Journal of Advances in Medical and Pharmaceutical Sciences

Comparative Antimicrobial and Antibiofilm Effects of Chlorhexidine, Lactobacillus reuteri Cell-free Supernatant, and Green Tea Extract against Major Periodontopathogens: An in vitro Study

Mehmet Murat Taşkan — 2026-06-19

Background: Periodontal diseases are associated with dysbiotic biofilms, and adjunctive strategies to chlorhexidine (CHX) are being explored because repeated antiseptic use may be accompanied by undesirable effects. This controlled in vitro study compared 0.12% CHX, Lactobacillus reuteri cell-free supernatant (CFS), and catechin-rich green tea extract against Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum.

Methods: Direct antimicrobial activity was assessed by agar diffusion and broth microdilution assays, including minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) determination. Biofilm-related outcomes were evaluated by crystal violet measurement of biofilm-formation inhibition and viable-count reduction in 24-hour pre-formed biofilms after 60 minutes of exposure. Each condition included three technical replicates in three independent experimental runs. Quantitative data were analysed using two-way ANOVA followed by Tukey-adjusted pairwise comparisons.

Results: CHX produced the largest inhibition zones, lowest MIC and MBC values, and greatest viable-count reductions in mature biofilms across all tested species. Green tea extract showed the strongest non-CHX anti-biofilm profile, inhibiting biofilm biomass by 67-72% and producing intermediate log10 CFU reductions of 1.8-2.2 in pre-formed biofilms. L. reuteri CFS demonstrated moderate, species-dependent activity, with the most evident response against P. gingivalis. The main effect of agent was significant for inhibition-zone and biofilm outcomes (p < 0.001), and post hoc testing confirmed the ordered pattern CHX > green tea extract > CFS > vehicle.

Conclusions: Within this in vitro model, CHX remained the most potent comparator, whereas green tea extract and L. reuteri CFS showed adjunctive anti-biofilm activity. Further formulation, multispecies biofilm, and host-relevant studies are required before clinical extrapolation.

Thoracic Manifestations of Behçet’s Disease Excluding Cardiac Involvement: A 17-Year Retrospective Study in a Moroccan Tertiary Referral Center

Soukaina Mounsif — 2026-06-22

Background: Thoracic involvement in Behçet’s disease (BD) is uncommon but is associated with significant morbidity and mortality, mainly due to vascular complications.

Aim: This study aimed to evaluate thoracic manifestations of Behçet’s disease, excluding cardiac involvement, in patients managed at a Moroccan tertiary hospital over a 17-year period.

Methods: This retrospective single-centre study was conducted over a 17-year period (2006–2023) in the Internal Medicine Department of Ibn Rochd University Hospital, Casablanca, Morocco. Among 563 patients diagnosed with BD according to the International Study Group (1990) criteria and the International Criteria for Behçet’s Disease (2013), 58 patients presented with thoracic manifestations excluding cardiac involvement.

Results: Thoracic involvement was observed in 10.3% of cases. The mean age was 35.3 ± 10.9 years, with a male predominance (M/F ratio = 2). Haemoptysis was the most frequent symptom (44.8%). CT angiography revealed pulmonary artery aneurysms in 32.7%, pulmonary embolism in 37.9%, and superior vena cava thrombosis in 15.5%. Treatment was based on corticosteroids and immunosuppressants. The clinical course was favourable in most patients after treatment, with regression of symptoms and stabilisation of vascular lesions. However, relapses occurred in some cases, reflecting the chronic relapsing nature of the disease. Mortality was mainly related to massive haemoptysis secondary to aneurysmal rupture.

Conclusion: Thoracic manifestations of BD are predominantly vascular and determine prognosis. Early diagnosis and intensive immunosuppressive therapy are essential to improve outcomes.

Integrating Digital Twins and Predictive Analytics for Personalized Patient Monitoring and Care Optimization

Fidele Nsanzumukunzi — 2026-06-15

The utilisation of digital twins in conjunction with predictive analytics has seen a marked rise in its promotion for applications in personalised patient monitoring, treatment planning and service optimisation. Nevertheless, the extent to which these claims are substantiated by real-world healthcare evidence remains uncertain. To map empirical applications of these technologies and summarise their impacts and implementation constraints, a scoping review was conducted using a Population–Concept–Context framework. The review searched MEDLINE/ PubMed and Web of Science for peer-reviewed studies published in English between 2015 and 2025. Nineteen studies met the inclusion criteria, with most published after 2022. Most were clinical twins spanning cardiovascular, hepatology, diabetes, oncology, and intensive care; one addressed emergency communication operations. Imaging-anchored and hybrid physiological twins achieved the strongest patient-specific validation, while continuous-data twins improved glycaemic control, risk prediction, and therapy optimisation. Acute-care and operational twins showed feasibility and safety gains, but inconsistent effects on efficiency. Barriers clustered around fragmented data standards, missing or noisy inputs, workflow fit, clinician trust, and limited multicentre prospective trials. Predictive digital twins are transitioning from proof-of-concept to early utility. However, scalable impact will depend on interoperable data ecosystems, rigorous staged validation, and human-centred deployment with governance for safety and equity.

Neglected Heavy Metals in the Niger Delta Region of Nigeria: A Systematic Review of Toxicity, Environmental Contamination, Health Risks, and Research Gaps

Ibioku Elekima — 2026-06-26

Background: The Niger Delta region of Nigeria hosts one of the largest crude oil reserves in Africa. Decades of oil exploration and production have released a wide range of toxic heavy metals into the environment. While lead (Pb), cadmium (Cd), and nickel (Ni) have attracted considerable scientific attention, other metals, including vanadium (V), arsenic (As), barium (Ba), cobalt (Co), and manganese (Mn), remain underreported despite having well-established toxic effects in humans. This review refers to these metals collectively as neglected heavy metals.

Objective: To systematically review published evidence on the occurrence, distribution, sources, exposure pathways, and human health risks of neglected heavy metals in the Niger Delta region of Nigeria, and to identify existing research and policy gaps.

Methods: A systematic literature search was conducted across PubMed, Scopus, Google Scholar, Cochrane Library, BIOSIS, Global Health, and ScienceDirect, covering publications from 2010 to 2026. Studies reporting measured concentrations of vanadium, arsenic, barium, cobalt, or manganese in any environmental or biological matrix from the Niger Delta were eligible. Screening, data extraction, and quality assessment followed PRISMA 2020 guidelines. Thirty-eight studies met the final inclusion criteria. The initial search for neglected heavy metals in the Niger Delta identified 4,019 unique publications from Google Scholar, PubMed, Cochrane Library, BIOSIS, and Global Health. Of the 4,019 articles, 3,453 were excluded due to duplications while 513 were excluded because of lack of defined location, studies conducted outside the Niger Delta, studies focusing on mercury, lead, and chromium, among others, and studies not reported in the English language. A total of 52 full-text articles were reviewed for eligibility of which 14 records were excluded because they were systematic or mini reviews. Overall, 38 full articles were included in the study.

Results: All five neglected heavy metals were consistently detected across water, soil, sediment, seafood, food crops, and biological samples in the Niger Delta. Concentrations frequently exceeded WHO, US EPA, and Nigerian DPR regulatory thresholds. Arsenic and manganese were the most widely reported. Cobalt showed the highest pooled concentration in seafood at 4.039 mg/kg dry weight. Vanadium was confirmed as a neuropathological hazard in ecological studies. Barium was primarily linked to drilling fluid discharge. Human health risks include neurotoxicity, carcinogenicity, kidney and liver damage, and reproductive harm.

Conclusion: Neglected heavy metals represent a serious but poorly characterised public health threat in the Niger Delta. Comprehensive biomonitoring studies, stronger regulatory frameworks, and community-level health surveillance programmes are urgently needed. Scientific and policy attention must expand beyond conventionally studied metals to capture the full toxic burden facing Niger Delta communities.