Medical Science: Recent Advances and Applications Vol. 10

The Expression of Lipoprotein Receptor Related Protein-1 and C/Enhancer Binding Homologous Protein Genes in Individuals with Type 2 Diabetes Mellitus: A Potential Therapeutic Approach

2025-09-12T09:11:16+00:00

Diabetes is a serious chronic condition caused by either insufficient insulin production or the body's inability to effectively use the insulin it produces, leading to a persistent metabolic imbalance. Increased serum glucose can cause altered insulin signalling, and dyslipidaemia leads to several pathological alterations in neurons, glia, and vascular cells, leading to nerve dysfunction and, ultimately, neuropathy, including DNA damage and endoplasmic reticulum stress. The low-density lipoprotein receptor–related protein 1 (LRP-1) is a type I transmembrane protein belonging to the low-density lipoprotein receptor (LDL-R) family. C/EBP homologous protein (CHOP) is a major transcription factor in endoplasmic reticulum (ER)stress-mediated apoptosis and has widely documented roles in the pathogenesis of type 2 diabetes mellitus (T2DM) and diabetic complications. In this review, we are trying to determine the role of LRP1 and CHOP genes in modulating ER stress and their role in the pathophysiology of diabetes. We conducted a review using the Medline, Scopus, and Cochrane databases to examine the literature regarding the distinctions in neuropathy between type 1 and type 2 diabetes, variations in neuropathies, molecular biomarkers associated with the LRP1 gene, and CHOP expressions, along with their impact on diabetic neuropathies and related complications. This review can help establish novel therapeutic strategies for preventing and managing ER stress and diabetes.

An Update on the Status of Laparoscopic Inguinal Hernia Repairs: Narrative Review Article

2025-09-12T09:16:27+00:00

The utilisation of laparoscopic techniques for inguinal hernia repair has been increasingly adopted in clinical practice. The Transabdominal Preperitoneal (TAPP) and Total Extraperitoneal (TEP) approaches are the predominant procedures employed for the treatment of primary, recurrent, and bilateral inguinal hernias. These techniques, however, necessitate specialised equipment and training, and they present a significant learning curve. This article aims to examine the advantages and disadvantages of the TAPP and TEP repair methods. Furthermore, we will compare these laparoscopic techniques with traditional open inguinal repairs and explore the role of robotic-assisted inguinal hernia repair.

Impact of Short-Term Yoga on Pulmonary Functions in Healthy Individuals

2025-09-12T09:19:18+00:00

Background and Objective: Yoga is widely practiced as a simple approach to good health. Yogic techniques are reported to enhance overall performance and physiological efficiency. This study aimed to evaluate pulmonary function in healthy individuals aged 20–65 years before and after short-term yoga training, and to compare the effects between young and middle-aged adults.

Methods: A comparative prospective study was conducted on 52 healthy individuals (age 20–65 years). Participants were divided into two groups: Group I (n=28, age 20–40 years, young adults) and Group II (n=24, age 41–65 years, middle-aged adults). Pulmonary function parameters, including Breath Holding Time (BHT), 40 mmHg Endurance Test, Vital Capacity (VC), FEV1%, and Peak Expiratory Flow Rate (PEFR), were measured before and after 2 weeks of yoga training.

Results: Before yoga training, Group I had significantly higher 40 mmHg Endurance Test values (23.48 ± 10.06 vs. 23.37 ± 9.92 sec; p=0.01) and PEFR (462.16 ± 69.17 vs. 413.46 ± 0.59 L/min; p=0.01) compared to Group II, while BHT (32.31 ± 11.03 vs. 29.54 ± 14.06 sec), VC (2156 ± 314 vs. 1826 ± 457 ml), and FEV1% (86.57 ± 9.20 vs. 83.03 ± 11.95) were higher but not statistically significant. After yoga training, Group I showed highly significant improvements in BHT (32.31 ± 11.03 → 41.51 ± 11.86 sec, p<0.001), 40 mmHg Endurance Test (23.48 ± 10.06 → 29.79 ± 10.36 sec, p<0.001), VC (2156 ± 314 → 2466 ± 306 ml, p<0.01), FEV1% (86.57 ± 9.20 → 95.32 ± 4.22, p<0.001), and PEFR (462.16 ± 69.17 → 557 ± 57.9 L/min, p<0.001). Group II also showed significant improvements in all parameters (p<0.001). Post-yoga, PEFR remained significantly higher in Group I compared to Group II (557 ± 57.9 vs. lower values in Group II, p=0.01), while other parameters were not significantly different.

Conclusion: Short-term yoga (2 weeks) significantly improved pulmonary function parameters in healthy adults aged 20–65 years, with more pronounced benefits in young adults (20–40 years).

Management of Mandibular Fracture Malunion: Strategies for Refracture and Realignment

2025-09-12T09:22:23+00:00

Mandibular fracture malunion represents a complex and challenging sequela, often culminating in significant functional and aesthetic deficits, including malocclusion, facial asymmetry, and impaired mastication. The primary objectives in managing these cases are the restoration of pre-injury dental occlusion, the achievement of stable bony union, and the mitigation of risk factors that predispose to failure. While modern open reduction and internal fixation (ORIF) techniques have improved outcomes, complications such as nonunion, malunion, infection, and hardware failure persist. Key risk factors encompass the severity of the initial trauma (e.g., panfacial fractures, soft tissue loss), technical surgical factors, premature loading, and patient-specific comorbidities like diabetes mellitus and immunosuppression.

This chapter provides a comprehensive review of the diagnostic and therapeutic pathways for mandibular malunion. It begins by elucidating the aetiology and biomechanics of malunion, followed by a detailed analysis of preoperative evaluation, emphasising the pivotal role of advanced imaging and virtual surgical planning (VSP) in crafting a precise surgical strategy. The core of the chapter is a detailed exposition of surgical techniques, focusing on the principles of corrective osteotomy, refracture, anatomic realignment, and contemporary rigid internal fixation methods, with critical consideration given to the management of associated soft tissue scarring and neurovascular structures.

These principles are vividly illustrated through a detailed case presentation of a 28-year-old male with a malunited mandibular fracture. The case demonstrates the successful execution of a multidisciplinary management plan involving refracture, intermaxillary fixation (IMF)-guided realignment, and ORIF, which successfully restored normal occlusion and masticatory function. The chapter concludes by synthesising key outcomes, post-operative care protocols, and long-term management strategies, offering a structured framework for oral and maxillofacial surgeons to achieve optimal, reproducible results in these demanding reconstructive procedures.

Dynamic 3D-Printed Anatomical Models for ENT Surgical Planning: A Comprehensive Review

2025-09-12T09:28:03+00:00

Dynamic 3D-printed anatomical models are rapidly transforming otorhinolaryngology by providing high-fidelity, patient-specific tools for surgical planning, education, and training. Evidence shows that these models replicate complex ENT anatomy with deviations from imaging data of less than 5%, while multi-material printing enhances tactile and visual realism by distinguishing bone, cartilage, and soft tissues. Their use in surgical training has been associated with improved procedural accuracy, trainee confidence, and skill acquisition, offering an ethical and reproducible alternative to cadaveric dissection. In clinical practice, patient-specific models aid preoperative planning, reduce operative duration, refine surgical strategies, and facilitate communication with patients and families. The integration of these models with augmented reality, surgical navigation, and telemedicine platforms has expanded opportunities for global collaboration and remote education. Despite these advantages, challenges persist, including high production costs, limited replication of tissue biomechanics, lack of standardised evaluation metrics, and sustainability concerns. Nevertheless, advances in bioprinting, smart materials, and digital integration hold promise to overcome current barriers and further strengthen their role in ENT surgical practice.

The Mutation Rates of NRAS, KRAS, BRAF and PIK3CA and Their Associations with Clinicopathological Features in Ugandan Colorectal Cancer Patients

2025-09-12T09:30:48+00:00

Introduction: In the clinical assessment of progression and development of colorectal cancer (CRC), mutations in KRAS, BRAF, PIK3CA, and NRAS genes are critical factors. In Uganda, however, the data regarding the genetic profile of CRC patients is limited except for BRAF and KRAS mutations. The objective of this study was to determine the mutational spectrum of these genes and the association between the clinicopathological features and these mutations in Ugandan CRC patients.

Methodology: To reach these objectives, a total of 127 patients with CRC were recruited between 2008-2021. Mutations in BRAF, KRAS, PIK3CA and NRAS were determined using pyrosequencing and PCR.

Results: BRAF, KRAS, PIK3CA, and NRAS mutations were identified in 3.2%, 6.3%, 29.1% and 2.4% of the cases, respectively. There were some significant correlations between BRAF and PIK3CA mutations and clinicopathological features. Mutations in BRAF were shown to be associated with the SRCC histopathological subtype 4(50%) (p=0.011) and were predominantly found in right-sided colon tumours 3(75%) (p=0.023). Whilst PIK3CA mutations were more prevalent in females 23, 62.2%) (p=0.012). There was a tendency for PIK3CA mutations to be associated with increasing size of the tumour; T3: 21(56.8%) compared to T1: 3(8.1%) (p=0.032).

Conclusions: This is the first study in Uganda analysing all four genes simultaneously. Our study revealed a high PIK3CA mutation rate similar to other studies in the Western world. The BRAF mutation was predominantly found in right-sided colon tumours and associated with poor prognostic markers such as small cell colorectal carcinoma. The PIK3CA mutation was associated with larger tumours in Ugandan CRC patients. KRAS mutations may be a poor prognostic factor in Ugandan CRC patients, and KRAS wild-type CRC patients could benefit from EGFR-targeted drugs. The detection of NRAS, KRAS, BRAF and PIK3CA gene mutations and their associated clinicopathological features may influence targeted therapy or cancer management strategies in Sub-Saharan Africa.

Temporomandibular Joint: Clinical Anatomy and Associated Disorders

2025-09-12T09:37:18+00:00

The temporomandibular joint is situated at the base of skull formed by articulation of mandibular fossa of temporal bone and head of condyloid process of mandible. It allows both hinge and gliding movement. As we are aware that due to movements of the temporomandibular joint, it is possible to chew food which provides nutrition to the body, and without which the body cannot function. However, the temporomandibular joint is subjected to various disorders like internal derangement, inflammatory arthritis, arthrosis, and muscular disorders affecting the movement of the joint. Owing to its functional significance, this joint assumes great importance for dental surgeons. The aim of the chapter is to highlight the anatomy and associated disorders of the temporomandibular joint, which will aid clinicians in managing various disorders of the joint.

Investigation of Hemoprotein Levels and Elemental Homeostasis in Brain Tumors and Their Intermolecular Interactions

2025-09-13T10:47:19+00:00

Primary tumours of the central nervous system are a rare group of diverse tumours that account for less than 2% of all tumours, but are the fourth most common cause of cancer death. The role of element homeostasis in neoplastic disease pathogenesis is beyond question. The imbalance of trace elements precisely underlies the initiation and promotion of tumour pathology. The aim of the study was to investigate blood and tissue macroelements, microelements and hemoproteins levels in brain tumours and their intermolecular interactions. Samples of blood and brain tumour tissues were taken from 12 patients with malignant brain tumours (glioma, glioblastoma, astrocytoma). Samples of tissues were taken from 7 patients who died as a result of trauma related to a road traffic accident, without connection to head and brain injury. Detection of myoglobin level was implemented by the reaction of passive hemagglutination and an immunoturbidimetric test. Catalase activity was determined by the method of Beer and Sizer. Free radical activity was determined by the method of induced biochemiluminescence. The microelements level was investigated using atomic emission spectrometry. Statistical data processing was performed using STATISTICA Base software (StatSoft Inc.). To build the networks of studied hemoprotein interactions with signalling pathways of proteins, expressed in brain tumours, molecular interaction databases (STRING, BioGrid) were used. Modern databases of signalling pathways (KEGG) suggest that in normal cells, hypoxia can lead to HIF-1A protein synthesis. ROS synthesis inhibits the PHD enzyme and triggers the release of calcium ions, and increases proliferation. Calcium ions are a triggering factor of apoptosis and cell proliferation. In this study, a significant increase (more than 7 times) of calcium concentration in blood and brain tumour tissue was detected, compared with healthy people. Myoglobin can possibly be the cell adaptation factor towards hypoxia, oxidative stress and element homeostasis violation, and myoglobin level decreasing can additionally stimulate proliferation, by apoptosis inhibition. This is one of the first studies to have examined intermolecular relationships between microelements, hemoproteins and antioxidant enzymes in gliomas, and future studies are required to validate these findings and explore their potential diagnostic and therapeutic implications.

Inflammatory Markers in Polycystic Ovary Syndrome (PCOS) with Special Emphasize on Interleukin-6 (IL-6)

2025-09-13T10:51:45+00:00

Chronic low-grade inflammation plays a crucial role in the pathophysiology of polycystic ovary syndrome (PCOS). Although there is an overwhelming number of studies investigating inflammatory markers in PCOS, inconsistencies and disparities in findings have made it challenging for clinicians and researchers to draw clear conclusions and design future studies. This systematic review aims to synthesise recent evidence on key inflammatory markers in PCOS, with a particular focus on the role of interleukin-6 (IL-6), to provide greater clarity and guidance for clinical decision-making and research directions. A comprehensive literature search was conducted using the PubMed, Web of Science, Cochrane Library, and Google Scholar databases. Studies published between 2014 and 2024 were screened based on predefined eligibility criteria. Both observational and interventional studies that reported levels of inflammatory markers in patients with polycystic ovary syndrome (PCOS) were included. Data were systematically extracted, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for observational studies, the Cochrane Risk of Bias tool for randomised controlled trials (RCTs), and the ROBINS-1 tool for non-randomised controlled trials. A statistical synthesis of IL-6 levels was performed for the meta-analysis using a random-effects model in R. A total of 44 studies met the inclusion criteria for qualitative analysis and identified 94 biomarkers. The most commonly used biomarkers across the majority of studies, listed in descending order, are as follows: high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), CRP, adiponectin, IL-18, vascular endothelial growth factor (VEGF), IL-8, IL-1β, sex hormone binding globulin (SHBG), leptin, and vascular cell adhesion protein 1 (VCAM-1). Additionally, four case-control studies conducted in four countries (Taiwan, Russia, Spain, and Turkey) were included in the quantitative analysis, which involved 689 participants (PCOS group: n = 365; Control group: n = 324). The pooled mean difference (MD), calculated using the random-effects model, was 0.72 (0.47; 0.98) (p < 0.0001), indicating a significant increase in IL-6 levels among PCOS patients compared to the control group. Compared to hs-CRP, a broad marker of systemic inflammation, VCAM-1 provides a more precise measure of vascular injury, making it a strong predictor of cardiovascular complications in PCOS. Unlike adiponectin, which has anti-inflammatory and insulin-sensitising properties and is reduced in PCOS, VCAM-1 is elevated, reflecting an increased risk of vascular inflammation and cardiovascular events. Chronic low-grade inflammation plays a crucial role in PCOS, and IL-6 levels in women with PCOS were elevated. Potential markers that can be investigated to assess inflammatory status in PCOS include hs-CRP, TNFα, CRP, adiponectin, IL-18, VEGF, IL-8, iIL-1β, SHBG, leptin, and VCAM-1. The results of this review suggest that IL-6 may serve as a valuable diagnostic and prognostic marker for assessing inflammation in PCOS.

From Macro to Micro: The Rise of Nanoparticles in Endodontics

2025-09-13T10:57:59+00:00

Nanotechnology has emerged as a transformative approach in endodontics, offering innovative strategies to overcome limitations of conventional therapies. Nanoparticles—ultrafine materials sized between 1 and 100 nm—exhibit unique physicochemical and biological properties that enhance antimicrobial efficacy, bioactivity, and mechanical performance of dental materials. This review comprehensively explores diverse nanoparticles, including hydroxyapatite, titanium dioxide, graphene, chitosan, carbon nanotubes, bioactive glass, silver, and copper nanoparticles, detailing their mechanisms of action, clinical applications, and potential in endodontics. These nanomaterials demonstrate capabilities such as biofilm disruption, reactive oxygen species generation, dentinal tubule occlusion, remineralisation, mechanical reinforcement, and regenerative support. Despite their promising therapeutic potential, challenges remain regarding cytotoxicity, stability, controlled release, cost, and regulatory approval. Addressing these barriers through rigorous research and clinical trials may pave the way for nanoparticle-based interventions to become integral components of predictable, long-lasting endodontic treatment outcomes. This review provides a valuable reference for researchers and clinicians seeking to integrate nanotechnology into more effective endodontic treatments.