Dijlah Journal of Medical Sciences

Prostate cancer is a common malignancy in men, and early detection is essential for effective treatment. While PSA is the most used biomarker, its limitations call for better diagnostic tools. This study aimed to evaluate the diagnostic potential of miR-155 expression using real-time PCR as an alternative to traditional ELISA-based markers such as PSA, TPS, and CEA. Blood samples were collected from 80 prostate cancer patients and 80 healthy controls at Al-Andalus Specialist Hospital. Serum miR-155 and blood PSA mRNA levels were measured using real-time PCR. Additionally, ELISA assays were used to assess PSA, TPS, and CEA levels. The expression of miR-155 and PSA mRNA was significantly higher in patients than in controls (3.8-fold and 1.7-fold, respectively; p < 0.0001). MiR-155 showed an AUC of 97% for sensitivity and specificity, outperforming PSA mRNA (AUC 89%). ELISA results also indicated elevated levels of PSA, TPS, and CEA in patients, but miR-155 was the most reliable biomarker. MiR-155 demonstrated superior diagnostic performance compared to traditional markers due to its high sensitivity, specificity, and cost-effectiveness, suggesting its potential as a powerful and practical tool for prostate cancer detection.

This study sought to elucidate whether the XRCC1 protein could serve as a predictive biomarker for treatment response in breast cancer (BC) women undergoing radiotherapy (RT). Between July 2024 and January 2025, 180 blood samples from 60 newly diagnosed BC patients, aged 34–56 years, before and after RT at the Al-Amal National Hospital for Cancer Management and the Baghdad Center for Nuclear Medicine and Radiotherapy, as well as 60 age- and sex-matched controls (30 RT workers and 30 healthy women), were tested. A made-on-request enzyme immunoassay measured XRCC1 levels. Serum XRCC1 levels in BC patients significantly increased after RT, followed by RT workers, compared to pre-RT patients and healthy controls (438.42±105.18 vs 348.58±104.56 vs 53.36±13.97 vs 93.71±27.56 pg/ml, P<0.001). In BC patients receiving RT, XRCC1 levels were higher in the 15-fraction and 30-fraction groups than the 20- and 25-fraction groups (449.95±105.48 vs 538.59±4.63 vs 336.18±3.01 vs 368.12±80.16 pg/ml, P<0.05). XRCC1 levels were elevated significantly with RT doses of ≥ 50 Gy and 45 Gy (570.33±45.07 and 472.47±66.92 pg/ml). RT at 6 and 10 MV did not significantly affect BC patients (449.39±101.35 vs. 428.83±109.11 pg/ml, P>0.05). The XRCC1 ROC curve showed a high AUC (0.801, 95% CI= 0.70-0.88) with 74.5% sensitivity and 89.7% specificity. Additionally, XRCC1 predicted RT response with 81% accuracy (95% CI= 71.48-88.52). In BC patients and RT workers, high XRCC1 levels were linked to RT parameters, suggesting that XRCC1 may predict RT responsiveness and DNA repair efficacy. XRCC1 may also predict radiation-induced DNA damage in RT workers and encourage greater radiation protection.

The goal of this investigation was to ascertain if biofilm-forming Klebsiella pneumoniae isolates may cause histopathological alterations. Thirty-eight K. pneumoniae isolates were obtained from patients who visited two hospitals in Baghdad; each isolate was identified using biochemical, microscopic, and cultural characteristics. Polystyrene microtiter plates were used to assess the K. pneumoniae isolates' capacity to produce biofilm. The degree of biofilm thickness was reflected in the optical density (OD), which was measured at 630 nm. Approximately 21.05% of the tested isolates were weakly adhering, 73.6% were moderately adherent, and 5.26% were strongly adherent, according to the results. Isolate K22 was comparatively biofilm-forming, while isolate K20 was poor. Eighteen male Swiss white mice (Mus musculus) were used to test these two isolates intranasally. Weak biofilm former K. pneumoniae K20 caused less lung damage than moderate biofilm former K. pneumoniae K22, with pathology scores of 9 and 13, respectively, according to histopathological abnormalities in mice's lungs.

Due to its prevalence, tendency to recur, and expense in treatment, lost work, disability and other factors, lower back pain is considered a significant health concern. This research explores the prevalence of lower back pain and the associated risk factors in patients attending the rheumatology clinic at Al-Yarmouk Teaching Hospital in Baghdad, Iraq, over the development timeline of September 2024 to March 2025. In total 2,013 patients attended the clinic in the study timeline, and 445 patients met the definition of this research on lower back pain (22.11%). Descriptive analytical data were collected through interviews and physical measurements. The majority of patients were in the 46-60 age group (39.6%; female 61.9%). The prevalence of obesity was 39.6%, and overweight was 35.5%. The most common occupational activity was sedentary work (27.1%), which was statistically associated with low back pain (p=0.0021). 69.2% of patients had concomitant diseases, with arthritis being the most common comorbidity (17.6%). 86.8% of patients used analgesics for their pain. These findings provide evidence of a significant disability burden in the general rheumatology population and support interventions aimed at reducing modifiable risks that can decrease the overall burden of disability related to low back pain in this population (such as obesity and occupational hazards).

Hepatitis B virus and Hepatitis C virus remain significant public health issues worldwide, especially in developing countries like Iraq, where awareness and access to healthcare are limited. These infections often progress silently, increasing the risk of late diagnosis and further transmission. This study aimed to assess the prevalence and associated risk factors of HBV and HCV among patients in Wasit Governorate, Iraq. A cross-sectional analytical study was conducted between December 2024 and April 2025 across six major hospitals in Wasit. Patients with confirmed HBV or HCV infection were included. Data were collected using a structured questionnaire that covered demographic information, clinical features, and behavioral risk exposures. Statistical analysis was performed using SPSS v29. Hepatitis B, C virus was found to be more prevalent than HCV among the participants. Most cases were among young adults aged 20–29 years, with a higher proportion of males, married individuals, and those with low socioeconomic status. Common risk factors included sharing personal hygiene tools (e.g., nail clippers, towels), unprotected sexual activity, and traditional practices like cupping. Many participants reported mild or no symptoms at onset, which contributed to delayed diagnosis. No significant associations were found between most socio-demographic variables and the type of hepatitis, except for a few behavioral practices. The study highlights the silent nature of hepatitis B and C infections and the need for improved public health awareness. Targeted interventions focusing on hygiene education, safe sexual practices, and the regulation of traditional healing methods are essential to reduce the spread of HBV and HCV in Wasit Governorate.

Measles, a highly contagious viral infection, which belongs to the Morbilivirus genus, Paramyxoviridae family. Remains a significant public health challenge worldwide, despite the availability of an effective vaccine. The objective is to determine the outcome of measles cases in Iraq and determine of measles trend from 2019-2023. The study is an epidemiological retrospective cross-sectional study that included information on Measles disease from 2019/January/1st to 2023/December/31st. The duration of data collection continued for the period from 2024/October/17th to 2025/February /28th. The data of the whole Iraq was collected from: Iraqi Ministry of Health\ Department of Public Health\ Communicable Disease Control Center from section of epidemiological surveillance that locates in Baghdad Governorate and obtains the information from health departments in the Iraq. The study included 3,873 laboratory-confirmed measles cases out of over 20,000 suspected cases. Descriptive statistics were applied, and inferential tests including the independent t-test, ANOVA, and chi-square test were used for data analysis via SPSS software (version 29.0), with a significance level set at p < 0.05. The clinical information show that the highest number of patients were from hospitals with 80.17% of patients, in contrast to primary health centers with 19.83%, the clinical methods of diagnosis had the highest ratio of result than others methods with 55.38%,) 15607 patients had diagnosed at hospital Lab 2.13% with positive result ,while 97.87% of the patients had negative result , The most of the cases had ELISA IgM test with 99.95% and the rest cases had Tissue Culture with 0.05%.Its reappearance the outbreak of measles has been facilitated by dwindling vaccination rates, inadequate healthcare systems, and the dissemination of false information. Its prevalence is 4104,728,199,633 and 14571 cases for the years (2019-2023) respectively, in Iraq. Regard to outcome of measles cases 99.94 % was cured.

Stunting represents a crucial measure of long-term nutritional deficiencies which continues to challenge public health systems especially in developing metropolitan areas. The research focused on establishing both the magnitude of stunting along with its socioeconomic variables which affect primary school children in Baghdad's Washash neighborhood. The research employed a cross-sectional survey method in 2024 to examine 357 children between the ages of 6 and 12 from eight public primary schools. The study collected height and weight measurements together with comprehensive information about personal demographics and family socioeconomic status. The study revealed that 17.4% of the children were stunted. The study demonstrated that specific factors including child gender together with guardian employment status and family monthly earnings and socioeconomic standing showed statistical significance in relation to stunting. The analysis showed no meaningful relationships between stunting and the child's age or guardian education level or number of people living in the household. The data demonstrates how financial hardship and unemployment lead to stunted growth in children thus creating a requirement for specialized nutritional and social programs in neglected urban areas. The research establishes basic guidelines to develop future public health strategies which will reduce child malnutrition while ensuring equal health benefits for Iraqi children.

Knowledge of common eye diseases plays an important role in encouraging people to seek treatment for eye problems. This study was conducted to assess awareness and knowledge of cataract, diabetic retinopathy and glaucoma in people 40 years and above. It was a descriptive cross-sectional study conducted by convenient sampling. Among 183 participants aged 40 years and above from the general population. Data was collected through a semi structured questionnaire and was conducted through direct interviews to 183 participants in Al Kindy hospital in Baghdad. The results showed awareness for cataract, diabetic retinopathy and glaucoma was 150 (82%), 142 (77.6%), and 132(72.1%) respectively. Knowledge about these diseases is treatable was 131(87.3%), 68 (47.9%) and 69 (52.3%) respectively and knowledge about the worst effect of these diseases is blindness was 71 (47.3 %), 114(80.3%) and 101(76.5%) respectively. About source of information for these diseases (44.3%) of the participants took their information from social media. There was a significant statistical association between age with awareness about cataract and occupation with awareness about glaucoma. Public education for periodic eye checks effective measures for its early detection and management regarding these three diseases.

Tobacco smoking is one of the leading risk factors for periodontal disease, impacting inflammatory process of periodontal tissue. Smoking is known to hinder the immune response of periodontal tissue by causing vasoconstriction to peripheral capillaries, and by so decreasing blood flow and subsequent incoming immune cells. Compared to non-smokers, tobacco smokers were found to have higher count of periopathogens present within dental biofilm. However, over the last decade, electronic cigarettes have made a significant rise in both users and frequency of use. Although the effects of e-cigarettes on oral health are not as evident and prominent as that of tobacco smoking. This study aims to understand the impact of e-cigarettes use on periodontal tissue in comparison to tobacco smoking. A total of 182 patients were included, and divided into three groups, 49 non-smoker, 66 tobacco smokers, and 67 e-cigarettes/vape smokers. Each individual was examined clinically and periodontal indices were recorded, including gingival index, plaque index and bleeding on probing. Overall gingival index scores were worse in smokers, however, bleeding on probing were significantly higher in e-cigarettes smokers and non and lower in tobacco smokers. The study found tobacco smoking had more harmful impact on periodontal status in comparison to e-cigarettes.

Presbyopia, the common condition of age-related vision condition which leads to difficulty in focusing on nearby objects because of alterations in the lenses of eyes. Its effect differs from emmetropic to hypermetropic persons.The present study aimed to compare between patients with fluctuating eyes and patients with fluctuating eyes when reaching (40) years of age. In this descriptive study, 80 persons with presbyopia whose ages were >35 years were enrolled. From each participant, demographic data were obtained including sex, age, occupations, educational levels as well as medical history and results of eye examination. For clinical examinations we used Snellen charts, retinoscopy, trial cases, auto-refractor as well as proximal charts for data collection. In the present study, we focused on the visual acuity variation and requirement through various demographics. In addition we focused on sex, age with the dynamic of accommodative amplitudes in relations to different types of refractions. Data obtained from (80) participants showed an evenly distribution of males and females, with a remarkable decline in accommodative amplitudes when age increased, and this decline was predominantly significant in the oldest group (70-79) years, who exhibited the lowest amplitude level. Moreover, our study investigated the association between accommodative amplitudes and refraction type and showed that emmetropia mostly happens at the lowest amplitudes, while myopia and hypermetropia were more predominant at the highest amplitudes. The main finding in the study was the direct relationship between declined accommodative amplitudes and increased dependence on near vision corrections, as shown by the highest diopter additions necessary for individuals with diminished amplitudes. This study’s results demonstrated the ages and refractive trait’s effects on accommodative capabilities and consequent needs for tailored corrective strategy.

Klebsiella pneumoniae is a clinically significant pathogen responsible for a wide range of hospital-acquired infections. This study aimed to investigate its molecular characteristics and genotype distribution in patient samples from Dhi Qar, Iraq. A total of 386 clinical samples were collected from hospitals in Dhi Qar, Iraq, from patients aged 10–60 years between July and September 2022. Among these, 69 samples were identified as Klebsiella spp. using the API 20E and VITEK 2 systems. DNA concentrations of the isolates ranged from 47.4 to 123.8 ng/µL. All 48 suspected K. pneumoniae isolates underwent molecular identification by PCR amplification of the 16S rRNA gene. The results of this study indicate that the magA and k2A genotypes may serve as reliable biomarkers for identifying the K1 and K2 serogroups of K. pneumoniae. For diagnosing the K1 serotype, PCR amplification of the magA gene using the primer sets magA-F and magA-R was sufficient. Among the 48 K. pneumoniae isolates, 29 (60.4%) tested positive for the magA gene. Overall, the findings demonstrate the effectiveness of PCR-based detection of the magA and k2A genes in identifying K. pneumoniae serogroups. These molecular markers can improve diagnostic accuracy and enhance understanding of infection pathways in clinical settings.

Pregnancy Associated Placental Protein A (PAPP-A) is Zinc-Binding metalloproteinase with a vital role in insulin like growth factor (IGF) pathway. IGF system plays a key role in follicular development, including steroid hormone synthesis, growth, recruitment, and apoptosis of follicles. There is minimal information in the literature regarding PAPP-A levels in Follicular Fluid (FF) of women that undergoing intra-cytoplasmic sperm injection (ICSI). The purpose of study to detect PAPP-A in blood and follicular fluid during oocyte pick up in infertile women undergoing ICSI, and to investigate the role of PAPP-A in embryonic development. The findings showed a nonsignificant relationship between total oocyte number and oocyte maturity and serum and FF PAPP-A, and fertilization rate. There was a significant correlation between live and dead embryos with different embryonic stages. There was a non-significant correlation between serum and FF PAPP-A with total, mature, and fertilized oocytes, and the oocyte quality parameters examined in this study (total oocyte, mature oocyte, and fertilized oocyte) were influenced by numerous factors (age, prior pregnancies, weight, and others). Live and the dead embryo was not-significant in the embryonic stages (two-cell stage, four-cell stage, and eight-cell stage embryos), except two cell stage dead embryo with serum PAPP-A and four-cell stage dead embryo with FF PAPP-A was high significant differences.

It is common for systemic lupus erythematosus (SLE) to affect the lungs, which can lead to moderate respiratory symptoms or severe restrictive lung disease. Pulmonary complications such as shrinking lung syndrome (SLS) are uncommon but significant from a clinical perspective. This study set out to answer several questions regarding SLE in Iraqi patients, including how common respiratory symptoms are, how often impaired pulmonary functioning, and what clinical and serological factors are associated with SLS in Baghdad Teaching Hospital in Baghdad, Iraq, was the site of the 2025 cross-sectional descriptive study. Eligible participants were adult patients who fulfilled the American College of Rheumatology (ACR) classification criteria for SLE. We collected demographic data, recorded clinical symptoms, and documented serologic markers. A chest X-ray or high-resolution computed tomography (HRCT) was ordered for all patients in addition to the pulmonary function tests (PFTs). Dyspnea, restricted lung physiology (Forced Vital Capacity (FVC) < 80% expected), and the absence of interstitial lung disease on x-rays were the diagnostic criteria for SLS. Patients exhibiting symptoms and radiographic interstitial alterations but no restrictive physiology served as controls. Of the 104 patients with SLE surveyed, 62 (59.6%) had respiratory symptoms, while 65 (65.4% of the total) had normal pulmonary function with abnormalities. The results showed that 9 patients had SLS (8.7). In a multivariate analysis where the length of the disease was controlled, a history of pleuritis, high American College of Rheumatology (ACR) clinical score, and seropositivity of anti-RNP antibodies were significantly associated with SLS. Longer illness duration, anti-RNP positive, and a history of serositivity were the independent predictors of SLS (OR = 1.18; 95% CI: 1.01132; p = 0.04). SLE patients from Iraq are more likely to experience respiratory symptoms, abnormal lung functions, and shrinking lung syndrome. When dealing with patients who have a history of pleuritis or who test positive for anti-RNP antibodies, clinicians should maintain a high suspicion for SLS. Timely diagnosis and treatment can lead to improved clinical outcomes.

Klebsiella pneumoniae is a significant pathogen responsible for wound infections, particularly in traumatic injuries like crushing and laceration wounds.

Differentiating bacterial from viral encephalitis remains a persistent diagnostic challenge. MRI provides rapid structural, metabolic, and perfusion insights, whereas cerebrospinal fluid (CSF) analysis using PCR and culture delivers pathogen-specific confirmation. Each modality, however, carries critical limitations when used in isolation. In this prospective single-center diagnostic-accuracy study conducted in accordance with STARD 2015 guidelines, seventy-six consecutive patients fulfilling the International Encephalitis Consortium criteria underwent standardized MRI protocols (DWI, FLAIR, SWI, ASL, and MRS) alongside comprehensive CSF microbiological testing (multiplex PCR and culture). Quantitative MRI biomarkers apparent diffusion coefficient (ADC), FLAIR intensity ratios, SWI microhemorrhage burden, MRS lactate/Cr and NAA/Cho ratios, and ASL cerebral blood flow were analyzed against a composite diagnostic reference. MRI alone achieved an area under the curve (AUC) of 0.87, CSF microbiology alone 0.90, and integrated MRI–PCR interpretation 0.96, with statistical superiority confirmed by DeLong testing (p = 0.01 vs MRI; p = 0.04 vs PCR). Quantitative thresholds improved reproducibility (ADC < 0.8 × 10⁻³ mm²/s and lactate/Cr > 0.25 indicating bacterial disease; FLAIR ratio > 1.4 and ASL hyperperfusion suggesting viral etiology), while inter-reader agreement was excellent (κ = 0.82; ICC = 0.87). Pathogen-level analysis demonstrated that MRI performed best for HSV and Streptococcus pneumoniae, whereas PCR remained essential for enterovirus and EBV. Decision-curve analysis confirmed that integration provided the highest net clinical benefit, reducing overtreatment and delays, shortening time to targeted therapy (10 h vs 24 h), and improving 90-day functional outcomes. Integrated MRI-PCR interpretation thus represents a superior, reproducible, and clinically meaningful framework that redefines the diagnostic standard of care for encephalitis.

Antibiotic resistance represents a critical threat to global public health, undermining the efficacy of antimicrobial therapy and complicating clinical management of bacterial infections. This retrospective study investigated the epidemiological profile and antimicrobial resistance patterns of bacterial pathogens isolated from clinical specimens at Mahmoudiyah Hospital in Baghdad during 2024. A total of 753 infection-suspected samples were analyzed using the VITEK 2 compact system and standard biochemical methods for identification and susceptibility testing. The most frequently isolated pathogens were Escherichia coli (10.1%), Klebsiella pneumoniae (8.5%), and Pseudomonas aeruginosa (7.7%), with Staphylococcus aureus (6.9%) also representing a significant proportion of isolates. Resistance profiles revealed alarming trends, including high methicillin resistance in S. aureus (MRSA prevalence: 77.5%) and widespread resistance among Gram-negative bacteria to commonly used antibiotics such as ampicillin, ciprofloxacin, and ceftriaxone. Notably, E. coli exhibited resistance patterns suggestive of extended-spectrum beta-lactamase (ESBL) production, while Acinetobacter baumannii showed complete resistance to colistin, a last-resort antibiotic. Further analysis of resistance patterns showed concerning rates of resistance to first-line agents: over 90% of E. coli isolates were resistant to ampicillin, while K. pneumoniae and P. aeruginosa displayed reduced susceptibility to fluoroquinolones and third-generation cephalosporins. Additionally, a substantial proportion of Gram-positive isolates, including Enterococcus faecalis, demonstrated high-level resistance to penicillin and ciprofloxacin. These findings underscore the urgent need for enhanced antimicrobial stewardship, robust infection control measures, and continuous surveillance to combat the escalating challenge of multidrug-resistant infections in hospital settings.

This study aimed to evaluate oxidative stress and lipid profiles in diabetic and non-diabetic acute myocardial infarction (AMI) patients. A cross-sectional analysis of clinical and laboratory data was conducted at Al-Hussein Educational Hospital in Al-Muthanna, Iraq, in collaboration with the College of Science at Al-Muthanna University. Data were collected for 84 subjects divided into three groups: non-diabetic AMI (GMI), diabetic AMI (GMI-DM), and diabetic (GDM). Biochemical parameters measured included malondialdehyde (MDA), ceruloplasmin (Cp), total cholesterol (Cho), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL), along with the patients' age and gender. MI, MIDM, and DM groups exhibited high levels of MDA, Cho, TG, LDL, and VLDL, with low levels of Cp and HDL compared to healthy controls. The study demonstrated increased oxidative stress and dyslipidemia in MI patients compared to controls, regardless of diabetes status.

Type 1 diabetes mellitus (T1DM) is an autoimmune ailment where the immune system destroys the β-cells in the pancreas, ensuing in absolute insulin insufficiency. Understanding immune regulatory markers may cause new techniques of diagnosis and therapy in addition to a deeper know-how of the mechanisms underlying disorder. The checkpoint protein VISTA which regulates Tcell activity and immunological tolerance is one example of such a hallmark. To evaluate serum VISTA levels in Iraqi patients with T1DM compared to healthy individuals, and to explore its potential as an immunological biomarker for early detection, risk stratification, and monitoring of the disease. A case-control study including 150 participants 100 T1DM patients and 50 healthy controls was conducted in Baghdad. The levels of C-peptide, VISTA, fasting blood sugar (FBS), and HbA1c in blood samples were measured using ELISA. T1DM patients showed significantly higher HbA1c and FBS levels compared to healthy controls. C-peptide levels were drastically reduced in patients, indicating near-total loss of β-cell function. VISTA levels were markedly elevated in patients (339.78 ng/mL) compared to controls (134.46 ng/mL). Positive correlations were observed between HbA1c and VISTA, as well as FBS and VISTA, suggesting that chronic hyperglycemia may influence immune checkpoint activity. In conclusion, T1DM, VISTA seems to be a promising biomarker that may be used for risk assessment, disease monitoring, and early identification. Also, VISTA pathway targeting could be a new therapeutic strategy to control immune responses and maintain β-cell function.

Type 2 diabetes mellitus (T2DM) is a metabolic disorder associated with neurological abnormalities, particularly in patients with prolonged disease duration. Given the similarities between diabetes and Alzheimer’s disease, amyloidogenic mechanisms may contribute to the pathogenesis of hyperglycemia; however, the precise roles of amyloid-related proteins and amyloid-β (Aβ) metabolism in diabetes-induced neural injury remain unclear. This study aimed to evaluate the involvement of Aβ-42, soluble amyloid precursor protein-α (sAPPα), β-secretase (BACE1), and neprilysin (NEP) in the pathogenesis of diabetes. For this purpose, the fasting blood samples from were prepared from patients with T2DM and age- and sex-matched healthy controls were analyzed for the levels of Aβ-42, sAPPα, BACE1, and NEP using enzyme-linked immunosorbent assay. Patients with T2DM showed remarkably higher FBS, HbA1c, insulin, and HOMA-IR values compared with controls. Serum level of Aβ-42 and BACE1 were significantly raised in T2DM group, whereas sAPPα levels were markedly downregulated. Blood concentration of NEP was increased in the T2DM and exhibited a positive correlation with HOMA-IR. According to the results, hyperglycemia promotes amyloidogenic APP processing and Aβ-42 accumulation, whereas the elevated NEP level may represent a compensatory response to increased Aβ production. These findings highlight a potential molecular link between T2DM and amyloid-associated neurodegeneration.

Type 1 diabetes T1D and type 2 diabetes T2D, two metabolic disorders that are common throughout the world, have different pathophysiologies but increasingly similar characteristics. Recent findings demonstrate how important the gut microbiota is in regulating immunological and metabolic processes associated with both forms of diabetes. In light of host-related variables such age, sex, genetics, method of birth, nutrition, and antibiotic use, this study investigates the role that microbial dysbiosis plays in the development and progression of T1D and T2D. Different microbial signatures linked to diabetes states have been found in both human and animal investigations. These signatures are frequently characterized by decreased diversity and an imbalance between pro-inflammatory and beneficial bacteria. Additionally, included are the potential therapeutic benefits of microbiota-targeted therapies, such as dietary modification, fecal microbiota transplantation [FMT], probiotics, prebiotics, symbiotic, and medications like metformin. Novel approaches to diabetes prevention, diagnosis, and treatment through microbial manipulation are made possible by an understanding of the gut-diabetes axis.

Over the past two decades, clear aligner therapy (CAT) has become a widely accepted alternative to fixed orthodontic appliances due to its removable nature and improved esthetics. Despite these benefits, several oral complications such as mucosal irritation and ulcer formation have been observed, which may negatively influence patient comfort and adherence to treatment. This review aims to summarize the current evidence on the occurrence, contributing factors, and management of oral ulcers linked to clear aligner therapy. A narrative literature search was performed in PubMed/PMC, Scopus, and Google Scholar up to September 2025. Search terms included “clear aligner,” “Invisalign,” “oral ulcer,” “mucosal ulceration,” “oral lesions,” and “adverse effects.” Eligible sources included clinical studies, case reports, and review papers. Oral ulcerations during CAT appear to be multifactorial. Reported causes include mechanical trauma from aligner edges or attachments, chemical irritation from residual materials or cleaning agents, microbial changes that promote plaque buildup, and patient-related conditions such as mucosal sensitivity or recurrent aphthous stomatitis. From this study we concluded that ulcers associated with clear aligners can significantly affect patient compliance. Preventive measures include careful aligner design, clear oral hygiene instructions, and early identification of soft tissue irritation. When ulcers develop, management strategies may involve minor adjustments to the aligner, topical medication, and supportive care. Further studies are recommended to establish standardized preventive and therapeutic protocols.

Regenerative endodontic treatments (RETs), which focus on biologically based regeneration with respect to the pulp-dentin complex instead of just infection control, have emerged as revolutionary approaches to treating necrotic immature permanent teeth. For regenerative methods to be efficient, growth factor-enriched scaffolds are necessary. In the case when combined with stem cells as well as signaling molecules, such scaffolds provide a supportive environment that drives the fundamental tissue engineering procedures in the case. Autologous scaffolds derived from patient blood, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF), are prized for their biological activity and ease of preparation. Additionally, natural biomaterials mimicking extracellular matrix and are biocompatible, including alginate, collagen, hyaluronic acid and chitosan, promoting neurogenesis and angiogenesis. Clinical adaptability requires customizable mechanical qualities and degradation rates, which are provided by synthetic scaffolds, like polymers, hydrogels, and cements depending on calcium silicate. There includes discussion regarding challenges including fibrous tissue growth in place of true pulp, microbial persistence, and incomplete regeneration. The main goal of this study is to provide an overview related to the many types as well as biological characteristics of biomaterial scaffolds utilized in pulpal regeneration. Examine the limitations and clinical efficacy regarding synthetic, natural, and host-derived scaffolds. Emphasize developments in scaffold fabrication technologies, such as nanotechnology and 3D bioprinting. Discuss the difficulties and potential paths for improving scaffold-mediated regenerative protocols. The method was used in this stury utilizing the Google Scholar, Pub Med, and Research Gate database, a thorough English-language search of published resources has been conducted from 2007 to December 2024. Through promoting biological regeneration related to the pulp-dentin complex, the application of growth factor-enriched scaffolds in regenerative endodontics provides a significant advancement above conventional treatment. Different scaffold types—synthetic, natural and host-derived—present different advantages and difficulties. Scaffold clinical potential and design are being advanced by innovations such as nanotechnology, 3D bioprinting, and stem cell homing. The growth Factor-Enriched Scaffolds, Regenerative Endodontic Treatments (RETs), 3D Bioprinting, Dental Pulp Regeneration, Mesenchymal Stem Cells (MSCs).