International Journal of Research in Medical Sciences
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Healing beyond borders: intellectual property, traditional knowledge, and the future of Unani medicine
Get PDFThere are unique issues and opportunities related to intellectual property in the development of modern Unani medicine. With increasing global interest in traditional and herbal medicines, Unani pharmaceutical companies face the challenge of continuously improving their products while staying true to traditional knowledge. Therefore, patent protection and compulsory licensing are essential in this transition process, balancing invention rights and public health concerns related to Unani treatments. Patents encourage innovation by providing exclusive rights for specific solutions and techniques, often attracting venture capital for development. However, these rights can also limit access, especially in poor regions where traditional cures are most needed. Compulsory licensing offers a viable alternative, allowing governments or authorized bodies to produce patented medicines without the patent holder’s consent in certain situations, such as in the public interest. In Unani medicine, compulsory licensing may be particularly useful for regulating patent-holding companies and ensuring they respond to societal needs by providing necessary treatments. This paper explores how patents and compulsory licensing influence Unani pharmaceuticals, focusing on how policy makers shape and enforce intellectual property rules to manage commercialization, access, and international market growth. It is crucial to balance the use of traditional Unani medicine to make it a practical, culturally sensitive, and affordable healthcare option for the global community
Guillain–Barre syndrome - clinical profile, diagnosis and recovery in a tertiary care setting
Get PDFBackground: Guillain–Barre syndrome (GBS) is an autoimmune disease and a recognized cause of generalized progressive paralysis worldwide. The present study was aimed to document the clinical finding, diagnostic challenges, and management outcome amongst the patients with GBS during the hospital stay.
Methods: A retrospective analysis of 22 cases diagnosed as GBS was conducted. Medical records and the data related to age, sex, antecedent illness, muscle power graded by the Medical Research Council scale, functional scores, details of intensive care unit complications and need for ventilation were obtained.
Results: GBS seems to affect all age groups with male preponderance. The male-to female ratio was 2.5:1. Maximum number of patients (50 %, n=11) were in the age group of 60 years and above. The next common age group was 13-30 years in which 31.8% (n=7) patient. Nearly 72% patients (n=16) had history of preceding illness. Paraparesis as a common clinical feature 54.5% (n=12). The majority (n=20) 90.9% were found to be of AMSAN followed by AIDP variants (n=2) 9.09%. About 59.09% patient (n=13) improved at the time of discharge on their F-scores with mild disability.
Conclusions: GBS remains a neurologic emergency that requires early recognition and prompt management to improve patient outcomes. Our study highlights the diverse clinical presentations and underscores the importance of supportive care and timely initiation of immunotherapy. While most patients show favourable recovery with appropriate treatment, residual deficits and complications can persist, emphasizing the need for ongoing rehabilitation and follow-up. Increased awareness among clinicians, especially in primary care and emergency settings, is crucial for early diagnosis. Further research is warranted to explore predictive markers of prognosis and optimize long-term care strategies
Enhanced surgical planning with 3D modeling in pediatric surgical oncology: management of complex abdominal tumors in a low-income country
Get PDFThree-dimensional (3D) modeling has emerged as a valuable tool in pediatric oncologic surgery, particularly for complex abdominal tumors where precise anatomical planning is critical. It enables enhanced surgical visualization, improved team communication, and more accurate estimation of vascular structures and adjacent organs, thereby increasing the safety and feasibility of extensive resections. We present six pediatric cases of complex abdominal tumors, including a NOS hepatic tumor, myofibroblastic tumor, cholangiocarcinoma, hepatoblastoma, neuroblastoma, and a Frantz-Gruber tumor, where 3D reconstruction and printing were employed to support preoperative planning and intraoperative navigation. All patients underwent contrast-enhanced thoracoabdominal CT, angiography, and 3D modeling due to tumor size, anatomical complexity, and vascular involvement. Additionally, we performed a literature review to contextualize the clinical value of 3D modeling in pediatric surgical oncology. Six patients underwent complete resections without complications. One patient was deemed unresectable after a detailed 3D evaluation, and only one patient presented a postoperative complication. The models were used to assess tumor boundaries, vascular proximity, and residual liver volume. They also improved interdisciplinary coordination and communication with families. 3D modeling facilitates individualized surgical planning, enabling more accurate, safer, and potentially curative interventions in patients with complex tumors. It enhances communication across the surgical team, supports medical education, and minimizes potential complications. As this technology becomes more accessible, it has the potential to significantly improve outcomes in pediatric surgical oncology
Isolated polydactyly of hands and feet in neonates: a case report
Get PDFPolydactyly is a common congenital limb anomaly characterized by the presence of extra digits on the hands, feet, or both. When it occurs without any associated syndromic or systemic abnormalities, it is referred to as isolated polydactyly. In neonates, this condition presents with a wide spectrum of manifestations, ranging from small soft-tissue projections to fully developed digits containing bones and joints, and it may occur unilaterally or bilaterally. Classification is typically based on the anatomical location of the extra digit—preaxial (thumb or big toe side), postaxial (little finger or little toe side), or central—with postaxial polydactyly being the most frequently observed type, particularly among certain ethnic populations. Isolated polydactyly commonly follows an autosomal dominant pattern of inheritance with variable expression, although sporadic cases are also frequently reported. Accurate and early diagnosis is critical to differentiate isolated polydactyly from syndromic forms, as this distinction plays a key role in determining clinical management strategies and providing appropriate genetic counselling to families. In cases involving non-functional or minimally developed extra digits, intervention may not be necessary; however, surgical removal is often considered during infancy or early childhood for functional or cosmetic reasons, especially when the anomaly may interfere with hand or foot function or affect the child’s psychosocial development. This case emphasizes the clinical importance of recognizing isolated polydactyly in the neonatal period and underscores the need for thorough clinical evaluation, precise classification, and a coordinated, multidisciplinary management approach involving pediatricians, geneticists, and surgeons. Early intervention and counselling are essential for addressing parental concerns, guiding developmental support, and ultimately enhancing the quality of life and long-term functional outcomes for affected children
Influence of proprioceptive neuromuscular facilitation on pulmonary gas exchange in a mechanically ventilated class I obese patient with acute respiratory distress syndrome: a case report
Get PDFAcute respiratory distress syndrome (ARDS) is a severe and life-threatening condition characterized by impaired oxygen exchange, reduced lung elasticity, and persistent hypoxemia, and although advances in mechanical ventilation have improved outcomes, oxygenation often remains suboptimal, necessitating supportive adjunctive therapies. This case report examined the effects of proprioceptive neuromuscular facilitation (PNF)-based respiratory physiotherapy in a 52-year-old male patient with ARDS associated with class I obesity on mechanical ventilation. Targeted PNF interventions, including anterior basal lifts and intercostal muscle stretching, were delivered over seven days, with oxygen saturation (SpO2) monitored by pulse oximetry and arterial oxygen pressure (PaO2) and PaO2/FiO2 (P/F) ratio measured through arterial blood gas analysis on the 3rd, 5th, and 7th days of ventilation. Progressive improvements in SpO2, PaO2, and P/F ratio were observed, reflecting enhanced pulmonary compliance and better gas exchange efficiency. These findings suggest that PNF-based respiratory physiotherapy may represent a valuable adjunct to conventional ARDS management in mechanically ventilated patients, though further research with larger samples is needed to validate its effectiveness in critical care
Diabetes mellitus masking an ectopic Cushing syndrome in a young male: a case report
Get PDFEctopic adrenocorticotropic hormone (ACTH) secretion is a rare but important cause of Cushing syndrome, often associated with neuroendocrine tumors such as bronchial or gastrointestinal carcinoids. Its presentation can be subtle or atypical, delaying diagnosis and increasing morbidity. Herein this case report presents a 24-year-old male presenting with uncontrolled diabetes mellitus, polyuria, and weight loss (13 kg over 6 months). He exhibited proximal muscle weakness, broad purple striae, and extensive hyperpigmentation. Laboratory evaluation revealed markedly elevated 8 am serum cortisol 82 mcg/dl, midnight awake cortisol 211 mcg/dl, overnight dexamethasone suppression test (27.32 mcg/dl), plasma ACTH 320 pg/ml, and a non-suppressed (<50%) high-dose dexamethasone suppression test (16 mcg/dl). High-resolution computed tomography (HRCT) chest demonstrated multiple pulmonary nodules. Ga-68 DOTANOC PET-CT imaging revealed somatostatin receptor expression in bilateral lung nodules. Endobronchial biopsy confirmed atypical carcinoid tumor, Ki-67 index 4%. This case highlights the diagnostic complexity of ectopic ACTH syndrome, particularly in young adults presenting with rapidly worsening diabetes. The presence of significant pigmentation, proximal myopathy, and metabolic derangements were key clinical clues. Atypical carcinoid tumors exhibit intermediate biological behavior and require a multidisciplinary management approach including surgical resection, somatostatin analog therapy, and cortisol-lowering strategies. Ectopic ACTH syndrome should be considered in young patients with severe metabolic abnormalities, rapid weight loss, and hyperpigmentation. Early recognition and appropriate work-up can prevent complications and improve outcomes
Ocular surface squamous neoplasia misdiagnosed as corneal opacity and dry eye: a case report
Get PDFOcular surface squamous neoplasia (OSSN) represents a spectrum of ocular surface epithelial neoplasms ranging from conjunctival intraepithelial neoplasia (CIN) to invasive squamous cell carcinoma. We report a case of a 75-year-old man initially misdiagnosed with corneal opacity and dry eye, whose symptoms persisted despite lubricant therapy. Detailed ophthalmic examination revealed a suspicious lesion extending across the temporal cornea with sentinel vessels and corneal invasion. Histopathological analysis confirmed high-grade intraepithelial dysplasia consistent with CIN, while immunohistochemistry for p16 was negative. The patient underwent surgical excision with wide margins, adjunctive cryotherapy, and postoperative topical 5-fluorouracil therapy. This case illustrates the diagnostic challenges of OSSN due to its ability to mimic benign ocular surface conditions. Prompt recognition, appropriate histopathological confirmation, and timely treatment are essential to prevent progression and preserve vision. Clinicians should maintain a high index of suspicion for atypical or persistent ocular surface lesions, particularly in elderly patients with risk factors such as ultraviolet exposure and diabetes
Evaluating the effectiveness of problem-based learning in promoting rational prescribing among undergraduate medical students
Get PDFIntroduction: Rational prescribing is a core competency for future physicians, but traditional pharmacology teaching often emphasizes factual recall rather than clinical application. Problem-Based Learning (PBL) is a student-centered approach that has been proposed to enhance problem-solving skills and rational prescribing. To evaluate whether a PBL-based pharmacology module improves knowledge transfer, problem-solving ability, and attitudes toward learning compared to conventional teaching.
Methods: This interventional study included two groups of undergraduate medical students. The intervention group received a structured PBL module on drugs used in bronchial asthma, while the control group was taught through conventional lectures and tutorials. Both groups were assessed with problem-based multiple-choice questions on bronchial asthma (direct knowledge) and peptic ulcer (transfer of knowledge). Assessments were conducted at four weeks and again at two months. Student attitudes toward PBL were also collected via a structured questionnaire. Results: Students in the PBL group scored significantly higher than the control group in both assessments (p<0.01). While performance declined over time in both groups, PBL students consistently maintained superior outcomes. Feedback revealed positive attitudes toward PBL, with high ratings for problem-solving, motivation, teamwork, and overall satisfaction.
Conclusion: PBL is more effective than conventional teaching in enhancing rational prescribing skills and student engagement. However, sustained practice and curricular integration are recommended to maintain long-term benefits
Comparative efficacy of aloe vera in the treatment of oral lichen planus: a systematic review and meta-analysis of randomized controlled trials
Get PDFOral lichen planus (OLP) is a chronic immune-mediated disorder that negatively affects oral function and quality of life. Corticosteroids are the standard therapy but may cause adverse effects with prolonged use. Aloe vera, a natural agent with anti-inflammatory and wound-healing properties, has been proposed as a safer alternative. Following PRISMA 2020 guidelines, a comprehensive search of PubMed, Scopus, Cochrane Library and Google Scholar was performed up to September 2025. Eligible studies were RCTs comparing Aloe vera (gel, paste or mouthwash) with placebo, corticosteroids or other therapies. Primary outcomes included post-treatment Visual Analogue Scale (VAS) pain scores and Thongprasom clinical scores; secondary outcomes were treatment response and lesion size reduction. A random-effects model was used to calculate pooled mean difference (MD) and risk ratio (RR) with 95% confidence intervals (CI). Nine RCTs involving 752 patients met the inclusion criteria. Aloe vera was associated with a significantly higher overall treatment response (RR=1.34, 95% CI 1.12–1.61; I2=28%). No significant differences were found for VAS pain scores (MD=−0.01, 95% CI −0.19 to 0.16; I2=90%), Thongprasom clinical scores (MD=−0.49, 95% CI −1.36 to 0.38; I2=96%) or lesion size (MD=0.81, 95% CI −0.57 to 2.19; I2=99%). Aloe vera demonstrates a favourable safety profile and may enhance overall treatment response in oral lichen planus compared with placebo or corticosteroids. However, its benefits on pain relief and lesion healing remain inconsistent across studies. Future multi-center RCTs with standardized Aloe vera formulations, longer follow-up and biomarker-based outcomes are warranted to confirm its clinical utility as a reliable adjunct or alternative to corticosteroids in OLP management
Early and guided physiotherapy in head and neck cancer: a narrative review of clinical interventions
Get PDFHead and neck cancer (HNC) patients frequently experience pain, fatigue, dysphagia, and psychological distress because of oncologic treatment. Physiotherapy has emerged as a key rehabilitative strategy to address these sequelae, particularly when initiated early and delivered through therapist-guided protocols. Objective: This narrative review aims to synthesize evidence from clinical trials and structured programs evaluating early and guided physiotherapy interventions in HNC, focusing on their impact on symptom management and functional recovery. A comprehensive literature search was conducted across five databases (PubMed, Scopus, Web of Science, Cochrane Library, and ScienceDirect) for studies published between 2010 and 2025. A total of 396 records were identified, with 304 screened by title and abstract. After full-text assessment of 141 articles, 13 studies met the inclusion criteria. Data were extracted on intervention type, timing, therapist involvement, and outcomes related to pain, fatigue, swallowing function, and quality of life. Early physiotherapy interventions, particularly those involving therapist supervision, demonstrated consistent improvements in fatigue, mobility, swallowing function, and emotional well-being. Multimodal approaches combining aerobic and resistance training were especially effective. Therapist-guided delivery enhanced adherence, safety, and individualized care. Early and guided physiotherapy offers significant benefits for HNC patients, supporting its integration into multidisciplinary cancer rehabilitation. Future research should focus on standardized protocols, long-term outcomes, and scalable delivery models