Advances in nanotechnology have positioned metal nanoparticles, especially gold (Au), iron (Fe) and silver (Ag), at the forefront of innovations in biomedical, environmental and catalytic applications. These qualities have enabled wide-ranging applications in wastewater cleanup, bio sensing, cancer treatment and antibacterial treatment. However, the synthesis method, structural characteristics, surface chemistry and colloidal stability of these nanoparticles significantly impact their performance and safety. This paper covers in detail the mechanics, benefits, drawbacks and environmental effects of both conventional and green synthesis techniques for creating Au, Fe and Ag nanoparticles. To illustrate their significance in determining nanoparticle size, shape, composition and surface functionality, key characterization techniques, including UV-Vis spectroscopy, transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD), forier transform infrared (FTIR) spectroscopy, dynamic light scattering (DLS) and zeta potential, are reviewed. The review also examines these nanoparticles' cytotoxicity to both healthy and malignant cells, as well as their antibacterial mechanisms, including membrane rupture, the production of reactive oxygen species (ROS) and biomolecular interference. Their functions in wastewater treatment are also investigated, with particular attention to catalytic reduction, heavy-metal removal, dye degradation and disinfection procedures. Significant obstacles still exist despite tremendous advancements, such as concerns about the toxicity of nanoparticles, their persistence in the environment, their economic viability and the scalability of green synthesis techniques. This analysis tackles existing gaps and proposes the creation of safer, more sustainable and application-oriented nanomaterials.

Natural Recovery of Descemet Membrane Rupture after Low-to-Moderate Velocity Blunt Trauma.

ABSTRACT Background: Since the 1980s, the global twinning rate has risen to about 1.6 million twin pairs annually due to the widespread use of IVF. Twin pregnancies carry a higher risk of complications compared to singleton pregnancies, with cervical insufficiency being a significant concern that can lead to preterm birth and adverse perinatal outcomes. It is estimated that around 430 000 cases of twins deliver prior to 28 weeks of gestation annually. The twin miscarriage rate at the second trimester is estimated at 5%–10%, amounting to 80–160 000 losses annually in the pre‐viable period. Emergency cerclage is often used in such cases to provide mechanical support to the cervix and prolong gestation. This report presents two cases of emergency cerclage in the second trimester for twin pregnancies, with delivery of the second twin after intervals of 110 and 123 days. Case 1: A 36‐year‐old woman at 21 + 1 weeks presented with bulging membranes. Despite initial attempts to manage the condition, the membranes ruptured, necessitating the extraction of the first twin. Emergency cerclage was successfully performed to preserve the remaining twin, and was delivered by caesarean section at 36 + 6 weeks. Case 2: A 48‐year‐old woman at 16 + 6 weeks with premature rupture of membranes underwent extraction of the non‐viable twin, followed by emergency cerclage. The second twin was delivered by caesarean section at 34 + 3 weeks. Both cases involved close monitoring of inflammatory markers and regular follow‐ups. Prophylactic antibiotics were administered post‐operatively, with no tocolysis required. Indomethacin and progesterone were used to manage uterine activity and inflammation. Conclusion: These cases highlight the potential benefits of emergency cerclage in twin pregnancies with cervical insufficiency. Success was attributed to rigorous monitoring, appropriate antibiotic use and careful management of uterine activity. These cases contribute valuable insights into the complex decision‐making process involved in such high‐risk pregnancies and highlight the importance of individualised care plans.

Maternal serum biomarkers, primarily introduced for aneuploidy screening, have also been investigated as predictors of adverse pregnancy outcomes. However, their value in late-preterm and term pregnancies remains unclear. In this retrospective cohort study, 592 singleton pregnancies screened at a tertiary perinatology center between 2020 and 2025 were analyzed. Participants underwent either the first-trimester combined test (n = 461) or the second-trimester triple test (n = 131). Serum biomarker multiples of the median (MoM) were categorized as low (< 0.5), normal (0.5-2.0), or high (> 2.0). Perinatal outcomes-including Apgar scores, umbilical artery pH, neonatal intensive care unit (NICU) admission, and preterm premature rupture of membranes (PPROM)-were assessed using predefined group comparisons, multivariate adjustment, and ROC curve analysis. Low first-trimester free β-hCG was significantly associated with reduced Apgar scores at 1 and 5min in term neonates (p = 0.025 and p = 0.005, respectively). In the second trimester, infants with normal AFP levels demonstrated lower umbilical artery pH compared to those with elevated AFP (p = 0.013), and low AFP was associated with an increased risk of NICU admission (p = 0.041). ROC analysis identified an AFP threshold ≥ 1.075 MoM as predictive of PPROM with 75.0% sensitivity and 69.3% specificity (AUC = 0.723, p = 0.035). No significant associations were observed for PAPP-A. First-trimester low free β-hCG and second-trimester AFP abnormalities showed modest associations with neonatal outcomes and PPROM in late-preterm and term pregnancies, whereas PAPP-A did not. These findings suggest limited standalone predictive capacity of serum biomarkers, underscoring the need for integrated multiparametric models in risk stratification.

Mitochondria at the membrane provide a route to inflammatory cell death.

IntroductionHigh-risk pregnancies, including those complicated by pre-eclampsia, fetal growth restriction or preterm pre-labor rupture of membranes, often require hospitalization for fetal and maternal monitoring. Home monitoring may reduce the psychological and family burden, improve patient satisfaction, and lower health care costs. The primary diagnostic tool for fetal home monitoring is cardiotocography (CTG). However, conventional CTG can suffer from poor signal quality due to maternal obesity or movements. Since electrophysiological cardiotocography (eCTG) relies on electrical activity in cardiac and uterine muscles, signal quality is less impacted by obesity and motion artefacts than with conventional CTG, making eCTG also interesting for home monitoring. As remote eCTG is self-administered, it eliminates the need for professional support at home, potentially increasing autonomy and satisfaction. Nevertheless, signal quality of self-administered eCTG in the preterm period is unknown. This prospective cohort study will assess the feasibility of self-administered eCTG, using NemoRemote in a hospital setting between 32–37 weeks of gestation, simulating home use.MethodsIn this single center prospective cohort study, 60 pregnant patients (≥18 years) with a singleton high-risk pregnancy from 32 until 37 weeks of gestational age will be recruited. Remote self-administered eCTG will be performed either daily for patients admitted to the hospital, or at least twice a week at the outpatient clinic. The primary outcome is the proportion of successful eCTG recordings. Secondary outcomes include maternal and perinatal outcomes, patient and healthcare professional satisfaction, and a cost analysis.ConclusionThis study will provide valuable insights into the technical and logistical feasibility of self-administered eCTG monitoring in high-risk pregnancies, with potential implications for the implementation of remote fetal monitoring. A hospital-based feasibility study was chosen over an implementation study to safely assess signal quality of remote eCTG before broader application.Trial registrationThis trial is registered on the Dutch trial register “Onderzoeksportaal” (NO. NL-OMON57084) https://onderzoekmetmensen.nl/en/trial/57084. Date registered: 05/11/2024 and the international trial register “ClinicalTrials.gov” (NO. NCT06859177); http://clinicaltrials.gov/study/NCT06859177. Date registered: 05/03/2025

Adverse Obstetrical Outcomes Associated with Treatment of Dysplastic Lesions of the Cervix in a Universally Funded, Single Payor Health Care System.

The effect of prophylactic antibiotics prior to catheter balloon insertion on clinical chorioamnionitis in GBS-colonized term pregnancies.

This review provides an overview of acute corneal hydrops (ACHs), focusing on their risk factors, epidemiology, pathogenesis, imaging techniques, and treatment options. This narrative review was based on a literature search conducted in PubMed and Google Scholar, covering publications from 1980 to 2025. No restrictions were applied regarding language or study type. The identified studies were assessed for their relevance and clinical applicability to the diagnosis, management, and outcomes of ACHs. ACHs are linked with corneal conditions like keratoconus (2.6%-7.5%), pellucid marginal degeneration (6%-11.5%), and keratoglobus (11%). It arises from structural changes in Bowman layer and the anterior stroma, triggered by factors such as trauma and increased intraocular pressure, leading to rupture of Descemet membrane. Risk factors include chronic allergic eye diseases (eg, vernal and atopic keratoconjunctivitis), eye rubbing, developmental conditions (eg, Down syndrome), early age, steeper keratometry, and reduced visual acuity at presentation. Imaging techniques such as ultrasound biomicroscopy, anterior segment optical coherence tomography, and in vivo confocal microscopy aid in characterizing CHs, monitoring recovery, and detecting complications. Treatments aim to reduce discomfort, promote healing, prevent complications, and support future visual rehabilitation. ACH develops in several corneal disorders, with risk factors overlapping those of keratoconus. Advances in imaging have improved the understanding of corneal changes, aiding in treatment and follow-up strategies. Despite various treatment options, no consensus exists on the best approach, underscoring the need for further studies to refine management and improve patient outcomes.

Engineering lysosomal collapse for cancer therapy: From mechanistic insights to nanotherapeutic innovations.

Bayesian posthoc trial analysis of cerclage management in preterm prelabor rupture of the membranes.

Fetal sex-related preterm birth and placental cell turnover in dichorionic twins.

Previable preterm premature rupture of membranes: the impact on maternal and neonatal outcomes at a tertiary care center

Infectious morbidity associated with early amniotomy during labor induction.

Chorioamnionitis has serious maternal-newborn risks. Risk factors include prelabor rupture of membranes (PROM), vaginal exams, and inadequate perineal hygiene. There may be opportunities to reduce chorioamnionitis with PROM and newborns affected by chorioamnionitis within the Joint Commission Measure of Unexpected Newborn Complications (PC-06) using an infection prevention bundle. An internal audit found an increased incidence of newborns born to women with chorioamnionitis. Patients with PROM had a 6.2% chorioamnionitis rate compared to a 3.6% overall chorioamnionitis rate. A quality improvement project using an infection prevention bundle for PROM was implemented using three interventions: avoiding unnecessary vaginal exams in PROM diagnosis, hourly pericare with peripad changes, and hand hygiene compliance. Data were compared from first quarter 2023 before bundle implementation through third quarter 2023 post bundle implementation. The rate of chorioamnionitis was decreased among patients with PROM from 8.1% (9/111) in first quarter 2023 to 3.1% (4/126) in third quarter 2023. There were fewer newborns affected by chorioamnionitis within PC-06, from 9% (3/32) in first quarter 2023 to 7% (3/46) in third quarter 2023. PROM with chorioamnionitis within PC-06 was 0% (0/32) at first and (0/46) third quarter 2023. Bundle adherence with PROM could help decrease chorioamnionitis and contribute to fewer newborn complications related to chorioamnionitis.

Enzyme-responsive biomimetic ferritin nanoparticles for selective cancer therapy.

Introduction: Hemolysis,caused by rupture of red blood cell membranes and subsequent release of hemoglobin into serum or plasma, is a major pre-analytical error in blood sample collection and a leading cause of sample rejection. Hemolysis was one of the most common pre-analytical errors in laboratory testing. Objectives: To minimize sample rejection associated with hemolysis and clotting Methods: This project utilized DMAIC process to implement modified protocol for blood collection to reduce hemolysis rate and sample rejection. Project was conducted at Apollo Multispeciality Hospital from October 2024 to September 2025 into two phase, pre intervention and post intervention phase and data was collected through haemolysis survey report to identify the hemolysis rate and RCA was done to identify the cause of hemolysis. Observation checklist had been done to assess the practice among staff nurses on sample collection process. All blood samples collected by the nurses were taken for the study except paediatric,neonates, disease condition like coagulopathy, pancytopenia, anasarca and patient on anticoagulant. Collected data were analysed through Pareto chart against standards using Root Cause Analysis (RCA). Then modified protocol had been developed, implemented and continuing it in post intervention phase in view to reduce hemolysis rate and the effect of modified protocol. Audit and cross audit had been done to sustain the process and reduce the hemolysis rate.

Preterm premature rupture of membranes (PPROM) is a major contributor to preterm birth and is strongly associated with increased neonatal morbidity and mortality. Objectives: To evaluate fetal outcomes among pregnancies complicated by PPROM and to compare neonatal morbidity and mortality between infants delivered at ≤34 weeks and those delivered after 34 weeks of gestation. Methods: A prospective observational study was carried out at Fatima Jinnah Medical University/Sir Ganga Ram Hospital. A total of 125 pregnant women who had preterm premature rupture of membranes (PPROM) during the period of 28-37 gestational weeks. The diagnosis was made by the examination through the sterile speculum with positive pooling, nitrazine, or ferning. Mothers and babies were observed until discharge. SPSS version 25.0 was used to analyze the data, and p&lt;0.05 was the significant value. Results: The mean gestational age at rupture was 31.2 ± 1.1 weeks in the ≤ 34-week group and 35.3 ± 0.9 weeks in the &gt;34-week group. Early gestation was associated with significantly lower birth weight (1.78 ± 0.34 kg vs. 2.36 ± 0.41 kg; p&lt;0.001), higher NICU admissions (82.3% vs. 35.1%; p&lt;0.001), and increased neonatal complications including respiratory distress syndrome (58.8% vs. 14.0%; p&lt;0.001) and sepsis (32.3% vs. 15.8%; p=0.03). Perinatal mortality was markedly higher among infants ≤ 34 weeks (20.6%) compared to those &gt;34 weeks (3.5%; p=0.002). Conclusions: PPROM is associated with substantial fetal morbidity and mortality, especially when occurring before 34 weeks of gestation. Prematurity, low birth weight, and infection remain the major determinants of poor neonatal outcomes.

Perinatal and maternal morbidity in the setting of preterm birth may differ by delivery indication. We compared perinatal and maternal outcomes of second trimester (24 0/7 - 27 6/7 weeks' gestation) deliveries indicated for preeclampsia with severe features (PE-SF) with those following preterm premature rupture of membranes (PPROM). Secondary analysis of an observational cohort study of singleton and twin preterm deliveries before 35 weeks' gestation at 33 hospitals across the United States. Singletons without congenital anomalies who were delivered due to PE-SF or PPROM from 24 0/7 - 27 6/7 weeks gestation were included. The primary outcome was a composite of perinatal morbidity or death, defined as fetal or neonatal death, severe bronchopulmonary dysplasia grade III, intraventricular hemorrhage grade III-IV, necrotizing enterocolitis stage IIA or greater, periventricular leukomalacia, retinopathy of prematurity stage III-IV, or culture-proven sepsis. Secondary outcomes included components of the primary outcome, small-for-gestational-age (SGA) birth, and a composite of maternal morbidity. Among 7515 in the original cohort, 164 deliveries for PE-SF and 119 deliveries following PPROM were included. Individuals with PE-SF were more likely to have BMI ≥ 30 kg/m2, hypertensive disorder of pregnancy in a prior pregnancy, chronic hypertension, and cesarean birth (p <0.05) compared with those who delivered following PPROM. Composite perinatal morbidity or death did not differ between groups (aOR 1.60, 95% CI 0.89, 2.85, p=0.11), but fetal death was significantly higher in the PE-SF group (aOR 6.04, 95% CI 1.42, 25.71). Neonates delivered for PE-SF were more likely to be SGA (aOR 13.45, 95% CI 2.92, 61.94). Composite maternal morbidity did not differ between groups (aOR 1.18, 95% CI 0.62, 2.26). Second-trimester preterm birth indicated for PE-SF was associated with a higher rate of fetal death than birth for PPROM. Composite neonatal and maternal morbidity did not differ by indication.

Lead (Pb) has progressively become ubiquitous due to widespread use. The liver represents a target of Pb toxicity due to its central role in metabolism and detoxification. The mechanisms of Pb hepatotoxicity have not yet been fully elucidated, although oxidative stress and iron dysregulation suggest the involvement of the ferroptosis pathway. It has been hypothesized that exposure to environmental Pb concentrations induces the activation of ferroptosis as a mechanism involved in Pb hepatotoxicity, an iron-mediated regulated cell death. To test this hypothesis, we exposed adult zebrafish to environmentally relevant Pb concentrations (2.5 and 5 μg/L), combining ultrastructural analysis (TEM) with the study of key markers of ferroptosis (GPX4, SLC7A11, NRF2, KEAP1 and ACSL4). The results demonstrated that Pb exposure induced dose-dependent and progressive mitochondrial damage in hepatocytes, characterized by loss of cristae and membrane rupture. At the same time, consistent with a ferroptotic molecular profile, increased expression of ACSL4, reduced levels of the protective factors NRF2, KEAP1 and SLC7A11, and altered expression of GPX4 were observed. Overall, our data collectively identify ferroptosis as a pathogenic pathway in Pb-induced hepatotoxicity.