Neurological injury remains a major contributor to morbidity, mortality, and long-term cognitive decline in patients undergoing cardiac surgery, despite significant advancements in surgical techniques and cardiopulmonary bypass (CPB) technology. These injuries arise from a complex interplay of embolic load, hypoperfusion, impaired cerebral autoregulation, inflammatory responses, and patient-specific vulnerabilities, underscoring the need for a precision-based approach rather than generalized neuroprotective strategies. This narrative review synthesizes current evidence across the perioperative continuum to propose an integrated, data-driven framework for precision neuroprotection. This structured narrative review was conducted according to the SANRA framework. Literature was retrieved from PubMed and Scopus databases covering publications from January 2005 to October 2025.Preoperative risk assessment is enhanced by multimodal imaging, frailty evaluation, neurocognitive screening, metabolic and inflammatory biomarkers, and emerging machine learning models capable of predicting postoperative delirium and cognitive dysfunction. Intraoperatively, precision neuroprotection centers on autoregulation-guided blood pressure management, individualized perfusion targets during CPB, optimized temperature and glucose control, and multimodal neuromonitoring, including transcranial Doppler (TCD), near-infrared spectroscopy (NIRS), processed EEG/BIS, and embolic load characterization, to identify and mitigate cerebral insults in real time. Postoperative precision strategies incorporate biomarker-based surveillance, delirium screening, early mobilization, cognitive rehabilitation, and digital monitoring through wearable devices and remote platforms to detect delayed neurological decline. Although these modalities demonstrate clear potential, major research gaps persist, including variability in device accuracy, limited ability to differentiate embolic subtypes, inconsistent biomarker performance and insufficient integration of AI-driven analytics with clinical workflows. Collectively, available evidence supports the transition from fragmented, organ-focused neuroprotection to a unified, multimodal continuum that leverages data integration, personalized thresholds, and predictive analytics. Future large-scale, human-centered clinical trials are essential to validate this approach and operationalize precision neuroprotection across cardiac surgical practice.

Chronic kidney disease (CKD) attributable to type 2 diabetes mellitus represents a substantial contributor to morbidity and mortality across Asia; however, comprehensive evaluations of long-term trends and regional heterogeneity remain limited. This study quantified the burden and temporal trends of CKD due to type 2 diabetes mellitus in Asia using estimates from the Global Burden of Disease (GBD) study. We estimated age-standardized incidence, prevalence, and mortality of CKD due to chronic kidney disease attributable to type 2 diabetes mellitus across Asia and its sub-regions using GBD data, with Asia-level estimates available through 2021 and sub-regional estimates through 2023. We performed Joinpoint regression analysis, with permutation tests (National Cancer Institute Joinpoint version 5.2.0), to imply significant changes in inflection points. Calculations for Annual Percentage Changes (APCs) and average annual percent changes (AAPCs) with 95% confidence intervals were also carried out. In 2021, an estimated 69.15 million individuals (95% UI: 53.73–74.77 million) in Asia were living with CKD attributable to chronic kidney disease attributable to type 2 diabetes mellitus, corresponding to an age-standardized prevalence rate (ASPR) of 1354 per 100,000 population (95% UI: 1248–1464). The age-standardized incidence rate (ASIR) was 20.26 (95% UI: 18.68–21.72) per 100,000, while the age-standardized death rate (ASDR) was 6.04 (95% UI: 5.08–7.21). From 1990 to 2021, ASPR declined modestly (AAPC: −0.28%), whereas ASIR increased (AAPC: 0.52%) and ASDR remained largely stable. Marked regional disparities were observed. Central Asia demonstrated sustained increases in prevalence, incidence, and mortality, including a rising ASDR between 1980 and 2023 (AAPC: 0.81%; 95% CI: 0.21–1.41). East Asia showed increasing prevalence alongside declining incidence and mortality, while Southeast Asia exhibited rising prevalence and incidence with decreasing mortality. Males consistently had higher prevalence, incidence, and mortality than females. The CKD in type 2 diabetics showed much regional variation throughout Asia. Although improvements in incidence and mortality were observed, the persistently high prevalence signifies a rapidly expanding population of diabetic CKD individuals. These findings underscore the urgent necessity for region-specific diabetes prevention and targeted health policies.

Foreign body ingestion in adults is rare and typically linked to psychiatric or cognitive disorders. We present a rare and challenging case of an 18‐year‐old congenitally deaf and mute male who presented with prolonged constipation and recurrent vomiting. Diagnostic imaging revealed extensive fecal impaction and multiple ingested foreign bodies, which were coins and seeds, and there was no sign of any perforation. Due to the patient's communication barriers, diagnosis and management were delayed and required extra care. The patient was successfully managed with conservative procedures, including manual evacuation under sedation and supportive care, avoiding the need for surgical or endoscopic intervention. This case highlights the importance of a multidisciplinary approach during the management of gastrointestinal conditions in patients with communication disabilities and emphasizes the need for improved healthcare accessibility and communication strategies for the deaf and mute population.

Harlequin Ichthyosis (HI) is an extremely rare, autosomal recessive, and highly fatal condition in neonates. It is especially difficult to control in the low‐ and middle‐income countries (LMICs) due to the low rate of prenatal screening, cultural reluctance, and lack of access to neonatal intensive care. We present a 37‐week neonate born to a diabetic mother from a consanguineous marriage with a background of HI‐related neonatal mortality. The child had classical manifestations of HI in the form of hyperkeratotic armor‐like plates, eclabium, ectropion, and limb contractures. Oral acitretin was started at 1.1 mg/kg/day along with intensive supportive care but the neonate had become septic and succumbed on day nine despite multi‐antibiotic therapy, intravenous fluid resuscitation, and oral retinoid therapy. There was mild dermatological improvement with retinoid therapy but systemic improvement was not observed. Antenatal diagnosis was not made because of poor prenatal care and religious reluctance. On record, the present case is the first reported one for our region showing a likely association between maternal diabetes and high HI severity because epigenetic studies suggest that hyperglycemia may alter fetal gene expression, particularly in pathways related to cell adhesion and barrier function. The case highlights the intersection of maternal comorbidities, consanguinity, and healthcare system gaps in aggravating HI outcomes in LMICs. It necessitates emergent interventions such as subsidized prenatal screening, genetic counseling outreach, particularly concerning maternal diabetes, additional research, consanguineous marriage counseling, and neonatal infection control to enhance prognosis and prevent recurrence.

The procedure of interval LTCC may be an option for women who have established history of cervical incompetence and a failed TVC, including those with pregnancy conceived after IVF treatment with twins. This should still be on a case‐to‐case basis considering that evidence is not abundant for this situation.