Archives of Advances in Biosciences

The articles published in the 2025 volume of Archives of Advances in Biosciences highlight several directions currently shaping contemporary bioscience research. Prominent themes include advances in cancer biology and therapeutic development, particularly studies involving peptide-based vaccines, biomarker identification, computational approaches to drug discovery, and photodynamic therapy. The volume also reflects the growing role of bioinformatics, molecular modeling, and predictive analytical methods in addressing complex biological questions. Contributions focusing on immunology, infectious diseases, and the long-term consequences of COVID-19 further emphasize the continuing importance of understanding disease mechanisms and public health challenges. In addition, research on natural products and bioactive compounds demonstrates the ongoing value of integrating traditional therapeutic resources with modern analytical and computational technologies. Collectively, the studies published this year illustrate the increasingly interdisciplinary nature of bioscience research, where collaboration across experimental, computational, engineering, and clinical disciplines has become essential. Looking ahead, emerging developments in artificial intelligence, omics technologies, precision diagnostics, and personalized medicine are expected to expand research opportunities while also highlighting the importance of scientific rigor, reproducibility, and ethical oversight. Together, these contributions reflect the broader goal of advancing biological knowledge and supporting improvements in human health.

 Introduction: The COVID-19 pandemic has highlighted the need to understand factors influencing the immune response to SARS-CoV-2. Immunoglobulin G (IgG) antibodies serve as indicators of prior exposure and potential immunity. This study aims to identify demographic, clinical, and exposure-related predictors of IgG positivity in individuals exposed to SARS-CoV-2 before the initiation of vaccination programs.

Materials and Methods: A cross-sectional study was conducted among 944 participants recruited from healthcare facilities. Eligible participants were aged 18 years or older, presented with COVID-19 symptoms or known exposure to confirmed SARS-CoV-2 cases, and had not received a COVID-19 vaccine. Data were collected via structured questionnaires, including demographics, clinical symptoms, and exposure history, and analyzed using logistic regression. IgG antibodies were detected using the SARS-CoV-2 IgG ELISA method.

Results: IgG antibodies were detected in 75.0% of participants. Younger age (B = -0.026, p < 0.001), divorced marital status (B = 0.973, p = 0.021, Exp(B) = 2.65), recent international travel (B = 0.953, p = 0.047, Exp(B) = 2.594), and symptoms such as runny nose (B = 2.561, p = 0.012, Exp(B) = 12.96), nausea (B = 1.614, p = 0.048, Exp(B) = 5.025), and lack of appetite (B = 1.366, p = 0.049, Exp(B) = 3.918) were significant predictors of IgG positivity. Each additional year of age was associated with a 2.6% reduction in the likelihood of IgG positivity. The model achieved 75.4% classification accuracy with an AUC of 0.640, indicating moderate predictive performance.

Conclusion: This study demonstrates the importance of demographic, clinical, and exposure-related factors in predicting IgG positivity. The findings enhance understanding of immune responses to SARS-CoV-2 and provide insights that can guide public health strategies in mitigating the pandemic's impact.

Introduction: Cervical cancer is a leading cause of mortality among women, largely influenced by clinical and histopathological tumor characteristics at diagnosis. While tumor size is an effective predictor of chemoradiotherapy (CRT) response, variability in treatment outcomes highlights the need for reliable biomarkers. OCT4 and SOX2, key stem cell markers, have been linked to cancer progression, poor prognosis, and chemoresistance. This study aims to evaluate the expression of OCT4 and SOX2 in cervical cancer tissues and assess their potential as predictive biomarkers for radiotherapy efficacy.

Materials and Methods: The study included 56 cervical cancer patients, with detailed data on cancer stage, tumor characteristics, and treatment modalities collected from medical records. Tissue microarrays were constructed from paraffin-embedded samples, and immunohistochemical staining was performed to assess OCT4 and SOX2 expression, with staining intensity analyzed using specialized software. Histoscores were compared across subgroups, and ROC analysis determined cut-off values for biomarker expression. Kaplan-Meier survival analysis, Cox regression, and chi-square tests were used to evaluate associations between biomarker expression, survival, and disease characteristics, with statistical significance set at p < 0.05.

Results: The study found that 66.1% of cervical cancer patients achieved a complete response to radiotherapy, while 33.9% had a partial response. Higher SOX2 and OCT4 expression levels were significantly associated with partial response and some toxicities like diarrhea. SOX2 showed stronger predictive value for radiotherapy response compared to OCT4, with significant differences in expression between complete and partial response groups. ROC analysis highlighted SOX2 as a more reliable biomarker for predicting treatment outcomes.

Conclusion: Higher expression of SOX2 and OCT4 was significantly associated with partial response to radiotherapy in cervical cancer patients, with SOX2 showing a stronger predictive value. These biomarkers may serve as useful tools for predicting radiotherapy efficacy and guiding personalized treatment strategies.

Introduction: Subclinical hypothyroidism (SCH) is defined as having elevated thyroid-stimulating hormone (TSH), normal levels of thyroxine (T4) and triiodothyronine (T3), and little to no hypothyroidism symptoms or indicators. In essence, it is a laboratory-based diagnosis. Microcytic anemia coupled with hypothyroidism is related to iron deficiency arising from malabsorption and menorrhagia. The body's iron reserves are indicated by serum ferritin (SF). Based on these data, we decided to investigate serum ferritin levels and their relationship to TSH in individuals with subclinical hypothyroidism.

Materials and Methods: The study was carried out at AIMSR, Bathinda's Department of Biochemistry in partnership with the Department of Medicine. The study included 100 euthyroid controls and 100 cases of subclinical hypothyroidism.

Results: In this investigation, there was a noteworthy distinction (p=0.001) in the TSH levels in the patients (7.7 ± 1.9 uI/ml) and controls (2.3 ± 1.1 uI/ml). Serum ferritin levels in cases (9.3 ± 1.7 ng/dl) and controls (101±5.6 ng/dl) differed significantly (p=0.001). In the cases, there was a non-significant negative correlation (r = -0.09, p = 0.79) between serum ferritin and TSH.

Conclusion: The non-significant negative correlation between ferritin and TSH in subclinical hypothyroidism can be explained by several factors, such as the mild nature of thyroid dysfunction in subclinical hypothyroidism, the influence of inflammation and autoimmunity on ferritin levels, iron status variability and inflammatory markers across individuals, and study design limitations. 

Introduction: Reactive oxygen species (ROS) levels increase in diabetes mellitus due to excessive glucose oxidation. The inflammatory response in cells triggers the activation of proinflammatory cytokines, including tumour necrosis factor (TNF)-α, interleukin (IL)-1, interleukin (IL)-6, and interleukin (IL)-18. Variations in the promoter region of the TNF-α gene can influence both the susceptibility to and severity of the disease. This research examines the correlation between TNF-α gene polymorphisms and the development of respiratory distress in patients with diabetes who are undergoing treatment in an intensive care unit.

Materials and Methods: A total of 100 participants were involved in the study, comprising 50 individuals diagnosed with diabetes and an additional 50 non-diabetic individuals who served as a control group. The nested T-ARMS PCR assay was employed to determine the genotypes associated with the TNF-α T>C single nucleotide polymorphisms (SNPs). Randomly selected samples underwent sequencing to validate the PCR findings, which revealed distinct genotypes for the TNF-α SNPs. Patient data were collected, and laboratory variables were assessed. The information was subsequently entered into SPSS Version 26.

Results: The presence of the heterozygous C/T genotype emerged as a notable risk factor, exhibiting an odds ratio (OR) of 5.87 (65% CI, 1.12 - 27.8) with a p-value of 0.03. In contrast, the homozygous TT genotype did not demonstrate statistical significance, presenting an OR of 1.87 (95% CI, 0.59 - 7.33) and a p-value of 0.25. These findings are derived from the genotyping of the TNF-α (rs1799964) C/T single nucleotide polymorphism (SNP) in a cohort comprising patients experiencing respiratory distress and a control group.

Conclusion: The association between the emergence of respiratory diseases and the TNF-α (rs1799964) T/C polymorphism has been established. This specific genetic variant may represent a potential risk factor for the development of respiratory distress and could also function as a prognostic indicator for patients with diabetes who are undergoing treatment in intensive care units.

Introduction: Staphylococcus aureus, known for its extensive genetic resistance elements and biofilm-forming capabilities, poses a significant challenge in clinical settings. This study aimed to investigate the prevalence of antibiotic resistance genes, the occurrence of biofilm formation genes, and the interrelation between zinc oxide nanoparticles (ZnO-NPs) and gene expression in S. aureus.

Materials and Methods: Clinical isolates were procured from samples in Tehran, Iran, and identified through biochemical tests. Antibiotic susceptibility profiles were determined, and multidrug-resistant (MDR) strains were selected. The presence of resistance genes (vanA, mecA, and tetC) and biofilm formation genes (fnbA, fibA, clfA, and clfB) was assessed. Microdilution methods were employed to determine the minimum inhibitory concentration (MIC) using ZnO-NPs, and real-time PCR monitored the relationship between nanoparticle treatment and gene expression.

Results: Results indicated high resistance among isolates to tetracycline (100%), amoxicillin (91%), ciprofloxacin, and oxacillin (85%), with low resistance to vancomycin (1%) and linezolid (2%). Profiling of resistance genes revealed a high prevalence of tetC (100%) and mecA (57%), while vanA exhibited a 0% prevalence. Biofilm formation genes were prevalent in 98% of strains, including clfA (98%), clfB (85%), fib (75%), and fnbA (0%). The MIC of iron oxide nanoparticles inhibiting S. aureus growth was recorded at 750 μg/mL. Real-time PCR results demonstrated a significant decrease in the expression of mecA (74%) and biofilm formation gene clfB (76%).

Conclusion: This study underscores the potential efficacy of ZnO-NPs in mitigating bacterial resistance in both methicillin-resistant S. aureus (MRSA) and less-resistant strains (LRSA), impacting the expression of resistance and biofilm formation genes. The utilization of ZnO-NPs presents a promising strategy for managing MRSA/LRSA-associated diseases while minimizing antibiotic use.

Introduction: Parallel to the significant and global expansion of research activities, various examples of research misconduct are also increasing and, in many cases, lead to the retraction of scientific publications. This study aimed to examine the characteristics of retracted papers in the field of basic medical sciences and conduct their citation analysis.

Materials and Methods: This study was conducted using scientometrics and citation analysis. The statistical population comprised retracted papers related to selected fields of basic medical sciences in the Web of Science (n=1576) retrieved by the end of January 2022. The characteristics of these papers and their citations were analyzed.

Results: The countries with the most retracted papers were China, the US, and Japan. The shortest time interval for retraction belonged to pathology (0.07 months). Most retraction petitioners were authors and editorial teams. Most of the retractions involved research misconduct. The highest and lowest number of citations belonged to cell biology and anatomy and morphology, respectively.

Conclusion: The results provide a basic analysis for researchers in basic sciences to better understand the reasons for the retraction of papers. Journals, peer reviewers, and publishers should all play their roles in ensuring adherence to publishing ethics.

Introduction: Inflammatory lesions of breast are close mimickers of malignancy clinically and therefore warrant a thorough examination and histopathological report for final diagnosis and treatment. Granulomatous mastitis may arise from bacterial, viral, mycobacterial infections, and systemic granulomatous diseases.

Materials and Methods: This study was conducted retrospectively by retrieving the medical records during the past 3 years. All cases that were histopathologically diagnosed as inflammatory lesions were included included in the study and the clinical and histopathological findings were analysed.

Results: The highest number of cases were seen during the year 2023.The age of the patients ranged from 23 to 73 years, with majority of the patients in the age group of 20 to 40 years. The presenting complaints of the patients included pain, swelling in breast and nipple discharge. The histopathological diagnoses of the patients included the following inflammatory lesions: Abscess, Granulomatous mastitis, Cystic neutrophilic granulomatous mastitis, plasma cell mastitis, and Periductal mastitis. Granulomatous mastitis was the most common histopathological diagnosis in the study population. In patients who presented with complaints of pain, the most common histopathological diagnosis was abscess. Twelve patients gave a history of recurring breast lump after incision and majority of these cases were reported as granulomatous mastitis.  Out of the cases that showed a duration of more than one month, majority were reported as granulomatous mastitis.

Conclusion: This study shows that majority of cases of inflammatory lesions have been noted in the reproductive age group and the most common histopathological diagnosis was granulomatous mastitis.

Introduction: This study aimed to evaluate the role of demographic characteristics and personality traits in ascertaining the severity of COVID-19 induced anxiety and the effectiveness of preventive behaviors among university students in Iran.

Materials and Methods: This descriptive-correlational study included a sample of 203 students (47 males and 156 females) enrolled in universities located in Mashhad (Iran) in 2021. Data collection was conducted using standardized questionnaires such as COVID-19anxiety questionnaire, Big Five personality traits, Preventive behaviors, and demographic characteristics through online platforms via social media to comply with health protocols. Data analysis was performed using SPSS version 26. Descriptive statistics, independent t-tests, Pearson correlation coefficients, and stepwise regression analyses were conducted to analyze the data.

Results: The findings from the regression analysis indicated that the personality traits of agreeableness and conscientiousness significantly elucidated the variability in COVID-19 anxiety. Specifically, agreeableness emerged as a significant predictor of preventive behaviors. Furthermore, this study revealed that male students exhibited higher anxiety levels than their female counterparts, while females demonstrated a greater engagement in preventive behaviors. Moreover, the consumption of substances and alcohol was associated with heightened anxiety and diminished preventive behaviors.

Conclusion: The results underscore the necessity of considering both demographic characteristics and personality traits when designing interventions that aim at mitigating health crises. Notably, the traits of agreeableness and conscientiousness may help reduce anxiety and promote preventive behaviors within such contexts.

Introduction: The presence of anti-A1 antibodies in individuals with A2 and A2B blood types can have clinical significance, particularly in transfusion medicine, organ transplantation, and genetic studies, as these antibodies may lead to hemolytic reactions. Therefore, assessing the prevalence of anti-A1 antibodies is essential to ensure patient safety. This study aimed to determine the frequency of A2 and A2B blood types with anti-A1 antibodies among blood donors in Bushehr Province.

Materials and Methods: The cell typing and reverse (back) typing results of all donors referred to the Blood Transfusion Institute in Bushehr Province between 2017 and 2023 were examined to identify any discrepancies between forward and reverse blood grouping. Donors with cell type A or AB and reverse type O were included in the evaluation. The collected data were then analyzed using statistical software. The study determined the frequency of A2 and A2B blood groups with anti-A1 antibodies among donors in Bushehr Province during the specified period.

Results: Between 2017 and 2023, a total of 160,435 individuals donated blood in Bushehr Province, comprising 7,497 females and 152,938 males. Among these donors, blood group analysis identified five male individuals with the A2B blood type.

Conclusion: Although the prevalence of anti-A1 antibodies in individuals with A2 and A2B blood types is rare, it remains clinically significant due to the potential for serological reactivity during transfusion. Accurate identification of these subgroups is essential for precise ABO blood grouping. ABO discrepancies occur when forward and reverse typing results do not align. For the safety of patients, it is crucial that such discrepancies are thoroughly investigated and resolved before confirming the blood group and issuing compatible blood products.

Introduction: Telfairia occidentalis is a tropical plant widely grown in West Africa, traditionally used for treating several health issues. This study examined the effects of methanol and water extracts of T. occidentalis leaves on oxidative stress markers, liver function, blood parameters, and biochemical indices in Wistar rats with breast cancer induced by 7,12-dimethylbenz[a]anthracene.

Materials and Method: A randomized design was used with five groups of rats (10 per group), treated with T. occidentalis extracts at 100, 200, and 400 mg/kg doses. The methanol extract was prepared using Soxhlet extraction (1:8 plant: solvent ratio). DMBA (30 mg/kg in corn oil) was administered orally once weekly for 4 weeks. Standard techniques were applied for phytochemical screening and toxicity testing. Antioxidant enzymes, liver markers, blood cells, glucose, and cholesterol were analyzed.

Results: Phytochemical screening showed varied levels of bioactive compounds. No toxicity was noted up to 400 mg/kg. Results showed significant (p < 0.05) dose-dependent improvement:  MDA, liver enzymes, WBC, glucose, and cholesterol levels decreased significantly, while SOD, CAT, and Hb levels increased in extract-treated rats compared to the cancer group.

Conclusion: The findings suggest that T. occidentalis leaves are rich in antioxidants and have liver-protective potential, making them a promising option for managing oxidative stress. The extract’s safety also supports its possible use in future clinical trials.

Introduction: Telfairia occidentalis is a tropical plant widely grown in West Africa, traditionally used for treating several health issues. This study examined the effects of methanol and water extracts of T. occidentalis leaves on oxidative stress markers, liver function, blood parameters, and biochemical indices in Wistar rats with breast cancer induced by 7,12-dimethylbenz[a]anthracene.

Materials and Method: A randomized design was used with five groups of rats (10 per group), treated with T. occidentalis extracts at 100, 200, and 400 mg/kg doses. The methanol extract was prepared using Soxhlet extraction (1:8 plant: solvent ratio). DMBA (30 mg/kg in corn oil) was administered orally once weekly for 4 weeks. Standard techniques were applied for phytochemical screening and toxicity testing. Antioxidant enzymes, liver markers, blood cells, glucose, and cholesterol were analyzed.

Results: Phytochemical screening showed varied levels of bioactive compounds. No toxicity was noted up to 400 mg/kg. Results showed significant (p < 0.05) dose-dependent improvement:  MDA, liver enzymes, WBC, glucose, and cholesterol levels decreased significantly, while SOD, CAT, and Hb levels increased in extract-treated rats compared to the cancer group.

Conclusion: The findings suggest that T. occidentalis leaves are rich in antioxidants and have liver-protective potential, making them a promising option for managing oxidative stress. The extract’s safety also supports its possible use in future clinical trials.

Introduction: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer characterized by the absence of estrogen receptors (ER), progesterone receptors (PR), and HER2 expression, which limits the efficacy of conventional targeted therapies. Immunotherapy, particularly peptide-based therapeutic vaccines, offers a promising alternative strategy by harnessing the body’s cytotoxic T lymphocyte (CTL) responses against tumor-specific antigens (TSAs). This study aimed to identify and validate immunogenic peptide epitopes derived from highly tumor-specific antigens for the design of a multi-epitope vaccine targeting TNBC.

Materials and Method: Using a comprehensive immunoinformatics workflow, tumor-associated antigens with high immunogenic potential—Survivin (BIRC5), MAGE-A3, and NY-ESO-1—were selected based on expression profiles and previous evidence of immunoreactivity. Candidate epitopes were predicted through NetCTL, SYFPEITHI, and MHCflurry servers, with selection criteria including strong binding affinity to HLA-A*02:01, favorable proteasomal cleavage patterns, TAP transport efficiency, and minimal cross-reactivity.

Results: Three high-scoring CD8⁺ T-cell epitopes were identified—LMLGEFLKL from Survivin (BIRC5), FLWGPRALA from MAGE-A3, and SLLMWITQC from NY-ESO-1. All epitopes exhibited IC50 values below 50 nM and high immunogenicity scores, supporting their suitability for incorporation into a multi-epitope vaccine construct targeting TNBC.

Conclusion: Our results support the rational design of a peptide-based therapeutic vaccine for TNBC by integrating three validated epitopes derived from the tumor antigens Survivin, MAGE-A3, and NY-ESO-1. This study contributes to the growing field of cancer immunotherapy by offering a novel, computationally driven approach for vaccine development against refractory breast cancers.

Introduction: Sepsis is a leading cause of death in intensive care unit (ICU) patients. This condition, in its advanced stage, leads to dysfunction of vital organs, resulting in the death of patients. Mesenchymal stem cells (MSCs) aid tissue regeneration by migrating to damaged areas, a process regulated by the CXCR7 gene. This study investigates the effect of serum from septic patients on the CXCR7 expression in MSCs.

Materials and Methods: The blood serum of 20 patients with sepsis was collected. The hUCB-MSCs were cultured under laboratory conditions (in vitro). Four groups of cells were treated with serum from patients and a control group was treated with serum from healthy volunteers. After 24 and 48 hours, the cells were trypsinized and RNA was extracted. cDNA was synthesized using a reverse transcription reaction and a specific kit. The expression level of this gene was determined using qRT-PCR.

Results: The results indicated that the expression of the CXCR7 gene in hUCB-MSCs treated with serum from sepsis patients significantly increased after 24 hours compared to the control group. Additionally, the expression level of this gene in the 48-hour treatment group showed a significant increase compared to the control groups and the 24-hour treatment group.

Conclusion: Exposure of hUCB-MSCs to septic patient serum led to a significant upregulation of CXCR7 compared with healthy serum (mean relative 2^−ΔΔCt fold-change: 24 h = 3.3-fold; 48 h = 19.3-fold; P < 0.01). These results are preliminary and warrant further functional and in vivo studies to confirm the biological and therapeutic implications of CXCR7 modulation in MSCs.

Introduction: Soursop, or Annona muricata, is a plant that has long been used to treat a variety of illnesses, including cancer. The purpose of this study was to use an in-silico method to assess the anti-cancer activity of chemicals produced from Annona muricata. 

Materials and Methods: To determine the bioactive substances found in Annona muricata that are known to have anti-cancer qualities, a thorough literature research was carried out. Following that, these substances were put through molecular docking tests against important protein targets linked to cancer, including receptors implicated in angiogenesis, apoptosis, and cell proliferation. Possible interactions between the identified Annona muricata chemicals and cancer-associated protein targets were discovered by the in-silico research.

Results: Several compounds demonstrated favorable binding interactions with Caspase-3. Coreximine showed the most favorable docking score (−6.7 kcal/mol), followed by Catechin (−6.5 kcal/mol), making these two the strongest potential bioactive or therapeutic candidates, Anomurine (−5.8 kcal/mol), Solamin (−5.4 kcal/mol), Annonacin (−4.8 kcal/mol), and Gallic acid (−4.7 kcal/mol). In contrast, the reference compound Doxorubicin displayed a weaker score (−2.2 kcal/mol). These docking values suggest potential micromolar-range affinities for several A. muricata compounds, which, while encouraging, indicate that they are likely to serve as lead compounds rather than direct therapeutic agents. The docking results highlighted promising candidates, although weaker docking indicates natural compounds’ potential advantage; however, real-world efficacy depends on multiple pharmacological factors and their biological and clinical significance can only be established through further experimental studies, including enzyme inhibition assays, cell-based apoptosis assay and in vivo validation.

Conclusion: In summary, this in-silico work opens the door for the creation of innovative natural anti-cancer treatment medicines by offering important insights into the molecular mechanisms behind Annona muricata's anti-cancer action.

Introduction: Indigenous African plants are increasingly studied as sustainable sources of nutrients and bioactive compounds. Chrysophyllum albidum (African star apple) and Celosia argentea (Lagos spinach) are widely consumed as food and medicine, yet their biomedical potential remains insufficiently explored. This study was designed to comprehensively evaluate their nutritional composition, phytochemical profile, antioxidant capacity, and antimicrobial properties.

Materials and Methods: Ripe fruits of C. albidum and leaves of C. argentea were collected and authenticated. Proximate and micronutrient analyses were conducted using AOAC methods. Phytochemicals were quantified via HPLC and GC-MS. Antioxidant capacity was assessed by DPPH and FRAP assays. Antimicrobial activity against bacteria and fungi was determined by MIC and MBC.

Results: C. albidum had significantly higher levels of carbohydrate (56.3 ± 1.2%) and vitamin C (41.8 ± 2.1 mg/100 g), while C. argentea was richer in protein (23.6 ± 0.9%), calcium (280.7 ± 6.3 mg/100 g), and iron (18.2 ± 0.7 mg/100 g). Phytochemical profiling revealed substantial flavonoids, phenolics, saponins, terpenoids, alkaloids, and carotenoids, with C. argentea showing significantly higher flavonoids and carotenoids contents. Antioxidant assays indicated strong radical scavenging activity (DPPH IC₅₀: C. albidum 42.6 µg/mL; C. argentea 38.2 µg/mL). Both extracts inhibited microbial growth, with MIC values as low as 125 µg/mL against Staphylococcus aureus.

Conclusion: Both plants exhibit nutritional and phytochemical richness, potent antioxidant capacity, and antimicrobial potential. Their integration into diets and nutraceutical development could aid in reducing oxidative stress and microbial infections.

Introduction: This article examines the intersection between psychological constructs—self-differentiation and alexithymia—and communicative competence in marital adjustment, reframing the discussion within applied linguistics. Marital relationships rely heavily on effective communication, which in turn depends on emotional awareness, regulation, and linguistic expression.

Materials and Methods: Drawing on a sample of 130 Married Medical Science Students at the University of Tehran, this study investigates how emotional variables influence communicative patterns that sustain or hinder marital adjustment.

Results: Findings revealed that self-differentiation positively predicts marital adjustment, while alexithymia negatively predicts it, together explaining 64% of the variance. These results are discussed in light of applied linguistics theories of discourse, intercultural pragmatics, and language pedagogy.

Conclusion: The study contributes to an interdisciplinary understanding of how emotional and psychological constructs interact with communicative competence in relational and linguis Book Antiqua tic contexts.

Introduction: Lung cancer remains the leading cause of cancer-related mortality worldwide, underscoring the urgent need for advancements in treatment options.  Although, current standard interventions, including surgery, radiotherapy and chemotherapy are widely employed, a significant number of patients experience relapses, highlighting the critical demand for innovative therapeutic strategies. This study was conducted to develop and evaluate a novel multi-epitope peptide vaccine designed from VEGF-A, TGF-β and MAGE-A3 markers, with the aim of enhancing therapeutic efficacy. Lung cancer remains the leading cause of cancer-related mortality worldwide, underscoring the pressing need for more effective therapeutic interventions. Although current standard treatments—including surgery, radiotherapy, and chemotherapy—are widely utilized, a substantial proportion of patients experience disease recurrence, highlighting the necessity for innovative therapeutic strategies. In this study, we developed and evaluated a novel multi-epitope peptide vaccine constructed from VEGF-A, TGF-β, and MAGE-A3 markers, with the objective of enhancing therapeutic efficacy.

Materials and Methods: Optimal epitopes from VEGF-A, TGF-β, and MAGE-A3 were systematically identified and selected, and subsequently conjugated using a KKK linker to form the final multi-epitope vaccine construct. Two groups of BALB/c mice were immunized with the peptide at concentrations of 10 mg/mL and 100 mg/mL, following an immunization protocol that included three weekly administrations. In the fourth week, spleen tissue was collected from the mice to assess the expression levels of IFN-γ, IL-4, IL-6, TNF-α, and IL-10 cytokine genes, thereby enabling a comprehensive evaluation of the immunogenic and functional efficacy of the peptide vaccine.

Results: Bioinformatics evaluations have revealed a promising multi-epitope peptide vaccine,SVRGKGKGQKRKRKKSKKKHHMVKISGGPHISYPPKKKRLESQQTNRRKKRALD.

This peptide notably enhances the expression of key cytokine genes, including TNF-α, IL-6, IFN-γ, IL-4 and IL-10 among the group that received the vaccine at a dose of 10. Even more pronounced levels of gene expression were observed at the higher dose of 100.

Conclusion: This multi-epitope peptide demonstrates considerable potential to elicit a robust immune response and effectively target cancer cells. We strongly recommend conducting further supplementary tests to evaluate its efficacy and possible side effects.

Introduction: Photodynamic therapy (PDT) relies on the interaction of light, photosensitizers, and molecular oxygen to generate reactive oxygen species capable of inducing cytotoxic effects, particularly in cancer cells. Metallophthalocyanines have emerged as promising photosensitizers due to their strong absorption in the red region, chemical stability, and tunable photophysical properties. Understanding their coordination chemistry and interactions with biological systems is essential for optimizing their therapeutic performance. This study evaluates the behavior of various metal-bound phthalocyanines and their capacity to induce DNA photo-damage, which is central to their effectiveness in PDT.

Materials and Methods: Metallophthalocyanines containing Zn, Cu, Ni, Co, Fe, and Mn were synthesized or obtained in purified form. Their photosensitizing activity was assessed using pBR322 plasmid DNA exposed to controlled light irradiation. DNA photo-damage was analyzed using standard gel electrophoresis techniques. The photochemical reactivity of each metal-phthalocyanine complex was evaluated to determine its DNA-interaction pattern and ROS-generation potential.

Results: All tested metallophthalocyanines showed varying capacities to photosensitize and damage plasmid DNA under light exposure. Complexes containing Zn and Cu exhibited the highest DNA photo-cleavage efficiency, correlating with their favorable photophysical properties. Differences in coordination chemistry among the metal centers notably influenced ROS generation and the extent of DNA strand breaks. The results highlight structural-dependent variations in photoactivity, revealing candidates with strong potential for PDT applications.

Conclusion: Metallophthalocyanines, particularly those containing Zn and Cu, demonstrate significant potential as efficient photosensitizers for photodynamic therapy. Their ability to generate reactive oxygen species and induce DNA damage suggests promising applications in targeted cancer treatment. Further investigation into their in vitro and in vivo bioactivity will support the development of more effective PDT agents.

Introduction: kidney dysfunction is the loss of elimination of wastes of the kidneys in an adequate manner, which causes the accumulation of nitrogenous substances in the circulation. This condition is present in acute and chronic forms. The last stage renal disease (ESRD) is the terminus stage which requires renal replacement measures.

The purpose of the research was to examine how the erythropoietin and ghrelin hormones are expected to play and how the biochemical parameters play in clinical assessment of patients with renal failure. 

Materials and Methods: The present study was undertaken using the sample of patients with renal failure undergoing dialysis at Baquba Teaching Hospital during the months of January to April 2022. The 62 and 35 were the patients who reported kidney failure and non-renal healthy controls, respectively. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) on serum samples were measured using the Cobas e411 analyzer. Nephric functional parameters (urea, uric acid and creatinine) were also measured on serum samples through the Cobas e411 analyzer. Ghrelin and erythropoietin hormone assays were done through the enzyme linked immunosorbent assay. The SPSS comprehension software was used to conduct the statistical analysis and data processing.

Results: Metabolic, hepatic and renal biomarkers, and hormonal values were also important (P < 0.05) between the patient group and the control group. The patients had high glucose, triglycerides, cholesterol, liver enzymes (ALT, AST and ALP) and kidney (urea, urate acid, creatinine and potassium) indicators. The patients experienced the reduction of albumin and erythropoietin. There was no significant difference between the total protein, sodium and calcium levels according to the group (p > 0.05.(

Conclusions: We found that physiological parameters are connected with the presence of renal dysfunction to a large extent. The chronic renal failure affects to a considerable extent the biochemical indicators and blood regulators, that is, the level of erythropoietin and ghrelin. The results indicate a lack of electrolyte, metabolism, and hormone homeostasis, which implies that ghrelin and erythropoietin are the possible diagnostic and treatment etiological variables in the treatment of renal diseases.

Background and Aim: Despite growing awareness of “long COVID” and its neurological sequelae, the long-term influence of SARS-CoV-2 infection on Alzheimer’s progression remains poorly understood. This study aimed to compare the long-term impact of COVID-19 on the progression of AD in elderly individuals, integrating real-time digital monitoring and biomarker analytics to establish predictive prognostic models.

Methods: A longitudinal cohort of 348 participants (age≥65 years) diagnosed with early-to-moderate AD was followed over four years (2021–2025). Participants were divided into COVID-19 positive (n=174) and COVID-19 negative (n=174) groups, matched for age, sex, and comorbidities. Serum inflammatory markers (IL-6, TNF-α, CRP), neurofilament light chain (NfL), and amyloid-β/tau ratios were analyzed biannually. Machine learning algorithms were applied to identify prognostic patterns linking infection-related biomarkers with cognitive and functional decline.

Results: COVID-19-positive AD patients showed a 29% faster rate of cognitive deterioration, indicating a strong association rather than a confirmed causal relationship—between prior SARS-CoV-2 infection and accelerated AD progression (p<0.01) and a 33% increase in NfL levels compared to controls. Real-time monitoring detected significant fluctuations in sleep quality, gait stability, and heart rate variability within six months post-infection, which preceded measurable cognitive decline. Predictive modeling achieved an accuracy of 87% in forecasting accelerated progression trajectories using combined digital and biochemical markers.

Conclusion: The incorporation of wearable and biochemical data into prognostic modeling marks a paradigm shift toward personalized, predictive neurology, enabling clinicians to anticipate and mitigate the long-term neurological consequences of COVID-19 in the aging population.

Background and Aim: The COVID-19 pandemic not only challenged immune and respiratory systems but also reshaped health-related behaviors, including tobacco use. Increasing evidence suggests that cigarette smoking exacerbates oxidative stress and genomic instability in COVID-19 patients. This study aimed to investigate the impact of smoking on DNA damage among young adults in the post-COVID-19 period using the Comet Assay technique.

Methods: This analytical study included 45 male COVID-19 patients (under 60 years old) who were active or former smokers and were hospitalized in May 2024 at a university-affiliated hospital in Sari, Iran. A comparison group consisted of 42 age-matched non-smoking COVID-19 patients, and 25 healthy non-smoking, non-infected individuals served as the control group. Peripheral blood samples were collected from all participants, and DNA damage in leukocytes was assessed by Single Cell Gel Electrophoresis (Comet Assay). Statistical analyses were performed to compare the extent of DNA damage among groups.

Results: The results showed a significant increase in DNA damage indices—including tail length and tail DNA percentage—in smoking COVID-19 patients compared with both non-smoking patients and healthy controls (p < 0.001). Former smokers also exhibited elevated but comparatively lower levels of DNA damage. These findings suggest that cigarette smoking, even after recovery from COVID-19, can exacerbate oxidative stress and impair DNA repair mechanisms, leading to persistent genomic instability. The Comet Assay proved to be a sensitive and valuable biomarker for detecting subtle DNA damage and monitoring post-viral cellular health.

Conclusion: Smoking remains a significant contributor to genomic injury in young adults recovering from COVID-19.

Background and Aim: Acinetobacter baumannii is a major cause of hospital‑acquired infections and exhibits increasing multidrug resistance (MDR). This study aimed to determine antibiotic resistance patterns and the prevalence of MDR and XDR phenotypes among clinical isolates from a tertiary‑care hospital in Tehran.

Methods: Clinical isolates were collected over 12 months. Identification was performed using standard biochemical tests and PCR (blaOXA‑51). Antimicrobial susceptibility testing was conducted using the CLSI‑standardized Kirby–Bauer disk diffusion method. MDR and XDR were defined according to international criteria.

Results: High resistance was observed to carbapenems and cephalosporins. Colistin remained the most effective

e agent. Overall, 92% of isolates were MDR and 47% were XDR.

Conclusion: MDR and XDR A. baumannii strains were widely prevalent, indicating an urgent need for antibiotic stewardship and routine surveillance.

Background and Aim: Cellular senescence, a common outcome of treatments like chemotherapy and radiotherapy, often acts as a therapeutic hurdle. Our prior investigations revealed that this senescent state is accompanied by the secretion of the senescence-associated secretory phenotype (SASP), a potent driver of chronic inflammation and a factor that can paradoxically facilitate tumor progression.

Methods: We investigated the effects of SAHA, alone or combined with the EZH2 inhibitor EPZ-6438, on NSCLC cell lines. Senescence induction was confirmed via SA-β-galactosidase staining, while cell growth was evaluated using MTT and colony formation assays. Mechanistic studies, including Western blotting, qPCR for SASP factors, and immunofluorescence for Cytoplasmic Chromatin Fragments (CCF), were performed to assess the underlying pathway.

Results: SAHA effectively induced senescence-mediated growth inhibition in A549 and H1299 cells but simultaneously triggered the SASP. This SAHA-induced SASP was linked to the generation of CCFs, thereby activating the cGAS–STING pathway. Importantly, the combined administration of SAHA and EPZ-6438 significantly reduced the expression of inflammatory mediators, such as IL6 and IL8. This co-treatment not only provided superior anti-proliferative activity compared to SAHA alone but also enhanced the suppression by attenuating the SASP.

Conclusion: Collectively, our data demonstrate that SAHA-induced senescence in NSCLC cells is critically linked to detrimental SASP production mediated by CCF formation. Crucially, combining SAHA with EZH2 inhibition successfully suppressed the SASP, leading to enhanced growth inhibition, thereby providing a robust rationale for this combination therapy in NSCLC treatment.

Background and Aim: Chronic obstructive pulmonary disease (COPD) is a complex, progressive inflammatory disorder of the respiratory system that predominantly affects the distal airways and is characterized by irreversible destruction of lung parenchyma. Genetic susceptibility plays an important role in the pathogenesis of COPD. The objective of this study was to examine the relationship between COPD and CHRNA5 gene polymorphism (rs16969968).

Methods: A total of 200 subjects were enrolled, including 100 diagnosed COPD cases and 100 age- and sex-matched healthy controls. Genotyping of the single nucleotide polymorphism (SNP) rs16969968 was carried out using allele-specific polymerase chain reaction (AS-PCR) with specific primers. Allele and genotype frequencies were measured, and statistical analysis was conducted using SPSS software to assess the association between CHRNA5 gene polymorphism and COPD risk.

Results: The distribution of CHRNA5 (rs16969968) genotypes did not show a statistically significant association with COPD. The AA genotype was observed in 6% of controls and 15% of COPD cases, the heterozygous AG genotype in 39% of controls and 43% of COPD patients, and the homozygous GG genotype in 55% of controls and 42% of COPD cases. The wild-type G allele was found in 149 (74.5%) of controls and 127 (63.5%) of COPD patients, while the A allele was found in 51 (25.5%) of controls and 73 (36.5%) of COPD cases. Statistical analysis revealed no significant difference in allele frequencies (p = 0.157). Although genotype distribution showed a trend toward significance (p = 0.055), it did not reach the conventional threshold (p < 0.05). Odds ratio analysis revealed an OR of 1.688 (p = 0.066), suggesting a possible increased risk among A allele carriers.

Conclusion: This study did not demonstrate association between the CHRNA5 rs16969968 polymorphism and COPD. However, odds ratio analysis indicated a possible 1.7-fold increased risk of COPD among carriers of the A allele, suggesting a potential role of CHRNA5 variants in disease susceptibility. Larger studies with diverse populations are warranted to further clarify the contribution of CHRNA5 variants to COPD risk.

Background and Aim: The frequency of the beta thalassaemia gene in India is 3.3 %, with considerable regional variations. There is limited data regarding the prevalence of beta thalassaemia in the state of Kerala. We studied the clinical and haematologic profile of cases with haemoglobinopathy, with special emphasis on beta thalassaemia trait (BTT). The sensitivity of the Mentzer Index (MI), Ricerca Index (RI), and Green & King Index (GKI) in diagnosing BTT was also evaluated.

Methods: Cases with a new diagnosis of haemoglobinopathy at a single center in Kerala between November 2023 and October 2024 were included in this study based on a chart review. High-performance liquid chromatography was used to detect abnormal haemoglobin variants. Clinical presentation, the red cell parameters – haemoglobin, RBC count, mean corpuscular volume, and red cell distribution width – were recorded. MI, RI and GKI in BTT cases were calculated.

Results: There were 1021 new registrations in the Haematology clinic at the time of the study. 72 cases had abnormal haemoglobin variants. Among them, 60 cases (83.33 %) had BTT. Sickle haemoglobin was present in 7 cases (9.7 %). The median age of the BTT cases was 37.5 years (range 3 – 79), and 60 % were female. Fatigue was the predominant symptom, reported in 65 % of cases. Anaemia was present in 86.67 % (52/60) of patients. The median Hb level was 10 g/dL (range 7 – 14.1). Hemolytic anaemia was observed in 15 % of patients. The sensitivity of MI, RI, and GKI in diagnosing BTT was 51.67 %, 86.67 %, and 53.33 %, respectively.

Conclusion: BTT is a significant cause of anaemia in our population. RI exhibited higher sensitivity than the MI and GKI for the diagnosis of BTT.

Background and Aim: Studies have confirmed the significance of microRNAs (miRNAs) in various biological processes. Various miRNAs have been studied in diabetes mellitus, among them miR-146a and miR-196a2 play an important role in the development of this disease. This research aims to examine the frequency of rs2910164, rs57095329 polymorphisms in miR-146a and rs11614913 in miR-196a2, T2DM patient comparing to control group.

Methods: One hundred patients with T2DM and 100 healthy individuals as normal control group were included in this study. Polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) was exploited for genotyping of rs2910164C>G and rs11614913C>T and amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) was used for rs57095329A>G. Genotypes frequencies were evaluated with chi square test.

Results: We found that the GG genotype rs2910164 is significantly associated with T2DM susceptibility (OR = 12.1, 95% CI = 1.36-7.9, P = 0.003). Another investigation showed a significant association between the TT genotype of rs11614913 polymorphism and T2DM susceptibility (OR = 4.36, 95% CI = 1.13-5.84, P = 0.006). The GG genotype of rs57095329 showed a significant difference between T2DM and controls (OR = 8.37, 95% CI = 3.07 - 22.82, P < 0.0001).

Conclusion: To sum up, the study found that three genetic variants, rs2910164C>G, rs11614913C>T, and rs57095329A>G, were associated with an increased risk of type 2 diabetes mellitus (T2DM) in the Iranian population. These findings suggest that these variants may be new risk factors in the development of T2DM.

Background and Aim: This study was undertaken to rigorously investigate the effects of extremely low-frequency magnetic fields (ELF-MF) on bladder cancer cells and apoptosis-related pathways.

Methods: T24 and 5637 cell lines were exposed to a 6 mT, 50 Hz magnetic field for 2 hours per day over three consecutive days. Cell viability was systematically assessed by MTT assay which revealed a significant reduction in survival of cancer cells following ELF-MF exposure.

Results: Quantitative real-time PCR analysis showed downregulation of the anti-apoptotic gene BCL2 and upregulation of the tumor suppressor PTEN. Moreover, the tumor-suppressive microRNA miR-34a was markedly increased, while the oncogenic miR-21 was decreased. These effects were largely specific to cancer cells, with minimal impact on normal urothelial cells, thereby indicating a degree of selective biological responsiveness.

Conclusion: The results suggest that ELF-MF can modulate key apoptotic regulators and selectively impair cancer cell viability. This work highlights the potential of ELF-MF as a non-invasive physical modality to enhance apoptosis and suppress tumor progression, providing a foundation for future studies in combination with conventional chemotherapeutics.

Context: Intelligent microbial systems capable of real-time adaptation to environmental perturbations represent a transformative innovation in synthetic biology and bioprocess engineering. These systems dynamically regulate gene expression and metabolic activity through context-responsive genetic circuits, enabling stable and efficient biosynthesis in variable and unpredictable environments. By integrating sensor technologies, control theory, and artificial intelligence, such platforms emulate cognitive biological functions such as perception, decision-making, and response at the microbial level.

Evidence Acquisition: This review conducts a systematic examination of the literature published between 2015 and 2025, sourced from PubMed, Web of Science, and ScienceDirect. Inclusion criteria focused on experimental and computational advancements in adaptive microbial systems, particularly studies combining synthetic biology, real-time biosensing, AI-based feedback control, and optimization algorithms. Studies on static or non-intelligent microbial systems were excluded.

Results: Emerging research highlights the convergence of biosensors, machine learning models, and modular genetic networks that enable microbes to sense and interpret environmental cues with high temporal resolution. Real-time feedback systems facilitate metabolic flux reprogramming, enhancing yield and process stability. Notable applications span biopharmaceutical production, environmental remediation, precision agriculture, and renewable bioenergy. Case studies demonstrate improvements in ethanol, astaxanthin, and lycopene biosynthesis through dynamic control mechanisms, adaptive laboratory evolution, and in situ optimization strategies.

Conclusion: Real-time adaptive microbial systems embody the next generation of programmable biological platforms. Their potential to autonomously adjust to environmental variability positions them as critical enablers of scalable, sustainable, and intelligent biomanufacturing. Advancements in biosensor miniaturization, genome editing, and AI-driven regulation will be essential for their industrial translation. This review outlines a framework for future interdisciplinary research that bridges biology, computation, and engineering to advance autonomous bio-production systems.

Context: Androgenic alopecia (AGA) is a common condition affecting both men and women, characterized by progressive hair loss due to genetic and hormonal factors. Hair loss has significant impacts on psychosocial well-being and quality of life.

Evidence Acquisition: A comprehensive review of peer-reviewed studies was conducted, including clinical trials, observational studies, and emerging treatment reports published from 2000 to 2024. Databases such as PubMed, Scopus, and Web of Science were searched using keywords related to AGA, hair growth, and therapies.

Results: Current treatments for AGA include topical agents like minoxidil and finasteride, oral medications, and advanced options such as hair transplantation. Emerging therapies, including platelet-rich plasma (PRP), low-level laser therapy (LLLT), JAK inhibitors, and gene therapy, show promising efficacy in promoting hair regrowth. Combination therapies often enhance clinical outcomes.

Conclusion: While traditional treatments remain effective, emerging therapies and combination approaches offer improved results for AGA management. Ongoing research in gene therapy and novel molecular interventions may transform future therapeutic strategies.

Context: The cancer epidemic is getting worse every day. Breast cancer is one of the leading causes of mortality worldwide, including in Pakistan. This condition is progressing due to a number of variables. According to recent investigations, lncRNAs play a major role in cancer development.

Evidence Acquisition: The post-surgical breast tissue samples were acquired by contacting different hospitals. The analysis of lncRNA expression profiles of publicly available breast cancer datasets will be done using overlapping Bioinformatics tools. To support the suggested mechanisms of lncRNA regulation in breast cancer, the experimental data will be compared.

Results: Almost 1900 lncRNA gene annotated in human genome so far (Gencode 41), which is almost equal to the number of genes that code for proteins. The effective characterization of lncRNAs remains a significant challenge in molecular biology, prompting numerous high-throughput initiatives and is a critical scientific priority. The great clinical potential that these molecules hold has sparked lncRNA research, which has been founded on the characterization of their expression and functional mechanisms.

Conclusion: This review depicted lncRNA role in breast cancer. Protein-coding genes and lncRNA are related to the development of breast cancer.

Contex: Optical biopsy, an innovative and interdisciplinary approach leveraging light-tissue interaction, holds significant potential to revolutionize medical diagnostics. This study explores the fundamental physical and biological principles underlying this approach, including light absorption, scattering, reflection, and fluorescence by endogenous and exogenous chromophores and fluorophores.

Evidence Acquisition: Key optical biopsy techniques, including fluorescence, Raman, and reflectance/absorbance spectroscopies, are detailed. Furthermore, advanced optical imaging methods such as confocal microscopy, optical coherence tomography (OCT), multi/hyperspectral imaging, and advanced optical endoscopy are systematically reviewed.

Results: The analysis highlights broad clinical applications in early cancer detection (skin, gastrointestinal, respiratory, cervical, and other organs), non-cancerous diseases (inflammation, infection, wound monitoring), and intraoperative guidance. Despite advantages like non-invasiveness and real-time diagnosis, limitations such as limited light penetration depth, complexity of data interpretation, and the inability to fully replace histopathology remain significant challenges.

Conclusion: The future outlook is highly promising, driven by the development of portable instruments, advancements in artificial intelligence (AI) algorithms, and multimodal approaches. This article concludes that optical biopsy will play a pivotal role as a powerful complementary tool in enhancing disease diagnosis and management in the future.

Context: Wiskott-Aldrich syndrome (WAS) is an X-linked primary immunodeficiency characterized by microthrombocytopenia, eczema, recurrent infections, and a significant predisposition to autoimmune diseases and malignancies, particularly B-cell lymphomas.

Case presentation: We report the case of a 14-year-old male with a confirmed diagnosis of WAS since infancy, who later developed Crohn’s disease. He presented with vegetative lesions in the rectum and transverse colon, which were diagnosed as diffuse large B-cell lymphoma (DLBCL) based on immunohistochemistry and positive EBV-encoded small RNAs (EBER). The patient received 12 cycles of chemotherapy, including Rituximab and Etoposide, along with intravenous immunoglobulin (IVIG) support.

Conclusion: This is a rare case of EBV-associated DLBCL in a WAS patient from Iran. The case highlights the importance of early and routine malignancy screening in WAS patients, even in the absence of significant symptoms. Molecular and immunophenotypic assessments, including PCR and immunohistochemistry, are essential for accurate diagnosis and management.

Introduction: Refractory pleural effusion (RPE) is a serious postoperative complication of cardiac surgery that often persists despite conventional chest tube drainage. Platelet-rich plasma fibrin glue (PRP-FG), a biologically active sealant with hemostatic and regenerative properties, has previously shown efficacy in reducing morbidity in postoperative chylothorax and pneumothorax. This clinical trial aimed to evaluate the safety and therapeutic efficacy of intrapleural PRP-FG in patients with RPE unresponsive to standard thoracostomy management.

Case Presentation: In this pilot clinical trial, 19 patients with unilateral or bilateral RPE resistant to standard therapy were treated with intrapleural PRP-FG. Treatment success was defined as pleural drainage of <50 mL/day for two consecutive days within one week post-intervention, accompanied by symptomatic improvement.

The mean age was 43.6 ± 19.6 years; 52.6% of patients had undergone coronary artery bypass grafting (CABG), and 36.8% had undergone congenital cardiac surgery. PRP-FG administration led to a significant reduction in effusion volume (624.2 ± 275.0 mL to 25.0 ± 20.1 mL; mean difference 599.2 mL, p < 0.001; Cohen’s d = 2.29). Five patients (26.3%) required a second application, and three (15.8%) required a third for complete resolution. No major adverse events or recurrence were observed during the six-month follow-up; minor, self-limited effects included pleuritic pain and transient dyspnea. One patient with uncontrolled diabetes died from a sternal wound infection unrelated to PRP-FG.

Conclusion: Intrapleural PRP-FG appears to be a safe, effective, and minimally invasive therapy for RPE following cardiac surgery. These promising findings warrant confirmation in larger multicenter studies with longer follow-up to establish its long-term efficacy and clinical applicability.