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
INSIGHTFUL EDUCATION RESEARCH INSTITUTE"
LEVEL OF SATISFACTION AMONG PHYSICAL THERAPY GRADUATES DURING HOUSEJOB AT TERTIARY CARE HOSPITALS IN PESHAWAR
Introduction: House job is an important part of health education, as at this point graduates learn to transfer their theoretical knowledge into practical skills. Physical therapy is an emerging field, and the demands are often stressful for the therapist. House job satisfaction is important to be determined as it would help the policy makers to make the necessary changes for the increased satisfaction and confidence of the physical therapy graduates. Objective: To determine the level of house job satisfaction among physical therapy graduates working at tertiary care hospitals of Peshawar. Results: The study had 150 participants, 38% being male and 62% being female. Males reported higher satisfaction scores compared to females; however, these differences were not statistically significant. Across hospitals, intrinsic satisfaction showed a statistically significant difference (p = 0.001), whereas extrinsic and general satisfaction did not demonstrate significant differences. Conclusion: Overall, the physical therapy graduates during house job in tertiary care hospitals of Peshawar demonstrated satisfactory levels of intrinsic, extrinsic, and general job satisfaction. Although satisfaction levels varied slightly according to gender and hospital setting, significant differences were observed only for intrinsic satisfaction across hospitals. Keywords: Physical therapy, job satisfaction, house job, intrinsic satisfaction, extrinsic satisfaction, general satisfaction, tertiary care hospitals
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THE EFFECTIVENESS OF MOTOR RE-LEARNING IN THE POST-STROKE UPPER LIMB FUNCTIONAL RESTORATION
Background: Stroke is the leading cause of disability worldwide currently. Upper limbs ADLs –based functions is grossly affected leading to functional dependence of the stroke patients. Upper limbs functional rehabilitation is an essential component of the stroke physical rehabilitation. The aim of this study is to find out the effectiveness of upper limbs –specific motor –re-learning approach in the upper limbs’ functional restoration. Method: 40 stroke outpatients (n=40) are selected through purposive sampling & randomly assigned into two groups (CG & TG) for this study irrespective of their gender, ethnicity, age, stroke type, chronicity & level of dependence. The control group (CG) for 40 minutes -30 sessions (5days/week for 8 weeks) received conventional physical therapy interventions while the TG received conventional physical therapy along with upper limb motor re-learning for 40 minutes -30 sessions (5days/week for 8 weeks). Results: The results of the study showed by comparing pre-intervention & post-intervention score, that motor-re-learning has significantly improved upper limb functions as compared to the conventional physiotherapeutic interventions. Conclusion; The result of this study can be concluded that comparatively motor-re-learning is clinically more effective in the functional restoration of upper limbs in stroke patients.
stroke, conventional physiotherapeutic interventions, motor re-learning, wolf motor functional test
ASSESSMENT OF LIVER ENZYME ALANINE AMINOTRANSFERASE (ALT) AND ASPARTATE AMINOTRANSFERASE (AST) IN DENGUE-INFECTED PATIENTS IN FAISALABAD, PUNJAB PAKISTAN IN 2026.
A cross sectional study was conducted in 2026 in Faisalabad, Punjab, Pakistan, to assess liver functional abnormalities in dengue patients by estimation of serum ALT and AST levels. The total number of serologically confirmed dengue cases included was 200, of which 120 (60%) cases were diagnosed as Dengue Fever and 80 (40%) cases as Dengue Hemorrhagic Fever. There were 115 females (57.5%) and 85 males (42.5) in the study population ranging from 15 years to 50 years of age, while the 21-25 years age group had the highest prevalence of the disease (20.5%). The blood samples collected at the time of diagnosis were used to confirm Dengue infection by NS1 antigen, IgM and IgG. ALT and AST levels were measured. The results showed that the values of ALT and AST had significant increase in all dengue positive cases as compared to normal range (40U/L) which showed there was significant liver involvement. Mean ALT levels were significantly higher in DHF patients (356.43 ± 85.29 U/L) than in DF patients (182.79 ± 56.98 U/L) (p < 0.001), while AST levels were also markedly elevated in DHF patients (500.81 ± 105.21 U/L) compared with DF patients (261.06 ± 72.85 U/L) (p < 0.001). Pearson correlation showed there was a strong positive correlation between ALT and AST levels (r = 0.631, p < 0.001), indicating that both enzymes raise concurrently in the presence of dengue infection. In addition, AST levels were higher than ALT levels in most patients, and 19.5% of patients had an AST/ALT ratio less than one reflecting predominant mitochondrial hepatic injury. The results show that there is significant liver damage after dengue virus infection, and that the liver damage is more extensive in DHF patients. Therefore, periodic monitoring of ALT and AST levels can be a practical and cost-effective method to assess liver injury and disease severity in dengue patients in Faisalabad.
ALT Alanine aminotransferase), AST(aspartate aminotransferase), Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF).
COMPARISON OF MILLIGAN MORGAN (OPEN) VERSUS FERGUSON (CLOSED) HEMORRHOIDECTOMY IN TERMS OF POST-OPERATIVE COMPLICATIONS: A RANDOMIZED CONTROLLED TRIAl
Background: Excisional hemorrhoidectomy remains the gold standard surgical treatment for advanced hemorrhoidal disease; however, controversy persists regarding the comparative superiority of the Milligan–Morgan (open) and Ferguson (closed) techniques in terms of postoperative outcomes. Variations in postoperative pain, wound healing, and bleeding reported in international literature necessitate further regional evidence to guide surgical decision-making. Objective: To compare postoperative complications, specifically hemorrhage, wound dehiscence, and postoperative pain, between the Milligan–Morgan (open) and Ferguson (closed) hemorrhoidectomy techniques in patients with Grade III and Grade IV hemorrhoids. Methods: This single-center, parallel-group randomized controlled trial was conducted at the Department of Surgery, Khyber Teaching Hospital, Peshawar, from February 2023 to July 2023. A total of 168 patients aged 30–70 years with Grade III or Grade IV hemorrhoids were enrolled and randomly allocated in a 1:1 ratio to either Group A (Milligan–Morgan/open hemorrhoidectomy; n=84) or Group B (Ferguson/closed hemorrhoidectomy; n=84) using block randomization with allocation concealment. Postoperative pain assessment was performed by an independent blinded observer. Primary outcome measures included postoperative hemorrhage, wound dehiscence, and postoperative pain assessed using the Visual Analogue Scale (VAS). Data were analyzed using IBM SPSS Statistics version 25.0. Results: Baseline demographic and clinical characteristics were comparable between the two groups. Postoperative hemorrhage occurred in 20 patients (23.8%) in both the Milligan–Morgan and Ferguson groups, with no statistically significant difference observed (p=0.999). Wound dehiscence occurred in 20 patients (23.8%) in the open group and 17 patients (20.2%) in the closed group (p=0.576). The relative risk (RR) for wound dehiscence in the Milligan–Morgan group was 1.18 (95% CI: 0.66–2.08). The mean postoperative pain score on the first postoperative day was 4.11 ± 1.98 in the open group compared with 3.77 ± 1.53 in the closed group, with a mean difference of 0.34 (95% CI: −0.20 to 0.88; p=0.224). Conclusion: Both Milligan–Morgan (open) and Ferguson (closed) hemorrhoidectomy techniques demonstrated comparable safety profiles, with no statistically significant difference in postoperative hemorrhage, wound dehiscence, or postoperative pain. However, the Ferguson technique showed favorable clinical trends toward lower wound dehiscence rates and reduced postoperative pain, suggesting potential advantages in enhancing early postoperative recovery and patient comfort. Keywords: Hemorrhoidectomy; Milligan–Morgan; Ferguson; postoperative complications; randomized controlled trial.
EXPERIENCES OF COUNSELORS DELIVERING MENTAL HEALTH SERVICES THROUGH TELETHERAPY
Teletherapy has rapidly evolved as an essential mode of delivering counseling services, especially following the COVID-19 pandemic, which reshaped traditional therapeutic practices. This study aimed to explore the lived experiences of counselors providing teletherapy, focusing on the challenges, strategies, and perceived outcomes of this practice. A qualitative research design was employed, and data were gathered through semi-structured interviews with six practicing counselors from diverse clinical and counseling settings. Thematic analysis revealed ten superordinate themes: transition to teletherapy, accessibility and convenience, challenges in teletherapy, client–therapist dynamics, ethical and risk management, coping and adaptation strategies, psychological and emotional impact, professional growth, future directions, and cultural considerations. Results indicated that teletherapy improved accessibility, flexibility, and client engagement, particularly for geographically distant clients, but also presented notable challenges including technical barriers, limited non-verbal communication, confidentiality concerns, and crisis intervention limitations. Counselors adopted strategies such as hybrid models, active questioning, structured routines, and technology optimization to enhance therapeutic effectiveness. This study underscores the importance of culturally sensitive tools, structured teletherapy training, and clear ethical guidelines to ensure the sustainable integration of teletherapy within mainstream counseling practices.
Teletherapy, Traditional Therapeutic Practices, Coping and Adaptation Strategies, Culturally Appropriate Digital Platforms
ASSESSMENT OF DRUG UTILIZATION PATTERN AND ADVERSE DRUG REACTIONS IN DIABETIC PATIENTS AT A TERTIARY CARE HOSPITAL
Diabetes Mellitus is a long-term chronic metabolic disorder where pharmacotherapy is a requirement to treat the underlying condition and includes comorbidities which creates polypharmacy with an increased potential for adverse drug reactions (ADRs). The objective of this study was to evaluate drug use and determine the occurrence of ADRs among diabetic patients treated at a tertiary care.A prospective, observational study was done with diabetic patients being treated in outpatient and inpatient settings. Patient demographics, clinical characteristics, medications prescribed, and medications associated with the ADRs, were collected and analyzed.Based on the type of antidiabetic medications used and how frequently they were prescribed, drug utilization was assessed. ADRs were evaluated for causality, severity, and outcome.According to the results, the most commonly prescribed drugs included the oral hypoglycemic agents (OHA) such as metformin followed by insulin and combination therapies. Many patients were prescribed multiple medications (polypharmacy) due to co-existing conditions (e.g., hypertension and dyslipidemia).Many of the ADRs associated with the use of these medications occurred: the three most often reported ADRs were hypoglycemia, gastrointestinal disturbances, and dizziness. Most of the reported ADRs were classified as mild-to-moderate in severity and were effectively managed without any major complications.The results of this study indicate that healthcare providers should use rational prescribing and will benefit from ongoing monitoring of their patients as well as enabling pharmacovigilance opportunities to improve treatment outcomes in diabetic patients while ensuring their patients are safe from drug-related issues. Keywords: Diabetes mellitus, Drug utilization pattern, Adverse drug reactions, Pharmacovigilance, Polypharmacy, Antidiabetic drugs, Metformin, Insulin therapy, Rational prescribing, Tertiary care hospital.
ROLE OF NURSE-DELIVERED COUNSELING IN ENHANCING TREATMENT ADHERENCE AND OUTCOMES IN PULMONARY TUBERCULOSIS
The aim of this study was to assess the role of nurse-delivered counseling in enhancing treatment adherence and clinical outcomes among patients with pulmonary tuberculosis. Pulmonary tuberculosis remains a significant global public health issue, particularly in developing countries, where poor adherence to long-term treatment contributes to continued transmission, relapse, and the emergence of drug-resistant strains. Despite the availability of effective therapy, multiple factors such as limited patient awareness, stigma, inadequate counseling, and socioeconomic constraints negatively affect adherence and treatment success. A quantitative cross-sectional research design was employed for this study. Data were collected from 54 pulmonary tuberculosis patients receiving treatment at a tertiary care hospital. The Morisky Medication Adherence Scale (MMAS-8) was used to assess adherence levels, while semi-structured interviews explored the role of nurses in providing counseling and support. Data were analysed using descriptive statistics and chi-square tests to determine associations between variables.The findings revealed that 57.41% of patients demonstrated moderate adherence, 38.89% had high adherence, and only 3.70% showed low adherence. Nurse-delivered counseling, particularly patient education (p = 0.001) and communication with family members (p = 0.045), showed a statistically significant association with improved adherence. Socioeconomic factors, including family support (p = 0.002), access to healthcare (p = 0.000), and stable economic conditions (p = 0.015), also significantly influenced treatment compliance.In conclusion, nurse-delivered counseling plays a crucial role in improving treatment adherence and clinical outcomes among pulmonary tuberculosis patients. Strengthening counseling practices and addressing socioeconomic barriers are essential for effective tuberculosis control and improved patient outcomes.
Pulmonary Tuberculosis, Medication Adherence.
AN ANALYSIS OF POSTOPERATIVE COMPLICATIONS FOLLOWING HIP REPLACEMENT SURGERY AMONG ELDERLY PATIENTS
Hip replacement surgery is a widely performed orthopedic procedure among elderly patients to restore mobility and improve quality of life; however, postoperative complications remain a significant clinical concern. This study analyzes the incidence, patterns, and determinants of postoperative complications following hip replacement surgery in elderly patients. The problem statement focuses on the increasing burden of complications such as infection, dislocation, thromboembolism, and delayed healing in geriatric populations. The objective of this study is to evaluate the frequency and nature of postoperative complications and identify contributing risk factors. A quantitative observational approach was used, reviewing clinical records of elderly patients who underwent hip replacement surgery. Data were analyzed to determine complication rates and associated demographic and clinical variables. The major results indicate that the most common complications include surgical site infection, deep vein thrombosis, and prosthetic dislocation. Higher complication rates were observed in patients with comorbidities such as diabetes, hypertension, and osteoporosis. Advanced age and delayed postoperative mobilization also significantly increased risk. In conclusion, postoperative complications remain a considerable challenge in hip replacement surgery among elderly patients, requiring improved perioperative care and risk stratification. The implications suggest that early rehabilitation, strict infection control measures, and individualized patient management can significantly reduce complication rates and enhance surgical outcomes.
Hip replacement surgery, elderly patients, postoperative complications, infection control, thromboembolism, prosthetic dislocation, orthopedic outcomes
PREVALENCE AND RISK FACTORS OF HYPERTENSION AMONG YOUNG ADULTS IN URBAN PAKISTAN: A CROSS-SECTIONAL STUDY
High blood pressure has become a key health issue of concern among young adults and especially in highly urbanizing areas in the low- and middle-income countries. Premature hypertension has a profound effect on the risk of cardiovascular morbidity and mortality in the long term. Nevertheless, there is a lack of information regarding its prevalence and risk factors in urban youth in Pakistan. The purpose of the current study was to estimate the prevalence of hypertension and identify determinants of hypertension in young adults living in urban Pakistan. The study was a community-based cross-sectional study involving 720 young adults aged 18-35 years and was done using a multistage random sampling method. A structured questionnaire based on WHO STEPS, which included sociodemographic characteristics, lifestyle behaviors, and clinical history, was used to collect the data. Standardized procedures were used to measure blood pressure and hypertension was determined based on AHA 2017 guidelines. The statistical analysis was done with the help of SPSS version 26 where chi-square and multivariate logistic regression were used to determine independent predictors. The general prevalence of hypertension was 27.1%, and the prevalence was much more in males (30.6%) than females (23.1%) (p = 0.012). The prevalence of hypertension was higher by age and body mass index. Multivariate analysis revealed that family history (OR: 2.91, 95% CI: 2.01–4.20) and BMI ≥25 kg/m² (OR: 2.48, 95% CI: 1.74–3.53) were the strongest predictors. Abnormal salt consumption (OR: 2.11), physical inactivity (OR: 1.72), stress (OR: 1.64), and fast food consumption (OR: 1.58) were also other important factors. The study presents the high prevalence of high blood pressure in young urban adults in Pakistan, which is mainly caused by lifestyle changes that are modifiable. There is a need to reduce the risk of cardiovascular diseases which is on the rise in this population through early screening, lifestyle change and specific public health interventions.
Hypertension; Young adults; Urban health; Risk factors; Pakistan; Lifestyle; Cross-sectional study; Cardiovascular risk; Obesity; Public health
ASSOCIATION OF PAIN AND QUALITY OF SLEEP DUE TO CALF TIGHTNESS IN SECURITY GUARDS
Prolonged standing is a common occupational requirement for security guards and may contribute to various musculoskeletal problems, including calf muscle tightness, lower limb pain, and disturbances in sleep quality. These issues can negatively affect physical performance, occupational efficiency, and overall quality of life. This cross-sectional observational study was conducted to determine the association between calf muscle tightness, pain intensity, and sleep quality among security guards. The study was carried out in different institutions, including colleges and banks, and involved 134 male security guards aged 30 to 50 years who performed standing duties for at least 8 hours daily. A non-probability convenience sampling technique was used to recruit participants. Calf muscle tightness was assessed using the Silfverskiöld Test, pain intensity was measured through the Numeric Pain Rating Scale (NPRS), and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Descriptive and inferential statistical analyses were performed to examine the relationships among the study variables. The findings revealed a high prevalence of calf muscle tightness and musculoskeletal pain among participants, particularly in the lower leg region. Most participants reported poor sleep quality, suggesting that occupational demands may have a considerable impact on their physical and psychological well-being. Statistical analysis demonstrated a significant moderate positive correlation between pain intensity and sleep disturbance (r = 0.589, p < 0.001), indicating that higher levels of pain were associated with poorer sleep quality. These findings emphasize the importance of implementing preventive strategies
Calf Muscle Tightness, Security Guards, Sleep Quality, Numeric Pain Rating Scale, Pittsburgh Sleep Quality Index.
FACTORS ASSOCIATED WITH INTERDIALYTIC WEIGHT GAIN AMONG PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS
One important measure of fluid management in patients receiving maintenance hemodialysis is inter dialytic weight gain (IDWG). Increased morbidity and mortality, hypertension, and poor cardiovascular outcomes are all linked to excessive IDWG. Improving patient outcomes requires an understanding of the elements that contribute to IDWG. Objective: The goal is to determine the variables linked to inter dialytic weight increase in patients receiving maintenance hemodialysis. Methodology: Patients undergoing maintenance hemodialysis at a dialysis facility participated in a cross-sectional study. Standardized questionnaires, medical record reviews, and patient interviews were used to gather data. Sociodemographic traits, clinical factors, dietary and fluid intake habits, dialysis-related factors, and patient understanding of fluid restriction were among the variables evaluated. The difference between pre-dialysis and post-dialysis weight from the prior session was used to compute inter dialytic weight increase. Descriptive statistics and inferential tests were used to analyze the data in order to identify correlations. Result: Excessive inter dialytic weight gain was seen by a considerable percentage of patients. Poor adherence to fluid restriction, excessive dietary sodium consumption, longer hemodialysis duration, inadequate patient education, the presence of comorbid illnesses such diabetes and hypertension, and reduced dialysis adequacy were factors that were substantially linked with greater IDWG. Significant correlations were also found between sociodemographic characteristics like age and educational attainment. conclusion, a number of controllable and non-modifiable factors affect inter dialytic weight increase in individuals receiving maintenance hemodialysis. To lower excessive IDWG and enhance clinical results, interventions that emphasize patient education, nutritional counselling, and customized fluid management techniques are crucial.
Inter dialytic weight gain, hemodialysis, fluid restriction, dietary sodium, chronic kidney disease
DEVELOPMENT AND EVALUATION OF NOVEL NANOPARTICLE-BASED DRUG DELIVERY SYSTEMS FOR TARGETED BIOMEDICAL APPLICATION
Nanoparticle drug delivery systems have been developed over the past few years and present new ways to improve the therapeutic efficacy, safety, and specificity of drugs within the scope of biological technologies. Our research aimed to develop a new type of nanoparticle for targeted drug delivery for patients suffering from chronic illnesses. The nanoparticles developed used biocompatible and biodegradable materials to create nanoparticles with enhanced drug encapsulation and stability and controlled release properties. The physicochemical properties of the nanoparticles developed were evaluated through multiple parameters, including size, surface area, zeta potential, and drug loading efficiency. In addition, the in vitro drug release profile of the nanoparticles was examined in relation to cellular uptake, biocompatibility and therapeutic efficacy using cell culture models. The results of these studies showed that the nanoparticles developed had a uniform shape and size, contained drug at a significantly higher level than did traditional pharmaceutical preparations, and released drug over time at a rate to maintain therapeutic efficacy. Moreover, the nanoparticles developed had an improved cellular uptake relative to conventional pharmaceutical drug formulations and enhanced therapeutic activity vs. traditional pharmaceutical formulations. The overall conclusion from the research is that nanoparticles have the potential to unambiguously provide targeted therapeutic agents and provide improved safety and specific delivery of therapeutic agents, in comparison to traditional dosing methods. Keywords: Nanoparticle-based drug delivery, Targeted drug delivery, Biomedical applications, Controlled drug release, Drug encapsulation, Biocompatibility, Cellular uptake, Surface functionalization, Therapeutic efficacy, Nanomedici
CHRONIC CANNABIS USE PRESENTING WITH NEUROCOGNITIVE IMPAIRMENT AND CANNABIS-INDUCED PSYCHOSIS: A CASE REPORT AND INTEGRATED TREATMENT APPROACH
Cannabis-induced psychosis is a serious psychiatric condition and is associated with chronic and prolonged cannabis use. The chronic use of cannabis often results in significant cognitive, behavioural and psychosocial impairment. The present case study examined the case history of SM. He was a 45-year-old married male with a twenty-year history of cannabis dependence. He was presented with recurrent psychotic episodes characterized by aggression, irritability, grandiose delusions, self-talk, insomnia, mood instability and impaired social functioning. Clinical assessment was conducted through comprehensive interviews, behavioural observations, psychometric testing and laboratory investigations. Assessment tools included the Mini-Mental State Examination (MMSE), DSM-5-TR Checklist for Cannabis Use Disorder, House-Tree-Person Test (HTP), Rotter Incomplete Sentence Blank (RISB), Thematic Apperception Test (TAT) and drug screening tests. Findings indicated severe Cannabis Use Disorder accompanied by recurrent psychotic symptoms, emotional dysregulation, impaired insight and significant personality vulnerabilities. The patient demonstrated a pattern of symptom exacerbation following cannabis use and medication non-adherence. A substantial improvement was observed with consistent pharmacological treatment and psychosocial intervention. A structured treatment approach incorporating antipsychotic medication, psychoeducation, relapse prevention strategies, motivational enhancement and family involvement was implemented to address both substance dependence and psychotic symptoms. The findings further underscore the need for early identification and comprehensive management of cannabis-related psychiatric complications within the Pakistani clinical context.
Cannabis-induced psychosis, Cannabis use disorder, Psychosis, Substance abuse, Cognitive impairment, Relapse prevention, Case study
EMERGING TRENDS IN VETERINARY PARASITOLOGY: ANIMAL HEALTH, DRUG RESISTANCE, AND SUSTAINABLE PARASITE CONTROL APPROACHES WORLDWIDE
Veterinary parasitology is changing fast due to the pressures created by public concern about the health of animals, zoonotic diseases, climate change, and the increasing prevalence of drug resistance against antiparasitic agents. The development of new techniques for improving parasite detection, monitoring drug resistance, and establishing sustainable control strategies (for livestock, pets, and wildlife worldwide) is a major focus of current research in this area. Technological advancement in molecular diagnostics, sequencing genomes, and utilizing Artificial Intelligence technologies allow for earlier identification of parasitic infections as well as differential treatment of parasitic infections based on individual animals’ needs. Current issues with conventional anthelmintic resistance also represent a significant challenge globally, especially in grazing animals, and are causing reduced treatment efficacy and economic loss. Researchers are now investigating alternative, eco-friendly methods of controlling parasites (including naturally occurring chemical agents, plant-derived therapeutics, vaccines, biological control agents, selective treatment protocols, and integrated parasite management systems). Additionally, climate change and international transportation of animals are being recognized as having a significant impact on the geographic distribution of parasites and their vectors; thus creating new risks to animal health and public health. Sustainable parasite management is also recognizing the need for reduced reliance on chemicals to control parasites, greater emphasis on managing farms to be sustainable, and the adoption of the One Health concept, which refers to the interconnectedness of animal health, human health, and environmental health. Keywords: Veterinary parasitology, animal health, drug resistance, sustainable parasite control, zoonotic parasites, integrated parasite management, anthelmintic resistance, One Health, molecular diagnostics, climate change.
RELATIONSHIP BETWEEN CPR KNOWLEDGE AND PRACTICE CHALLENGES AMONG NURSES IN A TERTIARY CARE HOSPITAL, LAHORE
Background Cardiac arrest is a leading cause of in-hospital mortality, and timely initiation of cardiopulmonary resuscitation (CPR) is critical for patient survival. Nurses are often the first responders to cardiac emergencies in tertiary care hospitals; therefore, adequate CPR knowledge and the ability to overcome practice-related challenges are essential. Despite established CPR guidelines, nurses frequently encounter barriers that may hinder effective resuscitation efforts, particularly in high-acuity clinical settings. Aim To determine the correlation between CPR knowledge and practice challenges among nurses working in a tertiary care hospital in Lahore, Punjab, Pakistan. Methods A correlational cross-sectional study design was employed. The study was conducted at Services Hospital, Lahore, and included 80 registered staff nurses selected using a convenience sampling technique. Data were collected using a structured self-administered questionnaire comprising demographic information, a CPR knowledge assessment based on American Heart Association guidelines, and a practice challenges scale. Data were analyzed using SPSS version 26. Descriptive statistics summarized demographic characteristics and CPR knowledge levels. Chi-square tests assessed associations between CPR knowledge and demographic variables, while Pearson’s correlation coefficient determined the relationship between CPR knowledge and practice challenges. Results The mean CPR knowledge score was 7.85 ± 2.41, indicating a moderate level of knowledge. More than half of the nurses demonstrated moderate CPR knowledge. Lack of confidence, inadequate training, and psychological stress were the most frequently reported practice challenges. CPR knowledge was significantly associated with clinical area and clinical experience (p < 0.05). A statistically significant moderate negative correlation was found between CPR knowledge and practice challenges (r = −0.42, p < 0.001). Conclusion Nurses exhibited moderate CPR knowledge, and higher knowledge was associated with fewer perceived practice challenges. Regular training, simulation-based learning, and institutional support are recommended to enhance CPR competency and improve resuscitation outcomes.
Cardiopulmonary resuscitation, CPR knowledge, practice challenges, nurses, tertiary care hospital
DIGITAL PHENOTYPING AND AI-BASED EARLY DETECTION OF DEPRESSION AND COGNITIVE DECLINE AMONG PAKISTANI YOUTH USING SOCIAL MEDIA BEHAVIORAL DATA
Depression and cognitive decline are growing mental health concerns among youth, particularly in developing countries where early diagnosis and access to mental healthcare remain limited. This study examined the role of digital phenotyping and artificial intelligence (AI)-based predictive analytics in the early detection of depression and cognitive decline among Pakistani youth using social media behavioral data. A quantitative cross-sectional design was employed, and data were collected from 500 active social media users aged 18–35 years in Pakistan. Social media behavioral indicators, including posting frequency, language and sentiment patterns, social interaction patterns, usage behavior, and engagement activities, were analyzed using Structural Equation Modeling (SEM) and machine learning techniques. The findings indicated that social media behavioral data significantly predicted both depression and cognitive decline. Digital phenotyping was found to mediate these relationships, while AI-based predictive analytics enhanced the accuracy of early detection. The study highlights the potential of integrating digital phenotyping and AI to develop scalable, cost-effective, and culturally relevant mental health screening systems for Pakistani youth. The findings contribute to the growing fields of digital health, computational psychiatry, and AI-enabled mental healthcare.
Digital Phenotyping, Artificial Intelligence, Depression, Cognitive Decline, Social Media Behavioral Data, Pakistani Youth.
High blood pressure has become a key health issue of concern among young adults and especially in highly urbanizing areas in the low- and middle-income countries. Premature hypertension has a profound effect on the risk of cardiovascular morbidity and mortality in the long term. Nevertheless, there is a lack of information regarding its prevalence and risk factors in urban youth in Pakistan. The purpose of the current study was to estimate the prevalence of hypertension and identify determinants of hypertension in young adults living in urban Pakistan. The study was a community-based cross-sectional study involving 720 young adults aged 18-35 years and was done using a multistage random sampling method. A structured questionnaire based on WHO STEPS, which included sociodemographic characteristics, lifestyle behaviors, and clinical history, was used to collect the data. Standardized procedures were used to measure blood pressure and hypertension was determined based on AHA 2017 guidelines. The statistical analysis was done with the help of SPSS version 26 where chi-square and multivariate logistic regression were used to determine independent predictors. The general prevalence of hypertension was 27.1%, and the prevalence was much more in males (30.6%) than females (23.1%) (p = 0.012). The prevalence of hypertension was higher by age and body mass index. Multivariate analysis revealed that family history (OR: 2.91, 95% CI: 2.01–4.20) and BMI ≥25 kg/m² (OR: 2.48, 95% CI: 1.74–3.53) were the strongest predictors. Abnormal salt consumption (OR: 2.11), physical inactivity (OR: 1.72), stress (OR: 1.64), and fast food consumption (OR: 1.58) were also other important factors. The study presents the high prevalence of high blood pressure in young urban adults in Pakistan, which is mainly caused by lifestyle changes that are modifiable. There is a need to reduce the risk of cardiovascular diseases which is on the rise in this population through early screening, lifestyle change and specific public health interventions
ROLE OF THERAPEUTIC NUTRITION IN CRITICAL AND CLINICAL CARE: A DIETITIAN'S PERSPECTIVE ON ICU PROTEIN INTAKE, ENTERAL NUTRITION IN INFECTION RECOVERY, AND INFLAMMASOME MODULATION IN HEART FAILURE
Therapeutic nutrition plays a pivotal role in the management of critically ill and clinically complex patients, yet optimal implementation requires integration of evolving mechanistic insights with pragmatic clinical protocols. This review synthesizes current evidence across three domains of high clinical relevance to dietitians: protein delivery in intensive care unit (ICU) settings, enteral nutrition strategies for infection and sepsis recovery, and dietary modulation of inflammasome pathways in heart failure. In ICU protein management, contemporary guidelines recommend staged escalation from low early doses to 1.2–2.0 g/kg/day after stabilization, with individualized adjustments for obesity, continuous renal replacement therapy, burns, and sepsis; however, randomized controlled trials demonstrate muscle-sparing effects without consistent mortality benefit, and delivery barriers necessitate active dietitian oversight. Enteral nutrition in infection recovery preserves gut barrier integrity, modulates the microbiome, and supports immune homeostasis, with early initiation (within 72 hours) associated with shorter ICU stays and reduced acute kidney injury, though clinical trial outcomes remain heterogeneous and immunonutrient formulas show context-dependent benefits and risks. Emerging evidence implicates the NLRP3 inflammasome in cardiac inflammation and heart failure progression; preclinical studies identify omega-3 fatty acids, polyphenols, short-chain fatty acids, and ketone bodies as inflammasome inhibitors through mitochondrial protection, redox modulation, and epigenetic mechanisms, yet clinical translation remains limited. Across all three domains, dietitians serve as essential integrators—assessing individual needs, prescribing tailored interventions, troubleshooting delivery obstacles, and bridging mechanistic science with bedside care. This review provides a structured framework for evidence-based nutrition practice in critical and clinical care, highlighting both established interventions and areas requiring further investigation.
therapeutic nutrition, ICU protein intake, enteral nutrition, sepsis recovery, gut microbiome, NLRP3 inflammasome, heart failure, clinical dietetics, critical care nutrition, immunonutrition
EFFECTS OF BLOOD FLOW RESTRICTION WITH AND WITHOUT TOTAL MOTION RELEASE ON RANGE OF MOTION IN POST-OPERATIVE ACL INJURY: A RANDOMIZED CONTROLLED TRIAL
Background and Objectives: One key component of the rehabilitation process following anterior cruciate ligament (ACL) reconstruction is restoration of knee range of motion (ROM), and maintaining a functional range of motion without excessive flexion or terminal extension deficit is important for promoting gait normalization and functional recovery. This RTC compared the influence of Blood Flow Restriction + Total Motion Release (BFR+TMR) on knee ROM in the rehabilitation of ACL injury. Methods: Forty-four patients who underwent ACL reconstruction surgery were randomly assigned to the BFR group (n = 22) and BFR + TMR group (n = 22). ROM was measured at baseline, 6 weeks, 12 weeks and 6 months for knee flexion of injured limb, knee extension deficit of injured limb, knee flexion of non-injured limb and knee extension deviation of non-injured limb. Two-way mixed ANOVA with time (the within-subjects factor) and group (the between-subjects factor) was used to analyze data. Results: All outcomes of the ROM showed significant time effects and Time × Group interactions. Injured-limb flexion improved from 63.05 ± 5.00 degrees to 93.86 ± 5.48 degrees in the BFR group and from 64.27 ± 5.36 degrees to 127.91 ± 4.47 degrees in the BFR+TMR group, with a significant Time × Group interaction, F(3,126) = 355.17, p < .001, partial eta squared = .894. There was also a significant interaction for injured-limb extension deficit, with the BFR group showing improvement of -0.82 ± 0.73 degrees and BFR+TMR group showing improvement of -0.14 ± 0.35 degrees, F(3,126) = 7.93, p < .001, partial eta squared = .159. There was also a significant interaction effect between the non-injured limb flexion and extension. Conclusion: In the framework of ACL injury rehabilitation, the use of Total Motion Release in addition to BFR yielded significantly higher and quicker ROM recovery compared to BFR alone. This combination of protocols can clinically be beneficial in enhancing knee flexion, terminal extension and bilateral movement symmetry. Clinical Trial Number: NCT07589309
Anterior cruciate ligament; Blood Flow Restriction; Total Motion Release; Range of Motion; Knee flexion; Knee extension
PHARMACEUTICS-BASED NATURAL PRODUCTS: EXPLORING MEDICINAL PROPERTIES FOR NOVEL DRUG DISCOVERY AND THERAPEUTIC APPLICATIONS
The development of today's pharmaceutical industry has been greatly influenced by nature's gifts - natural products. Natural products are important sources of bioactive compounds that are found in plants, microbes, and marine organisms and have a wide variety of therapeutic activities. The focus of research within the pharmaceutics fields on natural products is the identification, extraction, characterisation, formulation and delivery of these naturally occurring compounds with the aim of improving patient outcomes. Natural products provide a wide range of pharmacological activities, such as antimicrobial, anti-inflammatory, antioxidant, anticancer, antiviral and cardioprotective. Scientific advances within the pharmaceutical sciences in combination with advancements in analytical technology have significantly enhanced the discovery of new pharmaceutical drug candidates from nature by enabling the ability to isolate the active ingredients from natural products and understand their mechanism(s) of action. In addition to these advancements, new approaches to drug delivery systems (e.g., nanoparticles, liposomes, and controlled-release formulations) have also enhanced the bioavailability, stability and therapeutic potential of natural products. The combination of traditional medicine and modern pharmaceutics has significantly enhanced the development of safer and more effective drugs. Given the challenges associated with standardisation, quality control and large-scale production of natural products, they continue to offer significant opportunities for drug discovery and development. Keywords: Natural products, Pharmaceutics, Drug discovery, Bioactive compounds, Medicinal plants, Pharmaceutical formulations, Therapeutic applications, Drug delivery systems, Antioxidant activity, Anticancer agents, Herbal medicine, Novel therapeutics.
ASSOCIATION OF HYPONATREMIA WITH SEVERITY AND OUTCOME IN ACUTE HEMORRHAGIC STROKE: AN OBSERVATIONAL STUDY FROM A NEUROLOGY TERTIARY UNIT
Background: Hyponatremia is the most common electrolyte disturbance encountered in patients with acute hemorrhagic stroke and has been associated with adverse neurological outcomes in international literature. However, region-specific evidence from tertiary neurology units in Pakistan remains scarce. This study aimed to evaluate the frequency of hyponatremia, its association with stroke severity, and its impact on clinical outcomes in patients admitted with acute hemorrhagic stroke to a tertiary neurology unit in Pakistan. Methods: This prospective longitudinal observational study was conducted in the Department of Neurology, Pak Emirates Military Hospital, Rawalpindi. A total of 200 patients with confirmed acute hemorrhagic stroke were enrolled using consecutive non-probability sampling over four months. Hyponatremia was defined as serum sodium below 135 mmol/L measured within 24 hours of admission. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) at admission and discharge. Clinical outcomes were assessed using the modified Rankin Scale (mRS) at discharge and 90 days post-discharge. Multivariable logistic regression identified independent predictors of unfavorable outcome. Results: Hyponatremia was identified in 84 patients (42.0%). SIADH was the predominant etiology (69.0%). Hyponatremic patients demonstrated significantly higher NIHSS scores at admission (16.8 ± 4.2 vs 11.3 ± 3.9; p<0.001) and discharge (14.1 ± 4.8 vs 8.6 ± 3.7; p<0.001). In-hospital mortality was significantly higher in the hyponatremic group (26.2% vs 8.6%; p<0.001). Unfavorable functional outcomes at 90 days were present in 72.6% of hyponatremic versus 26.7% of normonatremic patients (p<0.001). On multivariable logistic regression, hyponatremia was the strongest independent predictor of unfavorable outcome (OR 3.4, 95% CI 1.9–6.1; p<0.001). Conclusion: Hyponatremia is frequent and independently associated with greater stroke severity, higher in-hospital mortality, and worse functional outcomes in acute hemorrhagic stroke. Serum sodium should be incorporated into routine risk stratification protocols, particularly in resource-limited settings. Keywords: Hyponatremia; Hemorrhagic stroke; Intracerebral hemorrhage; Subarachnoid hemorrhage; NIHSS; Modified Rankin Scale; SIADH; CSWS; Pakistan
BETWEEN FEAR AND FAITH: A CORRELATIONAL STUDY OF DEATH ANXIETY, RELIGIOSITY, AND SLEEP DISTURBANCES IN CLINICAL POPULATION
Background: Death anxiety, religiosity and sleep quality are empirical psychological constructs that play significant roles in patients' mental and physical health when they are confronted with a serious illness. The aim of this study was to explore the correlation between death anxiety, religiosity and sleep quality in a clinical sample. Design method: A cross-sectional survey design with purposive sampling was used and the respondents were 650 patients. Instruments used were the Death Anxiety Beliefs and Behaviors Scale (DABBS), the Religious Orientation Scale (IRO/ERO), and the Pittsburgh Sleep Quality Index (PSQI). The Pearson correlation was carried out. Results: Death anxiety was negatively and significantly related to religiosity (r = -.503, p < .001) and was positively and significantly related to sleep quality disturbance (r = .132, p < .001). Subscale analyses showed high internal consistency of the dimensions of death anxiety in regard to beliefs, behaviors and affect responses, and interesting differences among the religious orientations regarding these death anxiety dimensions in relation to sleep parameters. Discussion: Religiosity is a discernible protective factor in patients and higher death anxiety is a subtle sleep quality impairment. Spiritual assessment and Focused Sleep Intervention should be incorporated in the care of patients. Keywords: Death Anxiety, Religiosity, Sleep Quality, Patients, Intrinsic Religiosity, Extrinsic Religiosity
CRITICAL CARE NURSES AND PRESSURE INJURY PREVENTION: KNOWLEDGE, CHALLENGES, AND PERCEIVED BARRIERS
Background: Pressure injuries are a major patient safety issue in critical care settings, where immobility, complex conditions, and high workload increase risk. Nurses play a key role in prevention; however, knowledge gaps and workplace barriers may limit effective practice, especially in resource-limited settings such as South Punjab, Pakistan. Objective: To assess critical care nurses’ knowledge, perceived barriers, and the relationship between knowledge and barriers regarding pressure injury prevention. Methods: A descriptive cross-sectional study was conducted among 100 registered nurses working in ICUs and CCUs of tertiary care hospitals in South Punjab. Data were collected using a structured questionnaire including the pressure injuries Knowledge Assessment Tool (PUKAT) and an 11-item perceived barriers scale. Data were analyzed using SPSS version 27 with descriptive statistics, chi-square tests, and Pearson correlation analysis. Results: The mean age was 28.61 ± 6.60 years, and 55% were female. Overall, 63% of nurses had satisfactory knowledge, while 37% had inadequate knowledge. The mean knowledge score was 15.13 ± 4.87. Educational level was significantly associated with knowledge (p = 0.044). Major barriers included lack of written protocols, overcrowding, and inadequate staffing. A significant negative correlation was found between knowledge and perceived barriers (r ≈ -0.72, p < 0.05). Conclusion: Critical care nurses demonstrated moderate knowledge with significant organizational barriers. Strengthening continuous education, implementing standardized pressure injury prevention protocols, improving staffing and resource allocation, and enhancing institutional support are essential to improve preventive practices and patient safety in critical care settings.
Pressure injuries, critical care nurses, pressure injury prevention, perceived barriers, patient safety
BALANCING OVERTREATMENT AND DELAY: NEGATIVE APPENDECTOMY AND PERFORATION IN A FIVE-YEAR COHORT OF ACUTE APPENDICITIS
Background: Acute appendicitis is a common surgical emergency. The negative appendectomy rate (NAR) and perforation rate are complementary quality metrics reflecting the balance between diagnostic over-caution and delayed intervention. Methods: A five-year retrospective cohort study was conducted at Lady Reading Hospital, Peshawar (2021–2025), including all consecutive patients undergoing emergency appendectomy. Multivariable logistic regression identified independent predictors of NAR and perforation. Postoperative outcomes were graded by Clavien Dindo classification. Results: Of 500 patients (mean age 27.4 ± 14.2 years; 60.0% male), preoperative imaging was used in 40.0%. Histopathology confirmed appendicitis in 415 patients (83.0%), yielding a NAR of 17.0%. Of confirmed cases, 300 (60.0%) were simple, 70 (14.0%) gangrenous, and 45 (9.0%) perforated. The overall complication rate was 6.0% with no mortality. Perforation was associated with significantly higher morbidity versus simple disease (complication rate 33.3% vs. 4.0%; median stay 6 vs. 2 days; 30-day readmission 28.9% vs. 5.0%). Female gender (OR 2.1, 95% CI 1.3–3.5; p = 0.002) and absence of preoperative imaging (OR 1.8, 95% CI 1.1–3.0; p = 0.021) independently predicted negative appendectomy. Age ≥50 years (OR 4.5, 95% CI 2.0–10.1), symptom duration ≥48 hours (OR 6.2, 95% CI 3.1–12.4), and diabetes mellitus (OR 3.0, 95% CI 1.2–7.5) independently predicted perforation (all p < 0.05). Conclusion: A NAR of 17.0% and perforation rate of 9.0% identify clear targets for quality improvement. Standardized clinical scoring with selective imaging protocols and efforts to reduce diagnostic delay are recommended.
acute appendicitis; negative appendectomy; perforation; imaging; quality improvement; Pakistan
PREVALENCE OF SCIATICA AMONGST PREGNANT WOMEN IN ABBOTTABAD: A CROSS-SECTIONAL STUDY
Aim: Sciatica is a common peripheral neuropathy affecting pregnant women worldwide, characterized by pain, tingling, or numbness radiating down the leg due to sciatic nerve compression. Limited evidence exists regarding sciatica prevalence among pregnant women in Abbottabad. This study aimed to determine the prevalence of sciatica among pregnant women in Abbottabad. Methodology: A descriptive cross-sectional study was conducted at Ayub Medical Complex and Safe Maternity Home Abbottabad over six months. A total of 384 pregnant women in their second and third trimesters, aged 18-45 years, were recruited using convenience sampling. Data were collected using the Sciatica Bothersomeness Index Questionnaire and analyzed using SPSS version 22. Women with diabetes, psychological disorders, or previous lumbosacral fracture/surgery were excluded. Results: Among 384 pregnant women surveyed, 112 (29.1%) had sciatica symptoms. The condition was more prevalent in the third trimester with 92 women (82.1%) compared to 20 women (17.9%) in the second trimester. Leg pain was reported by 120 participants (31.2%), numbness or tingling by 120 (31.2%), weakness by 121 (31.4%), and pain while sitting by 123 (32.2%). The mean age of participants was 28.8 ± 5.28 years. Limitations and Future Implications: The study was limited to two healthcare facilities in Abbottabad with a cross-sectional design preventing causal relationships establishment. Future longitudinal studies should explore risk factors and long-term outcomes of pregnancy-related sciatica. Originality: This is the first comprehensive study documenting sciatica prevalence specifically among pregnant women in Abbottabad, providing baseline data for healthcare planning and intervention strategies in the region.
Sciatica, Pregnancy, Peripheral Nervous System Diseases, Prevalence, Cross-Sectional Studies, Pregnancy Trimesters, Pakistan, Women's Health
GREEN SYNTHESIS AND COMPARATIVE THERAPEUTIC EVALUATION OF MORIN HYDRATE–STABILIZED ZINC OXIDE AND IRON OXIDE NANOPARTICLES
This study focuses on the use of morin hydrate as a reducing agent and stabilizer for the green synthesis and characterization of zinc oxide (ZnO) and iron oxide (Fe3O4) nanoparticles, as well as the comparative evaluation of their therapeutic effects. The use of a naturally occurring flavonoid (morin) has demonstrated antioxidant potential, and thus was deemed appropriate for developing biocompatible nanoparticles via an environmental-friendly synthetic route. Various methods of analysis (UV-visible spectroscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, dynamic light scattering, scanning electron microscopy) were employed to characterize the newly created nanoparticles according to their structural, morphological, and physicochemical characteristics. Biologically-based evaluations were made on the nanoparticles by determining their ability to exhibit antioxidant, antimicrobial, and cytotoxic activities. The results suggested that the nanoparticles formed were stable, in the nanosphere size range; they possessed a crystalline structure; and they were well-dispersed. ZnO nanoparticles demonstrated greater antimicrobial activity against certain pathogenic microorganisms than did the iron oxide nanoparticles, while the iron oxide particles exhibited better biocompatibility and a significant level of antioxidant activity compared to the ZnO nanoparticles. Cytotoxicity testing demonstrated that both sets of nanoparticles had therapeutic potential that was concentration-dependent; therefore both types of nanoparticles will likely be suitable for use in medicine. The biodistribution of the morin with the nanoparticles appears to improve the stability and biological activity through means of the synergistic nature of the morin with either zinc oxide or iron oxide. Keywords: Morin hydrate, Green synthesis, Zinc oxide nanoparticles, Iron oxide nanoparticles, Nanotechnology, Antioxidant activity, Antimicrobial activity, Cytotoxicity, Biocompatibility, Therapeutic evaluation
BEYOND DETECTION: HARNESSING ARTIFICIAL INTELLIGENCE TO TRANSFORM EARLY BREAST CANCER DIAGNOSIS AND SURVIVAL OUTCOMES
Breast cancer remains one of the leading causes of cancer-related mortality among women worldwide, with delayed diagnosis significantly reducing survival rates and treatment effectiveness. This study investigates the transformative role of Artificial Intelligence (AI) in enhancing early breast cancer diagnosis and improving patient survival outcomes. Grounded in the Technology Acceptance Model (TAM) and the Diffusion of Innovation Theory, the research examines how AI-driven diagnostic systems contribute to more accurate, timely, and efficient detection of breast malignancies compared to conventional screening approaches. A quantitative research design was employed using a secondary dataset comprising mammographic imaging records, clinical reports, and patient outcome data obtained from publicly available breast cancer databases. Statistical analyses, including logistic regression, predictive modeling, and machine learning performance evaluation metrics, were conducted to assess diagnostic accuracy and survival-related outcomes. The findings reveal that AI-assisted diagnostic models achieved significantly higher sensitivity, specificity, and predictive accuracy than traditional screening methods. The results indicate an average diagnostic accuracy exceeding 94%, a reduction in false-negative diagnoses by approximately 22%, and improved identification of early-stage tumors. Furthermore, survival projections demonstrated that earlier AI-supported detection was associated with increased five-year survival rates and more favorable treatment responses. The study concludes that AI has the potential to revolutionize breast cancer screening by facilitating earlier detection, reducing diagnostic errors, and enhancing patient outcomes. These measurable improvements underscore the importance of integrating AI technologies into healthcare systems to advance precision medicine and strengthen global breast cancer management strategies.
Artificial Intelligence, Breast Cancer Diagnosis, Early Detection, Machine Learning, Survival Outcomes, Predictive Analytics, Healthcare Innovation.
HOST-DIRECTED ANTIVIRAL STRATEGIES: REPURPOSING DSRNA VIRUSES FOR BROAD-SPECTRUM PANDEMIC RESPONSE
Viral infections are a continuing challenge to the health of the world, because they spread so easily and have a high mutation rate and are becoming resistant to conventional antiviral medications. Antiviral tools are needed to respond quickly to the emergence of new pathogens, as evidenced by the recent epidemics of COVID 19, Ebola and influenza. Traditional antiviral therapies focus on viral proteins and replication mechanism, are, however, often not fully effective due to the rapid evolution of viruses, their limited spectrum of activity and the time needed for a new drug to be developed. These restrictions have led to a resurgence of interest in host directed antiviral therapies as a possible alternate means of therapy. Host directed therapies involve targeting cellular pathways and immune responses in the host that viruses exploit to enter, replicate and survive. This review discusses the mechanisms of host directed antiviral strategies such as the activation of innate immune pathways using Toll like receptor and RIG I like receptor and regulation of cytokine responses, autophagy mediated viral clearance and metabolic reprogramming of infected cells. The antiviral roles of double stranded RNA molecules and their synthetic analogues, including interferon inducers like poly I:C, that promote antiviral immunity against a wide spectrum of viruses is emphasized. The review also underscores the potential of drug repurposing in getting drugs available for viral outbreaks and the diverse families of therapeutic potential of host directed therapies. Furthermore, the challenges of translation, identification of biomarkers and safety and ethics issues with these therapies are discussed. Host directed antiviral therapy is overall an effective approach that can be used in order to increase pandemic preparedness or to create effective broad spectrum antiviral drugs against future emerging viral diseases.
THE MOUTH AS A MIRROR OF HEALTH: UNRAVELING THE HIDDEN LINK BETWEEN SYSTEMIC DISEASES AND ORAL DISORDERS
Many diseases of the body may reveal themselves through the mouth, including diabetes, heart disease, autoimmune diseases, gastroenteritis, blood disorders, and vitamin deficiency diseases and often may show early signs of their presence within the mouth. Examples of symptoms that may provide an important clue to diagnosing a systemic disease include periodontal disease, dry mouth, mouth ulcers, bleeding gums, defective enamel, and lesions of the mucosal tissues of the mouth. Conversely, oral diseases may worsen the systemic disease by causing chronic inflammation in the body and spreading infectious microorganisms in the body. Recent research has shown the bidirectional relationship between oral and systemic health and the value of a complete patient examination and working with other health care providers. Recognizing these oral signs early on by dental professionals can lead to timely referrals, diagnosis, and treatment of the systemic disease, which will ultimately improve patient outcomes and quality of life. In addition, providing prevention-based oral health care is an important way to decrease the total amount of illness and disease related to the mouth and the body as a whole. Keywords: Oral Health, Systemic Diseases, Periodontal Disease, Diabetes Mellitus, Cardiovascular Diseases, Oral Manifestations, Oral-Systemic Link, Chronic Inflammation, Xerostomia, Integrated Healthcare.
EXPLORING THE MOLECULAR CIRCUITS AT BRAIN BORDERS PARTICULARLY THE ROLE OF B-CELL RICH LYMPHOID STRUCTURES IN THE MENINGES IN DRIVING GRAY MATTER INJURY IN MULTIPLE SCLEROSIS
In Multiple Sclerosis, long-term disability and neurodegeneration depends on injury of gray matter, which is one of the central determinants. Even though historically treated as a white matter disorder, Multiple Sclerosis is currently considered to have an early cortical demyelination, synaptic changes, and neuronal degeneration that have a strong impact on the disease progression, especially during its progressive phases. The meninges appear to be dynamic immune niches in which inflammation can become compartmentalized and structured into B-cell rich tertiary lymphoid structures. These systems maintain persistent immune responses in the form of chemokines like CXCL13 and CCL19/CCL21 and survival factors like BAFF and APRIL thereby maintaining the B-cell persistence, plasma cell maturation, and intrathecal antibody generation. Diffused Soluble inflammatory mediators of tertiary lymphoid structures such as cytokines, antibodies and complement components cause neuronal degeneration, microglial and astrocytic activation, oxidative damage, and synaptic dysfunction. Coalescing neuropathology, cerebral fluid biomarker and advanced imaging, and animal model findings associate the tertiary lymphoid structures of the meninges with subpial cortical demyelination and rapid progression. Although B-cell therapeutic approaches and associated pathway therapies are promising, more mechanistic research and valid in vivo biomarkers are needed to establish approaches that are effective in preventing or restricting cortical neurodegeneration.
Multiple Sclerosis, Gray matter, Meninges, B-cells, Tertiary Lymphoid structures, Neurodegeneration, Cerebrospinal fluid