Scripta Medica

Harnessing the Anti-Inflammatory Potential of Lamiaceae Family Hydrolates: A Study of Satureja Montana and Origanum Vulgare in Burn Wound Management

Wed, 31 Dec 2025 12:49:44 +0100

Background/Aim: The management of severe thermal injuries is a significant clinical challenge, often leading to protracted inflammation, impaired tissue regeneration and increased susceptibility to infection, a situation exacerbated by growing antimicrobial resistance. Existing treatments frequently offer limited efficacy, creating a demand for novel treatment modalities. Our investigation explores the therapeutic efficacy of innovative hydrogels formulated with hydrolates from two Lamiaceae family species, Satureja montana L and Origanum vulgare L, to modulate recovery after skin burn.

Methods: Standardised grade IIIa thermal burns were induced in twenty-five rabbits. The animals were then randomised into several cohorts for treatment: groups receiving topical applications of either Satureja montana L hydrolate gel, Origanum vulgare L hydrolate gel, or a standard therapeutic regimen. Control groups consisted of animals with untreated burns and healthy controls. To assess systemic inflammation, serum concentrations of key pro-inflammatory markers, interleukin-6, tumour necrosis factor-alpha and C-reactive protein, were quantified in serum via ELISA, while plasma levels of oxidative stress indicators (malondialdehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH)) were determined via specific colorimetric assay kits. Histopathological analysis (HE staining) assessed tissue regeneration and inflammation and IL-1β immunohistochemistry evaluated inflammatory.

Results: After fourteenth days post-injury, the cohort treated with Satureja montana L hydrolate exhibited a reduction in systemic inflammatory markers, approaching physiological baseline levels. Histological examination confirmed epithelialisation, markedly reduced inflammatory cell infiltration and robust inflammation reduction in this group. While Origanum vulgare L also showed beneficial effects, Satureja montana L consistently outperformed both its herbal counterpart and conventional treatments in promoting tissue repair and immunomodulation.

Conclusion: Presented findings indicate that phytotherapeutic preparations utilising hydrolates, especially the formulation derived from Satureja montana L, constitute a highly promising adjunctive strategy for the clinical management of thermal burn injuries.

Pioneering e-FAST in North Macedonia: A Resource-Efficient Approach to Polytrauma Care (Prospective Cohort Study)

Wed, 31 Dec 2025 12:50:47 +0100

Background/Aim: Polytrauma is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries with limited healthcare resources. The "golden hour" following trauma is critical for effective intervention, yet reliance on computed tomography (CT) for diagnosis often delays treatment due to logistical challenges. Focused assessment with sonography for trauma (FAST) has emerged as a rapid, bedside diagnostic tool, offering a potential solution in resource-limited settings. This study evaluates the utility of FAST in the management of polytrauma patients in North Macedonia, focusing on its impact on diagnostic efficiency, patient outcomes and resource allocation.

Methods: A prospective longitudinal randomised clinical trial was conducted on 80 polytrauma patients, divided into two groups: one receiving FAST followed by CT (FAST/CT) and the other undergoing CT alone. Diagnostic time, accuracy, surgical intervention rates, hospitalisation duration and mortality were compared between the groups. Statistical analysis was performed using descriptive and analytical methods.

Results: A total of 80 polytrauma patients were included and randomly assigned to a FAST/CT group or a CT-only group. FAST significantly reduced diagnostic time compared with CT alone (mean 5.12 vs 23.55 minutes), without delaying subsequent CT imaging or definitive diagnosis. Both FAST and CT demonstrated high accuracy in detecting thoracic (92.5 % vs 97.5 %) and abdominal injuries (85 % vs 86.25 %), with a 97.5 % agreement between methods. No significant differences were observed between groups regarding surgical intervention rates, length of hospital stay, or mortality.

Conclusion: FAST proved to be a cost-effective, non-invasive and efficient diagnostic tool, particularly valuable in resource-limited settings. While its limitations, including false negatives, necessitate complementary CT for stable patients, FAST optimises trauma care by streamlining diagnosis and resource allocation. Challenges such as equipment availability and operator training must be addressed for effective implementation.

Nephroprotective and Hepatoprotective Effects of Ethanol Extract of Eleutherine bulbosa (Mill) Urb in Hypertensive and Hyperlipidaemic Rats

Wed, 31 Dec 2025 12:52:04 +0100

Background/Aim: Hypertension and hyperlipidaemia are interrelated conditions that elevate the risk of cardiovascular diseases and contribute to the dysfunction of critical organs such as the liver and kidneys. Eleutherine bulbosa (Mill) Urb, known as Dayak onion, contains bioactive compounds like flavonoids, phenolics, quercetin derivatives and oxyresveratrol, which are believed to have nephroprotective and hepatoprotective effects due to their antioxidant and anti-inflammatory properties. This study aimed to evaluate the protective effects of the ethanol extract of Dayak onion on kidney and liver function in hypertensive and hyperlipidaemic rats.

Methods: The experimental design employed a pre-post-test control group over 28 days. Thirty-five male Wistar rats were divided into seven groups: Normal group, Negative control (given NaCl solution at a dose of 3.75 g/kg body weight and fed a high-fat diet), Positive control (captopril and simvastatin) and three Treatment groups (given Dayak onion ethanol extract (EEEB) suspension at doses of 100, 200 and 400 mg/kg body weight, respectively). Serum was extracted via the ophthalmic vein on days 22 and 29.

Results: Compared to the negative control group, this study showed that administering doses of 100, 200 and 400 mg/kg BW of EEEB was able to significantly lower blood urea nitrogen (BUN), creatinine, alanine transaminase (SGPT) and aspartate aminotransferase (SGOT) levels (p < 0.05). The dose of 400 mg/kg BW demonstrated the highest potential to protect the kidneys and liver, coming close to or matching the effects seen in the positive control group. In addition, the protective effect of EEEB on the kidneys and liver was compared to the positive control group (captopril and simvastatin).

Conclusion: Based on these findings, it can be concluded that EEEB protects against kidney and liver damage caused by hypertension and hyperlipidaemia.

Effect Of Dragon Fruit Dadih Fortified With Selenium on SREBP-1c Expression and Liver Histopathology in Obese Rats

Ulan Safitri, Ninik Rustanti, Adriyan Pramono — Wed, 31 Dec 2025 12:53:00 +0100

Background/Aim: Obesity remains a major global health challenge, closely linked to an increased likelihood of developing metabolic disorders, such as non-alcoholic fatty liver disease (NAFLD), insulin resistance, type 2 diabetes and cardiovascular complications. This study aimed to investigate the effect of selenium-fortified dragon fruit dadih on sterol regulatory element-binding protein-1c (SREBP-1c) expression and liver histopathology in obese rats induced by a high-fat, high-fructose diet (HFFD).

Methods: Dadih, a traditional Indonesian fermented dairy product, was enriched with selenium (0.4 ppm) and 10 % red dragon fruit juice to enhance its antioxidant and metabolic regulatory properties. Thirty-six male Sprague-Dawley rats were divided into four groups: healthy control (K−), obesity control (K+), dadih (Di) and selenium-fortified dragon fruit dadih (Di+). After 28 days of intervention, liver tissues were analysed for SREBP-1c expression and histopathological alterations.

Results: The results showed a significant increase in hepatic SREBP-1c expression in the obese control group (2172.8 ± 32.3 pg/mL) compared to the healthy control (999.2 ± 45.5 pg/mL; p < 0.001). Intervention with Di reduced SREBP-1c expression to 1455.2 ± 40.3 pg/mL. At the same time, the Di+ group showed a greater reduction to 1174.0 ± 58.8 pg/mL (p < 0.001), suggesting a more potent suppression of hepatic lipogenesis with selenium and dragon fruit enrichment. Histopathological analysis revealed hepatocyte ballooning and inflammatory cell infiltration in the obese control group, indicating early signs of liver injury. Although steatosis was not yet prominent due to the relatively short 28-day induction period, structural alterations in hepatocytes were already evident and likely associated with elevated SREBP-1c expression. These pathological changes were attenuated in the intervention groups, especially in Di+, which showed more pronounced improvements in liver architecture.

Conclusion: Selenium-fortified dragon fruit dadih holds promise as a functional dietary intervention to attenuate hepatic lipogenesis and protect against obesity-induced liver damage by downregulating SREBP-1c. Further studies are warranted to evaluate its long-term effects and underlying molecular mechanisms.

Effectiveness of Jacobson's Progressive Muscle Relaxation in Reducing Anxiety and Depression in Hospitalised AIDS Patients

Yowel Kambu — Wed, 31 Dec 2025 12:53:55 +0100

Background/Aim: Hospitalised patients with AIDS frequently experience anxiety and depression due to social stigma, prognostic uncertainty, and the physiological effects of the disease. These conditions can adversely affect the quality of life and treatment adherence. A relaxation method known as Jacobson's Progressive Muscle Relaxation (JPMR) has shown efficacy in alleviating stress and anxiety across various medical conditions. However, evidence regarding JPMR's efficacy of JPMR in patients with AIDS remains limited, particularly in Indonesia. The research sought to assess the efficacy of JPMR in alleviating anxiety and depression amongst AIDS patients in hospital settings.

Methods: This study employed a randomised controlled trial (RCT) with a pretest-posttest design conducted at Dr. Jhon Piet Wanane General Hospital, Sorong Regency, Southwest Papua. The study involved 52 AIDS patients who fulfilled the selection criteria. These participants were divided equally and randomly into two groups: the intervention group (n = 26) and the control group (n = 26). Participants in the intervention group engaged in JPMR sessions lasting 20-30 minutes, twice per day for a period of 10 days. In contrast, the control group received only routine care. The Patient health questionnaire anxiety and depression scale (PHQ-ADS) was utilised to assess anxiety and depression levels both before and after the intervention. Statistical analysis was conducted using paired and independent t-tests to evaluate the results.

Results: The study findings revealed a notable decrease in PHQ-ADS scores amongst the intervention group when compared to the control group (p<0.001). Several factors were found to significantly contribute to elevated anxiety and depression scores in AIDS patients receiving hospital care. These included co-occurring tuberculosis (TBC), insufficient social support, prior mental health conditions, and alcohol use, with respective p-values of 0.04, 0.002, 0.001, 0.07, and 0.05.

Conclusion: Research indicates that JPMR serves as an efficacious non-drug treatment for alleviating anxiety and depression amongst AIDS patients in hospital settings. These results advocate for the incorporation of JPMR into psychosocial care programmes within hospitals. Additional studies involving a larger patient group are necessary to validate these outcomes.

Hypoxic Mesenchymal Stem Cells Mitigate UVB-Induced Collagen Loss by Suppressing IL-6 and MMP-3 in a Rat Model

Wed, 31 Dec 2025 12:58:46 +0100

Background/Aim: Persistent ultraviolet B (UVB) radiation exposure generates oxidative stress, facilitating proinflammatory interleukin-6 (IL-6) cytokine secretion that subsequently activates the matrix metalloproteinase 3 (MMP-3) enzyme, resulting in collagen degradation. Mesenchymal stem cells cultured under hypoxic conditions (HMSCs) demonstrate the capacity to stimulate diverse cytokines and growth factors capable of preventing collagen breakdown. This study aims to evaluate the role of HMSCs administration on MMP-3 and IL-6 levels in a rat model exposed to UVB radiation, which causes collagen loss.

Methods: This study was an experimental in vivo study using a post-test-only control group design with a completely randomised method. The study included male Wistar rats aged 2 to 3 months, weighing between 200 and 250 grams. Male Wistar rats were divided into 5 groups: T1 (healthy rats without UVB exposure), T2 (rats exposed to UVB without treatment), T3 (rats subjected to UVB radiation received a 200 μL subcutaneous injection of HA), T4 (rats subjected to UVB radiation received a 2.5 × 10⁵ HMSCs cells subcutaneously) and T5 (rats subjected to UVB radiation received a 5 × 10⁵ HMSCs cells subcutaneously). Analysis of MMP-3 and IL-6 levels was performed using the ELISA method.

Results: Administration of HMSCs at doses of 2.5 × 10⁵ and 5 × 10⁵ cells significantly decreased IL-6 levels to 66.22 and 42.19 pg/mL, respectively. HMSCs administration also significantly decreased MMP-3 levels, with a dose of 5 × 10⁵ cells reducing MMP-3 levels to 3329.00 pg/mL.

Conclusion: HMSCs improve the condition of collagen loss in the skin due to UVB radiation exposure through inhibition of IL-6 and MMP-3.

Impact of Oxidative Stress on Patients Before and After Exposure to Sevoflurane and Desflurane Inhalational Anaesthesia

Wed, 31 Dec 2025 12:59:44 +0100

Background/Aim: Oxidative stress, which is characterised by an imbalance between reactive oxygen species (ROS) production and antioxidant defences, is a critical factor influencing surgical outcomes. Inhalational anaesthetics such as sevoflurane and desflurane are widely used, yet their differential effects on oxidative stress remain a subject of investigation. This study aimed to evaluate the impact of these anaesthetic agents on oxidative stress biomarkers in surgical patients.

Methods: The study included a total of 60 patients who underwent laparoscopic cholecystectomy. The patients were categorised into two categories based on the type of anaesthetic they received: Sevoflurane (n = 30) and desflurane (n = 30). Blood samples were collected pre- and post-anaesthesia to assess oxidative stress markers, including glutathione (GSH), total antioxidant capacity (TAC), total oxidative status (TOS) and malondialdehyde (MDA). Statistical analyses were performed using an independent t-test, with a significance threshold of p < 0.05.

Results: Sevoflurane and desflurane both induced significant oxidative stress, but desflurane exhibited a more pronounced effect. Post-anaesthesia, the desflurane group showed a greater decrease in GSH (ΔGSH: -493.48 ± 153.85 vs. -245.77 ± 201.89; p < 0.0001) and TAC (ΔTAC: -0.75 ± 0.13 vs. -0.35 ± 0.27; p < 0.0001), along with a higher increase in MDA (ΔMDA: 2.06 ± 0.74 vs. 0.77 ± 0.47; p < 0.0001). Although both anaesthetics elevated TOS, the increase was more substantial with desflurane.

Conclusion: Desflurane induces significantly higher oxidative stress compared to sevoflurane, likely due to differences in their metabolic pathways and mitochondrial effects. These findings highlight the need for tailored anaesthetic strategies, particularly for patients with pre-existing oxidative stress conditions. Future research should explore potential mitigation strategies, including antioxidant supplementation and multimodal anaesthesia approaches, to optimise perioperative care.

Relationship Between Mast Cell Density and Various Histological Features in Melanocytic Lesions

Blagica Lazarova, Gordana Petrushevska, Dzengis Jashar, Zdenka Stojanovska — Wed, 31 Dec 2025 13:00:48 +0100

Background/Aim: Mast cells, derived from multipotent hematopoietic progenitors in the bone marrow, are immune cells typically found in varying concentrations within melanocytic lesions. Aim of this study was to investigate mast cell density (MCD) in 182 melanocytic lesions, with a particular focus on its association with demographic and histopathological characteristics.

Methods: MCD and secondary changes in melanocytic lesions were assessed histopathologically using paraffin-embedded tissue samples analysed under a Nikon Eclipse E400 microscope.

Results: MCD was significantly higher in lesions from females compared to males and in lesions located on the head and neck compared to those on the arm, trunk and leg. Nevi exhibited higher MCD than melanomas, with marked differences observed among specific lesion types. Histopathological analysis revealed that lesions devoid of clear cells and those exhibiting an angioadnexocentric pattern had significantly elevated MCDs. Furthermore, lesions characterised by prominent elastic fibres, mucin deposition and certain adjacent structural interactions demonstrated increased MCDs.

Conclusion: These findings underscore the complexity of mast cell functions in melanocytic lesions, offering valuable insights that may enhance diagnostic and therapeutic strategies.

Utility of Routine Laboratory Tests for Predicting Gram-Negative Neonatal Sepsis in Low Resources Settings

Wed, 31 Dec 2025 13:01:47 +0100

Background: Gram-negative bacteria increasingly recognized as major pathogens in early-onset neonatal sepsis (EONS). Accurate early prediction of causative agents in EONS remains challenging, particularly in resource-limited settings where specific diagnostic markers are lacking. This study evaluates the diagnostic utility of routinely performed laboratory tests in predicting gram-negative bacterial etiology in EONS.

Methods: retrospective study included neonates with culture proven EONS who admitted to tertiary hospital in Iraq over 12 months period. Based on result of blood culture, participants divided into 2 groups: (group 1): neonates diagnosed with gram negative bacterial sepsis, while (group 2) involve neonates having positive bacterial growth on blood culture. Clinical characteristics and the results of routine septic screen employed include C-reactive protein and hematologic parameters obtained from complete blood counts compared between both groups. A receiver operating characteristic curve (ROC) was plotted to evaluate the predictive value of routine laboratory tests for Gram-negative sepsis.

Results: a total of eighty neonates included in the study, Gram negative bacteria accounted for most bacterial isolates 64 (80%), from which Acinetobacter baumannii was the most frequent isolates 31 (38.8%). C-reactive protein titer was significantly higher in neonate with gram negative bacteria (P value 0.003), while each of absolute neutrophile count and N:L ratio was higher in gram positive bacteria (P value 0.03,0.04 consecutively). On multivariate analysis, CRP was significantly associated with gram negative sepsis and on ROC curve CRP titer at cutoff 19.53 demonstrated excellent prediction of gram-negative EONS with an area under the curve of 0.933 (95% CI: 0.807–1.000; p = 0.009).

Conclusion: Most EONS cases were due to gram-negative bacteria, especially Acinetobacter baumannii. High CRP with low ANC and N:L ratio pointed to gram-negative sepsis. CRP >19.5 mg/dl was a strong early predictor for gram negative bacterial growth in blood cultures.

Advancing Personalised and Precision Medicine Through Artificial Intelligence: Current Insights and Future Directions

Wed, 31 Dec 2025 13:03:48 +0100

The convergence of artificial intelligence (AI) and precision medicine is transforming healthcare by introducing a patient-centered, data-driven approach to treatment. Precision medicine, which tailors medical care based on individual characteristics, addresses the complexity and heterogeneity of diseases. The integration of AI into this field has unlocked unprecedented potential for enhancing disease management and advancing personalised care. AI leverages extensive datasets, including genomic sequences, clinical records and molecular profiles, to identify patterns and predict outcomes with remarkable accuracy. Its capabilities extend beyond automation, functioning as a critical tool for informed clinical decision-making. By analyzing complex molecular data, AI enhances diagnostic precision through the detection of subtle biomarkers and anomalies frequently overlooked by traditional methods. Machine learning–powered predictive analytics further empower clinicians by forecasting disease progression and guiding treatment personalisation. Practical applications of AI-driven precision medicine are already evident in clinical settings. From diagnosing rare genetic disorders to optimising drug therapies based on genetic profiles, AI is fundamentally reshaping patient care. However, critical challenges, including ethical considerations, data privacy and the need for transparent algorithms, persist. This review examines the synergistic relationship between AI and precision medicine, highlighting ongoing research, technological innovations and interdisciplinary collaboration. Together, these advancements herald a transformative era in healthcare, paving the way for highly personalised and effective therapeutic strategies.

Recent Advances in Natural Hydrolates for Burn Care: Anti-Inflammatory, Antioxidant and Antimicrobial Perspectives

Wed, 31 Dec 2025 13:06:38 +0100

Burn injuries represent a significant global health burden, characterised by complex pathophysiology that extends far beyond the initial thermal insult. The healing process is profoundly influenced by a cascade of molecular and cellular events, including acute and chronic inflammation, oxidative stress and microbial colonisation. These interconnected challenges frequently lead to severe complications such as delayed wound closure, impaired tissue regeneration and pathological scarring. A critical and escalating issue in contemporary burn care is the pervasive rise of antibiotic resistance, which severely compromises treatment efficacy, prolongs hospital stays and significantly increases both patient morbidity and mortality. This literature review critically examines the multifaceted aspects of burn wound healing, focusing on the intricate interplay between inflammation, oxidative stress and infection. It delves into the molecular mechanisms underlying these processes, including the dual role of reactive oxygen species (ROS) in cellular signalling and tissue damage and the dysregulation of key pathways that perpetuate chronic inflammation and promote fibrosis. The alarming rise of multidrug-resistant pathogens (eg Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, etc) further exacerbates these challenges, highlighting the urgent need for novel therapeutic strategies. The limitations of conventional therapies in precisely modulating these complex biological processes and effectively countering resistant microorganisms are thoroughly discussed. Special attention is given to the therapeutic potential of natural compounds, particularly hydrolates, as innovative and complementary interventions. Current evidence in specific literature demonstrates their anti-inflammatory, antioxidant and antimicrobial properties, supporting their capacity to create a favourable healing microenvironment and mitigate the impact of antibiotic resistance. By elucidating the mechanisms through which these botanical extracts may influence wound healing, this review seeks to identify critical knowledge gaps and provide a robust foundation for future research into integrative approaches that can optimise burn wound outcomes and address urgent clinical needs.

Trend of Non-Hodgkin Lymphoma Research Using a Genomics-Based Approach: A Bibliometric Analysis From 1985-2024

Wed, 31 Dec 2025 13:08:38 +0100

Non-Hodgkin lymphoma (NHL) is a group of malignant lymphoproliferative diseases that vary in histology, molecular biology, clinical presentation and prognosis. Genetic mutations and dysregulation play a critical role in its pathogenesis and classification. Understanding the publication landscape of NHL-related genetic studies is essential to map research trends and identify key contributors. This article aimed to conduct a bibliometric analysis of research trends in the field of Non-Hodgkin's Lymphoma and related genomic studies. This study used bibliometric analysis using Vosviewer 1.6.16 and Biblioshiny (R tool) to visualise and interpret global publication trends. Data were collected from the Scopus database using keywords related to "Non-Hodgkin's Lymphoma" and “Genomic”, covering publications from 1985 to 2024. The analysis identified that the United States dominates in citation contributions with a total of 7,328 citations, indicating strong research output and impact. The most productive journal was Blood with 57 publications, followed by Leukemia and the British Journal of Haematology. The most cited article was by Gaidano G (1991), published in PNAS, with a total of 906 citations. Co-authorship and keyword analysis revealed active international collaboration and emerging areas of focus such as BCL2, DLBCL and MYC. The trend in publications of NHL-related genetic research showed a significant increase over the years, with the US playing a dominant role in terms of output and citation impact. These findings highlight the growing interest and development in NHL genetic studies, which supports international collaboration and ongoing exploration of molecular targets.

Trend in Traditional Medicine Research as an Alternative Treatment for Lung Cancer: Bibliometric Analysis 2015-2024

Muhammad Farid, Mailia Zulfa Hasan, Solikhah Solikhah, Lalu Muhammad Irham — Wed, 31 Dec 2025 13:10:07 +0100

Lung cancer, a leading cause of death, is influenced by smoking. Treatment includes conventional and alternative therapies, with traditional medicine showing potential in overcoming resistance and improving patient prognosis. This study explored the trends and developments in research related to traditional medicine as an alternative therapy for lung cancer through bibliometric analysis during the period 2015–2024. Data were obtained from the Scopus database, resulting in 349 relevant documents. Analysis using VOSviewer and R Studio software showed a significant increase in the number of publications, with a peak in 2024. This article identified contributions from 1,839 authors and 177 sources, with the Journal of Ethnopharmacology as the main contributor. Keywords such as "lung cancer," "apoptosis" and "anticancer" were frequently used, reflecting the research focus on the molecular mechanisms and potential of traditional medicine. China and India dominated the global contributions, followed by the United States. International collaboration also played an important role in the development of research. The results showed that traditional medicine, including traditional Chinese medicine (TCM) and active compounds from spices such as curcumin, have the potential to inhibit cancer cell proliferation, enhance apoptosis and overcome drug resistance. This study underscores the importance of a multidisciplinary approach to exploring traditional medicine in lung cancer therapy.

Review of the Potential Effects of Semaglutide and Metformin in the Management of Polycystic Ovary Syndrome (PCOS) and Obesity

Prabhleen Kaur, Raj Solanki, Nimita Manocha, Rupesh K Gautam, Hitesh Chopra — Wed, 31 Dec 2025 13:12:15 +0100

Polycystic ovary syndrome (PCOS) is considered a lifestyle disorder. Various lifestyle factors hinder obesity and insulin resistance, which worsen the symptoms of PCOS and this makes existing treatment very challenging. This review examines 10 studies on the effectiveness of combining glucagon-like peptide-1 (GLP-1) receptor agonists, particularly liraglutide and semaglutide, with metformin for weight control in women with PCOS. Results declared that combined therapy gives greater effects in terms of weight loss and metabolic improvement. Combined liraglutide with metformin led to an average weight reduction of 6.5 ± 29.55 kg and side-by-side reductions in body mass index (BMI), fasting glucose and insulin levels over 12 weeks. While comparing the monotherapy of metformin and liraglutide, liraglutide was more effective for weight loss, but the combination is thought to be impactful. Semaglutide monotherapy also emerged as a strong alternative, achieving a 9 kg weight reduction within 12 weeks in obese PCOS patients and was well-tolerated with minimal side effects. These findings suggest that combining semaglutide with metformin may be an effective approach for weight and metabolic issues in PCOS women, with semaglutide offering additional promise. Further studies are encouraged to refine dosing and explore long-term benefits.

Impact of Community-Based Educational Package (CBEP) on Coping Strategies Among Postmenopausal Women

Rajinder Kaur, Reetu Malhotra, Shivani Chopra — Wed, 31 Dec 2025 13:13:37 +0100

Background/Aim: Menopause is a significant challenge for women’s psychological and physical well-being. Aim of this study was to examine the impact of a 60-minute community-based educational package (CBEP) designed to enhance coping strategies among postmenopausal women in rural Punjab.

Methods: A randomised controlled trial with 200 participants (Control: n = 100; Experimental: n = 100) utilised the modified postmenopausal coping scale (PMCS)—a 55-item tool assessing nine domains, including hot flushes, psychological changes, sleep disturbances and sexual dysfunction—to evaluate coping strategies pre- and post-intervention.

Results: Baseline assessments revealed significant disparities: 60.8 % of the control group exhibited poor coping knowledge compared to 39.2 % in the experimental group (χ² = 9.684, p = 0.002). Post-intervention, the experimental group demonstrated a marked increase, with poor coping knowledge decreasing to 8.8 % and average coping knowledge rising to 66.4 %, while the control group remained stagnant (91.2 % low knowledge; χ² = 54.202, p = 0.0001). Quantitative analysis further showed significant post-intervention gains in coping scores for the experimental group (mean = 24.92 vs Control: 17.84; t = 13.311, p = 0.0001), with a mean score increase of 6.55 compared to the control group’s 0.36 (t = 17.563, p = 0.0001).

Conclusion: Although neither group achieved “good” knowledge levels, the experimental cohort’s shift from poor to average coping strategies underscores the intervention’s effectiveness. These results highlight the value of structured, community-driven educational programs in empowering postmenopausal women to manage menopausal challenges, ultimately enhancing their quality of life.

Evaluating the Outcome of Distal Sodium Channel Block by Chennai Cocktail Composition in Active Phase (Stage 1) of Adhesive Capsulitis (Frozen Shoulder)

Wed, 31 Dec 2025 13:14:56 +0100

Background/Aim: The average age range for people with adhesive capsulitis, also referred to as frozen shoulder, is 40–70 years old. Diffuse, severe shoulder pain gradually develops; it usually gets worse at night and causes a progressive loss of range of motion (ROM), particularly external rotation. In the treatment of adhesive capsulitis, distal sodium channel block by the Chennai Cocktail Method has become popular. It works by apparently activating alpha-2 receptors and blocking distal sodium channels, which reduces pain and promotes healing with a low risk of infections and immune reactions. Aim of this study was to evaluate efficacy of this method in patients with adhesive capsulitis.

Methods: Chennai cocktail regime consisted of two millilitres (mL) of 2 % lidocaine hydrochloride + 1 mL of 40 mg/mL triamcinolone injection + 30 μg clonidine injection. Prior consent to be taken from the patient before the procedure. Xylocaine, clonidine and steroid test dose were given half an hour before the procedure After the skin was marked, under aseptic precautions parts were painted and draped with a hole towel. Chennai cocktail regime was injected into 1st web space of the affected upper limb.

Results: Internal rotation showed the most improvement, while abduction and external rotation showed the fastest and most noticeable recovery. At six weeks and three months, there was a considerable recovery (p < 0.05) in abduction and external rotation. Flexion, abduction and external rotation did not significantly improve at two weeks. The group's SPADI pain and disability scores significantly improved at six weeks and three months (p < 0.05). Most of the patients were able to return to their normal daily activities and sleep on the affected side without any problems. The VAS showed a significant (p < 0.05) improvement in the group at three months. At three months, flexion, abduction and external rotation all showed a discernible improvement.

Conclusion: Injections using the Chennai Cocktail Method for adhesive capsulitis seem to be a safe and efficient treatment that improves ROM and discomfort in individuals with adhesive capsulitis of the shoulder at short-term follow-up.

Serotonin Syndrome: A Clinical Case Report

Mohamed Alshmandi, Haider Ali Tariq Butt, Julia Kiernan — Wed, 31 Dec 2025 13:16:13 +0100

Serotonin syndrome is characterised by high levels of serotonin, a neurotransmitter, in the nervous system. A 36-year-old male was hospitalised due to generalised weakness, loss of appetite, jaundice, abdominal pain, recurrent fever and delirium. Diagnoses of serotonin syndrome, peptic ulcer disease and metabolic-associated fatty liver disease (MAFLD) were confirmed. Management required withdrawal of the causative agent and administration of intravenous fluid support and benzodiazepines to control agitation and neuromuscular symptoms. This case clearly demonstrates the critical importance of thorough history-taking, careful clinical examination and reassessment of provisional diagnoses when initial treatments prove ineffective.

Anaesthetic Challenges in Minimally Invasive Gastric Pull-Up for Oesophageal Atresia With Significant Proximal-Distal Oesophageal Discrepancy in an Infant - a Comprehensive Case Report

Wed, 31 Dec 2025 13:17:13 +0100

A unique subset of infants diagnosed with oesophageal atresia (EA) with tracheooesophageal fistula (TEF) are those born with pure long-gap oesophageal atresia (LGEA), constituting around 10 % of oesophageal atresia. Several procedures have been developed for oesophageal reconstruction and gastric pull-up has demonstrated promising outcomes. Anaesthetic management for the gastric pull-up surgery is challenging with a high risk of respiratory distress and a high incidence of perioperative tachyarrhythmias. Case of infant diagnosed with LGEA, marked by a significant proximal-distal oesophageal discrepancy, initially underwent cervical oesophagostomy and feeding gastrostomy in the neonatal period is presented. Anaesthetic challenges were faced both intraoperatively and postoperatively.

Intra-articular Injection of a Vital Micrograft Combined With a Metabolic Solution for Knee Osteoarthritis: A Case Report on Novel Two-Phase Regenerative Treatment

Fabiano Svolacchia, Lorenzo Svolacchia — Wed, 31 Dec 2025 13:18:24 +0100

Knee osteoarthritis (OA) is a prevalent degenerative joint disorder characterised by the gradual deterioration of the protective cartilage in the knee with limiting treatment options. A 55-year-old male with symptomatic knee osteoarthritis underwent a novel two-phase regenerative treatment combining micro-fragmented adipose tissue injection with metabolic solution infiltration. The patient presented with medial and anterior knee pain (visual analogue scale - VAS 4.5, knee injury and osteoarthritis outcome score - KOOS 64 %). Treatment involved intra-articular injection of 30-40 micron microfiltered adipose tissue followed by a solution containing non-cross-linked hyaluronic acid, branched amino acids and sodium bicarbonate to activate membrane glycoproteins and drive adipose-derived stem cells (ADSCa) to exosome budding. At six months, dramatic improvement was observed with VAS decreasing to 0.5 and KOOS increasing to 95 %. No adverse reactions occurred. This minimally invasive technique represents a promising approach for early-stage knee osteoarthritis treatment.

Perioperative Dysbiosis: Rethinking the Anaesthetic Contribution to Postoperative Outcomes via the Human Microbiota

Wed, 31 Dec 2025 13:19:30 +0100

The gut microbiome plays a crucial role in perioperative care. Surgical stress and anaesthesia disrupt the balance of intestinal flora, known as dysbiosis, which can affect gut health and metabolism. Pain relievers like morphine and certain anaesthetics contribute to this imbalance. Dysbiosis may also lead to memory loss and cognitive issues post-surgery. Future studies aim to use probiotics and beneficial substances to improve health and prevent cognitive decline.