Kasturba Medical College, Manipal

Anthracyclines significantly improve overall survival and play a vital role in the treatment of breast cancer. However, they are associated with cardiac dysfunction, which is often irreversible. Although anthracycline-induced cardiotoxicity (AIC) is dose-dependent, the difference in susceptibility patterns suggests the role of pharmacogenomics. Several studies explored the role of genetic variants in AIC. Integrating pharmacogenomic testing with routine anthracycline surveillance will help to predict the individuals who are at risk of developing AIC. Therefore, this current systematic review aims to evaluate and synthesize the evidence on the pharmacogenomics association of cardiotoxicity in individuals receiving anthracyclines for breast cancer treatment. PubMed, Embase, and Scopus databases are systematically searched for the literature. After the initial search, 842 records have been identified. Following screening, 18 studies investigating genetic associations with AIC in breast cancer patients were found to be eligible for inclusion in the study. The quality of studies is assessed with the Q-Genie tool. The data is extracted and summarized with odds ratios and corresponding confidence intervals were reported. A total of 18 candidate gene association studies involving 4,703 breast cancer patients were included in the qualitative synthesis. Out of 57 genetic variants reported, 18 genetic variants (31.5%) are associated with an increased risk, while 3 genetic variants (5.3%) have demonstrated a risk-reducing tendency. Characterizing genetic variants in biological pathways of anthracyclines could inform precision therapy and the development of targeted interventions. The limitations of the synthesized evidence include the inadequate sample size, methodological bias within the included studies, inconsistent findings from different studies, and imprecise effect estimates. The genetic variants influence susceptibility to AIC in breast cancer patients. Further large-scale studies with longer follow-up are warranted to validate these associations and facilitate their translation into clinical practice.

Purpose of the Research Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and eosinophil counts are altered in neonatal sepsis; this has not been studied in early-onset neonatal sepsis (EONS). Hence, in this cross-sectional study, we compared the blood counts and ratios of two groups of neonates: 69 each with or without EONS. Major Findings Neonates with EONS had higher median total leukocyte count, lymphocyte, and eosinophil count compared to those without sepsis. PLR was significantly lower in neonates with sepsis, with no significant difference in NLR. Hematological parameters of a subgroup of 49 preterm babies without sepsis were compared with those of 45 preterm babies with EONS. The findings were similar, with a significantly higher eosinophil count and lower PLR among preterm babies with EONS. Conclusions EONS among neonates was associated with a higher eosinophil count and a lower PLR. The differences were more pronounced among the subset of preterm babies.

Klebsiella pneumoniae is increasingly recognized as a pathogen of concern causing community-acquired pneumonia (CAP) due to its association with diabetes, alcohol use, and antimicrobial resistance. However, data from India regarding severity in K. pneumoniae CAP is limited. The primary objective of this study was to determine the factors associated with severity in K. pneumoniae CAP. We conducted a retrospective cohort study of culture-confirmed K. pneumoniae CAP at a tertiary care hospital between January 2017 and December 2023. Eligible cases were defined as those with radiological evidence of CAP and culture positivity from respiratory or blood samples obtained within 48h of admission. Demographic, clinical, laboratory, radiological, microbiological, treatment, and outcome data were extracted. Factors associated with severity were identified using multivariable logistic regression. Of 277 culture-confirmed cases of K. pneumoniae from samples sent within 48h of admission, 105 fulfilled inclusion criteria. Of these, 32 patients (30.5%) had a severe disease. Patients with severe disease frequently reported alcohol use, presented with bacteraemia, shock, higher leukocyte counts, elevated urea, lower serum albumin, and greater antimicrobial resistance. On multivariable analysis, factors associated with severe disease were alcohol use (aOR 18.8, 95% CI 3.5-101), bacteraemia (aOR 11.8, 95% CI 1.8-77.5), ceftriaxone resistance (aOR 6.6, 95% CI 2.1-20.5), and higher leukocyte counts (aOR 1.15 per unit increase, 95% CI 1.05-1.26). K. pneumoniae isolates from patients with CAP are frequently resistant to ceftriaxone. Ceftriaxone resistance, along with alcohol use, bacteraemia, and high leukocyte count, was associated with severe disease.

Introduction: Portable listening devices (PLDs) have transformed audio exposure among youth. Prolonged/high-volume PLD use may contribute to hearing impairment and affect academic performance. Methods: Cross-sectional study of 108 dental undergraduates (age 18–27). Questionnaire assessed PLD usage and academics; five non-invasive audiological tests were performed. Associations analysed using Kendall’s Tau-b and eta coefficients. Results: 29.6% reported regular exposure at 100–120 dB. Over 20% reported hearing issues. Moderate associations (η = 0.23–0.33) were found between years of PLD use and PTA, immittance, high-frequency tests and academic percentiles; OAE showed a stronger association (η = 0.44). Higher frequency of use associated with lower academic percentiles. Conclusions: There is a weak-to-moderate link between PLD use and hearing loss; long-term/frequent use may negatively impact hearing and academic performance in dental undergraduates.

Neurodegenerative diseases represent a major and growing clinical challenge due to their progressive nature, biological heterogeneity, and limited therapeutic options. Recent advances in artificial intelligence (AI) have introduced new analytical strategies for extracting clinically relevant information from complex biomedical data, offering complementary tools to established diagnostic and research approaches. This review provides a critical and method-comparative synthesis of AI applications in neurodegenerative diseases, with emphasis on studies published between 2022 and 2025. Rather than cataloging algorithms, the review evaluates how specific AI methodologies are selected, implemented, and validated across diverse data modalities, including molecular profiles, neuroimaging, biosensors, speech, gait, and electronic health records. Across Alzheimer's disease, Parkinson's disease, and other neurodegenerative disorders, the reviewed evidence indicates that AI-based models can support early risk stratification, disease characterization, and monitoring when applied within clearly defined analytic and clinical contexts. Importantly, performance gains are shown to depend strongly on data quality, feature representation, validation design, and alignment between model architecture and biological signal, rather than on algorithmic complexity alone. Emerging paradigms, including multimodal integration and next-generation AI frameworks, are discussed in relation to their methodological contributions rather than clinical readiness. By systematically comparing analytical strategies and highlighting sources of variability across studies, this review underscores the importance of methodological transparency, uncertainty-aware evaluation, and biological interpretability. Collectively, the work positions AI as an enabling and adjunctive analytical framework that can enhance neurodegenerative disease research and clinical decision support when deployed with rigor and caution, providing a balanced perspective on current capabilities and future directions.

Introduction: Safer, biocompatible alternatives to NaOCl for endodontic irrigation are being explored; papain (a plant protease) could be one. Methods: E. faecalis biofilms on dentin discs treated with 4% papain, 2.5% NaOCl, or saline. Outcomes: CFU counts, CLSM for viability and EPS; cytotoxicity via MTT on fibroblasts. Statistical testing via ANOVA/non-parametric tests (p<0.05). Results: Papain had antibiofilm activity but lower bactericidal effect than NaOCl. Papain reduced EPS content most effectively and showed significantly lower cytotoxicity than NaOCl. Conclusions: Papain disrupts biofilm matrix with better biocompatibility than NaOCl — a promising adjunct/alternative irrigant warranting further investigation.

• This study links Ki-67 to RCC prognosis using nuclear grade, dedifferentiation, metastasis, and event-free survival (EFS). • Ki-67 has been associated with tumour grade and dedifferentiation in RCC, supporting its role as a proliferation marker. • Ki-67 lacks independent prognostic value for metastasis or EFS; integrate it into broader multiparametric models. • This article highlights the potential utility of Ki-67 in RCC within a multiparametric prognostic model. Renal cell carcinoma (RCC) is a heterogeneous malignancy with variable clinical behaviour. Ki-67, a nuclear antigen associated with cellular proliferation, has been investigated for its prognostic relevance in RCC. However, its utility in predicting metastatic potential remains controversial, particularly in the Indian population. This study aimed to evaluate Ki-67 expression in RCC and its association with clinicopathological features and metastatic risk. A retrospective analysis of 95 RCC cases was performed at a tertiary care centre between January 2018 and December 2020. Clinicopathological data were retrieved from electronic records, and histological slides were reviewed. Ki-67 immunohistochemistry was performed on tissue microarray (TMA) sections using MIB-1 antibody. The labelling index was calculated, and cases were categorized into low (≤10%) and high (>10%) Ki-67 expression groups. Statistical analysis included chi-square tests, Mann-Whitney U tests, Kruskal-Wallis tests, logistic regression, ROC curve analysis, and Kaplan-Meier survival analysis using SPSS v27. The mean age was 57.09 years; 62.1% were males. Clear cell RCC was the predominant subtype (82.1%). Ki-67 expression was low in 86.3% and high in 13.7% of cases. A higher ISUP grade was significantly associated with increased Ki-67 expression (p = 0.002), and sarcomatoid differentiation correlated with high Ki-67 expression in univariate analysis (OR = 24.3, p = 0.008). However, Ki-67 was not significantly associated with tumour size, stage, or histologic subtype. Metastasis occurred in 13.7% of cases but was not significantly associated with Ki-67 expression (p = 0.49; AUC = 0.438). Event-free survival did not differ significantly between the low and high Ki-67 groups (p = 0.71). Ki-67 showed a significant association with tumour grade and dedifferentiation in RCC, reflecting increased proliferative activity in biologically aggressive tumours. However, Ki-67 lacks independent prognostic value for metastasis or event-free survival, suggesting that Ki-67 should be integrated into a broader multiparametric model rather than used in isolation.