Background: Ruxolitinib is a JAK1/JAK2 inhibitor with demonstrated success in treating MF intermediate to high-risk patients, although the implications for low-risk disease classes are not yet established. Objective: To evaluate the effect of ruxolitinib on spleen size reduction and symptom burden in patients with low- and intermediate-1 risk primary myelofibrosis, and to analysis the relationship between baseline hematologic parameters and treatment response. Methods: A cross-sectional study was carried out on 30 patients diagnosed with primary myelofibrosis who were treated at the Hematology consultant/Merjan teaching hospital between January and August 2025. Patients were classified according International Prognostic Scoring System (IPSS). Ruxolitinib treatment was initiated at doses of 15–20 mg twice per day and therapeutic response was assessed after a minimum of six months. The main outcomes studied were reduction in spleen size (%) (estimated by ultrasound measuring the longest axis) and alterations in the Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score (MPN-SAF TSS). Statistical evaluations were performed using Jamovi version 2.6.44, establishing significance at p < 0.05. Results: Among the 30 patients, 14 (46.7%) were classified as low-risk, while 16 (53.3%) were considered in the intermediate-1 risk category. The median baseline spleen sizes recorded were 20 cm for the low-risk group and 18.5 cm for the intermediate-1 group. After treatment, the median reduction in spleen size was 17.9% in low-risk compared to 15.4% in intermediate-1 group (p = 0.16). Moreover, an average decrease in the MPN-SAF TSS was 71.7% in the low-risk group as well as 66.4% in the intermediate-1 group (p = 0.52). There were no significant correlations in these data between initial hematologic parameters and treatment outcomes. Conclusion: Ruxolitinib therapy resulted in reduction of splenic size and symptom severity for patients with lower-risk myelofibrosis (MF). However, the variations observed between different International Prognostic Scoring System (IPSS) categories were not statistically significant. These results underscore the possible advantages of initiating ruxolitinib therapy earlier for symptomatic low-risk MF patients and point to the necessity for larger prospective studies to confirm these findings.

Background: The Somatic Mutation Theory (SMT) has dominated oncological science over the course of many decades representing cancer as a more primitively cell-autonomous pathology, as a consequence of the accumulation of somatic genetic changes. The heterogeneity, dormancy and treatment resistance that is so eminent in breast carcinoma often goes unnoticed by this view. Objective: The current review will attempt to amalgamate modern evidence supporting the Tissue Organisation Field Theory (TOFT), especially the histophysiological reprogramming of breast cancer cells in the microenvironment in which they can be found. Methodology: A systematic literature review was conducted on the following leading databases - Scopus, Web of Science, PubMed and high-impact studies published between 2010 and 2026 were prioritised. Results: The current use of empirical evidence places breast cancer progression as a breakdown of the organisation of tissues as opposed to as opposed to a genetic breakdown. Recent spatial proteomic studies (2025) prove that the increase in proteomic heterogeneity in line with tumour progression, regardless of prevailing underlying genomic mutations, is due to the non-steady interplay between malignant epithelial cells, cancer-associated fibroblasts (CAFs) and the immune microenvironment. Conclusion: Diverting analytical attention toward the solitary cancer cell, more wholesome information about malignancy is obtained by cultivating an alternate perspective that analyses the tissue field. Targeted therapeutic interventions to achieve microenvironmental normalisation and restoration of tissue architecture can be a promising potential solution to treatment resistance and achieve long-term clinical benefit.

Obesity is one of the most common and complex chronic conditions encountered in primary care. Its management extends beyond diet and exercise and requires sensitive communication, multidisciplinary collaboration, and system-level support. Drawing on clinical experience in a Canadian primary care setting, this article discusses practical strategies for obesity management, the role of Primary Care Networks (PCNs), challenges related to medication coverage, and approaches to addressing obesity with patients while minimizing stigma.

Diabetic foot ulcer (DFU) remains one of the most severe and costly complications of diabetes mellitus, and contributes to infection, amputation, and mortality on a large scale globally. This review performs an update reviewing the literature about epidemiology and principal risk factors for development of DFU. Recent global data indicate that the DFU affects ~6% of those who have diabetes, while prevalence in different areas of the world is quite variable because of disparities in access to care, social conditions and impediments to preventive care. DFU is a multifactorial disease that stems from the interactions among peripheral neuropathy, PAD, biomechanical abnormalities, metabolic disorder and wound healing defects. In the extant literature, multiple risk factors for DFU are once again described, including duration of diabetes, male sex, age older than 45-50 years, poor glycemic control, hypertension or metabolic syndrome abnormality [1], obesity overweight [3], and central fat accumulation with elevated waist: hip-ratio anorexia nervosa defined as related to a BMI less than 17.5 but also as a low volume intake such us reaching an initial idea more important rectal bleeding and syndromes following cerebrovascular accident Structural foot deformities history of ulceration or amputation current diabetic foot ulcer (DFU) unsatisfactory footwear inappropriate podiatric care. Behavioral and environmental factors such as wearing unsuitable shoes, low health literacy, and living in rural areas further add to vulnerability in several populations. Awareness of these common trends and predictors is essential to trigger improved preventive measures, help in risk stratification, and guide evidence-based clinical decisions. In the context of summarizing new evidence, this article reinforces the ongoing requirement for early screening, organized foot programs, and select interventions to diminish the devastating effects of DFU and its sequelae.

The harmful or hazardous use of substances including illegal drugs, prescription medications used non-medically, alcohol, and inhalants is known as drug abuse. Males tend to have a higher prevalence and more varied substance use, often starting at a younger age than females. Drug abuse is emerging as a global public health issue. Youth are more vulnerable because their brains are still developing, which makes drug use potentially more harmful. Early drug exposure may lead to addiction, poor academic performance, risky behavior, and mental health issues. The aim of this study is to Evaluate and compare the prevalence and types of substances commonly abused by male and female out of school in Kano metropolis. This study was a cross-sectional study that assesses and compares the pattern of substance abuse among males and females out of school youths in Kano metropolis. A total of 463 (257 males and 206 females) out of school youths were taken from eight local governments in Kano metropolis, with age between 18 and 29 years. A multistage sampling technique was used to collect data using an adapted interview administered semi structured questionnaire, SPSS Version 24 was used to analyse the data. The study revealed that the substances abuse by males and females out of school youths in Kano metropolis includes: alcohol, cigarette and shisha, marijuana, syrups and tramadol, among others while males commonly abuse cigarette and shisha the female, abuse more of syrups. The male out of school youths abuses drugs mainly to do something un-usual while females abuse drugs due to friend influence.

Introduction: Hypokalaemia or potassium deficiency in cancer patients is the second highest Electrolyte Disorder (ED) after Hyponatremia. Deficiency of potassium can cause sudden vital organ failure in malignancy, if it is not diagnosed and manage immediately. Additionally, there remain many risk factors related to malignancy and its treatment to developing potassium deficiency. This narrative review was conducted to document an overview of aetiology of Hypokalaemia in patients with different stage of various types of cancer. Aim: The narrative review could be informative and important in recognizing Hypokalaemia in oncology treatment and management. Research Question: What is the aetiology of developing hypokalaemia in cancer patients? Methodology: Literatures were selected for review based on inclusion and exclusion criteria. Selection was done purposively based on several outcome and information regarding potassium deficiency in cancer patients. Articles were reviewed by mainly considering the population and results of the study. Main author reviewed the papers and cross-checked with third author, and finally came to conclusion after consensus. Inclusion Criteria: a) Study on cancer patients developing hypokalaemia, b) Study on hypokalaemia as an outcome of cancer treatment and management, c) Study on mechanism of developing hypokalaemia in cancer patients, and d) Study on hypokalaemia resulting from risk factors as a consequence of cancer. Exclusion Criteria: a) Study on hypokalaemia not due to cancer treatment or management, b) Incomplete study, c) Not found in online publications/digital libraries/e-journals. Study Period: Review period was January to March 2021. Literature Search: Keyword based scientific paper search underwent through Google Scholar, PubMed and Embase. Results and Discussion: Aitiology of hypokalaemia can be grouped under four headings: a) Malignancy, itself, b) treatment of the cancer that includes chemotherapy and targeted therapies; c) concomitant drugs and d) concomitant diseases; endocrine dysfunction, toxic epidermal necrolysis, inflammatory bowel diseases among others. There are three mechanisms found to be involved which are caused by the above mentioned risk factors. They are: an inadequate potassium intake, redistribution of potassium among intra- and extracellular compartments, and potassium losses. Conclusion: Hypokalaemia in cancer patients is a life-threatening situation and increases mortality and morbidity. Recognizing and understanding the aetiology could be helpful for the clinicians, especially the oncologists to reduce the suffering and improve palliative management in cancer patients.

Introduction: Pulmonary function tests (PFTs) are critical tools in evaluating respiratory health by measuring lung capacity, airflow, and overall pulmonary performance. These tests provide insights into various respiratory disorders and help assess the impact of different physiological and environmental factors on lung function. Among the numerous factors influencing pulmonary function, body mass index (BMI) has emerged as a significant determinant. Methods: A Cross-sectional study was done at Department of Physiology NMMC Ahmedabad. The selection of samples based on their body weight. The present study included 120 participants (60 males and 60 females). All participants aged 18-20 years who are apparently healthy. Male and female according to BMI categorized into two groups, i.e., BMI < 25 and BMI > 25. Results: Respiratory parameters such as FVC, FEV1, FEV1/FVC, and PEFR are found to be significantly lower in female participants in comparison to male participants as shown in Table 1. The correlation of different pulmonary function parameters with BMI of the male and female participants are presented in Tables 2 and 3. It is observed that respiratory parameters such as FVC, FEV1, FEV1/FVC, and PEFR of both male and female participants correlated positively with BMI < 25 but there were substantial lung function losses with increasing BMI > 25, i.e., PFTs were negatively correlated. Conclusion: Obesity influences the respiratory function enhancing dyspnoea and increasing both cardiac load and respiratory muscle fatigue of the thoracic wall and the diaphragm due to the higher pressure exerted by intraabdominal adipose accumulation. In our study the results showed that increase in BMI had an inverse relationship with FVC, FEV1 and PEFR in obese when compared to the normal weight subjects.