A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term “Asia-Pacific” refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize regional perspectives. In addition, a manual literature review and voting were conducted to evaluate the current evidence on MRONJ. The key aspects of MRONJ, including definition, staging, diagnosis, pathogenesis, risk factors, management, and prevention, were generally consistent among the AFOS countries and regions. The annual incidence and incidence rate of MRONJ associated with low-dose antiresorptive therapy in patients with osteoporosis ranged from 0.025% to 0.136% and 21 to 283 cases per 100,000 person-years, respectively. However, evidence regarding the benefits of drug discontinuation before dental surgery, such as tooth extraction, remains insufficient. Large-scale, multinational studies across AFOS countries and regions are warranted to determine the incidence of MRONJ better and evaluate the impact of antiresorptive drug discontinuation before dental procedures. These findings may contribute to the devel opment of effective evidence-based strategies for preventing MRONJ in patients with osteoporosis.

Purpose: This study evaluated the feasibility and effectiveness of autologous adipose-derived mesenchymal stem cell (ASC) transplantation into the lacrimal gland for treating aqueous-deficient dry eye disease (DED) associated with Sjögren syndrome. Methods: Patients with Sjögren syndrome–related DED underwent autologous adipose tissue harvest via liposuction. ASCs were isolated, cultured, and injected into the lacrimal gland (volume ≤50% of estimated gland volume). Clinical evaluations— including Ocular Surface Disease Index (OSDI), tear osmolarity, tear film breakup time (TBUT), Oxford corneal staining, and Schirmer test I—were conducted at 1-, 4-, 16-, and 24-weeks after injection. Visual quality assessments included contrast sensitivity and higher-order aberrations (HOAs). Results: Six patients (mean age 56.1 ± 7.2 years) completed the study. Mean OSDI scores significantly decreased from 48.6 ± 8.4 to 28 ± 2.1. TBUT improved in both eyes (right, 3.3 ± 1.0 to 5.6 ± 1.2 seconds; left, 3.6 ± 1.0 to 6.1 ± 1.6 seconds). Schirmer test I values increased (right, 4.1 ± 0.7 to 7.8 ± 0.7 mm; left, 4.0 ± 0.6 to 7.6 ± 0.5 mm). Oxford staining scores decreased (right, 1.6 ± 0.5 to 0.67 ± 0.2; left, 1.3 ± 0.5 to 0.67 ± 0.2). Tear osmolarity also improved (right, 311.6 ± 6.1 to 299.1 ± 5.8 mOsm/L; left, 309 ± 7.6 to 298.3 ± 7 mOsm/L). HOAs were reduced in one eye. No significant change in contrast sensitivity or visual acuity was observed. No adverse events were reported. Conclusions Autologous ASC transplantation into the lacrimal gland appears to be a safe and promising therapeutic option for aqueous-deficient DED in Sjögren syndrome, offering significant improvement in both objective measures and patient-reported symptoms over a 6-month period.

Purpose: To compare vision-related quality of life (QoL) between surgical and nonsurgical interventions in Iraqi patients with unilateral keratoconus (KC) and to identify independent clinical predictors of QoL outcomes. Methods: This multicenter cross-sectional study enrolled 490 patients with unilateral KC. Participants were stratified into surgical (n = 240; intracorneal ring segments [ICRS], deep anterior lamellar keratoplasty [DALK], or penetrating keratoplasty [PKP]) and nonsurgical (n = 250; corneal collagen crosslinking [CXL], rigid gas-permeable, or scleral lenses) groups. Clinical assessments included best-corrected visual acuity (BCVA), maximum keratometry (Kmax), spherical equivalent, and disease stage. QoL was measured using the validated 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Subgroup analyses, pairwise comparisons, and multivariate regression were conducted to identify determinants of QoL. Results: Surgical patients demonstrated significantly higher NEI-VFQ-25 composite and subscale scores than nonsurgical patients (p < 0.001), with marked improvements in general vision, mental health, and daily activities. Subgroup analyses confirmed that ICRS provided superior outcomes in mild-to-moderate KC compared to CXL and contact lenses, while DALK and PKP yielded comparable benefits in advanced disease. Stratified analyses revealed sex-based and age-related differences, with females and older patients reporting better QoL. Multivariate regression analysis identified surgical treatment, BCVA ≤0.3 logMAR, patient satisfaction with surgery, and mild KC as independent positive predictors of QoL, whereas advanced stage, male sex, higher Kmax, and increasing age were identified as negative predictors. A treatment–age interaction indicated that younger patients benefited more from timely surgery. Conclusions Surgical interventions, particularly ICRS and PKP, are associated with superior QoL compared with nonsurgical options in Iraqi patients with KC. These findings underscore the importance of incorporating patient-reported outcomes into clinical decision-making and support individualized, stage-based surgical referral, especially in resource-limited settings.

Mpox, known before now as monkeypox, is a novel zoonotic disease that may infect both humans and animals. It usually spreads by direct contact with bodily fluids, lesion material, or fomites (such as contaminated linens) and prolonged face-to-face contact. Mpox can spread to laboratory animals in a research laboratory through either a general outbreak or during procedures. Animal models are essential as we learn more about how infections occur and how to treat illnesses in both humans and animals which require laboratory procedures with mpox virus. As drug-resistant organisms proliferate, bioterrorism becomes a greater danger, international trade and travel expand, and the number of newly developing infectious illnesses grows, the use of animals in infectious disease research has increased. Animal research offers a solid basis for clinical trials used in standard medication development.Animal studies must be planned to produce conclusive effectiveness evidence that is robust, rigorous, and repeatable per the animal rule so that the agency may depend on the results when making regulatory decisions.There is a need to understand the transmission risk and biosafety protocol to be in place in laboratory settings to prevent an outbreak and probably contain an outbreak. Hence, this review discussed the overview of mpox in animal research, biosafety protocols in mpox research, laboratory waste management methods, legal and ethical considerations in mpox research, challenges in carrying out mpox research and future directions.

Background: Orthognathic surgery has become increasingly accurate with the integration of computerized technologies. This study aimed to evaluate the accuracy of custom-made plates in transferring the three-dimensional virtual plan to intraoperative maxillary repositioning. Methods: This study included 10 patients. A digital surgical simulation technique was used for preoperative planning. The surgical components— osteotomy/plates, locating guides, and customized titanium plates—were fabricated using computer-aided design and manufacturing techniques, replacing the need for a surgical splint. Postoperative outcomes were assessed using unaltered anatomical landmarks from the preoperative virtual plan. Absolute discrepancies in translational and rotational movements between the planned and actual postoperative positions were measured through superimposition analysis. This evaluation assessed the precision of custom-made plates in transferring the virtual surgical plan, identifying deviations in the cephalocaudal, mediolateral, and anteroposterior directions that could influence functional and esthetic outcomes. Results: No statistically significant differences were observed for any landmarks across the axial, coronal, and sagittal planes. The greatest variability was noted at the posterior nasal spine landmark in the axial plane (1.7 mm), compared with the coronal (0.9 mm) and sagittal (0.5 mm) planes. Conclusion Customized titanium plates effectively transferred the virtual surgical plan for maxillary repositioning without the need for an occlusal splint. However, potential posterior interference should be considered during surgical execution.

Background: Cerebellopontine angle (CPA) tumors present surgical challenges due to their proxim-ity to the facial nerve. Despite preservation efforts, facial nerve paresis is a major issue. This study aims to identify key factors affecting facial nerve preservation during microsurgical resection of large CPA tumors in a low- and middle-income countries (LMIC) setting. Methods: This retrospective cross-sectional study, conducted at Aga Khan University, includedpatients who underwent microsurgical resection of large (>3 cm) CPA tumors with House-Brackmann (HB) grades 1–4. Postoperative facial nerve function was assessed using the HB grading system. Data was extracted from medical records and analyzed using SPSS 22. Results: This study analyzed 95 patients (M:F=1:1.16, mean age 44.24±13.71 years) withCPA tumors who underwent microsurgical resection. Common presenting complaints included a complete hearing loss (57.9%), headache (52.6%), and abnormal gait (40%). Preoperative facial nerve function was normal (HB grade I) in 75%, with 19%, 7%, and 2% having HB grades II, III, and IV, respectively. Schwannoma (69.5%), meningioma (16.8%), and epidermoid cyst (10.5%) were the most common diagnoses. Postoperative preservation of facial nerve function was achieved in 73.7% of patients. At six months, HB grades I and II were observed in 64% and 11.5%, respectively, while none had complete facial nerve palsy. On univariate analysis, larger tumor size and higher HB grade correlated with worse facial nerve outcomes (p=0.02). Complications were more frequent in patients with worsened outcomes (72% vs. 38.6%, p=0.004). However, in multivariate analysis, only preoperative HB grade was identified as a predictor. Conclusion Facial nerve preservation during CPA tumor resection is influenced by intrinsic tumorcharacteristics, surgical complexity, and patient-specific factors. Detailed preoperative counseling is crucial to set realistic expectations.

Objective: Cisplatin, a widely used chemotherapy agent, is known to induce testopathy and degeneration of the germinal epithelium (GE). Origanum vulgare L. (OV) leaf extract, due to its antioxidative properties, may alleviate such cellular damage. This experimental study was conducted to evaluate the protective and therapeutic effects of OV against cisplatin-induced testopathy. Methods: Forty-eight male Naval Medical Research Institute mice were assigned to six groups. Testopathy was induced via intraperitoneal injection of cisplatin (single dose, 1 mg/kg on day 0). OV was administered as treatment (400 mg/kg orally, 5 days per week, for 5 weeks). Phytochemical screening of OV was also performed. After the experimental period, the animals were euthanized, and both blood serum and testicular samples were collected. Total body weight and total testicular weight were measured. Histopathological examination using hematoxylin and eosin staining (to assess the gonadosomatic index [GSI]) and immunohistochemical (IHC) detection of 3β-hydroxysteroid dehydrogenase (3β-HSD) protein were conducted. Expression levels of the p53 and B-cell lymphoma 2 (Bcl-2) genes, as well as serum testosterone levels, were evaluated. Statistical analysis was performed with SPSS ver.16, and significance was set at p<0.05. Results: A phytochemical analysis of OV confirmed the presence of antioxidant compounds. Cisplatin administration resulted in significant detrimental alterations in testicular tissue (p<0.05). In animals receiving OV following cisplatin exposure, the GSI, testosterone levels, histological parameters, and total testicular weight improved toward physiological values (p<0.05). Additionally, IHC staining for 3β-HSD protein indicated regeneration of Leydig cells. Gene expression analysis showed down-regulation of p53 and up-regulation of Bcl-2 (p<0.05). Conclusion OV administration, owing to its antioxidative characteristics, shows promise as a protective phytomedicine against cisplatin-induced testopathy. OV promotes GE proliferation, enhances testosterone secretion, and modulates the expression of apoptotic genes.

BACKGROUND: Burn injuries are characterized by extensive and prolonged inflammatory responses that impair wound healing, especially in deep burns. Understanding the post-burn fibroblast dynamics in wound healing is critical to improve recovery and minimize scarring. This study aimed to develop a 3D reconstructed human skin (RhS) burn model to mimic superficial, partial-thickness, and deep burn injuries and assess fibroblast behavior over one week. METHODS: RhS consisted of a reconstructed epidermis on a fibroblast populated collagen hydrogel dermis. Papillary (fibroblast activation protein; FAP ?) and reticular (FAP-) fibroblasts located themselves in the upper and lower regions respectively within the dermal compartment in line with native skin. Burns of increasing temperatures (70 °C, 110 °C, and 140 °C) were introduced and RhS was analyzed up to one-week post-burn. RESULTS: Lactate dehydrogenase (LDH) staining for metabolic active cells in tissue sections enabled distinct histological zones to be observed in RhS with partial (110 °C) and deep burns (140 °C): including a viable fibroblast zone (zone V), a mixed dead and viable fibroblast zone (zone M), and a necrotic zone (zone N). Fibroblast migration from the wound edge (M) into the viable area (V) and changes in fibroblast phenotype, particularly an increase in papillary fibroblast markers (FAP ?), were observed, with a marked increased expression of Ki67 in fibroblasts at the burn wound edge (M).Additionally, burn temperature influenced the protein secretion of inflammatory and tissue remodeling mediators SAA, NGAL, MRP8/13, ICAM-1, CCL20, and MMP-9. CONCLUSION The RhS burn model enables complex fibroblast dynamics post-burn to be investigated in an organotypic model, providing a platform for studying burn pathophysiology which can be used for evaluating potential therapeutic strategies for enhancing burn wound healing and minimizing scarring in the future.

Introduction: Medicinal herbs Acorus calamus, Curcuma longa, Zingiber officinale, and Piper betle have been traditionally used for treating stomach-related conditions such as irregular bowel movement, bloating, and gastric ulcers. The present study aimed to explore current status, research trends, and future directions of these herbs as functional herbal teas in prevention and treatment of gastritis. Methods: A total of 80 articles from Scopus database were retrieved and reviewed. Research trends were quantitatively analysed using VOSviewer software, focusing on the keywords, authors, countries, journals, and documents. A narrative review was integrated to provide comprehensive insights into the study. Results: Analysis revealed China and India as driving forces of this specific area of research, with the Journal of Ethnopharmacology emerging as a prominent source for publications in this field. “Curcumin”, “ginger”, and “Helicobacter pylori” were the main keywords of the study. Several gastroprotective mechanisms, including stimulation of mucosal proliferation, regulation of gastric acid production, reduction of inflammation in the gastric mucosa, protection of the gastric mucosa from oxidative damage, and inhibition of the growth of H. pylori, were associated with these herbs. Active compounds, such as α-asarone, curcumin, gingerol, and piperbetol, were found to be responsible for these effects. Conclusion: This study highlights various gastroprotective properties of A. calamus, C. longa, Z. officinale, and P. betle, providing researchers with a deeper understanding of the subject matter and opening new avenues for potential development into a functional herbal tea formulation known as “Lega Tea” (Relief Tea).

Multiple engorged tick nymphs (n= 6) were collected from an injured spotted wood owl (Strix seloputo) in Kelantan, Peninsular Malaysia. Morphological identification of the nymphs revealed that the ticks were Haemaphysalis wellingtoni, based on several distinctive features: (1) internal edge of palpal article III extending far beyond the internal edge of palpal article II; and (2) four feathery and closespaced infrainternal setae. Subsequent molecular analysis of a randomly selected nymph targeting the mitochondrial 16S gene corroborated with the species identity of the tick. To date, this is first report of the infestation of H. wellingtoni on S. seloputo. Future studies are needed to determine whether native or endemic birds may serve as disseminators of ticks and tick-borne diseases.