Medical Science: Updates and Prospects Vol. 9

Intraventricular Infusion Strategies for the Treatment of Alzheimer’s Disease: A Review

Terry Lichtor — Tue, 19 May 2026 00:00:00 +0000

The present study highlights about Intraventricular Infusion Strategies for the Treatment of Alzheimer’s Disease. Alzheimer’s disease is the most common neurodegenerative disorder. Currently available therapies have limited symptomatic efficacy and do not alter disease progression. Immunotherapeutic approaches using anti-Aβ antibodies injected systemically have shown some reduction in amyloid plaques but are associated with several side effects. Intraventricular delivery methods for direct intracerebral delivery of antibodies against amyloid plaques are being developed with significant therapeutic potential without the complications seen with systemic infusions. The intraventricular infusion strategy should avoid the complications observed with intravenous infusion of antibodies against Aβ which include dermatitis, pulmonary edema, allergic/anaphylactic reactions, acute renal failure, venous thrombosis and aseptic meningitis.

Adjunctive Value of Diffusion and Perfusion Permeability Metrics in Differentiating Benign and Malignant Sinonasal Tumours: A Pilot Study

Lamyaa Abdel Galil Eissa, Aya Mohammed Abdel Aziz — Tue, 19 May 2026 00:00:00 +0000

The sinonasal area is affected by a variety of benign and malignant lesions that manifest by nonspecific symptoms which can be similar for both conditions. So, differentiating between benign and malignant sinonasal tumours remains a persistent diagnostic challenge. However, CT and MRI are the primary imaging modalities for evaluating sinonasal masses. Conventional magnetic resonance imaging (MRI) possesses no distinctive role in distinguishing between benign and malignant sinonasal masses. So, advanced functional MRI imaging techniques, including diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) perfusion MRI, have provided quantitative metrics related to tissue cellularity and vascular permeability, helping in better tissue characterisation and differentiating benign from malignant masses.

This chapter aims to assess the role of combined diffusion and perfusion by T1-weighed dynamic contrast enhancement (DCE) in characterising sinonasal tumours and solving such a pivotal question, estimating the accuracy of quantitative numeric data on limited low-standard machines.

A prospective pilot study including 30 patients with sinonasal masses is presented, in which combined diffusion-derived apparent diffusion coefficients (ADCs) and perfusion-derived quantitative numeric biomarkers demonstrated statistically significant differences between benign and malignant lesions. Notably, the quantitative results were comparable to those reported from higher-end MRI systems.

The findings highlight that a combined magnetic resonance image (MRI) weighted ADC and DCE perfusion imaging package improves diagnostic confidence and accuracy in sinonasal masses characterisation and differentiation. Importantly, these techniques can be applied in the lowest cost tertiary centres. This chapter discusses the underlying imaging protocols and interpretation strategies of incorporating these advanced MRI metrics into routine sinonasal tumour evaluation.

Radon Gas as the Risk Factor of Lung Cancer in Manipur, India: A Review

Angom Ronibala Devi, B. Arunkumar Sharma, Babina Sarangthem, Y. Indibor Singh — Tue, 19 May 2026 00:00:00 +0000

Lung cancer is the second most commonly diagnosed cancer globally, with tobacco smoking as the commonest factor responsible for most cases. In India, it is the commonest cancer among men and ranks fourth in women. It has a significant disease burden in the north-eastern part of India. The incidence of lung cancer in Manipur, a northeastern state of India, is disproportionately high despite the smoking prevalence. This suggests that there could be other major contributing factors, such as environment and genetic predisposition.

This review focuses on indoor radon exposure, a naturally occurring radioactive gas linked to lung cancer. Radon, along with other carcinogens like air pollution, asbestos and arsenic, poses a significant risk for lung cancer. While tobacco smoking is the leading cause of lung cancer, indoor radon exposure is particularly concerned in non-smokers, as it is the second leading cause of lung cancer worldwide. The geological substrate on which buildings are settled, the soil composition, construction materials, ventilation and seasonal changes affect indoor radon build-up, concentrations or levels. Research has shown that prolonged exposure to indoor radon can lead to DNA damage, mutations and increase the risk for lung cancer. Studies on lung cancer in underground and uranium miners and, more recently, home-based indoor radon research have confirmed a clear link between indoor radon exposure and lung cancer risk, with no safe exposure threshold.

Manipur has high radiation levels. A study on soil radioactivity in the region had found higher-than-average Global and National levels of radium, thorium and potassium content. Building materials like sand, bricks and RCC houses in the region could have contributed to elevated indoor radon concentrations that could possibly increase lung cancer cases. This review emphasizes the need for further studies to assess the indoor radon concentrations in homes and local buildings. It advocates for public health initiatives, stricter regulations on building materials, improved ventilation in homes and workplaces to reduce indoor radon exposure and lower the lung cancer incidence. Enhanced awareness and preventive measures are crucial in addressing the growing lung cancer burden. In regions like Manipur with high radioactivity levels, awareness about indoor radon becomes very important, besides smoking. Smoking co-exposure with indoor radon is also to be emphasised for prevention and the decrease of lung cancer cases.

Proteomics and Metabolomics for the Identification of Early Diagnostic Biomarkers in a Hamster Model of Cholangiocarcinoma

Tue, 19 May 2026 00:00:00 +0000

Background: Cholangiocarcinoma (CCA) poses a significant public health challenge, particularly in northeastern Thailand, which reports the highest prevalence worldwide. Early detection and effective intervention remain difficult due to the lack of sensitive and specific biomarkers. Recent advances in proteomics and metabolomics have created new opportunities for biomarker discovery in CCA.

Aim: This study aimed to identify novel plasma proteins and metabolites as potential biomarkers for the early diagnosis of CCA.

Methods: Six-week-old male and female Syrian hamsters (100-120 g) were housed under standard environmental conditions (22 ± 3 °C, 30-70% relative humidity, 12-h light-dark cycle) with free access to standard food and water ad libitum. Plasma samples were obtained from hamsters with Opisthorchis viverrini (OV) and dimethylnitrosamine (DMN)-induced CCA, as well as from healthy controls (n=3 per group). The samples were analysed using LC-MS/MS-based proteomics and metabolomics. Fold-change analysis was conducted to quantify the differential expression of identified proteins between the CCA and control groups, with statistical significance defined as p≤0.05.

Results: Proteomic profiling identified over 5,000 proteins, of which 572 were uniquely expressed in CCA-induced hamsters at week 12. Fold-change analysis revealed 412 and 545 upregulated proteins at weeks 8 and 12, respectively, which are functionally linked to cell proliferation, signal transduction, and metabolic regulation. Concurrently, metabolomic analysis identified 273 metabolites, of which 59 were significantly upregulated in the CCA group, including cystathionine, putrescine, UDP-N-acetylglucosamine, and flavin mononucleotide (FMN).

Conclusions: This study provides preliminary insights into candidate proteomic and metabolomic biomarkers for the early detection of CCA. These findings offer a foundational hypothesis for future research. Larger longitudinal studies, including validation in human cohorts, are warranted to confirm the clinical applicability of these novel biomarkers.

Artificial Intelligence and the Future of Medical Education: A Narrative Review

Sunny Chopra, Gracy Singh — Tue, 19 May 2026 00:00:00 +0000

Artificial intelligence (AI) has begun to significantly influence various fields, with medical education being a notable example. The integration of AI in medical education represents a technological evolution and a paradigm shift in how medical knowledge is acquired, applied, and retained. AI has moved from being a specialist topic in biomedical informatics to becoming a general educational concern across undergraduate, postgraduate, and continuing medical education. This transition has accelerated since the public diffusion of large language models, but it also rests on a longer trajectory involving machine learning, clinical decision support, adaptive learning, and simulation technologies. The central educational question is no longer whether AI will affect medical education, but how medical education should respond without compromising scientific rigour, ethical standards, or the humanistic foundations of practice. This narrative review examines how AI is reshaping the aims, content, methods, and governance of medical education. It synthesises literature on AI literacy, curriculum reform, personalised learning, assessment, faculty roles, virtual patients, generative AI, and professional accountability. The review argues that the future of medical education will depend less on teaching learners to use a single tool and more on developing durable capacities: critical data and AI literacy, interpretive judgement, ethical reasoning, communication, collaborative practice with digital systems, and the ability to recognise when human oversight must prevail. At the same time, the review highlights serious risks associated with opaque models, algorithmic bias, hallucinated outputs, privacy breaches, academic misconduct, over-reliance, and unequal access to technological infrastructure. Rather than treating AI as a separate technical elective, medical education will likely need a layered approach in which foundational AI concepts, domain-specific applications, and institutional governance are integrated longitudinally. The chapter concludes that AI can strengthen medical education when deployed as an augmentation of teaching, learning, assessment, and simulation, but only if implementation is guided by educational theory, transparent evaluation, robust governance, and an explicit commitment to patient safety and professional formation.

Profiling of Circulating microRNAs to Identify Prognostic Biomarkers in Intrahepatic Cholangiocarcinoma

Wanna Chaijaroenkul, Kesara Na-Bangchang — Tue, 19 May 2026 00:00:00 +0000

Cholangiocarcinoma (CCA) poses a severe public health challenge in Southeast Asia, where alterations in microRNA (miRNA) expression drive its pathogenesis. This study utilised high-throughput Nanostring nCounter© technology to investigate serum miRNA expression profiles in 24 patients with advanced intrahepatic CCA (stratified into metastatic and non-metastatic subgroups) and 8 healthy controls. Out of 803 evaluated miRNAs, 239 showed significantly different expression levels across the groups (p<0.001). Notably, miR-302d-3p demonstrated the highest variance (p<9.02×10⁻⁷, FDR: 7.25×10⁻⁴), showing significant upregulation in metastatic CCA compared to both non-metastatic and healthy groups. While miR-320e was the most significantly upregulated miRNA overall (p<0.001), miR-223-3p, miR-23a-3p, and miR-302d-3p were also elevated in both CCA subgroups relative to controls. Conversely, miR-16-5p and miR-451a were markedly downregulated in the CCA cohorts. These findings highlight that a specific panel of circulating miRNAs could serve as valuable non-invasive diagnostic and prognostic biomarkers for intrahepatic CCA, pending further validation in larger, multi-centre studies.

Assessment and Intervention in Brachmann Cornelia de Lange Syndrome: A Tailored Approach Using the Griffiths III

Jennifer M. Jansen, Elizabeth M. Green, Louise A. Stroud — Tue, 19 May 2026 00:00:00 +0000

Background: The process of evaluation and intervention of an atypical child poses challenges in numerous developmental areas. These challenges include measures that are not normed for a clinical population, the interpretation of test scores and the use of test scores to devise a meaningful individualised intervention plan that also considers sociocultural issues affecting family functioning.

Aims: This study aims to evaluate the developmental, behavioural, and adaptive functioning of a 7-year-1-month-old girl diagnosed with Brachmann Cornelia de Lange Syndrome using the Griffiths Scales of Child Development, Third Edition (Griffiths III).

Methodology: The Griffiths Scales of Child Development, Third Edition (Griffiths III), were used to assess the child’s developmental functioning across five domains: Foundations of Learning, Language and Communication, Eye–Hand Coordination, Personal–Social–Emotional functioning, and Gross Motor skills. Behavioural functioning was assessed using the Conners 3 Parent and Teacher Rating Scales, while adaptive functioning was evaluated using the Vineland Adaptive Behaviour Scales.

Results: The Griffiths III results confirmed a pattern of global delay in all areas of her developmental functioning. The child demonstrated difficulty with the medical and behavioural manifestations of her genetic disorder that needed to be factored into the intervention strategy. The results guided the interventions of different professionals in developing an individualised intervention plan considering the above-identified challenges.

Conclusion: This study serves as a guide for determining the level of functioning of an atypical child in the context of limited normed measures for such populations. As this is a single case study, the findings are not generalizable to the broader population; further, multiple case studies may provide deeper insight into similar presentations.

Thyroid Dysfunction in Type 2 Diabetes Patients in Rajasthan, India: Prevalence and Association with Heart Rate Variability

Tue, 19 May 2026 00:00:00 +0000

Introduction: Thyroid dysfunction is common in people with diabetes, though the relationship between the two is not fully understood. Because autonomic regulation influences cardiovascular, endocrine, and metabolic function, their coexistence may worsen cardiac autonomic dysfunction and increase cardiovascular risk. Despite its importance, limited research has comprehensively explored the combined impact of diabetes mellitus and thyroid dysfunction.

Aim: The aim of this study is to determine the prevalence of thyroid dysfunction in the Rajasthan population with type 2 diabetes mellitus and to investigate its relationship with heart rate variability (HRV) characteristics.

Methods: A cross-sectional study was conducted at the Department of Physiology at RUHS CMS Jaipur, India. A total of 270 patients with type 2 diabetes mellitus attending the outpatient department were included. All participants were tested for diabetes and thyroid problems. Patients with comorbid conditions such as diabetic nephropathy, retinopathy, or other chronic neuropathic disorders were excluded. Data collection included demographic details (age, gender, ethnicity), anthropometric measurements (height, weight, BMI, waist-hip ratio), and biochemical parameters (fasting blood sugar, HbA1c, lipid profile, and thyroid profile). Heart rate variability was assessed in all participants. The acquired data were analysed using a statistical tool for social sciences (IBM SPSS version 21.0 for Windows 10).

Result: Thyroid dysfunction was present in 20% of participants, with hypothyroidism (14.81%) being more common than hyperthyroidism (5.19%). Females were more frequently affected than males. Participants with both diabetes and thyroid dysfunction showed significantly worse glycemic control, lipid profiles, and HRV parameters. A significant association was observed between thyroid status, diabetic parameters, and HRV indices.

Conclusions: The prevalence of thyroid dysfunction was 20% in this study. Hypothyroidism was more common among the study subjects than hyperthyroidism. Early screening may facilitate timely intervention. However, the study is limited by its single-centre, cross-sectional design, and further multicenter longitudinal studies are recommended.