Mital Shah

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This multicenter real-world study compared two post-transplant maintenance strategies in high-risk multiple myeloma: lenalidomide alone versus lenalidomide combined with bortezomib. After a median follow-up of over 7 years, adding bortezomib produced numerically longer progression-free survival (51 vs. 36 months) but the difference was not statistically significant, and overall survival was similar. The findings highlight that high-risk myeloma remains difficult to control with current maintenance regimens and that prospective trials testing newer targets like CD38 and BCMA are urgently needed.

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A meta-analysis of seven studies covering 225 patients found that carbonic anhydrase inhibitors reduced the thickness of the fluid-filled layer under the retina in central serous chorioretinopathy, but did not improve visual acuity or produce more complete fluid resolution compared to placebo. The drug group also had significantly more adverse events. The results suggest carbonic anhydrase inhibitors have a measurable but incomplete biological effect and should be used cautiously pending better evidence.

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Using national survey data from nearly 50,000 US adults, researchers found that people with more cardiovascular risk factors, those who are younger, uninsured, female, and low-income were most likely to skip filling prescriptions due to cost. Having public insurance or Medicaid was strongly protective against cost-related non-adherence. The study identifies a clear target for intervention: people under 65 with multiple cardiovascular risk factors and limited or no insurance coverage.

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Applying a soil bacterium (Bacillus subtilis) to cadmium-contaminated soil improved maize growth, photosynthesis, and antioxidant defenses — and reduced cadmium accumulation in plant tissues by 25 to 85 percent. The bacterium activated protective genes, improved nutrient uptake, and reduced oxidative damage at two critical growth stages. The results position this bacterium as a practical, low-input strategy for growing food crops safely in cadmium-contaminated agricultural soils.

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An analysis of FDA device approval data from 1990 to 2023 found that urological device approvals have dropped 76% since their peak in 1994, with the biggest declines in endourology. Subspecialties like urogynecology and neurourology showed strong recent growth but from very low baselines, and their longer regulatory approval times may be slowing progress. The authors argue that regulatory reform and greater industry investment are needed to revitalize innovation in urological devices.

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Two species of green marine algae from the Borneo coast were tested for antiviral activity against a fish pathogen (infectious hematopoietic necrosis virus) and for toxicity to fish cell lines. One species reduced viral counts by 98%, and GC-MS analysis identified multiple bioactive compounds with potential antiviral properties in both species. The findings suggest these algae could be developed as natural antivirals for managing disease in aquaculture settings.

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This comprehensive review covers a decade of research on benzothiazole-based drug candidates for Alzheimer's disease, cataloging how changes to the molecule's structure affect its potency against key Alzheimer's targets including acetylcholinesterase, BACE1, and various kinases. Electron-withdrawing groups consistently enhanced activity, and many compounds showed promise in lab tests and docking simulations. The review guides future drug design efforts toward improving brain penetration and confirming effects in animal models.

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The Emergency Care Redesign intervention trains emergency department teams to use structured assessments and non-drug solutions to manage Alzheimer's patients and their caregivers, with the explicit goal of reducing unnecessary hospitalizations and 30-day returns. Three core steps — identifying problems, prioritizing them, and addressing them with community resources — form the backbone of the approach. This paper describes the intervention as one arm of a large cluster-randomized trial being conducted across 79 US emergency departments.

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A multi-omics study of 25 soybean varieties grown in cadmium-contaminated water identified two cultivars as highly tolerant. The tolerant plants activated isoflavonoid biosynthesis pathways and showed specific patterns of DNA methylation in genes controlling those pathways. This combined genetic and epigenetic analysis points to molecular targets that could be used in breeding programs to develop soybean varieties better suited for growing in contaminated soils.

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Large language models were tested on their ability to classify sexual and reproductive health questions asked in code-mixed Hindi-English (Hinglish) by underserved urban Indian women. Top proprietary models like GPT-5 performed best, but the Indian open-weight model Sarvam-M achieved comparable accuracy to large multilingual systems. All models struggled with culturally specific euphemisms and colloquial terms, highlighting the need for culturally adapted AI tools to provide equitable health information in low-resource language settings.

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Interviews with 21 emergency physicians about how they decide whether to admit or discharge dementia patients revealed that caregiver availability and the clinical trajectory were the most influential factors — and that physicians used informal, variable approaches to assess caregiver capacity. Few physicians spontaneously mentioned that hospitalization itself could worsen a dementia patient's condition. The findings suggest that structured caregiver assessments and better outpatient alternatives to hospitalization could lead to more patient-centered disposition decisions.

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A 3D neural network was trained on 391 head CT scans to automatically identify the pressure setting of a specific adjustable brain shunt valve. The model successfully segmented valve components in 97% of test cases and predicted the correct or an adjacent setting in 96% of cases. The tool could support clinicians who find it difficult to read shunt valve settings on CT scans, reducing errors in shunt management.

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This review argues that structured rehabilitation starting during the early hospital stay — not weeks after discharge — is essential to help major trauma survivors regain function and reintegrate into the community. International comparisons show that countries with integrated acute rehabilitation achieve better long-term outcomes, but the UK's trauma network suffers from workforce shortages, fragmented funding, and poor data systems. The authors propose specific reforms to embed rehabilitation as a core part of trauma care alongside surgery and intensive care.

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Adding either an antibiotic mixture or propolis (a natural bee product) to standard glass ionomer dental cement improved its ability to kill bacteria without significantly degrading its physical properties — including strength and fluoride release. Both modified cements outperformed the plain version in antimicrobial tests while remaining mechanically acceptable. The results support further investigation of these additives as a way to reduce bacterial contamination under dental restorations.

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Australian national health survey data tracked cardiovascular health scores in people with prior heart disease or stroke from 2011 to 2022, using five lifestyle factors: smoking, blood pressure, BMI, diet, and physical activity. The proportion achieving ideal cardiovascular health did not increase over the decade, though there was a small increase in people reaching intermediate — rather than poor — health by 2022. The stagnation in ideal cardiovascular health in this high-risk group signals the need for more intensive secondary prevention efforts.

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A mouse model of menopause (ovary removal) developed higher circulating levels of asprosin — a hormone released by fat tissue — along with weight gain, arterial stiffness, and metabolic syndrome features over 20 weeks. Asprosin directly caused blood vessels to constrict in lab tests, suggesting it may contribute to the vascular complications seen after menopause. The findings support investigating asprosin as a biomarker and potential drug target for cardiovascular risk in postmenopausal women.

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This conceptual review proposes combining speed breeding techniques (manipulating light and temperature to accelerate plant generations) with strategically chosen early-bearing parent plants to dramatically shorten apple and walnut breeding programs. Traditional breeding for these crops takes decades because juvenile trees don't flower for years. By using columnar apple varieties and lateral-bearing walnuts as intermediate parents, and pairing this approach with AI-assisted trait selection, breeders could potentially achieve in years what currently takes a generation.

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Researchers collected five rhubarb species from different altitudes in the Himalayas and found that higher altitude plants contained more bioactive compounds — including flavonoids, phenolics, and antioxidants — with one species (R. spiciforme) having the richest chemical profile. The increases at high altitude were linked to greater oxidative stress and UV exposure, which triggers defensive chemistry in plants. The study identifies elite high-altitude chemotypes that could be prioritized for medicinal or nutraceutical use.

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A government health department in a small Indian union territory used mobile technology, student enumerators, and cross-departmental coordination to complete a population census of 736,179 people in just one month, achieving 95% coverage. Nearly all residents shared their national ID number, and the resulting database is now shared across multiple government programs. The case study demonstrates how digital tools and administrative convergence can rapidly generate population data in resource-limited settings.

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A systematic review and meta-analysis of 13 studies covering patients with blockages in multiple coronary arteries found that bypass surgery (CABG) reduced the risk of death by 18% and repeat procedures by half compared to stenting (PCI) over five or more years. CABG carried a slightly higher stroke risk. The results support favoring bypass surgery for most patients with multi-vessel disease, while stenting remains appropriate for patients who are poor surgical candidates.

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A real-world multicenter study of 195 patients with relapsed/refractory multiple myeloma treated with teclistamab — a bispecific antibody — found that patients with pre-existing kidney impairment had similar response rates and adverse event profiles as those with normal kidney function. Patients with kidney disease required more blood transfusions but were not at higher risk for cytokine release syndrome or infections. The findings support using teclistamab in renally impaired patients and call for dedicated prospective studies in this population.

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This review examines whether ethanol instillation into the vein of Marshall — an adjunct ablation technique for persistent atrial fibrillation — still has a role now that pulsed-field ablation (PFA) has transformed the field. Four randomized trials consistently showed that this approach improves outcomes beyond standard pulmonary vein isolation, yet adoption remains low. The authors argue that the electrophysiologic rationale remains strong and that its role should be evaluated specifically in the context of PFA-based procedures.

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A randomized trial tested a community health nurse intervention with smartphone-based adherence support in 76 young people with HIV and detectable viral loads. The intervention showed higher rates of viral suppression at 6, 12, and 18 months than standard care (75% vs. 33% at 18 months), though the differences were not statistically significant given the small sample size. The trial demonstrated feasibility — nurses completed most visits, including unscheduled ones — and supports scaling up this type of alternative care model for at-risk youth.

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This study reviewed community outreach and public disclosure strategies across 20 US sites for a pediatric emergency seizure trial conducted under a federal waiver of informed consent. Paid social media advertising reached far more people than free posts to institutional followers (median 13,992 vs. 2,504 on Facebook), at reasonable cost. The authors recommend that future research of this type budget for paid social media campaigns and develop clear success metrics before starting community consultation activities.

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This review examines how heart imaging guides decisions about revascularization in patients with ischemic heart disease and weakened hearts. Advanced imaging tools — cardiac MRI, PET, and stress echocardiography — identify viable muscle that can recover after surgery, though recent large trials have complicated the assumption that viability testing always predicts who benefits from revascularization. The authors propose that viability testing remains useful in selected patients and works best when combined with ischemia assessment and symptom evaluation.

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Interviews with 36 clinicians and patients identified the key barriers and facilitators to implementing a shared decision-making tool for managing drug-drug interactions that increase bleeding risk in patients on anticoagulants. Limited visit time, workflow integration challenges, and role constraints were the main barriers; clear bleeding risk visualization and familiar interface design were strong facilitators. The study highlights workflow and role alignment as the most important design considerations before a larger effectiveness trial.

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This case report describes a rare variant of Takotsubo cardiomyopathy — where the base of the heart balloons out instead of the tip — in a 24-year-old woman who developed it immediately after a cesarean delivery. Her heart function recovered completely within one week. The report also discusses how to distinguish this condition from peripartum cardiomyopathy, which looks similar but has a different cause, different treatment, and potentially worse long-term outcomes.

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This paper reviews the evidence that mineralocorticoid receptor antagonists (a class of heart failure medication) reduce mortality and hospitalizations, but notes that these drugs are the least-prescribed heart failure medications in India despite their benefits. The authors identify provider-level and patient-level barriers to prescribing and adherence and argue that closing these gaps could meaningfully improve heart failure outcomes in the Indian population.

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A prospective study of 30 patients who had open surgical drainage (arthrotomy) for infected knee joints in India found that functional scores improved dramatically — from severely impaired before surgery to near-normal by 24 weeks. Complication rates were low, with only one recurrence (a drug-resistant staph infection) and no deaths or deep re-infections. The results support open arthrotomy as a reliable, safe procedure for knee joint infections in settings where minimally invasive options are not available.

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This case report describes a young woman with lupus who appeared to have a lupus kidney flare but whose kidney biopsy instead showed IgA nephropathy — a different kidney disease with different treatment and implications. The patient responded well to early immunosuppression and improved significantly. The case highlights that not all kidney disease in lupus patients is lupus nephritis, and that biopsy with detailed immune staining is essential before starting treatment.

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A pilot program at a quaternary hospital used a four-item checklist to screen patients admitted with a central line already in place — a group at high risk for bloodstream infections that were acquired before admission. Over 22 months, screening identified 56% of patients as at risk, cultures were drawn in 97% of those, and 15% tested positive. After the program launched, hospital-acquired bloodstream infections declined and time to diagnosis shifted, suggesting the tool improves identification without dramatically increasing testing burden.

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A randomized controlled trial compared two dental implant placement techniques — standard drilling versus osseodensification, which compacts bone rather than removing it — in 31 patients receiving 44 implants. Both techniques produced nearly identical implant stability at placement and at three months, with no differences in pain or swelling. The findings show that osseodensification offers no universal advantage over conventional drilling for cylindrical implants, and technique choice can be driven by surgeon preference and case specifics.

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An online dental hygiene course incorporated game-based homework assignments using the platform Gimkit in the week before final exams. Students were highly engaged, and they performed significantly better on exam questions that had been covered in the game assignments than on questions that had not. The results suggest game-based homework can meaningfully improve learning outcomes in asynchronous online health professions education.

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A 27-year-old man with years of nasal obstruction was found at surgery to have Ewing's sarcoma — an aggressive cancer — in his nasal cavity, having previously been misdiagnosed with a benign lesion. Diagnosis required a combination of pathology and specific protein markers (including CD99 and NKX2.2) to distinguish Ewing's sarcoma from other small round cell tumors that look similar under the microscope. The case illustrates how rare sinonasal cancers can masquerade as benign disease and require thorough workup.

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A single-center study of 40 patients whose implantable defibrillators failed to successfully shock them out of dangerous heart rhythms found that whether doctors chose surgery or medication adjustments made no difference in long-term outcomes. Both groups had similar rates of repeat defibrillation failure at 2.4 years of follow-up. The overall rate of repeat failures remained troublingly high at 15%, underscoring that failed defibrillation is a serious problem without a reliable fix under current management approaches.