Mitochondria are highly dynamic organelles that adapt to cellular stress and metabolic demands through processes such as fission, fusion, mitophagy, and transport, all of which are vital for maintaining cellular signaling and metabolic homeostasis. Fission facilitates mitochondrial division and biogenesis, while fusion enhances mitochondrial fitness and metabolic flexibility by mitigating damage. Together, these processes play a critical role in regulating cellular stress responses and apoptosis. Dysregulation of mitochondrial dynamics has been linked to impaired development and cancer progression, including breast cancer metastasis. A comprehensive understanding of mitochondrial dynamics in breast cancer progression is essential for advancing precision medicine. This review delves into the intricate molecular mechanisms governing mitochondrial biogenesis, fission, fusion, and mitophagy, with a particular focus on the role of mitophagy in maintaining mitochondrial homeostasis and its connection to metastasis progression. Furthermore, it discusses potential therapeutic strategies targeting mitochondrial dynamics and highlights the critical steps necessary to translate these approaches into clinical trials.

Escalating antimicrobial resistance is a global threat, emphasizing the need to explore alternative treatment options. Hence, we aimed to explore the in-vitro activity of ceftazidime-avibactam (CAZ-AVI) in clinical isolates of carbapenem-resistant gram-negative bacteria.

This was an observational, cross-sectional study conducted at the Microbiology Department of Indus Hospital, Karachi, Pakistan, from January 2023 to October 2024. Carbapenem-resistant gram-negative rods isolated from clinical specimens received from the outpatient, emergency, and inpatient departments were included. Consecutive, non-probability sampling was employed for the collection of isolates. Identification of the organisms was confirmed using API® ID strips, and antimicrobial susceptibility for carbapenems and CAZ-AVI was determined via the Kirby-Bauer disc diffusion method.

A total of 158 bacterial isolates were characterized as carbapenem-resistant. Of these, 92 (58%) were Enterobacterales, and 66 (42%) were Pseudomonas aeruginosa. CAZ-AVI was susceptible in 17 (11%) of the isolates, of which four (24%) were Klebsiella spp. and Escherichia coli each, and nine (52%) were P. aeruginosa. CAZ-AVI-susceptible strains were predominant among patients aged 26–50 years (n = 6; 35%), most of whom were females (n = 10; 59%) and inpatients (n = 8; 47%). Clinical samples from patients with urinary tract infections grew the most CAZ-AVI-susceptible strains (n = 9; 53%).

Our study demonstrated low CAZ-AVI susceptibility in our carbapenem-resistant gram-negative bacterial strains. Understanding regional antimicrobial patterns in multidrug-resistant bacteria is crucial for the effective use of CAZ-AVI, along with the strict implementation of strategies for controlling antimicrobial resistance.

Hermansky-Pudlak syndrome (HPS) is a rare, autosomal recessive disorder predominantly affecting individuals of Puerto Rican descent. It is characterized by oculocutaneous albinism, platelet storage pool deficiency, and lysosomal ceroid accumulation in tissues. Lysosomal dysfunction has been shown to be associated with pulmonary fibrosis and granulomatous colitis in HPS patients, accounting for a significant portion of morbidity and mortality in this population. Clinical and endoscopic gastrointestinal manifestations in HPS patients are similar to those of active Crohn’s disease, including abdominal pain, bleeding, fissures, fistulas, and perianal involvement. Histology reveals granulomatous colitis that can be difficult to distinguish from Crohn’s disease. Identifying distinct morphologic features from Crohn’s disease is crucial for the diagnosis of HPS. Here, we present a case of a 27-year-old male with a history of HPS and refractory granulomatous colitis with severe perianal disease, who underwent total proctocolectomy and perianal excision. The unique, distinguishing morphologic features from Crohn’s disease in this case are: 1) grossly diffuse ulceration in the ano-rectum and cecum, 2) ulcerative and granulomatous inflammation predominantly involving the mucosa and submucosa of the colon, and 3) accumulation of ceroid pigment in the histiocytes of the lamina propria throughout the entire gastrointestinal tract. Immunohistochemical stains for CD3 and FoxP3-positive T cells in the granulomatous colitis were further analyzed. Thus, we fully document the extent of disease involvement and morphologic features in this patient and extensively discuss the similarities and differences between HPS and Crohn’s disease.

Hepatic biliary adenofibroma is an exceedingly rare biliary neoplasm that primarily affects adults. It typically presents as a solitary mass composed of low-grade microcystic and tubuloglandular bile duct structures, which are lined by low columnar to cuboidal non-mucin-producing biliary epithelium and supported by abundant fibrous stroma. Histologically, it resembles the Von Meyenburg complex but is much larger in size and often shows cytologic atypia. Although considered benign, emerging case studies and analyses suggest that biliary adenofibroma may serve as a precursor lesion to intrahepatic cholangiocarcinoma. However, its extreme rarity, coupled with an incompletely understood histogenesis, perpetuates diagnostic uncertainty and may lead to misclassification with other similar entities. This review consolidates the current understanding of the histopathological and molecular characteristics of biliary adenofibroma, highlights its differential diagnosis, explores its potential progression to cholangiocarcinoma, and discusses unresolved questions while proposing future research directions.

This review explores the integration of complexity science—specifically, the biological holographic phenomenon and chaos-fractal theory—with the fundamental principles of traditional Chinese medicine (TCM) to optimize perioperative recovery. It examines how these theories provide a scientific foundation for developing a digital TCM diagnosis and treatment platform. Key topics discussed include the application of digital four-diagnosis technology, visualization of perioperative Yin-Yang states, and artificial intelligence-driven biomarker discovery. By quantifying and digitizing core TCM concepts, this approach enables their incorporation into Enhanced Recovery After Surgery protocols. Ultimately, the review highlights the potential of integrating TCM with Western medicine to advance personalized postoperative management, offering both theoretical insights and practical strategies for improving perioperative care.

Pituitary tumors are common intracranial neoplasms that can cause significant morbidity due to hormonal dysregulation and compression of surrounding structures. Despite advancements in surgical techniques, challenges persist in treating large, invasive, or recurrent tumors, where complete resection is often difficult. The molecular and genetic mechanisms underlying pituitary tumorigenesis are not yet fully understood, limiting the development of targeted therapies. This review provides a comprehensive overview of recent advancements in neuroendoscopic treatment of pituitary tumors, with a focus on pathogenesis, technological innovations, clinical outcomes, and future directions. We highlight the potential of neuroendoscopic surgery to improve patient outcomes while addressing persistent challenges, such as the steep learning curve and limitations in instrument maneuverability. Future research should prioritize enhancing instrument design, developing 3D and augmented reality visualization systems, and improving training programs to further advance neuroendoscopic techniques.

A colouterine fistula is an extremely rare condition that has been reported in various diseases, including diverticulitis, sigmoid colon malignancy, and complications from radiotherapy. It can also arise from iatrogenic conditions such as the insertion of intrauterine devices, endometrial curettage with urinary tract and bowel perforation, and obstetrical injury. Although colovaginal fistula caused by a foreign body has been reported, colouterine perforation by a foreign body has not been previously documented. We report the first case of foreign body colouterine perforation and its successful treatment by endoscopic removal and repair, resulting in the complete resolution of symptoms without the need for surgery. This case is highly significant due to its rare occurrence and successful treatment by endoscopic removal and repair without the usual and expected necessity for surgical intervention.

Endometrial cancer (EC) is one of the most prevalent malignancies of the female reproductive system and ranks among the three primary types of gynecological cancers. Recent trends indicate a rising incidence of EC in younger patients, highlighting the urgent need for effective early screening strategies. This review examines the challenges associated with early diagnosis and screening, including ambiguous methodologies (e.g., transvaginal ultrasound: sensitivity 80–90%, specificity 60–70%), undefined target populations, and the absence of efficient, cost-effective, minimally invasive solutions (e.g., cytology sensitivity ≤50% in community settings). The article provides an overview of the current landscape and emerging innovations in universal EC screening, highlighting advancements in early detection and diagnosis, such as DNA methylation panels (sensitivity 89–94%, specificity 91–97% in phase II trials) and vibrational spectroscopy (sensitivity 92%, specificity 88% in pilot studies). Additionally, future directions for implementing effective screening strategies are explored, emphasizing the potential of high-accuracy biomarkers and scalable technologies to reduce mortality and healthcare costs.

The number of molecular abnormalities identified in hematopoietic and lymphocytic neoplasms has grown exponentially over the past decades. Patients with genetic biomarker-matched targeted therapies have experienced significantly improved survival rates. Modern molecular laboratories, equipped with advanced technologies such as next-generation sequencing, can simultaneously test hundreds of genes and thousands of hotspots in a single run with multiple samples analyzed side by side. Bioinformatics tools provide seamless, evidence-based information to determine whether the detected mutations are benign or pathogenic, somatic or germline, druggable or diagnostic. This review is divided into five sections, each aiming to provide a comprehensive overview of the genetic landscape of myeloid and lymphocytic neoplasms. It highlights the challenges and proposes potential solutions to facilitate interpretation and maximize the clinical utility of molecular profiling results.