INNOVAPATHTM: Journal of Translational Medicine & Biotechnology is a premier scientific journal of the INNOVACORE Center for Research & Biotechnology and CorePath Laboratories. Our mission is to bridge the gap between scientific discovery and clinical application by publishing cutting-edge research in translational medicine, pathology, biotechnology, precision medicine, clinical research and innovations in healthcare. We aim to accelerate the development of innovative diagnostics, therapeutics, and biomedical technologies by fostering collaboration between researchers, clinicians, and industry leaders.
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Road Traffic Accidents and Trauma Care in Pakistan: Lessons from the UAE
Road traffic accidents cause a very high number of deaths in Pakistan each year. Trauma care in the country is weak because there is no national trauma registry, pre-hospital services are limited, and hospital coordination is poor. In the United Arab Emirates, a trauma registry and organized emergency system have helped improve survival and reduce deaths. This short review looked at reports from the UAE trauma registries and published surveys from Pakistan. The UAE has shown major improvements, while Pakistan still struggles with delays and lack of basic facilities. To improve outcomes, Pakistan needs to build a trauma registry, train and expand emergency medical services, and introduce standard hospital protocols. Learning from the UAE model can help reduce preventable trauma deaths in Pakistan.
Efficacy of Taletrectinib to treat ROS1-positive non-small cell lung carcinoma.
ROS1 rearrangements represent a rare but clinically significant oncogenic driver in non-small cell lung carcinoma (NSCLC), occurring in approximately 1–2% of cases. While crizotinib and entrectinib are established targeted therapies, limitations such as central nervous system (CNS) progression and acquired resistance underscore the need for next-generation inhibitors. Taletrectinib, a highly selective ROS1 tyrosine kinase inhibitor, has shown promising activity in both TKI-naïve and pretreated patients, including those with CNS metastases and resistance mutations like G2032R. Early-phase clinical trials report encouraging objective response rates with a manageable safety profile, distinguishing taletrectinib as a potential best-in-class therapy. Its favorable pharmacokinetics and brain penetration may address key gaps left by earlier ROS1 inhibitors, particularly for patients with intracranial disease progression. Given the unmet clinical need, taletrectinib represents an important advancement in precision oncology for ROS1-positive NSCLC. Ongoing phase II and III studies will be crucial in validating its efficacy and positioning within treatment algorithms. Integration of taletrectinib into clinical practice has the potential to improve survival outcomes and quality of life in this molecularly defined subset of NSCLC patients.
Taletrectinib; ROS1 inhibitor; Non-small cell lung carcinoma
Antimicrobial Resistance: The Diagnostic Bottleneck We Cannot Ignore
Antimicrobial resistance (AMR) is a growing global health emergency: in 2021, 4.71 million deaths were linked to infections resistant to drugs, of which 1.14 million were directly due to AMR—and we risk seeing this increase to nearly 1.91 million AMR-associated deaths per annum by 2050 (1). One of the major, under-discussed causes of this menace is the diagnostic gap: in low- and middle-income nations, the delay in culture and sensitivity reports has clinicians making decisions on the basis of broad-spectrum empiric therapy, which itself promotes resistance. Pathologists and microbiologists are key players in filling the gap.Milestone technologies—ultra-rapid antibiotic susceptibility platforms (viz., SERS-AST)—generate same-day MIC values, providing timely, target antimicrobial therapy (2). Furthermore, the WHO’s Antimicrobial Resistance Diagnostic Initiative (2023) places diagnostics at center stage highlighting lab capacity building, equitable access to quality testing, and inclusion of diagnostic testing in stewardship and surveillance (3). Our Three-Step Strategy of Action: Improving diagnosis: Install rapid AST systems to allow same-day MIC reporting. Stewardship via data: Regularly generate and disseminate institutional antibiograms; align with WHO’s AWaRe prescribing framework (4). Laboratory empowerment: Formalize inclusion of pathologists in antimicrobial stewardship committees in a way that laboratory diagnostics inform clinical decision-making in real-time. Pathology is not a spectator during the AMR war, but rather must be the proactive center. Reform focused on diagnosis, established today, is required in order to avoid a post-antibiotic world.
Rising Colorectal Cancer in Young Adults: A Call for Earlier Screening and Awareness in Pakistan
SGLT2 Inhibitors role in Heart Failure: More Than Just Glycemic Control
Artificial Intelligence in Rare Disease Diagnosis: A Clinical Milestone with Ethical Considerations
With great promise to transform the rare disease diagnosis scene, artificial intelligence (AI) has emerged. Using huge databases from genomics, imaging, and electronic health records, artificial intelligence systems can identify patterns that even experienced doctors often overlook (1).For those with orphaned diseases, who sometimes have to bear years of uncertainty, this capacity to shorten the diagnostic journey is quite crucial. But while AI has advantages, its abrupt involvement in diagnostic procedures presents major ethical and clinical problems necessitating more investigation. Most artificial intelligence algorithms' interpretability poses a major difficulty. Usually black boxes, deep learning algorithms provide diagnostic results without a clear justification. This hurts openness and may compromise the mutual decision-making process between doctor and patient (2). In medicine, especially when rare diseases are being diagnosed, where patient involvement and customized treatment are vital, trust in medical decision-making grounds decision-making. Bias in the training data for artificial intelligence is another critical problem. Learned from data from high-income nations, the majority of algorithms do not take under resourced populations into consideration (3). This could compromise diagnostic accuracy in ethnically and geographically varied populations and so worsen existing health inequities. For instance, in underrepresented communities (4) using recent artificial intelligence models applied to the diagnosis of genetic disease, performance gaps were observed. Furthermore worrisome is the possibility that doctors will increasingly rely too much on artificial intelligence systems. A 2024 multicenter simulation study showed how clinicians can become too dependent on AI output, even when it goes against clinical intuition (5).Particularly in rare disease environments when subtlety and world understanding are essential, this might cause loss of critical thinking ability and aid in unfavorable patient outcomes. Though AI has the potential to revolutionize the identification of rare diseases, its application in clinical practice must be consistent with the tenets of openness, equity, and ethical responsibility. Independent real-world practice testing, inclusive training datasets, and ongoing clinician education are required to make sure that technical developments result in actual patient benefit.
Closed-Loop Fully Automated Wireless Vagus Nerve Stimulation: Heralding a New Paradigm in Bioelectronic Medicine
Abstract Closed-loop vagus nerve stimulation (VNS) represents a transformative advancement in bioelectronic medicine, offering real-time, adaptive neuromodulation for conditions such as epilepsy, heart failure, inflammatory diseases, and neurorehabilitation. Unlike traditional open-loop systems that rely on fixed parameters and surgical battery-based devices, closed-loop VNS dynamically adjusts stimulation based on physiological feedback, enhancing therapeutic precision and safety. Recent innovations, such as the wireless, fully automated VNS system developed by Mathews et al. (2025), integrate heart rate-driven feedback loops for personalized modulation. Clinical studies further validate its promise: microburst-pattern VNS reduced seizure frequency in 68% of drug-resistant epilepsy patients (Nichol et al., 2024), while closed-loop taVNS improved motor recovery post-stroke (Xie et al., 2024). Functional MRI data show enhanced cortical engagement with optimized VNS protocols (Verner et al., 2024), and real-time motor-triggered stimulation significantly improved outcomes in spinal cord injury rehabilitation (Rennaker et al., 2025). Despite these advances, limitations persist, including variability in patient responses, lack of standardized biomarkers, and insufficient large-scale trials. Future directions must focus on AI-driven algorithms, robust biophysical modeling, and wearable-compatible miniaturization to enable broader clinical translation. With these innovations, closed-loop VNS may redefine the standard of care in precision neuromodulation.
Addressing the Recent Spike in Bird Fancier’s Lung in Karachi: Time for Policy Making and Public Awareness
Bird fancier lung (BFL) is a variant of hypersensitivity pneumonitis (HP), an immune-mediated interstitial lung disease (ILD) caused by the recurrent inhalation of avian proteins present in bird excrement, feathers, and serum presenting with cough and dyspnea mainly. There has been recent surge in BFL cases in Karachi with 20–25 new cases reported weekly that a decade ago was 1-2 cases weekly, primarily due to unhygienic pigeon feeding practices in the city. In order to prevent further increase in the BFL cases and the progression of already existing cases to chronic stages, there is a need of timely policy making by healthcare administration ensuring public awareness about the disease and community engagement in preventive health-strategies.
Breaking Ships, Breaking Bodies: Public Health at Risk at Gadani
Objective: To evaluate the public health consequences of unsafe working and environmental conditions at Pakistan's Gadani ship-breaking yard in Balochistan, Pakistan, and to recommend sustainable, rights-based interventions to safeguard workers and the community. Methods: A qualitative review was undertaken from secondary sources of data such as PubMed, Google Scholar, online news releases, and reliable blogs. The research did not entail direct human contact, and thus no ethical approval was needed. The critical analysis was centered on recording common health problems, environmental pollution, and policy loopholes in occupational safety. Results: The results indicated a variety of public health problems, such as nutritional deficiencies, infectious conditions, injuries, long-term toxic exposures (e.g., asbestos, mercury), and mental problems. Hazardous dismantling activities without protective equipment, inaccessibility to clean water and medical services, and inadequate emergency preparedness lead to high mortality and morbidity. The workers are exposed to exploitation because of informal work, no health monitoring, and no compensation or protection by law. Conclusion: In order to convert Gadani into a safe and sustainable industrial area, the multi-stakeholder, rights-based approach must be implemented. Suggestions are made to enforce international labor standards (ILO Convention No. 155), adopt occupational safety guidelines as of Rotterdam Port, carry out systematic environmental assessments and health monitoring, and increase health and hygiene activities in the community. By concerted effort and focused investment, Gadani can be converted from exploitation to a model of ethical, sustainable industry.
Avmapki-Fakzynja Combination: A Breakthrough in Treating Low-Grade Serous Ovarian Cancer
Low-grade serous ovarian carcinoma (LGSOC) is a rare subtype of epithelial ovarian cancer characterized by unique molecular features and poor response to conventional chemotherapy. Recent advances in molecular profiling have led to the development of targeted therapies, including MEK and FAK inhibitors. On May 8, 2025, the FDA approved AVMAPKI™ FAKZYNJA™ CO-PACK, a combination of avutometinib and defactinib, specifically for adults with KRAS-mutated recurrent LGSOC who have undergone prior systemic therapy. This dual inhibitor regimen targets the MAPK and FAK signaling pathways, showing promising efficacy with an overall response rate of 44% in clinical trials. While offering a novel and more effective treatment option, the therapy requires careful monitoring for potential side effects such as liver toxicity and skin reactions. This approval marks a significant advancement in personalized treatment for LGSOC and highlights the need for improved accessibility to ensure patient benefit.
Lenacapavir: Advancing HIV Control Requires Resistance Vigilance and Equitable Access
Lenacapavir is a long-acting HIV-1 capsid inhibitor proven to be effective against preexposure prevention (PrEP) and multidrug-resistant HIV. It can be injected subcutaneously every six months, a major advancement in HIV prevention and treatment. Very high rates of viral suppression and prevention have been seen in clinical studies including CAPELLA and CALIBRATE; in the lenacapavir arm of a large PrEP study, there were no infections. Despite these successes, two major issues remain: the emergence of resistance-related mutations (RAMs) like Q67H and N74D and the challenge of global travel brought on by high prices and limited licensing. Better resistance monitoring, the development of next-generation capsid inhibitors, inexpensive diagnostics, pricing modifications, and research including underprivileged locations are all required for lenacapavir to provide its power to the fullest extent. Lenacapavir: Without these joint efforts, lenacapavir runs the risk of becoming a transformative treatment only accessible to a select elite.
CRISPR-Cas9 as a Targeted Therapeutic Strategy for Primary Hyperoxaluria: A New Frontier in Gene-Based Nephrology
Primary hyperoxaluria (PH), most commonly caused by mutations in the AGXT gene (type 1), is a rare inherited metabolic disorder leading to oxalate overproduction and progressive renal damage. Current treatments, including pyridoxine supplementation and RNA interference therapies, are supportive but not curative, with liver–kidney transplantation remaining the definitive option. CRISPR-Cas9 gene-editing technology offers a potential one-time curative solution by directly correcting pathogenic mutations or silencing disease-related genes. Recent preclinical studies and early clinical trials, such as those investigating YOLT-203, have shown promising reductions in urinary oxalate with minimal toxicity. However, challenges related to long-term safety, delivery, cost, and ethical concerns must be addressed. With further research and responsible innovation, CRISPR-Cas9 could revolutionize the treatment landscape of primary hyperoxaluria.
High-Intensity Focused Ultrasound (HIFU): A Non-Invasive Breakthrough in Therapeutic Intervention
Abstract High-Intensity Focused Ultrasound (HIFU) represents a groundbreaking advancement in non-invasive therapeutic intervention, offering precise tissue ablation with minimal damage to surrounding structures. This paper explores its validated clinical applications across prostate cancer, pancreatic cancer, and refractory hypertension. Recent trials demonstrate that HIFU achieves comparable oncologic outcomes to standard therapies while preserving organ function, improving quality of life, and reducing treatment-related complications. Its expanding utility in neuromodulation further highlights its interdisciplinary impact. With ongoing technological refinement and clinical integration, HIFU is poised to become a transformative modality in the future of precision medicine.
From Metformin to Microbiome: The Missing Links in Metabolic Modulation
Abstract Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and impaired glucose metabolism. Emerging evidence suggests that gut microbiota plays a pivotal role in the pathogenesis and management of T2DM. Metformin, the first-line therapy for T2DM, exerts its glucose-lowering effects not only through classical mechanisms of enhancing insulin sensitivity and reducing hepatic gluconeogenesis but also by modulating the gut microbiota. Metformin-induced alterations in gut flora, including an increase in beneficial species such as Bifidobacterium and Akkermansia, contribute to improved glucose metabolism, enhanced gut barrier integrity, reduced inflammation, and increased GLP-1 secretion. Animal studies have demonstrated that metformin-modified microbiota can improve glycemic control when transferred to germ-free mice, highlighting the therapeutic relevance of microbiome modulation. However, most existing evidence stems from animal models, with limited large-scale, long-term human trials available. Further research employing multi-omics approaches is essential to elucidate specific microbial species' roles and their clinical implications. Understanding the metformin–microbiome interaction could pave the way for novel microbiota-targeted therapies in T2DM management.
Sudden Cardiac Arrest in Young Adults - Hidden Dangers in Your Lifestyle
Sudden cardiac arrest (SCA) is a life-threatening emergency defined by the abrupt loss of cardiac function, leading to cessation of blood flow to vital organs. Although traditionally associated with older adults, SCA is increasingly reported among seemingly healthy individuals under 40 years of age, with an incidence rate of 4 to 14 per 100,000 person-years. Most affected individuals have no prior diagnosis of cardiac disease. Genetic cardiac disorders, such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and channelopathies like Brugada and long QT syndromes, account for many early-onset cases. Notably, around 30% involve hereditary mutations without evident cardiac abnormalities, a condition termed concealed cardiomyopathy. Lifestyle-related risk factors—including smoking, obesity, disrupted sleep, psychological stress, steroid abuse, and energy drink overconsumption—further elevate the risk. Despite these threats, routine cardiac screening using tools like electrocardiography (ECG) and echocardiography remains limited outside athletic populations, leaving many young individuals unassessed. Importantly, recent large-scale studies have found no link between COVID-19 vaccination and SCA in young adults. Instead, prior COVID-19 hospitalization and modifiable risk factors play a more significant role. A strong public health and educational approach is urgently needed. Integrating cardiac risk education into schools, colleges, and recreational centers, alongside early screening efforts, may enable timely detection and prevention. Raising awareness of behavioral risks and genetic predispositions can help reduce the growing toll of SCA in youth.
THE CHALLENGES OF PPIS IN GENERAL PRACTICE: ADDRESSING MISUSE AND RESEARCH GAPS
Proton pump inhibitors (PPIs) are widely prescribed for acid-related disorders due to their potent acid-suppressing effects. However, increasing evidence highlights concerns regarding their long-term and often inappropriate use. This letter emphasizes the risks associated with sustained PPI therapy, including gastrointestinal infections, nutrient malabsorption, bone demineralization, and a potential link to gastric cancer. It also addresses issues such as over-the-counter availability, lack of public awareness, inconsistent drug interaction data, and habitual prescribing without clinical reevaluation. To mitigate these risks, the need for unified prescribing guidelines, standardized interaction databases, and evidence-based deprescribing protocols is underscored. Future research should focus on assessing self-medication trends, the effectiveness of targeted interventions, and the underlying causes of irrational PPI use to ensure safer pharmacological practices.
Addressing the Emotional and Ethical Risks of Using AI Chatbots in Psychotherapy
Artificial Intelligence (AI) chatbots have the potential to support mental health therapy by introducing novel approaches to diagnosis and treatment. AI psychotherapy is being tested as a possible substitute or supplement to conventional human-led therapy, and it has the potential to improve availability and customization of mental health services[1]. Despite their promise, AI chatbots lack core therapeutic competencies such as emotional empathy, ethical judgment, and contextual understanding. They may struggle to meaningfully integrate personal history or respond appropriately to emotional vulnerability. A key concern is accountability—particularly in cases where a chatbot provides misleading information or fails to recognize psychological distress. Despite rapid AI development, mental health clinicians have been slow to adopt these tools. Some psychiatrists who value interpersonal interactions with patients may be hesitant to use such procedures, implying a slow adoption of the innovation process within the mental health sector[2]. Because AI chatbots often mimic human conversation, users may develop unrealistic expectations of their capabilities. For example, anticipating sophisticated conversations or receiving emotional support that leads to new insights. Therapists and developers must clearly communicate the chatbot’s limitations and intended role in therapy. Human therapists should interpret and contextualize AI-generated insights within the therapeutic process. To manage user expectations effectively, AI should clearly describe the scope of its job at the start of any encounter, as well as which goals can and cannot be achieved[3]. Therefore, a responsible future for digital mental health necessitates establishing trust by assuring data privacy, security, and openness in AI-driven decisions, as well as evidence-based and effective regulatory supervision to ensure quality. Usability, design, and ethical alignment with users' interests will all be vital, while liability frameworks and accreditation standards ensure accountability as the field evolves.[4]. To summarize, while AI chatbots offer promising advances in increasing access to mental health care, their integration into psychotherapy should be treated with caution. The limitations in emotional comprehension, responsibility, and therapeutic nuance underline the importance of human clinicians. To enable safe and ethical implementation, clear communication of AI limitations, strong regulatory oversight, and alignment with user safety and values are essential. A collaborative model—in which AI assists but does not replace human therapists—has the greatest potential for ethically defining the future of digital mental health.
The Antimicrobial Potential of Virophages Against Multidrug-Resistant Bacteria
Antimicrobial resistance is becoming a serious danger to global health as it has caused more than 1.27 million deaths in 2019 alone. When it comes to multidrug-resistant (MDR) organisms like Klebsiella pneumoniae and Pseudomonas aeruginosa, traditional antibiotics are becoming less and less effective. A promising substitute is provided by engineered virophage therapy, that makes use of genetically altered bacteriophages. By interfering with genes that provide resistance, these virophages lyse bacteria and integrate into their defense mechanisms. Recent developments show that they can both reverse resistance traits and eradicate MDR bacteria. Studies on animals have demonstrated a notable decrease in bacterial load and an increase in survival. In contrast to traditional antibiotics, virophages change with bacterial populations, which may postpone the formation of resistance and protect the human microbiome. There are still issues, nevertheless, such as intricate host-phage dynamics and a lack of regulatory frameworks. However, to validate efficacy, large-scale trials are needed. Engineered virophages should be given priority in global antimicrobial stewardship initiatives since they are a breakthrough step in the fight against superbugs.
IBI305 vs. Compounded Avastin – A Biosimilar Breakthrough for Safer and More Cost-Effective Retinal Therapies
Retinal diseases, such as neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO), demand accessible and safe therapies. Off-label use of bevacizumab (Avastin®) in ophthalmology raises safety concerns due to compounding practices, including risks of endophthalmitis and dose inconsistencies. The FDA/EMA-approved biosimilar IBI305 addresses these limitations with a single-use vial formulation, eliminating contamination risks and ensuring manufacturing compliance. Clinical studies confirm its pharmacokinetic equivalence to reference bevacizumab, with cost advantages enhancing its suitability for retinal disease management. Transitioning to IBI305 can improve safety, efficacy, and cost-efficiency, establishing it as a preferred therapeutic option.
Reimagining Healthcare: Practical Impacts of AI, AGI, and Emerging Technologies
Artificial Intelligence (AI), Artificial General Intelligence (AGI), and other emerging technologies are significantly reshaping modern healthcare systems. Their integration across clinical, operational, and public health settings has already produced measurable improvements in diagnostic accuracy, treatment personalization, operational efficiency, and epidemic response. These technologies leverage vast amounts of data, advanced algorithms, and computational power to augment clinical decision-making, optimize workflows, and expand access to care. This manuscript explores the real-world applications of these technologies, drawing on recent literature and case studies to illustrate both their potential and limitations. Specific examples include AI-driven diagnostic imaging, predictive analytics for hospital management, and AI-based models for pandemic surveillance. It also addresses the growing use of AI in personalized medicine and the increasing incorporation of robotics, deep learning, natural language processing, edge computing, quantum computing, health information and learning technologies (HILT), digital twin systems, and neural networks in everyday clinical practice (Topol, 2019; Rajkomar et al., 2019; Esteva et al., 2017). The findings indicate that while AI and related innovations hold promise for revolutionizing care delivery, challenges related to algorithmic bias, data privacy, ethical governance, and regulatory oversight remain critical considerations. The disparity in access to these tools, particularly in low-resource settings, underscores the need for inclusive and equitable frameworks. A multi-stakeholder, ethical, and interdisciplinary approach is required to ensure these tools fulfill their transformative potential while safeguarding patient rights and promoting equitable healthcare outcomes worldwide. As the healthcare landscape evolves, the thoughtful integration of AI, AGI, and complementary technologies will be pivotal in achieving scalable, efficient, and patient-centered care delivery.
The Role of Artificial Intelligence in Cervical Cancer Screening: From Pap Smears to Deep Learning
Cervical cancer screening has evolved from conventional Pap smears to liquid‐based cytology and HPV DNA testing, and now increasingly leverages AI-driven image analysis. Modern AI approaches – especially convolutional neural networks (CNNs) – can automatically detect and classify cells in digital cytology and whole‐slide images. Emerging transformer‐based models further integrate multimodal data (HPV status, cytology, colposcopy images) to enhance diagnostic sensitivity and reduce missed cases. These tools markedly increase detection rates while alleviating the burden on human screeners. In practice, portable AI-assisted devices are being fielded: for example, smartphone colposcopes with embedded deep learning have demonstrated CIN2+ sensitivities (>90%) that exceed expert readers. Cloud-linked systems (e.g. MobileODT’s EVA Scope) enable centralized analytics and regular model updates, while on-device AI can operate offline for low-connectivity settings. However, limitations remain. Algorithmic bias from non-representative training data can skew performance, and the “black box” nature of deep models raises interpretability and trust issues. Regulatory and privacy gaps must be addressed – clear guidelines are needed to ensure patient data security and to define AI’s role as an adjunct (not a replacement) to clinician judgment. Moving forward, robust validation in diverse populations, human–AI collaboration in screening workflows, and equitable deployment in underserved regions are essential. By coupling AI with human expertise and broad access, these innovations can help reach WHO targets (70% screening by 2030) and accelerate progress toward global cervical cancer elimination
Artificial Intelligence vs. Evidence-Based Clinical Trials in Humans: A Paradigm Shift in Clinical Research
Prospective interventional clinical studies in humans remain the cornerstone of evidence-based medicine, guiding clinical decision-making and regulatory approvals. However, with the rapid advancement of Artificial Intelligence (AI) and the conceptual emergence of Artificial General Intelligence (AGI), the medical community is beginning to explore whether these technologies can augment or even replace traditional clinical trials. This manuscript critically examines the capabilities of AI and AGI in simulating, predicting, and evaluating clinical interventions. We discuss the methodological, ethical, and regulatory considerations of such a paradigm shift. While AI shows promise in retrospective analyses, clinical decision support, and trial optimization, replacing prospective interventional trials remains beyond current technological and ethical limits. Though theoretically more capable, AGI introduces concerns of explainability, bias propagation, and validation challenges. The future of clinical trials may lie in hybrid models that integrate AI with traditional methodologies, enhancing efficiency without compromising scientific rigor.
Brain Death and Organ Donation in Islam: Reconciling Medical Science with Ethical Tradition
The acceptance of brain death and organ donation within Muslim societies continues to generate significant theological, ethical, and medical discourse. Grounded in both classical Islamic jurisprudence (fiqh) and contemporary biomedical standards, this manuscript investigates the evolving definitions of death, particularly the legitimacy of brain death as a medically and theologically valid criterion for end-of-life determination. It further examines the permissibility of organ donation, both living and posthumous, through the lens of maqasid al-shari‘ah (objectives of Islamic law), which prioritize the preservation of life, dignity, and public welfare (maslaha). Drawing on a synthesis of authoritative fatwas, global medical consensus, and community-level educational initiatives, the paper presents a narrative argument for promoting ethically sound, religiously sanctioned organ transplantation. It also underscores the importance of culturally sensitive public engagement and interfaith dialogue to dispel misconceptions and enhance trust in medical systems. Through this lens, brain death and organ donation are positioned not as contradictions to Islamic ethics but as deeply aligned with its higher moral objectives.
From Isolation to Integration: How Community Hospitals Can Benefit from Participating in National Clinical Research Networks (NCRNs)?
National Clinical Research Networks (NCRNs) play a pivotal role in modernizing the health research landscape by fostering collaboration, standardizing methodologies, and broadening access to evidence-based care (Selby, Krumholz, & Kuntz, 2013). These networks function as expansive, interconnected platforms that unify researchers, clinicians, and institutions pursuing improved health outcomes. Through active participation in NCRNs, institutions gain early access to multicenter clinical trials, advanced infrastructure, robust data ecosystems, and consistent opportunities for career development and funding (Califf et al., 2016). This narrative review synthesizes current evidence on the strategic advantages of joining NCRNs, with a particular focus on enhancing institutional capacity, increasing access to real-world data, fostering health equity, and promoting patient-centered research. The manuscript outlines the unique contributions of key U.S.-based networks, including PCORnet, NCORP, CTSA, and REACHnet, emphasizing their critical role in closing translational gaps and democratizing research opportunities (PCORnet, 2024; REACHnet, 2024). By illuminating the value proposition of NCRN participation, this review offers a compelling case for expanding membership, especially among community hospitals and underserved regions, to ensure a more inclusive, efficient, and impactful clinical research ecosystem in the United States and beyond (Fleurence et al., 2014).
Recognizing Type 5 Diabetes: A Distinct and Urgent Clinical Challenge
The recent recognition of a fifth type of diabetes (Type 5 diabetes) by the International Diabetes Federation represents a meaningful step forward in identifying a new and historically undefined type of diabetes largely consisting of malnutrition-related diabetes in low- and middle-income countries. Type 5 diabetes has been described as aberrant insulin secretion without insulin resistance, of which both pancreatic atrophy and renal cysts may be present and display differential mutation-dependent characteristics based on HNF1B mutations, which represents a very large proportion of malnutrition-related diabetes reported primarily in lower-income regions. For too long, Type 5 diabetes, has been misrepresented or misdiagnosed as Type 1 diabetes, including incorrect treatment with insulin therapy, which has been found to increase clinical complications. Emerging evidence, including responses to GLP-1 receptor agonists such as liraglutide, continue to build support for better health determinants through more accurate diagnosis and tailored and individual treatment possibilities. This letter seeks to promote increased awareness, screening and testing for Type 5 diabetes, and ultimately the development of country specific clinical guidelines which takes into consideration the clinical and ethical implications associated with witnessing the unfolding of Type 5 diabetes, particularly in low-income and middle-income geographic regions.
Neurofluidic Exoskeletons for Adaptive Gait Rehabilitation: A Translational Perspective
Neurofluidic exoskeletons are a revolutionary innovation for gait retraining of individuals with neurological impairments, such as stroke or multiple sclerosis. These fluid-based devices adjust according to patient progress and can provide personalized torque and timing for smoother and more natural movement than traditional, rigid exoskeletons. Recent studies report that exoskeleton-assisted gait training improves gait function and lower limb strength in subacute stroke patients. In contrast, enhanced neuroplasticity appears to arise from the intervention through the use of adaptive control algorithms. However, issues such as device miniaturization, the ease with which devices can be fitted, and equitable access still need to be pondered. Other large-scale studies are needed to establish the long-term effectiveness and cost-benefits. The present commentary argues that the neurofluidic exoskeletons can make a paradigm shift in neurorehabilitation and notes the need for further inquiry and policy mechanisms for integrating these technologies into clinical practice to improve mobility and the quality of life.
A Rare Case of Partial Gonadal Dysgenesis (46,XY) from Pakistan
46XY Partial gonadal dysgenesis(PGD) is a rare subset of disorders of sexual development (DSD). Diagnosing and managing such cases can be particularly challenging in resource-limited settings like Pakistan. We present the case of a 17-year-old male with ambiguous genitalia and hypospadias. On presentation, he was diagnosed with perineal hypospadias, rudimentary blind ending vagina, asymmetric testicular descent and a hypoplastic prostate. Hormonal tests revealed high levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and low testosterone, and imaging studies showed a normal bladder shape but no prostate. Surgical treatment was performed in two steps. Stage one consisted of scrotoplasty, urethroplasty, chordea correction and grafting. The second operation involved tubular reconstruction of the urethra. Along with that, we also gave hormone replacement therapy for testosterone deficiency and sent the patient for psychological counselling. To our knowledge, no previously published cases of PGD have been reported from Pakistan. Nevertheless, a complete gonadal dysgenesis (Swyer Syndrome) case was described by Jawed et al in 2023. This case report describes this patient’s unique presentation thereby exemplifying the wide spectrum of clinical findings and management difficulties of this case while adding to the scant literature on DSD in Pakistan, in hopes of providing insight to improve patient outcomes.
The Re-Emergence of Measles in the United States: Analyzing Causes, Trends, and Public Health Implications
Objective: To investigate the sharp resurgence of measles in the United States in 2024 through 2025, this commentary analyzes clinical, sociopolitical, and systemic drivers contributing to outbreak severity. It also explores data-backed strategies to rebuild vaccine trust and prevent future epidemics. Methods: A literature review of ten peer-reviewed studies and official public health reports was conducted, covering U.S case trends, vaccine uptake, misinformation impacts, and global contextual data. Emphasis was placed on sources with 2024 through 2025 surveillance data and expert recommendations. Results: Measles cases in the United States reached a 25-year high, with Texas alone reporting over 700 cases by mid-2025. Vaccination refusal, disinformation, and gaps in public health infrastructure were the strongest predictors of outbreak spread. Nearly all severe cases occurred in unvaccinated individuals. In multiple states, Measles, Mumps, and Rubella (MMR) coverage dropped well below the 95 percent herd immunity threshold. Commonly cited solutions included pre-travel immunization, school mandate enforcement, and use of trusted community messengers to improve vaccine acceptance. Conclusion: Measles’ return represents not just an infectious threat, but a breakdown of public trust in science. Combating it requires reinvestment in public health systems, updated vaccination policies, and long-term trust-building through culturally competent outreach.
Addressing the Health Risks of Metal Contamination and Microbial Hazards in Instant Noodles
Instant noodles, a popular staple due to their convenience and affordability, have come under scrutiny for posing serious food safety risks. Recent studies have identified heavy metal contamination—particularly lead, cadmium, and arsenic—in seasoning packets, along with microbial hazards such as Escherichia coli and Salmonella present in noodle products. These contaminants pose significant health threats, especially to vulnerable populations including children and the immunocompromised. This letter highlights the urgent need for stringent food safety regulations, improved quality control in spice production, and public education to mitigate long-term health consequences. Coordinated efforts by regulatory authorities, manufacturers, and consumers are essential to ensure the safety of widely consumed food products like instant noodles.
Association Between Cardiovascular Diseases and Oral Health
Oral health is highly associated with cardiovascular health.It has been found that poor oral health is a risk for diabetes, hypertension, dyslipidemias and low HDL levels.Patients with inflammatory gums have high levels of CRP and IL-6 that disrupts endothelial functional and increases the risk of hypertension and atherosclerosis. Moreover, Porphyronomas gingivalis speeds up the atherosclerosis plaques.Oral health needs to be emphasized especially in low socioeconomic states to decrease the global burden of CVDS.