Scripta Medica

Phytochemical Profiling and Antioxidant Assessment of Indian Cymbalaria Muralis Extracts

2026-02-28T10:59:46+01:00

Background/aim: Cymbalaria muralis (ivy-leaved toadflax) is a small creeping plant native to Europe, South Africa and some regions of India. Indian Cymbalaria muralis is recognised as a plant of traditional importance, but scientific literature available for its pharmacological activities as well as its bioactive constituents is very limited, hence this plant draws more attention for research. Aim of this study was to access phytochemical profile and potential antioxidative potential.

Methods: Phytochemical profiling of Indian Cymbalaria muralis methanolic (CMME) and aqueous extract (CMAE) was carried using gas chromatography-mass spectrometry (GC-MS) and liquid chromatography–tandem mass spectrometry (LC-MS/MS) techniques and LC-MS/MS techniques. In addition to determining total phenolic content (TPC) and total flavonoid content (TFC), antioxidant activity of both extracts was evaluated using DPPH radical scavenging method.

Results: The GC-MS spectrum of CMME and CMAE showed a presence of 52 compounds (86 peaks) and 8 compounds (11 peaks) respectively with majority of compounds corresponding to fatty acids or lipids. LC-MS/MS studies further confirmed the presence of some anticipated compounds, namely apigenin, luteolin, chrysoeriol 7-glucosides, 7-glucuronides, apigenin 7-O-glucoside, chrysoeriol 7-rutinosides, diosmin, catapol, linarin, glucosyringic, 8-epimuraloside and 8-epiloganic acid with discovery of 3 novel metabolites namely harpagide, aucubin and actinidine. The total phenolic content (TPC) was found to be 91.33 ± 0.67 mg/g (CMME) and 68.75 ± 0.65 mg/g (CMAE), total flavonoid content (TFC) in CMME and CMMA was 30.16 ± 0.15 mg/g and 10.04 ± 0.17 mg/g respectively. In DPPH radical scavenging activity, CMME was found as better antioxidant (IC₅₀-40.82 g/mL) in comparison to CMAE (IC₅₀-75.20 g/mL).

Conclusion: The Indian Cymbalaria muralis exhibited remarkable antioxidant activity and rich phytochemical profile.

The Phytochemical Screening of Ethanolic Extract of Kopasanda (Chromolaena Odorata (L) RM King and H Rob) Leaves and Its Anti-Hyperglycaemic Activity in the Mouse Model Of Hyperglycaemia

2026-02-28T10:59:46+01:00

Background/Aim: Hyperglycaemia is a defining feature of diabetes mellitus, a chronic metabolic disorder. Complications of diabetes mellitus may include vascular issues both macrovascular and microvascular as well as nervous system abnormalities or neuropathy. The herb “Kopasanda” (Chromolaena odorata (L)) has been shown to reduce blood glucose levels. This study aimed to investigate the antihyperglycaemic potential of ethanol-extracted Kopasanda leaves in male mice induced with oral glucose. Phytochemical screening was conducted to confirm the presence of bioactive constituents by identifying secondary metabolites.

Methods: The test animals were randomly divided into five groups. Three groups were administered ethanol extract of C odorata leaves at doses of 5, 10 and 20 mg/kg body weight (bw) orally. The positive control group received glibenclamide (0.013 mg/kg bw), while the negative control group was given a 0.5 % w/v CMC solution at a dose of 2.5 mL/kg body weight orally.

Results: Administration of the ethanol leaf extract at a dose of 5 mg/kg bw resulted in a significant 55.21 % reduction in blood glucose levels. A 38.24 % decrease was observed in the group receiving 10 mg/kg bw while a notable reduction was also recorded at the 20 mg/kg. These findings were statistically significant compared to the negative control (p < 0.05).

Conclusion: Phytochemical analysis confirmed the presence of alkaloids, flavonoids, saponins and tannins in the ethanol extract of C odorata L leaves. The extract demonstrated notable antihyperglycaemic effects.

Integrative Analysis of VEGFA Gene Expression and Drug Targeting in Kidney Renal Clear Cell Carcinoma (KIRC)

2026-02-28T10:59:47+01:00

Background/Aim: Vascular endothelial growth factor A (VEGFA) plays an important role in angiogenesis and is known to have a strong association with the development of various types of cancer, including kidney renal clear cell carcinoma (KIRC). The purpose of this study was to analyse VEGFA expression in KIRC tissue, identify genes that have high expression correlation and explore the therapeutic potential of VEGFA through the identification of drugs that target it.

Methods: This study used a public data-based bioinformatics approach to evaluate VEGFA gene expression, identify genes that have similar expression patterns (co-expression) with it and examine the potential of drugs targeting VEGFA in KIRC. Data and analysis were obtained from various trusted databases, namely UALCAN, GEPIA, TCGA, TISIDB and DrugBank.

Results: VEGFA was found to be significantly higher expressed in KIRC tissue compared to normal tissue. Ten genes showed high expression correlation with VEGFA, namely RP1-261G23.7, FLT1, ZNF395, COL23A1, RP11-255M6.1, PLVAP, EXOC3L2, ESM1, EGLN3 and HIF1A-AS2. In addition, VEGFA is known to be the target of various therapeutic agents such as ranibizumab, VEGF-AS, bevasiranib, gliclazide, SNS-032, denibulin, aflibercept, ABT-510, dalteparin and chondroitin sulphate, most of which have a mechanism of action in inhibiting angiogenesis.

Conclusion: VEGFA has the potential to be an important biomarker and therapeutic target in KIRC. The combination of gene expression analysis and drug data confirms the strategic value of VEGFA in the development of more effective antiangiogenic therapies.

Oolong Tea-Derived Manganese Nanoparticles as an Alternative Oral Negative Contrast Agent for MRCP Imaging

2026-02-28T10:59:47+01:00

Background/Aim: Conventional natural manganese contrast agent for magnetic resonance cholangiopancreatography (MRCP) have produced suboptimal visualisation of the gastric, duodenum and biliary system. While various studies have explored manganese-based media, limited research has focused on manganese nanoparticles (Mn-NPs). This study investigated oolong tea-derived Mn-NPs as a potential alternative oral contrast agent for MRCP imaging, aiming to enhance image clarity while minimising neurotoxic effects in healthy volunteers.

Methods: A true experimental approach with a pre-test and post-test control group setup was employed, involving thirty healthy volunteers divided into three groups: (K1) Mn-NPs derived from oolong tea, (K2) manganese extracted from oolong tea and (K3) standard manganese chloride. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and blood levels of IL-1β and TNF-α were assessed pre- and post-contrast administration for efficacy and neurotoxicity.

Results: The extracted Mn-NPs of oolong tea decreased signal strength in the stomach (3.40 %) and the duodenum (1.60 %), while increasing signal blockage in the gallbladder (0.80 %), cystic duct (4.40 %), common hepatic duct (13.80 %), intrahepatic duct (4.10 %), common bile duct (4.10 %) and pancreatic duct (3.10 %). These results outperformed those of standard contrast agent and manganese sourced from oolong tea. IL-1β (3.24 pg/mL) and TNF-α (6.9 pg/mL) levels showed no neurotoxic effects. Mn-NPs from oolong tea showed superior imaging performance. This is due to their long residence time and stronger magnetic properties. The anti-inflammatory compounds in oolong tea likely contributed to the stable cytokine levels observed, indicating a good safety profile. In addition, integration with the FIESTA MRI suite further enhances image contrast.

Conclusion: Mn-NPs prepared from oolong tea can be used instead of traditional contrast agent in MRCP examinations. They provide better image quality and do not harm the brain.

Gene Variants That May Enhance the Effectiveness of Non-Hodgkin Lymphoma Therapy: Genomic and Bioinformatics Approaches

2026-02-28T10:59:47+01:00

Background/Aim: Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system with a high incidence rate globally. Patient responses to therapies such as chemotherapy and immunotherapy often vary, which is thought to be related to individual genetic differences. The development of genomic and bioinformatic technologies allows the identification of gene variants that play a role in the effectiveness of therapy, thus opening up opportunities for personalised treatment of NHL. This study aimed to identify genetic variants that have the potential to improve the effectiveness of therapy in NHL patients.

Methods: This study used a bioinformatics approach to analyse genetic and clinical data available in several database sources, including PharmGKB, Haploreg v4.2, GTEx Portal and Ensembl.

Results: This study identified two significant genetic variants, rs396991 in the FCGR3A gene and rs3957357 in the GSTA1 gene, that play a role in improving the effectiveness of NHL therapy. The rs396991 variant showed increased affinity to IgG1 and effectiveness of antibody-dependent cellular cytotoxicity (ADCC) mechanism in rituximab therapy. Meanwhile, the rs3957357 variant in GSTA1 was associated with better event-free survival in patients receiving R-CHOP chemotherapy. High expression of FCGR3A gene in immune tissues and GSTA1 gene in liver also reinforced its biological role in therapy response.

Conclusions: Genetic variations in FCGR3A (rs396991) and GSTA1 (rs3957357) have potential as predictive biomarkers of R-CHOP therapy effectiveness in NHL patients. These findings support the application of genetic analysis as a basis for more personalised and effective therapeutic strategies in the treatment of NHL.

The Development of Polyclonal Antibody Against Glucose-6-Phosphate Dehydrogenase (G6PD) for G6PD Deficiency Newborn Screening in Indonesia

2026-02-28T10:59:47+01:00

Background/Aim: Glucose-6-phosphate dehydrogenase (G6PD) deficiency, an enzymatic disorder affecting carbohydrate metabolism, is a common cause of haemolytic anaemia and jaundice in newborns. Despite the proven benefits of G6PD screening, Indonesia faces significant challenges in implementing nationwide programs. Standard screening via dried blood spot (DBS) samples has limitations, prompting the need for improved diagnostic methods. This study aimed to develop a more sensitive and accessible screening method by creating polyclonal antibodies against G6PD.

Methods: G6PD protein was isolated from newborn cord blood and confirmed using western blot analysis. The rabbits were immunised with purified G6PD antigen. The polyclonal antibody with the highest titre was purified by SAS method.

Results: Western blotting confirmed the presence of G6PD at approximately 56 kDa in the isolated protein fraction. Immunised rabbits showed a significant increase in antibody titre compared with the control group. This research successfully isolated G6PD and produced polyclonal antibodies against it. However, further work is required to fully characterise the antibody and evaluate its suitability for G6PD deficiency screening. This antibody development holds promise for creating a dipstick kit for G6PD deficiency screening, thus overcoming the limitations of the DBS method. Colloidal gold-based immunochromatographic strips could be a suitable platform for such a kit due to their ease of use and rapid results.

Conclusion: Presented findings constitute a solid foundation for introducing a novel immunochemical reagent and developing a rapidly scalable protocol for producing G6PD-specific antibodies.

Functional Outcome of Hooked/Locked Patellar Plate Versus Tension Band Wiring in Treatment of Patellar Fractures: A Comparative Case Series

2026-02-28T10:59:48+01:00

Background/Aim: Patella fractures significantly compromise the knee joint function and usually require surgical fixation to restore the knee extensor mechanism. Tension band wiring (TBW) and locked patellar plate (LPP) are widely used surgical methods for the fixation of these fractures. With in 12-months post-surgery functional outcome using Lysholm knee score (LKS) as primary outcome and visual analog score (VAS) were compared, degree of knew flexion, complication and radiographic union as a secondary outcome.

Methods: Prospective comparative case series consecutively enrolled 24 patients with patella fractures allocated by chosen fixation method into: TBW (12/24) group and hooked part of the locked patellar plate (H/LPP) group (12/24). Patients’ demographics, fractures criteria, 12-months LKS and 12-month VAS were recorded in addition to other secondary parameters (operative time, radiographic union, complication).

Results. At 1-year follow-up, mean LKS was significantly higher in H/LPP group vs TBW group (89.4 ± 4.8 vs 79.2 ± 6.5; p = 0.0016). The VAS scores were lower in H/LPP than TBW group (1.8 ± 0.9 vs 3.1 ± 1.2; p = 0.0042). Radiographic union time showed trend in H/LPP vs TBW group (10.3 ± 1.5 vs 11.2 ± 1.8 weeks; p = 0.125). Complications occurred in 4 (33.3 %) of TBW group (one wire breakage, 2 patients with k-wire prominence and superficial infection) but only one patient (8.3 %) had implant related discomfort as a complication which resolved spontaneously was seen in LPP group, p = 0.093.

Conclusion: H/LPP fixation demonstrates superior functional outcomes, lower pain scores and fewer complications compared to TBW in the treatment of patella fractures, making it a recommendable option for patellar fracture management.

Feasibility of Pulmonary Valve Balloon Dilation as Palliative Procedure in Children With Symptomatic Tetralogy of Fallot

2026-02-28T10:59:48+01:00

Background/Aim: Tetralogy of Fallot (TOF) is the most prevalent cyanotic congenital heart disease, for which surgical correction remains the definitive treatment. Balloon dilatation of the pulmonary artery provides recognised immediate palliative benefits in selected TOF patients. Nonetheless, optimal patient selection and midterm outcomes remain subjects of ongoing debate. This study aimed to assess midterm results following pulmonary valvoplasty at 6 months period in children with TOF focusing on defining factors that affect response to palliative therapy.

Methods: A retrospective study assessed 25 children with TOF who underwent transcatheter balloon dilatation of pulmonary valve over 5 years period. Three parameters were used to assess the palliative effect of the procedure including: oxygen saturation, pulmonary artery size and body weight, all of which measured before and 6-month post Cath. Besides, the effect of patients age, sex and presentation on palliative effects was done.

Results: Of the 25 children who subjected to palliative procedure, three patients died within 24 hours. At 6 months follow-up remnant 22 children demonstrate significant improvements in oxygen saturation, pulmonary size and body weight (p < 0.001). Children older than one year had significantly higher weight and pulmonary size than infants (p = 0.002, p = 0.001), respectively. Children with spells and cerebrovascular accident (CVA) had significantly higher weight than those with spells only (p = 0.040).

Conclusion: Transcatheter balloon valvuloplasty is an effective palliative intervention for children with TOF with excellent midterm outcomes for those who survived the first day. Older children and presentation with CVA indicated higher response.

Regulatory Effects of Chromium Picolinate and Phytochemicals on Blood Glucose via AMPK Pathway Activation

2026-02-28T10:59:48+01:00

The study examines the scientific work and clinical reports to emphasise the roles of Brassica juncea in glucose metabolism and glycogen synthesis, Gymnema sylvestre in insulin secretion and beta-cell regeneration and chromium picolinate in chromodulin synthesis and insulin receptor activation. Additionally, focus was placed on their combined ability to aggregate AMP-activated protein kinase (AMPK) signalling pathway, which play major role in insulin sensitivity and cellular energy homeostasis. By promoting glucose metabolism, chromium picolinate improves insulin sensitivity. By boosting insulin release and decreasing glucose absorption, Gymnema sylvestre helps manage diabetes. Glycogen production and enzyme activation are two ways that Brassica juncea aids in blood sugar management. When combined, these compounds enhance glucose absorption and decrease gluconeogenesis by activating the AMPK pathway. These synthetic and natural substances present encouraging diabetic treatment approaches. When combined with dietary changes, they can improve the effectiveness of treatment. Clarifying their mechanisms and improving their therapeutic uses should be the main goals of future studies.

Pharmacotherapeutic Strategies in High-Risk Pregnancy: Balancing Maternal and Foetal Safety

2026-02-28T10:59:48+01:00

Pharmacotherapy in high-risk pregnancies necessitates customised, evidence-based strategies to provide optimal results for women and their infants. A keen awareness that physiological changes during pregnancy can affect medication pharmacokinetics necessitates careful consideration of dose and therapeutic selection to reduce teratogenic risk without compromising treatment efficacy. Likewise, non-obstetric problems such as hypertension in pregnancy, gestational diabetes, auto-immune disorders and infections necessitate immediate medical intervention according to safety classifications and evolving labelling systems. Multidisciplinary care involving obstetricians, pharmacists, subspecialists and mental health professionals is crucial for managing the intricate relationships between maternal comorbidities and foetal development. Moreover, emerging domains including pharmacogenomics, placental-drug-delivery and diversity in clinical trials are further transforming the future of perinatal pharmacotherapy. This article aimed to examine the role of pharmacotherapy in high-risk pregnancies, emphasising the contemporary paradigm of safe drug use, collaboration within a multidisciplinary framework and prospective advancements to optimise maternal and foetal health outcomes. The personalised, evidence-based pharmacotherapeutic approach that improves high-risk pregnancy outcomes is based on body modifications, safe medication use, multidisciplinary approaches and advances in pharmacogenomics and placenta-targeted therapies.

An Insight into Skincare and Antiaging Products Derived from Marine Origin

2026-02-28T10:59:49+01:00

Marine resources are attracting significant attention from the cosmetics sector as a source of active ingredients. The oligo-elements like iron, copper and zinc, as well as proteins, amino acids, carbohydrates and vitamins A, B and C, are abundant in both micro- and macro-algae. These active components provide a range of benefits including hydration, firmness, shine, protection and slimming effects. Marine life is found in a variety of environments, each offering unique compounds with beneficial properties. Organisms living in places with high UV radiation levels, like tropical regions or shallow seas, can create compounds that provide photoprotection. Similarly, microbes that thrive in extreme conditions, such as hydrothermal vents, can produce substances with antioxidant properties. Polysaccharides from marine algae, such as alginate and carrageenan have been developed as cosmetics owing to their moisturising and skin-barrier enhancing properties. The scientific community believe that harnessing the potential of marine bioactive compounds is highly beneficial as medicinal products. By exploiting these resources, the skincare industry can develop innovative medicinal products that promote healthy, youthful skin while supporting environmental sustainability. In the present review, we have discussed the compounds derived from marine sources and their skin-nourishing properties marine-derived compounds, emphasising their role in developing novel skincare and antiaging products.

Effects of Amino Acids and Their Mechanisms in Alzheimer’s Disease: Narrative Review

2026-02-28T10:59:49+01:00

Alzheimer's disease is the most common form of dementia, a complex and progressive neurodegenerative disorder that slowly decreases memory, thinking skills and the ability to perform the simplest tasks. It is characterized by the formation of extracellular amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles (NFTs). In the human body, amino acids are a source of metabolites and neurotransmitters. Various studies have also proven their association with Alzheimer's disease. Therefore, the research was conducted to review the effects of amino acids and their mechanisms on Alzheimer's disease. This descriptive study is a narrative review of articles on in vivo and in vitro amino acid-induced Alzheimer’s disease in the PubMed and ScienceDirect databases. The selected papers were in English, topic-relevant and published from 2011 to 2021 in journals of Q1, Q2 or Q3 category according to the Scimago Journal & Country Rank. The search yielded 27 relevant articles, but only 22 with 12 types of amino acids were included. Amino acids with positive effects were glutamine, d-serine, selenomethionine, s-adenosylmethionine, d-ribose-l-cysteine, s-allyl-cysteine, N-acetylcysteine, Se-methyl-selenocysteine and l-theanine, whereas some negative results come from homocysteine and N-methylamino-L-alanine. While taurine generally has a positive effect, there is a mechanism that negatively influences Alzheimer's disease. These amino acids are involved in all parts of the pathophysiology mechanism of Alzheimer's disease differently. The mechanisms include preventing (positive impact) or inducing (negative impact) mitochondrial dysfunction, inflammation, oxidative stress, formation of oligomers/plaque Aβ, tau hyperphosphorylation and neuronal/synaptic damage. Thus, not all amino acids have the activity of preventing/treating Alzheimer's disease.

The Role of Endocrine Disruptors and Environmental Chemicals in Causing Cancer: Focusing on Genetic and Epigenetic Mechanisms

2026-02-28T10:59:49+01:00

Endocrine-disrupting chemicals (EDCs) and environmental pollutants are ubiquitous and increasingly linked to the aetiology of cancer. This review synthesises existing evidence on the carcinogenic potential of EDCs, including bisphenols, phthalates, pesticides, heavy metals and persistent organic pollutants, with a focus on genetic and epigenetic pathways. The molecular mechanisms by which these chemicals induce carcinogenesis, including DNA damage, chromosomal aberrations, dysregulation of oncogenes and tumour suppressor genes and alterations in DNA repair was critically accessed. Epidemiological research emphasises epigenetic changes, including aberrant DNA methylation, histone modifications and deregulated non-coding RNA expression, which mediate long-term and potentially transgenerational effects of exposure. The interplay among endocrine signalling, oxidative stress, inflammation and epigenetic reprogramming is discussed in relation to hormone-dependent and hormone-independent cancers. Epidemiological, in vivo and in vitro experimental evidence, together with high-throughput omics data, were integrated to strengthen mechanistic plausibility. This review identified important research gaps, including low-dose and mixture effects, timing of exposure and population-wide vulnerability and provides future directions for risk assessment and regulatory policy. Greater insight into the genetic and epigenetic effects of EDCs is needed to advance cancer prevention and inform evidence-based community health interventions.

Pharmacological Potential of Inonotus Obliquus: An Integrative Review of Antitumour, Immunomodulatory and Anti-Inflammatory Effects

2026-02-28T10:59:49+01:00

Inonotus obliquus (Chaga mushroom), long used in traditional medicine, has recently gained substantial scientific attention due to its diverse pharmacological activities. While numerous preclinical studies exist, the lack of a comprehensive understanding of its molecular mechanisms continues to hinder clinical translation. This review summarises current evidence on the antitumour, immunomodulatory, anti-inflammatory and antioxidant effects of I obliquus, with emphasis on the underlying cellular pathways. The pharmacological activity of Chaga is mediated by a complex array of bioactive compounds that collectively induce apoptosis and cell-cycle arrest in cancer cells, modulate the complement system, suppress pro-inflammatory mediators in macrophages and enhance antioxidant defence mechanisms. These effects result from multifactorial and often synergistic interactions with key signalling cascades, including nuclear factor-kappa B (NF-kB), mitogen-activated protein kinase (MAPK) and PI3K/Akt pathways. Although experimental data are promising, the translation of I obliquus from a traditional remedy into standardised therapeutic formulations is constrained by chemical variability and a lack of robust clinical validation. Continued multidisciplinary research is essential to elucidate its pharmacological potential and to position Chaga as a valuable source of novel therapeutic agents in modern medicine.

Global Research Trends on Herbal Medicine for Hypertension: A Bibliometric and Visual Analysis from 1979 to 2025

2026-02-28T10:59:50+01:00

Hypertension is a major risk factor for cardiovascular disease globally. Despite widespread availability of conventional treatments, blood pressure control rates remain low globally. Herbal medicine is an alternative or complementary medicine that is gaining increasing attention. Scientific analysis is needed to understand the dynamics of global research on this topic. This study uses a data-driven bibliometric approach from Scopus, covering publications from 1979 to 2025. The analysis was conducted using Biblioshiny and VOSviewer software to evaluate publications, collaborations and keyword trends. A total of 2,954 documents were analysed with an annual growth rate of publications of 9.74 % and an average of 31.38 citations per document. China, the United States and India were the countries with the highest contributions in terms of both publications and citations. Institutions such as the China Academy of Chinese Medical Sciences and China Medical University emerged as the most active research centres. Plants such as Allium sativum, Hibiscus sabdariffa and Olea europaea were the main focus of research. Keyword clusters indicated two major focuses: clinical and pharmacological aspects. International collaboration was still relatively low (17.81 %) but showed potential for growth. Research on herbal medicine for hypertension shows steady growth and multidisciplinary approaches.

Personalised Anaesthesia, Arterial Blood Gases and Tissue Hypoxia: Modulating Postoperative Regeneration and Healing

2026-02-28T10:59:50+01:00

The fundamental limiting factor of major surgery is the body's ability to regenerate and heal tissue after it has been operated on, but this process must take its own course. Recent evidence is available to show that the method of anaesthesia employed during operative procedures and in particular the maintenance of arterial blood gases (ABG), may have a significant influence on regenerative processes by altering, as the case may be, the degree of hypoxia present within tissues. This narrative review addresses the issue of an individualised plan of anaesthesia, aiming to maintain a constant and progressive improvement in oxygen tension (PaO₂) and carbon dioxide tension (PaCO₂), as well as their impact on cellular repair processes. The view taken is that the best results cannot be attained by a rigid generalised state of normoxia, but by individualising the treatment by the means of the arterial blood gas results to achieve ends which will have a bearing upon such factors as hypoxia-inducible factor 1-alpha (HIF1α), which refers to a factor evidenced in the regulation of angiogenesis, collagen synthesis and the processes of wound healing. We are considering important clinical experiments and data, taking into account oxygenation strategies, ventilation policies and methods of checking that support individual arterial blood gas aims with the goal of improving the quality of recovery and outcomes beyond the operative phases.

A New Approach to Amniotic Band Disease

2026-02-28T10:59:50+01:00

Background: Amniotic band disease (ABD) is a rare condition, generally associated with three types of anomalies: malformations, deformities and amputations. Several theories have been put forward, the extrinsic theory being the most widely adopted. The aim of the study was to clarify the pathophysiology of the disease, to propose a new classification and to precise the therapeutic indication through a radio-clinical description of seventy-five amniotic bands in ten patients.

Methods: This was a descriptive radio-clinical and surgical study of 75 amniotic bands in amniotic disease. The clinical features were used to describe the type of amniotic band: deep (impeding vascular circulation, compressing soft tissues and bone) or superficial cutaneous with a good prognosis. The shape of the band was described as semicircular, circular, heliocoidal or complex figure of two linked circles shaping the number 8 flat/bended. There were 5 mild constrictions without lymphedema, 28 moderate (constrictions without lymphedema in 7 cases and severe constrictions with lymphedema in 21 cases) and 41 amputations (one leg and 40 fingers and toes). Surgical treatment involved 16 deep constrictions and three feet.

Results: Resection of the amniotic bridges gave an acceptable cosmetic result, but lymphedema persisted. Surgery on both feet enabled walking with plantigrade support. However, the Ponseti technique was used on a child with a severe and complex heliocoid constriction. He developed ischaemia, requiring immediate removal of the cast. Digital separation of the fingers restored a functional hand in particular the pauci-digital pincer, but the aesthetics were judged insufficient by the parents.

Conclusions: Based on presented findings, amniotic limb disease should be classified into three types: ‘Type A’ with a good prognosis, ‘Type B’ subdivided into six sub-types and “Type C’ defined by circular or complex constriction. The classification provides a therapeutic orientation. Depending on the type of the constriction band of the disease, different strategies can be envisaged: therapeutic abstention, cosmetic surgery or emergency limb salvage surgery.

Retrieval of Migrated Guidewire Extending From Right Ventricular Apex to the Inferior Vena Cava via Pigtail-Assisted Snaring

2026-02-28T10:59:50+01:00

Intravascular embolisation of foreign bodies (FB) is a rare, serious complication that may occur during central venous line insertion. A 39-year-old male in a critical condition presented to casualty department with a through-and-through chest gunshot wound. Chest X-ray showed left haemothorax; an urgent chest tube was introduced and central venous access was introduced via the right femoral vein. The guided wire used in the procedure was unintentionally pushed to reach the right ventricular apex. Echocardiography confirmed FB location. Once stabilised, the patient was referred to Iraqi Centre of Cardiac Diseases, where transcatheter retrieval was performed. To stabilise the FB, a 6F pigtail catheter was used to create a U-shaped loop in the guided wire body, coupled with successful snaring. By strategic planning and effective teamwork, retrieval of FB was safely accomplished using a standard catheterisation tool from a high-risk anatomical site without complication.

Post-Polypectomy Syndrome (PPS): A Case Report

2026-02-28T10:59:51+01:00

A 51-year-old female with unremarkable medical history developed right iliac fossa pain and fever one day post-polypectomy procedure. Management involved hospital admission for monitoring, supportive care with intravenous fluids and “nothing by mouth (NPO)”, broad-spectrum intravenous antibiotics and analgesia. The case here points the critical importance of post-polypectomy syndrome (PPS) occurring after cold endoscopic mucosal resection (EMR). Clinicians should consider PPS in patients admitted with fever, abdominal pain and raised inflammatory markers within a week of polypectomy, regardless of the technique used. Prompt CT imaging is crucial for accurate diagnosis and to exclude perforation.

The Silent Crisis: Economic Burden of Diagnosis for Genetic Diseases in Low- and Middle-Income Countries (LMICs)

2026-02-28T10:59:51+01:00

Genetic disorders, although secondary to infectious and non-communicable diseases in the global health priority agenda, are an important drain, albeit ill-defined, on the economies of low- and middle-income countries (LMICs) and on their health resources. The economic costs of diagnosing a genetic disorder in these settings, both direct and indirect, are detailed in the narrative review. Direct costs include the significant expense of advanced molecular diagnosis, inadequate infrastructure and dependence on expensive foreign services, which are largely financed through catastrophic, out-of-pocket payments. Indirect costs include the prolonged and expensive “diagnostic odyssey,” the loss of productivity in patients and patients’ relatives and the costs to society of misdiagnosis and avoidable disability. This emergency can be addressed by investing in strategic local diagnostic capacity, task-shifting and innovative finance models to enable equal access to genomic medicine and to break the vicious cycle of health-related poverty in LMICs.