Articles

Background: Nicotinamide adenine dinucleotide (NAD⁺) is a pivotal coenzyme and signaling substrate that integrates redox balance with mitochondrial energy production, DNA repair, epigenetic control, and cellular stress resilience. Declines in NAD⁺ availability—frequently observed with ageing, chronic inflammation, and metabolic stress—have intensified interest in NAD⁺ restoration as a potential strategy to influence disease biology across multiple organ systems.Objective: This narrative review summarizes contemporary mechanistic and translational evidence on NAD⁺ biosynthesis and turnover, highlighting the de novo kynurenine pathway and vitamin B3–dependent salvage routes (nicotinic acid, nicotinamide, nicotinamide riboside, and nicotinamide mononucleotide). We also examine how major NAD⁺ consumers and sensors, sirtuins, poly(ADP-ribose) polymerases (PARPs), and CD38 link NAD⁺ status to inflammation, oxidative stress, and tissue dysfunction in diverse clinical contexts.Methods: Peer-reviewed literature on NAD⁺ metabolism, NAD⁺-dependent signaling, and preclinical/clinical studies of NAD⁺ precursors was evaluated and organized into: (i) core biochemical functions in cellular energetics, (ii) NAD⁺ consumption in genome maintenance and immune signaling, and (iii) organ-focused evidence relevant to skin disorders, infertility and reproductive health, osteoarthritis, hearing loss, vision decline, gut barrier dysfunction, cardiovascular and renal metabolism, hepatic steatosis, neurological diseases, and skeletal muscle health.Results: NAD⁺ supports glycolysis, the tricarboxylic acid cycle, and oxidative phosphorylation, while acting as an essential substrate for PARP-driven DNA repair and sirtuin-mediated deacylation programs that shape mitochondrial fitness, inflammatory tone, and metabolic flexibility. Across experimental models, impaired NAD⁺ homeostasis repeatedly associates with mitochondrial dysfunction, heightened oxidative injury, and dysregulated immune–barrier responses, features shared by intestinal inflammation, neurodegeneration and ischemic injury, cardiometabolic disease, kidney injury, and fatty liver disease. Supplementation with NAD⁺ precursors (notably NR and NMN) reliably elevates NAD⁺ in preclinical systems and increases circulating NAD⁺ metabolites in humans, with early signals of pathway engagement; however, clinical outcomes remain heterogeneous across populations, dosing regimens, and endpoints. Evidence for intravenous NAD⁺ “drip” therapy is comparatively limited and insufficiently standardized, with constraints related to tolerability, dose consistency, and cost, underscoring the need for controlled trials.Conclusion: NAD⁺ occupies a central position at the interface of energy metabolism, genome integrity, and immunometabolic signaling, providing a coherent framework for understanding how cellular stress can propagate multisystem dysfunction. Although NAD⁺-boosting strategies are biologically plausible and mechanistically supported, definitive clinical benefit across skin, fertility, osteoarthritis, sensory decline, gut disorders, cardiovascular and hepatic disease, neurological conditions, and muscle health will require well-designed human studies with standardized biomarkers, safety surveillance, and clinically meaningful endpoints.

In this manuscript, we present an Hiatal hernia(HH) with situs inversus totalis(SIT) performed by transumbilical single-incision laparoscopic hiatal hernia repair and Nissen fundoplication, which is rarely reported previously. A 62-year-old woman was admitted with a diagnosis of hiatal hernia and gastroesophageal reflux disease (GERD), as proven by Gastroesophageal Reflux Disease Questionnaire (GERD-Q) scoring, endoscopic, and radiologic findings. The patient had a history of spinal correction surgery for scoliosis five years ago, during which her SIT was identified. We performed a classic LHHR plus Nissen fundoplication for the patient, especially through a transumbilical single incision. An atraumatic method of liver retraction with a Veress needle sheathed by a latex tube and a convenient autosuturing device was used to overcome the difficulties. The patient experienced an uneventful recovery and presented complete resolution of GERD at the one-month follow-up.

Penile fracture is a rare urological emergency typically characterized by an audible “cracking” sound, immediate detumescence, and rapid penile swelling following trauma to an erect penis. We present clinical and intra-operative images of a 37-year-old man with a proximal tunica albuginea tear confirmed at urgent exploration and repaired with absorbable sutures. Early surgical exploration with hematoma evacuation and primary repair remains the preferred approach to reduce long-term complications such as penile curvature and erectile dysfunction.

Objective: This study investigated the utility of the second version of the Children’s Depression Inventory (CDI-2) as a screening tool to identify children and adolescents aged 8-21 years suffering from depressive symptoms. Method: Data were collected by combining questionnaire data from multiple clinical and control subsamples in which the CDI-2 child and parent version were administered to clinically depressed children (n = 111), children with other psychiatric disorders (n = 74) and control children (n = 2246) as well as their parents (respectively n = 104, n = 112, n = 2130). Results: Results showed that the CDI-2 has good psychometric properties in terms of internal consistency, factor structure, parent-child agreement, convergent and divergent validity. However, the factor structure of the parent version was insufficient. The CDI-2 total score of the child version and parent version can differentiate between clinically depressed children, children with other psychiatric disorders, and control children. Further, reliable cut-off scores were established. There were also significant gender and age effects.Conclusion: The total score of the CDI-2 child and parent version can be used as a screening tool to detect clinically significant depressive symptoms in children and adolescents. 

Nosocomial infections are infections acquired during a stay in a healthcare facility, representing a major public health challenge worldwide, and particularly in Africa, due to their frequency, potential severity, and associated costs. In Congo, their epidemiological profile is not yet well understood. It’s in this context that we undertook to conduct a retrospective descriptive study on nosocomial infections between January 1, 2012, and December 31, 2016, in the internal medicine department of the Army Central Hospital of Brazzaville, in order to analyze the bacteriological profile of nosocomial infections.The study involved 189 patients. The results revealed that hospital-acquired infections were frequent, with a female predominance (71.43%), an average age of 32 years, and risk factors including self-medication with antibiotics (51%) and urinary catheterization (39%). Urinary tract infections were the most common (57%), with Escherichia coli as the main pathogen (17%), and mortality from these infections reached 53%.The study highlighted a high mortality rate linked to hospital-acquired infections, primarily associated with HIV status and self-medication. Management, prevention, and infection control measures, including improved antibiotic stewardship, are necessary to reduce mortality.

Purpose: To determine trends in breast imaging services utilization among privately and government-insured patients at a national radiology practice.Method: Monthly breast imaging volume data from January 2019 to September 2022 were analyzed across five insurance types: three commercial carriers (Com1-Com3), Medicaid, and Medicare. Primary analysis involved calculating quarterly volumes and standard errors of the mean, followed by a joinpoint regression to identify trend inflection points and quarterly percentage changes (QPC). In the secondary analysis, the entire period trend was obtained and measured as the average quarterly percentage change (AQPC).Results: Between 2019 Q1 and 2022 Q3, a total of 4,640,619 breast imaging services were accessed, including 2,034,833 2D screening mammograms, 1,640,689 screening digital breast tomosynthesis, 497,592 diagnostic mammograms, 452,549 breast ultrasounds, and 14,956 breast MRIs. AQPC values for imaging modalities varied across insurance types. Medicare and Medicaid patients showed the highest rates of utilization increases, particularly for modalities other than screening breast tomosynthesis, where private insurers dominated. Variations were observed between different commercial payors.Conclusion: Breast imaging utilization increased among patients insured by Medicare and Medicaid from 2019 to 2022, outpacing that of those with private insurance. These findings contrast previous research suggesting better access and utilization among privately insured individuals, highlighting increased access for government-insured patients in this study.

Depression, trauma, and anxiety disorders continue to be predominant causes of global disability, with typical therapies proving to be only marginally successful. Heart Rate Variability Biofeedback (HRVB) offers patients a self-regulation method that improves the flexibility of the autonomic nerve system via resonance breathing. Clinical research shows that training can significantly lower symptoms of sadness and PTSD, with improvements shown after 4 to 8 weeks. HRVB is inexpensive, non-invasive, and scalable, making it a promising supplementary therapy in psychiatry. Subsequent study ought to inform its incorporation into clinical protocols.

Sagittal split osteotomy (SSO) of the mandible is still an important part of orthognathic surgery, but “bad split” fractures that happen during the surgery are still a big problem. This report describes a rare case of bilateral bad split associated with highly compact mandibular bone (D1–D2 type) in a 53-year-old male undergoing mandibular advancement. The bone was too hard for the piezoelectric and rotary tools to work, and there was very little bleeding. This caused fractures in the cortex and lingual. Postoperative computed tomography confirmed the presence of highly dense bone, correlated with delayed healing and recurrence. Consistent pre-surgical CT scanning for an assessment of the density of the mandibular bone can provide essential information about the potential risk of the osteotomy procedure in the patient. Performing a careful bone quality and density examination pre-operatively will allow the surgeons to select the most appropriate instruments and surgical techniques that will fit the patient’s individual anatomy. Such a point escalates to being very significant when dealing with the geriatric population, as bone density increase can not only alter the fracture behavior but also the recovery process during and after surgery. The inclusion of regular CT-based bone density evaluations into the preoperative routine not only facilitates the anticipation of surgical difficulties but also results in safer and more efficient osteotomies.

Aims: The study was conducted from January to June 2023 to observe the prevalence of repeat breeding syndrome in cows, to isolate and identify the bacteria with their molecular confirmation, and antibiotic sensitivity in Bangladesh. Study design & Place and duration of study: The study was conducted under the supervision of the Department of Medicine, Surgery, and Obstetrics, Hajee Mohammad Danesh Science and Technology University, Dinajpur-5200. Some laboratory work was performed at the Microbiology Department of Pathology and Parasitology laboratory, HSTU, from January to June 2023.Methodology: A questionnaire was used to identify repeat breeding syndrome. Bacteria were isolated and identified from the cervical mucus of affected cows. For confirmation of the detected bacteria, PCR was used. The agar disc diffusion method was utilized to investigate the antibiotic sensitivity of the detected isolates against widely used antibiotics in vitro. Results: The prevalence of Repeat Breeding (RB) was 41.33%. The prevalence of E. coli was 40%, Staphylococcus aureus 40% and Klebsiella spp. 10%. Molecular detection of E. coli and Staphylococcus aureus was confirmed by using Eco 223 (F), Eco 455 (R), Sau 234(F), and Sau 1501(R) primers. The target genes were 16S and 23S rRNA, and the size of the product amplified at 232 bp and 1267 bp, respectively. According to the antibiogram profile, E. coli was resistant to ciprofloxacin, penicillin, tetracycline, amoxicillin, and erythromycin, but sensitive to ceftriaxone and gentamicin. While Staphylococcus aureus was resistant to ampicillin and erythromycin, it was sensitive to ciprofloxacin, ceftriaxone, and levofloxacin. It was also intermediately resistant to vancomycin and amoxicillin. Klebsiella spp. Showed resistance to ceftriaxone, penicillin, and amoxicillin, while remaining sensitive to ciprofloxacin, tetracycline, and intermediate resistance to erythromycin and gentamicin. Conclusion: This study concluded that E. coli, Staphylococcus aureus, and Klebsiella spp. are the most common bacteria causing repeat breeding syndrome in cows.

One of the most important and critical red blood cell disorders is dysfunction and deformation of the membrane structure, which affects the metabolic and biological red blood cell functions. On the other hand, the basic causes of these problems are the genetic mutations in the production of proteins that correlate to the structure and receptors of cells. The diagnosis methods and techniques are the other essential points that focus most scientists on. In this systematic review, the article pointed to the key title, which is the diagnosis of novel genes with different techniques and methods. The result of articles studies that were published in the last decades underlined the types of techniques such as Whole-Exome Sequencing, Quantitative Real-Time PCR, Targeted Next-Generation Sequencing, and Sulphate-Polyacrylamide Gel, which investigated the different membraned gene mutations that are novel and correlated to the genes that make the structures and functions of red blood cells such as hereditary spherocytosis, hereditary elliptocytosis, hereditary pyro poikilocytosis. In addition, the hereditary membrane disorders correlated to others, such as hereditary spherocytosis, have a relationship with vitamin B12, immunodeficiency.