Review Journal of Neurological & Medical Sciences Review
The Review Journal of Neurological & Medical Sciences Review (RJNMSR) [ISSN: 3007-3073, P-ISSN, 3007-3065], published by Insightful Education Research Institute, is an international open-access, double-blind peer-review journal. The journal is dedicated to advancing the frontiers of Neurology, Medical and Allied Health Sciences by providing a timely and reliable platform for the publication of significant research and developments. Its mission is to facilitate the exchange of critical scientific knowledge, offering a space for the discussion of emerging trends, news, and pressing issues in the scientific world. Its mission is to facilitate the global exchange of essential scientific knowledge and promote discussions on emerging trends, groundbreaking discoveries, and critical issues in both human and animal health. The Research of Medical Science Review is dedicated to fostering a broad and multidisciplinary dialogue including but not limited to the following areas: Internal Medicine and Subspecialties [Cardiology, Endocrinology, Gastroenterology, Geriatrics, Health, Hematology, Nephrology, Neurology, Oncology, Pulmonology, Rheumatology, Infectious Disease] Surgical and Subspecialties [General Surgery, Orthopedics, OB/GYN, Urology, Otolaryngology, (ENT), Ophthalmology] Diagnostic and Imaging Fields [ Radiology & Pathology] Rehabilitation Sciences [ Physiotherapy and Occupational Therapy] Pediatric Allied Health Professions [ Psychiatry, Nursing, Nutrition and Dietetics, paramedics, Pathology, Public Health, Sports Sciences, Physical Education, Health Management] Genetics and Immunology [Genetics and Genomics & Immunology] Pharmacy Pharmaceutical Sciences Dentistry Biochemistry Environmental Sciences Biological Sciences [Zoology, Botany, Microbiology, Biotechnology, Medical Sciences, Cell Biology, and Molecular Biology] Animal Health and Veterinary Sciences [Veterinary Medicine, Animal Physiology, and Pathology, Animal Nutrition, Zoonotic Diseases, Livestock Management, Wildlife Health and Conservation] Anesthesiology Agriculture Forensic Science
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IN VITRO EVALUATION OF ANTIBIOTIC SYNERGY AGAINST BIOFILM-FORMING PSEUDOMONAS AERUGINOSA ISOLATED FROM POST-CESAREAN SURGICAL SITE INFECTIONS AND ITS MOLECULAR RESISTANCE PROFILE
Background: Biofilm-associated Pseudomonas aeruginosa infections complicate post-cesarean surgical site infections (SSIs) and contribute to treatment failure. Objective: To evaluate antimicrobial susceptibility, disc-diffusion–based synergy of selected antibiotic pairs against biofilm-forming P. aeruginosa, and molecular detection of a carbapenemase gene (blaVIM) and a biofilm-associated gene (pelA). Methodology: This prospective in-vitro study was conducted after the approval of IRB of Azra Naheed Dental College, Superior University, from Aug 25 to Feb 26, on 100 cultured pus swabs from post-cesarean SSIs. Isolates were identified using standard microbiological methods. Biofilm formation was assessed using crystal violet ring assay. Antimicrobial susceptibility testing was done by Kirby–Bauer disc diffusion on Mueller–Hinton agar following CLSI guidance. Synergy testing involved paired discs, 20mm apart, interpreted qualitatively and by an interaction-zone size (≥18 mm) indicating synergy. PCR was used for blaVIM and pelA detection in a subset of biofilm-forming isolates. Results: Seventy-seven (77%) samples were culture-positive, and P. aeruginosa were 32/77 (41.5%), and biofilm was seen in 24/32 (75%). Resistance among P. aeruginosa was high to meropenem (83%) and imipenem (75%), and ciprofloxacin (75%). Among biofilm-forming isolates (n=24), synergy was most frequent with meropenem+gentamicin (22/24, 91.7%) and meropenem+ciprofloxacin (20/24, 83.3%), while cefixime-based combinations reported limited synergy (≤12.5%). blaVIM was detected in 5/8 tested isolates and pelA in 5/8. Conclusions: Biofilm-forming P. aeruginosa was common in post-cesarean SSIs and reported significant resistance to tested antipseudomonal agents. Meropenem combined with gentamicin or ciprofloxacin reported strong in-vitro synergistic activity, indicating further validation using quantitative synergy, biofilm-eradication assays and in-vivo studies.
Antibiotic synergy, Biofilm, Carbapenem resistance, Cesarean section, Pseudomonas aeruginosa, Surgical site infection
PREVALENCE OF HEPATITIS B AND C AMONG THE EMPLOYEES OF SARHAD UNIVERSITY OF SCIENCE AND INFORMATION TECHNOLOGY
Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections pose significant public health challenges worldwide, particularly in Asia. HBV is a double-stranded DNA virus with a high prevalence in Asia, primarily transmitted through blood and body fluids. High-risk groups include individuals undergoing blood transfusions, dialysis, intravenous drug users, and healthcare workers. This cross-sectional study aimed to determine the prevalence of HBV and HCV among employees of Sarhad University of Science and Information Technology, Peshawar. A total of 45 employees, aged 25 years and above, were selected using random sampling. Participants provided informed consent and completed questionnaires capturing demographic and medical history. Venous blood samples were collected, labeled, and transported to the laboratory for testing using the ICT method. Hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) were detected using specific ICT kits. The prevalence rates for HBV and HCV were calculated, and data were analyzed using statistical software. The study found a prevalence rate of 4.44% for HBV and 2.22% for HCV among the sample population, indicating the presence of these infections among university employees. Keywords : Prevalence, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), University Employees
Copyright (c) 2025 Review Journal of Neurological & Medical Sciences Review
ASSOCIATION OF VOLUME AND TYPE OF INTRACRANIAL HEMATOMA WITH MIDLINE SHIFT IN PATIENTS WITH HEAD INJURY ON COMPUTED TOMOGRAPHY
Background: Traumatic brain injury (TBI) is physical injury to brain tissue that temporarily or permanently impairs brain function.It happens when a sudden,external,physical assault damages brain. Objective: To find out association between volume and type of intracranial hematoma with midline shift in patients with head injury on computed Tomography. Methodology: A crosssectional analytical study was conducted at Department of Radiology, LGH Hospital. Data of 55 participants were collected, done by suitable sample method. SPSS version 21.0 was used for data analysis. The inclusion criteria was all adult patients (>15 years) with traumatic hematoma. The exclusion criteria were patients who had any history of previous brain surgery and patients who were already undergoing treatment . Association of volume and type of intracranial hematoma with midline shift in patients with head injury was measured by using Computed Tomography Machine 64 slices Toshiba edition 2002 was used. Results: Out of total number of 55 patients, 35(63.6%) were males and 20(36.4%) were females. Out of all 55 cases Mode of injury was fall in 12(21.8%) and RTA in 43(78.2%) patients, Type of hematoma out of all 55 cases 33(60.0%) patients had epidural hematoma, 1(1.8%) had intracerebral hematoma and 21(38.2%) had subdural hematoma.Side involved in 28(50.9%) patients was right and in 27(49.1%) patients was left. Locations accounted Fronto Parietal for 2 cases (3.6%), "Fronto - Temporal" for 3 cases (5.5%), "Occi - Temporal" for 2 cases (3 .6%), "Occipital" for 10 cases (18.2%), "Parietal" for 5 cases (9.1%), "Parieto - Occipital" for 2 cases (3.6%), "Parieto - Temporal" for 2 cases (3.6%), the highest frequency, 29 cases (52.7%), were observed in Temporal.Out of all 55 cases midline shift was present in 27(49.1%) and was absent in 28(50.9%) patients. Conclusion: Our study was aimed to find out association between volume and type of intracranial hematoma with midline shift in patients with head injury.Patients with traumatic brain injury were more prone to midline shift and epidural hematoma was observed in more cases. Hence the study concluded that there is association between intracranial hematoma with midline shift in patients with head injury on computed tomography.
Epidural Hematoma, Midline Shift, Occipito Frontal and Traumatic Brain Injury, Head Injury, Computed Tomography
INVESTIGATING THE EFFECTS OF PROBIOTIC SUPPLEMENTATION ON COGNITIVE FUNCTION AND MENTAL WELL-BEING IN UNDERGRADUATE STUDENTS
The gut-brain axis is a key to cognitive performance and mental health, and the increasing number of studies points to the possibility of probiotic supplementation to improve neurological performance. This was a randomized controlled trial (RCT) that examined the impacts of a 6-week probiotic intervention on cognitive ability between undergraduate students. They randomly divided 30 subjects into probiotic (treated with Lactobacillus rhamnosus and Bifidobacterium longum, 10 billion CFU/day) and control group. The pre- and post-intervention cognitive performance was measured with the help of Digit Span Test (working memory) and Stroop Test (executive function). Findings indicated that the probiotic group had major improvements in terms of higher scores in Digit Span (forward: p < 0.01, d = 0.85; backward: p < 0.01, d = 0.92) and lower Stroop response time (p < 0.01, d = 0.78). There were no serious side effects, and the adherence was 92. These results indicate that young adults with cognitive benefits of probiotics might be due to microbiota regulation of the gut and neurotransmitter. The fact that there was no placebo group and very small sample size is, however, an opportunity to conduct research that will help confirm the findings in larger, more long-term research.
Probiotics, executive function, Gut-brain axis, working memory, undergraduate students, cognitive function
PREVALENCE OF UROPATHOGEN AND ANTIBIOTIC SUSCEPTIBILITY PROFILE OF UROPATHOGEN ISOLATED FROM URINE AT TERTIARY CARE HOSPITAL PESHAWAR
Urinary tract infection (UTI) is one of serious health problem and should be address on urgent basis. It is one of important cause of prolong stay of patients in hospitals and economic burden on society. UTI primarily affects the Urinary tract; along other parts of body. This was descriptive crossectional study conducted at Khyber Teaching Hospital Peshawar, Pakistan design to determine the prevalence of Uropathogen in district Peshawar, Pakistan and to find out the antibiotic susceptibility profile of uropathogen. Total 131 Urine samples were collected from both male and females of all ages group who presents clinical sign and symptoms of urinary tract infection while antibiotic prophylaxis patients and patients who were unable to give sample excluded from the current study. Out of these 131 UTI patients there were 51 confirmed cases including 35 female and 21 males having mean age between 1-35 years were more effected as compared to other age group. AST profile showing that the most resistance antibiotic was Cefiod and most Sensetive antibiotic was amikacin against bacteria. From the current it was concluded the study showed that UTIs are the leading public-health problem mainly in women. In our study, the predominant isolated organisms responsible for UTI in Pakistan were E. coli, Citrobacter and Morganella. The majority of isolates were resistant to commonly prescribed antibiotics. Therefore, routine monitoring and surveillance are crucial for the better management of patients. Keywords : UTI, Antibiotic, AST, Prevalence, Sensetive, Resistance
SCREENING OF BACTERIURIA IN ASYMPTOMATIC UNDERGRADUATE STUDENTS OF SARHAD INSTITUTE OF ALLIED HEALTH SCIENCES, PESHAWAR
Urinary tract infections (UTIs) are among the most common bacterial infections worldwideand often caused by Escherichia coli, Klebsiella, Staphylococcus, Enterococcus, and Enterobacter species. They present a significant health burden, ranging from mild cystitis to severe pyelonephritis, and are complicated by the emergence of antimicrobial resistance due to the widespread and inappropriate use of antibiotics. A descriptive cross-sectional study was conducted at the Sarhad Institute of Allied Health Sciences, Peshawar, from April to July 2025. A total of 52 undergraduate students, selected through convenience sampling were enrolled. Midstream urine samples were collected and urine routine examination was done at lab of Sarhad Institute of Allied Health Sciences. Those samples which were positive for bacteria are then cultured on CLED and MacConkey agar for the isolation and identification of uropathogens using standard biochemical tests and Gram staining.Out of 52 enrolled students the male and female ratio was equal with the majority aged 18–22 years. Bacterial growth was detected in 4 (7.7%) urine samples and all of the positive samples belong to female participants. Our finding indicated that females having more chances of bacteriuria although they are asymptomatic as compared to male in our study population. Keywords : Uropathogens; Prevalence; Asymptomatic Bacteriuria; Undergraduate Students.
THE ACCURACY OF SELF-ADJUSTABLE ADLENS AGAINST THE AUTO REFRACTOR RESULTS AND THE EFFECTS OF THESE SPECTACLES ON THE BINOCULAR VISION
Adlens adjustable eyeglasses are constructed for use as a short term or supplementary pair of glasses. The power of the lenses can be adjusted from -6 to +3 diopters. There were 25 subjects aged between 18 to 35 years. All the participants had refractive errors were between the range of -6 to +3 D. There was no history of any ocular disease in any of the participants. The maximum amount of astigmatism in all the participants was not more than 2 D. Visual acuity was recorded binocularly and monocularly for both eyes. Phoria was measured using Maddox rod for distance and near and fixation disparity was also tested. Autorefraction based prescription was set in a trial frame and visual acuity and binocular tests were carried out in the same way. All the examinations were done randomly and the power of Adlens was assessed using a focimeter. The MSE for the right eye with both methods of refraction had a mean difference of -0.01 with standard deviation of ±0.46. The MSE for the left eye was -0.22 with standard deviation of ±0.43. The mean difference for J0 right eye was -0.03 with ±0.44 SD. The mean difference for J0 left eye was 0.04 with ±0.18 SD. The mean difference of J45 for right eye was -0.14 with ±0.17 SD. J45 left eye mean difference was 0.23 with ±0.19 SD. Similarly, binocular visual acuity mean difference was 0.06 with ±0.07 SD. Mean difference in VA for right eye was 0.05 with ±0.07 SD and for left eye mean difference was 0 and ±0.08 SD. Bland Altman plots were created for all the variables regarding the two methods of refraction with 95% confidence interval. Keywords: Self-adjustable Adlens, binocular vision, auto refractor
Copyright (c) 2026 Review Journal of Neurological & Medical Sciences Review
NOVEL THERAPEUTIC PROTEIN TARGETS IDENTIFICATION IN ANAPLASMA PHAGOCYTOPHILUM IN POST-GENOMIC ERA
Anaplasma phagocytophilum, a Gram-negative obligate intracellular bacterium causing human granulocytic anaplasmosis (HGA), necessitates the development of targeted interventions due to its non-specific clinical presentation and potential morbidity. This study utilized in-silico reverse vaccinology and subtractive genomics to identify conserved vaccine and drug targets across multiple A. phagocytophilum strains. Comparative genomic analysis of five A. phagocytophilum strains identified a core genome of 1007 genes. Subsequent non-host homology filtering against host genomes yielded 726 potential targets. Prioritization based on gene essentiality narrowed the selection to 21 candidates, which were further characterized for cellular localization, functionality, and structural properties via 3D modeling. Druggability assessment was performed on the modeled structures of conserved, essential, and non-host homologous proteins.In-silico screening revealed three promising targets: 30S ribosomal protein S10, 2,3-bisphosphoglycerate-independent phosphoglycerate mutase, and biotin synthase. These proteins exhibited high conservation across analyzed strains, demonstrated essentiality for bacterial viability, and lacked significant host homology. Structural modeling and druggability analysis suggest their potential as effective targets for novel drug and vaccine development against A. phagocytophilum.
NOVEL THERAPEUTIC PROTEIN TARGETS IDENTIFICATION IN ARCOBACTER CRYAEROPHILUS IN POST-GENOMIC ERA
Arcobacter cryaerophilus, a gram-negative, curved or helical bacillus primarily known as a bovine and porcine pathogen. Arcobacter cryaerophilus is found in the gastrointestinal tract of healthy animals such as poultry, pigs, sheep and sheep, but is associated with enteritis in animals and may play a pathogenic role in reproductive disorders in cattle, pigs and sheep. Arcobacter transmission to humans is mediated by contaminated foods and water, and poultry products act as an important reservoir. Here, we applied a reverse vaccinology and subtractive genomic approach for in silico prediction of potential vaccines and drug targets for seven strains from the A. cryaerophilus species. Next, the core genome (942) was predicted, followed by non-host homology analysis, resulting in 662 target proteins. By screening for essential genes, 35 genes can be obtained. After screening for essential genes, we also checked their intracellular localization, functionality, structural modeling, and protein-protein interactions. 6 proteins (Tryptophan synthase alpha chain, Homoserine kinase, Anthranilate phosphoribosyl transferase, Tryptophan synthase beta chain, Imidazole glycerol phosphate synthase subunit HisF and Phenylalanine-tRNA ligase beta subunit beta chain) are considered highly conserved non-host essential homologues with 3D modeled structures and were further subjected to druggability analysis, followed by toxicity factors prediction. The proposed approach facilitates the study of putative targets for selected Arcobacter species for the development of a broad spectrum of new drugs and vaccines based on experimental validation. Keywords: Arcobacter Cryaerophilus, Post-Genomic Era and Reverse Vaccinology
HEMATOLOGICAL PARAMETERS AS INDICATORS OF DENGUE SEVERITY: A CROSS-SECTIONAL ANALYSIS AT KTH, PESHAWAR
Dengue fever is a mosquito-borne viral infection that significantly affects hematological parameters, often leading to complications such as thrombocytopenia and hem concentration. This study aimed to assess hematological profiles in dengue patients admitted to Khyber Teaching Hospital (KTH), Peshawar, and to compare variations across gender. A simulated dataset comprising 60 confirmed dengue patients (30 males and 30 females) was analyzed. The mean age of participants was 43.8 ± 14.6 years. Males exhibited higher mean hemoglobin (Hb) levels (15.1 ± 1.1 g/dL) compared to females (13.6 ± 1.0 g/dL), and higher red blood cell (RBC) counts (5.21 ± 0.38 ×10¹²/L vs. 4.64 ± 0.31 ×10¹²/L). White blood cell (WBC) and platelet counts remained within reference ranges for most cases; however, platelet counts showed a downward trend in several patients, consistent with dengue-associated thrombocytopenia. Statistical analysis revealed significant gender differences in Hb and RBC counts (p < 0.05), while WBC, platelet, and red cell indices showed no significant variation. These findings highlight the importance of routine hematological monitoring in dengue management, as early detection of abnormal trends can guide timely clinical interventions and reduce the risk of severe complications
INFLUENCE OF EXCESSIVE USAGE OF ANDROID SMARTPHONES ON ULNAR NERVE COMPRESSION SYMPTOMS AMONG PHYSIOTHERAPY STUDENTS OF ALLIED HEALTH SCIENCES
Objective: To determine the influence of excessive Android Smartphone usage on Ulnar Nerve Compression Symptoms among physiotherapy students. Methodology: Cross‑sectional study among 125 physiotherapy students aged 20–25 years using a structured questionnaire. Data analyzed using SPSS with Chi‑square tests. Results: Students using Android Smartphones more than 6 hours daily showed higher prevalence of symptoms including numbness in the fourth and fifth fingers, hand weakness, and elbow discomfort (p < 0.05). Conclusion: Excessive Android Smartphone use is associated with Ulnar Nerve Compression Symptoms. Ergonomic education and limiting screen time are recommended.
Android Smartphone usage, Ulnar nerve compression, Cubital tunnel syndrome, Physiotherapy students, Android Smartphone addiction
ASSOCIATION OF SLEEP QUALITY AND PSYCHOLOGICAL DISTRESS WITH FUNCTIONAL ABILITY IN PATIENTS WITH CHRONIC SPINAL CORD INJURY: A CROSS SECTIONAL STUDY AT PARAPLEGIC CENTRE, PESHAWAR
Objectives: Spinal cord injury (SCI) is a severe disorder that causes severe physical, psychological, and socioeconomic disabilities. The spinal cord is the primary channel of communication between the brain and the body and injuries to this portion interfere with the motor, sensory, and reflex activities. Over 200,000 individuals (primarily young males) are affected by spinal cord injury (SCI), with increasing survival rates at the cost of substantial lifelong disability and economic burden. This highlights the fact that there is a dire need of effective treatments. Methodology: A cross-sectional study that was descriptive was carried out in the Paraplegic Center Peshawar within a period of six months. Cumulative sampling was applied to recruit eighty-three patients with chronic incomplete spinal cord injury. The data were gathered via interviews with the help of standardized measures: Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale (DASS-21), and Modified Barthel Index. The statistical analysis was done on SPSS version 26 and the relative tests that were applied to measure associations were non-parametric tests. Results: In 83 participants, it was found that poor sleep quality and greater psychological distress had significant association with less functional ability (p < .001) with moderate to large effect sizes, which suggests a significant effect on functional independence. Conclusion: The quality of sleep and psychological distress relates much with functional ability among chronic persons of spinal cord injury. Functional independence and the suggested quality of life can be enhanced by tackling sleep issues and mental distress.
Spinal cord injury, sleep quality, psychological distress, functional ability, rehabilitation
A COMPARISON OF BOWEN AND GRASTON TECHNIQUE IN PATIENTS OF TENSION NECK SYNDROME
Visual display terminal syndrome (VDTS) is increasingly common, with tension neck syndrome (TNS), characterized by myofascial pain and muscle adhesions causing localized hypoxia, being a prevalent manifestation. This randomized single-blinded trial compared the effects of Graston versus Bowen's soft tissue techniques on pain, cervical range of motion (ROM), and disability in 30 participants (aged 20–45, both genders) with VDTS-induced TNS and device usage >2 hours/day. Excluding those with radiculopathy, malignancy, surgery, or systemic conditions, participants received treatment three times weekly for two weeks, with outcomes assessed via NPRS (pain), NDI (disability), and goniometry (cervical ROM). Mixed ANOVA showed significant time interactions for disability and cervical ROM, but not pain (p<0.05); within-group analysis revealed both techniques equally reduced neck pain, while the Graston group demonstrated markedly greater gains in cervical flexion (mean difference: 10.0°) and disability reduction (mean difference: 9.133). In summary, although both interventions improved pain, function, and mobility in TNS patients, Graston technique proved more effective than Bowen's for enhancing cervical range of motion and reducing functional disability
Instrument-assisted soft tissue mobilization
CHARACTERIZATION AND ANTIMICROBIAL ACTIVITY OF ZINC NANOPARTICLE SYNTHESIZED FROM SOIL BACTERIAL ISOLATES
Zinc (Zn) nanoparticles have piqued the interest of researchers all over the world due to their numerous potential as antibacterial and antifungal compounds in biomedicine and agriculture. Green nanotechnology has developed as an important approach for the fabrication and production of Zn nanoparticles in recent years. Bacteria have unrivalled capability to convert zinc ions into nanoparticles, which make them the best candidate for the synthesis of Zn nanoparticles because of their rapid growth rates and ease of handling. Therefore, this study was performed to characterize and evaluate the anti-microbial activity of zinc nanoparticles synthesized from soil bacterial isolate. Three different bacteria, J-1, J-2 and J-3 were found in the soil sample. A single bacteria i-e., J-2 with isolated colonies was selected from them and subjected to further processing and later on identified as Serratia nematodiphila through biochemical tests and sequencing. The Zn nanoparticles were prepared by mixing zinc sulphate stock solution with the bacterial supernatant culture and incubated in the dark in shaking incubator for 3-5 days. After incubation, the appearance of white color precipitate indicated the successful formation of Serratia-nematodiphila mediated Zn nanoparticles. The nanoparticles were further analyzed via UV-Vis, XRD, FT-IR, SEM and TEM analysis. The nanoparticles were pure, spherical, polydispersed and crystalline in nature. The nanoparticles ranged in size from 17 nm to 28 nm with an average size of 24.74 nm. The FTIR values for the synthesized Zn nanoparticles were 510, 620, 880, 1430, 1600, 2400, 3100, 3350, 3600 and 3700 cm -1. The highest peaks formed ranged from 3100 to 3700 cm -1. Weak peak was formed at 2400 cm -1, whereas, medium peak was observed at 1430 and 1600 cm -1. The maximum SPR was found at 379 nm. The nanoparticles showed antibacterial activity and antifungal activity against S. aureus, E. coli, Sporothrix schenkii and Aspergillus fumigatus, respectively at a concentration of 100 µg/mL and 75 µg/mL, respectively. The zones of inhibitions were reduced with the decrease in nanoparticles concentrations. Hence, according to the findings of the preceding investigations the bacteria-synthesized Zn nanoparticles have a strong antibacterial and antifungal potential. Keywords : Aspergillus fumigatus, FT-IR, Serratia-nematodiphila, Sporothrix schenkii, Zn nanoparticles.
PREVALENCE AND MULTIDRUG RESISTANCE PROFILING OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) ISOLATED FROM CLINICAL SPECIMENS IN TERTIARY CARE HOSPITALS OF PESHAWAR
Background: Methicillin-resistant Staphylococcus aureus (MRSA) remains a critical challenge in clinical settings due to its extensive multidrug-resistance profiles. This study aimed to isolate, identify, and determine the antibiotic susceptibility patterns of MRSA strains obtained from various clinical wards at Lady Reading Hospital (LRH) and Khyber Teaching Hospital (KTH) in Peshawar, Pakistan. Methodology: Clinical samples were processed using the spread plate technique on Nutrient Agar. Suspected colonies were subjected to Gram staining and a battery of biochemical tests, including catalase, coagulase, methyl red, and urease assays. MRSA confirmation was performed using Oxacillin and Methicillin resistance tests, alongside Cefoxitin (30 μg) disc diffusion as per Clinical and Laboratory Standards Institute (CLSI) guidelines. In vitro antibiotic susceptibility against ten different therapeutic agents was evaluated using the Kirby-Bauer disc diffusion method. Results: Out of 25 initial suspected S. aureus isolates, 5 strains (20%) were confirmed as MRSA. All five confirmed strains (LRH-01, LRH-07, LRH-11, KTH-04, and KTH-09) were Gram-positive cocci and exhibited positive reactions for catalase, coagulase, methyl red, and beta-hemolysis. The antibiogram revealed significant resistance across multiple antibiotic classes. High levels of resistance were observed against Minocycline (80%), Cefotaxime (80%), Aztreonam (60%), and Azithromycin (60%). Conversely, the isolates demonstrated higher sensitivity toward Cefixime, Amikacin, and Ciprofloxacin. Notably, only one strain showed complete resistance to Cefixime and Amikacin, suggesting these may remain viable treatment options in local clinical settings. Conclusion: The study identifies a 20% prevalence of MRSA among suspected staphylococcal clinical isolates in the region. The high resistance to commonly used antibiotics like Cefotaxime and Azithromycin underscores the necessity for regular antimicrobial surveillance and the implementation of stringent infection control policies to manage the spread of resistant strains in tertiary care hospitals. Keywords : MRSA (Methicillin-Resistant Staphylococcus aureus)Antibiotic Susceptibility, Antibiogram, Clinical Isolates,Multidrug Resistance (MDR)
GREEN SYNTHESIS, CHARACTERIZATION, AND BIOEVALUATION OF SALVIA OFFICINALIS SILVER NANOPARTICLES FOR ALZHEIMER'S DISEASE THERAPY
Alzheimer's disease (AD) is a progressive neurodegenerative disorder with limited therapeutic options, necessitating the development of safer and more effective alternative treatments. This study focused on the green biosynthesis, characterization, and in vitro biological evaluation of Salvia officinalis-derived silver nanoparticles (AgNPs) as a potential therapeutic approach for Alzheimer's disease. Aqueous leaf extract of S. officinalis served as both reducing and stabilizing agent for the synthesis of AgNPs from 1 mM silver nitrate solution. Successful nanoparticle formation was visually confirmed by color change to dark brown within 30-60 minutes. Comprehensive physicochemical characterization revealed spherical, uniformly dispersed nanoparticles with a mean hydrodynamic diameter of 20-22 nm and a polydispersity index (PDI) of 0.154, indicating excellent monodispersity. Scanning Electron Microscopy (SEM) confirmed smooth, spherical morphology with uniform surface coverage. Zeta potential analysis showed a narrow symmetrical distribution range of -20 mV to +20 mV, demonstrating colloidal stability. Fourier Transform Infrared (FTIR) spectroscopy identified key functional groups including O-H/N-H stretching (2500-3500 cm⁻¹), C=C aromatic ring stretching (1400-1600 cm⁻¹), and C-O stretching vibrations (1000-1200 cm⁻¹), confirming the involvement of phenolic compounds, flavonoids, and proteins in nanoparticle capping and stabilization. Biological evaluation demonstrated potent antioxidant activity with DPPH radical scavenging of 65.50 ± 4.20% and FRAP reducing power of 1550 ± 40.41 μM Fe²⁺ equivalents, exhibiting strong concentration-dependent activity (R² = 0.9572). The nanoparticles also displayed significant acetylcholinesterase (AChE) inhibitory activity in a dose-dependent manner, reaching 89.9 ± 1.2% inhibition at 650 μg/mL, comparable to the standard drug donepezil (98.9 ± 0.7%). These findings demonstrate that Salvia officinalis-derived AgNPs possess stable physicochemical properties, robust antioxidant capacity, and potent AChE inhibitory activity, establishing their potential as a promising nanotherapeutic platform for Alzheimer's disease management. Further in vivo studies and clinical optimization are warranted to validate their therapeutic efficacy.
SOCIOECONOMIC, MATERNAL, AND CHILD-LEVEL DETERMINANTS OF UNDERNUTRITION AMONG CHILDREN UNDER FIVE YEARS IN SELECTED DISTRICTS OF PUNJAB, PAKISTAN: A CROSS-SECTIONAL STUDY
Background: The problem of child under nutrition has been one of the most significant problems in the context of low and middle income countries such as Pakistan. Punjab, the largest Pakistani province has severe socioeconomic and regional inequalities, which affect nutritional outcomes of children. This paper was to investigate the socioeconomic, maternal, child-related, and environmental factors of stunting, underweight and wasting in children under the age of five years in sample districts in Punjab. Methods: A cross-sectional study involving analysis was done on 3,200 children aged 059 months who were living in Lahore, Faisalabad, Multan, Bahawalpur and Rawalpindi. The data were gathered with the help of household-based survey based on the use of standardized questionnaires and anthropometric measurements. The definition of stunting, underweight and wasting was based on the World Health Organization growth standards. The independent determinants of each nutritional outcome were identified by multivariable logistic regression models and adjusted odds ratios with 95 per cent confidence intervals were presented. Findings: Stunting, underweight and wasting were found to occur at 29.6, 23.1 and 8.9 percent, respectively. The best predictors of stunting and underweight were household poverty and low maternal education. The all kinds of undernutrition were significantly correlated with small birth size and short intervals of birth. In terms of age, exclusive breastfeeding deficiency analysis indicated that it was a major factor in underweight in infants, but scanty dietary diversity played a bigger role in older children. Wasting was mainly correlated with such acute factors as recent illness, unclean drinking water, incomplete immunization, and absence of skilled birth attendance. Implications: The complex of socioeconomic deprivation, maternal features, early-life influences, and environment conditions contribute to child undernutrition in Punjab, which points to the necessity of interventions based on age and complexity of causes.
DIETARY INTERVENTIONS AS A CORNERSTONE OF DIABETES CARE
Diabetes Mellitus, a Type 2 is considered the most common disease that is rising around the world. It is most complex metabolic disease that is manifested by a long-term hyperglycemia. The multifactorial origin of Type 2 diabetes mellitus is complicated and is related to Irremediable determinants such as age, progeny, ethnicity, and genetics and is also related with remediable determinants like dietary patterns, physical exertion, and tobacco smoking. It emphasizes the need for efficacious, adherable lifestyle changes, affordable and feasible clinical interventions. The objectives of narrative review article are to evaluate several studies to investigate relationship of type 2 diabetes mellitus with dietary pattern practices and its comorbidities. The significant risk factor for progressing comorbidities is the elevated of HbA1C level, Overweight, physical inactivity, Obesity, High intake of saturated fat, trans fat, and intrauterine growth retardation. It is possible that through diet management like Omega-3 Fatty acid rich diet, low GI food intake, and precision dietary management interventions used to improve optimization of raised HbA1C level, normalize glycemic status, glycemic control, and maintenance of weight loss. Thus, patients could be getting rid of developing the comorbidities. To give awareness about dietary knowledge, attitude, practices lead to control of disease complications. This review can collect evidence on the effects of diet like low carb diet, keto diet, Vegan diet, Mediterranean diet, and usage of complex carbs, high fiber, protein diet which can increase eating of fullness. It can help to improve the Glycemic control, weight loss, long term comorbidities, patient concordance, tolerability, and satisfaction. Based on evidence regarding diet, lifestyle, normal weight status, regular physical activity, prevent abdominal obesity, metabolic dysfunction, reduce saturated fats, Trans fat intake, and decrease risk of Diabetes mellitus of type 2.This review article tells how a regular intake of such food act as metabolic booster’s results in postprandial glucose surges that causes hyperinsulinemia; disrupt insulin sensitivity, increase insulin resistance, obesity and metabolic disorders.
DIETARY FIBER AND ITS ROLE IN PREVENTION OF OBESITY AND CHRONIC DISEASES
Dietary fiber (DF) is an essential element of factory- grounded foods and exists in answerable and undoable forms. It promotes health through several mechanisms, including the product of short- chain adipose acids by colonic microbiota, regulation of gut hormones, and enhancement of lipid and glucose metabolism. Advanced input of Dietary fiber (DF) is associated with a reduced threat of obesity, type 2 diabetes mellitus, and cardiovascular complaint. Substantiation regarding its part in colorectal cancer and seditious bowel complaint remains limited or inconclusive. Adding the input of fiber-rich foods similar as whole grains, fruits, vegetables, and legumes provides a practical and cost-effective approach to precluding habitual conditions. Obesity is a major global health concern and a well- known threat factor for diabetes, cardiovascular complaint, and certain cancers. Dietary fiber (DF) supports weight operation by decelerating digestion, altering nutrient immersion, and adding malnutrition. Both answerable and undoable filaments have shown salutary goods on weight reduction in fat and fat individualities. Whole grains and high- fiber diets also supply bioactive composites, including vitamins, minerals, antioxidants, and resistant bounce, which contribute to metabolic balance. Epidemiological and interventional studies largely support the part of DF in perfecting insulin perceptivity, regulating blood glucose, and promoting cardiovascular health. Despite these benefits, DF exploration faces limitations similar as short follow- up ages, tone- reported salutary data, and variability in fiber type and source. Nonetheless, adding DF input remains a dependable, substantiation- grounded strategy to reduce obesity and related habitual conditions. Unborn studies should concentrate on specific fiber fragments, mechanisms of action, and long- term issues.
EFFECTS OF A TEAMWORK INTERVENTION ON VOLLEYBALL-SPECIFIC PERFORMANCE: A RANDOMIZED TRIAL
Interventions based on teamwork have been receiving the growing interest of sport psychology as means of increasing attentional regulation, emotional regulation, and stability of performance in the presence of competition. This paper has discussed the impact of an eight-week team-based intervention on technical performance of university level female volleyball players on volleyball specific performance. Randomly chosen were twenty-eight volleyball players between the ages of 18-22 years (n = 14) who were exposed to experimental group, with 14 players who received 30-35 minutes of teamwork intervention per day followed by regular volleyball training, or control group with 14 players who only received regular volleyball training. The load during training was normalized to groups and observed to ensure homogeneity. The performance in volleyball was measured prior to and after the intervention using the standardized skill test battery, which comprised of forearm pass, overhead pass, serve, spike, and block accuracy measures. The experimental group showed much more improvements in the overall technical performance than the control group. The greatest improvement in performance was recorded in serves and spike accuracy. The findings show that teamwork-based training can be used as a complementary method of training in volleyball, particularly in technical and physical training, to facilitate skill performance and consistency in the field.
Mindfulness Meditation Training for Sport volleyball
NEUROMODULATION IN BRAIN FUNCTIONAL DISORDERS: TECHNOLOGICAL FRONTIERS, CLINICAL PARADIGMS, AND THE FUTURE OF NEURAL CIRCUIT INTERVENTIONS: A NARRATIVE REVIEW
Introduction Neurological disorders affect over 3 billion people globally and represent the leading cause of disability and mortality worldwide. Conventional pharmacotherapies often fail in treatment-resistant cases, necessitating innovative circuit-based interventions. Neuromodulation, including deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), spinal cord stimulation (SCS), vagus nerve stimulation (VNS), and responsive neurostimulation (RNS) has emerged as a transformative therapeutic paradigm for brain functional disorders. Methods This narrative review synthesizes recent clinical trials, systematic reviews, and technological advancements (2024–2026) in invasive and non-invasive neuromodulation. Emphasis was placed on adaptive closed-loop systems, personalized targeting strategies, waveform innovations, and integration of artificial intelligence (AI) in therapeutic modulation across movement disorders, depression, chronic pain, epilepsy, and systemic inflammatory conditions. Results Adaptive DBS demonstrated significant improvements in “on” time without dyskinesia and reduced energy consumption compared to conventional stimulation. Functional magnetic resonance imaging (fMRI) guided TMS improved response rates in treatment-resistant depression (77.5% vs. 62.2% with standard targeting). Closed-loop SCS using Evoked Compound Action Potential (ECAP) sensing provided stable pain control, while novel waveforms such as Differential Target Multiplexed (DTM) enhanced modulation of neuron–glial interactions. Non-invasive VNS showed promising anti-inflammatory and analgesic effects. In epilepsy, RNS achieved progressive seizure reduction up to 75% over long-term follow-up. AI-driven closed-loop systems and neuromorphic computing enabling real-time signal decoding and personalized stimulation adjustments. Conclusion Neuromodulation is transitioning from static, symptom-based therapy to precision, adaptive circuit intervention. Integration of closed-loop technology and AI promises improved efficacy, reduced adverse effects, and expanded indications. Ensuring equitable access and ethical oversight will be essential as these technologies redefine the future of brain disorder management.
PARENTING FEEDING STYLES, FEEDING CONTROL PRACTICES IN RELATION TO PSYCHOPATHOLOGY AMONG MIDDLE AGED CHILDREN
This study investigates the relationship between parental feeding styles, feeding control, and psychopathology in middle-aged children with diagnosed psychopathologies. Using a correlational research design, data were collected from 80 parents of children aged 6-12 years from special education institutes in Lahore, employing purposive sampling. Three primary assessment tools were utilized: the Parenting Feeding Style Questionnaire (PFQ), the Child Feeding Questionnaire (CFQ), and the Child Behavior Checklist (CBCL) each demonstrating high reliability. The analysis revealed significant correlations between parental feeding styles and both feeding control and psychopathology. Instrumental feeding was positively related to feeding control and psychopathology. Hierarchical regression analysis indicated that demographic variables explained (11.5%) of the variance in psychopathology, with parental feeding styles adding an additional (20.5%). Instrumental and encouragement feeding styles were significant predictors, though feeding control did not significantly improve the model. Mediation analysis revealed that feeding control partially mediates the relationship between instrumental and encouragement feeding styles and psychopathology, suggesting that feeding control significantly contributes to the observed psychopathological outcomes. The findings highlight the complex interplay between parental feeding practices and child psychopathology, emphasizing the need for targeted interventions that address feeding styles and control mechanisms to potentially mitigate psychopathological symptoms in children.
PREVALENCE AND DETERMINANTS OF FEMALE SEXUAL DYSFUNCTION AMONG TYPE 2 PATIENTS OF DIABETES IN HYDERABAD, PAKISTAN: A CROSS-SECTIONAL STUDY
The purpose of this study was to identify the prevalence and associated risk factors of female sexual dysfunction (FSD) in women with Type 2 diabetes mellitus (T2DM) in Hyderabad, Pakistan. This cross-sectional analytical survey was conducted among 170 married women who were registered in outpatient clinics for T2DM at a hospital in Hyderabad. A standardized questionnaire was used as the primary means of collecting demographic and clinical information about each participant, as well as using the FSFI test to screen for sexual dysfunction; the Patient Health Questionnaire (PHQ) to assess depressive symptoms; and recent HbA1c levels to determine glycemic control. Multiple logistic regression analyses were conducted to examine the association between participant characteristics and sexual dysfunction. The overall prevalence of FSD among the study population was 62.9%. The FSFI domain with the most dysfunction was sexual desire (69.2%), followed by arousal (64.5%); the least dysfunctional domain was pain (38.3%). Significant predictors of FSD identified by multivariable analysis were: age of ≥40 years (AOR = 1.97; 95% CI, 1.10-3.54), diabetes duration of ≥5 years (AOR = 1.76; 95% CI, 1.01–3.08), glycemic control of (HbA1c ≥7.0%) (AOR = 2.21; 95% CI, 1.25-3.92), diabetic complications (AOR = 1.88; 95% CI, 1.05–3.36) and depressive symptoms (AOR = 2.67; 95% CI = 1.42-5.01). Additionally, women who had completed secondary education or higher were less likely to have FSD (AOR = 0.58; 95% CI, 0.33-0.99).
Female sexual dysfunction; Type 2 diabetes mellitus; Education; Prevalence; Determinants; Pakistan
ASSESSMENT OF BREAST CANCER AWARENESS AMONG NON-MEDICAL STUDENTS In Peshawar
Introduction: Breast cancer is the second leading cause of death for women globally, affecting millions and presenting a substantial health challenge. Early detection is crucial to reducing mortality, yet limited awareness of symptoms and risk factors often leads to delayed diagnosis. This challenge is especially pronounced in developing countries, where restricted access to healthcare and information results in more advanced-stage diagnoses and poorer patient outcomes. Objective of our study is to assess the level of knowledge, attitudes, and awareness about breast cancer among non-medical students, identify gaps in understanding about early detection methods, symptoms, risk factors, and preventive measures, and inform future educational interventions. Methodology: A descriptive cross-sectional study was carried out in Peshawar with 369 participants using convenience sampling and a structured questionnaire to assess breast cancer knowledge and awareness. SPSS version 26 was used for data analysis, with findings presented in tables and charts for clarity. Result: This study of 369 non-medical students revealed substantial breast cancer awareness, with 89.4% having heard of it and 77.8% acknowledging its prevalence in Pakistan. While 60.7% recognized hereditary risk factors, only 37.4% were aware of breast self-examination (BSE), and only 20.6% performed it. Although only 29.3% were aware of lump palpation, 85.9% expressed an interest in learning more about breast cancer prevention. Screening preferences revealed 62.9% favoring ultrasonography, underlining the need for increased breast health education. Conclusion: School children show minimal risk factor awareness, low BSE involvement and preferred ultrasound over mammography. College students had moderate, higher BSE practice and familiarity with ultrasonography. University students were the most knowledgeable about BSE, risk factors and clinical screening tools.
Breast Cancer Gene 1 and Breast Cancer Gene 2
A SYSTEMATIC REVIEW OF COUMARINS, ITS USE, BIOAVAILABILITY AND INTERACTION WITH PHARMACOLOGICAL ACTIVITIES
Coumarins are one of the most important classes of heterocycles that occupies prime position in synthetic and pharmaceutical chemistry due to their diverse applications. The Tonka bean, which was first isolated in 1820, gave rise to the French word "coumarou," which gave rise to the name "coumarins". All coumarins are members of the benzopyrone family, which is made up of benzene rings connected to pyrone rings. The benzopyrones can be subdivided into the benzo-alfa-pyrones to which the coumarins belong and the benzo-gama-pyrones. Since there aren't many studies on coumarin bioavailability, more research is required to examine the bioavailability of several coumarins that have previously shown strong biological activity. Many medicinal plants are source of coumarin. Coumarins, found in a variety of plants from different biodiversity regions. We will try to enumerate the natural coumarin compounds here, along with their occurrence, abundance and potential for use as pharmacological treatments. The biosynthesis of coumarin is related to the higher plants. However, it was also found that several microorganisms such as fungi and bacteria may produce coumarin compounds through specific metabolic routes. Natural coumarins shows a wide spectrum of pharmacological activities including anti-inflammatory, anticancer, antioxident, antiviral and Alzheimer’s disease inhibition.
KNOWLEDGE, ATTITUDE AND PRACTICE OF ARTIFICIAL INTELLIGENCE AMONG UNDERGRADUATE NURSING STUDENTS AT KARACHI
Introduction/Background: The study was shown to assess the knowledge, attitude, and practice of artificial intelligence (AI) among undergraduate nursing students in Karachi, recognizing the growing role of AI in improving healthcare efficiency and decision-making. Method: A cross-sectional design was used, and data was collected from 195 BSN students across all four years at Jinnah College of Nursing and Ilmiya College of Nursing via structured questionnaire, with analysis performed in SPSS version 25. Results: The findings showed that although maximum students had a basic understanding of AI (80.5%), fewer demonstrated knowledge of machine learning and deep learning (46.7%) or AI applications in healthcare (47.7%). Male students exhibited higher knowledge levels than females. Attitudes toward AI were mostly positive, with over 81% agreeing that AI was essential in nursing practice, while opinions were mixed regarding whether AI possibly will replace nurses in the future. Only 41.5% had previously used AI tools, yet a majority (83.6%) expressed willingness to apply AI in their future practice. Conclusion: The study concluded that nursing students influenced limited detailed knowledge and minimal practical experience with AI despite showing favorable attitudes toward its use. It was suggested that nursing curricula be strengthened with AI-related content, supported by awareness programs and hands-on training, to better prepare future nurses for evolving technological advancements in healthcare
THE EFFECT OF BODY AWARENESS THERAPY ON BALANCE AND COORDINATION IN STROKE
Stroke represents a significant global health burden with approximately 13.7 million annual cases, often resulting in neurological damage that compromises sensorimotor control, balance, and cognition. To address these deficits, this Randomized Controlled Trial evaluated the impact of Body Awareness Therapy (BAT), a mind-body physiotherapeutic intervention, on stroke survivors. Twenty-six participants were recruited via convenience sampling and randomly allocated into experimental (n=13) and control (n=13) groups using the sealed envelope method; both groups underwent conventional physical therapy for two weeks (five days per week), with the experimental group receiving additional BAT. Outcome measures included the Berg Balance Scale, Mini-Mental State Examination, and coordination tests. While both groups demonstrated improvements from baseline, between-group analysis revealed no statistically significant difference in balance or coordination; however, the experimental group showed a statistically significant improvement in cognitive function compared to the control. Consequently, while the addition of BAT to conventional rehabilitation did not significantly enhance balance or coordination over the two-week period, the findings suggest it demonstrates a positive and significant effect on cognitive function in stroke patients.
Body Awareness Therapy; Stroke; Cerebrovascular Accident; Balance; Coordination; Cognition; Randomized Controlled Trial; Rehabilitation
INTENSIVE EXERCISE THERAPY ON FUNCTION AND QUALITY OF LIFE IN PATIENTS WITH TOTAL KNEE REPLACEMENT
Background: Total Knee Replacement (TKR) is a common orthopaedic procedure aimed at relieving pain and restoring function in patients with severe knee osteoarthritis. Postoperative rehabilitation is crucial for optimizing patient outcomes. However, the comparative efficacy of routine physical therapy (RPT) versus intensive exercise therapy (IET) in the postoperative recovery phase remains under-explored. Objective: To evaluate the intensive exercise therapy compared to routine physical therapy on function and quality of life in patients following TKR. Methods: A Randomized Controlled Trial was conducted at the Department of Hidayat Physiotherapy and Rehabilitation Centre in Sukkur. The study spanned 9 months following the approval of the synopsis. Initially, the study was designed to include 58 participants across both groups. However, considering the likelihood of dropouts, an additional 20% was factored in, raising the total to 70 participants, with each group comprising 35 individuals. Intervention efficacy was assessed using the Oxford Knee Score (OKS), SF-12 Physical and Mental Component Summary scores, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) across various domains at baseline, 6 weeks, and 12 weeks postoperatively. Statistical analysis employed the Mann-Whitney U test for between-group comparisons and Chi-square tests for within-group changes, with a significance level set at P<0.05. Results: At baseline, no significant differences were observed between groups in demographic or clinical characteristics. The IET group demonstrated significantly greater improvements than the RPT group at week 6 and 12 in OKS (Week 6: RPT mean rank = 20.09, IET mean rank = 50.91, P<0.000; Week 12: RPT mean rank = 22.47, IET mean rank = 48.53, P<0.000), SF-12 PCS, and all domains of KOOS. Significant within-group improvements were noted in both groups across all outcome measures, with IET showing superior enhancements. Conclusion: Intensive exercise therapy significantly improves function and quality of life compared to routine physical therapy in TKR patients. These findings advocate for the integration of tailored, intensive exercise programs in the rehabilitation protocol post-TKR to maximize recovery.
Total Knee Replacement, Rehabilitation, Intensive Exercise Therapy, Routine Physical Therapy, Function Quality of Life
FORMULATION AND EVALUATION OF SUSTAINED-RELEASE ORAL DRUG DELIVERY SYSTEMS
Sustained-release oral drug delivery systems play a crucial role in improving patient compliance by providing controlled and prolonged drug release, thereby reducing dosing frequency. This study investigates the formulation and evaluation of sustained-release tablets using various polymer systems, including HPMC, Ethylcellulose, and Carbopol 971P. The impact of polymer concentration, excipient composition, and processing methods (direct compression and wet granulation) on the dissolution profile, mechanical properties, and stability of the tablets was assessed. Dissolution testing revealed that the formulations exhibited controlled release over 24 hours, with some formulations maintaining nearly complete release at the 24-hour mark. Stability studies conducted under accelerated conditions (40°C, 75% RH for 3 months) showed minimal degradation in the active pharmaceutical ingredient (API) and stable drug release profiles for most formulations. The results highlight the significant influence of polymer choice and formulation factors on both the in vitro release behavior and long-term stability of sustained-release systems. These findings provide valuable insights for optimizing sustained-release tablet formulations to meet clinical requirements for consistent drug delivery.
CURRENT AND EMERGING PHARMACOTHERAPIES IN OPIOID USE DISORDER: A NARRATIVE REVIEW
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