International Journal of Medical Science and Clinical Invention
Welcome to the International Journal of Medical Science and Clinical Invention (IJMSCI). Our journal is dedicated to publishing cutting-edge research and innovative clinical advancements in the field of medical science. Our mission is to serve as a platform for researchers, clinicians, and healthcare professionals to disseminate their findings and share their expertise with the global community. IJMSCI provides a wide-ranging and interdisciplinary forum for the exchange of ideas and information in the areas of medical science, clinical practice, and invention. We publish original research articles, review articles, case reports, and short communications in all areas of medical science and clinical invention, including but not limited to, internal medicine, surgery, pediatrics, obstetrics and gynecology, dermatology, orthopedics, neurology, and oncology. At IJMSCI, we strive to maintain the highest standards of quality and rigor in our publishing process. Our editorial board comprises experts from leading medical institutions worldwide, and our peer-review process ensures that only the most relevant, novel, and impactful research is published. We welcome submissions from researchers and clinicians around the world and encourage you to share your work with us. If you have any questions or need assistance, our editorial team is here to help. Join the global community of medical science and clinical invention experts and stay ahead of the curve with IJMSCI!
Genetic Alterations in MAPK/PI3K Pathways and Their Impact on Radioiodine Therapy in Differentiated Thyroid Cancer
Differentiated thyroid cancer (DTC), primarily papillary (PTC) and follicular (FTC) subtypes, usually follows a favorable course after total or near-total thyroidectomy combined with radioactive iodine (RAI, I-131) ablation. Nevertheless, 10–15% of patients experience recurrence, distant metastases, or progression to radioiodine-refractory thyroid cancer (RAIR-TC), which represents the major cause of disease-specific mortality in DTC [1]. Such variability in treatment response strongly suggests that underlying molecular factors play a decisive role. Among these, genetic alterations in oncogenic pathways, particularly MAPK (Ras → Raf → MEK → ERK) and PI3K (PI3K → AKT → mTOR), are critical determinants of cell differentiation, invasive behavior, and iodide uptake [1]. Understanding these alterations provides a rational framework for predicting RAI failure and guiding individualized therapeutic strategies.
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Prevalence of extended-spectrum beta-lactamase genes in Acinetobacter baumannii strains isolated from nosocomial infections in Van, Türkiye
blaSHV, blaTEM and blaVEB are a group of Extended-Spectrum Beta-Lactamase enzymes (ESBLs) which are able to hydrolyze Penicillins and some cephalosporin antibiotics. The present study evaluated the frequency of ESBL genes blaSHV, blaTEM and blaVEB in Acinetobacter baumannii strains isolated from nosocomial infections to outline the importance of these genes in antibiotic resistance. One hundred Acinetobacter baumannii strains were isolated from different nosocomial infections. After antibiotic resistance evaluation with the Kirby-Bauer disc-diffusion method, the Minimum Inhibitory Concentration (MIC) of Ciprofloxacin was measured using the E-test method. Then, the ESBL producing strains were identified employing Combined Disk Methods. Finally, all isolates were evaluated with the Polymerase Chain Reaction (PCR) technique to detect the ESBL genes of interest. Out of 100 Acinetobacter baumannii isolates, 59% were ESBL positive according to the phenotypic method. The PCR assay could not detect the blaSHV and blaVEB genes in the studied isolates, but the presence of blaTEM gene was demonstrated in 42% of the strains. The high resistance tomost antibiotics, the high prevalence of ESBLs-producing strains and also a high prevalence of blaTEM gene in A. baumannii strains found in the current study gives cause for major Iran concern about nosocomial infections in Iran because of the treatment complexity of these strains. Our results highlight the need for infection control measures to prevent the spread of resistant isolates, especially in hospitals.
Acinetobacter baumannii, blaSHV, blaTEM, blaVEB, drug resistance, PCR
Effects of Dietary Supplementation with Moringa oleifera on HIV Viral Load in Adults Receiving Standard Care
HIV, antiretroviral therapy, Moringa oleifera, viral load
Avoiding Diagnostic Overshadowing: A Case Report of ACL Rupture and Concurrent Thromboembolism
Magnetic Resonance Imaging (MRI) plays an integral role in the evaluation of musculoskeletal injuries, especially in the context of acute knee injuries. However, relying solely on imaging studies and not incorporating clinical evaluation may result in missed diagnoses of other important and potentially fatal conditions. We present a case of a 45-year-old male patient with an anterior cruciate ligament (ACL) tear and meniscal tears who, upon careful clinical examination, was incidentally discovered to have deep vein thrombosis (DVT) along with bilateral pulmonary embolism (PE). This case highlights the importance of a comprehensive physical examination and evaluation in conjunction with advanced imaging techniques.
deep vein thrombosis, anterior cruciate ligament tear, pulmonary embolism, musculoskeletal imaging, clinical examination, cognitive errors.
A Single Center Experience; Therapeutic Mammoplasty and Local Perforator Flaps as An Extreme Oncoplastic Measures
Abstract Introduction: Extreme oncoplastic breast surgery involves utilizing OPBS (Oncoplastic Breast Surgery) techniques to preserve the breast in a patient who, according to many surgeons, should have a mastectomy, for example, large tumors (>5cm), multifocal / multicentric tumors in A/B cup size breast. We are reporting our early experience as a single center to assess the oncological safety and cosmetic results of intercostal perforator flap (LICAP and AICAP) and therapeutic mammoplasty as extreme OPBS measures in patients who were giving OPBS instead of the planned mastectomy at the initial surgical consultation. Method: Retrospective analysis of patients having Extreme OPBS in cases where a mastectomy would typically be recommended. Patients were included if their imaging revealed tumors larger than 40 mm or less in A/B breast Cup or if the tumors were multifocal or multicentric. Results: From October 2022 till November 2023, 20 patients underwent extreme OPBS. The tumor sizes range 0.7 cm to larger 7 cm, with a median of 4 cm. The Oncoplastic procedures for which these patients underwent includes LICAP performed in 8 patients, AICAP in 1 patient, mammoplasty in 10 patients, and bilateral donut mastopexy in 1 patient. In 20 patients, 8 underwent single stage symmetrizing procedures. All patients had axillary surgery such as SLNB (Sentinel Lymph Node Biopsy), TAD (Targeted Axillary Dissection) and ALND (Axillary Lymph Node Dissection). All margins were negative on final histopathology. Conclusion: In our data, we have shown that the indications for Extreme OPBS can be safely expanded to patients who would traditionally only be considered for mastectomy based on tumor size or multicentricity. However, longer follow-up will be investigated in the future.
IRIS-X Field Validation: Subsurface Exploration for Natural Hydrogen and Helium in Serpentinization and Radiolysis Formations – Padang Region, Indonesia
This investigation presents the comprehensive field validation of the IRIS-X (Integrated Reconnaissance and Imaging System - eXtended) platform for subsurface exploration of natural hydrogen and helium resources in serpentinization and radiolysis geological formations within the Padang region, West Sumatra, Indonesia. The system leverages proprietary nanomaterial-based detection matrices integrated with advanced metal-oxide semiconductor sensor arrays and machine learning algorithms to achieve unprecedented analytical precision in complex subsurface environments. Executed over a 14-week validation campaign across tectonically active ophiolite complexes and granitic basement formations, the deployment architecture employed a radial well configuration with central injection at 100-meter depth and peripheral capture arrays at 70-meter depth, encompassing interrogation volumes of approximately 20,000 m² per configuration. The nanomaterial platform incorporates engineered nanoparticles (10-30 nm) with tailored surface chemistry exhibiting selective affinity for target analytes through chemisorption mechanisms, achieving detection sensitivities spanning low-yield radiolytic outputs (tens of ppm) to high-concentration serpentinization regimes (thousands of ppm). Multi-modal detection capabilities integrate Surface-Enhanced Raman Scattering with femtomolar sensitivity (10⁻¹⁵ M), fluorescence spectroscopy, and electrochemical transduction to provide orthogonal validation of analytical measurements. Artificial intelligence algorithms process sensor telemetry through neural network architectures trained on synthetic datasets, executing real-time three-dimensional pathway reconstruction and volumetric resource estimation via geostatistical interpolation with Monte Carlo uncertainty quantification. Empirical results demonstrate exceptional performance metrics including 92% detection efficacy across variable lithological settings, cost reduction of 95-98% relative to conventional drilling programs, and deployment cycle compression from 6-18 months to 1-2 weeks. The system successfully quantified hydrogen concentrations from trace radiolytic signatures to elevated hydrothermal yields while maintaining measurement precision within ±5% variance across environmental gradients encompassing tropical humidity conditions (80-95%), temperature fluctuations (24-32°C), and high precipitation regimes (>2,500 mm annually). Resource quantification delineated 5-10 million m³ hydrogen accumulations with concomitant helium signatures, validated through independent geochemical correlation analysis achieving 95-98% accuracy. Environmental performance exceeded regulatory standards through zero-incident operations, minimal surface disturbance (<0.1% footprint compared to conventional methods), and biodegradable nanomaterial formulations ensuring complete environmental breakdown within predetermined degradation pathways. The platform's resilience to aqueous saturation conditions enables operation in water-logged tropical terrains where conventional surface expression methods demonstrate limited effectiveness. This technological advancement establishes new paradigms for sustainable exploration of clean energy resources, providing scalable solutions for accelerating natural hydrogen and helium discovery while maintaining superior environmental stewardship standards essential for responsible resource development in geologically complex Southeast Asian terranes.
Prostatic Abscess Caused By Staphylococcus aureus: A Clinical Case Report
Prostatic abscess is a rare complication of acute bacterial prostatitis and is most commonly caused by Enterobacteriaceae. We report on a case of prostatic abscess caused by Staphylococcus aureus and conduct a review of the literature. We present a case of S. aureus prostatic abscess that was successfully treated with a combination of antibiotic and surgical therapy. The isolate was non–multidrug-resistant, methicillin-resistant Staphylococcus aureus and was genotyped as clonal complex 5, an emerging regional clone that is trimethoprim resistant and Panton-Valentine leukocidin positive. This current case report is the first to describe the use of clindamycin step-down therapy. A literature review identified a further 39 cases of S. aureus prostatic abscesses, of which 26 were methicillin resistant. S. aureus is an uncommon cause of prostatic abscess. Optimal management includes both antibiotic therapy and surgical drainage. Our use of clindamycin as step-down therapy was guided by its excellent prostatic penetration.
Prostatic abscess, Staphylococcus aureus, MRSA, MSSA, PVL
Geocasing-Embedded AI Monitoring Systems for Enhanced Quantum Geothermal Operations in Volcanic Environments: Multi-Lithological Response Analysis and Predictive Seismic Intelligence
This publication presents a comprehensive study on the integration of artificial intelligence with volcanic monitoring systems for Enhanced Quantum Geothermal (EQG) exploration utilizing the GEIOS-KAIGEN technological framework. Our research combines real-time seismic data from geocasing-embedded nanomechanical sensors with advanced machine learning algorithms to optimize nitrogen hybrid nanofoam injection protocols in complex volcanic environments. Through controlled laboratory simulations and extensive field deployment at the Cyprus Troodos ophiolite complex, we demonstrate significant improvements in geothermal resource characterization and extraction efficiency while maintaining comprehensive volcanic stability monitoring protocols. The study encompasses diverse geological formations including ophiolites, peridotites, gabbros, sheeted dike complexes, and metamorphic derivatives within active and fossil volcanic systems. Our AI-GMS (Artificial Intelligence - Geothermal Management System) platform integrates Long Short-Term Memory (LSTM) networks, Convolutional Neural Networks (CNN), and Deep Q-Networks (DQN) for real-time optimization of multi-thread well operations and nanofoam stimulation parameters across heterogeneous lithological units. Laboratory results demonstrate exceptional performance across all tested lithologies: pillow basalts showed 340% permeability enhancement with 94.2% AI prediction accuracy, sheeted dike complexes achieved 280% permeability improvement with 91.7% prediction accuracy, gabbroic sections exhibited 410% enhancement with 96.1% accuracy, and peridotite sequences demonstrated 520% permeability increase with 89.3% prediction accuracy for serpentine mineral stability. The nitrogen hybrid nanofoam system, incorporating functionalized silica, alumina, and magnetite nanoparticles, achieved optimal stimulation with minimal seismic impact across all geological units. Field deployment results from the 18-month Cyprus Troodos operation show 39.7% average thermal extraction enhancement across the complete ophiolite sequence, with 847 monitored seismic events (M0.1-M2.3) remaining within acceptable safety parameters. The AI system maintained 99.4% uptime with 97.8% sensor survival rate in extreme temperature environments up to 180°C. Notably, ultramafic sections demonstrated 380% increase in CO₂ mineralization rates, establishing significant carbon sequestration co-benefits with 2.3 Mt CO₂ equivalent storage capacity. The geocasing-embedded sensor network, featuring 75 sensors per 100m with nanomechanical strain resolution of 10⁻⁹, fiber optic distributed temperature sensing (±0.1°C accuracy), and real-time chemical composition analysis, enabled unprecedented multi-scale process monitoring. AI algorithms achieved lithological boundary detection accuracy of 94.7% and demonstrated successful transfer learning between laboratory and field conditions with 78% performance retention. Predictive scenario modeling validated the system's capability for volcanic risk assessment, with 96.1% accuracy for structural instability detection at lithological contacts and 91.4% accuracy for serpentinization-induced volume changes. The integrated approach successfully managed complex geological processes from millisecond seismic events to months-long mineral alteration reactions across seven orders of magnitude in temporal scale. This research establishes the first comprehensive AI-enhanced monitoring framework for EQG operations in volcanic environments, demonstrating safe and efficient geothermal development in complex multi-lithological settings while providing significant environmental co-benefits through enhanced carbon sequestration. The technology enables access to previously challenging geological environments and represents a paradigm shift toward intelligent, adaptive geothermal exploration systems.
Enhanced Quantum Geothermal, AI-GMS optimization, nitrogen nanofoam stimulation, volcanic monitoring, ophiolite complex, multi-lithological systems, geocasing sensors, predictive analytics, carbon sequestration, GEIOS-KAIGEN technology
Antıbıotıc Resıstance and Genotype of Beta-Lactamase Producıng Escherichia Coli In Nosocomıal Infectıons in Van, Türkiye
Beta lactams are the most commonly used group of antimicrobials worldwide. The presence of extended-spectrum lactamases (ESBL) affects significantly the treatment of infections due to multidrug resistant strains of gram-negative bacilli. The aim of this study was to characterize the beta-lactamase resistance genes in Escherichia coli isolated from nosocomial infections in Van, Türkiye. E. coli strains were isolated from various biological samples such as urine, pus, vaginal swab, sperm, blood, spinal fluid and catheter. Isolated bacteria were submitted to eleven usual antibiotics, using disc diffusion method according to NCCLS criteria, for resistance analysis. Beta-lactamase production was determined by an acidimetric method with benzylpenicillin. Microbiological characterization of ESBL enzymes was done by double disc synergy test and the resistance genes TEM and SHV were screened by specific PCR. ESBL phenotype was detected in 29 isolates (37.5%). The most active antibiotic was imipenem (98.4% as susceptibility rate) followed by ceftriaxone (60.3%) and gentamicin (56.8%). High resistance rates were observed with amoxicillin (94.8%), ampicillin (96%) and trimethoprim/sulfamethoxazole (87.7%). The genotype TEM was predominant in ESBL and non ESBL isolates with respectively 74.4% and 82%. SHV-type beta-lactamase genes occurred in 26.1% ESBL strains and in 20.1% of non ESBL isolates. This study revealed the presence of ESBL producing Eschericiha coli in Cotonou. It demonstrated also high resistance rate to antibiotics commonly used for infections treatment. Continuous monitoring and judicious antibiotic usage are required.
Osteoradionecrosis of the Maxillofacial Region: Contemporary treatment after radiotherapy (A Literature Review)
Osteoradionecrosis (ORN), a severe and potentially deadly bone complication arising from radiation therapy in the head and neck region, is defined by exposed, irradiated bone that fails to alleviate within three months, with no signs of remaining tumor or cancer recurrence. Research into more effective, less invasive, and safer treatments for ORN is of great importance, highlighting the need for Maxillofacial surgeons and oncologists to carefully select the most suitable treatment plan based on the disease's advancement. Considering the central role of the RANKL-RANK system in the remodelling and resorbing processes of the bone, new therapies with denosumab and bisphosphonate have been used recently with promising results.
Osteoradionecrosis, Head and neck cancer, Radiotherapy, Bisphosphonates, Denosumab.
Anastomotic colonic inflammatory polyp as a cause of large bowel obstruction: a case report
We report the case of a 55-year-old male who complained of colicky abdominal pain, progressive abdominal distension,constipation and bilious vomiting, eight days after a left hemicolectomy and colo-colic anastomosis. The previous operation was for a colo-colic intussusception where a submucous lipoma was found as the lead point. Physical examination revealed a middle aged man in obvious respiratory distress, tachycardia,grossly distended abdomen and absent bowel sound .A clinical diagnosis of intestinal obstruction was made, resuscitation with intravenous fluid was commenced, nasogastric tube was passed for decompression and a Foley’s catheter was passed. Plain abdominal radiograph showed distended bowel loops mainly in the periphery and lack of bowel gas in the rectum. He underwent an emergent laparotomy.The anastomotic site was completely obstructed, it was resected, and an end colostomy was sited. Histopathology revealed inflammatory polyp.Colostomy reversal was performed a few months later .
inflammatory polyp, large bowel obstruction
Chylothorax revealing non-Hodgkin's lymphoma: a case report
Chylothorax is a rare condition resulting from the extravasation of chyle into the pleural space due to obstruction or injury of the thoracic duct or its tributaries. It has diverse etiologies, both traumatic and non-traumatic, and requires multidisciplinary management. We report the case of a 48-year-old patient, a chronic smoker with a 5-pack-year history, who presented with left-sided laterothoracic pain and stage II mMRC dyspnea of progressive onset for 2 months prior to admission. This revealed left-sided pleurisy with significant fluid accumulation and mediastinal adenopathy, with a reduced caliber of the left main bronchus. Flexible bronchoscopy revealed tumor-like infiltration of the left lingula and lower lobe, and bronchial biopsies were consistent with type B non-Hodgkin's lymphoma. The patient was started on chemotherapy according to the R-ACVBP protocol, with good radiological and clinical progress.
chylothorax, lymphoma, etiologies, traumatic, chemotherapy, management
A Rare Case of Multiple Endobronchial Hamartoma
Pulmonary hamartomas are rare benign tumors, with a prevalence of 0.25% in the general population, accounting for approximately 8% of all benign lung neoplasms. Only 10% of pulmonary hamartomas are endobronchial in location, while the rest are peripheral. We report the case of a 50-year-old woman presenting with right basal thoracic pain lasting four months, associated with exertional dyspnea and a dry cough, all occurring in a context of general health deterioration. A chest CT scan revealed a calcified mediastinal-pulmonary lesion in the right lower lobe, causing lobar atelectasis. Flexible bronchoscopy revealed a tumor mass bridging the orifice of the right lower lobe and the middle lobe bronchus (Fowler’s segment), associated with infiltrative stenosis. The diagnosis of endobronchial hamartoma was confirmed after pneumonectomy. The postoperative course was favorable, with significant clinical improvement observed after one year.
Hamartoma, endobronchial tumor, bronchoscopy, diagnosis, management
The characteristic of fusion bicuspid aortic valve in pediatric patients at Ramathibodi Hospital
Bicuspid aortic valve disease is considered a congenital condition. The severity of the disease depends on the effects on the valve, whether it is stenosis or leakage, or whether it causes aortic dilatation. The cause is related to genes and genetics causing the cusp to fuse or malfunction of commissure. The most common types are left and right coronary cusp fused (L+R). The echocardiography is considered the Golden standard equipment of imaging to rule out and classification fused especially valvular, subvalvular and supravavlular structure and complication. The search for pathology required observation of the parasternal short axis at the aortic valve level, cross section of aortic valve opening and closed was show raphe scar and coronary was identified cusp. Echocardiographic data will inform the rationale of treatment selection, patient behavior, and postoperative care. Especially the left and right coronary cusp of aortic fused was a common type. This data was similar and nearly another study in western. Therefore, cardiologist, cardio thoracic technologists or sonographer should have the knowledge and skills to analyze and diagnose bicuspid aortic valve abnormalities.
Aortic valve, Bicuspid aortic valve, Echocardiography, Pediatrics
Role of Indirect Pulp Capping In Pediatric Dentistry - A Review of the Literature
Pulp exposure of the dental pulp exists when the continuity of the dentin surrounding the pulp is broken by physical or bacterial means leading to direct communication between the pulp and the oral environment which will be managed by Indirect Pulp Therapy(IPT). IPT aims at treating deep carious lesions that are asymptomatic by removing the carious dentin that contain the majority of the microorganisms and sealing the lesion to allow pulp to regenerate tertiary dentin. The purpose of this article is to systemically review the IPT procedures, its materials and success rate by summarizing the review articles taken from Pubmed, Science direct, Scopus and other libraries.
Indirect pulp capping , Indirect pulp therapy , pulp capping materials , Calcium Hydroxide , Zinc Oxide Eugenol , Glass Ionomer Cement
Nanofat Tendon Coating (NTC) A Promising Procedure In Treatment Of Tendinopathy
Introduction Tendinopathies are complex, often multifactorial, tendon pathologies that can be treated using the NTC+PPI technique, which involves applying nano fat to the affected tendon with a blunt cannula of different measures and calibre. Methods Thirty patients with various tendinopathies (Achilles, patellar, epicondylitis, etc.) were treated with NTC and followed up for six months. Patients were evaluated using specific scales for each type of tendinopathy (VISA-A, VISA-P, PRTEE, VAS). Results The results show a significant reduction in pain and improvement in tendon function in all patients. Evaluation scale scores improved significantly between T0 and six months after the procedure (T6). Conclusions The NTC technique appears to be a promising therapeutic option for the treatment of tendinopathies, with positive clinical and imaging results and significant pain reduction. The procedure is minimally invasive and does not require rest or immobilization.
Evaluation Of KPC Positive Colistin Resistant Klebsiella pneumoniae in A Patient With Ventilator Associated Pneumonia: A Case Report And Literature Review
Klebsiella pneumoniae producing KPC-type carbapenemase causes severe nosocomial infection at a high mortality rate. Nosocomial pneumonia in particular is associated with high mortality, likely due to the unfavorable pulmonary pharmacokinetics of the antibiotics used against this agent. Therefore, early and accurate microbiological identification and susceptibility evaluation are crucial in order to optimize antibiotic therapy. We report a case of ventilator-associated pneumonia caused by colistin-resistant K. pneumoniae producing KPC-type carbapenemase treat edusing a carbapenem-sparing therapy and tailored according to the serum procalciton in concentration in order to limit the duration of antibiotic therapy.
Ventilator-associated pneumonia, Colistin-resistant KPC producing, Klebsiella pneumoniae, Intensive care unit, Drug pharmacokinetics
Is Phosphorus Supplementation Systematic in Diabetic Ketoacidosis?
Diabetic ketoacidosis (DKA) is a severe acute complication of diabetes, resulting from an insulin deficiency that leads to hyperglycemia, metabolic acidosis, and significant fluid and electrolyte losses, particularly phosphorus. This element plays a crucial role in energy metabolism and bone mineralization. Our study aims to assess the frequency of hypophosphatemia in patients with DKA, analyze the impact of phosphorus supplementation on insulin requirements, and examine its influence on the length of hospitalization in the intensive care unit. This prospective study was conducted over 12 months and included 55 cases of diabetic ketoacidosis admitted to the medical intensive care unit at CHU Ibn Rochd in Casablanca. Serum phosphate levels were measured in all patients, with a median value of 18 mg/L. Based on these levels, our sample was divided into two groups: one with normal phosphatemia and the other with hypophosphatemia. The average age of patients was 43.85 years, with a female predominance. Hypophosphatemia was observed in 56% of patients at admission, requiring systematic intravenous correction, with an average supplementation duration of 8.6 ± 5.4 days. In these patients, a significant reduction in insulin requirements was noted. The average length of hospital stay was 8.9 ± 6.1 days, with a longer stay in the hypophosphatemic group. The overall mortality rate was 29.1%. Hypophosphatemia is frequent in DKA. Its correction through phosphorus supplementation improves glycemic control and may contribute to an optimized management of patients in intensive care by reducing insulin requirements and potentially influencing the length of hospitalization.
Biomimetic Anti-Cancer Nanosystem: CRISPR-Engineered Hypertumors with Dual-Responsive Release for Targeted Tumor Vascular Disruption.
We present a novel therapeutic paradigm for cancer treatment that synergistically integrates CRISPR-Cas9 genetic engineering with dual-responsive nanotechnology. Inspired by Peto's Paradox, we developed "hypertumors" - patient-derived cancer cells genetically modified to be non-proliferative while producing anti-angiogenic factors. These cells were engineered using CRISPR-Cas9 to knock out MYC, CDK4/6 genes and express thrombospondin-1 and soluble VEGF receptors. The hypertumors were integrated into PLGA-gold Nano shell carriers with cancer-targeting ligands and a dual-responsive release system triggered by tumor microenvironment acidity (pH ~6.5) and matrix metalloproteinases. This dual-trigger approach ensures maximum precision, requiring both pH and enzyme conditions for hypertumors deployment. Our computational simulations demonstrated 92% CRISPR editing efficiency and functional hypertumors creation. The nanocarriers (420±35nm) achieved 78% hypertumor loading efficiency, 83% binding to EGFR-positive cancer cells, and precisely controlled release kinetics. Computational modeling showed 79% reduction in angiogenesis and 76% decrease in tumor spheroid volume. Predictive models project 65-70% tumor reduction after 28 days. While tested only through in silico methodologies thus far, this platform combines the specificity of genetic engineering with precise nanotechnology delivery, offering a potentially transformative approach for personalized cancer treatment.
CRISPR-Cas9 gene editing, Hypertumor engineering, Dual-responsive nanotechnology, Vascular-disrupting therapeutics, Biomimetic cancer treatment, Targeted drug delivery systems.
Unveiling Hidden Sugars: A Critical Analysis of Maltodextrin as a Polysaccharide Additive in Processed Foods and Its Health Implications
Maltodextrin, a polysaccharide derived from enzymatic hydrolysis of starch, is widely used in processed foods due to its multifunctional roles as a thickener, filler, and texturizer. Despite its seemingly innocuous classification as a complex carbohydrate, maltodextrin exhibits a high glycemic index (GI) comparable to or exceeding that of glucose, leading to rapid blood sugar spikes and potential metabolic disruptions. This characteristic, coupled with its ubiquitous use across a spectrum of consumables—from sports drinks and infant formulas to meal replacement bars—raises significant public health concerns. This paper critically examines maltodextrin’s biochemical structure, functional applications, and regulatory classification, while investigating its metabolic effects, interaction with gut microbiota, and association with chronic conditions such as insulin resistance and inflammatory bowel disease (IBD). The study synthesizes current literature and market data to highlight how maltodextrin often escapes classification as a “sugar” on nutrition labels, allowing it to remain undetected by consumers aiming to reduce sugar intake. Empirical evidence and survey results further reveal a disconnect between scientific knowledge and consumer awareness, suggesting an urgent need for improved labeling standards and public education. By integrating chemical analysis, literature review, regulatory assessment, and consumer insights, this research underscores the necessity of reevaluating maltodextrin’s role in processed foods. It also calls for the development of transparent food policies and the use of alternative low-GI polysaccharides that align with metabolic health goals.
Maltodextrin, Hidden Sugars, Processed Foods, Glycemic Index, Food Labeling, Gut Microbiota, Metabolic Health, Food Additives
Colistin- and Carbapenem-Resistant Klebsiella pneumoniae Isolated from Blood Cultures Among Neonates in a Regional Hospital in Turkey
pneumoniae is a cause for concern due to its ability to produce carbapenemases and carry multiple resistance genes, characteristics that define it as a 'difficult-to-treat' pathogen. This study aimed to perform a microbiological analysis of colistin- and carbapenem-resistant Klebsiella pneumoniae strains isolated from blood cultures of neonates in our hospital. Between January 2022 and December 2022, patients with bloodstream infections in the neonatal intensive care units (NICUs) at Van Training and Research Hospital were monitored. All isolates were identified using the Vitek II automated microbiological identification system and conventional biochemical tests. Antibiotic susceptibility and minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Polymerase chain reaction (PCR) was used to identify the resistance mechanisms of K. pneumoniae isolates. Pulsed-Field Gel Electrophoresis (PFGE) and multilocus sequence typing (MLST) were employed to determine clonal relatedness. Of the 27 neonates diagnosed with bloodstream infections, 10 were preterm and 17 were full-term infants. Confirmation using the Vitek II system identified all 27 samples as positive for K. pneumoniae isolates. Among the environmental samples, the presence of multidrug-resistant K. pneumoniae was detected in the filtered incubator water sample. Antibiotic susceptibility testing results revealed that all isolates, including the environmental one, with the exception of a single isolate, were resistant to first-generation cephalosporins, aminoglycosides, carbapenems, and colistin. K. pneumoniae strains were found to carry various resistance genes. The prioritized detection of such high-risk clones of multidrug-resistant strains, surveillance practices, and appropriate infection control programs are crucial for preventing infections and limiting their further spread into the community.
Carbapenem resistance, Colistin resistance, K. pneumoniae
Laparoscopic surgery in a Patient with a Ventriculoperitoneal Shunt: Management and care of peritoneal catheter of shunt
Ventriculoperitoneal Shunt (V.P. Shunt) surgery is common surgery routinely performed for Hydrocephalous. Patient survival is increasing day by day due to new techniques and better facilities in hospitals. Patients with VP shunt, in the long run, may suffer, from abdominal pathologies like cholecystitis, ovarian cysts, ectopic pregnancy, etc. which require Laparoscopic intervention as a procedure of choice With the advances in surgeries of cerebral shunts and the increased life span associated with them, has made the incidence of patients with VP shunts presenting with an indication for laparoscopy higher.(1,2) A few questions arise to avoid complications associated with VP Shunt.(3) Whether the pneumoperitoneum created during a laparoscopy procedure will cause retrograde diffusion of gases into the ventricles causing increased intracranial pressure and associated complications? There is still controversy regarding the safety of performing laparoscopic surgery in patients with VP shunt and potentially decreased cerebral compliance. This retrospective study is based on observations made with 12 patients operated on in the last five years. Initially, laparoscopic surgeons used to clamp or exteriorize of peritoneal VP Shunt catheter. But currently, there is no evidence to suggest that clamping of the catheter or exteriorization is necessary. So Laparoscopic procedures are not contraindicated in patients with VP Shunt only a cautious approach is required.
Safety of VP Shunt, Laparoscopic surgery, Management of peritoneal catheter
Development of a Platform in Augmented Reality for Remote Surgical Training in the Context of Health Emergencies and Environmental Disasters
In the wake of escalating health emergencies and environmental disasters, the ability to provide timely and effective surgical training has become a strategic priority for global health systems. Traditional educational models, heavily dependent on in-person mentorship and access to fully equipped clinical environments, often fail under extreme conditions. Augmented reality (AR) offers an innovative alternative by enabling immersive, interactive, and scalable remote training that can be rapidly deployed even in resource-constrained settings. This integrative review explores the current landscape of AR applications in remote surgical education, particularly emphasizing their role in emergency medicine and disaster response. Across diverse studies, AR demonstrated significant potential to enhance procedural instruction, simulate complex scenarios, and support decision-making under pressure. However, widespread adoption remains limited due to persistent barriers, including a lack of long-term validation, insufficient integration into standardized curricula, and minimal deployment in real-world emergencies. Additional challenges include ethical concerns, digital infrastructure disparities, and limited cross-cultural adaptability. This review underscores the urgency of bridging these gaps by promoting interdisciplinary innovation, policy alignment, and robust field-based research. AR represents a transformative frontier in graduate medical education—one capable of strengthening global surgical preparedness and resilience when it is most urgently needed.
augmented reality, operative surgical procedures, remote consultation, disaster medicine, emergency medical services, graduate medical education.
Splenectomy in a Patient with Idiopathic Thrombocytopenic Purpura and Critical Thrombocytopenia of 1,000/mm³: A Case Report
Chronic idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by low platelet counts due to increased destruction and impaired production. A 24-year-old male from Kashmir presented with bleeding gums, nosebleeds, petechiae, and oral ulcers. Initial evaluation revealed critical thrombocytopenia (platelets: 45,000/mm³) and positive antinuclear antibodies, consistent with ITP. Despite treatment with steroids, rituximab, and IVIg, his platelet count dropped to 1,000/mm³, necessitating laparoscopic splenectomy. A multidisciplinary approach ensured preoperative stability. The surgery, marked by controlled blood loss (350–250 mL), improved platelet counts postoperatively (75,000/mm³). This case underscores the challenges of splenectomy in severe ITP and the importance of comprehensive care.
Idiopathic thrombocytopenic purpura, Severe thrombocytopenia, Splenectomy, Multidisciplinary care, Platelet count management
Cardiac amyloidosis, as the extracellular deposition of amyloid proteins in the cardiac tissue, is associated with a high risk for thromboembolic events, with the highest risk being in those with wild-type transthyretin amyloidosis, followed by variant transthyretin and light-chain amyloidosis. The CHA2DS2-VASc score, as used traditionally to guide anticoagulation in atrial fibrillation, has been shown to be untrustworthy in this cohort as it underestimates the true thromboembolic risk. While direct oral anticoagulants (DOACs) have demonstrated a certain advantage in reducing thrombotic events compared to vitamin K antagonists (VKAs), their efficacy remains less than optimal due to the complex interplay of prothrombotic mechanisms in cardiac amyloidosis. This article presents a comprehensive literature review of anticoagulation in cardiac amyloidosis, supplemented by a case report of an 80-year-old female with wild-type transthyretin amyloidosis who, under DOAC therapy, developed acute lower limb arterial occlusion. The case reinforces the multifactorial etiology of thrombosis in cardiac amyloidosis, including left atrial enlargement, blood stasis, and amyloid-induced endothelial dysfunction. Postoperative course and challenges in anticoagulant therapy demonstrate the need for patient-specific treatment strategies. The authors underscore the distinctive thromboembolic mechanisms in transthyretin and light-chain amyloidosis and the limitations of the current therapeutic approaches. The paper concludes by calling for randomized clinical trials to create firm, evidence-based guidelines for anticoagulation therapy in this high-risk population. This research aims to close the knowledge gap and improve clinical outcomes in cardiac amyloidosis patients.
Cardiac Amyloidosis, Thromboembolism, Direct Oral Anticoagulants (DOACs), VitaminK Antagonists (VKAs), Atrial Remodeling, Anticoagulation Therapy, Amyloid Cardiomyopathy, Endothelial Dysfunction
Personality Traits as Correlates of the General Well-being of Pregnant Women
Different individuals respond to the same event differently. This study examined personality traits as correlates of general well-being of pregnant women in Benue State. An ex-post-facto design was used with 370 pregnant women sampled from three geo-political zones of Benue State, Makurdi 157(42.4%), Otukpo 123(33.2%) and Katsina-Ala 90(24.3%) through simple random sampling technique. Their age ranged between 18 and 43 years, with mean age of 1.63 and standard deviation of 0.48. Two instruments were used for data collection namely; Big Five Personality Inventory and General Well-being Questionnaire. One hypothesis was generated and tested using regression analysis. The result showed that personality traits jointly predicted the general well-being of pregnant women [F (5,327) = 3.532, P<.05], while only neuroticism positively predicted the general well-being of pregnant women (β= .138, P<.05). On the dimensions of general well-being, personality traits predicted anxiety [F (5,327) = 3.952, P<.01], self-control [F (5,327) = 2.785, P<.05], and vitality [F (5, 327) = 3.248, P<.05], but failed to predict general health [F (5,327) = 4.997, P>.05], depression [F (5,327) = 3.701, P>.05], and positive well-being [F (5,327) = 8.722, P>.05] among pregnant women in Benue State. Conclusively, pregnant women’s personal characteristics can play a role in the general well-being with neuroticism making a positive contribution in Benue State. Based on these findings, it was recommended that emotional outburst and uncontrolled impulses of women during pregnancy should be condoned for that may be a way of releasing inner tensions that might be harmful to their health.
personality traits, general well-being, pregnant, women.
Rısıng Antıbıotıc Resıstance of Klebsıella Pneumonıae: Case Report and Lıterature Revıew
Carbapenemases are being increasingly reported in Enterobacteriaceae including Klebsiella pneumoniae causing considerable increases in morbidity and mortality with limited therapeutic options. Issues related to difficulties associated with pathogen identification and infection control have been identified as major obstacles to the control of these multi-drug resistant organisms. Identification of this enzyme in organisms not previously found to harbor them has added to the already existing challenge in the control of this growing problem. The case of a 60 year-old Saudi lady with diabetes, hypertension, pituitary adenoma, hypothyroidism, and obstructive sleep apnea who was admitted in our intensive care unit following a cardiac arrest is hereby presented. During the course of her treatment she acquired various infections that led to her exposure to antimicrobials from almost all classes at various times; including bacteremia due to a pan-drug resistant Klebsiella pneumoniae and multi-drug resistant Acinetobacter baumannii. She was successfully treated with a combination of colistin and amikacin. This case highlights the resurgence of colistin in clinical practice and also calls for the need to expand our antibiogram to include antibiotics not conventionally reported, especially in areas where drug resistance is a growing problem. Improving susceptibility detection methods for Klebsiella pneumoniae and hand hygiene could prove effective in reducing nosocomial infections. Involvement of clinical pharmacists in antimicrobial stewardship could reduce the development of antimicrobial drug resistance.
Klebsiella pneumoniae, pan-drug resistance, infection, intensive care unit.
Pregnancy Outcome among Teenagers in Burgas Region
Objective: The study aims to investigate the pregnancy outcomes among teenagers in Burgas region, Bulgaria, to order to outline the factors that influence the occurrence of teenage pregnancies, number of births attributed to teenage mothers, related concomitant diseases, duration of the birth periods and mechanism of birth in adolescent. Methodology: The study focuses on adolescent patients between the ages of 10 and 18 who presented for childbirth in the time period between 2016 and 2022 in the Mulpi-profile University Hospital for Active Treatment - Burgas, Bulgaria. The focus of the questionnaire was demographic features, birth rate, comorbidities, birth mechanisms, infant anthropometric features and the operative interventions. The data that was collected and analyzed using Excel and IBM’s Statistical Package for Social Sciences (SPSS) to provide the demographic and inferential statistics related to the topic of research. Findings: A significant difference was found between the performed episiotomies (p = 0.00001) in adolescent patients (10-18) 61.77% compared to patients in the age group 20-24, where the percentage is 30.83%. The difference between the number of perineoraphys is also statistically significant (p < 0.0072), in adolescent patients (10-18) 10.58% and in patients in the age group 20-24, where the percentage of performed perineoraphys is 4.17%. A significant difference is also found in the number of Obstetrical forceps application (p=0.0654), in the group of adolescent patients (10-18) it was performed in 2.73% and in the patients in the age group 20-24 years the percentage is 0.84%. The findings show that anemia is a primary comorbidity factor for adverse pregnancy outcomes for teenagers and the control group. Conclusion: Adolescent pregnancy is a social and medical problem. Regional and national policies need to be developed for the early identification of pregnant women in the discussed age group, which would significantly reduce complications during pregnancy. The significant adverse outcomes that are directly linked to teenage pregnancies include higher rates of anemia, operative interventions and infant anthropometric anomalies as well as increased fetal complications such as fetal growth restriction and miscarriage.
adolescent pregnancy, pregnancy outcome, anemia, preeclampsia, perineoraphy, episiotomy, cesarean section
Liver Cancer Recovery through Neo Ayurveda in 3 Months: A Case Study on the Effectiveness of Dr. SM Raju’s Standardized Treatment Protocol without Allopathic Medication
This study explores the potential of the Neo Ayurveda protocol, developed by Dr. S.M. Raju, in the treatment of liver dysfunction and post-cancer recovery. A 54-year-old female patient, previously treated for breast cancer (2019–2020), developed symptoms of liver dysfunction, including elevated liver enzymes and the presence of lesions, as detected by blood tests, ultrasound, and MRI in January 2023. Given her prior negative experience with chemotherapy and radiation, she opted for an alternative treatment approach through Neo Ayurveda, which integrates Ayurvedic principles with modern scientific methods, including the use of an uncooked diet ("monkey diet"), herbal supplements, and gut health optimization via prebiotics and probiotics. The patient’s liver enzyme levels (SGOT, SGPT, Gamma GT, and Alkaline Phosphate) were monitored over the course of treatment, showing a significant reduction from elevated levels in January 2023 to normal or near-normal levels by March 2023. Specifically, SGOT reduced from 211 to 19, SGPT from 364.11 to 21, Gamma GT from 589 to 26, and Alkaline Phosphate from 310 to 108. This dramatic improvement suggests that Neo Ayurveda may play a crucial role in supporting liver recovery and overall health regeneration, even in cases of potential metastatic cancer recurrence and liver dysfunction. The underlying mechanisms of the treatment are based on the principles of detoxification, cellular regeneration, and activation of heat shock proteins (HSP60), which are responsible for proper protein folding and organ repair. The treatment also emphasizes the importance of maintaining an alkaline body environment to support optimal organ function and prevent further disease progression. This case study provides promising evidence for the efficacy of the Neo Ayurveda protocol in treating liver disorders and post-cancer complications, offering an alternative approach to traditional medical treatments. Further research is necessary to explore the full scope of Neo Ayurveda's potential in the management of liver diseases, cancer recovery, and other chronic conditions.
Copyright (c) 2024 International Journal of Medical Science and Clinical Invention https://creativecommons.org/licenses/by/4.0/
Orofacial Granulomatosis in Upper Lip : A Case Report
Introduction: In 1985 Wiesenfeld et al., suggest the terminology of “Orofacial granulomatosis (OFG)” to explain a chronic granulomatous lesion that involving the orofacial area include the lip, face and oral cavity, the histopathological examination usually associated with noncaseating granulomas and multinucleated Langhans‑type giant cells Aim of Reporting This Case: The aim of reportioning this case is highlighting the awareness of orofacial granulomatosis disease after excluding all diseases that has granulomatous lesion Case presentation: A 30-year-old male patient was referred to the oral medicine clinic due to swelling of the upper lip and redness of the gingiva. Clinical examination revealed a nodular lesion in the central area of the upper lip with a firm sensation upon palpation. Additionally, there was slight redness in the gingiva. The patient was medically fit, and our clinical differential diagnoses included Crohn’s disease, Wegener's granulomatosis, sarcoidosis, and orofacial granulomatosis. Lab tests requested for the patient included CBC, ACE, ESR, and CRP. All investigations yielded negative results.The patient was also referred to internal medicine for endoscopy.A biopsy was taken from the inner area of the upper lip under local anesthesia (1.8 mL of lidocaine with epinephrine) and sent for histopathological evaluation. The histopathology report showed non-caseating granulomas, confirming the final diagnosis of orofacial granulomatosis. Intra-lesional injection of triamcinolone acetonide (40 mg/10 mL) was initiated. At the 2-week follow-up visit, the patient reported softening of the upper lip, though the redness persisted. Conclusion: Swelling in the upper lip can have various potential causes, including Crohn’s disease, Wegener’s granulomatosis, sarcoidosis, and orofacial granulomatosis. Greater awareness of the oral manifestations of these conditions is essential for accurate diagnosis and effective treatment.