Agaram Sundaram Vickram

The increasing survival rates among paediatric and adolescent cancer patients has increased attention on long-term consequences of chemotherapy, particularly male fertility. This review addresses age- and dose-dependent gonadotoxicity and drug type on reproductive potential. It further investigates the damage, including disruption of the hypothalamic-pituitary-gonadal axis and epigenetic alterations that may pose transgenerational risks. A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies from database inception to April 2025. Inclusion criteria included paediatric and adolescent male cancer patients or adult survivors of childhood cancer and reported chemotherapy-related effects on fertility. Preclinical animal models were included to elucidate epigenetic changes. Due to heterogeneity of study designs, a narrative synthesis was performed to categorize findings into hormonal, cellular, and clinical outcomes. Chemotherapy-induced infertility is highly dependent on the developmental stage and specific regimen. Alkylating agents and platinum-based therapies were consistently associated with impaired spermatogenesis, hormonal disruption, and azoospermia or oligospermia. Chemotherapy and cranial irradiation were altered hormonal system that regulates male reproduction and persists epigenetic changes in germ cells. Fertility preservation for postpubertal males is through sperm cryopreservation, while prepubertal boys relied on experimental strategies such as testicular tissue cryopreservation and in vitro spermatogenesis. Chemotherapy induces epigenetic after-effects, including altered DNA methylation patterns that persist even after spermatogenesis recovers. Chemotherapy compromises male fertility through cytotoxic damage and potential long-term genomic instability. The findings highlight that reproductive recovery does not guarantee genomic recovery (epigenetically intact sperm). Consequently, oncofertility care must adapt a reproductive health model that prioritizes early, customized counselling and use of biomarkers to better predict and preserve fertility in young survivors. Although sperm banking remains a standard approach for postpubertal, promising experimental may expand fertility options for prepubertal boys in future.

CRISPR-Cas systems have emerged as a versatile tool for diagnosing, treating, and preventing infectious diseases. This review highlights translational advancements in CRISPR-Cas-based applications, concentrating on the past decades in diagnostics, therapeutic genome editing, and vaccine development. The article highlights key platforms like DETECTR and SHERLOCK, which enable rapid, sensitive pathogen detection, and explores CRISPR-Cas9 systems in therapeutic strategies for directly targeting viral genomes and combating antimicrobial resistance. It also examines the role of CRISPR-Cas9 in engineering live-attenuated and personalized neoantigen vaccines. Principal findings demonstrate a clear progression from experimental proof-of-concept to preclinical applications primarily in CRISPR-based diagnostics and the engineering of live-attenuated vaccine candidates, whereas translation in CRISPR-based therapeutics and personalized neoantigen vaccines for infectious diseases remains at earlier, more exploratory stages. CRISPR-based diagnostics have progressed further toward clinical evaluation than therapeutics due to delivery and safety constraints, while personalized neoantigen vaccines are included mainly as an emerging, comparative concept for infectious diseases rather than a mature application. This review uniquely integrates CRISPR-based diagnostics, therapeutics, and vaccine development within a single infectious disease framework, critically assesses their current maturity, and systematically highlights technical, regulatory, and ethical barriers alongside realistic future priorities. The review concludes that while CRISPR-Cas holds transformative potential for infectious disease management, significant challenges in delivery efficiency, off-target effects, and ethical regulation must be addressed to ensure safe and equitable clinical translation.

Giant cell arteritis (GCA) is a common vasculitis of the big arteries that affects people as they get older and it usually results in potentially serious problems like vision loss and stroke. Steroids remain the cornerstone of GCA treatment, although long-term steroid use is associated with significant adverse effects and a high chance of recurrence. This review looked at biomaterials as a new treatment technique that could help improve GCA management through focused therapy, reduced systemic side effects and facilitated vascular restoration. A comprehensive evaluation of current breakthroughs in biomaterial-based GCA techniques was carried out, with an emphasis on nanoparticles, hydrogels and tissue-engineered scaffolds. The literature was reviewed to determine their therapeutic efficacy, biocompatibility and potential for clinical use. Biomaterials such as nanoparticles and hydrogels have showed promise in controlled drug delivery, allowing for focused treatment at sick artery sites while lowering systemic steroid exposure. Tissue-engineered scaffolds have shown promise for vascular repair and regeneration, at least more effectively than standard methods of treating an injured vessel. However, many problems exist, including maintaining long-term biocompatibility, stability and avoiding immunological responses. Although early preclinical studies have produced encouraging results, clinical translation is still in its infancy. Emerging biomaterials will be a potential area in GCA care, offering new opportunities for treatment efficacy enhancement while reducing side effects. Advanced research in the areas of biocompatibility and immune response challenges should be conducted to ease these promising tactics into clinical practice as a new hope for people suffering from this debilitating condition.

The rising prevalence of diabetes necessitates accurate, noninvasive methods for early detection and personalized management. Breathomics, the investigation of exhaled volatile organic compounds (VOCs), offers a promising approach for evaluating glycemic control, oxidative stress, and metabolic alterations associated with diabetes. Specific VOCs, such as acetone, isoprene, and ethanol, reflect glucose fluctuations, lipid oxidation, and insulin sensitivity, linking metabolic changes to real‐time physiological states. Recent analytical advancements in gas chromatography–mass spectrometry, proton transfer reaction–mass spectrometry, and electronic nose technologies have enhanced the reliability and clinical applicability of breath‐based assessments. The investigations focus on integrating VOC‐based metabolic signatures with lifestyle and behavioral factors to establish a precision, noninvasive framework for diabetes management. This review also discusses key challenges that remain in standardizing breath analysis techniques, interpreting complex breath data, and implementing breath‐based technology into personalized diabetes management. Breathomics provides a novel pathway for dynamic real‐time assessment of metabolic health, bridging physiological biomarkers with lifestyle responses to enable individualized diabetes management.

New biomedical technologies are transforming the practice of medicine for the patients and healthcare providers of today. Advanced technologies, such as AI, CRISPR-Cas9 genome editing, 3D bioprinting, and wearable biosensors, are becoming incorporated into clinical practice, with impact in a time frame that can be calibrated. For example, AI-based diagnostic systems have shown the performance that exceeds the average of clinicians with an accuracy of 94.6% for diabetic retinopathy detection. Early-phase trials have reported success rates of more than 85% with CRISPR to treat β-thalassemia and sickle cell anemia. Likewise, 3D bioprinted skin grafts accelerated healing by 30% in burn victims when compared to traditional methods. These transformative advances raise perplexing ethical issues such as data privacy, consent, equity of access, and long-term safety. For instance, although wearable biosensors contribute to better real-time patient surveillance in cardiology, aviation and aerospace, continuous monitoring also raises major privacy issues. In addition, the expensive nature of gene-editing treatments (typically costing more than $1 million per treatment) imposes constraints on accessibility in low-resource settings. The misalignment of incentives will require ethical frameworks to shape the responsible integration of these disparities. On the whole, as new biomedical technologies have unprecedented scope, their clinical dissemination should be accompanied with adequate ethical governance, in order to guarantee a fair, safe and effective health care for all.

Male infertility accounts for almost half of infertility cases among couples globally. One of the primary reasons for decreased male reproductive function is oxidative stress (OS), which occurs when the body's antioxidant defense systems are overwhelmed by the synthesis of reactive oxygen species (ROS). An excess of ROS can harm sperm quality and reproductive capacity by causing lipid peroxidation, mitochondrial malfunction, and sperm DNA breakage, even while healthy ROS levels define optimal sperm activity. Testicular tissue is particularly vulnerable to oxidative damage due to its high metabolism and the high quantity of polyunsaturated lipids in sperm membranes. Numerous internal and external variables, including varicocele, infections, environmental contaminants, aging, and bad lifestyle choices, can accelerate the generation of ROS and overwhelm the testicular antioxidant system. The pathophysiological implications of testicles' oxidative stress on male fertility are addressed in this review, which also critically explores the fundamental sources and mechanisms of this stress. The laboratory procedures and diagnostic indications are now being applied to detect oxidative stress in the sperm. The focus is on antioxidant-based treatment options, which include both new and possibly helpful chemicals as well as established supplements like vitamins C and E, Coenzyme Q 10, carnitines, and N-acetylcysteine. This review supports a personalized strategy to antioxidant therapy as a viable adjuvant in the treatment of male infertility and underlines the importance of large-scale, properly planned trials.

Epigenetic modulation has emerged as a central strategy that can change the fate of tumour cells to offer more rational and precise approaches by modulating reversible changes in chromatin structure, regulating gene expression without altering DNA sequence. Many reports have indicated the contributions of abnormal epigenetic alterations, particularly DNA methylation and histone modification patterns, as well as their association with non-coding RNA interactions during cancer emergence, development or resistance to standard therapies. Ongoing studies on various inhibitors also demonstrate encouraging preclinical results and potent inhibitory activity. Furthermore, combining epigenetic medicines with conventional treatment approaches such as chemotherapy and radiotherapy is proven to improve therapeutic efficacy in resistant cases of various malignancies. This article also briefly reviews RNA modifications (epitranscriptomics, such as m6A and m5C), novel acetylation modifications, chromosomal interaction studies, and the role of AlphaFold. The present review further illustrates these translational challenges and future opportunities in epigenetic drug development, while shedding light on the necessity of developing predictive biomarkers capable of informing personalized therapies to reduce off-target effects. The ability to target epigenetic modulators has the potential to improve patient outcomes and increase treatment options when coupled with traditional guidelines, as evidenced by on-going clinical trials and FDA approvals. Graphical abstract

Artificial intelligence (AI) and machine learning (ML) are transforming medication discovery, particularly in neuropsychiatric illnesses, where traditional drug research presents major obstacles. This paper looks at how artificial intelligence might help advance neuropsychiatric medication development, with an emphasis on early-stage research, drug design, and clinical diagnostics. This review discusses AI's contribution to understanding the blood-brain barrier and its link with the central nervous system, which is an important aspect of medication efficacy in neuropsychiatric treatments. AI-facilitated de novo drug design, using predictive algorithms and deep learning models, speeds up the discovery of new medicinal molecules. AI is employed in brain imaging and diagnosis, boosting the accuracy with which neuropsychiatric diseases are identified. BBB permeability prediction is one of the most important uses of AI in drug discovery, as it improves the selection of CNS-active drugs. Additionally, AI is transforming treatment techniques for neurodevelopmental disorders and assisting in the discovery of novel antidepressant medications through data-driven methodologies. Despite these accomplishments, AI-driven drug discovery still has several constraints, such as data biases, regulatory barriers, and ethical issues. Overcoming these restrictions will be critical to unlocking AI's full potential in neuropsychiatric research. This paper concludes with several future possibilities and opportunities, such as incorporating AI into personalized medicine using sophisticated neural network models and multimodal data fusion techniques. This might increase treatment choices for certain conditions by fine-tuning AI approaches. This paper presents a perspective on AI as a highly transformative instrument for influencing neuropsychiatric drug development, as well as an emerging field that has the potential to impact the modern idea of pharmacology.

Fruits' popularity has grown due to their ability to protect against neurodegenerative illnesses and to be an important dietary component for good brain activity. This review focuses on fruits' potential for preventing such, taking into account their bioactive compounds and mode of action. It emphasizes the abundance of flavonoids, polyphenols, vitamins, and minerals found in berries, citrus, and other tropical fruits, which have been shown to reduce oxidative damage, prevent neuroinflammation, and improve synaptic plasticity. There is an extensive literature on the neuroprotective actions of compounds such as resveratrol, quercetin, and anthocyanins in neurogenesis and mitochondrial process functions. The review also mentions emerging literature with the gut-brain axis, where it underscores the way in which fruit-derived prebiotics and dietary fibers regulate gut microbiota, which in turn affects brain health. This study analyzes gaps by adopting a comprehensive approach to studying fruits' preventive power in the treatment of neurodegenerative illness. This study combines molecular biology, clinical trial, and dietary science findings to highlight the use of fruits in ordinary diets as a sustainable, natural way of promoting neuroprotection and slowing the course of NDs.