The study of individual drug response due to genetic variation, known as Pharmacogenomics (PGx), has transitioned from a research concept to become a key component of precision medicine in the clinic. New advances in genetic research have led to the identification of variants of cytochrome P450 metabolising enzymes (such as CYP2D6, CYP2C19, CYP2C9) and drug transporters (SLCO1B1), and human leukocyte antigen (HLA) genes, which account for much of the inter-individual differences in efficacy and toxicity of commonly used drug classes including antiplatelets, anticoagulants, antidepressants, statins, and chemotherapeutic drugs. This review collates recent literature (2020-2025) on three interwoven themes: (i) clinically actionable genetic variants and guidance for their use in consortia, such as the Clinical Pharmacogenetics Implementation Consortium (CPIC); (ii) the progression of drug response prediction, from rule-based algorithms through regression-based dosing models to novel machine learning and deep learning approaches incorporating multi-omics data; and (iii) the implementation of precision medicine, such as embedding clinical decision support in electronic health records (EHRs), establishing preemptive testing programmes, and the ongoing challenges of ancestral diversity, cost-effectiveness, and workforce education. We include a summary table of representative drug-gene pairs, a methodological comparison table, and an implementation efforts table, along with four figures visualising the PGx prescribing workflow, cytochrome P450 metabolizer phenotypes, an artificial intelligence approach to the prediction pipeline, and global disparities in pharmacogenomic representation. We believe the scientific and regulatory foundation for pharmacogenomic-informed prescribing is developing, but translating it into routine use worldwide remains an unfinished agenda that will require coordinated clinical, informatics, and policy action.

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Background: With the increasing demand for biocompatible, cost-effective, and environmentally friendly nanocarriers, plant-mediated (“green”) synthesis of metallic and metal-oxide nanoparticles has become a major direction in pharmaceutical research. Phytochemical synthesis uses the polyphenols, flavonoids, terpenoids, and proteins available in plant extracts as reducing and capping agents to produce nanoparticles that are less toxic and more biologically active than those produced by conventional physicochemical methods. Objective: This study aims to summarise the literature on the synthesis, characterisation, and therapeutic potential of plantmediated nanoparticles over the past five years (2020-2025), focusing on theirincorporation into current drug delivery systems. Methodology: We used PubMed, ScienceDirect, Web of Science/Scopus, SpringerLink, and Google Scholar to conduct the structured narrative review. We screened articles published from January 2020 to September 2025 using combinations of keywords, including green synthesis, characterisation, phytochemicals, drug delivery, plant-mediated nanoparticles, and nanotoxicology. We included articles only if they reported a synthesis mechanism, physicochemical characterisation, or a biomedical/toxicological outcome. Findings: Plant-extracted-synthesised silver, gold, zinc oxide and iron oxide nanoparticles show good physicochemical characteristics (around 1-100 nm), which are supported by the results of UV-Vis, FTIR, and XRD, TEM/SEM and dynamic light scattering studies show antimicrobial, anticancer, antioxidant, and targeted drug-delivery activities. However, important barriers to translation remain, including batch-to-batch variability, incomplete phytochemical characterisation, and insuf icient long-term toxicity data. Conclusions: Plant-mediated nanoparticles are a potential scalable alternative for next-generation drug delivery, but future applications require standard synthesis protocols and thorough safety testing.

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Nanocarrier-based drug delivery has evolved from a concept into a clinically proven platform technology, with lipid nanoparticle (LNP)- based messenger RNA vaccine delivery systems and a wide array of polymeric and metallic nanomedicines as just a few examples. The review aims to be a synthesis of recent advances in the four main classes of nanocarriers: lipid-based (liposomes, solid lipid nanoparticles, nanostructured lipid carriers, and ionizable-lipid LNPs); polymeric (poly (lactic-co-glycolic acid), chitosan, polymeric micelles and dendrimers); metal-based (gold and iron oxide nanoparticles); and green-synthesised nanoparticles (via plants, algae and microbes). For each class, the review discusses synthesis strategies, targeting mechanisms (passive enhanced permeability and retention versus active ligandmediated targeting), and representative preclinical and clinical applications. It compares these approaches with other systems to highlight trade-offs in biocompatibility, payload flexibility, targeting accuracy, and manufacturing scalability. The review discusses key translational obstacles in depth, including interpatient EPR heterogeneity, reproducibility of green-synthesis batches, and gaps in regulatory standardisation, as well as novel solutions such as stimuli-responsive design, microfluidic manufacturing, and image-guided dosing. Based on the overall picture emerging from the review, the future of targeted therapeutics depends on nanocarriers that can adapt to the tumour/tissue microenvironment, with a stronger mechanistic understanding of the tumour/tissue environment.

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Methylene diphosphonate (⁹⁹ᵐTc-MDP) is a boneimaging radiopharmaceutical widely used in nuclear medicine for decades. This review provides a detailed introduction to ⁹⁹ᵐTcMDP bone imaging, including preparation, chemical properties, radiolabeling techniques, quality control, clinical applications, and recent developments. This article emphasises MDP kit preparation, the basic principles of radiopharmaceutical labelling, and the importance of technetium-99m as a diagnostic radionuclide. Over the years, researchers have also emphasised radiolabeling efficiency, radiochemical purity, and the stability of radiopharmaceutical preparations to ensure safe, effective use. This review highlights the clinical role of ⁹⁹ᵐTc-MDP in detecting and evaluating different skeletal lesions (i.e., fractures, bone metastases, metabolic bone diseases). It also describes the current state of bone imaging and the enduring role of ⁹⁹ᵐTc-MDP as a diagnostic tool. The discussion also covers new applications, technological advances, radiation exposure, and patient safety. It also discusses future perspectives in nuclear pharmacy, including the development of new radiopharmaceuticals and improved imaging strategies. This review compiles available data and provides insights for nuclear medicine professionals, radiologists, and researchers on current applications, technical aspects, and prospects for ⁹⁹ᵐTc-MDP in imaging skeletal phenomena.

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