This case report describes the diagnostic odyssey of a 41-year-old woman with recurrent uveitis, ultimately diagnosed with presumed ocular tuberculosis. Initial consultations at a secondary care facility failed to identify the underlying cause, leading to delays in appropriate treatment and the development of complications, including cataracts and posterior synechiae. Referral to a specialized eye institute resulted in a positive interferon-gamma release assay (IGRA) and initiation of anti-tubercular therapy. This case highlights the challenges in diagnosing and managing uveitis, the importance of access to specialized care, and the need for increased awareness among healthcare providers regarding ocular tuberculosis. The patient's perspective, obtained through a semi-structured interview, emphasizes the need for a patient-centered approach in healthcare. This report serves as a valuable resource for clinicians, researchers, and public health professionals, advocating for improved patient care and outcomes in uveitis management.

Antibiotics are developed to kill those germs that infect the human body. When these germs develop resistance to the drugs, the treatment of the patients becomes highly complex. This study aimed to highlight the phenomenon of antibiotic resistance and new emerging diseases. The study found that the process of developing resistance among germs is a natural and evolving process. Bacteria use intrinsic resistance to various antibiotics (multi-drug resistant) by the changes in the channels and pumps in cell membrane, inhibiting the influx of drugs. Significant gaps remain in proportion to the global impact of investment, international collaboration and collective action on antibiotic resistance. When the germs, bacteria and fungi develop resistance, they also transmit this resistance to other bacteria. Research in antibiotics resistance is focused on two aspects. In the first aspect, researchers find out those bacteria that have become resistant. Some bacteria develop resistance to some antibiotics, in which case, the patients may be treated with other antibiotics. Antibiotic-resistant genes (ARG) are transferable by HGT (horizontal gene transfer) where genetic elements like plasmid, transposons and insertion sequences were transferred which is the second aspect of reserachers. The study tries to investigate the culpability of antimicrobial resistance to the healthcare system by reviewing various articles. As per WHO guidelines, healthcare professionals should develop surveillance programs in their facilities and report information regarding antibiotic-resistant pathogens. The methodology includes systematic literature review, clinical data analysis and microbial resistance profiling. Specific outcomes highlight rising antibiotic resistance patterns, impact on healthcare costs and effectiveness of alternative treatments in mitigating resistance trends.47 The study also found that some bacteria develop resistance against all antibiotics. The interventions should focus on preventive measures because the new antibiotics are costly and the bacteria may also develop resistance against new antibiotics

Objectives: Overcoming drug resistance by altering the medication's characteristics and the tumor microenvironment might be a therapy improvement strategy. Newly used is Pegylated Liposomal Doxorubicin (PLD) but is significantly more effective under the Magnetothermy (Hyperthermy) modification. The optimal dose and cycle of PLD-based neoadjuvant chemotherapy for Breast Cancer (BC) have yet to be determined. Magnetothermy (Hyperthermy) is a treatment for Advanced Breast Cancer (ABC) that uses time-varying magnetic fields to create eddy currents, resulting in tumor heating (<40̊C). Enhance the therapeutic benefits resulted from the synergistic effect of Pegylated Liposomal Doxorubicin in a dose-dense regimen and Local mild Magnetothermy (Hyperthermy) electromagnetic field effect against chemoresistant advanced breast cancer. Methods: The study included forty-three patients with chemoresistant ABC: First group: 23 patients, who received a PLD 50 mg/m2 and regional inductive mild hyperthermia treatment every four week (standard regimen), second group: 20 patients, who received PLD 50 mg/m2 and regional inductive mild hyperthermia treatment every two week (dose-dense regimen). Results: Patients with chemosensitivity (65.12%) reported significantly greater levels of chemotherapy-related variables compared to those with chemoresistance (34.88%), p = 0.0014. When PLD was given for the second group, chemosensitivity was higher than when given for the first group (15 patients or 75.00% vs 13 patients or 56.52%, respectively p = 0.038). But, when PLD was given for the first group, chemoresistance was higher, than when given for the second group (10 patients or 43.48% vs 5 patients or 25.00%, respectively p = 0.023). Conclusion: Achieving a quicker clinical response for chemoresistant ABC with a PLD dose-dense regimen while minimizing side effects and adverse responses. The complex employment of magnetothermy and pegylated liposomal drugs resulted in synergy of their anticancer action, which allowed to devitalize the tumor parenchyma of breast carcinoma.

Objectives: Refractive errors, which include myopia, hyperopia and astigmatism, can lead to visual impairment if left uncorrected, ultimately affecting academic performance and quality of life. This study aims to evaluate the influence of ocular exercises on eyestrain and refractive error among school children. Methods: The study consisted of 170 school children with refractive error from Government schools around Aundi Patti Taluk. Permission was obtained for conducting this study from Block Medical Officer and Principals of the Government schools.  The study proposal was approved by the Institutional Ethics Committee of Government Theni Medical College. Voluntariness and confidentiality were ensured.  The inclusion criteria were children of 8 to 15 years, with eyestrain and refractive error of <3.00 diopters. Any congenital eye defect children were excluded. The children were divided in to 85 for control and 85 for experimental groups by random numbers.  The sample size was estimated by power analysis using computer software and found to be adequate for 90 % power and 5 % confidence level. The study was carried out from February 2022 to April 2023. Results: The data on the eyestrain questionnaire reveal that symptoms such as stinging, itching, redness, headache and blurred vision were moderate to severe in the pre-test for both groups. Post-test results showed significant improvement in the experimental group, with symptoms reduced to none or slight compared to the control group (p<0.001), indicating the effectiveness of eye exercises. The refractive index data showed significant improvements in the experimental group's median dioptres for both right and left eyes in post-tests (-1.0) compared to pre-tests (-1.5), while the control group showed no significant change. Between-group comparisons were significant in post-tests (p<0.001) but not in pre-tests. These findings confirm that the intervention is effective in alleviating eye symptoms and improving vision. Conclusion: The study provide evidence supporting the effectiveness of ocular exercises in reducing eyestrain symptoms among school children.

Objectives: This study explores the impact of health insurance schemes on healthcare disparities in Asian countries, focusing on policy implications. It evaluates various insurance models, such as the Basic Healthcare Insurance for Urban Employees in China and the New Cooperative Medical Scheme and their effects on healthcare access and outcomes across different socioeconomic groups. Methods: An exploratory design was used with a sample of 446 respondents selected via convenient sampling in Tamil Nadu, India. Data were collected through surveys and analyzed using SPSS, employing tools such as clustered bar graphs, pie charts, ANOVA and linear regression to assess relationships between insurance coverage and healthcare disparities. Results: Findings suggest that health insurance schemes have improved healthcare access and reduced disparities but challenges remain, particularly in addressing the needs of marginalized populations. The 26-35 age group showed strong support for increased government funding for rural healthcare. Males were more likely to believe rural populations benefit more from insurance than urban populations. Barriers like high administrative costs and low healthcare professional availability were identified. Urban respondents emphasized government roles in funding and regulation, while semi-urban and rural populations indicated concerns over the effectiveness of insurance policies. Discussion: The results highlight the importance of tailored health insurance policies to address the needs of marginalized groups. Despite progress, more targeted interventions are necessary to ensure equitable healthcare access. Addressing administrative costs and professional shortages will enhance the effectiveness of health insurance schemes. Conclusion: Health insurance schemes are crucial in reducing healthcare disparities in Asia. However, targeted reforms are necessary to improve equity and accessibility, particularly for marginalized populations.

Objectives: Coronary artery disease remains a major contributor to global morbidity and mortality, primarily driven by atherosclerosis. Genetic variations and adipocytokines like omentin-1 and leptin play critical roles in inflammatory pathways and atherosclerotic processes. This study aims to evaluate the association of Cdx2 (A>G) variant, omentin-1 and leptin with CAD risk in a Pakistani population. Methods: This case-control study comprised 500 angiographically confirmed CAD patients and 500 age- and gender-matched healthy controls. Detailed anthropometric measurements, blood pressure and fasting blood samples were obtained from all contributors. Genotyping of the Cdx2 (A>G) variant was conducted using tetra-primer amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Serum levels of omentin-1, leptin and vitamin-D were evaluated by using enzyme-linked immunosorbent assay (ELISA) kits. Statistical analyses was done by SPSS version 23. Results: The frequency of the AA genotype in the control group (49.2%) was significantly higher than in CAD patients (32.4%), indicating a protective effect (p<0.001). The AG genotype was associated with a 58% increased risk of CAD (OR = 1.58, 95% CI: 1.24-2.02). Serum omentin-1 levels were significantly lower in CAD patients (368±3.7 ng/mL vs. 615±6.5 ng/mL, p<0.001) compared to controls, whereas, leptin levels were significantly elevated in CAD patients (8.62±0.7 ng/mL vs. 4.02±0.5 ng/mL, p<0.001). Both omentin-1 and leptin levels were significantly associated with the AG and GG genotypes, suggesting a genetic influence on these adipocytokine. Conclusion: In conclusion Cdx2 (A>G) variant of promotor region of VDRG was found to be associated with greater risk of CAD and also influence on adipokines levels, particularly omentin-1 and leptin, may play a crucial role in CAD pathogenesis. These findings offer insights into the molecular mechanisms of CAD.

Objectives: Climate change anxiety, or eco-anxiety, is an emerging mental health concern worldwide, particularly in regions heavily impacted by environmental and socio-political challenges. This study aimed to explore the prevalence, correlates and underlying dimensions of climate change anxiety among residents of the Kurdistan Region of Iraq (KRI). Method: This cross-sectional study was conducted online from July 2nd to September 29th, 2024, across three main governorates of the KRI: Erbil, Sulaymaniyah and Duhok, using convenience sampling. The questionnaire included two parts: demographic data and the Hogg Eco-Anxiety Scale (HEAS). Statistical analyses, including Chi-square tests, Principal Component Analysis (PCA) and Pearson correlation, were conducted using IBM SPSS Version 26. A p-value of less than 0.05 was considered statistically significant. Results: A total of 385 participants were enrolled in the study. Eco-anxiety levels were categorized as mild (38%), moderate (43%) and severe (19%). Significant associations were observed between eco-anxiety levels and type of residence (p = 0.021) and city of residence (p = 0.006). PCA identified four dimensions of eco-anxiety, explaining 80.613% of the variance. Strong correlations were found between the dimensions of the HEAS, with the highest correlation observed between behavioral symptoms and anxiety about personal impact (r = 0.854, p < 0.01). Conclusions: The study highlights that most participants experienced moderate levels of eco-anxiety. It is recommended that healthcare providers and policymakers prioritize strategies to address eco-anxiety and its impacts, particularly in urban areas and among vulnerable populations in the Kurdistan Region of Iraq.

Objectives: Diabetes mellitus has increased worldwide, including in Saudi Arabia. Probiotic foods can lower the consequence of diabetes complications. Kefir fermented milk (KM) is a valuable source of probiotics. It has attracted increasing attention in the field of preventive medicine. This is due to its antioxidant, immunomodulatory and anti-inflammatory characteristics. This study aimed to examine the impact of KM on markers of hyperglycemia and lipid profile, pro-inflammatory cytokines and hepatic damage in streptozotocin (STZ)-diabetic rats. Methods: Thirty-two male rats were distributed into four groups: I- Control; II- Diabetic (rats injected with 60 mg/kg STZ to induce diabetes); III- Diabetic + 10 ml/kg KM: diabetic rats treated with 10 ml/kg KM; IV- Diabetic + 20 ml/kg KM group: diabetic rats treated with 20 ml/kg KM. The KM treatment period was 35 days. Serum hyperglycemia markers (glucose, glycosylated hemoglobin (HbA1c) and insulin), lipid profile (total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C), very low-density lipoprotein (VLDL-C), low-density lipoprotein (LDL-C)) and pro-inflammatory markers (tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)) were estimated. Furthermore, hepatic tissue histopathologic changes were assessed. Results: KM effectively relative to diabetic group reduced blood glucose, HbA1c, TG, TC, VLDL-C and LDL-C. Besides, KM significantly increased serum insulin and HDL-C. The levels of two inflammatory mediators, TNF-α and IL-6, were reduced in the KM-treated group. KM treatment improved hepatic inflammation and necrosis induced by STZ. These effects were most pronounced in the group receiving the high KM dose. Conclusion: KM administration effectively reduced elevated blood sugar levels caused by STZ by enhancing insulin secretion. KM administration reduced inflammation and markers of dyslipidemia. Furthermore, KM consumption appears to improve STZ-induced hepatic damage.

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer, accounting for 1–5% of all breast malignancies. Male breast cancer is particularly uncommon, comprising less than 1% of all cases and IBC in males presents even greater diagnostic and therapeutic challenges. This case study highlights a 49-year-old Sudanese male diagnosed with inflammatory breast cancer of the lobular subtype. The patient initially presented with a palpable right breast mass and nipple discharge, without characteristic skin changes often associated with IBC. Diagnostic imaging and biopsy confirmed infiltrating lobular carcinoma, characterized by estrogen receptor positivity (ER+), HER-2 overexpression and a Ki-67 index of 30%. Despite treatment delays, the patient underwent four cycles of palliative chemotherapy, achieving a significant reduction in tumor burden. However, complications such as axillary lymphedema and pleural effusion emerged during treatment. Follow-up evaluations, including imaging and clinical assessments, demonstrated no palpable masses or axillary lymphadenopathy, suggesting a favorable response to therapy. This case underscores the importance of early detection and multidisciplinary management in improving outcomes for male IBC patients. The findings emphasize the necessity for heightened awareness of male breast cancer, particularly rare subtypes like lobular IBC, among healthcare providers. Moreover, this case contributes valuable insights into the clinical presentation, diagnostic strategies and treatment outcome

Objectives: Younger adulthood is defined as an identity-forming period in which people experience changes in their physical and social selves as well as related to behavior, emotion, socioeconomic status and education. It is proposed that medical students have anxiety associated with the illnesses they are learning about, known as medical student syndrome. In Saudi Arabia's Medical College, Northern Border University, understanding the significant difference in anxiety status based on gender or academic level variables is critical for effective management. This study aimed to examine the occurrence and some of the factors that contribute to anxiety among medical students at the Northern Border University in Arar, Saudi Arabia. Methods: A cross-sectional design among 305 participants of medical students in the College of Medicine, Northern Border University, was employed, utilizing convenience sampling. Data were collected through an online questionnaire. Results: The findings revealed the most frequent symptoms in the "low" category are numbness or tingling, indigestion, flushed face and lightheadedness with 251, 229, 229 and 228, respectively, with a percent of 82.30%. The overall anxiety levels among students, with the majority experiencing low anxiety (200, 65.57%). Notably, anxiety is common across genders; mild levels seem to be more prevalent in males overall. In addition, 4.5-5 GPA students have the highest percentage of low anxiety. Conclusion: The study highlights the multifaceted nature of anxiety, which, though mild for most, can severely impact a vulnerable subset of students. The correlation of anxiety with multiple demographic and academic factors underscores the necessity for nuanced interventions.