Background: Sjögren’s syndrome (SS) is a systemic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands, leading to dryness of the mouth and eyes. When SS occurs in association with rheumatoid arthritis (RA), it is known as secondary Sjögren’s syndrome (sSS). The coexistence of these two diseases significantly impacts disease progression, and patient quality of life. Aim: This review aims to summarize and analyze recent literature concerning the prevalence and severity of SS among RA patients across different populations, with special attention to variations in diagnostic criteria, immunological markers, and therapeutic implications. Methodology: A structured literature search was conducted in PubMed, Scopus, and Google Scholar databases, focusing on studies published between 2018 and 2025. The review includes data from multiple cohort, cross-sectional, and population-based studies that met the 2010 ACR/EULAR classification criteria for RA and the 2016 ACR/EULAR criteria for SS. Results: Findings consistently demonstrate that the prevalence of SS among RA patients ranges between 8% and 22% in Western populations and up to 40% in Asian populations, suggesting both genetic and diagnostic influences. RA-SS patients exhibit distinct serological profiles, including elevated anti-Ro/SSA and anti-La/SSB antibodies, and are more prone to ocular surface disorders, fatigue, and systemic complications. Conclusion: Despite variations among studies, the evidence supports that SS represents a frequent and clinically relevant comorbidity in RA. Standardized diagnostic methods and unified criteria are essential for accurate prevalence estimation and better clinical management. Future large-scale, prospective studies are needed to clarify the immunopathogenic links between these two autoimmune diseases.

Background: Abdominal aortic aneurysm (AAA) is a potentially fatal vascular condition that frequently presents with atypical features, creating diagnostic challenges particularly in primary and out-of-hours care settings. When ruptured, AAA carries a mortality rate approaching 80–90%, and delayed diagnosis significantly worsens outcomes. Objective: This narrative literature review examines the evidence on atypical AAA presentations, misdiagnosis rates, the role of screening and diagnostic tools, and the implications for primary care clinical governance and quality improvement. Methods: A structured search of PubMed, Cochrane Library, Scopus, and Web of Science was conducted covering literature published between March 2022 and December 2025. Search terms included 'abdominal aortic aneurysm,' 'primary care,' 'misdiagnosis,' 'rupture,' 'atypical presentation,' 'point-of-care ultrasound,' 'out-of-hours,' and 'screening.' Peer-reviewed studies, systematic reviews, clinical guidelines, and meta-analyses were included. Key Findings: Up to 39% of ruptured AAAs are initially misdiagnosed, with common mimics including renal colic, musculoskeletal pain, and urinary tract infection. Only 25–50% of patients with rAAA present with the classic triad of abdominal pain, hypotension, and pulsatile mass. Women, elderly patients, and those presenting to non-specialist settings are at particular risk of delayed diagnosis. Point-of-care ultrasound (POCUS) demonstrates sensitivity exceeding 98% and specificity of 99.84% for AAA diagnosis. Current NHS screening remains restricted to men aged 65, leaving women and younger high-risk individuals undetected. Conclusion: Improved diagnostic vigilance, expanded POCUS availability, enhanced telephone triage protocols, and inclusive screening policies are urgently needed in primary and out-of-hours care. Quality improvement programmes targeting AAA recognition should be implemented across urgent primary care settings.

Infective endocarditis is a disease characterized by endocardial involvement, where vegetations infected by microorganisms form on the valves, cardiac chambers, and endothelium of large blood vessels. It is potentially fatal, with an incidence of 3 to 7 cases per 100,000 people per year. Diagnosis is made according to the modified Duke criteria, which include two major and five minor criteria. The most common infectious agents are Streptococcus viridans, Streptococcus bovis, HACEK group, and Staphylococcus aureus. Streptococcus gallolycticus is a rare causative agent in infective endocarditis, occurring in 18% of cases. Colorectal cancer is almost pathognomonic, present in up to 71% of cases, and of these, 5% are associated with prosthetic valves. For colorectal cancer, blood cultures, echocardiograms, and colonoscopies are necessary. According to the evolution time of the biological prosthetic valve, it is considered early when it presents clinical symptoms within the first year and late when it presents 1 year after the replacement.

Background: Diabetes Mellitus type 2 (T2DM) is an epidemic metabolic condition that is typified by persistent hyperglycemia. Although the gold standard in the evaluation of long-term glycemic control is glycated hemoglobin (HbA1c), the polyol 1.5-anhydroglucitol (1.5-AG), a naturally occurring polyol, is reabsorbed in the renal tubules and is competitively inhibited by glucose, thus it may represent early glucose fluctuations. Change in 1.5-AG is a reflection of the variation in blood glucose over one to two weeks. Objective: The objective of the study was to establish the relationship between serum 1,5-AG and glycemic control variables (HbA1c, FBS) in T2DM patients. Materials and Methods: The study was a cases control study where 60 healthy controls were used, and 60 T2DM patients were used. 1.5-AG has been demonstrated to indicate change in blood glucose over a period of one to two weeks. An ELISA kit was used to measure serum 1, 5-AG. Fasting glucose, insulin (with a Maglumi device), insulin resistance index (HOMA-IR), renal function test (B.Urea and S.Cr) and GH-900Plus HbA1c Analyzer. Results: Serum 1.5-AG was also found to be lower in the T2DM patients than the control group (9.31 ± 4.73 mg/L vs. 22.39 + 8.20 mg/L; p<0.001). There was a considerable negative correlation between (1.5-AG and FBS, HbA 1c and HOMA-IR). The receiver operating characteristic (ROC) curve analysis indicated the diagnostic accuracy of (1.5-AG on T2DM (AUC = 0.94)) was high and the best cutoff value of 11.95mg/L offered 85.0% sensitivity and 98.3% specificity. Conclusion: It is possible to consider that 1.5-AG is a good marker to study levels in people with type 2 diabetes during the period of one to two weeks. More research will be required to ascertain the use of these chemicals in diagnosis. The blood glucose variations in the patients with T2DM. Specifically the people who are below 180mg/dl and those above 180mg/dl of blood sugar.

Background: Chronic inflammation and dyslipidemia are part of type 2 diabetes mellitus (T2DM) associated cardiovascular complications. Interleukin-6 (IL-6) and interleukin-17 (IL-17) are pro-inflammatory cytokines associated with metabolic disturbances. Objectives: To evaluate the levels of IL-6 and IL-17 in serum of T2DM patients, and to explore their association with lipid profile parameters. Methods: A case-control study with 100 individuals was carried out including T2DM patients (n=50) and healthy group as a control group (n=50). Demographic information was collected such as age, sex and body mass index (BMI). The concentrations of IL-6 and IL-17 were detected by enzyme-linked immunosorbent assay (ELISA). Serum lipid profile, including total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) was evaluated. The data was analyzed using SPSS version 26.0 control-group software. Results: The T2DM patients had significantly higher level of IL-6 (48.3 ± 12.4 pg/mL vs. 18.2±5.6 pg/mL, p<0.001) and of IL-17 (35.7±9.8 pg/mL vs 12.4±4.2 pg/ml, p<0.l)) than control subjects. T2DM patients had a higher incidence of lipid abnormalities, such as increased TC, TG and LDL-C levels, and decreased HDL-C level. IL-6 was positively correlated with TG (r=0.64, p<0.001), TC (r=0.52, p<0.001), and LDL-C (r=0.48, p<0.001). IL-17 significantly correlated with TG (r=0.58, p<0.001) and LDL-C (r=0.44, p<0.01). Both cytokines were inversely associated with HDL-C. Conclusion: Increased levels of IL-6 and IL-17 in T2DM patients are significantly associated with dyslipidemia, supporting their potential value as inflammatory biomarkers for cardiovascular risk analysis in diabetic population.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disorder of fibrosing interstitial lung disease with variable courses of the disease. Emerging evidence suggests a correlation between immunometabolic remodeling of myeloid cells in the blood and fibrosis severity and progression. Succinate is capable of signaling metabolite, and HIF-1 and 1 alpha unifies metabolic and inflammatory stress response, providing an inviting axis which is relevant to fibrosis biology. Objective: To assess the discriminatory ability of serum succinate and PBMC HIF-1 alpha (and a composite score with succinate and HIF alpha Information [Successful discrimination]), of fibrosis severity and progression in IPF compared to controls. Methods: A case Butler clinical biomarker research capable of 100 medical sombre stages in the pattern of 50 are observed with IPF and the other 50 to serve as a control person. Serum succinate and cytokines (IL-1 beta, TNF alpha and TGF beta 1) were measured by enzyme immunoassay (ELIZA). HIF-1a was analyzed in lysates of the PBMCs (normalized on total protein). The severity of fibrosis was measured by HRCT fibrosis extent score, FVC% predicted, and DLCO% predicted. Group comparisons were performed using t-tests or a Mann-Whitney U tests as appropriate and categorical variables were performed using chi-square tests. Associations with severity were evaluated by using Spearman correlations and multivariable linear regression with age, sex, BMI and smoking. Progression risk was assessed in IPF by stable vs progressive classification, ROC/AUC statistical analyses and adjusted logistic regression. Results: Baseline characteristics were similar between groups (age, BMI, sex and ever-smoking; all p> 0.05). IPF had significantly increased serum Succinate (median, 3.14 [3.00-3.49] vs 2.24 [2.06-2.35] umol/l; p < 0.001) and PBMC HIF-1a (187.6 (+-21.6) vs 129.3 (+-27.2) pg/mg protein; P < 0.001). IL-1 beta and TNF alpha were up in IPF (both p<0.001) and TGF beta 1 slightly (p=0.013). Succinate was associated with HRCT score (rho=0.734, p<0.001), FVC% (rho=-0.480, p<0.001) and DLCO% (rho=-0.612, p<0.001) in IPF. A positive correlation was found between HIF-1a and HRCT (rho=0.360, p=0.010) and DLCO% (rho=-0.343, p=0.015). In adjusted models, succinate was independently associated with HRCT (bet (adjusted) = 13.991 per 1umol/L; p<0.001) and DLCO% (bet = -22.633; p<0.001), whereas HIF-1alpha was independently associated with HRCT (beta = 0.839 per 10 pg/mg; p=0.011) and DLCO% (beta = -1.207; p=0.013). Progression analysis revealed an increase in PBMC HIF-1a (p=0.003) and increase in axis score (p=0.008) during progressive disease. ROC analyses revealed the AUC value of succinate (0.608), HIF-1 alpha (0.794), and the axis score (0.755). Axis score was found to be an independent predictor of progression (OR = 3.33 per 1 SD; p= 0.012). Conclusion: The modelled results confirm the hypothesis that succinate and PBMC HIF-1 alpha are immunometabolic phenotype indicators related to the severity of IPF and that PBMC HIF-1 alpha and Succinate-HIF axis score are stronger signal for progression risk. Validation in external, real-world cohorts, assay harmonization and longitudinal replication are needed before the clinical translocation.

Women in low-resource communities are women who live in environments with limited access to economic, social, educational, and healthcare resources. Their lives are shaped by poverty, inequality, and structural barriers that affect their well-being and opportunities. The psychosocial impacts of infertility are often more intense and complex for women in low-resource communities because infertility intersects with poverty, gender inequality, and limited access to health and social support systems. The psychosocial impacts of infertility and women in low-resource communities are deeply intertwined. Infertility is not only a medical condition but a social and psychological crisis that can affect women’s identity, mental health, safety, and economic survival. Infertility among women in low-resource communities is not caused by women themselves, but is often the result of social, economic, and healthcare-related factors that increase health risks. Infertility has serious psychosocial impacts on women in low-resource communities because motherhood is often closely linked to a woman’s social status, identity, and security. This study is aim to evaluate the Psychosocial Impacts of Infertility Among Women in Low-Resources Communities in South-South, Nigeria. This was a cross-sectional study involving 250 women with age between 18 to 47 years. A well-structured questionnaire was administered to participants. The study lasted for a period of 3 months. Statistical analysis was done using SPSS version 25.0 and p < 0.05 was significant. The results revealed that 68% of the participants were married, 60% has married for more than 5 years, 60% residence in rural areas, 60% had secondary level of education, 80% were of low class, 80% have not sought medical help for infertility, 70% sought traditional healer, 68% had stress, 76% are anxious or worried, 72% are sad, 80% are pressured, 80% had relationship affected, 80% had family relationship affected, majority had economic impacts.