Introduction The eustachian tube [ET] acts as a regulator of pressure and ventilation for the middle ear and prevents barotrauma [1,2]. A number of etiological factors like inflammation, allergies can contribute to one or more of its functions being disrupted and result in eustachian tube dysfunction [ETD] [1,2]. The prevalence of ETD in the USA is

Introduction Clinical practice guidelines hold significant value in the common occurrences of connective tissue disorders, such as interstitial lung disease, and are linked with elevated morbidity and mortality (1). Connective tissue disease-related interstitial lung disease (CTD-ILD) manifests subtly in individuals with systemic sclerosis (SSc), r

Introduction Asthma is a prevalent condition among adults aged 65 and above, affecting their psychological and physical quality of life. Individuals with asthma has often been categorized into two groups- those who experienced asthma during childhood or early adulthood and those newly diagnosed at an advanced age. While diagnosing asthma in the fir

Introduction Multimorbidity reflects shared biological pathways shaped by cumulative stress (1). Smoking amplifies inflammation, vascular dysfunction, and oxidative injury, accelerating disease clustering (1). Far from being random, multimorbidity reflects interconnected biological processes shaped by aging, environment, and cumulative physiologica

Introduction Cardiac aging reflects cumulative biological stress rather than chronological time alone (1). Smoking accelerates functional, structural, and molecular markers of cardiac aging by sustaining inflammation and endothelial dysfunction (1). Importantly, individuals of the same chronological age may exhibit markedly different degrees of car

Introduction Mitochondria regulate cellular energy metabolism, oxidative balance, and survival signalling (1). Chronic exposure to inflammatory and oxidative stress, including smoking-related oxidants, impairs mitochondrial integrity, leading to energy failure and accelerated aging (1). Beyond ATP generation, they act as central hubs integrating me

Introduction The skin serves as a visible mirror of internal physiology, often reflecting systemic inflammation, vascular dysfunction, and immune imbalance before deeper organ involvement becomes apparent (1,2). As a highly vascularized and immunologically active organ, the skin responds sensitively to chronic inflammatory and oxidative stress, inc

Introduction: The immune system functions as a finely regulated network designed to defend against threats while preserving tissue integrity (1). When this balance is disrupted, immune dysregulation emerges as a foundational mechanism driving a wide range of chronic diseases (1). Rather than presenting as a single clinical entity, immune imbalance

Introduction The gut-lung axis challenges traditional organ-based thinking by highlighting continuous immune and inflammatory communication between the gastrointestinal and respiratory systems (1). Rather than functioning independently, these organs interact dynamically through circulating immune mediators, microbial metabolites, and epithelial bar