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Background & objectives: Mitochondrial DNA (mtDNA) contains valuable genetic information and plays a crucial role in missing person investigations, mass disasters, and forensic cases involving limited or degraded biological material. mtDNA is maternally inherited, with a highly variable control region divided into three hypervariable regions are generally used for forensic investigation. This study aimed to evaluate maternal inheritance patterns of mtDNA using PCR-RFLP techniques to confirm maternal relatedness. Method: The study was designed after prior permission from the institute’s ethical committee in which subjects were enrolled. This pilot study analyzed 50 voluntary participants (mother-child pairs). DNA was extracted from blood or saliva, and the mtDNA hypervariable region (HV region) was amplified by PCR using specific primers for the HV1 region. The amplified fragments (1024 bp) were subjected to RFLP analysis using seven restriction endonucleases (Alu I, BsuR I (Hae III), Hinf I, HsYF31 (Dde I), Mbo I, Rsa I, and SsPI) to reveal morphotypes. Results: The study identified five morphotypes for Alu I, three for BsuR I (Hae III) and Rsa I, two for Hinf I, and one each for HsYF31 (Dde I), Mbo I, and SsPI. There was minimal genetic polymorphism in the hypervariable region among unrelated individuals, but consistent restriction patterns were observed between mothers and their children in same pair. Conclusion: The findings demonstrate the low genetic polymorphism in the hypervariable region among unrelated individuals and consistent restriction patterns within maternal pairs, underscoring mtDNA's utility in forensic and genealogical applications. 

Background: Absence of nocturnal decrease in Blood Pressure (BP) (“non-dipping”) has been shown to be a strong and independent predictor of cardiovascular events, target organ damage, cardiovascular sequela and cardiovascular mortality. Obstructive Sleep Apnea (OSA) has been associated with non-dipping with an estimated prevalence of approximately 50%, but factors associated with non-dipping in OSA patients remain poorly understood. In this study, we examined clinically relevant variables associated with non-dipping in OSA.Methods: Patients (n = 35) undergoing overnight valuation for OSA, laboratory-based polysomnography, structured clinical interviews, and comprehensive metabolic and anthropometric evaluations, and ambulatory BP monitoring for 24 hours. Patients were classified into a) dipping BP group or b) non-dipping BP group, based on (a) a nocturnal systolic BP decrease of 10% - 20% or (b) a systolic BP decrease of < 10%. Results: Patients had moderate and severe OSA (AHI = 34.8 ± 29.1), and 42.9% demonstrated a non-dipping BP pattern. The severity of OSA measures did not differ between dipping group and non-dipping group. However, Wake after Sleep Onset (WASO) and chronicity of insomnia predicts non-dipping BP independent of demographics, sleep stages, anthropometrics, metabolic measures, or arterial stiffness. Conclusion: These findings contribute to a better understanding of the cardiovascular impacts of OSA and indicate that sleep quality should be incorporated into clinical assessments and management of OSA patients.

Microplastics (MPs) pose a significant risk to human health, particularly through seafood consumption. Once ingested, MPs can spread from the digestive system to other organs via phagocytosis and endocytosis, leading to toxicological effects. Accumulation of MPs in tissues causes swelling, blockages, oxidative stress, and Cytotoxicity. Studies show MPs alter metabolism, disrupt immune function, and contribute to autoimmune diseases. Chronic exposure has been linked to neurotoxicity, vascular inflammation, and increased cancer risk due to DNA damage. MPs can cross biological barriers, including the placenta, affecting fetal development. Additionally, they serve as vectors for pollutants and bacteria, further complicating health risks. MPs in the bloodstream can trigger inflammatory responses, endothelial adhesion, and red blood cell coagulation, leading to cardiovascular complications. In vitro studies indicate MPs impair renal function and cause long-term inflammation in distal tissues. Moreover, oxidative stress caused by MPs plays a critical role in carcinogenicity. Despite growing evidence of adverse health effects, further research is necessary to understand the full impact of MPs’ exposure on human health and develop effective mitigation strategies.

Pancreatic duct stones (PDS) are a common complication of chronic pancreatitis (CP). PDS can lead to duct obstruction and cause chronic abdominal pain. Ductal stone clearance, as well as short and long-term pain relief, is the cornerstone of endoscopic or surgical treatment. A step-up approach seems reasonable in pancreatic duct stone clearance. Extracorporeal shock wave lithotripsy (ESWL) combined with standard endoscopic retrograde cholangiopancreatography (ERCP) is as effective as a surgical approach for treating painful CP with less morbidity and medical costs. Therefore, endotherapy is considered a first-line therapy in selected patients. In case of insufficient pancreatic ductal clearance or strictures, advanced endoscopic techniques, per-oral pancreatoscopy (POP) with intraductal lithotripsy and/or endoscopic ultrasound-guided ductal drainage (EUS-PDD), will expand the role of the endoscopic approach. Because these new techniques are challenging, technically complex, and with high adverse events (AEs), they should be reserved for advanced tertiary care centers. Although there is increasing data that early surgical intervention may lead to better pain control and pancreatic duct stone clearance, surgery is reserved for patients failing endotherapy or patients with suspected malignancy.

Preterm birth, defined as delivery before 37 weeks of gestation, remains a leading cause of neonatal morbidity and mortality globally. One of the developmental challenges in preterm infants is the immaturity of the sucking-swallowing-breathing triad, which hinders successful oral feeding. Non-Nutritive Sucking (NNS) is an innate reflex in neonates that involves sucking motions without the intake of nutrition. This behaviour, often facilitated by pacifiers or a gloved finger, plays a vital role in neurodevelopment, feeding maturity, and physiological regulation in preterm infants. Recent studies also highlight its psychological and lactational benefits for mothers. This review presents a synthesis of current evidence supporting NNS as a low-cost, non-invasive intervention with multidimensional benefits for both preterm infants and their mothers.

Background: Human 30kb coronaviruses entered through the ACE-2 receptors causing fibrosis of the lungs and causing six million deaths worldwide. Here, we have investigated the mutations, deletions and insertions of the recent JN.1 omicron coronaviruses to demonstrate that coronaviruses have reached the pre-elimination stage. Methods: We multi-aligned the genomes of recent JN.1 variants using NCBI Virus Portal and CLUSTAL-Omega. The spike proteins are multi-aligned using MultAlin software and CLUSTAL-Omega.Results: The 17MPLF spike insertion was confirmed to compensate 24LPP, 31S, 69HV, 145Y, 211N and 483V deletions. The 49nt deletions in the 3’-UTR were found in 4997 JN.1 sequences although 26nt deletion was initiated previously in JN.1 as well as BA.5, BF.7, BQ.1 and XBB.1.5 omicron viruses. We first compare 3-D structures of spike proteins with or without 17MPLF four amino acids insertion and nine amino acids deletions using SWISS MODELLING. The JN.1 viruses caused a more stable trimeric spike involving Thr342, Lys436, Lys440, His441, Ser442, Gly443, Tyr445, Lys479, Ser489, Tyr490, Arg493, Pro494, Thr495, and Gln501 amino acids to interact with ACE-2 receptors. The FLiRT spike mutations were found in most KP.2 variants and other changes occurred at the NH2 terminus.Conclusion: We claimed that pre-death changes were initiated in JN.1 COVID-19 lineages and computer simulation showed that the Howard spike with 17MPLF spike insertion appeared more stable than the Oppentrons-spike without 17MPLF insertion. Surely, conflicts of COVID-19 spike sequences must be resolved.

Background: Acute Respiratory Distress Syndrome (ARDS) is a clinically, radiologically, and biologically heterogeneous condition. This variability contributes to diagnostic challenges and inconsistent responses to therapy. Identifying homogeneous subgroups or phenotypes within ARDS may enhance precision medicine and therapeutic targeting.Objective: This review evaluates the utility of decision tree–based supervised machine learning (ML) algorithms—specifically CART, Random Forest, and AdaBoost—in phenotyping ARDS using clinical, radiological, and biological data.Methods: A comprehensive literature search was conducted between December 2023 and March 2024 using PubMed and Google Scholar. Search terms included ‘decision tree in ARDS’, ‘phenotype in ARDS’, and ‘ML in hypo- and hyperinflammatory ARDS’. Twenty-six relevant articles were included, comprising original studies and reviews.Results: Decision tree–based models have demonstrated significant potential in classifying ARDS subtypes using routine clinical variables, radiographic features, and biomarker profiles. These algorithms have shown strong predictive performance in differentiating inflammatory phenotypes, forecasting mortality, and enabling early ARDS prediction.Conclusion: Decision tree algorithms offer a promising approach to ARDS phenotyping by leveraging routinely available data. Their interpretability and predictive accuracy may aid in translating complex biological insights into bedside clinical decision-making, advancing personalized care in critical illness.

Background: Toumbak, a form of smokeless tobacco made from Nicotiana rustica and sodium bicarbonate, is widely used in Sudan and poses potential health risks, particularly concerning cardiovascular function. Despite its high prevalence, especially among adult males, limited data exist regarding its impact on blood pressure.Objective: To assess and compare blood pressure parameters among Sudanese Toumbak users and non-users, and to investigate the association between Toumbak use, age, and gender with systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP).Methods: A comparative cross-sectional study was conducted from 2022 to 2025 among 1000 Sudanese adults (500 Toumbak users and 500 matched non-users) aged 18–60 years in Khartoum State. Blood pressure measurements were recorded using a digital sphygmomanometer following WHO guidelines. Independent t-tests and ANOVA were used to compare SBP, DBP, and PP between groups. A p - value < 0.05 was considered statistically significant.Results: Toumbak users exhibited significantly elevated SBP (141.7 ± 21.9 mmHg), DBP (89.3 ± 6.0 mmHg), and PP (52.4 ± 19.3 mmHg) compared to non-users (SBP: 121.2 ± 3.2 mmHg, DBP: 80.5 ± 3.8 mmHg, PP: 40.7 ± 3.9 mmHg), with p < 0.001 for all parameters. Males demonstrated significantly higher SBP (145.6 ± 24.0 mmHg) and PP (56.7 ± 22.1 mmHg) than females (SBP: 137.8 ± 18.6 mmHg, PP: 48.2 ± 14.5 mmHg). While no statistically significant differences were observed in BP across age groups, adolescents and middle-aged users had the highest SBP.Conclusion: Toumbak use is significantly associated with elevated blood pressure and increased cardiovascular risk, particularly among male users. These findings highlight the need for targeted public health interventions and awareness campaigns addressing the health consequences of smokeless tobacco in Sudan.

Background: Platelets are increasingly recognized as important inflammatory markers. This study explores the association between platelet indices and disease severity in ulcerative colitis (UC).Objective: To evaluate platelet parameters in patients with newly diagnosed UC and assess their correlation with disease severity indices.Methods: A cross-sectional observational study was conducted at IMS & SUM Hospital, Bhubaneswar, between October 2022 and September 2024. A total of 62 newly diagnosed UC patients aged over 18 years were included. Disease severity was evaluated using Truelove and Witts (TLW) criteria, Mayo Disease Activity Index (Mayo DAI), and Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Platelet count, mean platelet volume (MPV), platelet distribution width (PDW), platelet mass index (PMI), and platelet large cell ratio (PLCR) were measured. Statistical analysis included Pearson correlation, ROC curves, and sensitivity/specificity assessment.Results: The majority of patients were male (81%) with a mean age of 28.2 years. A significant positive correlation was observed between platelet count and disease severity by UCEIS (r = 0.32, p = 0.015) and Mayo DAI (r = 0.35, p = 0.009). PMI showed strong correlations with UCEIS (r = 0.45, p = 0.001) and Mayo DAI (r = 0.48, p < 0.001). MPV was inversely correlated but showed weak significance. PLCR also showed significant correlations. ROC analysis revealed platelet count (AUC = 0.815) and PLCR (AUC = 0.729) as good predictors of disease severity.Conclusion: Platelet parameters, particularly PMI, PLCR, and platelet count, may serve as accessible, non-invasive biomarkers for assessing disease severity in UC. Further studies with larger cohorts are warranted.