Evaluating The Effectiveness of Pelvic Clock Exercise Versus 90-90 Hemibridge with Ball and Balloon Techniques Along with Conventional Therapy on Pain and Quality of Life in Female College Students with Primary Dysmenorrhea

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Background: Primary dysmenorrhea is a common gynecological condition in young women, characterized by cramping lower abdominal pain during menstruation. It begins in adolescence and adversely affects daily activities, academic performance, and quality of life. Associated symptoms include low back pain, fatigue, headache, nausea, and mood disturbances. Exercise therapy is widely used to reduce symptoms. This study aims to evaluate the effectiveness of pelvic clock exercise versus 90–90 hemibridge with ball and balloon technique, along with conventional therapy, on pain and quality of life.

Methods: A comparative study conducted on 30 female college students aged 18–25 years with primary dysmenorrhea. The subjects were divided into two groups. Group A received pelvic clock exercise with conventional therapy, Group B received 90–90 hemi-bridge with ball and balloon technique with conventional therapy. The treatment duration was 45-60 minutes, 3 times /weeks for 4 weeks.  Pain was assessed by Visual Analogue Scale (VAS) and severity and quality of life were assessed by WaLIDD questionnaire before and after treatment.

Result: Using an unpaired comparison of post-test values showed significant improvement in Group B than Group A, with t-value of VAS scale is 5.136.  and WaLIDD questionnaire is 4.431 respectively.

Conclusion: The study concludes that there is notable improvement in 90-90 hemibridge ball and balloon technique along with conventional therapy was found to be more effective in reducing pain and improvement in quality of life in individual with primary dysmenorrhea.

Exercise During Chemotherapy in Colorectal Cancer: A Systematic Review

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This study investigates the effects of structured exercise on treatment tolerance, physical function, and frailty-related outcomes in adults with colorectal cancer (CRC) receiving chemotherapy, with separate appraisal for older patients to evaluate its potential to support safe and effective treatment delivery. Using a Systematic Review methodology, this study synthesized research published between January 2021 and March 2026 from PubMed, Taylor & Francis Online, and SAGE Journals searched (1 May–1 June 2026). Data were analyzed using a narrative synthesis approach, focusing on tolerance, function, fatigue, frailty, quality of life, adherence, and safety, with bias assessed via RoB 2 and ROBINS-I. The findings indicate that of 701 studies screened, 7 reports (5 cohorts) were eligible, with no serious exercise-related adverse events. A geriatric intervention with supervised physiotherapy showed higher chemotherapy completion than usual care (45% vs 28%, p=0.037), though not isolated from concurrent nutritional therapy and medication review. Unsupervised home-based resistance training did not improve relative dose intensity, while function improved most consistently with supervised or progressive resistance programs. Unlike previous review studies, this research integrates tolerance, function, frailty, and safety outcomes into a unified narrative framework specific to the CRC chemotherapy population. The study concludes that structured exercise appears feasible and may preserve physical function, though its independent contribution to treatment tolerance remains undetermined and frailty-specific evidence is limited to one geriatric cohort. Additionally, further research is required to compare exercise delivery models using adequately powered trials and standardized frailty/tolerance measures.

Protective effects of vitamin E and vitamin C against cisplatin nephrotoxicity in female Wister rats

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Cisplatin (CP) is a potent anticancer agent used in cancer treatment. However, Cisplatin had ability to induce multiorgan toxicity including nephrotoxicity. This study aims to investigate the effect of vitamin E (Vit. E) and Vitamin C (vit. C) on nephrotoxicity induced by cisplatin in female rats.

Twenty Female white albino rats were divided to four groups, control, cisplatin, vit. E + cisplatin and vit. C + cisplatin. Cispatin (8 mg/kg as a single dose on the day on and second dose at 14 experimental day.vit. E was administered Intraperitoneal injection 3 days prior to cisplatin (8 mg/kg, i.p) injection two does same process for two weeks with two-week rest period. vitamin C (200 mg/kg), were administered Intraperitoneal injection 3 days prior to cisplatin (8 mg/kg, i.p) injection two does same process for two weeks with two-week rest period. The result of this study administration of cisplatin induced Necrosis of epithelial cells of renal tubules in cortex area led to form spaces filled with inflammatory cells forming a cluster in affected areas in the cisplatin treated group compared with vit. E + Cisplatin treated group which reduced nephrotoxicity by antioxidant activity of vitamin against cisplatin induced oxidative stress in these rats. However, vit. C + Cisplatin treated group showed mild nephroprotection. Necrosis of epithelial cells was observed in renal tubules with infiltration of inflammatory cells that formed small cluster near the glomerulus in cortex area. The study findings indicated that vitamin E exert protective effects against CP-induced nephrotoxicity, a finding which requires larger studies for confirmation. cisplatin treatment alone induced the upregulation of cytokeratin-8 (CK-8), a marker of tubular injury, co-treatment with Vit.E attenuated this effect, indicating protection of renal tubular integrity. Also,cisplatin treatment group showed positive expression of vimentin in cortical convoluted renal tubules and normal expression in glomerulus.

Safety and Efficacy of Antihypertensive Deprescribing in Frail Geriatric Patients: A Narrative Review of Contemporary Clinical Trial Evidence

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Polypharmacy with antihypertensive agents in frail older adults presents a clinical dilemma: continuing therapy may preserve cardiovascular protection, yet it simultaneously increases the risk of orthostatic hypotension, falls, and drug-related adverse events. This narrative review synthesizes contemporary clinical evidence on the safety and efficacy of antihypertensive deprescribing (gradual withdrawal or dose reduction) in frail geriatric populations, particularly those residing in long-term care facilities. Literature searches were conducted in PubMed/MEDLINE, Cochrane Library, and Google Scholar (2011–2025).

Key findings include: the OPTIMISE randomized trial, which demonstrated that withdrawing one antihypertensive agent in patients aged ≥80 years was non-inferior to usual care for systolic blood pressure control over 12 weeks, with 66% sustaining the reduction. The DANTE trial found no cognitive benefit from discontinuation in older adults with mild cognitive impairment. Observational data from the PARTAGE study revealed that low systolic blood pressure combined with ≥2 antihypertensives was associated with increased two-year mortality in frail nursing home residents, supporting the rationale for deprescribing in this subgroup. A Cochrane systematic review (2020, updated 2023) encompassing six trials (1,073 participants) found no significant association between antihypertensive withdrawal and mortality, myocardial infarction, stroke, or hospitalization, though evidence on falls and quality of life remains limited.

Overall, current evidence supports selective, closely monitored deprescribing in frail geriatric patients. However, long-term outcomes and data specific to Asian populations, including Indonesia, remain scarce, underscoring the need for further research.

Pharmacogenomics of Adverse Drug Reactions: Integrating Genetic Biomarkers into Precision Pharmacotherapy

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Adverse drug reactions (ADRs) remain a major global healthcare challenge, accounting for significant morbidity, mortality, treatment failure, and increased healthcare expenditure. Although clinical factors such as age, comorbidities, organ function, and polypharmacy contribute to ADR susceptibility, they inadequately explain the marked interindividual variability in drug response. Pharmacogenomics has emerged as a transformative approach to precision medicine by identifying inherited genetic variants that influence drug metabolism, transport, efficacy, and toxicity. This review critically examines the role of pharmacogenomic testing in predicting, preventing, and managing ADRs, with emphasis on clinically actionable pharmacogenes including CYP2D6, CYP2C19, TPMT, NUDT15, HLA-B15:02, HLA-B57:01, and HLA-B 58:01. Evidence from international pharmacogenomic guidelines demonstrates that genotype-guided prescribing significantly reduces severe hypersensitivity reactions, drug toxicity, and treatment failure while improving therapeutic efficacy and patient safety. The review further discusses current clinical applications, implementation challenges, ethical considerations, and emerging advances in genomic technologies, artificial intelligence, and clinical decision-support systems. The integration of pharmacogenomics into routine healthcare has the potential to optimize individualized drug therapy, minimize preventable ADRs, and accelerate the transition toward precision medicine, ultimately improving clinical outcomes and healthcare quality.

Rickets on the Rise: A Case Series Highlighting the Importance of Growth Monitoring and Nutritional Assessment in Preventing Rickets

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Nutritional rickets, though a preventable condition, continues to show an increased incidence in clinical practice. It is crucial to recognize these cases during early stages in order to prevent the progression from vitamin D deficiency to clinical rickets, with the potential for irreversible complications. This case series describes five pediatric patients in which vitamin D deficiency and rickets was identified by close observation through growth monitoring and nutritional assessment. These workups were conducted due to the initial presentation of failure to thrive in each of these cases, prompting further evaluation to identify the underlying causes of growth faltering. A common theme throughout was normocalcemia, however, it is important to understand that this finding does not rule out the potential for rickets, as both subclinical rickets and stage two compensatory rickets can lead to normal laboratory findings. Therefore, growth faltering should always prompt nutritional assessment because early recognition, growth monitoring, a well-balanced diet with calcium-rich foods, compliance with vitamin D supplementation, and consistent follow-ups are essential to prevent the risk of developing clinical rickets.

Lessons from Leptospirosis Deaths in Sri Lanka, 2025: Findings from a National Secondary Data Analysis

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Background: Leptospirosis is a globally important zoonotic disease and a leading cause of preventable mortality in Sri Lanka, with deaths driven by occupational and environmental exposure, delayed care-seeking, late clinical recognition and severe complications.

Methods: A descriptive secondary data analysis was conducted using the national leptospirosis death review database of the Epidemiology Unit, Ministry of Health, Sri Lanka. The analysis included 206 valid death records reported during 2025 through institutional death review forms.

Results: The median age was 53 years (IQR 41.5–61.5; range 16–84). Males accounted for 168/205 deaths (82.0%). The largest age group was 45–59 years (79/205, 38.5%). The highest numbers of deaths were reported from Kurunegala (34/206, 16.5%), Gampaha (19/206, 9.2%) and Rathnapura (16/206, 7.8%). Fever (155/198, 78.3%), headache (121/198, 61.1%), myalgia (115/198, 58.1%) and anuria/oliguria (93/198, 47.0%) were the most commonly documented features. Paddy field exposure was recorded in 68/206 (33.0%) of deaths. The median time from symptom onset to admission was 3 days, and the median time from symptom onset to death was 7 days. Among death review findings, late presentation or delayed treatment-seeking was the most frequent theme (75/87, 86.2%).

Conclusions: These findings highlight opportunities to reduce leptospirosis deaths in Sri Lanka through earlier detection, prompt evidence-based treatment supported by regular clinician training, targeted risk communication for high-risk populations, improved chemoprophylaxis uptake, timely referral, and strengthened access to critical care and renal support services.

When a Hemangioma is not a Hemangioma: Diagnostic Challenges in Infantile Soft Tissue Masses

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Infantile fibrosarcoma’s are the most common soft tissue sarcomas in infants under the age of one, and also have an excellent survival rate. However, these tumors also have a propensity to grow rapidly, and as such, require prompt evaluation and intervention to avoid negative outcomes, such as increased local invasion, more extensive surgical resections or amputations, as well as the potential risk for distant spread. This case report describes the presentation of an infantile fibrosarcoma that was initially misdiagnosed as an infantile hemangioma. Two conditions that can present very similarly in both clinical and radiologic evaluation, but require very different treatment strategies. Through our case presentation, we aim to highlight the importance of vigilance and accuracy during diagnostic work-up to ensure swift intervention for patients with potentially sinister underlying diagnoses.

Impact of Screen Time [PHONES, T.V., SOCIAL MEDIA] on Snacking Frequency in Children [5–14 Years] of Meerut District

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Children today spend a good part of their day in front of some screen or another, and parents often wonder how much of an effect this really has on the way their kids eat. That question is what this study set out to answer. Fifty parents of children aged 5–14 years in Meerut district, Uttar Pradesh, were interviewed using a structured questionnaire as part of a cross-sectional descriptive study, and their answers were analysed using simple frequency and percentage calculations, then laid out in tables and graphs. What came out of the data was fairly consistent: television and mobile use both hovered around 1–2 hours a day for most children (36% and 32% respectively), and screen use was heaviest in the afternoon (56%) rather than morning or night. YouTube Shorts turned out to be the clear favourite among children (42%). Eating in front of a screen was the norm rather than the exception 34% of children always ate this way, and only 8% never did. Interestingly, when parents were asked why their children snack during screen time, taste (26%), hunger (24%) and habit (24%) came up far more often than advertisements (8%), which goes against the common assumption that ads are the main culprit. Nearly half the parents (46%) also mentioned that their child gets irritated if the screen is taken away mid-meal. Taken together, these findings suggest that screen time and snacking have become tightly woven into daily routine for many children in Meerut, and that the fix probably lies less in banning screens outright and more in building steadier mealtime habits and a bit more mindfulness around eating.

Risk Factors for Needle Stick Injuries (NSIs) Among Medical Solid Waste Handlers at Hospital X, Lampung Province, Indonesia

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Background: Needle Stick Injury (NSI) is an occupational accident that poses a risk of transmitting infectious diseases to personnel responsible for managing solid medical waste. The occurrence of NSI is presumed to be influenced by compliance with the use of Personal Protective Equipment (PPE), the implementation of safety boxes, adherence to Standard Operating Procedures (SOPs), and Occupational Health and Safety (OHS) training.

Objective: To analyze the association between compliance with PPE use, safety box implementation, adherence to SOPs, and OHS training with the occurrence of NSI among solid medical waste management personnel at Hospital X, Lampung Province.

Methods: A quantitative study with a case–control design was conducted from May to July 2026 involving 45 respondents, consisting of 9 cases and 36 controls. Data were collected through questionnaires, observations, and secondary data, and were analyzed using the Chi-square test with a 95% confidence level.

Results: A total of 20.0% of respondents had experienced NSI. No significant associations were found between PPE compliance (p = 0.171), safety box implementation (p = 0.086), or adherence to SOPs (p = 0.118) and the occurrence of NSI. However, OHS training was significantly associated with NSI (p = 0.048). Respondents who had inadequate OHS training were six times more likely to experience NSI than those with adequate training (OR = 6.000; 95% CI = 1.238–29.069).

Conclusion: OHS training was identified as a factor significantly associated with the occurrence of NSI, whereas compliance with PPE use, safety box implementation, and adherence to SOPs showed no significant associations. Strengthening structured and comprehensive OHS training programs is essential to reduce the risk of Needle Stick Injury.