Vol. 13, Issue 05, May, 2026

Immune checkpoint inhibitors (ICIs) have transformed oncological practice by generating durable antitumour responses across a broad spectrum of malignancies. However, meaningful clinical benefit accrues to only a fraction of patients, and resistance remains a persistent challenge. This review examines the evolution of ICI-based therapy from single-agent checkpoint blockade through multimodal combination regimens to biomarker-directed, personalised strategies. Combination approaches pairing ICIs with cytotoxic chemotherapy, radiotherapy, molecularly targeted agents, and emerging platforms such as oncolytic viruses and therapeutic vaccines exploit mechanistic synergies and have demonstrated improved immunological and clinical endpoints. The expanding repertoire of predictive biomarkers encompassing PD-L1 expression, tumour mutational burden (TMB), microsatellite instability (MSI) status, and transcriptomic immune signatures has refined patient stratification. The tumour immune microenvironment and the gut microbiome are increasingly recognised as modulable determinants of treatment response, offering avenues aligned with integrative oncology. Artificial intelligence and machine learning applied to multi-omics datasets are advancing response prediction and resistance identification. Key challenges include immune-related adverse events (irAEs), treatment costs, and biomarker standardisation. Future priorities encompass next-generation checkpoint targets, bispecific antibodies, liquid biopsy-guided surveillance, and microbiome-directed interventions. The convergence of immunological precision, integrative patient-centred care, and computational decision-making defines the next chapter of cancer immunotherapy.

Background: Avascular Necrosis (AVN) is a degenerative bone disorder caused by compromised blood supply, leading to structural collapse. In Ayurveda, it correlates with Asthimajjagata Vata, where aggravated Vata localized in bone and marrow causes debilitating pain and restricted mobility. Case Report: A 26-year-old male diagnosed with Grade 2 Bilateral AVN presented with chronic hip pain, limping gait, and restricted joint movements. He sought a non-surgical alternative to the recommended total hip arthroplasty. Intervention: The primary intervention consisted of Panchatikta Ksheera Basti, administered in three 21-day cycles. This was supported by oral medications including GandhaTailam capsules (600mg BD) and Panchatikta Ghrita Guggulu to facilitate deep tissue rejuvenation and channel clearance. Additionally, ChitrakadiVati was prescribed for Deepana-Pachana to ensure proper metabolic correction and enhance the efficacy of the overall treatment.Results: Post-treatment, the Visual Analogue Scale (VAS) for pain dropped from 3 to 0 (Right) and 3 to 1 (Left). Gait improved significantly, and sleeplessness was completely resolved. Objective improvements were noted in Range of Motion (ROM), with right hip flexion increasing from 90° to 110° and extension from 10° to 30°. Conclusion: The combination of Basti and nourishing Vata-pacifying drugs effectively reduced Srotorodha (obstruction), improved microcirculation, and restored joint function. This integrative approach offers a viable conservative strategy for early-stage AVN.

Objectives: Over time, there has been a development in veneer materials, changes in preparations, and improvements in veneer cementation. Multiple research have assessed the impact of coffee on various physical characteristics of both direct and indirect veneers, as well as the materials utilized in their fabrication. The attribute of veneers that has received the most extensive research is their color stability. This systematic review aimed to study the effect of coffee as a beverage on color stability of direct and indirect veneers. Material and Methods: The current investigation was done according to the PRISMA 2020 Guidelines. The procedure for the systematic review was recorded in PROSPERO (CRD42024519382).A systematic qualitative search was conducted in two databases (PubMed, Scholar) until January 18, 2024. Two independent reviewers executed the search strategy, screened and selected studies, extracted methodology and result data, and assessed the internal methodological risk of bias. Strict inclusion and exclusion criteria were followed. The titles of the studies and their respective abstracts were reviewed independently by two authors in accordance with the inclusion criteria in order to choose the studies. The authors of the current review reached a consensus on the final inclusion of research after fully evaluating and screening the texts. “Modified CONSORT checklist of items for reporting in vitro studies of dental materials" assessed the bias. The study's final evaluation involved assigning a risk of bias of "low," "medium," or "high" to each researched aspect. The fulfillment or non-fulfillment of each of the 14 characteristics considered in the quality assessment was evaluated individually, and the percentage of compliant items was calculated using the formula (number of compliant items/total number of items x 100). Results: From the identified 1014 studies, 23 in-vitro studies were included for systematic review after removal of duplicates and strictly following the inclusion criteria. Among the studies reviewed, 37 different veneer materials were examined. The studies that were retrieved used various artificial staining techniques. Coffee is investigated in this review as a staining solution. The CIEDE2000 color difference formula and CIELAB formula was used for color assessment in the included studies. Four studies had low risk of bias (RoB) while remaining studies had medium risk of bias. Analysis revealed better color stability of indirect veneers when compared with direct veneers. Conclusions: This current study reviewed the effect of coffee on the various materials used for veneers. Based on current evidence, coffee definitely has a major impact on color stability of veneers. Resin materials that are machined instead of direct or prefabricated exhibit greater color stability. Indirect or direct materials do not exhibit the same color stability as resin-based blocks used in CAD/CAM processes.

Ports as a significant pillar of India trade and logistics infrastructure have impressive large macroeconomic impacts as well. This research paper studies the factors of top operational indicators for major Indian ports along with its relationship with macroeconomic variables such as GDP, Exports & Imports in India from 2018–19 to 2022-23. A methodology Pearson’s correlation analysis has been used to see whether operational efficiency indicators available can be correlated with their related possible national economic performance indicators for ports. The findings show that, as far as GDP and financial indicators (operating surplus, profit before tax and profit after tax) are concerned, the relationship is positive but mixed for exports and imports in operational indicators. Conclusion These inferences expose an exigency to improve port productivity & financial sustainability for long-term economic growth & trade prosperity in India.

The expansion of local resources is one of the greatest challenges to food security in Africa. Among these, the pulp of the R. sese De Wild fruit is practically considered an important staple food in certain communities. The objective of this study is to assess consumption patterns, sociodemographic indicators, and perceptions of this pulp in the city of Kikwit. A descriptive and analytical cross-sectional study was conducted on 320 households selected through stratified sampling. We collected data using a face-to-face questionnaire and analyzed the collected data using descriptive and inferential statistics. Statistical analyses showed that most respondents were over 30 years old (90.3%) and female (72.8%). The fruit in question is known to the majority of respondents (88.8%) and is consumed by most of them (87.2%); nearly half of the respondents (47.5%) consume it regularly. The pulp is primarily used as food (95%), but also as medicine (90%) and for cultural reasons, including in the production of traditional wine (70%). The main reasons for consumption include regulating blood sugar levels (88.8%), treating hepatitis (34.4%), and treating spleen disorders (31.6%). Data from statistical analyses revealed statistically significant correlations between knowledge of and consumption of the pulp under study and several sociodemographic variables such as gender, educational level, occupation, and household size (p < 0.05). Statistics show as well as that the likelihood of consuming this pulp is 12.37 times higher among patients with spleen disorders and 5.2 times higher among patients with diabetes. In summary, the pulp under study represents an important local food resource known for its use and cultural significance. Nevertheless, its nutritional properties remain unexplored. Its promotion could contribute to improving food and nutritional security in urban areas.

In our lives, we are constantly faced with difficult and difficult problems in decision-making. In order to overcome the problem effectively, we need to make the right decision. Many factors affect decision-making. Researchers have determined that personality differences or personality types can affect these. Depending on the personality types, the time to decide and the approach to it differ. When making decisions, the personality types that are necessary when determining the goals and objectives of a person's actions and activities and making a choice are affected. There are studies that have studied decision-making styles at the level of leaders, but they have rarely been studied in relation to their individual characteristics. The reason for conducting this study on doctors is that they interact with people every hour and minute and work for the most precious thing, which is health. They also have a very stressful job and face a lot of problems. One wrong decision or one wrong step can cause great harm. Therefore, it was considered necessary to determine the characteristics of problem-solving and personality types of these professionals. A total of 300 doctors working in Mongolian state hospitals were randomly selected and the results were presented. The results of the study showed the relationship between problem-solving characteristics and personality types. In terms of viewing, the characteristics of vigilance, critical external environment (0.289**) and receptive external environment. There was an inverse correlation with the (-0.289**).

Higher education in rural regions plays a vital role in promoting inclusive development, particularly through colleges offering traditional streams such as Arts, Commerce, and Science in Maharashtra. This study examines the administrative challenges and opportunities faced by these institutions, with special reference to the impact of the COVID-19 and the implementation of the National Education Policy 2020. The findings reveal that challenges such as lack of resources, financial constraints, and shortage of qualified teachers continue to persist. The pandemic has further intensified issues related to digital infrastructure, resulting in a widened digital divide, decline in student attendance, and learning loss. Comparative analysis shows a shift from structural challenges before COVID-19 to a combination of structural and technologydriven challenges in the post-pandemic period. The study concludes that effective institutional administration and targeted policy support are essential for strengthening rural higher education.