An Overview of Disease and Health Research Vol. 9

Interlinking Depression and Oral Health: A Public Health Perspective

Abdulhameed G. Albeshr — 2026-01-31

Depression is one of the most common and disabling psychiatric disorders worldwide, and exerts a profound impact on physical, emotional, and social health. It is characterised by depressive symptoms such as relentless sadness, loss of interest in enjoyable activities, changes in appetite and weight, sleep disturbances or hypersomnia, fatigue or loss of energy, impaired concentration, feelings of guilt, and suicidal thinking. The aetiology of depression arises from a complex interplay of genetic, neurobiological, psycho-social and environmental factors. People who have experienced major life events, early life trauma, or chronic stress are most at risk. Recent studies provide compelling evidence that there is a strong yet overlooked link between depression and oral health. Patients with depression lead suboptimal oral health lives due to poor oral hygiene behaviours, unhealthy dietary habits, additional tobacco and alcohol use, and being less likely to seek dental care. Depression involves dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, systemic inflammation, immunosuppression, and the decrease of salivary gland function, which all increase susceptibility to oral sepsis, xerostomia and dental caries. Similarly, the reversed pathway of the relationship could be suggested, as poor oral health leads to psychological discomfort, poorer quality of life, and increased depression symptoms. The chapter is a summary of details regarding the epidemiology of the condition; classification of depression; biological and behavioural mechanisms involved with the relationship between depression and oral health, preventive measures for the condition & treatment strategies. It highlights the need for collaboration among dental and mental health workers who deal with the public health concern of the burden of Depressive Disorders. This study aimed to explore the association between depression and oral health by examining the different categories of depression, their impact on oral health, and recommended preventive measures to bridge gaps in awareness and care in this area.

A Retrospective Analysis of National Surveillance Data on the Epidemiology of Meningitis in Niger (2005 – 2020)

Alkassoum S. I. — 2026-01-31

Background: Bacterial meningitis is a major public health problem, especially in low-income countries. It is caused by Nesseria meningitidis (Nm), a Gram-negative bacterium of the family Neisseriaceae that infects humans only. In Africa, epidemics of meningitis caused by Neisseria meningitides have been a public health problem for over a century.

Aim: This study analysed national surveillance data and isolates from Niger to describe the epidemiology of bacterial meningitis from 2005 to 2020.

Methods: A retrospective study was conducted using nationwide case-based surveillance data of all reported meningitis cases in Niger from 2005 to 2020. A modified case definition was used to classify the cases. Data were collected and analysed using Stata 12.0.

Results: Neisseria meningitidis (Nm) was recorded over the entire period from 2005 to 2020. A total of 47,953 suspected meningitis cases and 3,276 deaths (CFR=6.83%) were reported, corresponding to an incidence of 189.01 cases per 100,000 population. The male represented 55.41% (sex-ratio male: female = 1.30), and 40.52% were 5 -14 years old. A total of 29,998 cases were reported through RNL, of which 10,979 (36.60%) were confirmed, and 6,149 (56.01%) were confirmed by culture. The predominant organism identified was N. meningitidis serogroup A (33.91%). All regions reported meningitis cases, and a consistent and substantial reduction was seen in confirmed NmA cases, with no cases occurring in the country after the completion of mass campaigns. Nevertheless, other pathogen species and Nm variants, including NmX, NmC, and Streptococcus pneumoniae, have become more prevalent.

Conclusion: Increased surveillance of multiple serogroups throughout is necessary, as well as consideration of vaccination with combination vaccines rather than just using a single strain, as is currently the case with NmA.

Quantitative Study on Immunity and Tissue Regenerative Capacity in Hemodialysis Patients with Diabetes: General Characteristics and Paradoxical Aspects

Mihaela Gheorghiu — 2026-01-31

Aims: This chapter aims to present the results of studies on intestinal microbiota, innate and acquired immune responses, and tissue regenerative capacity in hemodialysis patients with T2DM.

Study Design: It is a quantitative study that used two types of biological samples: blood and faeces.

Place and Duration of Study: Institute of Virology and University Research Institute laboratories, between January and June 2024.

Methodology: The study was conducted on 60 patients divided into two groups: the test group (patients with ESRD and T2DM) and the control group (ESRD only). The intestinal microbiota was investigated using a genetic study. As markers for innate immunity (inflammation), the IL-6, sIL-6R, IL-1β, TNFα, IL-10, and NGAL serum levels (ELISA kits). As a cellular immunity marker, TNFβ/LTα was investigated. Regenerative capacity was studied using NT-3 (this is the first study to do so) and VEGFβ (another marker that is scarcely found in this patient category) (ELISA kits).

Results: The results proved a marked polarisation. IL-6 and sIL-6R presented significant increases in both groups, especially in diabetics. IL-6 generates trans-signalling through sIL-6R, with proinflammatory and anti-regenerative effects, confirmed through a significant reduction in NT-3 and VEGF-β. Statistical analysis has allowed us to conclude that the high level of IL-6 significantly influences IL-1β, TNF-β, NT-3, VEGF-β and IL-10 behaviour. But we were very surprised to find unexpected immunological changes and tissue regenerative capacity in an 82-year-old female patient, diagnosed with insulin-requiring T2DM, with multiple complications, including ESRD.

Conclusions: Although this research is in its early stages, it generates important conclusions and directions for further research. Regarding the particular case presented, we support the following causal hypotheses: genetically conditioned IL-6 overproduction (possibly acquired post-infection), together with its predominant anti-inflammatory and pro-regenerative signalling through IL-6R membrane receptors; the possibility that the extremely high levels of growth factors predict severe decompensation of the two associated diseases.

Tubercular Osteomyelitis of the Skull in a 14-Year-Old Female: A Rare Case Report and Review of the Literature

Mohammad Humayun Rashid — 2026-01-31

Background: Skeletal tuberculosis constitutes about 1٪ of all cases. Usually, spine and limb bones are involved. Tuberculosis is endemic in many developing countries, including Bangladesh, where the disease remains highly prevalent. Tubercular osteomyelitis of the skull is a rare entity; therefore, diagnosis is rarely suspected. Given the rarity of the condition, only a few patients with Tubercular osteomyelitis of the skull have been reported in the medical literature.

Case Report: This chapter reports one such rare case of an atypical calvarial skull osteomyelitis in a 14-year-old female who presented with swelling on the right frontoparietal region for 3 months. CT scan of the brain and bony window revealed a lytic bony lesion at the right parietal bone with an associated epidural soft tissue component at the right parietal top, causing compression over adjacent parenchyma- possibly eosinophilic granuloma or chronic osteomyelitis. Haematological test reveals no abnormality except ESR 61mm in 1^st hour with a normal chest X-ray. The patient was treated surgically by excision of the lesion with cranioplasty using synthetic bone cement. After surgical treatment, the specimen was sent for histopathology, which showed granulomatous inflammation histologically consistent with tuberculosis. She was treated with antitubercular therapy as per the national tuberculosis guideline.

Conclusion: Our Case highlights all these aspects of skull tuberculosis with a review of the available literature relevant to skull tubercular osteomyelitis.

Targeting Chronic Oxidative Stress: Ozone Therapy as a Key Modulator in Restoring Redox Homeostasis

Emma Borrelli — 2026-01-31

Chronic degenerative diseases—including cardiovascular disorders, type II diabetes, chronic obstructive pulmonary disease, and neurodegenerative conditions—constitute the leading causes of disability and mortality worldwide. These disorders share common pathogenic mechanisms, notably chronic inflammation and sustained oxidative stress, which are only partially addressed by conventional pharmacological therapies. Restoration of redox homeostasis, therefore, represents a critical unmet therapeutic objective.

This review examines integrative strategies aimed at modulating oxidative stress, including lifestyle interventions such as caloric restriction and regular physical exercise, as well as selected bioactive dietary compounds. While these approaches contribute to improved metabolic regulation and may enhance endogenous antioxidant defences, their efficacy is often limited by poor adherence, variable bioavailability, and modest or inconsistent clinical impact.

In contrast, particular emphasis is placed on controlled ozone therapy administered as major ozonated autohemotherapy, which uniquely exploits a hormetic mechanism to activate endogenous adaptive responses. When applied within a precisely defined therapeutic window, ozone does not act as a direct pharmacological agent but as a transient oxidative stimulus, generating secondary messenger molecules such as hydrogen peroxide and lipid-derived electrophiles. These signals activate key cytoprotective pathways, most notably the Nrf2-dependent phase II antioxidant and detoxification system, leading to enhanced redox balance, modulation of chronic inflammation, and improved tissue oxygen utilisation.

Unlike exogenous antioxidant supplementation, which primarily affects the extracellular compartment, ozone therapy induces an intracellular adaptive response by stimulating the body’s own defence systems. This mechanistic distinction may explain its broader and more sustained effects in chronic diseases characterised by progressive oxidative stress. Clinical observations suggest that, when integrated with standard medical treatments and applied before irreversible tissue damage occurs, ozone therapy may offer meaningful functional and symptomatic benefits.

Importantly, the translational relevance of redox-modulation therapies depends on the adoption of standardised clinical procedures, precise dosing protocols, and appropriate regulatory oversight to ensure safety, reproducibility and clinical validity. While emerging clinical evidence suggests that controlled ozone therapy may integrate conventional treatments in selected chronic degenerative conditions, further well-designed clinical trials and harmonised guidelines are required before broader clinical implementation.

Needlestick and Sharp Injuries among Healthcare Workers in the Operating Theatre

Richard Wismayer — 2026-01-31

Introduction: The risks and leading occupational accidents that healthcare workers are exposed to include needlestick injury. Most surgeons and healthcare workers face at least one injury during their professional life, and therefore, such injuries are an important problem. The present narrative literature review was carried out to determine situations that caused needle stick injury in the operating theatre, the precautions taken to prevent these injuries and to highlight the importance of this issue in the light of the current literature. In as many as 50% of surgical operations, the mucus membranes and skin of surgical theatre personnel are in contact with patient blood. In as many as 15% of operations, needle sticks or cuts may occur, and the risk increases with procedures involving a high blood loss, longer procedures and more invasive procedures. Surgeons and primary assistants incur the greatest risk at 59.1% for operating theatre injuries. The remainder of injuries are sustained by scrub nurses (19.1%), anaesthesiologists (6.2%), circulating nurses (6%), medical students (3.1%), attendants (0.8%) and others (5.7%). The greatest risk-per-needle of sharps injury to the surgeon occurs with straight suture needles. During the suturing of muscle and fascia with curved suture needles, 59% of suture needle injuries occur. Routine use of blunt suture needles and double gloving by surgeons and healthcare workers is strongly supported for use in the operating theatre as recommended techniques to reduce sharp injuries. Under-reporting rates among surgeons mean that the true rate of sharps injuries remains undetermined, resulting in an unquantified risk to surgeons and, therefore, patients. All healthcare staff should be updated on hospital policy, and hospitals should consider designing a simplified method to ease the process of reporting sharps injuries. Although there is a low risk of transmission of blood-borne viruses with a sharps injury, the consequences of transmission are high, and the healthcare worker should report early and practice appropriate precautions.

Interventional Pain Management in Trauma: Bridging Acute Injury, Critical Care and Chronic Pain

Sony Sony — 2026-01-31

Interventional Pain Management (IPM) has emerged as an integral component of modern trauma anaesthesia, particularly in the care of patients with neurotrauma. Traumatic injuries to the nervous system are frequently associated with complex pain syndromes that extend beyond the acute phase and may progress to chronic, function-limiting pain. Reliance on systemic pharmacological therapy alone is often insufficient and may adversely affect neurological assessment, haemodynamic stability, and long-term functional outcomes. This chapter examines the role of IPM across the continuum of neurotrauma and trauma care, including the acute perioperative period, intensive care management, rehabilitation, and chronic pain treatment. Emphasis is placed on the neurobiological mechanisms of trauma-related pain, rational selection of interventional techniques, and safety considerations unique to neurologically vulnerable and critically injured patients. Integration of IPM within a multidisciplinary trauma care framework is presented as a key strategy to enhance patient outcomes and quality of life.

Percutaneous Cholecystostomy in Acute Calculus Cholecystitis: Current Management

Kumar Hari Rajah — 2026-01-31

Percutaneous cholecystostomy is an interventional radiological procedure that entails the insertion of a catheter into the gallbladder lumen for bile drainage. This procedure can be executed via either a transhepatic or transperitoneal approach. It is indicated for patients with severe acute calculus cholecystitis, serving to stabilise them prior to a subsequent laparoscopic cholecystectomy. Percutaneous cholecystostomy is considered a safe procedure, with the most prevalent complications being bleeding, perforation, and bile leakage. This chapter examined the role of percutaneous cholecystostomy in the management of acute calculus cholecystitis. Percutaneous cholecystostomy was compared with laparoscopic cholecystectomy as a definitive treatment for acute calculus cholecystitis, and the duration and timing of percutaneous cholecystostomy removal were explored. The study concluded that percutaneous cholecystostomy is a valuable, minimally invasive interim procedure for patients with severe acute calculus cholecystitis who are deemed unsuitable for surgical intervention.

Role of Fusobacterium nucleatum and KRAS Genotype in Colorectal Cancer Development

Ahmed Dewan — 2026-01-31

Fusobacterium nucleatum (Fn) and activating mutations in the Kirsten rat sarcoma viral oncogene homolog (KRAS) are increasingly recognised as synergistic drivers of colorectal cancer (CRC). Fn promotes tumorigenesis through several mechanisms, such as virulence factors including FadA and Fap2. KRAS mutations amplify proliferative and inflammatory signalling. This chapter explores how Fn enhances KRAS-driven oncogenic cascades and how KRAS-mutant epithelium fosters bacterial colonisation. We also examine KRAS as a prognostic biomarker and highlight emerging microbiome-targeted strategies. Understanding this microbial–genetic crosstalk provides a foundation for precision prevention and combined therapeutic approaches in CRC.