Medical Research: Emerging Concepts and Applications Vol. 3

Solitary Breast Human Cysticercosis Simulating Benign Tumor: A Case Report of a Young Female

Prakriti Shukla — 2026-09-12

Human cysticercosis is a zoonotic parasitic infection caused by ingestion of Taenia solium eggs in contaminated food or water. Although neurocysticercosis is well recognised, isolated involvement of the breast is uncommon and may clinically resemble a benign or malignant breast lesion. This case report describes a 28-year-old unmarried woman who followed a strict vegetarian diet and presented with an 11-month history of a painless lump in the upper outer quadrant of the left breast. The lump had gradually increased from approximately pea size to tennis-ball size and was associated with intermittent low-grade fever. On examination, it measured 4 × 3.5 cm and was non-tender, mobile, and soft to firm, without remarkable skin changes. A clinical diagnosis of fibroadenoma was considered. Mammography suggested a calcified cyst with an echogenic nidus, whereas fine-needle aspiration cytology was inconclusive. The excised specimen contained a glistening white cyst measuring 2.8 × 2.5 cm. Histopathological examination demonstrated a cyst with diagnostic scolices and a characteristic three-layered wall, with surrounding foreign-body-type giant cells, eosinophils, lymphocytes, and plasma cells. The patient subsequently received albendazole for four weeks. This case highlights that breast cysticercosis can mimic a common benign breast lump and that histopathological examination can provide definitive confirmation. In endemic settings, cysticercosis should remain a differential consideration for breast lumps, including in patients who do not consume pork.

Ormeloxifene for Fibroadenosis, Fibroadenoma and Associated Mastalgia: A Critical Narrative Review of Mechanistic Rationale, Clinical Efficacy and Safety

Lavu Jayanth — 2026-09-12

Benign breast disorders frequently present with mastalgia, diffuse nodularity or a discrete fibroadenoma, but these phenotypes differ biologically and should not be treated as interchangeable therapeutic targets. Ormeloxifene (centchroman) is a non-steroidal selective oestrogen receptor modulator developed in India and subsequently investigated as a medical treatment for benign breast symptoms and fibroadenoma regression. This critical narrative review evaluates the biological rationale, clinical effectiveness, safety and practical positioning of ormeloxifene for fibroadenosis or fibrocystic-type nodularity, fibroadenoma and associated mastalgia. Literature published from 1974 to 12 June 2026 was identified through live searches of PubMed, Europe PMC, Crossref and OpenAlex, supplemented by citation searching and verification against authoritative bibliographic records. Early uncontrolled studies and several active-comparator trials reported substantial reductions in breast pain, nodularity and fibroadenoma size. Their interpretation is constrained by small samples, open-label designs, short follow-up, heterogeneous dosing, imprecise diagnostic labels and the natural fluctuation of both mastalgia and fibroadenoma. Later placebo-controlled evidence substantially weakens the case for routine use. In mastalgia, a three-arm randomised study found high improvement rates in both ormeloxifene and placebo groups, whereas more recent comparison with tamoxifen suggests similar medium-term symptom control rather than clear superiority. For fibroadenoma, a 2024 double-blind placebo-controlled trial showed no improvement in complete regression and more adverse events, while a later randomised trial reported a favourable responder subgroup despite a non-significant primary between-group volume comparison. A 2025 meta-analysis of randomised trials found no significant efficacy advantage for fibroadenoma regression and a higher rate of adverse effects. Menstrual disturbance is the most consistent toxicity signal; ovarian cysts and dizziness have also been reported. The current evidence therefore supports diagnostic precision and stepped symptom management rather than routine ormeloxifene prescribing, with any use for refractory mastalgia requiring careful selection, counselling and monitoring. Evidence is insufficient to support ormeloxifene as standard pharmacological therapy for fibroadenoma regression.

Clinical Nursing Audit as a Quality-Improvement Tool in Intensive Care: A Critical Narrative Review of Pressure Injury Prevention and Management

Manashi Sengupta — 2026-09-12

Pressure injury in intensive care is a clinically consequential, nursing-sensitive safety problem whose prevention depends on the reliability of many small processes performed repeatedly under conditions of physiological instability, immobility, device dependence and competing treatment priorities. Clinical nursing audit is therefore attractive as a quality-improvement mechanism, yet audit can become a documentation exercise if indicators are poorly specified, outcome rates are interpreted without case-mix or ascertainment context, or feedback is disconnected from action. This critical narrative review examines how clinical nursing audit can be designed and used to improve pressure injury prevention and management in adult intensive care. Literature published from 1 January 2006 to 14 June 2026 was identified through live searches of accessible scholarly sources and targeted citation searching; earlier foundational work was retained where conceptually necessary. Evidence was synthesised across pressure-injury epidemiology and risk, prevention interventions, measurement reliability, nursing-sensitive indicators, audit and feedback, implementation, and post-injury management. The synthesis indicates that audit is most defensible when it combines structure, process, outcome and contextual measures rather than relying on hospital-acquired pressure injury counts alone. High-value process measures include comprehensive risk assessment linked to action, serial skin and device assessment, individualised repositioning delivery, support-surface appropriateness, device offloading, nutrition assessment and timely escalation. Evidence for several individual preventive interventions remains low or very low certainty, particularly for fixed repositioning schedules, specific support-surface modes and nutritional supplementation; consequently, audit standards should distinguish evidence-based care processes from locally preferred products or rigid routines. Device-related, mucosal and prone-position pressure injuries require distinct surveillance because conventional staging and denominators can obscure their burden. Effective audit and feedback is likely to be iterative, timely, credible, team-level and action-oriented, with re-audit used to close the loop. Future work should test audit architectures themselves, including risk-adjusted measures, electronic data capture, human validation, implementation fidelity and patient-centred balancing outcomes.

Antimicrobial Dental Adhesives: A Critical Appraisal of Mechanism, Evidence Quality and the Persistent Gap Between Laboratory Efficacy and Clinical Benefit

Ram Avinash Babu — 2026-09-12

Adhesive restorations fail predominantly through fracture and caries at the restoration margin, and the resin-dentine interface has therefore become an attractive target for materials that kill or suppress bacteria. Since the incorporation of a polymerisable quaternary ammonium monomer into a dentine primer in the late 1990s, several hundred laboratory investigations have reported that antibacterial adhesives suppress biofilm viability, acidogenicity and biomass, frequently by several orders of magnitude, and often without measurable loss of immediate bond strength. Only one such system has reached widespread commercial availability, and the clinical evidence supporting a caries-preventive benefit remains thin. This critical narrative review examines whether the biological premise, the mechanistic evidence and the outcome data of antimicrobial dental adhesives cohere. Literature was identified through structured searching of open scholarly databases and indexes, supplemented by citation searching, with reference identity and digital object identifiers verified against registry records. The synthesis is organised around the causal model of secondary caries, the principal chemistries and their structure-activity relationships, the architecture of the laboratory models used to demonstrate efficacy, interactions with bonding performance and interfacial durability, biological safety and resistance, and clinical translation. Three findings dominate. First, wall lesion development in situ and in vitro is governed principally by interfacial gap dimension rather than by bacterial viability at an intact interface, which places much of the demonstrated antibacterial activity at a site where lesions do not readily form. Second, antibacterial activity of adhesive surfaces attenuates markedly with pellicle deposition, water ageing and thermal cycling, whereas most efficacy testing is performed on freshly cured specimens. Third, the largest clinical dataset available found no difference in restoration survival or in failure attributed to caries between an adhesive containing an antibacterial monomer and a conventional control. Confidence in the concept is currently limited by outcome measures that are only loosely connected to lesion progression, by short observation periods and by probable reporting bias. Priorities include ageing-inclusive testing protocols, gap-relevant model systems and adequately powered trials in demonstrably high-risk populations.

The Dental Substrate as a Determinant of Adhesive Performance: A Critical Narrative Review of Enamel and Dentine Variability

Padma Priya Shanmugam — 2026-09-12

Adhesive dentistry is routinely evaluated as a problem of material chemistry, yet the tissue to which adhesives are applied is neither uniform nor inert. Enamel and dentine vary systematically with anatomical region, developmental history, disease activity, ageing, operative manipulation and systemic exposure, and each of these sources of variation alters the micromechanical and chemical conditions on which hybridisation depends. This critical narrative review examines the extent to which substrate condition governs the effectiveness and durability of resin bonding to dental hard tissues, and evaluates how confidently current evidence supports substrate-specific clinical protocols. Literature was identified through structured searching of biomedical and multidisciplinary scholarly sources, supplemented by backward and forward citation tracking and by inspection of the reference lists of recent syntheses. Evidence was appraised for design adequacy, substrate characterisation, ageing protocol and the strength of the link between laboratory measurement and clinical outcome. Several conclusions are well supported. Sound enamel remains the most predictable bonding substrate, and phosphoric acid conditioning of enamel improves marginal outcomes irrespective of the adhesive class used elsewhere in the cavity. Caries-affected dentine, sclerotic cervical dentine and hypomineralised enamel consistently yield lower and more variable bond strengths than their sound counterparts, and the magnitude of the deficit depends on how the altered tissue was obtained and characterised. Other conclusions remain tentative. The comparative performance of etching strategies on altered dentine is inconsistent across meta-analyses, the biological equivalence of artificially demineralised and naturally altered tissue is not established, and almost no randomised clinical trial has been designed with substrate condition as the primary allocation variable. The principal obstacle to progress is methodological rather than chemical: substrate definition, characterisation and reporting are insufficiently standardised for laboratory findings to be pooled or translated with confidence. Priorities include consensus definitions of altered substrates, mandatory quantitative substrate characterisation in bonding studies, and clinical trials stratified by lesion type.

Risk Factors for Ischemic Stroke: A Meta-Analysis of Modifiable and Non-Modifiable Determinants

Qinyuan Cui — 2026-09-12

Background: Ischaemic stroke accounts for about 80% of the stroke population and is a leading cause of mortality, presenting a serious threat to public health. Most strokes occur in people older than 70 years and rarely occur in those below 35 years of age. Ischaemic stroke is a multifactorial condition influenced by modifiable risk factors, such as lipid profiles (total cholesterol, triglycerides, HDL-C and LDL-C) and glucose levels, as well as non-modifiable factors such as age. Understanding the contribution of these risk factors could enhance stroke prevention efforts.

Methods: This meta-analysis examined data available up to 2018 on both modifiable and non-modifiable risk factors in patients with ischaemic stroke compared with healthy controls. Relevant data, including publication year, first author, ethnicity/country, numbers of stroke cases and controls, were extracted from eligible studies and analysed for heterogeneity.

Results: Among the risk factors analysed, triglyceride and glucose levels were significantly associated with ischaemic stroke risk, with an overall 95% CI of -0.62 to -0.09 for triglycerides (P = 0.008) and -1.08 to -0.14 for glucose (P = 0.01). Other factors, including total cholesterol, HDL-C, LDL-C and age, did not show a significant association with ischaemic stroke (P > 0.05). The analysis revealed substantial heterogeneity among studies (P < 0.001; I² >96%).

Conclusion: This meta-analysis suggests that elevated triglyceride and glucose levels are significant predisposing factors for ischaemic stroke in Asian populations, underscoring the importance of managing these modifiable risk factors in stroke prevention strategies.