Articles

Adverse effects of E-cigarettes or Vapes in otherwise Healthy Young and Middle-aged Adults who have No History of Smoking: A Systematic Review

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Introduction: The use of Electronic cigarettes and Vapes have been widely accepted as a less-harmful means of smoking when compared to cigarettes. While this is true, the adverse effects and harms of E-cigarettes and Vaping are not inconsequential.

Methods: We searched the PubMed database exclusively for Randomized controlled trials, while limiting our search between 2007 – 2023. We initially identified 234 articles from PubMed which were then screened by abstract. Articles were screened for relevance based on the topic of E-cigarettes or Vaping and of adverse effects. Exclusion of 205 studies left 29 full-text articles to assess. Assessing based on our inclusion and exclusion criteria left 6 studies eligible for systematic analysis. Data extraction was performed on each study with focus on baseline demographics and covariates. Using the Jadad-scale, three independent reviewers assessed the methodological quality of each study on a 5 point scale. It was found that 1 study was of poor quality, 4 studies were of moderate quality and 1 study was of good quality.

Results: 6 RCTs were included in the analysis with 4 being performed in the United States, 1 in Italy and 1 in Canada. A total of 137 participants were included in the randomized controlled trials published between 2015 and 2021. Acute vaping indicated a positive correlation and dose-response relationship with an increase in CD14, CD16, T-cells, natural killers and monocytes. Furthermore, the findings from the review suggests that EC usage alters expression of the transcriptome in both small airway epithelium (SAE) and alveolar macrophages (AM).

However, acute electronic cigarette use does not affect lung and heart functions as long as they do not contain nicotine.

Discussion: This systematic review was conducted using Randomized controlled trials, which minimizes bias and adjusts for confounding, with a robust internal validity. Randomization also provides the best means for determining a causal relationship between an intervention and outcome. However the average quality of the included studies are not of good quality and sample size (137 subjects) may be considered quite small and not representative. Database for studies included was limited to only Pubmed. Moreover health-care practitioners must also actively inquire about the recreational use of vapes in youth and adults, as they are becoming popularized due to the misconception of having few harmful effects.

Conclusion: Acute use of electronic cigarettes show a significant increase in inflammatory cell and cytokine release, leading to oxidative stress, potential airway remodeling and DNA damage. It was found that acute E-cigarette usage also decreases FEV1, however these changes were not clinically significant towards pulmonary function and cardiac function tests. While this study only assesses the acute effects of electronic cigarette vape usage, further studies must be conducted on the chronic usage of E-cigarettes and their clinical effects.

Chamomile (Matricaria Chamomilla L.) as An Anti-Inflammatory Agent for Oral Mucosa: Mechanisms and Clinical Evidence

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Matricaria chamomilla L. commonly known as chamomile is a medicinal herb widely recognized for its potent anti-inflammatory, antioxidant, and antimicrobial properties. This narrative review synthesizes current evidence on the therapeutic potential of chamomile in managing oral mucosal inflammation, emphasizing its pharmacological mechanisms and clinical efficacy. Chamomile’s major bioactive compounds including flavonoids such as apigenin and essential oils like chamazulene and α-bisabolol modulate key inflammatory pathways by inhibiting cyclooxygenase-2 (COX-2), suppress the production of proinflammatory cytokines (TNF-α, IL-1β, IL-6), and regulating NF-κB activity. These effects collectively reduce oxidative stress, inflammation, and microbial colonization in oral tissues. Clinical trials demonstrate chamomile’s efficacy in reducing symptoms and accelerating healing in conditions such as oral mucositis, recurrent aphthous stomatitis, and gingivitis. Given its favourable safety profile and multi-targeted mechanisms, chamomile represents a promising natural adjunct or alternative in oral healthcare. Further standardized clinical research is warranted to optimize its therapeutic use.

Immunopathology and Laboratory Diagnosis of Rheumatoid Arthritis: A Review of Literature

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This review explores rheumatoid arthritis, an autoimmune disorder whose immunopathology involves a convergence of genetic susceptibility (notably HLA-DRB1 shared epitope alleles) and environmental exposures (smoking, infections) leading to an aberrant immune response. RA is a prevalent autoimmune disease globally, and though historically considered uncommon in Africa, emerging data show it is an important and likely under-recognized health issue in regions like Nigeria. Epidemiologically, ~0.5% of the world’s population is affected with millions suffering chronic pain and disability. In Africa and Southeastern Nigeria, true prevalence is uncertain due to diagnostic gaps, but RA cases are increasingly reported as awareness grows. Autoimmune processes – generation of RF and ACPA autoantibodies, activation of T cells and macrophages, and a cytokine-driven inflammation – result in synovial damage and systemic effects. Understanding these mechanisms explains why specific biomarkers (RF, ACPA) are useful in diagnosis and why therapies targeting cytokines (like TNF or IL-6 inhibitors) are effective. In laboratory diagnosis, we identified the core tools: RF and ACPA testing for confirming autoantibodies, ESR and CRP for gauging inflammation, and newer panels for disease activity. In resource-constrained settings, basic assays can be performed with relatively low-cost methods (e.g. ESR by Westergren, RF by latex agglutination), but introducing more specific tests like anti-CCP is vital for improving diagnostic specificity. We provided practical outlines for these assays, emphasizing adherence to SOPs and quality control to ensure accuracy of results.

Urinary Tract Infections as a Trigger for Dementia Progression

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Urinary tract infections (UTIs) are one of the infections that occur most frequently among the elderly and are now increasingly recognized as a significant factor in the causation of cognitive decline, particularly among those who had previously experienced dementia. This broad review focuses on epidemiological evidence, underlying pathophysiological mechanisms, and clinical consequences for examining the complex interrelationship between UTIs and dementia. Frequent UTIs have been shown to worsen the symptoms of dementia and accelerate cognitive deterioration due to the induction of systemic inflammation, neuro-inflammation, and disturbances of the blood-brain barrier. Delayed treatment due to diagnostic difficulties in the elderly further exacerbates cognitive effects. Preventive measures associated with alleviation of UTI-related cognitive burden include early detection, efficient management of UTI, and techniques reducing inflammation. It thus emphasizes on integrating multidisciplinary approaches as an improvement pathway towards better results in this highly vulnerable population.

Hyperbaric Therapy for Auto Immune Diseases

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An autoimmune disease arises when the immune system mistakenly targets the body’s own tissues, causing damage rather than providing protection. Hyperbaric oxygen therapy (HBOT) involves the administration of 100% pure oxygen within a specialized environment known as a hyperbaric chamber. While atmospheric air contains only 21% oxygen, HBOT leverages increased air pressure within the chamber to enhance the lungs’ ability to absorb oxygen. This elevated oxygen intake delivers vital oxygen to tissues, promoting healing and aiding in the fight against certain infections.

HBOT operates through multiple mechanisms: it reduces inflammation, combats infections, and facilitates the repair of damaged tissues. The therapy’s pure oxygen content supports the immune system in combating bacteria while stimulating the production of stem cells. These stem cells play a pivotal role in generating various cell types essential for bodily functions, including blood cells, brain cells, and muscle cells. In essence, HBOT fosters tissue repair and enhances overall immune functionality.

Biochemical Influence of Uric Acid and Some Inflammatory Biomarkers on the Association of Oral Hygiene with Cardiovascular Diseases

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Oral hygiene was associated with cardiovascular diseases (CVD), and the link is verified by bacterial colonization of the oral cavity and their products that spread into the circulation, starting endothelial dysfunction, pro-atherogenesis, pro-inflammation, and host immune mechanisms. High levels of serum uric acids are linked with CVD that are intern, associated with worsening gum hygiene. Several studies show that hyperuricemia could modify purine catabolism in case of oral disorders, including periodontal diseases (PD) and dental loss. PD and tooth caries were also linked with diabetes mellitus hypertension, insulin resistance, metabolic syndrome, dyslipidemia, and CVD. Dental caries was defined as an independent risk factor for coronary atherosclerosis too. However, dental restoration was correlated with the burden of arteriosclerosis negatively. Several experimental trials did not affirm the relationship between oral hygiene and CVDs.

Recent research has revealed similar biochemical and inflammatory biomarkers that are involved in CVD and oral diseases like C-reactive protein, interleukins, TNF-α, and others.

This consensus review aims to summarize some of the biochemical and inflammatory evidence connecting poor oral hygiene with the risk of CVD.

The Role of Cupping Therapy (CT) In Pain Tackling, an Insight into Mechanism Therapeutic Effects and its Relevance in Current Medical Scenario

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Cupping Therapy (CT) is popular as ʻAl-Hijamaʼ in Egypt and Arabic countries which is an ancient traditional method which is practiced for the treatment of various medical conditions, especially claims to be a potential remedy in pain related diseases. Basically, this therapy is an integrated part of the Complementary and alternative medicine, it has got utmost popularity in Unani system of medicine too. Although cupping therapy has been a treatment for long, but its mode of action is not well established yet, several studies have been conducted so far in order to investigate the actual mechanisms behind this therapy, still cupping therapy is a matter of dilemma in medical science. So far, several theories and hypothesis have been put forwarded to explain the effects produced by the cupping therapy. This article provides an overview of cupping therapy practice and associated adverse events, therapeutics potential and current prospective in today’s medical science.