Journal of Advances in Medicine and Medical Research

Novel Management Approaches Diabetic Kidney Disease and Chronic Kidney Disease: A Systematic Review

Wed, 17 Sep 2025 00:00:00 +0000

Background: Diabetic Kidney Disease (DKD), a major health concern, leads to renal replacement therapy and increased mortality, primarily due to cardiovascular complications. DKD, a prevalent and progressive condition, affects a significant portion of the global population, estimated at around one in every seven individuals. Despite advances in treatment, a comprehensive understanding of novel biomarkers for DKD progression is essential for effective management. This systematic review aims to integrate emerging research on these biomarkers, considering the complex nature of DKD and the range of therapeutic interventions.

Aim: This systematic review aims to integrate and critically evaluate the emerging research on novel biomarkers in the context of DKD progression, considering the multifaceted nature of the disease and the varied therapeutic approaches that have shown renoprotective effects.

Methods: Adhering to PRISMA Statement 2020 guidelines, this review includes studies focusing on patients with DKD, evaluating novel biomarkers for disease progression. The search covered PubMed, Embase, and the Cochrane Library, including only Randomised Controlled Trials (RCTs) published in the last five years. A narrative synthesis approach was used for data analysis.

Results: Thirteen studies involving various interventions like cholecalciferol, Coenzyme Q10, probiotics, and DPP-4 inhibitors were included. These studies assessed the impact of interventions on biomarkers related to kidney function and disease progression, such as eGFR, albumin-to-creatinine ratio, and various inflammatory markers. Key findings include improvements in angiogenic markers, prognostic value of TNF receptors in CKD progression, and the benefits of treatments on renal and cardiovascular outcomes.

Conclusion: This review highlights the importance of novel biomarkers in understanding and managing DKD. The findings suggest that a multifaceted approach, including a panel of biomarkers and omics-based techniques, is essential for a comprehensive understanding of DKD progression. Future research should focus on validating these biomarkers and methodologies for their integration into clinical practice.

Exosomal Shuttle RNAs (esRNAs) as Diagnostic, Prognostic and Therapeutic Tools: New Frontiers in Precision Medicine

Rajeev Goel — Tue, 23 Sep 2025 00:00:00 +0000

The exosomes have recently emerged as key players in modulating different physiological and pathological processes including tumor progression, neurodegenerative disorders, cardiovascular diseases, osteoarthritis, angiogenesis, wound healing and immune responses. They are vital for cell- to- cell communication and in maintaining cellular homeostasis via cell proliferation, differentiation and apoptosis. Exosomes carry a diverse cargo of bioactive molecules such as signaling proteins, membrane proteins, DNA, RNAs, metabolites and pathological molecules, that can be transferred to the recipient cells. Among these, the exosomal shuttle RNAs (esRNAs), which primarily include coding and non-coding RNAs (ncRNAs) such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), circular RNAs (circRNAs) and small interference RNAs (siRNAs), have gained significant attention for their involvement not only in diseases pathogenesis but also in diagnosis as well as RNA based precision therapeutics across a spectrum of diseases and is the focus of this review article.

Hematology Descriptions’ Significance for Toddlers Who are Stunting and those Who are Not in Babakan Mandang, Gunung Pancar, Sentul

Erida Manalu, Nia Reviani, Pratiwi Dyah Kusumo — Thu, 18 Sep 2025 00:00:00 +0000

Introduction: Inadequate intake of macronutrients and micronutrients is associated with the incidence of stunting. Apart from affecting linear growth, inadequate nutritional intake also affects erythropoiesis, which can cause anemia. Lack of micronutrients such as zinc can also affect a child's immunity, hence increasing the risk of infection. This research aims to understand the hematological features of stunting and non-stunting in Babakan Mandang, Gunung Pancar, Sentul.

Study Objective: The research method used is an observational case-control analytical study with a cross-sectional approach. Analysis of the data obtained used an Independent T-Test.

Methods: Observational case-control analytical research with a cross-sectional design. The sampling method employed is non-probability sampling, specifically quota sampling. The total sample in this study was 42 samples, with each group consisting of 21 samples. Research was conducted in Babakan Mandang, Gunung Pancar, Sentul, West Java, between June and December 2023. Determination of stunting status is based on height for age (HAZ) WHO anthropometry analysis (SD ≤-2).

Results: There was a significant average difference between stunting and non-stunting; hemoglobin levels (P =.004), hematocrit levels (P = .003). But the average levels of MCV, MCH, and leukocyte count in the two study groups showed no significant differences. In both study groups, MCV levels decreased, but the lowest amount of MCV in stunting children (51,3 fL) is lower than the lowest amount of MCV in non-stunting children (56,7 fL). The average amount of MCV in children stunting was 67,3 fL and in non-stunting was 68,5 fL. Meanwhile, the average MCH levels in children with stunted growth were 23.1 pg, and in those without stunted growth, they were 24.2 pg. The average number of leukocytes in children who suffer stunting is 10,3 10³/uL and in non-stunting is 12,4 10³/uL

Conclusion: Stunted toddlers had lower average hemoglobin, hematocrit, MCV, and MCH levels than non-stunted toddlers, but a larger average number of leukocytes.

Bridging Competency and Training Outcomes: An Evaluation of Life Support Courses Via the Dubai Health Authority (DHA) Framework

Mon, 22 Sep 2025 00:00:00 +0000

Background: Life support training is a critical component for healthcare professionals, particularly those working in emergency care settings. The Dubai Health Authority (DHA) operates a state-of-the-art training center that offers resuscitation courses, including Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), Paediatric Advanced Life Support (PALS), and Paediatric Emergency Assessment, Recognition, and Stabilization (PEARS). Following each course, participants complete a standardized evaluation, which serves as the primary data source for this study.

Objectives: To evaluate participants' perceptions of teaching methods, course effectiveness, and skill acquisition, and to compare evaluation outcomes across four life support courses: BLS, ACLS, PALS, and PEARS.

Methods: This observational, retrospective, quantitative study analysed participant evaluation data collected between 2014 and 2016 using a modified American Heart Association (AHA) evaluation tool. Data were reviewed for three key domains: instructor performance, course content, and skill mastery. Inclusion and exclusion criteria were applied to ensure data quality and relevance.

Results: In 2014–2015, all courses received high evaluation scores, with average ratings between 4.4 and 4.6, reflecting strong instructor performance, relevant content, and effective skill training. In 2016, a decline in ratings was observed for BLS, ACLS, and PALS, particularly in areas such as instructor clarity, learner confidence, and facility adequacy. In contrast, PEARS maintained consistently high ratings and showed slight improvement. These trends highlight a decline in perceived course quality for most programs in 2016, with PEARS as a notable exception.

Conclusion: Life support training programs delivered by DHA demonstrated high levels of participant satisfaction in 2014–2015, particularly in instructional quality and skill development. A systemic decline in 2016 suggests a need for improvements in instructor consistency, practical training reinforcement, and facility upgrades. Despite this, course content and participant trust in the programs remained strong throughout the study period.

Histopathological Patterns in Orofacial Tumors: An Explicit Concepts

Mandeep Kaur, Gunveen Kaur, Sumit Dubey — Wed, 17 Sep 2025 00:00:00 +0000

Oral health is essential to the quality of life of individuals. Oral lesions including tumors can disrupt daily activities by causing pain and discomfort during essential functions like mastication, swallowing, and speech. The oral and maxillofacial regions are susceptible to various irritants that can result in diverse injuries, consequently contributing to a broad spectrum of pathology. Histological patterns are characteristic of particular tumors or group of tumors. Thus these particular patterns are essential for the histopathological diagnosis. The knowledge of various patterns in different lesions helps in the diagnosis and delivery of appropriate treatment. It will help us to understand the nature and the behavior of the lesions. They provide crucial insights into an intricate architecture of various lesions. Recognization of these patterns such as tubular, basaloid, biphasic, staghorn, herring bone etc are fundamental for correlating structural organization with physiological conditions and identifying both normal and pathological conditions. This article is an attempt to highlight various histopathological patterns seen in head and neck lesions.