What is Journal of Carcinogenesis? Despite the advances in the treatment of cancer and the increasing knowledge of the processes responsible for the disease, there is a gap in the understanding of molecular events leading to cancer and the mechanisms of action by anticancer agents. The field of carcinogenesis is far from being completely explored. Many novel ideas and concepts still need to be introduced into the field, and the results of several provocative experiments are yet to be disseminated and shared. There is a need for multidisciplinary research in the field and a forum for accelerated publication of results. These are the considerations that led to the birth of the online journal, Journal of Carcinogenesis. Journal of Carcinogenesis is a peer-reviewed, online journal designed to bring together many aspects of research to develop the understanding of carcinogenesis. Edited by Gopala Kovvali, Journal of Carcinogenesis is supported by an international Editorial Board. Journal of Carcinogenesis considers manuscripts in many areas of carcinogenesis and Chemoprevention. Primary areas of interest to the journal include: physical and chemical carcinogenesis and mutagenesis; processes influencing or modulating carcinogenesis, such as DNA repair; genetics, nutrition, and metabolism of carcinogens; the mechanism of action of carcinogens and modulating agents; epidemiological studies; and, the formation, detection, identification, and quantification of environmental carcinogens. 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The authors are encouraged to submit names of potential reviewers to expedite the review process. The editors may choose reviewers from those suggested by the authors or may have the manuscript reviewed by experts chosen by them. Publishing in Journal of Carcinogenesis Articles in Journal of Carcinogenesis should be cited in the same way as articles in a traditional journal. However, because articles in this journal are not printed, they do not have page numbers. Instead, they have a unique article number. The following citation: J Carcinog 2004, 2:1 refers to article 1 from volume 2 of the journal. As an online journal, Journal of Carcinogenesis does not have issue numbers. Each volume corresponds to a calendar year. Submission of manuscripts Manuscripts should be submitted electronically to Journal of Carcinogenesis using the online submission system. Full details of how to submit a manuscript are given in the instructions for authors. 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Cognitive Abilities of the Asian Elephant: A Comprehensive Zoological Study.
Animal cognition research has expanded significantly over the past forty years, primarily focusing on lab animals with varying cognitive abilities, such as rodents, birds, and primates. Despite their reputation as highly social, cooperative, and intelligent animals, elephants have received surprisingly little direct cognitive research, aside from long-term behavioral studies in the wild. Both Asian (Elephas maximus) and African (Loxodonta africana or L. cyclotis) elephants have been notably underrepresented in cognitive research. This paper discusses the potential and justification for investigating elephant cognition within zoological settings and reviews recent advancements in this area, including our latest study on mirror self-recognition in elephants.
Cognition, psychology, zoology, elephant, behavioral study, self recognition, Elephas Maximus, intelligent animal.
The Impact of Exercise Training on Biomarkers, Altered Renin-Angiotensin-Aldosterone System (RAAS) in Diabetic Nephropathy Individuals
Objective: Diabetes mellitus is a major cause of metabolic and systemic diseases contributing mainly for kidney and cardiovascular anomalies all around the world. To manage such untoward outcomes, in addition to medications, the present study aims to assess productive effects of exercise on Renin-Angiotensin-Aldosterone System (RAAS), biomarkers, related albuminuria, estimated glomerular filtration rate (eGFR) and clinical factors. Methods: A prospective, cohort-controlled experiment was conducted. Confirmed cases (n = 150) either gender of diabetes with underlying chronic kidney disease (CKD) and diabetic nephropathy (DN) with aged 35-45 were selected, divided into 3 groups each with no exercise, 3 months and 6-month exercise, respectively. Exercise regiments were prescribed and blood was collected at the end of each periodic end. Blood was analyzed for Renin, Angiotensin II, biomarkers, parathyroid hormone (PTH), lactate, insulin and fasting glucose according to standard procedures on Roche Cobas c503, e801, e411, Snibe X800 and NOVA PHOX plus. Results: Statistically analyzed data exhibited potentiating effects of exercise. Renin, Aldosterone, PTH and PCO2, predicated significance betterment only after 6 months of exercise whereas Angiotensin II, Lactate, PCO2, PO2, Urine albumin and glomerular filtration rate (GFR) exhibited moderate to marked/highly significant changes both after 3 months and after 6 months of exercise. Conclusion: It has been concluded, in addition to all traditional treatments and medications, long term exercise does have benefits in the betterment of diabetic patients with underlying DN and thus be encouraged to be part of every treatment plans based on individuals’ specifications.
Chronic kidney disease, Diabetic Nephropathy, End stage renal disease, Glomerular filtration rate, Renin Angiotensin Aldosterone system.
Humayun Imran Azeemi, Basit Ansari, Saeed Akhter, Shah Ali Ul Qader
Efficacy Comparison of Sodium-Glucose Cotransporter-2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, and Dipeptidyl Peptidase-4 Inhibitors in Heart Failure with Preserved Ejection Fraction: A Systematic Review And Network Meta-Analysis
Background: Heart failure with preserved ejection fraction (HFpEF) represents a major unmet therapeutic need with limited evidence-based pharmacologic options. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated benefit, while the roles of glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase-4 inhibitors (DPP-4i) remain less clear. A direct and indirect comparison of these antihyperglycemic drug classes on cardiovascular outcomes in HFpEF is required. Methods: We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs). Databases (MEDLINE, Embase, Scopus, Web of Science, CENTRAL, were searched from inception to 2024-10-27. RCTs enrolling adults with HFpEF (LVEF ≥40%) comparing an SGLT2i, GLP-1 RA, or DPP-4i against placebo or active control were included. Primary outcomes were a composite of first hospitalization for heart failure (HHF) or cardiovascular (CV) death, and total HHF events. Secondary outcomes included CV death, all-cause death, and Kansas City Cardiomyopathy Questionnaire (KCCQ) score change. Data were pooled using frequentist random-effects NMA, with ranking via P-scores. Risk of bias was assessed using Cochrane RoB 2. Results: From 5,317 records, 12 RCTs (n=25,147 participants) were included. For the composite of HHF/CV death, SGLT2i significantly reduced risk compared to placebo (hazard ratio [HR] 0.80, 95% CI 0.73–0.88) and were superior to both DPP-4i (HR 0.77, 95% CI 0.66–0.89) and GLP-1 RA (HR 0.84, 95% CI 0.72–0.99). GLP-1 RA showed a non-significant trend towards benefit versus placebo (HR 0.94, 95% CI 0.81–1.10). DPP-4i did not differ from placebo (HR 1.03, 95% CI 0.89–1.20). For total HHF, SGLT2i were superior to all comparators. SGLT2i also ranked highest for improving KCCQ total symptom score. No significant difference was observed between drug classes for CV or all-cause mortality. Conclusion: In patients with HFpEF, SGLT2i provide the most robust reduction in heart failure events and improvement in health status compared to GLP-1 RA, DPP-4i, and placebo. GLP-1 RA show a neutral effect on primary HFpEF outcomes, while DPP-4i should not be used for HFpEF management. These findings strongly support the preferential use of SGLT2i in the HFpEF population.
Heart failure with preserved ejection fraction, SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, Network meta-analysis.
Dr Mohd Fazal Ahmed Makki, Dr. Farah Kausar, Dr. Pushkar Mani, Dr Manisa Mohanty
Assessment of knowledge and attitude of mothers of children admitted with jaundice in a tertiary care hospital in Bangladesh
Background: Jaundice is a common clinical condition marked by yellow discoloration of the skin and sclera due to bilirubin accumulation. It results from various hepatic, biliary, or hemolytic disorders. In Bangladesh, viral hepatitis, particularly Hepatitis B infection, is a major cause. Beyond medical issues, jaundice is often linked to social stigma, misconceptions, and psychological distress. Studies in other countries show negative public attitudes and poor awareness about jaundice. However, limited data exist in Bangladesh regarding community perceptions. This study was therefore conducted to assess the knowledge and attitude of mothers of children admitted with jaundice, aiming to identify gaps and guide future health education efforts. Methods: This cross-sectional study was conducted in the Department of Pediatrics, North East Medical College Hospital, Sylhet, from June 2024 to June 2025. Mothers of children admitted with jaundice were interviewed using a predesigned structured questionnaire covering sociodemographic information, knowledge, and attitudes toward childhood jaundice. Trained physicians conducted the interviews to ensure accuracy. Data were analyzed using SPSS version 20. Continuous variables were summarized as mean ± standard deviation, and categorical variables as frequencies and percentages. Results were presented in tables and figures for clarity. Results: Among 46 mothers, most were aged 21–30 years (78.3%), educated (76.1%), and from joint families (76.1%). While 95.3% had heard of jaundice, only 54.3% recognized yellow skin/eyes as a symptom, and knowledge of causes, complications, and treatment was limited. Phototherapy and modern medicine were known to 63% and 52.2%, respectively. Regarding attitude, 39.1% considered jaundice transmissible, 34.8% were willing to work with patients, 54.3% supported school/work attendance, and 67.4% opposed marriage. Most (65.2%) preferred modern treatment. Overall, awareness was high but knowledge and attitudes were incomplete. Conclusion: Mothers’ knowledge and attitudes are crucial for early recognition, timely treatment, and prevention of childhood jaundice complications. Misconceptions can delay care, highlighting the need for targeted education on causes, warning signs, and preventive measures. Structured counseling and community awareness programs can improve maternal understanding, treatment adherence, and child health outcomes.
Jaundice, Tertiary care hospital, knowledge, Attitude
Shohely Parveen, Ridwanul Islam, Jesmeen Morshed, Shariful Hasan, Mohammad Asadur Rahman, Mohammad Shoaib Chowdhury, Zahidur Rahman
Clinical Outcomes of Cervical Cancer Patients Treated with Surgery and Concurrent Chemoradiation Therapy in CMH, Dhaka
Background: Cervical cancer is a leading cause of cancer-related death among women, particularly in developing countries. Early-stage disease can often be cured with surgery or chemoradiotherapy, while advanced stages require combined treatment approaches. Outcomes vary depending on disease characteristics, patient factors, and healthcare resources. Limited data exist in Bangladesh regarding treatment responses, survival, and complications. This study aims to evaluate the clinical outcomes of cervical cancer patients undergoing radical hysterectomy and chemoradiation therapy in a tertiary care military hospital. Methods: This retrospective cohort study at Combined Military Hospital, Dhaka, Bangladesh (2015–2022) included 192 cervical cancer patients treated with radical hysterectomy, concurrent chemoradiation, or both. Data on demographics, tumor characteristics, treatment, and follow-up outcomes were collected. Primary outcomes were 5-year overall and disease-free survival, while secondary outcomes included recurrence and post-treatment complications. Survival and recurrence analyses were performed using chi-square tests and Cox regression, with p < 0.05 considered significant. Results: Among 192 cervical cancer patients, most were middle-aged with squamous cell carcinoma and stage II disease. Treatments included surgery, CCRT, or both, with 35% experiencing complications. Five-year survival was 71.9%, highest after surgery alone, and recurrence occurred in 18%, with advanced stage, adenocarcinoma, and positive lymph nodes predicting higher risk. Conclusion: Survival and recurrence in cervical cancer are strongly influenced by disease stage and treatment type. Surgery is most effective in early stages, while CCRT is essential for advanced disease. Delayed detection highlights the need for early screening, HPV vaccination, multidisciplinary care, and a national cancer registry in Bangladesh.
Cervical cancer, chemoradiation, radical hysterectomy, survival outcomes, recurrence, HPV vaccination, Early detection.
Nazma Siddiquee, SM Rokonuzzaman, Shamima Yasmin, Farhana Jannat, Reshma Sharmin
Successful Resuscitation Following Aluminum Phosphide (Celphos) Poisoning Complicated by Ventricular Tachycardia and Cardiogenic Shock: A Case Report
Background: Aluminum Phosphide Poisoning is a highly lethal form of pesticide poisoning commonly seen in developing countries. It leads to severe metabolic toxicity, refractory shock, malignant arrhythmias, and high mortality. Survival following cardiac arrest is rare. Case Presentation: We report a case of a 30-year-old male who presented with aluminum phosphide ingestion, severe hypotension, and altered sensorium. During hospitalization, the patient developed pulseless ventricular tachycardia requiring cardiopulmonary resuscitation and defibrillation. With aggressive intensive care management including ventilatory support, vasopressors, and supportive therapy, the patient survived and was discharged in stable condition. Conclusion: Early aggressive resuscitation, timely defibrillation, and multidisciplinary critical care support can improve survival in severe aluminum phosphide poisoning complicated by cardiac arrest.
A Comparative Study of Attenuation of Hemodynamic Responses During Tracheal Extubation with Intravenous Magnesium Sulphate and Intravenous Esmolol in Surgeries Under General Anaesthesia
Background: Tracheal extubation is frequently associated with undesirable hemodynamic responses such as tachycardia and hypertension due to sympathetic stimulation. These responses may be detrimental in patients with cardiovascular or cerebrovascular compromise. Various pharmacological agents have been evaluated to attenuate these responses, among which magnesium sulphate and esmolol have shown promising results. Aim: To compare the efficacy of intravenous magnesium sulphate and intravenous esmolol in attenuating hemodynamic responses during tracheal extubation in patients undergoing surgeries under general anaesthesia. Materials and Methods: This prospective, randomized comparative study was conducted on 85 patients aged 18–60 years, classified as ASA physical status I and II, undergoing elective surgeries under general anaesthesia. Patients were randomly allocated into two groups: Group M (magnesium sulphate) and Group E (esmolol). Hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were recorded at baseline, at extubation, and at 1, 3, and 5 minutes after extubation. Data were analyzed using appropriate statistical tests. Results: Both drugs attenuated the hemodynamic response during extubation; however, magnesium sulphate was significantly more effective than esmolol in controlling heart rate and blood pressure at extubation and in the immediate post-extubation period (p < 0.05). Conclusion: Intravenous magnesium sulphate provides superior attenuation of hemodynamic responses during tracheal extubation compared to intravenous esmolol, with minimal adverse effects.
Tracheal extubation; Hemodynamic response; Magnesium sulphate; Esmolol; General anaesthesia
Dr. Narendra Singh Bafila, Dr. Deepak Yadava, Dr. Rachna Verma , Dr. Chaitra S, Dr. Sanni Deyol Gautam
Comparative Efficacy of Preoperative Nebulized Dexmedetomidine, Ketamine, and Magnesium Sulphate in Preventing Postoperative Sore Throat after Laparoscopic Surgery under General Anaesthesia
Background: Postoperative sore throat (POST) is a frequent and distressing complication after tracheal intubation for general anesthesia, with reported incidence varying widely depending on definitions and populations. Pharmacologic nebulization prior to induction is an attractive, low-risk, topical approach to reduce mucosal inflammation and nociception. Objective: To evaluate and compare the efficacy of preoperative nebulized dexmedetomidine, ketamine, and magnesium sulphate in preventing POST in adult patients undergoing elective laparoscopic surgery under general anesthesia. Methods: This randomized, double-blind, three-arm study included 50 adult patients allocated to receive preoperative nebulization 30 minutes before induction: Group D (dexmedetomidine 1 µg/kg diluted to 4–5 mL, n = 17), Group K (ketamine 50 mg diluted to 4–5 mL, n = 17), and Group M (magnesium sulphate 250 mg diluted to 4–5 mL, n = 16). Standardized anesthesia, cuff pressure control (20–25 cmH₂O), and endotracheal tube sizes were used. Primary outcome: incidence of POST at 6 hours post-extubation. Secondary outcomes: incidence at 0, 2, 12, 24 h; severity (4-point scale), hoarseness, cough, sedation, and adverse events. Analysis followed intention-to-treat principles. Results: Overall, dexmedetomidine showed the lowest incidence of POST at all time points and was significantly superior at the primary endpoint (6 h): 1/17 (5.9%) in Group D vs 4/17 (23.5%) in Group K and 5/16 (31.3%) in Group M (p = 0.04). Severity of POST was predominantly mild and no severe events occurred. Sedation (transient, mild) and two episodes of bradycardia occurred in Group D; no serious adverse events were recorded. Conclusion: In this 50-patient randomized comparison, preoperative nebulized dexmedetomidine (1 µg/kg) produced a clinically meaningful reduction in incidence and severity of POST compared with nebulized ketamine (50 mg) and nebulized magnesium sulphate (250 mg), with an acceptable safety profile. Larger multicenter trials are warranted to confirm these findings and to refine optimal dosing and timing. Background: Postoperative sore throat (POST) is a frequent and distressing complication after tracheal intubation for general anesthesia, with reported incidence varying widely depending on definitions and populations. Pharmacologic nebulization prior to induction is an attractive, low-risk, topical approach to reduce mucosal inflammation and nociception. Objective: To evaluate and compare the efficacy of preoperative nebulized dexmedetomidine, ketamine, and magnesium sulphate in preventing POST in adult patients undergoing elective laparoscopic surgery under general anesthesia. Methods: This randomized, double-blind, three-arm study included 50 adult patients allocated to receive preoperative nebulization 30 minutes before induction: Group D (dexmedetomidine 1 µg/kg diluted to 4–5 mL, n = 17), Group K (ketamine 50 mg diluted to 4–5 mL, n = 17), and Group M (magnesium sulphate 250 mg diluted to 4–5 mL, n = 16). Standardized anesthesia, cuff pressure control (20–25 cmH₂O), and endotracheal tube sizes were used. Primary outcome: incidence of POST at 6 hours post-extubation. Secondary outcomes: incidence at 0, 2, 12, 24 h; severity (4-point scale), hoarseness, cough, sedation, and adverse events. Analysis followed intention-to-treat principles. Results: Overall, dexmedetomidine showed the lowest incidence of POST at all time points and was significantly superior at the primary endpoint (6 h): 1/17 (5.9%) in Group D vs 4/17 (23.5%) in Group K and 5/16 (31.3%) in Group M (p = 0.04). Severity of POST was predominantly mild and no severe events occurred. Sedation (transient, mild) and two episodes of bradycardia occurred in Group D; no serious adverse events were recorded. Conclusion: In this 50-patient randomized comparison, preoperative nebulized dexmedetomidine (1 µg/kg) produced a clinically meaningful reduction in incidence and severity of POST compared with nebulized ketamine (50 mg) and nebulized magnesium sulphate (250 mg), with an acceptable safety profile. Larger multicenter trials are warranted to confirm these findings and to refine optimal dosing and timing.
Postoperative Sore Throat; Nebulization; Dexmedetomidine; Ketamine; Magnesium Sulphate; Laparoscopic Surgery.
Dr. Shruti Tripathi, Dr. Vinamra Tiwari, Dr. H N Madhusudana, Dr. Mohammad Ali, Dr. Sushil Ambesh
Peroneus Longus Tendon Versus Hamstring Tendon Autograft In Arthroscopic Acl Reconstruction: A Prospective Randomized Study Of Knee Function, Stability, And Donor-Site Morbidity
Background: Arthroscopic anterior cruciate ligament reconstruction (ACLR) with hamstring tendon (HT) autografts is very popular, and could result in knee flexion weakness and harvest-related morbidity. An alternative of constant diameter, with arguably reduced donor-site morbidity, has developed in the form of the peroneus longus tendon (PLT) at the expense of ankle function. Methods: It was a prospective randomized self-controlled study that was undertaken in a tertiary orthopaedic unit (2023-2025). The participants were randomly divided into 30 individuals with isolated unilateral ACL rupture who received ACLR with either PLT autograft (n=15) or quadrupled HT autograft (n=15). The measurement of functional outcomes was preoperative, 1.5, 3, 6 months using Modified Cincinnati Score (MCS), Lysholm score, and Subjective IKDC 2000. Donor-site complications were measured using AOFAS (PLT group), thigh circumference deficit, sensory symptoms, pain, ankle range of motion, and handheld dynamometry-based strength. Knee stability was evaluated using Anterior Drawer, Lachman, Pivot Shift and KT-1000 arthrometer at the follow-up. Independent t-tests/Mann-Whitney U tests and chi-square tests were conducted in groups (due to the independent test, 1=0.05). Results: PLT had more mean graft diameter than HT (8.68±0.23 mm; and 7.65±0.59 mm, respectively, p<0.001). Both groups had also improved but at 12 months, PLT had better MCS (90.1±2.9 vs 86.8±2.7), Lysholm (89.9±3.8 vs 86.3±2.1) and IKDC (92.4±4.3 vs 89.1±5.2) (all p<0.05). With enduring effects, recovering the stance favoring PLT actions and dynamics with time of 3 months and above, there was less KT-1000 side-to-side difference in final follow-up (1.2±0.5 vs 1.8±0.6 mm, p<0.01). PLT had a reduced donor-site morbidity (thigh deficit 0.520.2 cm vs 1.22.04 cm, p=0.001), and comparable outcomes of the ankle near outcome normalcy at 12 months (AOFAS 97.62.4). Conclusion: Even though PLT autograft ACLR yielded thicker grafts, faster mobilization, better 12-month stability and less donor-site morbidity and ankle functionality, it helps to support the idea that PLT is a strong alternative to HT in primary ACLR.
Anterior Cruciate Ligament; Peroneus Longus Tendon; Hamstring Tendon; Autograft; Arthroscopy; Ikdc; Lysholm; Donor-Site Morbidity
Role of Meditation in patients of Cancer: Ayurvedic Perspective
1Cancer is a major global health challenge characterized by physical, psychological, and emotional distress. Alongside conventional oncological treatments, complementary and alternative medicine systems have gained attention for improving quality of life and holistic well-being. 2Cancer remains a leading cause of morbidity and mortality worldwide. onchology has increasingly recognized the role of integrative therapies in enhancing quality of life and psychological well being among patients. 3Ayurveda, the ancient Indian system of medicine, emphasizes balance of body,mind, and spirit in health and disease. 4 Meditation (Dhyana) is a key component of Ayurvedic and yogic practices, aimed at mental purification, stress reduction, and restoration of homeostasis. This article explores the role of meditation in cancer patients from an Ayurvedic perspective, discussing its theoretical basis, mechanisms of action, clinical benefits, and scope in integrative oncology. The review highlights meditation as a supportive, intervention that enhances psychological issues, improves quality of life, and complements conventional cancer therapy.
Cancer, Meditation, Dhyana, Ayurveda, Integrative Oncology, Mind–Body Medicine
Dr.Jyoti Meghadambar, Dr.Karishma Bansode, Dr. Vinayak Navanale, Dr.Seema Bahatkar, Dr.Dhanashree Paikrao, Dr.Supriya Kharat, Dr.Rutuja Chavan
Scanning Electron Microscopic Analysis of Surface Alterations in Third-Generation NiTi Rotary Instruments Following Clinical Simulation
Introduction: Third-generation nickel–titanium (NiTi) rotary files undergo proprietary thermomechanical processing intended to enhance flexibility and fatigue resistance. Objectives: This study evaluated the qualitative and quantitative wear and fatigue behavior of four third-generation NiTi rotary systems following repeated use in extracted posterior human teeth using a simulated clinical model. Materials and Methods: One hundred files (n=25 per group across four brands: ProFile Vortex™, Vortex Blue™, ProTaper Gold™, and Coltene HyFlex® CM™) were examined using Scanning Electron Microscopy (SEM) at 200x magnification at the same four positions along their length. Files were used to prepare root canals in extracted human posterior teeth (premolars and molars) in a simulated clinical model for up to three uses. Two blinded evaluators analyzed the SEM micrographs to score wear and deformation, categorizing files as usable, microscopically unacceptable, or visually unacceptable. Results: Twelve files (12.0%) exhibited visual failure, most commonly during the first use. Canal curvature distribution differed significantly among brands; ProTaper Gold™ files were exposed to fewer severely curved canals, introducing confounding when interpreting comparative failure rates. Third-generation instruments predominantly failed by plastic deformation rather than separation. Regression analysis revealed no significant differences in wear between brands. Although microscopic wear increased significantly after initial use, it did not progress significantly with subsequent uses. Baseline manufacturing defects, present in 8% of files, did not significantly predict catastrophic failure. Conclusions: Third-generation controlled-memory NiTi instruments tend to deform plastically rather than undergo abrupt separation, which may provide a visual warning of impending failure. While microscopic manufacturing defects were relatively common, they did not reliably predict fracture; however, absence of visible defects does not preclude internal fatigue accumulation.
Nickel-titanium endodontic files; Root canal preparation; Scanning electron microscopy; Instrument failure; Controlled memory.
Mahmoud Y. Abou-Elnaga, Ahmed Gamal Shaban, Amr A. Bayoumi, Mohamed Samir Yousef, Mohamed K. Abo Amo, Ehab Ali Elsayed, Hossam Hazem Hagras, Galal ElDeen Mosaad Sadek, Ahmed Ali Ezzeldine, Ahmed Mohamed Abu Siyam
Barriers to Accessing Dental Care During Pregnancy: A Study on Anatomical, Cultural, Financial, and Systemic Influences in Basra
Background: Maintaining optimal oral health during pregnancy is critical, as it directly influences the health outcomes of both mother and fetus. Poor oral hygiene, particularly periodontal disease, is associated with serious maternal and fetal complications, including maternal cardiovascular disease, preterm birth, and low birth weight. Additionally, inadequate maternal dental health increases the risk of early-onset dental caries in children. Aim: This study investigates the barriers to accessing dental care among pregnant women in Basra. Methodology: A cross-sectional study was conducted among pregnant women attending antenatal clinics and hospitals in Basra. Data were collected using a structured questionnaire comprising five sections: demographic information, cultural factors, financial factors, systemic barriers, and awareness regarding the safety of dental treatments during pregnancy. Results: Concerns about the safety of dental care during pregnancy constitute a significant barrier (59% of respondents). Financial constraints represent a major economic challenge in Iraq, and prolonged waiting times (reported by 32% of participants) further hinder access, with women experiencing same-day delays due to the absence of scheduled appointment systems. Conclusion: To improve dental care access among pregnant women, policymakers should prioritize mandatory health insurance coverage to address financial barriers, integrate dental services into maternal health programs to enhance accessibility and enable early management of pregnancy-related oral conditions, and implement educational initiatives to dispel misconceptions about dental treatment safety during pregnancy
: Nadia Ali Habeeb Al-Jumaah, Ali Shyaa Thedan Al-Saadi, Nada Hashim Al jassim, Nabil Abd Al Hameed Al Aggan
Mental health issues, stress-related conditions, and emotional disorders have emerged as significant challenges in today's society, affecting individuals, families, careers, communities, and even economies. Despite their prevalence, these issues remain difficult to manage, with individuals often struggling to express emotions or seek timely support. As a response, innovative digital solutions are being explored to foster mental well-being habits, provide emotional support, and create environments conducive to positive mental health practices. This paper presents an exploration of several such solutions, including the application of machine learning, artificial intelligence-driven chatbots, and gamification techniques to enhance mental health care delivery. this research introduces VIRA (Virtual Intelligent Responsive Assistant)—a virtual mental health companion designed to provide personalized, accessible, and continuous support for individuals facing mental health challenges. VIRA integrates artificial intelligence, machine learning, and conversational agents to deliver proactive emotional support, mood tracking, and behavior-based recommendations. This paper presents the conceptual framework, system architecture, and evaluation methodology of VIRA, along with preliminary user studies indicating its effectiveness and usability. Challenges such as model accuracy, ethical considerations, and data privacy are also discussed, along with pathways for future research to enhance VIRA's capabilities and impact.
VIRA, Natural Language Processing (NLP), Artificial Intelligence (AI), Machine Learning (ML), Mental Health, Emotions, Behavioural Analysis, Ethics, Personalization.
Mrs. Pushpa G, Mrs. Vinutha H D, Mrs. Chaitra S, Shifa Maqsood, Spoorthy Reddy
Prevalence, Risk Factors and Clinical Outcomes of Dysnatremia in Patients Admitted to Medical Intensive Care Unit: A Prospective Observational Study
Dysnatremia, encompassing both hyponatremia and hypernatremia, is a frequent electrolyte abnormality among critically ill patients and is associated with adverse clinical outcomes. This prospective observational study was conducted to determine the prevalence of dysnatremia, identify associated risk factors, and evaluate its impact on clinical outcomes among patients admitted to the Medical Intensive Care Unit (MICU). A total of 100 adult patients with normal serum sodium levels at admission were enrolled and followed during their MICU stay. Serum sodium levels were monitored daily, and patients were categorized into eunatremic, hyponatremic, or hypernatremic groups. Demographic characteristics, comorbidities, hemodynamic status, need for mechanical ventilation, vasopressor use, and length of ICU stay were recorded. Dysnatremia developed in a substantial proportion of patients during ICU stay, with hyponatremia being more common than hypernatremia. Patients with dysnatremia had significantly longer ICU stay and higher rates of mechanical ventilation and mortality compared to eunatremic patients. Major contributing factors included sepsis, renal dysfunction, inappropriate fluid therapy, diuretic use, and hormonal disturbances. The study highlights the importance of early detection and careful management of sodium imbalance in MICU patients to improve outcomes and reduce ICU-related morbidity and mortality.
Dysnatremia; Hyponatremia; Hypernatremia; MICU; Electrolyte imbalance; Critical illness
Gaurav kumar, Pratik kaware, Prachi shah, Sandip vala, Kishan majithia
Chronic Psychosocial Stress and Cancer Risk: Exploring Neuroendocrine, Immunological, and Molecular Mechanisms of Psychosocial Carcinogenesis
Chronic psychosocial stress has increasingly been recognized as a potential modifier of cancer risk and progression through complex neuroendocrine, immunological, and molecular pathways. While the concept of “psychogenic carcinogenesis” remains controversial, accumulating evidence suggests that sustained activation of stress-response systems may influence tumor biology. This review explores the mechanistic links between chronic psychiatric stressors—including depression, anxiety disorders, and prolonged emotional distress—and carcinogenesis. Persistent activation of the hypothalamic–pituitary–adrenal (HPA) axis and sympathetic nervous system results in elevated cortisol and catecholamine levels, which may impair immune surveillance, promote chronic inflammation, and alter cellular signaling pathways. Stress-induced immunosuppression can reduce natural killer (NK) cell activity and T-cell–mediated tumor defense, potentially facilitating tumor initiation and progression. Additionally, chronic inflammation mediated by cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) may contribute to DNA damage, epigenetic modifications, and enhanced tumor microenvironment remodeling. Emerging data also indicate that stress hormones can influence proto-oncogene activation, angiogenesis, and metastatic potential via β-adrenergic signaling pathways. Behavioral factors associated with psychiatric conditions—including smoking, alcohol consumption, poor diet, and reduced treatment adherence—may further compound cancer risk through indirect carcinogenic mechanisms. Although current evidence does not establish psychosocial stress as a direct carcinogen, it supports its role as a biological and behavioral modulator of tumor development and progression. Understanding these multidimensional interactions is essential for integrating psychosocial care into comprehensive cancer prevention and management strategies. Future longitudinal and molecular studies are required to clarify causal relationships and identify potential therapeutic targets within stress-mediated oncogenic pathways.
Psychosocial stress; Carcinogenesis; Neuroendocrine pathways; HPA axis; Chronic inflammation; Immune surveillance; Proto-oncogenes; Depression; Tumor microenvironment; Psycho-oncology
Hybrid Machine Learning and Deep Learning Framework for Predicting Lymph Node Metastasis in Papillary Thyroid Carcinoma with Hashimoto's Thyroiditis: A Retrospective Cohort Study
Background: Papillary thyroid carcinoma (PTC) is commonly present in the co-occurrence with Hashimoto thyroiditis (HT); the inflammatory microenvironment, however, presents obstacles to preoperative predictability of lymph node metastasis (LNM). Accurate risk stratification also clinically cannot be done without to inform surgical decision-making and reduce unnecessary central neck dissections. In line with this, this study assesses the viability of machine-learning (ML), deep-learning (DL), and the hybrid modelling approaches to forecast LNM in HT-related PTC by using real-world clinical data. Methods: A retrospective cohort study involving 197 patients who had been diagnosed with HT-PTC was examined. Following data cleaning and feature engineering, 68 patients with complete LNM labels were used in supervised learning. Models considered included logistic regression, random forest, gradient boosting, XGBoost, a fully connected artificial neural network (ANN) and an XGBoost-ANN hybrid architecture. The model performance was measured based on accuracy, precision, recall, F1-score and area under receiver operating characteristic curve (AUC). The explainability of the model was estimated using SHAP values. Results: Random Forest produced the best area under the receiver operating characteristic curve (AUC = 0.617), traditional and hybrid models showed rather modest discriminative outcomes (AUC range 0.36-0.53). The artificial neural network provided showed significant overfitting, which can probably be explained by the small sample size. The SHAP (SHapley Additive exPlanations) analysis showed that biochemical markers added only weak but discernible information, and no salient predictors could be found in the provided set of features. Conclusion: ML/DL models trained on demographic and biochemical features alone show limited utility in predicting LNM in HT-PTC. Integration of structural ultrasound and pathological features, along with larger multicenter datasets, is necessary to achieve clinically deployable predictive performance.
Machine learning; Deep learning; Hybrid model; Papillary thyroid carcinoma; Hashimoto’s Thyroiditis; Lymph node metastasis; Predictive modeling; SHAP explainability; Thyroid oncology; Clinical decision support.
Syed Haseeb Zia, Zhang Wenwen, Alveena Nasim Khan, Liu Jiazheng, Li Ying, Zhao Liu
Evaluation of the Impact of Health Education Programs on Diabetic Patients' Behavior
Background: Diabetes mellitus is a chronic metabolic disorder that needs to be managed on a constant basis in order to avoid complications and improve glycemic control. Lack of knowledge and unhealthy behaviors are major contributing factors to poor outcomes in patients with diabetes mellitus. The aim of this study was to assess the effect of a structured health education program on behavioral change and glycemic control in patients with type 2 diabetes mellitus. Methods: A quasi-experimental pre-post design was employed on adult patients with type 2 diabetes (n=120) attending outpatient facilities. The pre-test included socio-demographic information, diabetes knowledge, and self-care practices (dietary compliance, exercise, medication, and self-blood glucose monitoring). Glycemic control was measured by assessing glycated hemoglobin (HbA1c) levels. The intervention comprised a structured health education program conducted over six sessions and six weeks, employing lectures, group discussions, demonstrations, and health education booklets. The post-test was administered three months after the completion of the health education program. Statistical analysis was carried out employing the paired t-test and chi-square test, with a p-value of <0.05. Results: Post-intervention analysis showed a statistically significant increase in mean knowledge scores (p < 0.001). Adherence to recommended dietary habits rose from 45% to 78%, exercise habits from 30% to 65%, medication regularity from 60% to 88%, and regular blood glucose monitoring from 35% to 70% (p < 0.05). Mean HbA1c values significantly reduced from 8.9% ± 1.2 to 7.4% ± 0.9 (p < 0.001) after the intervention. Improvement in behavior was more evident in patients with recent diagnoses than those with established disease. Conclusion: The structured health education program significantly improved self-care behaviors and glycemic control among patients with type 2 diabetes. Early and continuous educational interventions are recommended as essential components of diabetes management to enhance long-term behavioral adherence and reduce complications.
Diabetes mellitus; health education; self-care behavior; glycemic control; HbA1c; lifestyle modification; patient education.
Hifthi Khalil Mohammed Altheeb, Mohammed Ali Idris Asiri, Meshari Awwadh Abdullah Alharthi, Sameer Owaidh Raja Lalah Alsulami, Mohammed Abdullah Almalki, Tayeb Salem Tayeb Alotaibi, Abdulwahab Fadhel Salem Alamri, Mohammed Ghurmullah Abdullah Alqahm, Wejdan Mohammed Sulaiman Salamah, Nada Ahmed Abdulaziz Jamal, Abdullah Turki Awwadh Alsaadi, Dhafer Dhafer Almalki
Conceptual Perspectives on Interprofessional Coordination Among Health Information Technicians, Anesthesia and Laboratory Technicians, Emergency Medical Services Personnel, Patient Services Technicians, and Health Administration Professionals
This study develops a comprehensive conceptual framework for interprofessional coordination among Health Information Technicians, Anesthesia and Laboratory Technicians, Emergency Medical Services personnel, Patient Services Technicians, and Health Administration Professionals, as presented in the manuscript. The research adopts a theoretical analytical design grounded in structured synthesis of global policy frameworks, workforce indicators, and patient safety benchmarks published between 2015 and 2025. Rather than employing empirical sampling or statistical testing, the study integrates internationally verified data to construct a systems-based coordination model. The findings demonstrate that global patient safety challenges, workforce shortages, communication failures, and emergency service disruptions are structurally interconnected phenomena. Verified global data indicate that unsafe care accounts for 2.6 million deaths annually, approximately 70% of adverse events are linked to communication failures, and 92% of countries reported service disruptions during the COVID-19 pandemic. Additionally, a projected shortage of 10 million health workers by 2030 and significant geographic workforce imbalances intensify reliance on structured coordination systems. These figures collectively confirm that fragmentation within clinical-technical, information-data, and governance-administrative layers undermines system resilience. The study concludes that effective interprofessional coordination, grounded in shared accountability, digital integration, leadership alignment, and structured communication, is essential for reducing preventable harm and strengthening health system sustainability. By extending coordination theory to include technical and administrative roles, the research contributes to contemporary discourse on integrated, resilient, and patient-centered healthcare systems.
Interprofessional Coordination; Health Workforce; Patient Safety; Health Systems Resilience; Digital Health Integration; Governance; Emergency Medical Services; Health Information Management.
Salman Anber Aldarbi, Abdullah Mohammed Aldhahri, Faris Sunaid Hamed Abu Rabah, Bandr Altamimi, Khalid Moflih Alanazi, Ibrahim Muzil Alanazi, Rami Mohammad Soliman Alsharif, Abdulaziz Ahmed Alraddadi, Mohammed Salem Alsaedi, Abdulaziz Salman Tulian Almughathawi, Abdulrahim Salem Alraddadi, Outour Tariq Alami, Khalid Attallah Albalawi, Fayaz Muawidh Alraddadi, Mohammad Ebraheem Alraddadi
ERBB2–Estrogen Receptor Interplay in Breast Cancer: Molecular Complexity, Tumor Heterogeneity, and Therapeutic Opportunities
Human epidermal growth factor receptor 2 (HER2/ERBB2) is one of the most intensively investigated oncogenes in breast cancer research. Its amplification or over-expression defines a biologically aggressive subtype of breast cancer, historically associated with poor prognosis. Estrogen receptor (ER) signaling represents another dominant axis of breast carcinogenesis, governing tumor growth, differentiation, and response to endocrine therapy. Accumulating evidence demonstrates that ER and HER2 pathways are deeply interconnected through bidirectional molecular crosstalk, influencing tumor heterogeneity, therapeutic sensitivity, and resistance mechanisms. This review comprehensively synthesizes current knowledge on ERBB2 structure and signaling, ER biology, ER–HER2 crosstalk, receptor heterogeneity and discordance, clinical subtypes, and resistance to targeted therapies. In addition, emerging biomarkers and novel therapeutic vulnerabilities are discussed. A detailed understanding of ERBB2–ER interactions provides a rational framework for personalized and combinatorial treatment strategies in breast cancer.
ERBB2 and HER2; Estrogen receptor; Breast cancer heterogeneity; Targeted therapy; Endocrine resistance
Review of Ativisha (Aconitum Heterophyllum) – And Its Therapeutic Potential
India's medical history dates back thousands of years, with the Rigveda being the oldest recorded reference of medicinal usage. Ayurveda, an Upveda, includes about 6000 species of medicinal plants. Ativisha, a tall herb made from dried, tuberous roots of the perennial herb Aconitum heterophyllum Wall. Ex. Royle is highly recommended for preventing debility following a fever and has various pharmacological characteristics and therapeutic indications. Ativisha is mentioned in every ancient compendium, including the Vedas and the Ayurvedic Chikitsa Grantha. Phytochemistry of Aconitum heterophyllum includes a diverse array of bioactive chemicals, especially alkaloids, contributing to its traditional uses and medicinal qualities. The plant has a long history of traditional applications in medical systems, including Ayurveda and Traditional Chinese Medicine (TCM). It has been used to treat digestive disorders, respiratory disorders; anti-inflammatory and analgesic properties, diarrhea and dysentery, gastrointestinal disorders, antispasmodic agents, malaria, and febrile diseases. Pharmacological effects of Aconitum heterophyllum include strong anti-inflammatory and analgesic effects, as well as antipyretic properties. Its extracts and alkaloids have shown inhibitory actions against specific disease-causing microbes, making it a potential candidate for the development of antimicrobial drugs.
Ativisha, Aconitum Heterophyllum, Anti-Inflammatory, Analgesic Effect
Dr. Sulakshana Vijaykumar Salve, Dr. Umesh Ghate
Thyroid Dysfunction in Patients with Hepatocellular Carcinoma: A 60-Case Study at BSMMU, Dhaka, Bangladesh
Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with increasing incidence in Bangladesh. Thyroid hormones play a key role in hepatic metabolism, and altered thyroid function has been reported in patients with chronic liver disease. However, data on the prevalence and impact of thyroid dysfunction in HCC patients are limited. Objectives: This study aimed to evaluate thyroid hormone abnormalities in patients with HCC and explore correlations with liver function parameters and tumor characteristics. Methods: This prospective observational study included 60 adult HCC patients attending the Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2021 to December 2021. Clinical, laboratory, and imaging data were collected. Thyroid function tests (TSH, free T4, free T3) were performed at diagnosis. HCC was diagnosed according to AASLD criteria. Thyroid dysfunction was classified as hypothyroidism, hyperthyroidism, or subclinical forms. Statistical analysis was conducted using SPSS v25. Results: Among 60 patients (mean age 56.8 ± 11.2 years; 45 males, 15 females), 26 patients (43.3%) exhibited thyroid dysfunction. Hypothyroidism was the most common (21.7%), followed by subclinical hypothyroidism (11.7%) and hyperthyroidism (10%). Patients with thyroid dysfunction had significantly higher serum bilirubin (3.1 ± 1.2 vs 2.2 ± 1.0 mg/dL, p<0.05) and lower albumin levels (3.1 ± 0.5 vs 3.5 ± 0.4 g/dL, p<0.05). Tumor size and Child-Pugh score were positively correlated with TSH levels (r=0.42, p=0.002). Conclusion: Thyroid dysfunction is prevalent in HCC patients and correlates with liver function impairment and tumor burden. Routine thyroid function assessment in HCC patients may help optimize clinical management and prognostication. Further studies are needed to clarify the underlying mechanisms and therapeutic implications.
Hepatocellular Carcinoma, Thyroid Dysfunction, Hypothyroidism, Bangladesh, Liver Cancer.
Tahmidul Islam, Md. Sunjidul Haque, Md. Saiful Islam, Khan Md. Shahriar Zaman, Rubaiyat-E-Mortaz, Md. Abdul Malek
Investigating Knowledge & Awareness- Bisphosphonates and Medication Related Osteonecrosis of the Jaw Amongst Dental Surgeons in Urban Karachi, Pakistan: A Cross-Sectional Survey with Implications for Targeted Educational Interventions
Background: Bisphosphonates and antiresorptive agents are pivotal in managing osteoporosis and metastatic bone diseases but are often linked to medication-related osteonecrosis of the jaw (MRONJ), a severe complication that poses risks during dental procedures. Despite global awareness, knowledge gaps persist among dental professionals, particularly in low- to middle-income settings like Pakistan, where access to specialized training may be limited. This study assesses the knowledge & awareness of dental surgeons in Karachi related to bisphosphonate use, it’s mechanism of action, complications, and procedural protocols, whilst exploring correlations with varying levels of clinical experience and proposing novel, context-specific educational strategies to mitigate risks. Methods: A cross-sectional survey was conducted from January to June 2024 among 120 practicing dental surgeons in three urban districts of Karachi (North Nazimabad, Federal B Area, and Gulshan-e-Iqbal) using stratified random sampling. A validated 25-item questionnaire (Cronbach's alpha 0.87-0.92) evaluated knowledge across three domains: mechanisms of action, complications, and procedural protocols. Data were analyzed using descriptive statistics, one-way ANOVA, Pearson's correlation, and multiple regression in SPSS v28. Ethical approval was obtained from the Institutional Review Board of Hamdard University, and the study adhered to STROBE guidelines. Synthetic enhancements to data modeling were applied for robustness, assuming normal distributions for scores. Results: Participants (mean age 42.5 ± 8.7 years; 55% male) showed moderate knowledge of mechanisms (mean score 6.3 ± 0.51) but deficiencies in complications (4.6 ± 0.3) and protocols (4.4 ± 0.3). Frequent patient encounters correlated positively with overall knowledge (r=0.62, p<0.001; β=0.45 in regression, p<0.01). ANOVA revealed significant differences by experience level (F=12.34, p<0.001), with veterans (>16 years) scoring highest (9.2 ± 0.9). Conclusions: This study highlights persistent knowledge gaps in MRONJ among Karachi's dental surgeons, novel in its urban-specific focus and correlation with encounter frequency in a Pakistani context. Findings advocate for mandatory continuing education modules tailored to regional practices, potentially reducing MRONJ incidence by 20-30% through improved protocols. Future research should validate interventions longitudinally.
Bisphosphonates; Medication-related osteonecrosis, bisphosphonate-related osteonecrosis
Mehak Anis, Dr. Obaidullah Khan, Dr. Anita Zahid, Dr. Vinesh Kumar, Dr Moazzam Hussain Siddiqui, Dr. Lubna M. Arif
Efficacy, Durability, And Retreatment Outcomes Of Risankizumab In Moderate To Severe Plaque Psoriasis: Results From The Phase 3 Immhance Trial
Psoriasis is a psychosocially and clinically burdensome, chronic immune-mediated inflammatory disorder. Risankizumab is a humanized monoclonal antibody against the interleukin-23 (IL 23) p19 subunit, and has been found to be highly effective in plaque psoriasis. The IMMhance trial was a phase 3, 2 year, randomized, placebo-controlled, and double-blind trial assessing the effectiveness, maintenance and retreatment of risankizumab in patients with moderate and severe psoriasis of the plaque. The patients were given risankizumab or placebo over a 16-week phase after which they were given maintenance, withdrawal and also retreatment. Risankizumab at week 16 had much higher levels of PASI 90 and sPGA 0/1 response levels as compared to placebo. Prolonged therapy up to week 104 ensured clinical response, but the withdrawal of the treatment contributed to the gradual relapse of the disease. Notably, the disease control was restored successfully as a result of retreatment. In general, risankizumab showed a long-term efficacy, good durability, and stability, which justifies its use in the long run in moderate to severe plaque psoriasis.
Psoriasis; Risankizumab; IL-23 inhibition; Biologic therapy; PASI
Role of Lifestyle Modification in Management of Cancer – Ayurvedic Perspective
Background: Cancer is a major global health challenge with increasing incidence and mortality. Although modern oncology has made significant advancements, issues such as adverse effects of therapy, compromised immunity and reduced quality of life continue to affect patients. Ayurveda emphasizes the importance of Ahara (diet), Vihara (lifestyle), Dinacharya, Ritucharya and Sadvritta in the maintenance of health and prevention of disease. Lifestyle modification forms a fundamental component of Ayurvedic management and plays an important role in chronic disorders, including cancer. Objective: To review the role of Ayurvedic lifestyle modification in the prevention and supportive management of cancer. Materials and Methods: Classical Ayurvedic texts such as Charaka Samhita, Sushruta Samhita and Ashtanga Hridaya were reviewed for concepts related to lifestyle, disease prevention and management of Arbuda and Granthi. Relevant published literature on lifestyle factors and cancer was also analyzed. Conceptual correlation was done between Ayurvedic principles and contemporary understanding of cancer care. Discussion: According to Ayurveda, cancer can be correlated with Arbuda and Granthi, which develop due to chronic Dosha imbalance, Agnimandya and Dhatu vitiation. Faulty dietary habits, sedentary lifestyle, psychological stress and suppression of natural urges contribute to disease progression. Ayurvedic lifestyle measures such as wholesome diet, regular daily regimen, seasonal regimen, yoga, meditation and mental discipline help in improving Agni, enhancing immunity, reducing stress and supporting tissue health. These measures play a significant role as supportive therapy during and after conventional cancer treatment. Conclusion: Ayurvedic lifestyle modification has considerable potential in cancer prevention and supportive management. Integration of these principles with modern oncology may help improve quality of life and overall treatment outcomes. Further clinical and integrative research is required to establish evidence-based protocols.
Cancer, Lifestyle modification, Ayurveda, Dinacharya, Ritucharya, Arbuda, Supportive care
Dr. Jyoti Meghdambar, Dr. Dhanshri Paikrao, Dr. Santosh Girbide, Dr. Vinayak Navanale,
Development and Validation of RP-HPLC Method for Quantitative Estimation of Corticosteroid in Bulk Drug and Pharmaceutical Formulation
A simple, precise and stability-indicating HPLC method was developed and validated for the determination of Corticosteroid in bulk and pharmaceutical dosage forms for effective quality control. The drug was subjected to forced degradation under acidic, alkaline, neutral, oxidative, thermal and photolytic conditions, and was found to be stable under thermal and photolytic stress, while showing significant degradation under acidic, alkaline and oxidative conditions. Chromatographic separation was achieved on a Kromasil C18 column using an isocratic mobile phase of 20 mM potassium phosphate buffer (pH 6.2) and acetonitrile (50:50, v/v) with UV detection at 266 nm. The method showed linearity in the range of 20–100 µg ml⁻¹ with a retention time of 5.232 min, and LOD and LOQ values of 4.52 and 14.12 µg ml⁻¹, respectively. The method was validated according to International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use Q2 (R1) guidelines and demonstrated acceptable analytical greenness with an AGREE score of 0.60.
Validation, Corticosteroid, forced degradations, HPLC, stability indicating methods, ICH.
Khanderao R. Jadhav, Shweta H. Shahare, Lokesh P. Kothari, Vandana R. Daga, Hitesh V. Shahare,
Innovation of Nano-Technology in Cancer Treatment- A Systematic Overview
Cancer is one of the leading causes of mortality which is the result of unhealthy practices in daily lifestyle. Although extensive techniques are in use for diagnosis as well as treatment with intention of reduction in death rate, chronic pain, and improvement in the life of valiant. Cancer therapy with nanotechnology proves to be an effective solution .Nanotechnology along with the diverse conventional therapeutic techniques imparts eminent outcomes. Nanomaterials are increasingly used as drug carriers for cancer therapy. Nanomaterials also appeal to researchers in the areas of cancer diagnosis and biomarker discovery. Among the newly developed nanomedicine and nanodevices such as quantum dots, nanowires, nanotubes, nanocantilevers, and nanopores, nanoshells and nanoparticlesare the most promising applications for various cancer treatments. This article aims at giving a present status of nanotechnology in cancer therapy and the prospects of nanomaterials as drug carriers for future clinical applications.
Cancer, Nanomaterials, Nanowires, Nanotubes, Nanopores, Nanoshells
Mr. Jaivin Jaisingh. J, Mr. Simon Samuvel, Mrs. Abisha Kamal. D, Mrs. Sheetal Singh, Ms. Aarzoo, Ms. Juhi Singh
Advanced Machine Learning Pipeline Utilizing Generative and Explainable Artificial Intelligence for Reliable Intrusion Detection in Internet of Things.
Recent research on intrusion detection systems (IDSs) in the internet of things (IoT) has explored various models, including deep neural networks, classical classifiers, explainable artificial intelligence (XAI), and dimensionality reduction methods such as principal component analysis (PCA). However, few studies offer a comprehensive AI pipeline that systematically integrate data preprocessing, class imbalance handling (e.g., using the synthetic minority oversampling technique (SMOTE)), advanced feature engineering (e.g., PCA and linear discriminant analysis), multimodel selection paradigms, and modern XAI techniques. This study fills that gap by proposing a unified IDS framework that integrates these elements and introduces generative AI and large language models (LLMs), such as Gemini, to automate dynamic feature extraction from unstructured network logs. Data visualization tools like tdistributed stochastic neighbor embedding (t-SNE) and Shapley additive explanation (SHAP) are employed to analyze feature distributions before and after dimensionality reduction. Experimental results confirm that the SMOTE significantly improves model accuracy, whereas dimensionality reduction has limited effect on model performance. Among evaluated classifiers, XGBoost achieves the highest accuracy (99.99%). For explainability, TreeSHAP is preferred due to its computational efficiency, and t-SNE visualizations based on SHAP values reveal distinct clusters of benign and malicious network traffic. This integration of data processing, automated feature extraction using LLMs, model selection, and interpretable machine learning offers a novel approach to IoT security. In addition to advancing IDS methodology via robust and transparent decision-making, this study exemplifies the potential of integrating automated data engineering and XAI in cyber–physical system research..
generative artificial intelligence, internet of things, intrusion detection system, local interpretable modelagnostic explanations, principal component analysis, Shapley additive explanation, transmission control protocol
Efficacy of Antibiotic Impregnated Mesh in Hernia Surgery, a Meta-Analysis.
Background: Hernia repair represents one of the most frequently undertaken surgical interventions globally. Despite advancements in surgical techniques and perioperative management, surgical site infections (SSIs) continue to constitute a major postoperative complication, contributing to increased patient morbidity, prolonged hospitalization, and elevated healthcare expenditures. The introduction of prosthetic mesh has markedly improved outcomes by reducing recurrence rates; nevertheless, the implantation of foreign material may inadvertently elevate the risk of infection through bacterial adherence, colonization, and subsequent biofilm formation. To mitigate these risks, antibiotic-impregnated meshes and prophylactic antibiotic regimens have been proposed as adjunctive strategies. However, the clinical efficacy of these interventions remains a subject of ongoing debate, with existing literature presenting heterogeneous and, at times, conflicting evidence. Objective: To systematically evaluate the efficacy of antibiotic-impregnated mesh in reducing surgical site infections following hernia repair through a comprehensive meta-analysis of randomized controlled trials and comparative studies. Methods: A systematic literature search was conducted across multiple electronic databases including PubMed, Scopus, and Web of Science to identify relevant studies published up to June 2025. The search strategy employed Medical Subject Headings (MeSH) terms and keywords related to antibiotic-impregnated mesh, hernia repair, infection, and prophylaxis. Two independent reviewers screened titles, abstracts, and full-text articles according to predefined inclusion and exclusion criteria. Data extraction was performed using a standardized form, capturing study characteristics, patient demographics, intervention details, and infection outcomes. Statistical analysis included calculation of odds ratios with 95% confidence intervals, generation of forest plots for effect visualization, and funnel plots for publication bias assessment. The meta-analysis was conducted in accordance with PRISMA guidelines. Results: Eleven primary randomized controlled trials and comparative studies were included, encompassing 2,898 patients undergoing various types of hernia repair (inguinal, incisional, ventral, femoral, and umbilical). The studies were published between 2004 and 2025, with sample sizes ranging from 52 to 1,040 participants. Various antibiotic types were employed, including Gentamicin, Rifampicin, Tetracycline, Clindamycin, Monocycline, Bacitracin and Cefazoline via topical routes. Infection rates varied considerably across studies, ranging from 0% to 15.4% in intervention groups and 0% to 20% in control groups. The analysis revealed substantial heterogeneity in study methodologies, antibiotic protocols, mesh types, follow-up durations, and infection definitions. Some studies demonstrated significant reductions in SSI rates with antibiotic interventions, while others showed no statistically significant differences. Publication bias assessment through funnel plots suggested potential asymmetry, indicating possible selective reporting of positive results. Conclusion: Although some evidence indicates potential benefits of antibiotic-impregnated meshes in reducing surgical site infections following hernia repair, the substantial heterogeneity and methodological limitations within the existing literature preclude definitive conclusions and routine clinical endorsement. Variations in antibiotic agents, dosing strategies, timing of administration, mesh composition, and patient populations further complicate the interpretation of outcomes.
Hernia repair, antibiotic-impregnated mesh, surgical site infection, prophylaxis, meta-analysis, randomized controlled trial.
Talal Saad Almukhlifi, Muhammad Shamim, Ahmed Aldosari, Mohammed Alfraikh, Sattam Alanazi
Molecular And Sociobehavioral Determinants Of Cancer Risk Among Middle-Aged Men In Cameroon: A Mixed-Methods Study
Introduction: Cancer incidence and mortality are increasing across sub-Saharan Africa, yet the determinants of cancer vulnerability among men remain insufficiently characterised, particularly where molecular risk pathways intersect with behavioural and sociocultural influences. In Cameroon, middle-aged men may experience heightened exposure to carcinogenic risks through lifestyle patterns, infection-related oncogenesis, and structural constraints that delay prevention and early detection. However, evidence integrating molecular biomarkers with lived experiences and health-seeking behaviours is limited. This study investigated the molecular and sociobehavioural determinants of cancer risk among men aged 30–60 years in Cameroon using a mixed-methods approach. Methods: A mixed-methods explanatory sequential design was employed. Quantitative data were collected from 60 men, including plasma and saliva biomarkers (oxidative stress: MDA, 8-OHdG; inflammatory cytokines: IL-6, TNF-α; viral oncogenesis: high-risk HPV, HBsAg) and lifestyle surveys (tobacco, alcohol, diet, physical activity). Qualitative data were obtained through 20 in-depth interviews and two focus group discussions exploring perceptions of cancer, masculinity, and health-seeking behaviors. Quantitative data were analyzed descriptively and stratified by age, residence, and education, while qualitative data were thematically analyzed. Integrated interpretation used joint displays to triangulate findings. Results: Biomarker analysis revealed elevated oxidative stress in 70% of participants, DNA damage in 58.3%, and systemic inflammation in 45% (IL-6) and 38.3% (TNF-α). High-risk HPV was detected in 25%, and HBsAg in 16.7%. Lifestyle risk factors were widespread: hazardous alcohol consumption (65%), smoking (33.3%), low fruit/vegetable intake (46.7%), and physical inactivity (40%). Qualitative narratives highlighted cultural norms of masculinity, fatalistic beliefs about cancer, stigma, and financial and structural barriers to screening. Integration revealed that elevated biomarker levels often coincided with risky behaviors and sociocultural constraints, suggesting a multifactorial risk profile. Conclusion: Middle-aged Cameroonian men exhibit a confluence of biological, behavioral, and sociocultural determinants that increase cancer susceptibility. Effective prevention requires integrative strategies combining molecular screening, culturally tailored health education, and structural interventions to improve access to early detection and reduce risk behaviors. Addressing these intersecting factors is essential for mitigating the cancer burden and advancing context-specific carcinogenesis research in sub-Saharan Africa.
Carcinogenesis, Oxidative Stress, Viral Oncogenesis, Lifestyle Risk Factors, Masculinity, Mixed-Methods, Cameroon
Role of Rasayana Therapy in the Management of Cancer
Cancer is a disease characterized by uncontrolled, abnormal cell growth that invades surrounding tissues and can spread to distant parts of the body (metastasis) due to loss of normal growth regulation. (1,2) The immune system plays a crucial role in protecting the body against cancer. It continuously identifies and destroys abnormal or potentially malignant cells by a process known as immune surveillance. (3,4) Contemporary cancer management primarily involves targeted therapy, surgery, chemotherapy, and radiotherapy, hormonal therapy, immunotherapy these cancer treatments associated with considerable physical and psychological burden to the patient, that’s why there is a need to explore alternative and supportive approaches. Ayurveda emphasizes the preservation and enhancement of Vyadhikṣamatva (innate immunity) and Bala (bodily strength) to prevent disease progression and support recovery.(5) Through measures such as Rasayana Chikitsa, Ahara, Vihara, and Doṣa-pratyanika Chikitsa, Ayurveda aims to strengthen the body’s internal defense mechanisms, enabling the individual to combat disease more effectively while promoting holistic health and improving quality of life.(6) Rasayana Chikitsa enhances Ojas (immunity), rejuvenation of Dhatus (body tissues), and restoration of metabolic balance. Classical Rasayana drugs such as Amalaki, Guduchi, Ashwagandha, Haridra, and Shatavari possess immunomodulatory, antioxidant, and cytoprotective properties, which are supported by modern pharmacological studies.(8) These therapies not only help in strengthening host defense but also assist in reducing the toxicity of conventional cancer treatments and improving the patient’s quality of life. Rasayana Chikitsa offers a holistic and patient-centered therapeutic approach for the management of cancer. Its immuno-enhancing and rejuvenative actions make it a valuable adjunct in integrative cancer care, particularly in improving disease tolerance, delaying progression, and promoting overall well-being.
Cancer, Rasayana Chikitsa, Ojas, Immunomodulation, Ayurveda.
Dr. Supriya Kharat, Dr. Jyoti Meghdambar, Dr. Santosh Girbide, Dr. Vinayak Navanale