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Antimicrobial resistance (AMR) is a serious global health crisis. It is getting worse every year. Low- and middle-income countries (LMICs) are the most affected. This is mainly because infectious diseases are very common there. Poor water, sanitation, and hygiene (WASH) systems make things worse. On top of that, vaccination rates in these countries remain very low. All these factors together make AMR a much bigger threat in LMICs than anywhere else.The recent data showed that bacterial AMR was linked to about 4.95 million deaths worldwide, and 1.27 million of the deaths were directly attributable in 2019. Using information from the Global Burden of Diseases, Injuries and Risk Factors Study 2021. The GBD Antimicrobial Resistance Collaborators employed statistical modelling to evaluate AMR trends from 1990 to 2021 and to forecast the burden through 2050 across 204 nations and territories.The results are concerning. AMR-related deaths have increased significantly. Older adults aged 70 and above are the most affected group. However, there is some good news too. Deaths among children under five have dropped by nearly 50%. This is a big achievement. Better infection prevention has played a major role in this. Vaccination programs have also made a real difference. Improved water and sanitation (WASH) initiatives have helped as well. These combined efforts have clearly saved many young lives.Key pathogens contributing to AMR mortality include Klebsiella pneumoniae, Escherichia coli, Streptococcus pneumoniae and meticillin-resistant Staphylococcus aureus (MRSA). In the absence of improved interventions, deaths attributable to AMR are anticipated to rise to 1.91 million annually by 2050. It is important to strengthen infection prevention, surveillance, vaccination, and WASH with integrated One Health approaches to ease the future impact of AMR.

Inverted Urothelial Papilloma (IUP) is an unusual variety of urothelial tumors that typically occurs in adults, with a predominance in males. The definitive diagnosis of IUP relies on histopathological examination, as the clinical presentation and endoscopic appearance are non-specific. The recommended treatment for IUP includes the complete transurethral resection, with some controversy regarding the need for cystoscopic follow-up. In this case, we present an atypical instance of IUP in a 21-year-old male patient, diagnosed with gross hematuria and irritative lower urinary tract symptoms. A clinical assessment revealed a 3.0 × 2.6 cm intravesical mass. The definitive diagnosis was confirmed histopathologically and further substantiated by immunohistochemistry, which demonstrated low expression of p53 and Ki-67, effectively ruling out malignancy. This case underscores the diagnostic challenges posed by bladder masses in young adults, emphasizing the necessity of integrating morphological and immunohistochemical findings to prevent overdiagnosis of urothelial carcinoma. The paper focuses on the diagnostic approach and management of this rare condition in the young male population.

Background: Paratesticular liposarcoma is a rare entity, with dedifferentiated liposarcoma (DDLPS) representing the most aggressive subtype. Late recurrences with unusual patterns of spread have been documented but remain poorly characterized.Case presentation: We report a case of a 68-year-old male with a 10-year recurrence of paratesticular DDLPS following right orchiectomy. The patient initially underwent resection of a 5×4×4.5 cm paratesticular mass in 2015, with histopathology confirming DDLPS and negative distal spermatic cord margins. After loss to follow-up, he presented in 2026 with extensive regional recurrence involving bilateral pubic soft tissues, abdominal wall musculature, and right external iliac lymphadenopathy. Biopsy confirmed recurrent DDLPS with Mouse double minute 2 homolog (MDM2) positivity. Given the multi-site infiltrative nature and muscle involvement, the multidisciplinary team recommended neoadjuvant chemotherapy with ifosfamide and doxorubicin before consideration of surgical resection.Conclusion: This case illustrates the propensity for late regional recurrence in paratesticular DDLPS and highlights the unusual pattern of spread along anatomic pathways, including the abdominal wall and inguinal region. The case underscores the importance of long-term surveillance, aggressive initial surgical margins, and multidisciplinary management in this rare malignancy.

Background: Bladder exstrophy is a rare congenital abnormality that is usually managed with multiple surgical interventions. Long-term consequences include recurrent urinary tract infections, bladder stones, fistulae, and metaplastic changes with malignant potential.Case Presentation: We present a case of a 21-year-old male with a history of failed childhood surgeries for bladder exstrophy who presented with a vesicocutaneous fistula and a 7 cm bladder stone. He underwent an open cystolithotomy with bladder augmentation and creation of a Benchekroun continent valve. However, the patient developed recurrent fistulae due to poor tissue quality. Histopathological examination confirmed early squamous metaplasia in the bladder mucosa. After discussion in a multidisciplinary meeting, the patient underwent a radical cystectomy with ileal conduit urinary diversion using the Bricker technique. He is doing well at 3 months with no evidence of any complication.Conclusion: This case illustrates the difficulties encountered in managing adult patients with bladder exstrophy and failed reconstructions. The presence of squamous metaplasia, poor bladder tissue, and recurrent complications all contributed to the decision for radical cystectomy. It is important to recognize these changes and address them appropriately in a timely manner to prevent further complications and possible malignant changes.

Background: Renal malakoplakia is a rare chronic granulomatous inflammatory disorder characterized by defective macrophage function. It typically occurs in immunocompromised patients with recurrent urinary tract infections. We present a case of renal malakoplakia in a diabetic patient who progressed to nephrectomy despite initial conservative management.Case presentation: A 57-year-old female patient with a medical history of insulin-dependent type 2 diabetes mellitus was admitted to the hospital with symptoms including fever, left flank pain, and dysuria. A physical examination revealed a tender left lumbar mass. Laboratory investigations revealed a leukocytosis (16,500/mm³), elevated C-reactive protein (142 mg/L), and preserved renal function. A urine culture revealed the presence of multidrug-resistant Escherichia coli (>106CFU/mL). A subsequent Computed Tomography (CT) scan revealed an enlarged left kidney with a 9 × 6 cm multiloculated subcapsular collection, causing significant parenchymal compression, along with two non-obstructive inferior pole calculi. The initial management strategy encompassed ultrasound-guided percutaneous drainage and targeted antibiotic therapy, with the latter being contingent upon bacterial sensitivities. Notwithstanding the patient’s positive clinical recovery, Technetium-99m Dimercaptosuccinic Acid ((99m)Tc-DMSA) renal scintigraphy performed four weeks after the episode revealed a non-functional left kidney, exhibiting a 15% differential function. Following a multidisciplinary discussion, a total left nephrectomy was performed. A histopathological examination revealed extensive replacement of renal parenchyma by polymorphous inflammatory infiltrate with pathognomonic Michaelis-Gutmann bodies. These bodies are spherical, basophilic, perinuclear inclusions that demonstrate strong positivity for Periodic Acid-Schiff and Perls stains. The postoperative course was complicated by self-limited lymphorrhage. At the 3-month follow-up, the patient reported complete resolution of symptoms and remains under nephrological surveillance.Conclusion: This case underscores the diagnostic challenges posed by renal malakoplakia, a condition that can present with a wide spectrum of mimics, including infectious and neoplastic processes. Early diagnosis and prolonged antibiotic therapy with agents capable of intracellular penetration may preserve renal function; however, nephrectomy remains necessary when irreversible parenchymal damage has occurred. Diabetes mellitus has been identified as a significant risk factor for malakoplakia development through impaired leukocyte function. 

Background: Obesity is one of the most pressing global health challenges, with over one billion people now living with the condition worldwide. In Southeast Asia, nearly 40% of the population is projected to be overweight or obese by 2035, with Thailand reporting prevalence exceeding 42%. Intensive Lifestyle Modification (ILM) combined with Meal Replacement (MR) has emerged as a promising strategy for achieving sustainable weight loss, supported by landmark trials including the Diabetes Prevention Program, Look AHEAD, and DiRECT.Objective: To illustrate the clinical effectiveness of ILM combined with MR through detailed case presentations documenting anthropometric outcomes at baseline, 8 weeks, and 52 weeks, contextualized within international obesity management guidelines and comparative research across diverse populations. We hypothesized that selected participants undergoing the ILM+MR intervention would demonstrate clinically significant weight loss (≥5% of initial body weight) sustained through 52 weeks, with concurrent improvements in waist circumference indicating reduced central adiposity.Methods: Twelve participants (9 female, 3 male) from the ILM+MR arm of a previously published retrospective cohort study (n = 702) were selected based on complete longitudinal data and representativeness. The intervention comprised structured nutritional counseling, soy-based MR (220 kcal per serving, twice daily for 8 weeks), behavioral modification with group therapy, and physical activity guidance aligned with the 2013 AHA/ACC/TOS guidelines. Body weight and waist circumference were measured at baseline, 8 weeks, and 52 weeks.Results: Mean total weight loss was 38.2 kg (35.3% of initial body weight), with mean waist circumference reduction of 13.0 inches (33.0 cm) over 52 weeks. All 12 participants achieved clinically significant weight loss (>5%), substantially exceeding the 5–10% threshold recommended by international guidelines. Weight loss occurred in two phases: a rapid intensive phase (mean 14.0 kg during weeks 0–8) followed by continued loss during maintenance (mean 24.2 kg during weeks 8–52). All participants completed the 52-week follow-up.Conclusion: This case series demonstrates the potential for substantial, sustained weight loss through ILM+MR intervention, supporting findings from the larger Thai cohort study and international research including the DiRECT trial and systematic meta-analyses. These results reaffirm the foundational role of comprehensive lifestyle programs and highlight their relevance as scalable, culturally adaptable interventions for obesity management across diverse populations.

The prevailing dogma regarding urinary tract sterility has been fundamentally challenged by advances in culture-independent molecular techniques. The urinary microbiome, also known as the urobiome, is defined as a complex ecosystem comprising bacteria, fungi, and viruses. This microbiome plays a pivotal role in maintaining urological health. Emerging evidence suggests a potential link between urinary microbial dysbiosis and the pathogenesis of Urologic Chronic Pelvic Pain Syndrome (UCPPS), a clinical umbrella term that explicitly encompasses two major phenotypes: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) and Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS).This review examines the paradigm shift in understanding urinary tract microbiology, characterizes the urobiome in health and disease, and explores the therapeutic implications of microbiome-targeted interventions for UCPPS management.

Obesity represents a significant public health challenge on a global scale, with its prevalence increasingly linked to socio-economic factors, most notably family income. This study investigates the relationship between family income and several obesity measures specifically, the Body Shape and Size Index (BSSI), Body Mass Index (BMI), Body Surface Area (BSA), Ponderal Index (PI), Weight/Body Mass (BM), and Height within a sample of 9,906 respondents from Pakistan. Utilizing descriptive statistics and p - values, the analysis aims to provide a comprehensive understanding of how variations in income affect these obesity indicators, ultimately informing potential public health interventions. The findings reveal a complex, variable association between family income levels and obesity measures that differs by the specific obesity index examined. For BSSI, individuals in the lowest income bracket demonstrated higher values (indicating greater adiposity), while for BMI and weight, higher income brackets showed elevated values. These mixed findings suggest that the direction of association depends critically on which obesity measure is analysed. The study reveals that lower-income families are more likely to face barriers in accessing nutritious food, engaging in physical activity, and achieving favourable health outcomes. This situation is often exacerbated by economic constraints that drive families toward caloric-dense, nutrient-poor food choices. The implications of this research are far-reaching, emphasizing the need for targeted public health strategies to address obesity, particularly among economically disadvantaged populations. The study advocates for policies that enhance food security, improve access to health-promoting resources, and create supportive environments for physical activity. Through a nuanced exploration of these relationships, the research aims to contribute valuable insights to the field of public health, promoting equity in health outcomes and addressing the root causes of obesity in Pakistan.

Spinal muscular atrophy (SMA) is a devastating autosomal recessive neuromuscular disorder characterized by progressive muscle weakness, atrophy, and respiratory failure due to selective degeneration of lower motor neurons arising from homozygous deletion of exon 7 (95%) or mutation in the SMN 1 gene (5%),with severity correlating with SMN2 copy number—from fatal Type1 to milder Type 4—affecting 1:6,000–10,000 births worldwide and burdening India with 1,500–2,000 annual cases amid diagnostic delays. Although the backup SMN2 gene compensates a bit for SMN deficiency, a critical C→T transition in exon 7 leads to exon skipping and production of a truncated, unstable and nonfunctional SMN protein. Recent advances in disease-modifying therapies-including antisense oligonucleotides, small-molecule splicing modifiers, and gene replacement-have significantly improved clinical outcomes; however, they do not restore endogenous SMN expression in all tissues and often require repeated administration. Despite these medications like Spinraza injections, Zolgensma gene therapy, Evrysdi pills that increase SMN protein, the condition still has got significant morbidity: Type 1 babies frequently die before the age of two, 60–95% develop scoliosis, which makes spinal injections uncomfortable and dangerous, and lifetime expenses for each patient surpass $2 million. What if we could edit the nucleotide base of SMN2(T6C) using ABE10 to make it emulate like SMN1 gene to restore stable functional SMN protein that would be the permanent cure for SMA. This cutting edge molecular tool “AI-based Adenine Base Editors” would facilitate an endogenous regulation, laying the groundwork for precision medicine in rare disease management.

Background: Malaria and typhoid fever remain major public health problems and important causes of febrile illness in sub-Saharan Africa, particularly in urban settings characterized by poor sanitation, unsafe water supply, overcrowding, and persistent malaria transmission. The clinical manifestations of both diseases frequently overlap, making accurate diagnosis difficult and often leading to empirical treatment, inappropriate antimicrobial use, and delayed patient management. This study assessed the occurrence, associated risk factors, and clinical implications of malaria–typhoid co-infection among febrile patients attending the Camrail Medical Center in Douala, Cameroon. Methods: A hospital-based analytical cross-sectional study was conducted among 220 febrile patients recruited systematically at the outpatient department. Data were collected using structured questionnaires, clinical assessment forms, and laboratory investigations. Malaria infection was diagnosed using standard parasitological methods, while typhoid fever was assessed using routine laboratory procedures. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression in SPSS version 25. Results: Malaria mono-infection accounted for 31.8% of cases, typhoid mono-infection for 10.9%, and malaria–typhoid co-infection for 15.5%, whereas 41.8% of participants had neither infection. Significant predictors of co-infection included unsafe water sources (AOR = 3.12; p = 0.001), poor food hygiene (AOR = 3.85; p < 0.001), non-use of bed nets (AOR = 2.21; p = 0.021), and exposure to stagnant water (AOR = 2.76; p = 0.004). Co-infected patients experienced significantly more severe clinical manifestations, including high fever, vomiting, diarrhea, abdominal pain, and headache. Age-stratified analysis showed a higher proportion of co-infection among participants aged ≤25 years (18.8%) compared with those aged ≥26 years (12.9%), although the difference was not statistically significant (p = 0.194). Gender-based analysis demonstrated no significant association between sex and infection category (p = 0.606).Conclusion and recommendations: Malaria–typhoid co-infection remains a significant public health concern in Douala. Integrated diagnostic approaches, improved environmental sanitation, safe water access, food hygiene promotion, and strengthened malaria prevention measures are essential to reducing the burden of co-infection and limiting inappropriate antimicrobial use.

Cancer is a highly heterogeneous and dynamic disease whose progression, metastasis, therapeutic resistance, and immune escape are strongly regulated by the tumor microenvironment (TME). However, conventional two-dimensional (2D) cell culture systems and animal models often fail to recapitulate the structural organization, multicellular interactions, biochemical gradients, and mechanical properties of native tumors, thereby limiting the translational efficiency of preclinical cancer research and drug development. In recent years, in vitro three-dimensional (3D) biomimetic tumor models-including tumor spheroids, tumor organoids, and tumor-on-a-chip systems—have emerged as powerful platforms for reconstructing physiologically relevant tumor microenvironments and investigating complex tumor behaviors.In this review, we systematically summarize the construction principles, biological characteristics, advantages, and limitations of major 3D biomimetic tumor models. We further discuss their recent applications in drug screening, precision medicine, tumor heterogeneity research, cancer stem cell investigation, metastasis, therapeutic resistance, and immunotherapy evaluation. Particular emphasis is placed on the comparative advantages of different 3D systems in modeling dynamic tumor–microenvironment interactions and supporting translational oncology research. Additionally, we will discuss the current problems of vascularisation, extracellular matrix biomimetics, experimental reproducibility, standardisation, and large-scale clinical translation. Finally, we present some new directions for future work, including three-dimensional bioprinting, multi-omics technology, artificial intelligence, and multi-organ-on-a-chip platforms, which may further improve the physiological relevance and predictive power of next-generation tumor models.In short, this review has listed the current progress of 3D biomimetic tumour modelling and discussed some prospects for its use in mechanistic studies of cancer, drug discovery, etc.

Background: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are two common conditions in aging men. Their association exceeds mere age-related coincidence and involves shared vascular, neurological, endocrine-metabolic and psychosexual mechanisms. Objective: To evaluate the prevalence of ED in patients followed for symptomatic BPH, to identify factors associated with its severity, and to analyze the evolution of erectile function after medical treatment. Methods: A prospective cross-sectional study conducted at the Urology Department A of Ibn Sina Hospital, Rabat, from August 1 to November 30, 2021. After excluding 37 records, 100 male patients aged 50 to 80 years followed for BPH were included. LUTS were assessed using the IPSS score and erectile function using the IIEF-5 score. Sociodemographic, clinical, biological, ultrasonographic, cardiovascular and therapeutic data were analyzed. The significance threshold was set at p < 0.05. Results: Mean age was 66 ± 15 years. The overall prevalence of ED was 72%, with 30% mild, 33% moderate, and 27% severe forms among interpretable cases. Only 25% of patients had spontaneously reported their sexual dysfunction. Factors significantly associated with ED were age (p < 0.001), LUTS severity by IPSS (p < 0.001), obesity (p < 0.001), and history of prostatic surgery (p < 0.01), arterial hypertension (p < 0.02) and nocturia (p < 0.05). Alpha-blocker–tadalafil combination therapy improved the IIEF-5 score by +4.3 to +5.2 points. Alpha-blockers alone did not significantly improve erectile function. Conclusion: ED is common and largely under-reported in patients with BPH. LUTS severity, particularly nocturia, is closely linked to erectile impairment. Systematic sexual assessment should be an integral part of BPH management, and the alpha-blocker–PDE5i combination represents a relevant therapeutic strategy in patients with associated ED.

Radical cystectomy with urinary diversion is the standard treatment for muscle-invasive bladder cancer. The impact of the type of urinary diversion on quality of life (QoL) remains debated. This cross-sectional study assessed QoL in 57 patients who underwent radical cystectomy between 2014 and 2022 at two urology departments in Rabat, Morocco, using the Bladder Cancer Index (BCI), the SF-36, and the Body Image Scale (BIS). Multiple linear regression identified socioeconomic status, body image perception, urinary discomfort, and comorbidities as the main determinants of QoL, with the type of urinary diversion playing an indirect role mediated through these factors. These findings underscore the need for a multidimensional approach when evaluating and optimizing QoL outcomes after radical cystectomy.

Introduction: Few studies have explored the vulnerability of women with polycystic ovary syndrome (PCOS) to developing cervical cancer and its precursor lesions. Objective: To describe the clinical, metabolic, and endocrine characteristics of a series of women with cervical squamous intraepithelial lesions and polycystic ovary syndrome, aiming to generate hypotheses regarding the potential pathophysiological mechanisms linking both conditions.Methods: A descriptive and hypothesis-generating study was conducted. The series consisted of nine women with a cytological diagnosis of cervical squamous intraepithelial lesions (SIL) who also met the Rotterdam criteria for PCOS. Characterization included age, sexual behavior, toxic habits, history of hypertension and diabetes mellitus, body mass index (BMI) and waist-to-hip ratio (WHR), metabolic parameters (insulin resistance, dyslipidemia), serum hormone levels (testosterone, prolactin, estradiol), human papillomavirus (HPV) 16/18 infection, grade of the lesion, and PCOS phenotypes. Results: The mean age was 37,11 ± 12,8 years. Abdominal obesity was detected in 55,5% and insulin resistance in 44,4% of cases. Hyperprolactinemia was present in 33,3%. HPV 16/18 infection was identified in 77,7% of cases. Most patients presented high-grade squamous intraepithelial lesions (HSIL) and PCOS phenotype D. Conclusion: The presence of HSIL in more than a third of the women in this case series is compatible with the hypothesis that PCOS, particularly those with insulin resistance, abdominal obesity, or hyperprolactinemia, may act as a multifactorial risk factor for cervical lesions, either independently or synergistically through metabolic and hormonal pathways that interact with HPV. These findings should be interpreted as preliminary observations that warrant confirmation in larger, controlled studies.