology usually occurs as a manifestation of some systemic issues, such as diabetes mellitus, inflammatory bowel disease, or any autoimmune disorders. Its diagnosis is complicated due to resemblance to various types of infectious or vascular ulcers, thus delaying treatment and contributing to increased morbidity. Case Presentation: A 45-year-old woman presented with painful ulcers of both lower extremities with associated erythema, pus formation, swelling, as well as a fever. Initially, she developed some pustules which quickly evolved into necrotic skin ulcers with violaceous undermined edges. Inflammation markers were elevated. Her poorly controlled diabetes mellitus should also be mentioned. There were no results from wound cultures, however, the histopathological examination revealed significant presence of neutrophils in the dermis without signs of vasculitis or any malignancy. The patient was treated with systemic corticosteroids and cyclosporine, as well as insulin, analgesics, and proper wound management. Follow-up showed significant improvement of the condition: ulcer size decreased, pain, and inflammation alleviated, as expected. Conclusion : Pyoderma gangrenosum remains a diagnostic challenge because of its rarity and similarity to other ulcerative skin disorders. Early diagnosis, exclusion of differential conditions, and prompt initiation of immunosuppressive therapy are essential for favorable clinical outcomes. Multidisciplinary management and proper wound care play important roles in reducing complications and improving quality of life.
In the past decade, there have been significant advances in the field of artificial intelligence (AI) in cancer research and clinical practice, which have revolutionized early detection, diagnosis, and precision medicine. Artificial intelligence (AI) strategies such as machine learning (ML) and deep learning for improving the efficacies of medical imaging, digital pathology and genomics which in turn will aid biomarker identification as well as precise patient stratification. Another area where nanomedicine AI is making an impact is in cancer therapy development, offering enhanced drug delivery systems and decreasing toxicity. There are, however, several great challenges which include aspects like data standardization, model interpretability and the uptake of models into the clinic. Clinician validated AI algorithms are crucial to the interplay between clinicians and AI in an embodiment of socioeconomic healthcare disparities. There would also be a need for more interdisciplinary team work and extensive clinical validations to make AI a useful tool in precision oncology. This review summarizes recent developments and future prospects, focusing on the pivotal role of AI for a new era in cancer care and global inequality alleviation in patient outcome.
Chronic musculoskeletal pain, disability, decreased mobility and independence are significant issues in older adults due to degenerative joint and spine disorders. Sarcopenia can contribute to this burden by decreasing muscle strength, balance, gait function and physical capacity. Yoga has been featured as a complementary, low impact intervention, which incorporates flexibility, postural control, breathing regulation, relaxation, and body awareness. In this narrative review, the rationale, evidence, safety, and practical application for using yoga as a complementary approach for pain and functional impairment in sarcopenic individuals with degenerative joint and spine disease were assessed. Adapted yoga is evidenced for reducing pain, movement, improving mobility, improving balance, improving quality of life, and improving movement confidence in the following fields: osteoarthritis, chronic low back pain, frailty, older-adult physical function, and mind-body exercise. However, there is limited information available in patients with known sarcopenia and concurrent degenerative musculoskeletal disease in humans. Yoga should be a complement to conventional medical treatment, physiotherapy, resistance training, the optimalization of nutrition, and personalized pain management. Additional studies are required to elucidate long term effects on pain, strength, mobility, falls, and functional independence.
Background: Pauwels type III femoral neck fractures are characterized by a vertical fracture orientation that produces significant shear forces across the fracture site, making stable fixation difficult and increasing the risk of fixation failure and non-union. Preservation of the native femoral head remains the primary goal in young adults. Objective: To evaluate fracture union, functional recovery, and complication rates following fixation with a dynamic hip screw (DHS) combined with a derotation screw in Pauwels type III femoral neck fractures in young adults. Methods: A prospective observational study was conducted between June 2024 and May 2025 involving 72 patients aged 18–55 years with Pauwels type III femoral neck fractures. All patients underwent internal fixation using a dynamic hip screw supplemented with a superiorly positioned 6.5-mm cancellous derotation screw. Clinical and radiological outcomes were assessed over a minimum follow-up period of 12 months. Functional outcomes were evaluated using the Modified Harris Hip Score (MHHS). Results: Radiological union was achieved in 69 of 72 patients (95.8%). The mean time to fracture union was 3.5 ± 0.8 months. The mean Modified Harris Hip Score at final follow-up was 89.41 ± 6.72. Excellent or good functional outcomes were achieved in 66 patients (91.67%). Complications included non-union in 3 patients (4.2%), superficial infection in 2 patients (2.8%), and implant back-out in 1 patient (1.4%). No cases of avascular necrosis were identified during the follow-up period. Conclusion: Dynamic hip screw fixation supplemented with a derotation screw provides stable fixation, high rates of fracture union, and satisfactory functional outcomes in Pauwels type III femoral neck fractures in young adults. The construct represents a reliable head-preserving option for vertically oriented femoral neck fractures.
Abstract Migraine is a headache usually on one side of the head of varying intensity, often accompanied by nausea/ vomiting and sensitivity to light and sound. Conventional therapies along with the alternative medicines have a good action on the treatment of migraine. Management strategies encompass indicated treatment for immediate relief during acute episodes. Preventive therapy to reduce frequency and severity, dietary modifications and personalized lifestyle adjustments are also required. Inclusion of elimination diets, ketogenic diets etc. help prevent migraine episodes along with change in mode of living. Identifying the trigger factors and removing them from diet and regimen act as prophylactic but these measures fail to prevent all attacks so individualized homoeopathic treatment is needed to reduce the frequency and intensity of migraine episodes paving the way to recovery. This interventional clinical study included 30 patients comprising 2 groups. The control group is given homoeopathic treatment and avoidance of trigger factors as per individual case.Study group is given both homoeopathic treatment & prescribed diet & regimen. The study concludes that the homoeopathic treatment of migraine is more effective along with diet and regimen in comparison to indicated medicines alone as there is significant reduction in the MIDAS score before and after the intervention both clinically and statistically with p value < 0.05.
Importance: Premature ovarian insufficiency (POI) affects 1–4% of women under 40 years of age, resulting in infertility, hypoestrogenism, and elevated risks of osteoporosis, cardiovascular disease, and premature mortality. Conventional treatments, including hormone replacement therapy and donor-oocyte IVF, provide symptomatic relief but fail to restore intrinsic ovarian function. Hydrogel-encapsulated autologous stem cell therapy represents a potentially transformative regenerative approach capable of addressing both the follicular depletion and hostile microenvironmental barriers that underlie POI pathophysiology. Objective: To systematically identify, appraise, and synthesize evidence on the use of hydrogel biomaterials and autologous stem cell therapies—individually and in combination—for ovarian rejuvenation in women with POI or diminished ovarian reserve (DOR), and to evaluate the translational potential of hydrogel-based stem cell delivery systems. Evidence Review: A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science (WoS), and Cochrane Central Register of Controlled Trials from January 2014 through February 2026. Search terms included: "premature ovarian insufficiency," "diminished ovarian reserve," "mesenchymal stem cells," "adipose-derived stem cells," "umbilical cord MSC," "menstrual blood-derived MSCs," "hydrogel," "biomaterial scaffold," "ovarian rejuvenation," "cell encapsulation," and "intraovarian transplantation," combined using Boolean operators. Studies were screened by two independent reviewers against pre-specified eligibility criteria. Disagreements were resolved by consensus. Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2) for randomized trials and ROBINS-I for non-randomized intervention studies. The review adheres to PRISMA 2020 guidelines. Findings: Thirty-one studies met eligibility criteria, comprising 6 clinical trials, 7 prospective cohort/case series, 4 randomized controlled trials evaluating intraovarian platelet-rich plasma, and 14 preclinical or translational studies. Mesenchymal stem cells (MSCs)—particularly adipose-derived (ADSCs), umbilical cord-derived (UC-MSCs), and menstrual blood-derived (MenSCs)—demonstrated consistent regenerative capacity via paracrine signaling, angiogenesis, anti-apoptosis, and immunomodulation. Clinical trials reported improved anti-Müllerian hormone (AMH) levels, increased antral follicle counts, and documented pregnancies. However, direct intraovarian injection achieved poor cell retention (10–30% at 24 h; <5% at 7 days). Hydrogel platforms (alginate, hyaluronic acid, collagen, PEG) enhanced cell retention 5–10-fold, maintained viability >85%, and achieved superior functional outcomes in preclinical POI models. Decellularized ovarian extracellular matrix (OvaECM) hydrogels provided ovarian-specific biochemical cues not replicated by conventional biomaterials. Conclusions and Relevance: Current evidence supports the mechanistic rationale and early efficacy signals for hydrogel-encapsulated autologous stem cell therapy as a regenerative strategy for POI. Clinical translation of the hydrogel delivery modality remains limited to preclinical proof-of-concept, underscoring the need for Phase I/II combination trials. Standardized protocols, rigorous long-term follow-up, and regulatory engagement for this combination-product classification are essential for therapeutic advancement.
Background Blunt abdominal trauma remains to be a significant factor of surgical admissions in emergencies and causes significant morbidity and mortality. Factors like rapid urbanization, higher numbers of vehicles on roads, and occupation-related injuries have resulted in increased incidences of injuries, especially in developing nations. Knowledge of patterns of injury in a locality is crucial in improving the trauma care system. Objectives To assess the clinical outcomes, therapeutic strategies, organ involvement, mechanisms of injury, and demographic profile of patients who report with blunt abdominal trauma at a tertiary care facility. Methods An observational investigation was carried out on 70 individuals with blunt abdominal trauma at a tertiary care centre. Information related to demographics, mechanism of injury, presence of extra-abdominal injuries, involved organs, treatment methods, and mortality rates was gathered and analyzed in a descriptive manner. Results The sample size for this study comprised 70 individuals. 87.1% of the study sample consisted of males, thus resulting in a sex ratio of 6.8:1. Patients aged between 20 to 29 years comprised the largest age group (40%). Road traffic accidents emerged as the leading cause of injury (50%), with falls from height coming in second (41.4%). Surgery was done on 74.3% of the total patients whereas conservative treatment was applied in 25.7% of the cases. Extra-abdominal injuries were found in 22.9% of the total number of individuals, with chest and pelvic injuries being the most common. Splenic injuries turned out to be the commonest visceral injuries (20%), followed by jejunal (13.7%) and hepatic injuries (11.8%). Conclusion Most blunt abdominal injuries occur in younger male patients and are commonly due to road traffic accidents. Injuries to the spleen were the most frequent abdominal organ injuries identified. Prompt diagnosis, resuscitation, treatment by a multidisciplinary team, and prevention through public health measures remain vital.
Objective: To evaluate the effectiveness of Mulligan Mobilization with Movement (MWM) combined with Proprioceptive Neuromuscular Facilitation (PNF) techniques in improving pain and functional outcomes following arthroscopic triangular fibrocartilage complex (TFCC) repair. Materials and Methods: Thirty patients aged 21–65 years who underwent arthroscopic TFCC repair were allocated into two groups: the Control group (n = 15) received the Wrist Sensorimotor Rehabilitation Program (WSRP), and the Experimental group (n = 15) received WSRP combined with Mulligan Mobilization with Movement and Proprioceptive Neuromuscular Facilitation techniques. The intervention was conducted over a median duration of 90 days. Outcome measures included the Numerical Pain Rating Scale (NPRS) for pain assessment and the Patient-Rated Wrist and Hand Evaluation (PRWHE) for functional assessment. Within-group and between-group comparisons were analyzed using paired and independent t-tests. Statistical significance was set at p ≤ 0.05. Results: The experimental group showed significantly greater reduction in NPRS scores (1.73 ± 0.79) compared to the control group (2.40 ± 0.63) (p = 0.002). Similarly, post-treatment PRWHE scores were significantly lower in the experimental group (14.5 ± 5.76) compared to the control group (21.6 ± 5.92) (p = 0.001). Conclusion: The addition of Mulligan Mobilization with Movement and Proprioceptive Neuromuscular Facilitation to a wrist sensorimotor rehabilitation program significantly improves pain reduction and functional outcomes following arthroscopic TFCC repair. These findings support the inclusion of manual therapy and neuromuscular facilitation techniques in postoperative rehabilitation protocols.
Build orientation, or printing angulation, is among the most influential and most readily controllable parameters in the vat-photopolymerisation of dental prostheses, yet its optimisation remains inconsistent across applications. This narrative review synthesises current evidence on how printing angulation affects the dimensional accuracy of 3D-printed fixed dental prostheses, removable denture bases, occlusal devices, surgical guides, and diagnostic models. The literature was identified through a structured search of PubMed, Scopus, and Web of Science for studies published up to 2026. Across prosthesis types, angulation acts through layer stair-stepping, support-structure placement, resin drainage, anisotropic polymerisation shrinkage, and post-curing behaviour, and its effect is consistently entangled with layer thickness, printer technology (stereolithography [SLA] versus digital light processing [DLP]), resin chemistry, and post-processing. No single angle is universally optimal: intermediate orientations (~45–60°) tend to favour fixed prostheses, technology- and arch-dependent optima apply to denture bases, shallow angles (0–30°) suit some occlusal-device systems, and near-vertical orientation (90°) improves surgical-guide sleeve geometry. The review highlights the methodological heterogeneity of the underlying in vitro evidence and argues that orientation should be selected deliberately and validated for each printer–resin combination, ideally with assessment after simulated clinical aging.
Traditional Indian knowledge systems are preserved across a vast corpus of Sanskrit literature, among which the Mahāpurāṇas occupy a unique position as repositories of religious, philosophical, cultural, and scientific knowledge. Although the Purāṇas are primarily regarded as theological and cosmological texts, they also contain significant references to health, physiology, dietetics, psychology, and preventive medicine. These references, however, remain scattered and largely unexplored from the perspective of Ayurvedic physiology (Kriyā Śarīra). The present study aims to identify, classify, and digitally organize Ayurvedic content embedded within the eighteen Mahāpurāṇas through the development of a structured digital corpus. Using textual analysis, semantic categorization, and corpus-development methodologies, references related to Pañcamahābhūta, Tridoṣa, Sapta Dhātu, Mala, Agni, Srotas, Prāṇa, Manas, Nidrā, Ātma, and other physiological concepts were systematically extracted and organized. The study demonstrates that the Purāṇas preserve a coherent framework of physiological knowledge that complements classical Ayurvedic literature while integrating cosmological, ethical, and spiritual dimensions of health. The resulting digital corpus contributes to the preservation of traditional knowledge and provides a foundation for future interdisciplinary research in Ayurveda, Sanskrit Studies, Indology, Artificial Intelligence, and Digital Humanities.
Background: Efficient postsurgical discomfort management is vital for better healing following laparoscopic lower abdominal procedures. Adjuvants may make the ultrasound-guided transversus abdominis plane (TAP) block, a crucial part of multimodal analgesia, more effective. Methods:This prospective, randomized, double-blind comparative study included patients undergoing laparoscopic lower abdominal surgeries under general anesthesia. Random assignments were made to two groups of sixty patients (n = 30 each) undergoing laparoscopic lower abdominal procedures while under general anaesthesia. Group D received 20 mL of 0.2% ropivacaine with dexamethasone (4 mg) and Group M received 20 mL of 0.2% ropivacaine with midazolam (2 mg) for the ultrasound-guided bilateral TAP block. The Visual Analogue Scale (VAS) was used to measure post-operative discomfort. Additionally assessed were hemodynamic parameters, total tramadol consumption, time to first rescue analgesia, Ramsay Sedation Score, and postsurgical nausea and vomiting (PONV). Results:The baseline demographic characteristics of the groups were comparable. At 6, 8, 12, 16, and 24 hours after surgery, Group M showed noticeably lower VAS scores. Group M had a pointedly longer mean time to first rescue analgesia than Group D (17.87 ± 2.92 vs. 16.27 ± 2.33 hours; p = 0.015). Group M had a significantly lower total tramadol requirement (63.33 ± 22.48 mg) than Group D (80.00 ± 28.16 mg; p = 0.012). PONV incidence was similar across groups, and hemodynamic parameters stayed constant. Conclusion: Midazolam provided superior postsurgical analgesia compared with dexamethasone, prolonging analgesic duration and reducing postsurgical analgesic requirements while maintaining an acceptable safety profile.
INTRODUCTION: Obesity is a pathophysiological condition that results in many metabolic disorders affecting carbohydrate, protein and lipid metabolism. Body composition particularly increased waist circumference is associated with higher BMI and lower Glycated Albumin (GA) levels. GA is a ketamine formed through the binding of albumin and glucose by a non-enzymatic glycation reaction. Glycated Albumin allows earlier detection of rapid changes in blood glucose over 2-3 weeks. METHODS: The study included 80 subjects aged between 20-40 years, 40 of them were obese (groupI) and 40 were apparently healthy individuals (groupII). Blood samples were collected in a red-capped vacutainer for Lipid profile and GA. Lipid Profile was measured using standard autoanalyzer-based kit methods and GA was measured using the ELISA method RESULTS: GA had a lower mean value in individuals with a BMI ≥30. Total cholesterol and LDL cholesterol were directly associated with a higher mean value of BMI. DISCUSSION AND CONCLUSION: Waist circumference (WC) which is a simple measurement of central obesity can identify the risk of metabolic and cardiovascular diseases. As a consequence of the greater susceptibility to glycation of albumin and other plasma proteins compared to intracellular proteins such as hemoglobin, the blood levels of GA exhibit a broader fluctuation than those of HbAlc, thus allowing earlier detection of rapid changes in blood glucose. Our study findings concluded that subjects with central obesity had lower GA levels when compared with subjects without central obesity. These findings suggest that GA may detect early dysglycemia in non-obese individuals without derangement of the lipid profile.
Background: Aushadha Sevana Kala (the appropriate timing of medicine administration) is an important yet relatively underexplored principle of classical Ayurvedic therapeutics. Traditional Ayurvedic texts emphasize that the effectiveness of treatment depends not only on the medicinal substance itself but also on factors such as Agni (digestive and metabolic state), patient constitution, disease stage, and the timing of intervention. In parallel, contemporary biomedical disciplines such as chronopharmacology and Precision Medicine have highlighted the importance of biological timing and individual variability in determining therapeutic outcomes. Objective: This narrative review aims to critically examine the classical foundations of Aushadha Sevana Kala, explore its conceptual relationship with Agni, chronopharmacology, and Precision Medicine, and propose an integrative theoretical framework for understanding therapeutic timing in the context of personalized healthcare. Methods: A comprehensive narrative review and conceptual analysis of classical Ayurvedic literature and contemporary biomedical evidence were undertaken. The discussion adopts the principle of functional convergence, emphasizing shared clinical objectives between traditional and modern knowledge systems while avoiding unsupported claims of direct mechanistic or historical equivalence. Results: The review suggests that Aushadha Sevana Kala may be interpreted as a sophisticated clinical strategy for optimizing therapeutic outcomes through the coordinated consideration of metabolic readiness, biological timing, and patient individuality. Agni is reinterpreted as a systems-level representation of functional therapeutic readiness, chronopharmacology contributes to the dimension of temporal physiology, and Precision Medicine provides the framework of individualized therapeutic adaptation. Building upon these complementary perspectives, this review proposes the Agni–Chronopharmacology–Precision Medicine (ACP) Model, in which Aushadha Sevana Kala functions as the practical clinical interface integrating these three domains. Conclusion: The ACP Model offers a novel, hypothesis-generating framework that reinterprets a classical Ayurvedic therapeutic principle through the lens of contemporary personalized and time-sensitive healthcare. By adopting a non-reductionist approach based on conceptual overlap, the model provides a scientifically balanced conceptual bridge between Ayurveda and modern biomedical science and establishes a foundation for future interdisciplinary research in the emerging field of Evidence-Based Precision Ayurveda.
Skin closure is a critical component of orthopaedic surgery, influencing wound healing, postoperative recovery, patient comfort, and complication rates. Staples and nylon sutures are commonly used for skin closure; however, evidence regarding their comparative effectiveness remains inconclusive. To compare wound outcomes following the use of staples versus nylon sutures for skin closure in clean orthopaedic surgeries, with emphasis on wound healing rate, pain on removal, and cost effectiveness. A prospective randomized controlled trial was directed among 66 patients undergoing clean elective orthopaedic surgeries. Individuals were randomly allocated into two groups: Group A (staples, n=33) and Group B (nylon sutures, n=33). Patients were evaluated for wound healing, pain during removal using the Visual Analogue Scale (VAS), cost effectiveness, and postoperative complications. Statistical analysis was executed using Student’s t-test and Chi-square test, with p<0.05 considered substantial. Patients treated with staples experienced significantly lower pain during removal. However, nylon sutures demonstrated superior wound healing outcomes and were significantly more cost effective. Delayed removal and postoperative dressing requirements were more frequent in the staples group, while surgical site infections occurred only among patients receiving staple closure. Although staples were associated with less pain during removal, nylon sutures provided better wound healing, greater cost effectiveness, and fewer postoperative complications. Nylon sutures may therefore be considered the preferred skin closure method in clean orthopaedic surgeries.
Hip fractures by fragility are a major cause of illness, disability, and healthcare burden among elderly individuals. Metabolic comorbidities such as diabetes mellitus and hypertension may adversely affect postoperative recovery, fracture healing, and functional outcomes following surgical treatment. To assess the functional and radiological outcomes of surgically treated fragility hip fractures in elderly patients and to assess the influence of diabetes mellitus, hypertension, and comorbidity burden on postoperative recovery. A prospective observational cohort study was done at the Department of Orthopaedics, Mahatma Gandhi Medical College and Research Institute (MGMCRI), SBV Deemed University, Puducherry, from January 2024 to June 2025. Elderly patients aged ≥60 years with fragility hip fractures and diabetes mellitus and/or hypertension who underwent surgical treatment were enrolled. Functional outcomes were assessed using the University of California-Los Angeles (UCLA) Activity Scale preoperatively and at 4, 8, and 12 weeks postoperatively. Comorbidity burden was evaluated using the Charlson Comorbidity Index (CCI), while radiological healing was assessed through serial radiographs. Twenty-eight patients completed follow-up. Functional recovery improved progressively after surgery; however, diabetic and hypertensive patients demonstrated poorer UCLA Activity Scale scores than their counterparts. Most patients achieved satisfactory radiological union by 12 weeks, whereas delayed union was observed predominantly among those with greater comorbidity burden. Perioperative complications occurred more frequently in patients with metabolic comorbidities. Diabetes mellitus, hypertension, and increased comorbidity burden were related with poorer functional recovery and less favourable radiological outcomes following fragility hip fracture surgery. Comprehensive perioperative optimization and multidisciplinary rehabilitation may improve outcomes in this high-risk population.
