Medical Science: Updates and Prospects Vol. 6

Demographic Patterns and Biochemical Determinants of Iron Disorders: A Retrospective Study

2026-03-14T11:23:12+00:00

Background: Disorders of iron homeostasis, including iron deficiency and iron overload, represent clinically important and biologically interconnected conditions. Iron deficiency remains the most common nutritional deficiency worldwide and a major cause of Anemia, impaired cognitive function, and adverse pregnancy outcomes. Conversely, iron overload—most commonly due to hereditary hemochromatosis or secondary causes—can lead to progressive parenchymal iron deposition, culminating in hepatic, cardiac, and endocrine complications. Real-world comparative data across the full spectrum of iron dysregulation in hospital-based populations remain limited.

Objectives: The primary objective of this study is to characterise demographic patterns and biochemical profiles of iron deficiency and iron overload and to identify independent predictors using routinely available laboratory parameters.

Methods: A retrospective study was conducted in 110 patients who underwent iron profile testing at a tertiary care centre. Patient data were extracted from the hospital’s electronic health records. Patients were categorised into iron deficiency, normal iron status, and iron overload groups using predefined cut-offs for serum ferritin, serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT). Laboratory analyses were performed in an accredited clinical laboratory using standardised automated immunoassays and spectrophotometric techniques. Group comparisons were performed using appropriate statistical tests, and multivariable logistic regression was used to identify independent predictors.

Results: Iron-deficient patients were significantly younger and more likely to be female, with markedly lower ferritin and TSAT and significantly higher TIBC (p < 0.001). The iron overload group showed significantly elevated ferritin and TSAT with a male predominance and relatively lower TIBC. Post-hoc analysis confirmed significant differences across all groups. Female sex, younger age, and higher TIBC independently predicted iron deficiency, while older age and elevated TSAT were associated with iron overload.

Conclusions: Hospital-based patients demonstrate clear demographic and biochemical stratification across iron status categories. The findings emphasise the importance of interpreting iron parameters as an integrated panel rather than in isolation. Integrated interpretation of iron indices, together with simple demographic variables, may improve early identification and risk stratification of iron dysregulation in routine clinical practice. Given the single-centre, retrospective design, future multicenter prospective studies with larger sample sizes are warranted to validate these findings and assess their clinical applicability across diverse populations.

Factors Contributing to Delayed Diagnosis of Oral Malignancies: An Observational Study

2026-03-14T11:26:10+00:00

Background: Oral malignancy is an emerging disease all over the world. Treatment failure is grave if the diagnosis is delayed in this disease, which will ultimately increase the mortality rate. This issue is more important for Bangladesh, as oral cancer is highly prevalent in this country.

Aim: This study intends to evaluate the factors contributing to the delayed diagnosis of oral malignancies. Health care seeking behaviour of the patients, their socioeconomic conditions, difficulties in the health care delivery and referral systems were assessed to identify the delay between the appearance of symptoms and seeking medical treatments.

Materials and Methods: This is an observational sociodemographic study. The study was done with a sample size of 215 cases of oral cancer patients. This observational study was conducted from 1^st August 2015 to 31^st December 2016 at Upazila Health Complex, Mirsarai, Chattogram & later at the ENT Department of Chittagong Medical College Hospital from 1^st March 2017 to 30^thApril 2018. Patients underwent thorough clinical examination; medical records were reviewed, necessary investigations were performed, and interview data were recorded using a pre-designed questionnaire.

Results: The study found that people in the age group of 55-64 years were affected most (33.95%), and the least affected age group was 25-34 yrs (1.86%). In the study, most of the patients were found in the advanced stage of oral malignancy, stage-III (31.6%). Within stage III, most patients are of age group 55-64 years. Several causes of diagnostic delay were identified. Among them, monetary issues (78%) and Ignorance or Illiteracy (69%) have been found as the most important causes. Factors contributing to delayed cancer diagnosis included the stage of the disease, delays in the referral system, tobacco use, age, gender, use of alternative medicine, social taboos, and the distance between the hospital and the patient’s residence.

Conclusion: Diagnostic delay in oral cancer is strongly influenced by socioeconomic factors, poor awareness, and delayed referral systems. Many of the causes of delay can be prevented. The authority should establish awareness among the patients and a protocol for early detection of cancer by the health professionals.

Transverse Humeral Ligament: True Ligament or Expansion from Adjacent Tendons

2026-03-14T11:28:40+00:00

The main features of the upper end of the humerus are the presence of greater and lesser tubercles, with the bicipital groove intervening between these tubercles. The bicipital groove, also known as the intertubercular sulcus, houses the tendon of the long head of the biceps brachii muscle. As per the classical description, the bicipital groove is bridged by the transverse humeral ligament. But literature search including histological studies revealed that tissue overlying the bicipital groove is not a ligament; instead, the tissue covering the bicipital groove consists of tendinous fibres from the subscapularis and supraspinatus muscles. Thus, the aim of this chapter is to establish whether the tissue bridging the bicipital groove is ligament or tendinous fibres from various muscles constituting the rotator cuff. In this chapter, data from various radiological studies consisting of MRI, including dissection and histological studies, have been expounded to validate the presence of tissue over the bicipital groove, i.e. whether it is ligament or tendinous fibers.

From Biotype to Therapy: Tailoring Periodontal Treatment

2026-03-14T11:33:22+00:00

For many years, clinicians described gingival tissue simply as “thin” or “thick.” Today, this view has expanded into the broader concept of the periodontal phenotype, which considers not only gingival thickness but also the width of keratinised tissue and the underlying bone structure. This evolution reflects growing recognition that soft tissue dimensions are not just anatomical features—they play a critical role in determining periodontal stability, aesthetic outcomes, and the risk of complications across preventive, surgical, restorative, orthodontic, and implant therapies.

Individuals with a thin phenotype are more prone to gingival recession, whether triggered by inflammation or mechanical trauma. They also face greater challenges after surgery, with marginal tissue changes and a higher chance of aesthetic compromise when restorative or implant materials show through delicate tissue. In contrast, a thick phenotype generally offers more resilience: improved resistance to recession, better wound stability, and enhanced ability to conceal restorative components.

Importantly, phenotype is not a fixed trait. Advances in mucogingival and peri-implant soft tissue augmentation now allow clinicians to increase gingival thickness and keratinised tissue dimensions, reducing risks and improving long-term stability.

This review brings together current knowledge on definitions, diagnostic methods, biological mechanisms, and clinical implications of gingival biotype and periodontal phenotype. It emphasises practical decision-making and the value of interdisciplinary planning. Evidence from clinical studies and systematic reviews supports phenotype-based personalisation, particularly in mucogingival surgery and peri-implant care, where tissue thickness strongly influences early remodelling and the stability of soft tissue outcomes. At the same time, areas where evidence remains indirect are highlighted, along with the promise of emerging digital diagnostic workflows that may help standardise phenotype assessment in everyday practice.

Drug Abuse among University and Medical College Students regarding Motivations and First Encounters: A Qualitative Study

2026-03-14T11:36:47+00:00

Background: The transition to higher education represents a critical period of vulnerability, where academic rigour and social shifts often precipitate maladaptive coping mechanisms, including substance use. Within the competitive landscape of tertiary education, students face unique stressors that may normalise self-medication and drug initiation.

Objective: To investigate the qualitative experiences, social influences, and academic pressures that contribute to the initiation and continuation of drug use among this population.

Methodology: A qualitative study was conducted at the Department of Forensic Medicine & Toxicology, Shaheed Monsur Ali Medical College, from January to July 2024. Using purposive sampling, ten students who self-reported current drug use were recruited from the Shahbag area. Data were analysed using thematic analysis to identify core drivers of substance initiation and usage patterns.

Results: Thematic analysis revealed that drug use was primarily driven by the need for coping mechanisms against chronic academic stress and anxiety. Social circles played a pivotal role in the normalisation of substances, with first encounters often triggered by peer pressure and curiosity. Furthermore, many students reported using substances for perceived cognitive enhancement, such as improved focus for long study hours, despite acknowledging the long-term negative health and social consequences. These findings suggest that the university environment and social networks act as both a gateway and a sustaining factor for drug abuse.

Conclusion: Drug initiation in this population is deeply tied to social environments and a lack of healthy coping strategies for academic rigour. Prevention programs should move beyond basic awareness and focus on robust mental health support, stress management workshops, and debunking myths regarding cognitive enhancers.

Determining the Prevalence of Molecular Subtypes of Colorectal Cancer in the Indigenous Population of Uganda: Focus on Jass Classification and Lynch Syndrome

2026-03-14T11:40:22+00:00

Introduction: Colorectal cancer is the third most common cancer and the second most common cause of cancer mortality worldwide. There are disparities in the epidemiology of colorectal cancer across different populations, most probably due to differences in exposure to lifestyle and environmental factors related to colorectal cancer. In the next decade, East Africa is predicted to face an unprecedented growth of cancers, including colorectal cancer. There are indications of a significant burden of late-stage and aggressive colorectal cancer in the Ugandan population. Survival rates in SubSaharan Africa remain poor, with Uganda registering a low 3-year overall survival of 33.3%. There is a paucity of data on colorectal cancer molecular subtypes and their characteristics among patients in East Africa.

Objective: The objective is to determine the prevalence of colorectal cancer molecular subtypes among Ugandan colorectal cancer patients.

Methodology: A descriptive cross-sectional study was conducted in two referral hospitals and two missionary hospitals in Uganda. Data was obtained on demographics, topography of tumour and stage. The histopathological subtype, grade and LVI status of CRC were obtained from H&E slides. Immunohistochemistry was carried out to determine whether PMS2 and MLH1 were MMR-deficient or proficient. CRC formalin-fixed paraffin-embedded (FFPE) tissue blocks were used to extract DNA. The MLH-1, MSH2, MSH6, BRAF and KRAS genes were sequenced using NGS sequencing, and the CIMP status was obtained using targeted NextGen Bisulphite sequencing (tNGBS). The tumour molecular subtypes were defined according to the Jass classification: Type 1: MSI positive, CIMP-positive, BRAF-mutated (positive), K-ras mutation negative; Type 2: MSS (MSI negative), CIMP-positive, BRAF-mutated (positive), Kras-mutation (negative); Type 3: MSS (MSI negative), CIMP-negative, BRAF-mutation negative, Kras mutated (positive); Type 4: MSS (MSI negative), CIMP-negative, BRAF-mutation negative, Kras-mutation negative.; Type 5: MSI positive, CIMP-negative, BRAF mutation-negative, Kras-mutation negative (Lynch syndrome). Other marker combinations were grouped together as “other category”. Categorical data were summarised using proportions and frequencies corresponding to the MSI status and each of the five molecular subtypes defined using the Jass classification. Categorical and continuous variables were analysed using the Chi-square and Fisher’s exact tests. For all the analyses, a p-value ≤0.05 was considered statistically significant.

Results: Out of 127 CRC patients, the median (IQR) age was 54(43-67) years. Advanced stage III+IV was found in 109(85.8%) cases. Poorly differentiated tumours constituted 14(11.02%), moderately differentiated 96(75.6%) and well differentiated 17(13.4%). There were 52(40.9%) MSI positive tumours and 75(59.06%) MSS tumours. The molecular subtypes defined by the Jass classification included 0% type I, 2.3% type 2, 3.3% type 3, 45.7% type 4, and 38.0% type 5 (Lynch syndrome). Colorectal cancer patients with Lynch syndrome have a pathogenic germline variant in one MMR gene and a secondary gene inactivation due to promoter hypermethylation or loss of heterozygosity.

Conclusions: Importantly, sporadic MSI-high/CIMP-high tumours (Jass type 1) were not present (0%), and BRAF/KRAS pathogenic mutations were infrequent, unlike tumours from the Western world. Many young CRC participants presented with poorly differentiated and advanced-stage tumours, with MSI-positive tumours mainly due to Lynch syndrome. Immunohistochemistry, MSI testing and colonoscopic surveillance are cheaper than germline testing, and in Uganda may be carried out on CRC patients with MSI-positive histology.

Altered Plasma and Hepatic Tissue Uric Acid Levels in Alloxan-Induced Diabetic Rats

2026-03-19T11:55:10+00:00

Background: Uric acid is a heterocyclic weak organic acid, formed during the oxidation of purine nucleotides in humans. The levels of serum uric acid (UA) alteration in human beings cause major health problems due to its pivotal role in the aetiology of many systemic diseases. Many research works in the recent past have shown elevated uric acid levels in diabetic subjects. Despite a large number of research activities, the prevalence of diabetic related complications is increasing worldwide. Some reports indicate that uric acid elevation is related to diabetic complications, whereas a few claim that uric acid elevation is also seen in pre-diabetic conditions. The reason for this elevation of uric acid and a possible role of insulin in this regard is obscure.

Aim: The aim of this study is to assess the uric acid status in alloxan diabetic rats with an attempt to establish the possible cause for uric acid elevation.

Methods: The studies were carried out on healthy male Wistar rats with a body weight of 150-180g. The rats were divided into two groups, the normal group (Group-1) and the alloxan diabetic group (Group-2), with six animals in each group. Induction of diabetes was done by administering a single intraperitoneal injection of freshly prepared aqueous solution of Alloxan Monohydrate (150mg/ Kg body weight) prepared in normal saline, to the overnight fasted rats. Rats with blood-glucose levels above 250mg/dL were considered diabetic and were employed in the study. After the stipulated period of 30 days, the animals (Group-1 and Group-2) were anaesthetised using Isoflurane and sacrificed. They were dissected immediately, and liver tissue was procured, blotted to remove blood stains, and placed in cold phosphate buffer saline (pH 7.4). Blood samples were collected using heparin as an anticoagulant. The uric acid levels in plasma, erythrocytes and liver tissue, as well as the levels of ADA in plasma and liver tissue, were estimated. Results were expressed as mean ± SD, and statistical significance was assessed using Student’s t-test.

Results: A significant (p<0.001) rise in uric acid levels in plasma, erythrocytes and liver tissue, as well as increased levels of ADA in plasma and liver tissue was observed in alloxan diabetic rats compared to normal control.

Conclusion: The increased uric acid levels noticed in alloxan diabetic rats may be due to increased catabolism of purines, as evidenced by increased activity of ADA. This study was limited by a small sample size, warranting further investigations with larger cohorts.

Survival and Complications of Impacted Teeth Versus Immediate Post-Extraction Implants: A Comparative Review

2026-03-20T11:37:13+00:00

Dental implant therapy increasingly emphasises shortening treatment time and minimising surgical morbidity while maintaining long-term biological stability and esthetic integration. Two approaches that aim to reduce or avoid extensive hard-tissue surgery are (i) implant placement through impacted teeth or retained dental tissues (hereafter, “transdental” placement) and (ii) immediate post-extraction implant placement in fresh sockets. Implant placement through impacted teeth generally describes preparing an osteotomy that passes through the enamel and/or dentin of an impacted tooth that remains in situ, followed by insertion of an implant along that trajectory. On the other hand, immediate implant placement refers to inserting an implant into a fresh extraction socket during the same surgical session as tooth removal. Although both strategies may reduce the number of surgical stages compared with conventional delayed placement, they arise from different clinical problems: transdental placement is typically considered when an impacted tooth obstructs the ideal implant trajectory and surgical removal would create substantial defects, whereas immediate placement addresses replacement of a failing or hopeless tooth at the time of extraction.

This narrative review synthesises contemporary evidence on survival, marginal bone loss, and complications for each approach, and interprets these outcomes through a biological and risk-management lens. A structured literature search was conducted on major biomedical databases using predefined keywords related to transdental and immediate implant placement. Current human data indicate that implants placed through impacted teeth can achieve high short- to medium-term stability in carefully selected cases, but the evidence base remains dominated by small case series and heterogeneous follow-up. Immediate post-extraction implants demonstrate high overall survival in systematic reviews and randomised trials, though slightly lower survival than delayed protocols have been reported in some meta-analyses, and esthetic complications remain a key concern in thin phenotypes or compromised sockets.

Across both approaches, outcomes appear highly dependent on case selection, meticulous imaging-based planning, primary stability, infection control, and soft-tissue management. Robust comparative studies with standardised radiographic and patient-reported outcomes are needed before transdental placement can be recommended beyond narrowly defined indications. A significant research gap exists in the transdental field due to the absence of well-designed prospective trials, standardised outcome reporting, and long-term comparative data. Future research should prioritise prospective multicentre studies and registries with standardised reporting of implant systems, surgical protocols, radiographic assessment methods, and patient-reported outcomes to enable meaningful comparison and evidence-based clinical recommendations. Standardisation of outcomes is also recommended.

Implementing Healthcare Information Systems in Developing Countries: Challenges and Lessons Learned

2026-03-23T12:08:01+00:00

Information systems (IS) have permeated every facet of life, including healthcare. While developed nations efficiently employ information systems in healthcare, developing countries face significant challenges. In many developing countries, sustainable Healthcare Information Systems (HIS) are constrained by weak policies and outdated technologies. In Bangladesh, fragmented and largely non-digital health records continue to limit access to effective care. Evidence shows that standardised hospital information systems can improve patient management and allow healthcare providers to serve more patients efficiently. This study reviews the main barriers to HIS implementation in developing countries using a systematic literature review (SLR). Relevant studies were drawn from IEEE Xplore, EBSCO, and ScienceDirect. From an initial pool of 4,014 papers, 11 studies were selected through rigorous inclusion and exclusion criteria. The review identifies 24 key barriers to HIS adoption, grouped into six categories: limited funding, poor infrastructure, low education and awareness, cultural and political constraints, resistance to change, and weak system quality. The study concludes that addressing these barriers is a complex, long-term process often compounded by limited research in developing countries. To overcome these barriers and promote the effective adoption of IS in healthcare, the study recommends focusing on improving infrastructure, securing funding, enhancing training, ensuring system quality, addressing cultural barriers, managing resistance, planning long-term, fostering collaboration, leveraging data-driven decisions, and building local capacity. The journey towards effective HIS implementation in developing countries is marked by complex challenges, but this study highlights critical areas for intervention. Future research and collaborative efforts are crucial to bridging the healthcare technology gap and ultimately improving healthcare outcomes for the populations of these countries.

Critical Success Factors in the Implementation of Healthcare Information Systems in Developing Countries

2026-03-23T12:15:51+00:00

Many developing countries face persistent barriers to implementing healthcare information systems (HIS). Weak regulatory frameworks and outdated digital infrastructure remain key challenges. Bangladesh illustrates this situation, where fragmented services and limited electronic patient records reduce access to quality healthcare. Evidence suggests that standardised hospital information systems can improve patient management and service efficiency. However, successful adoption requires strong institutional and policy support. This chapter synthesises the critical factors influencing HIS implementation in developing country contexts. It draws on a systematic literature review grounded in information systems research. Eight core studies were identified from IEEE Xplore, EBSCO, and ScienceDirect following rigorous screening of 4,014 records. Twelve success factors emerged and were grouped into four policy-relevant themes. Effective resource allocation and governance capacity were identified as the most decisive factors for sustainable HIS implementation.

Unusual Presentation of Solitary Fibrous Tumour Prostate: A Case Report

2026-03-25T09:44:27+00:00

Background: Solitary fibrous tumour (SFT) is a rare mesenchymal neoplasm of fibroblastic differentiation, characterised by unpredictable biological behaviour. While SFTs are most commonly present in the fifth and sixth decades of life, they are frequently diagnosed incidentally.

Aim: This study aims to report and describe a rare case of a solitary fibrous tumour (SFT) involving the prostate/pelvic region, highlighting its clinical presentation, diagnostic process, surgical management, and patient outcome.

Case Presentation: A 57-year-old gentleman presented with lower abdominal pain and difficulty in passing urine for six months, and the examination revealed a suprapubic hard mass, which was bimanually palpable. A guided core biopsy from the prostate revealed a high-grade spindle cell neoplasm. The patient subsequently underwent resection of the pelvic tumour along with prostatectomy and permanent suprapubic cystostomy. Postoperative histology confirmed the preoperative diagnosis, and the patient completed adjuvant radiotherapy. He has been disease-free for the last 30 months.

Conclusion: SFTs typically arise from the pleura and are often pedunculated, representing about 30% of cases; other commonly affected areas include the meninges (27%), the abdominal cavity (20%), the trunk (10%), the extremities (8%), and the head and neck (5%). Due to their nonspecific clinical presentation, SFTs can be difficult to diagnose, but they are treatable when detected early. Surgical management of SFTs is similar to that of most soft tissue sarcomas, with a goal of wide resection margins and preservation of any critical surrounding organs. It is highly variable based on the location and involved structures. A multidisciplinary team approach with surgeons experienced in sarcoma surgery is recommended for the treatment and management of these tumours.

Biophotonic Therapy on Hematologic Parameters in Diabetes

2026-03-25T09:48:39+00:00

In diabetic patients, haematological alterations are associated with the production of reactive oxygen species (ROS) as a consequence of long-term hyperglycemia. This chapter examines the beneficial effects of biophotonic therapy on hematologic parameters, with particular emphasis on its relevance to diabetes management. Sunlight, a primary natural source of photonic energy, has historically been associated with healing processes, including relief from infections, support of wound repair, and enhancement of general vitality. Although the molecular mechanisms underlying photon-mediated therapies remain incompletely defined, emerging evidence suggests that UV-derived light can modulate immune responses, inhibit microbial replication, and improve peripheral tissue oxygenation. The complex immunologic effects of UV exposure include both vitamin D–mediated immune support and, in excessive doses, immunosuppressive changes accompanied by DNA damage. Notably, biophotonic interventions have been linked to reductions in HbA1c concentrations, representing a potentially significant advance in diabetic care. These effects may stem from the photodissociation of oxygen from oxyhemoglobin, resulting in enhanced oxygen availability and improved tissue regeneration. Collectively, the chapter highlights the therapeutic promise of biophotonic approaches as adjunctive strategies for improving hematologic function and metabolic outcomes in individuals with diabetes.