International Journal of Scientific Reports

Hypertension in young adults and exploring its role in sudden cardiac death: expert opinion from India

2026-08-20T19:38:57+0530

Hypertension, once considered a disease affecting older adults, is now alarmingly increasing in young Indian adults. Several lifestyle and environmental factors are linked to this sudden increase in hypertension in young adults in both urban and rural settings. However, there is a lack of guideline recommendations and clinical trial data for managing hypertension in young adults and adolescents, leaving clinicians with a lack of recommendation-based treatment for this population. Five focused group discussions including 60 eminent cardiologists from India were conducted to understand their perspectives on the approach to management of hypertension in young adults and whether it is linked to sudden cardiac death (SCD), particularly in those with left ventricular hypertrophy. Prevention of SCD in young adults, risk factors, and challenges in the early diagnosis and management approach for young adults with hypertension were also discussed. This review provides an overview of relevant literature and summarizes the perspectives of Indian experts on the merits of the fixed-dose combination of telmisartan plus bisoprolol that has shown promise in controlling hypertension in young adults.

A preventable severe influenza A pneumonia after rituximab therapy for pemphigus vulgaris: a case report highlighting the critical role of vaccination

2026-08-20T19:38:56+0530

Rituximab is an effective first-line therapy for pemphigus vulgaris (PV) but causes prolonged B-cell depletion, increasing susceptibility to infections. We report a 38-year-old man with PV who developed severe influenza A (H3) pneumonia 20 days after his second rituximab infusion, having declined influenza vaccination. Prior to rituximab, he received corticosteroids and azathioprine, but lesions persisted. Upon presentation, he experienced headache, myalgia, arthralgia, and fatigue. Laboratory tests revealed lymphopenia and elevated C-reactive protein, and a respiratory viral panel confirmed influenza A H3. Imaging showed bilateral basal infiltrates with ground-glass opacities. The patient required hospitalization, antiviral therapy with oseltamivir, antibiotics, and supplemental oxygen. He recovered without intensive care admission. This case highlights the critical importance of influenza vaccination before rituximab therapy. Vaccination should not be left to patient discretion, and rituximab should never be administered without prior immunization, especially during winter months, to prevent severe or potentially fatal influenza complications.

A cognitive behavioural therapy-based intervention for an adolescent experiencing social anxiety and stuttering: a clinical case study

2026-08-19T09:36:11+0530

Stuttering is frequently associated with social anxiety, resulting in avoidance, negative self-evaluation, and impaired social functioning. This case study describes the assessment and cognitive behavioral therapy (CBT)-based treatment of a 17-year-old adolescent presenting with stuttering and severe social anxiety. Case formulation and intervention were guided by Rapee and Heimberg’s cognitive model of social anxiety. Treatment included psychoeducation, development of a hierarchy of feared situations, cognitive restructuring, Socratic questioning, behavioral experiments, and attentional refocusing. Outcomes were assessed using the social phobia inventory (SPIN). The adolescent’s SPIN score decreased from 40 (severe social anxiety) to 22 following treatment, accompanied by improved self-confidence and greater participation in social situations. This case highlights the effectiveness of CBT in modifying maladaptive cognitions and safety behaviors that maintain anxiety in adolescents who stutter. It also contributes to the limited literature supporting CBT-based interventions for this population and emphasizes the need for further clinical research.

Atypical bullous erythrodysesthesia mimicking fixed drug eruption during cabozantinib therapy: a case report

2026-08-20T19:38:54+0530

Cabozantinib is a multi-targeted tyrosine kinase inhibitor used in the treatment of advanced renal cell carcinoma. Palmar-plantar erythrodysesthesia (PPES) is a well-recognized cutaneous adverse effect of tyrosine kinase inhibitors; however, atypical bullous presentations are extremely rare. We report a 79-year-old man who developed painful, pruritic, well-demarcated bullous lesions on the distal fingers of both hands and the left heel three weeks after initiating cabozantinib therapy. Unlike classic PPES, the lesions consisted of tense bullae without hyperkeratosis and closely resembled bullous fixed drug eruption. This case highlights a rare presentation of cabozantinib-induced bullous erythrodysesthesia that mimics fixed drug eruption. Awareness of this uncommon adverse reaction is important for accurate diagnosis, appropriate treatment modification, and avoidance of unnecessary diagnostic procedures.

An axillary mass in the postpartum period: accessory breast tissue confirmed by ultrasonography and milk aspiration: a case report

2026-08-20T19:38:53+0530

Accessory breast tissue is a congenital anomaly defined by the presence of more than two glandular breast tissues in addition to the normally developed breasts. This ectopic breast tissue may remain clinically silent for long periods; however, it can become symptomatic due to hormonal influences, particularly during pregnancy, lactation, or menstrual cycles, as it undergoes physiological changes similar to those observed in normal breast tissue. These changes may lead to localized swelling, pain, or discomfort, most commonly in the axillary region. In this report, we describe the case of a 32-year-old woman who presented to our clinic with a unilateral axillary swelling that developed after her second delivery. The clinical presentation, along with the patient’s obstetric history, raised suspicion of accessory breast tissue. This case highlights the importance of considering accessory breast tissue in the differential diagnosis of axillary masses, especially in women of reproductive age presenting during hormonally active periods.

Analysis of cancer in Palestine: epidemiological trends, system-level constraints and regional disparities

2026-08-20T19:38:52+0530

Background: Cancer represents an increasingly significant public health concern in Palestine. Few comprehensive studies address the rising mortality rates, emerging incidence trends, and limitations within the health system.

Methods: Data from the Palestinian Ministry of Health were utilized to examine temporal cancer patterns. The analysis included new cases and mortality in both the West Bank and Gaza Strip. Trends from 2014 to 2024 were assessed using descriptive and comparative statistics, including the compound annual growth rate (CAGR) to quantify average annual increases.

Results: In 2024, the cancer incidence rate was 130.8 per 100,000 population, with an age-standardized incidence rate (ASIR) of 201.4. Breast cancer was the most prevalent, followed by colorectal and lung cancers. Lung cancer accounted for the highest number of cancer-related deaths. Incidence rates were higher in the West Bank compared to Gaza Strip. CAGR analysis indicated consistent increases in both new cases and mortality.

Conclusions: Cancer mortality rates continue to rise in Palestine, with marked regional disparities. Reducing future risks requires enhanced surveillance, improved early detection, and equitable access to care.