Medical Science: Recent Advances and Applications Vol. 6

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of global morbidity and mortality, with acute exacerbations frequently resulting in hospitalization and early readmissions. Traditional management approaches are reactive, focusing on in-hospital care rather than prevention. The integration of digital health technologies offers a promising strategy to enhance disease monitoring and reduce healthcare utilization.

Methods: A narrative review was conducted to evaluate the effectiveness of digital interventions in COPD management. Seventy-three studies, including systematic reviews, randomized controlled trials, and observational studies published between 2000 and 2024, were sourced from PubMed, Scopus, and the Cochrane Library. Search terms included “COPD,” “digital health,” “telemedicine,” “remote monitoring,” and “hospital readmission.” Inclusion criteria focused on English-language studies with adult populations and clinical outcomes related to hospitalization or emergency visits.

Results: Digital interventions such as telemonitoring, mobile health apps, wearable devices, and AI-driven platforms were consistently associated with reduced hospital admissions, improved symptom tracking, better medication adherence, and enhanced patient engagement. However, disparities in digital access and integration challenges persist. A major obstacle to disparities in digital access is technological literacy among both patients and healthcare professionals. Infrastructure disparities, particularly in low-resource settings, further compound the issue by hindering reliable access to the internet, devices, and technical support. In addition, the integration of digital tools with existing healthcare systems is frequently fragmented, leading to inefficiencies and reluctance among providers to adopt new workflows.

Conclusion: Digital health technologies have significant potential to transform COPD care by reducing hospitalizations and promoting proactive disease management, though equity and implementation barriers must be addressed.

Recommendations: To maximize the benefits of digital health in COPD management, healthcare systems should prioritize the integration of telemonitoring and mobile health solutions into routine care pathways. Clinicians must be trained in digital tools to support patient adherence and early detection of exacerbations. Additionally, efforts should focus on addressing digital literacy and access disparities, particularly among older adults and underserved populations. Policymakers should invest in infrastructure and reimbursement models that support the sustainable implementation of digital health interventions.

De Quervain’s Tenosynovitis is a common ailment involving inflammation of tendons in the wrist’s first dorsal compartment. The Finkelstein test is a clinical examination used in the identification of De Quervain’s tenosynovitis. When conservative treatments like splinting and NSAIDs fail, corticosteroid injections are a minimally invasive alternative. The case series includes 18 patients from Orthopaedics OPD of Sree Balaji Medical College and Hospital in the year 2023 diagnosed with De Quervain’s Tenosynovitis. All patients received Triamcinolone injections after the failure of conservative therapy. This case series highlights how triamcinolone injections provided significant and rapid symptom relief in most patients, with over 80% showing improvement. The recurrence of symptoms and adverse effects were minimal, reinforcing corticosteroid injections as an effective first-line treatment following conservative management failure. These findings support the use of corticosteroid injections as a first-line treatment after failed conservative measures, with a low risk of recurrence or complications. Further studies could help identify which patient subgroups benefit most from this treatment.

Metastatic Breast Cancer (MBC) is the leading cause of breast cancer-related death. MBC is a very devastating disease, not curable and associated with poor outcomes. The rate and site of metastasis vary significantly, but it depends mainly on the primary subtype of the tumor, age and stage of the disease. The aim of this study is to review the underlying mechanisms of MBC, evaluate current challenges in its clinical management, and discuss potential future strategies for improving patient outcomes. Metastasis of breast cancer is a multistep process with complex mechanisms. The crosstalk between disseminated tumor cells and microenvironment has been identified as a critical determinant of metastasis. The most common target organs for breast cancer metastasis are bone, lungs, liver and brain along with distant lymph nodes. Bone metastasis is the most frequent metastatic site. The 5-year survival rate is 32.6%.

Most of the patients of MBC are treated with systemic therapy that includes hormone therapy, chemotherapy, targeted therapy, or a combination of these to reduce the tumor burden, relieve the symptoms and improve survival. The focus for MBC patients should be on symptom palliation. Although chemotherapy remains the major treatment, MBC patients need additional supportive care like nutrition; psychology, nursing and palliative care services. Moreover, early detection of metastatic lesions improves the survival rate as well as the quality of life of breast cancer patients. So, there is a dire need for validated biomarkers to identify women at risk of metastasis after diagnosing primary disease. Measurement of circulating tumor DNA may be useful for this purpose. Micro RNAs (miRNAs) are also emerging as promising biomarker for metastasis of breast cancer as it has been observed to link to all stages along the cascade of MBC.

Simulation-based education offers an innovative method for replicating real-life situations with adequate realism to meet targeted learning outcomes, all while ensuring safety for both learners and patients. Originally utilized in high-risk fields such as aviation, defence and nuclear energy, simulation has now become integral to healthcare and other professional sectors. It promotes active, experiential learning through repeated practice, real-time feedback, and reflective evaluation. The objective is to highlight the importance of incorporation of Simulation-based learning strategies, to underline the types of systems available at our disposal for the same and to identify the processes involved in the path of implementation of such innovations in Medical Education. Simulators stand to impact Medical Education by improving exposure to real-life scenarios and their management among the trainees as well as they may also serve to improve the hands-on skills of the trainees while dealing with such situations in real life, ultimately improving the efficiency of healthcare delivery in terms of time and quality both. Simulators are categorised by type and fidelity, each addressing different training objectives. Successful simulation design depends on well-defined goals, authentic scenarios, integrated feedback, and alignment with curricular needs. Its implementation demands institutional commitment, educator training, and a phased approach. In conclusion, simulation strengthens skill acquisition, knowledge retention, and learner confidence within a risk-free, interactive learning environment and should be considered as an adjunct learning tool for efficient communication of medical knowledge.

It is the god given right of every human being to appear human. Face is the patient’s contact with the world and it forms the physical basis for personal recognition. In today’s appearance-conscious society, having a reasonably pleasant appearance has become almost mandatory for social acceptance. Few areas of dentistry offer more challenges to the technical skills or greater satisfaction for the successful rehabilitation of function and esthetics in the patient with gross anatomic defects and deformities of the maxillofacial region. Although remarkable advances in the surgical management of oral and facial defects, but cannot be satisfactorily repaired by plastic surgery alone. Hence, the demand for maxillofacial prosthetic devices for the rehabilitation of patients with congenital or acquired defects has intensified in recent years. This study gives an insight into the latest innovations and improvisations in the field of maxillofacial prosthodontics. Maxillofacial prosthetist normally provides appliances and devices to restore esthetics and function to the patient who cannot be restored to normal appearance or function by means of plastic reconstruction. Biocompatibility is the major prerequisite for a prosthetic material, but the prosthesis must also be easy and inexpensive to fabricate. Over the years, there has been some improvement in facial biomaterials; but still, there exists a clear need for new or improved facial materials in all clinical situations. Maxillofacial prosthetists as a part of anaplastological team can rehabilitate maxillofacial disfigurement with more comfortable, durable, and life-like prosthesis using the latest research, advancements, materials, and techniques in the field to create confidence and a sense of well‑being to the patients.

Background: Due to the increased risk of uterine rupture with prostaglandins in previous cesarean patients, its use has been discouraged as a ripening agent in previous cesarean patients. Alternatively, the Foley catheter has been studied as a cervical ripening agent in previous cesarean patients. Low-dose oxytocin has also been studied as a cervical ripening agent in women with an unscarred uterus.

Aim of the Study: The aim of the study is to compare the efficacy and safety of Foley catheters with low-dose oxytocin as a cervical ripening agent in women with previous cesarean section (CS).

Materials and Methods: A prospective randomized study was conducted on 60 women (30 per group) with previous CS with unfavorable cervix who needed induction of labor after 28 weeks. Outcomes were analyzed in terms of change in Bishop score (BS), route of delivery and complications. Statistical analysis was performed using Student’s unpaired t-test, Chi-square test, and Mann — Whitney U-test.

Results: The BS before and after ripening between the two groups was similar (P > 0.05). However, the change in BS within each group was 3.07 and 3.30 in the Foley and oxytocin groups, respectively, and this was statistically significant (P < 0.001). Vaginal delivery occurred in 20 patients (66.7%) in the Foley group and 18 patients (60%) in the oxytocin group. There were two cases of scar dehiscence in the oxytocin group and none in the Foley group. Foley has proved to be an effective as well as safe cervical ripening agent in patients with previous cesarean deliveries.

Conclusion: Both Foley and low dose oxytocin are good cervical ripening agents in previous cesarean patients. However, the two cases of scar dehiscence in the low dose oxytocin group are a concern of safety. Future studies should focus on large-scale, prospective trials evaluating the safety and efficacy of Foley catheter use in women with previous cesarean sections, specifically those meeting the eligibility criteria outlined by ACOG.

Saliva is the fluid that is always present in the human’s oral cavity. It is composed of water, mucus, mineral salts, proteins, and amylase. It assists in the lubrication of the oral cavity, mastication, swallowing, and protection of the mouth and teeth. The salivary glands make, modify, and secrete saliva. These glands may be affected by wide spectrums of pathology, ranging from developmental anomalies and inflammatory disorders which may be acute or chronic and lead to hyposalivation and xerostomia. Dry mouth affects geriatric patients but can also be seen in young people. The aim of this review is to investigate the underlying causes of dry mouth (xerostomia) and evaluate effective treatment options to improve patient outcomes. A search of English-language scientific literature from 1989 to 2025 was conducted using Google Scholar, PubMed, and Scopus. The criteria focused on reports about xerostomia, its diagnosis, effects, and treatment, with inaccessible or duplicate reports excluded. Hyposalivation can be caused by age-related changes, systemic diseases, radiotherapy, certain medications, infections, lifestyle habits, and autoimmune diseases. Each of these factors can affect saliva production and composition, leading to dry mouth symptoms. Dry mouth can be managed through endogenous approaches, like pharmaceutical or genetic modifications, and exogenous approaches, like topical saliva substitutes. Artificial saliva substitutes typically contain water, electrolytes, and other ingredients to lubricate and protect the mouth.

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia. The incidence of Left Atrial Thrombi (LAT) was significantly higher in patients with atrial fibrillation (14%) compared with patients in sinus rhythm (1%; P<0.001). Patients with AF have a fivefold higher risk of stroke. Cerebral thromboembolism is the number one cause of long-term disability and the third leading cause of death in patients with AF.

Objective: The aim of the study is to assess the effectiveness of intraoperative suture closure of the left atrial appendage in the prevention of thromboembolism.

Methods: In this study, 400 patients underwent bio-prosthetic mitral valve replacement between 2011 and 2017. Pre-operatively, they had rheumatic mitral valve disease and atrial fibrillation with controlled heart rate. The study group included 200 cases. Intra-operatively, each one had continuous suturing of margins of the mouth of the left appendage with 4/o polypropylene suture. Postoperatively, they received anticoagulants for 90 days. The control group, comprising another 200 patients, did not have such suturing of appendage. They received indefinite anticoagulants. Follow-up continued for 78 months and included clinical examination every 3 months and trans-esophageal echocardiography every year. Clinical profiles of the patients were compared using the Fisher exact test. All data were analysed using SPSS software version 11.0.

Results: Study group included 200 patients 109 (54%) females, mean age of 29 ± 2.1 years. Suturing of the margins of atrial appendage needed 4 ± 0.25 minutes to be conducted after incising the left atrium and examining the appendage. Atrial thrombi were removed from the appendage in 10 patients (5%). Postoperative thrombi or thrombo-emboli were not reported. Control group 200 patients, 101(51%) females, mean age 30 ± 1.02 years. Intra-operatively, thrombi in appendages were extracted in 8 patients (4%). Trans-esophageal echocardiography showed left appendage-thrombi in six patients (P-value 0.0001) and one case of thromboembolism was reported. Sinus rhythm was noticed for a mean period of 29 ± 3.5 hr postoperatively followed by Atrial Fibrillation among all patients.

Conclusion: Atrial Fibrillation, being a complex type of arrhythmia, is still not thoroughly understood in many patients. Intra-operative suture closure of left atrial appendage (LAA) kept patients, having atrial fibrillation, free of thromboembolic events in contradistinction to the control group. This technique is effective and reproducible. If complete LAA occlusion can safely take place in patients experiencing AF, it should be performed.

One of the biggest causes of illness and death on the globe, cancer continues to be a problem for healthcare systems. From early detection and diagnosis to treatment planning and long-term patient monitoring, recent developments in artificial intelligence (AI) and big data technologies have brought forth revolutionary possibilities in the field of cancer care. This chapter explores the pivotal role of AI and Big Data in revolutionising oncology by providing innovative, data-driven health solutions aimed at improving patient outcomes and optimising healthcare delivery.

This chapter's main goal is to give an overview of how AI and Big Data are changing cancer research, diagnosis, treatment, and patient care. It starts by providing basic information about cancer, such as its definitions, the main types (solid tumours, hematologic malignancies, and rare cancers), and statistics on incidence, survival rates, and healthcare burden as of right now. Building upon this foundation, the chapter delves into the critical sources of Big Data in oncology—such as Electronic Health Records (EHRs), genomic databases, clinical trials, and patient-reported outcomes, and addresses the challenges of integrating and managing these vast data sets. The chapter further investigates the application of AI in cancer diagnosis through advanced imaging analysis, machine learning models for early detection, and risk prediction tools. It highlights how AI facilitates personalised treatment planning by enabling genomic profiling, biomarker discovery, and the development of clinical decision support systems. Patient monitoring is also examined, showcasing the role of remote technologies, wearable devices, and telemedicine in enhancing quality of life and symptom management for cancer patients. Ethical considerations, including data privacy, algorithmic bias, and the regulatory landscape, are critically analysed to ensure responsible AI implementation. The chapter concludes with a discussion on future innovations—such as Natural Language Processing (NLP), next-generation machine learning techniques, and AI’s potential role in drug development—and presents real-world case studies demonstrating successful integration of AI and Big Data in cancer care.

The main aim of this chapter is to emphasise the transformative potential of AI and Big Data in oncology while advocating for continuous research, interdisciplinary collaboration, and a strong patient-centric approach. It calls on healthcare professionals, technologists, researchers, and policymakers to work together in harnessing these technologies for more equitable, efficient, and effective cancer care in the future.

This study underscores the critical role of selecting appropriate decalcification methods in the histopathological and molecular evaluation of mineralised tissues. A thorough understanding of the chemistry, efficacy, and biological implications of decalcifying agents is essential for guiding pathologists and researchers in making informed, application-specific decisions that preserve both diagnostic accuracy and scientific integrity. Bone, distinct among body tissues, possesses the unique capacity for self-repair and structural adaptation in response to mechanical stimuli. Its complex biochemical composition and micromorphology also enable remarkable long-term preservation, even under varied burial conditions. Bone remodelling, governed by the basic multicellular unit (BMU), involves tightly regulated interactions between osteoclasts and osteoblasts, culminating in mineralisation through the deposition of organic matrix and hydroxyapatite nucleation. The fundamental mechanisms underlying calcium removal—rapid ionic dissolution by acids versus the more controlled chelation by agents such as EDTA—highlight the trade-offs between speed and preservation. This chapter reinforces the need for context-driven decalcification strategies to support evolving histological and molecular diagnostic demands.

Background: Sickle cell disease is one of the most common inherited haemoglobin disorders in the world. It is the most prevalent haemoglobin disorder in other parts of the world, including sub-Saharan Africa, the Middle East, the Mediterranean Basin, southern India and also South America.

Aim: A local hospital preoperative transfusion guideline was developed for sickle cell disease (SCD) patients to reduce perioperative and postoperative complications. This study was conducted to evaluate the outcome of clinical practice on SCD patients undergoing surgeries at King Fahd Hospital-Jeddah.

Methods: A retrospective review of 75 SCD patients undergoing surgery at King Fahd Hospital, Jeddah, Saudi Arabia, was conducted between April 2005 and May 2010. The medical records were reviewed to define the perioperative risks and the postoperative complications in relation to the type of transfusion modality selected. The data of patients’ details, transfusion type, risk factors and postoperative outcome were expressed in tables using SPSS v18.

Results: The median age of the patient was 24 years, and 34 of them were males and 41 were females. Preoperatively, 25.3% had complete exchange transfusion (CETX), 17.3% had partial exchange transfusion (PETX), 26.7% had simple top-up transfusion (STX), and 30.7% did not require transfusion (NTX). The postoperative complications included vaso-occlusive crises (VOC) in 20%, acute chest syndrome (ACS) in 2.7%, and fever in 16% of cases. In this study, 33.3% of patients required a prolonged period of hospital stay. In the patients of this study, postoperative fever, VOC, ACS, and the length of hospital stay did not show any difference regardless of the types of transfusion modalities. However, the correlation was highly significant between the pre-operative haemoglobin (Hb) level and postoperative fever (P<0.01) and VOC (P<0.01). Interestingly, SCD patients who received hydroxyurea had fewer postoperative complications such as fever (P<0.05) and vaso-occlusive crises (P<0.05), while those who received prophylactic heparin in the postoperative period had a reduced length of hospital stay (P<0.01) and vaso-occlusive crises (P<0.01).

Conclusion: The guidelines for preoperative transfusion in SCD patients were effective in reducing the postoperative morbidity and mortality. Moreover, this guideline emphasises the operative situations where preoperative transfusion is needed and the optimum regimen is required for different surgical operations subtypes. Further recommendations are extended to ensure patient safety by providing proper hydration, oxygenation, antibiotics and anticoagulation during and after surgery.