Medical Science: Updates and Prospects Vol. 1

Personalised Medicine: From Genomics to 3D-Printed Pharmaceuticals

Sat, 25 Oct 2025 00:00:00 +0000

Personalised medicine (PM) is a patient-specific approach to treatment that integrates genetic, epigenomic, and clinical data. PM has the potential to transform traditional medical practice by tailoring therapies to individual genetic profiles. The significant advantages and limitations must be carefully considered. Manufacturers are using drug repurposing, biomarker-driven R&D, and collaborations with diagnostics and IT sectors. Personalised medicine not only enhances therapeutic precision but also advances preventive care through polygenic risk scores and early biomarker detection. The integration of digital health tools, including wearables and telemedicine, further supports patient-specific monitoring. Real-world examples, such as FDA-approved targeted therapies and CAR-T cells, illustrate its transformative potential. Innovations such as CRISPR-based interventions, AI-driven decision support, and personalised vaccines are highlighted. Liquid biopsy, single-cell omics, artificial intelligence, and healthcare digitalisation, further supporting its implementation, are cutting-edge tools. The Quality by Design (QbD) principles for safe, consistent, and effective production of personalised 3D-printed tablets have been explained. Critical material attributes (CMAs), critical process parameters (CPPs), and critical quality attributes (CQAs) together enable regulatory-compliant manufacturing by ensuring drug dosage accuracy, content uniformity, dissolution control, and robust production conditions. Beyond treatment, it raises ethical considerations related to data privacy and equitable access. Although cost-intensive, it reduces long-term healthcare burdens by minimising adverse reactions.

The Common Open Non-mesh-based Inguinal Hernia Repair: A Review

Kumar H.R. — Sat, 25 Oct 2025 00:00:00 +0000

The open non-mesh-based inguinal hernia repairs are rarely performed now since the introduction of the Lichtenstein repair. The most common non-mesh-based inguinal hernia repairs include the Shouldice repair, the Bassini repair, and the Desarda repair. Knowledge of how to perform these procedures is important if the standard mesh-based repairs, like the Lichtenstein repair, are contraindicated. In this review, we will look at the Shouldice repair, the Bassini repair, and the Desarda repair, looking at their complications and comparing them with the mesh-based repairs.

Impact of Malocclusion on Oral Health-Related Quality of Life among Rural Adolescents in Hamirpur Block, Himachal Pradesh, India

Sat, 25 Oct 2025 00:00:00 +0000

Malocclusion is one of the three major oral diseases and may cause deterioration in oral health-related quality of life (OHRQoL). Factors affecting oral health can impact physical and economic well-being and quality of life by influencing functionality, appearance, relationships, social interactions, self-esteem and psychological health. Unlike other medical and dental conditions, malocclusion is a ‘set of dental deviations’ rather than a disease. Orthodontic treatments address these deviations from a normative standard rather than curing a pathological condition. This study aimed to examine the effect of malocclusion on OHRQoL using the Index of Orthodontic Treatment Need (IOTN) and the Oral Health Impact Profile-14 (OHIP-14) questionnaire for OHRQoL among school-going children in the Hamirpur Block of Himachal Pradesh, India. This cross-sectional study was conducted in government senior secondary schools of Hamirpur Block, Himachal Pradesh. A total of 294 students aged 12–18 participated in this study. The assessment tools used to determine the need for orthodontic treatment included the OHIP-14 questionnaire for OHRQoL and the dental health component (DHC) of the IOTN. Data were analysed using the SPSS (Statistical Package for the Social Sciences) version 23, with statistical significance defined at P < 0.05.

Of the 294 samples, the highest proportion (approximately 29%) exhibited borderline treatment needs, whereas the lowest proportion (approximately 6%) had high treatment needs. Overall, treatment needs were identified in approximately 165 individuals, accounting for approximately 56% of the total samples. Self-consciousness was the most prevalent factor, observed in 81% of the participants. The mean overall score (± SD) was 4.29 ± 5.25. Physical disability exerted the least impact (0.19 ± 0.42), whereas psychological discomfort had the most significant effect (1.51 ± 1.67). A high need for orthodontic treatment significantly impacted the participants’ overall OHRQoL score across all domains of OHIP-14. Both bivariate and multivariate analyses of OHIP-14 regarding IOTN–DHC, sex, and age group revealed a significant association between normative orthodontic treatment needs and overall OHIP-14 scores. In either analysis, boys had a statistically nonsignificant lower impact score than girls. With increasing age, the impact score for quality of life declined significantly for the 15–16 age group in multivariate analysis.

Malocclusion negatively affects OHRQoL and its various domains. Individuals with Grade 5 malocclusion (indicating a high treatment need) experience a considerable negative impact on their overall OHRQoL score across all domains of OHIP-14. Further research is needed to comprehend how the need for orthodontic treatment changes as individuals age. In future, investigations should employ standardised tools for assessing both malocclusion and OHRQoL.

End-Stage Renal Disease in a Solitary Kidney: A Complex Clinical Presentation with Multiple Systemic Complications

Vinay Singh — Sat, 25 Oct 2025 00:00:00 +0000

Background: End-stage renal disease (ESRD) represents the terminal phase of chronic kidney disease (CKD), characterised by irreversible loss of renal function requiring renal replacement therapy. Patients with a solitary functioning kidney face unique challenges when progressing to ESRD, particularly when multiple comorbidities are present.

Case Presentation: The clinical course of a 49-year-old female with ESRD and a solitary kidney who developed numerous life-threatening complications, was presented. The patient had undergone right nephrectomy two decades prior and presented with severe uremia, anuria, and multisystem involvement including hepatic dysfunction, haematological abnormalities, and cardiopulmonary complications. Despite regular hemodialysis and comprehensive medical management, she experienced recurrent pleural effusions requiring multiple interventions, along with persistent electrolyte disturbances and severe anaemia.

Clinical Findings: Laboratory investigations revealed markedly elevated serum urea (110-190 mg/dL) and creatinine (8-13 mg/dL) levels, with a glomerular filtration rate of 8 mL/min. Imaging studies demonstrated bilateral massive pleural effusions with septations, and abdominal ultrasonography showed moderate to gross ascites with splenomegaly. The patient also exhibited pancytopenia, hyperkalemia, and hemoptysis, requiring intensive multidisciplinary care.

Management and Outcome: The patient received bi-weekly to tri-weekly heparin-free hemodialysis through an arteriovenous fistula, supplemented with erythropoietin therapy and blood transfusions for refractory anaemia. Tube thoracostomy and therapeutic thoracentesis were performed repeatedly to manage recurrent pleural effusions and associated respiratory distress.

Conclusion: This case underscores the significant clinical challenges encountered in managing ESRD patients with a solitary kidney and multiple comorbidities. Early recognition of CKD, timely initiation of renal replacement therapy, aggressive management of complications, and patient education remain critical components in improving outcomes. The case highlights the importance of integrated multidisciplinary care and the need for heightened awareness regarding CKD progression in high-risk populations.

Novel Automatic Segmentation Approach for Early Brain Tumour Detection: Comparative Evaluation with AI Approaches

Sat, 25 Oct 2025 00:00:00 +0000

Background: Automatic object detection in medical images is a crucial step in the diagnostic process. The problem of detecting brain tumours at an early stage is well advanced with deep learning algorithms (DLA) such as convolutional neural networks (CNN). The issue lies in the fact that these algorithms necessitate a training phase involving a large database of several hundred images, which can be time-consuming and require complex computational infrastructure.

Objective: This study aimed to comprehensively evaluate a proposed method, which relies on an active contour algorithm, for identifying and distinguishing brain tumours in magnetic resonance images.

Methods: The proposed algorithm was tested using brain images from the BRATS Challenges 2021, specifically focusing on glioma tumours. The proposed segmentation method is made up of an active contour algorithm, an anisotropic diffusion filter for pre-processing, active contour segmentation (Chan-Vese), and morphological operations for segmentation refinement.

Results: Its performance was evaluated using various metrics, such as accuracy, precision, sensitivity, specificity, Jaccard index, Dice index, and Hausdorff distance. The proposed method exhibited higher performance measures than most classical image segmentation methods and was comparable to the deep learning methods. These results indicate its ability to detect brain tumours accurately and rapidly.

Conclusion: The results section provided both numerical and visual insights into the similarity between segmented and ground truth tumour areas. The findings of this study highlighted the potential of computer-based methods in improving brain tumour identification using magnetic resonance imaging. Future work must validate the efficacy of these segmentation approaches across different brain tumour categories and improve computing efficiency to integrate the technology into potential clinical processes.

Therapeutic Implications of the Interactions between Cancer Stem Cells and the Tumour Microenvironment

Sharmy Saimon Mano — Sat, 25 Oct 2025 00:00:00 +0000

The tumour microenvironment (TME) is composed of various cellular and non-cellular elements, including immune cells, fibroblasts, endothelial cells, mesenchymal stem cells (MSCs), extracellular matrix (ECM) components, and soluble factors such as cytokines, chemokines, and growth factors. The dynamic interaction between cancer stem cells (CSCs) and the TME is now recognised as a critical driver of tumour progression, metastasis, and therapeutic resistance. Targeting this molecular crosstalk presents a promising avenue for improving cancer treatment outcomes. This review explores the therapeutic implications of the interactions between cancer stem cells and the tumour microenvironment. CSC-derived exosomes serve as key mediators of communication with the TME, fostering tumour growth by sustaining CSC stemness, promoting angiogenesis, facilitating metastatic spread, and shaping an immunosuppressive milieu through immune modulation. Emerging evidence underscores the therapeutic potential of disrupting this supportive CSC niche, reprogramming immune responses, and blocking exosome-mediated signalling to eliminate CSCs and counteract resistance. Novel strategies such as precision stem cell therapies, personalised approaches tailored to TME characteristics, and advanced 3D tumour models or organoids are driving the development of more effective, individualised interventions. Moreover, 3D tumour models and organoids are evolving in response to treatment, identifying biomarkers of resistance, and testing new drugs designed to overcome the therapeutic barriers. MSCs in combination with immune checkpoint inhibitors have reported encouraging outcomes, including increased tumour response rates and prolonged survival in patients with certain cancers like melanoma and non-small cell lung cancer. Furthermore, combining immunotherapy with CSC-directed treatments holds promise for enhancing clinical efficacy. Sustained research into CSC–TME interactions remains essential for translating these mechanistic insights into transformative cancer therapies.

Forensic Odontology as a Public Health Tool: Integrating Identification, Safeguarding, and Data Governance

Indrapriyadharshini — Sat, 25 Oct 2025 00:00:00 +0000

Forensic odontology operates at the nexus of health systems and justice, where population-level outcomes—dignified disaster victim identification, timely safeguarding of vulnerable groups, and resilient data infrastructures—depend on how dental information is captured, curated, and interpreted. This review synthesises contemporary evidence on the public health functions of forensic odontology and delineates methodological and governance priorities for the next decade. The study explores the advances in disaster victim identification, emphasising how high-quality ante-mortem records, digital intraoral scans, cone-beam CT, and 2D–3D superimposition can accelerate reconciliations and reduce family uncertainty during mass fatality incidents. It also examines age-estimation practices, highlighting the usefulness of third-molar maturation alongside the real risk of misclassification near legal thresholds, and outlines safeguards for probabilistic reporting and multidisciplinary oversight. This study also assesses the field’s contribution to violence prevention and response, including the detection and documentation of orofacial signs of child maltreatment, intimate partner violence, and human trafficking within trauma-informed care pathways. Community-facing preparedness measures—such as standardised denture marking in long-term care—are discussed as low-cost identification adjuncts. Across domains, the review underscores three imperatives: strict validation with transparent error reporting, privacy-preserving and interoperable data systems linked to missing-person workflows, and workforce development that embeds disaster readiness and safeguarding into dental education and continuing professional development. Equity considerations run throughout, with recommendations for scalable models suited to resource-limited settings and for international collaboration to bolster surge capacity. The review concludes that forensic odontology yields measurable public health benefits when practised within evidence-based protocols and robust governance, and it cautions against techniques that lack a scientific foundation. Limitations include its narrative scope and heterogeneity in study designs and legal frameworks, which may affect generalizability.

Calcinosis Cutis as a Rare Complication of Acne Vulgaris

Qais Nouri Zghair — Sat, 25 Oct 2025 00:00:00 +0000

Introduction: Calcinosis cutis is a rare complication characterized by abnormal deposition of calcium salts in the skin and subcutaneous tissue. While acne vulgaris is a common dermatologic condition marked by comedones, papules, pustules, and nodules, its typical complications include post-inflammatory hyperpigmentation and scarring. Calcinosis cutis secondary to acne is an uncommon and underrecognized entity.

Case Presentation: We report the case of a 30-year-old woman with a longstanding history of skin-colored papules localized to the cheeks. Initially diagnosed with comedonal acne, she was treated with isotretinoin (30 mg/day) for over three months without clinical improvement. Physical examination revealed multiple firm, skin-colored papules (2–6 mm) over both cheeks. Closer inspection using a magnification lens revealed no comedones, prompting reconsideration of the diagnosis. Radiographic imaging confirmed the presence of soft tissue calcifications in the affected areas. Laboratory investigations, including serum calcium, vitamin D, parathyroid hormone, and antinuclear antibody levels, were within normal limits. The diagnosis of calcinosis cutis was established, and the patient underwent successful surgical excision of the calcium deposits under local anesthesia.

Discussion: This case highlights calcinosis cutis as an unusual yet important complication of acne vulgaris. It typically arises in areas with chronic inflammatory lesions and may mimic persistent acne clinically. Accurate diagnosis requires a combination of detailed clinical examination and imaging studies. Surgical excision remains an effective treatment in localized cases.

Conclusion: Calcinosis cutis is an uncommon complication of acne vulgaris and should be considered in patients with long-standing acne-like skin lesions and poor response to conventional anti-acne medications.

Technology Assisted Aerobic Exercise in Patients with Mild to Moderate Parkinson’s Disease: A Pilot Quality Assurance Study in a Community Setting

Nancy Byl — Sat, 25 Oct 2025 00:00:00 +0000

Background: Physical inactivity is a significant health risk, particularly in the growing population of elders with chronic neurodegenerative conditions like Parkinson’s Disease (PD).

Purpose: The primary purpose of the study was to determine if individuals with mild to moderate PD could safely achieve intense levels of exercise using novel rehabilitation technology (AlterG^R, GlideTrak_TM or the NuStepTMT5XR/Vasper) without exacerbating pain or PD signs and symptoms

Methodology: Two quality assurance studies, QA I and II, were carried out in a Health and Wellness Centre with individuals >60 years of age, of any gender, with mild to moderate PD (Hoehn and Yahr I-III). Participants in QA1 were randomly assigned to daily, intense training (5 days, 40 minutes per session, 200 minutes) on the AlterG^Ror the GlideTrak_TM, with a crossover after 3 months. In QA II, participants trained for 5 weeks, 2x/week, 20 minutes/session, 5 weeks (200minutes) on the NuStepTMT5XR/ Vasper. Mobility and balance measurements were made pre- and immediately post study:10-meter walk, Six-minute Walk, Timed Up and Go (TUG), and Five Times Sit to Stand (5XSST). Nonparametric Wilcoxon Tests were applied to test gain scores for statistical significance. At the end of the study, participants self-reported signs, symptoms, training challenges and technology preferences.

Results: In QA I, 11 participants safely completed all 5 sessions of body unweighted aerobic training on the AlterG ^R and the GlideTrak_TM without adverse effects. Nine participants achieved a target heart rate of 60-80% of age-relevant maximum, and 2 achieved >3 /10 exertion. In QA II, 9 participants safely completed the training sessions on the NuStepTMT5XR /Vasper without adverse events. Seven participants achieved the target heart rate of 60-80% of age-relevant maximum with 2 achieving >3/10 exertion level. Participants training on the Alter G^Ror the NuStepTMT5XR /Vasper made significant gains in gait speed, endurance and balance, performing at normative values. Post AlterG^R training, the participants net the minimal clinically important differences (MICD) in gait speed and endurance (0.22 m/sec and 82,2 meters). In QA II, the participants met all MCIDs for gain scores in gait speed (0.28m/sec), distance walked in 6 minutes (30.8 m) and balance (-4.1 sec TUG and – 2.9 sec 5XSST). Post study, participants self-reported mild to moderate discomfort (0.5-1.6 on a scale of 0-10), but improved energy and resilience.

Conclusion: Novel rehabilitative technology allowed participants with mild to moderate PD to exercise aerobically and improve performance without exacerbating pain or PD signs and symptoms. Participants expressed selective preferences, but recommended technology-assisted equipment to be incorporated into community fitness centres to enable patients with neurodegenerative disease to exercise safely and intensively to maintain health and wellness.