Search

Objective: This study was aimed to assess the impact of tele dentistry on bracket breakage and orthodontic plaque index during the covid pandemic. Study Design: An experimental study. Place and Duration of Study : The study was conducted from 1st April 2020 to 1st March 2021 in the orthodontic department of Rawal Institute of Health Sciences Islamabad. Materials and Methods: Seventy-six orthodontic patients were selected from the orthodontic department of Rawal institute of Health Sciences. Each patient had a minimum orthodontic plaque index of 1 and experienced at least four bracket breakages. The treating doctor provided counseling and communicated with the patients via WhatsApp messages, offering them the opportunity to reach out at any time with questions. After a period of three months, the patients were reassessed clinically. A paired sample t-test was applied to evaluate the pre and post counseling values pertaining to bracket breakage and the orthodontic plaque index. Results: The findings revealed that by using tele dentistry incidence of bracket breakage reduced from 20% to 5% in most of the study participants. Similarly mean plaque index was reduced from 1.78 to 0.53 after online counselling session and WhatsApp messages over a period of three months. Conclusion: This study highlights the potential of tele dentistry not only to enhance access to oral healthcare and its delivery but also to reduce bracket breakage incidents and promote superior oral hygiene in orthodontic patients

Aerosol aggravation poses a significant challenge in the administrative Lahore Division of Punjab, Pakistan and contributes greatly to the persistent issue of smog. Since 2017, the division has experienced recurrent episodes of smog pollution, most notably in the months of October and November. In the present study, aerosol optical depth (AOD) has been analyzed alongside three metrological parameters: temperature, humidity and rainfall. These were tracked in October and November of 2018, 2020, and 2022 using remote sensing data and satellite imaging. Additionally, anthropogenic emissions data from automobile exhaust, industries and stubble burning were derived from secondary sources. Ultimately, the study helped piece together the complex environmental picture in Lahore Division in October and November. The results showed that AOD levels not only increased during this time, they were significantly influenced by a full range of metrological variables such as low temperature, high relative humidity, lack of rainfall and emissions from a variety of human activities. It was found that trucks, tractors and buses were among the worst contributors, alongside industry and stubble burning. Therefore, the present study suggests multi sectoral plans to mitigate aerosol levels and combat the smog menace, promoting environmental sustainability in the Lahore Division. A full set of recommendation is included, divided into three categories: industry, transport and agriculture. These are focused on technology, control systems, disposal, incentives, green solutions and more. At all levels, commitment, collaboration, and coordination are absolutely vital.

Abstract Introduction Colorectal cancer (CRC) is the second leading cause of cancer-related death worldwide. There is a significant burden of mortality from colorectal cancer in Africa. Due to the heterogeneity of dietary and lifestyle practices throughout Africa, our work sought to define risk factors for the development of CRC in the African continent. Methods We systematically searched PubMed, Embase, Global Health, CINAHL, Cochrane CENTRAL, and African Index Medicus for studies written in English, examining the incidence and risk factors of CRC in Africa. A systematic analysis was done to compare different risk factors in constituent studies. A meta-analysis random effects model was fitted to estimate the pooled incidence of CRC. Results Of 2471 studies screened, 26 were included for the quantitative analysis; 20 in the incidence analysis, and six in the risk factor analysis. The overall ASIR per 100,000 person-years of CRC for males and females was 7.51 and 6.22, respectively. The highest incidence rates were observed between 2012 and 2021. Risk factors for CRC in Africa include tobacco smoking, and consumption of red meat, butter, and alcohol. Protective factors included, regular consumption of fruits and regular physical activity. Conclusion The incidence of CRC in Africa is higher than that suggested by previous studies. Our study shows that nonmodifiable and modifiable factors contribute to CRC in Africa. High-quality studies conducted on generalizable populations that examine risk factors in a comprehensive fashion are required to inform primary and secondary prevention initiatives for CRC in Africa.

Background: The leukemic microenvironment has become an area of interest for researchers in recent times. Nonmalignant T and B lymphocytes form a significant part of leukemic microenvironment and are postulated to have an effect on its progression and behavior. These lymphocytes are constantly interacting with blasts and are actively involved in innate and acquired immune responses against these blasts. We decided to look at the role of T-regulatory lymphocytes in tumor surveillance and treatment outcome. Aim and Objectives: The aims and objectives of the study are to evaluate the role of T-regulatory lymphocytes in acute leukemia cases and its correlation with treatment outcome. Materials and Methods: We evaluated consecutive 55 acute leukemia cases to investigate the prognostic effect of T-regulatory cells (T-regs) in acute leukemia. The study period was between January 2021 and December 2021. All patients whose complete records were available till the completion of induction were included in the study. The immunophenotype used to characterize and evaluate T-regs was CD4+CD25+ T lymphocytes. For comparison, a total of 10 healthy controls were included in the study. Clinicohematological parameters including fever, lymphadenopathy, hepatosplenomegaly, extramedullary involvement, day 1 total leukocyte count, and blast percentage in peripheral blood and bone marrow were studied and documented to establish any possible correlation with T-regs percentage and treatment outcome. The treatment outcome evaluated in the study was complete remission postfirst induction. Results: As compared to those of healthy participants, the frequencies of CD4+CD25+ T-regs in the peripheral blood of acute leukemia patients were significantly increased (1.5% [range: 0.50%–4.3%] vs. 0.58% [range: 0.40%–1.05%], P = 0.0001). Furthermore, the frequencies of CD4+CD25+ T-regs in the peripheral blood of acute leukemia patients who did not achieve remission were significantly increased as compared to those who achieved remission (2.9% [range: 0.20%–4.3%] vs. 1.3% [range: 0.30%–2.9%], P = 0.002). No significant correlation was noted in the T-reg cells and parameters such as fever, lymphadenopathy, hepatosplenomegaly, extramedullary involvement, day 1 total leukocyte count, and blast percentage. Conclusion: This study suggests the possibility of using T-regs percentages as a prognostic indicator of acute leukemia and possible role of anti-T-regulatory immunomodulators in improving the outcome of disease.

Background: Increasing incidence has been seen among women of reproductive age with every one out of five women being affected by obesity. Obesity poses unfavorable outcomes for both mother and child causing ten percent of gestational diabetes and pre-eclampsia, neonatal deaths. Objective: To find the association of obesity in pregnancy with maternal and perinatal outcomes.The objective is to investigate the association between maternal obesity during pregnancy and various fetomaternal outcomes and outcome of occurrence of cesarean section deliveries, gestational diabetes, preeclampsia, macrosomia, low birth weight babies, and shoulder dystocia among pregnant women with obesity compared to non-obese pregnant women. The study will assess the relative risk and confidence intervals for all the described outcomes. Subject and Methods: This cohort study was performed in the Department of Obstetrics and Gynaecology, Kulsoom Bai Valika Hospital, site area, Karachi from February to August 2021. A total of 220 patients were included, 110 patients with a BMI equal to or more than 30 kg/m2 were exposed group and 110 cases BMI less than 30 kg/m2 were in the non-exposed group. A detailed history and examination, baseline investigations were carried out. Performa was given to patients of each group, and outcomes were recorded. Results: The average age of the patients was 28.73±6.52 years. The rate of cesarean section and PIH was 3 times more likely in obese groups than non-obese groups [RR=2.74 95%CI: 1.69-3.31] and [RR=3.08 95%CI: 2.11-4.49] respectively. The rate of GDM and preeclampsia was also 2 times more likely in the obese group than the non-obese group [RR=1.48 95%CI: 1.07-2.05] and [RR=2; 95%CI: 1.05-3.79] respectively. The rate of low birth weight was not statistically significant between obese and non-obese groups (p=0.053). While rate of macrosomia 7 times and Shoulder Dystocia time 5 more likely in obese groups than non- obese groups [RR=6.85; 95%CI: 3.24-14.48] and [RR=4.80; 95%CI: 2.56-8.99] respectively. Conclusion: Obesity is a challenge of the present era for obstetricians, which is reaching the status of epidemic worldwide. This study shows that obesity in pregnant females is directly proportional to poor fetomaternal outcomes, therefore pregnant obese females should be managed as a high-risk case.

In this article, we study the majorization problem for the general class of functions with bounded radius rotation, which the authors introduced here. Furthermore, the coefficient bound for majorized functions associated with this class is derived. Consequently, we present new results as corollaries and point out relevant connections between the main results obtained from the ones in the literature.

Abstract Cancer cells with BRCA1/2 deficiencies are sensitive to poly (ADP-ribose) polymerase (PARP) inhibitors. We evaluated the efficacy of talazoparib in DNA-Damage Repair (DDR)-altered patients. In this phase II trial, patients were enrolled onto one of four cohorts based on molecular alterations: (1) somatic BRCA1/2, (2) other homologous recombination repair pathway, (3) PTEN and (4) germline BRCA1/2. The primary endpoint was a clinical benefit rate (CBR): complete response, partial response or stable disease ≥24 weeks. 79 patients with a median of 4 lines of therapy were enrolled. CBR for cohorts 1–4 were: 32.5%, 19.7%, 9.4% and 30.6%, respectively. PTEN mutations correlated with reduced survival and a trend towards shorter time to progression.Talazoparib demonstrated clinical benefit in selected DDR-altered patients. PTEN mutations/loss patients derived limited clinical benefit. Further study is needed to determine whether PTEN is prognostic or predictive of response to PARP inhibitors.

Abstract The context of education has changed due to revolutionary developments in the information communication technology (ICT) industry in the post-COVID era. Innovative learning methods were introduced in the education sector to promote quality education. The students find it more convenient to use ICT tools to integrate their knowledge-seeking. China has recently paid more attention to developing and adopting electronic infrastructure. The study assesses the effect of technology self-efficacy (TSE) on ICT acceptance and implementation in China’s education sector. It also analyzed the role of perceived trust, perceived security, and electronic word of mouth (eWOM) in integrating digital information sharing and interaction tools. Data is collected from 382 business students at Chinese universities. The results revealed that perceived trust mediates the relationship between TSE and the actual use of ICT tools, intention to use ICT tools for information, and intention to use ICT tools for interaction. Further, perceived security and eWOM significantly moderate the relationship between TSE and perceived trust. The findings indicate that it is essential to offer assistance and instruction to students in the educational sector so they can use ICT technology more frequently. It is also crucial for organizations to establish a supportive culture and provide the necessary technological resources to facilitate the use of ICT.

In situ monitoring of bone regeneration enables timely diagnosis and intervention by acquiring vital biological parameters. However, an existing gap exists in the availability of effective methodologies for continuous and dynamic monitoring of the bone tissue regeneration process, encompassing the concurrent visualization of bone formation and implant degradation. Here, we present an integrated scaffold designed to facilitate real-time monitoring of both bone formation and implant degradation during the repair of bone defects. Laponite (Lap), CyP-loaded mesoporous silica (CyP@MSNs) and ultrasmall superparamagnetic iron oxide nanoparticles (USPIO@SiO2) were incorporated into a bioink containing bone marrow mesenchymal stem cells (BMSCs) to fabricate functional scaffolds denoted as C@M/GLU using 3D bioprinting technology. In both in vivo and in vitro experiments, the composite scaffold has demonstrated a significant enhancement of bone regeneration through the controlled release of silicon (Si) and magnesium (Mg) ions. Employing near-infrared fluorescence (NIR-FL) imaging, the composite scaffold facilitates the monitoring of alkaline phosphate (ALP) expression, providing an accurate reflection of the scaffold's initial osteogenic activity. Meanwhile, the degradation of scaffolds was monitored by tracking the changes in the magnetic resonance (MR) signals at various time points. These findings indicate that the designed scaffold holds potential as an in situ bone implant for combined visualization of osteogenesis and implant degradation throughout the bone repair process.

Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease without meaningful therapeutic options beyond the first salvage therapy. Targeting PDAC metabolism through amino acid restriction has emerged as a promising new strategy, with asparaginases, enzymes that deplete plasma glutamine and asparagine, reaching clinical trials. In this study, we investigated the anti-PDAC activity of the asparaginase formulation Pegcrisantaspase (PegC) alone and in combination with standard-of-care chemotherapeutics. Methods Using mouse and human PDAC cell lines, we assessed the impact of PegC on cell proliferation, cell death, and cell cycle progression. We further characterized the in vitro effect of PegC on protein synthesis as well as the generation of reactive oxygen species and levels of glutathione, a major cellular antioxidant. Additional cell line studies examined the effect of the combination of PegC with standard-of-care chemotherapeutics. In vivo, the tolerability and efficacy of PegC, as well as the impact on plasma amino acid levels, was assessed using the C57BL/6-derived KPC syngeneic mouse model. Results Here we report that PegC demonstrated potent anti-proliferative activity in a panel of human and murine PDAC cell lines. This decrease in proliferation was accompanied by inhibited protein synthesis and decreased levels of glutathione. In vivo, PegC was tolerable and effectively reduced plasma levels of glutamine and asparagine, leading to a statistically significant inhibition of tumor growth in a syngeneic mouse model of PDAC. There was no observable in vitro or in vivo benefit to combining PegC with standard-of-care chemotherapeutics, including oxaliplatin, irinotecan, 5-fluorouracil, paclitaxel, and gemcitabine. Notably, PegC treatment increased tumor expression of asparagine and serine biosynthetic enzymes. Conclusions Taken together, our results demonstrate the potential therapeutic use of PegC in PDAC and highlight the importance of identifying candidates for combination regimens that could improve cytotoxicity and/or reduce the induction of resistance pathways.

Purpose: To evaluate the effect of topical carbonic anhydrase inhibitor (brinzolamide) versus placebo on visual function and waveforms in infantile nystagmus syndrome (INS). Design: Prospective, placebo-controlled, double-blind, cross-over study. Methods: Setting- A tertiary eye care center. Patients- Cases of idiopathic INS with and without abnormal head posture aged ≥10 years who had not received previous treatment for nystagmus. Intervention- Patients were randomized into two groups. Group 1 was given placebo for 3 months, and after a washout period of 7 days started on topical brinzolamide for the next 3 months. In group 2, the order was reversed. The drops were administered topically three times (every 8 hours) in both eyes. Outcome measure- Binocular best corrected visual acuity (BCVA) using the ETDRS chart, eXpanded nystagmus acuity function (NAFX) score and INS waveforms obtained from eye movement recordings, intraocular pressure (IOP) by Goldmann applanation tonometer, near stereopsis by TNO stereo test, and change in abnormal head posture before and after intervention in the null position. Results: A total of 29 cases completed the study (23 with abnormal head posture; 6 without abnormal head posture) . A significant improvement was noted in INS waveform characteristics, mean NAFX score (P < 0.001), and mean binocular visual acuity (P < 0.001) with topical brinzolamide in comparison to baseline as well as placebo. No significant change in head position and stereopsis was noted. No side effects were reported with 3 months of brinzolamide therapy. Conclusions: While brinzolamide shows improvement in visual acuity and NAFX score in idiopathic INS, its clinical significance needs further evidence.

In this study, the polar root extract of Cyperus scariosus R.Br. was used for the biogenic synthesis of ZnO NPs. The results of this study show that ZnO NPs have a spherical structure with an average size of 85.4 nm. The synthesized catalysts were tested for their photocatalytic activity by degrading methyl orange and methylene blue under sunlight. Improved degradation efficiencies of 79.44% and 84.92% were achieved within 120 min. ZnO NPs exhibited strong antibacterial activity against both Gram-positive Listeria monocytogenes (18 mm) and Staphylococcus epidermidis (20 mm) and Gram-negative strains of Escherichia coli (16 mm) and Bordetella bronchiseptica (14 mm), as shown by the inhibition zones, which were comparable to the positive control (ceftriaxone) but larger than the plant root extract. ZnO NPs showed high antioxidant activity, as a ferric-reducing antioxidant power assay value of 66.29 µg (AAE µg·mL−1) and a DPPH value of 57.44 µg (AAE µg·mL−1) were obtained at a concentration of 500 µL, which was higher than those of the C. scariosus root extract. Quantification of the total phenolic and flavonoid content yielded values of 57.63 µg (GAE µg·mL−1) and 70.59 µg (QCE µg·mL−1), respectively. At a concentration of 500 μL (1 mg·mL−1), the tested nanoparticles (NPs) showed a greater anti-inflammatory effect (84.12%) compared to the root extract of C. scariosus (34.39%). Overall, our findings highlight the versatile properties of green synthesized ZnO NPs and demonstrate their potential for environmental remediation and antimicrobial formulations, as well as promising candidates for further investigation in biomedical fields such as drug delivery and therapy.

Samiah Shahid,1,2 Ayesha Khan,1 Wajeehah Shahid,3 Mehvesh Rehan,2 Roha Asif,1 Haseeb Nisar,4 Qudsia Kanwal,5 Jeong Ryeol Choi6 1Research Centre for Health Sciences (RCHS), The University of Lahore, Lahore, Pakistan; 2Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan; 3Department of Physics, The University of Lahore, Lahore, Pakistan; 4School of Life Sciences, University of Management and Technology, Lahore, Pakistan; 5Department of Chemistry, The University of Lahore, Lahore, Pakistan; 6School of Electronic Engineering, Kyonggi University, Suwon, Kyeonggi-do, 16227, Republic of KoreaCorrespondence: Samiah Shahid, Research Centre for Health Sciences (RCHS), Associate Professor, Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, 54590, Pakistan, Email samiah.shahid@yahoo.com Jeong Ryeol Choi, School of Electronic Engineering, Kyonggi University, Suwon, Kyeonggi-do, 16227, Republic of Korea, Email choiardor@hanmail.netAbstract: Breast and ovarian cancers, despite having chemotherapy and surgical treatment, still have the lowest survival rate. Experimental stages using nanoenzymes/nanozymes for ovarian cancer diagnosis and treatment are being carried out, and correspondingly the current treatment approaches to treat breast cancer have a lot of adverse side effects, which is the reason why researchers and scientists are looking for new strategies with less side effects. Nanoenzymes have intrinsic enzyme-like activities and can reduce the shortcomings of naturally occurring enzymes due to the ease of storage, high stability, less expensive, and enhanced efficiency. In this review, we have discussed various ways in which nanoenzymes are being used to diagnose and treat breast and ovarian cancer. For breast cancer, nanoenzymes and their multi-enzymatic properties can control the level of reactive oxygen species (ROS) in cells or tissues, for example, oxidase (OXD) and peroxidase (POD) activity can be used to generate ROS, while catalase (CAT) or superoxide dismutase (SOD) activity can scavenge ROS. In the case of ovarian cancer, most commonly nanoceria is being investigated, and also when folic acid is combined with nanoceria there are additional advantages like inhibition of beta galactosidase. Nanocarriers are also used to deliver small interfering RNA that are effective in cancer treatment. Studies have shown that iron oxide nanoparticles are actively being used for drug delivery, similarly ferritin carriers are used for the delivery of nanozymes. Hypoxia is a major factor in ovarian cancer, therefore MnO2-based nanozymes are being used as a therapy. For cancer diagnosis and screening, nanozymes are being used in sonodynamic cancer therapy for cancer diagnosis and screening, whereas biomedical imaging and folic acid gold particles are also being used for image guided treatments. Nanozyme biosensors have been developed to detect ovarian cancer. This review article summarizes a detailed insight into breast and ovarian cancers in light of nanozymes-based diagnostic and therapeutic approaches. Keywords: breast cancer, ovarian cancer, nanoenzymes, diagnosis, treatment

Congenital bilateral absence of vas deferens (CBAVD) is a urological syndrome of Wolffian ducts and is responsible for male infertility and obstructive azoospermia. This study is designed to explore the integrity of exon 10 of CFTR and its role in male infertility in a cohort of CBVAD patients in Pakistan. Genomic DNA was extracted from 17 male patients with CBAVD having clinical symptoms, and 10 healthy controls via phenol-chloroform method. Exon 10 of the CFTR gene was amplified, using PCR with specific primers and DNA screening was done by Sanger sequencing. Sequencing results were analyzed using freeware Serial Cloner, SnapGene, BioEdit and FinchTV. Furthermore, bioinformatics tools were used to analyze the mutations and their impact on the protein function and stability. We have identified 4 mutations on exon 10 of CFTR in 6 out of 17 patients. Two of the mutations were missense variants V456A, K464E, and the other two were silent mutations G437G, S431S. The identified variant V456A was present in 4 of the studied patients. Whereas, the presence of K464E in our patients further weighs on the crucial importance for its strategic location to influence the gene function at post-transcriptional and protein level. Furthermore, Polyphen-2 and SIFT analyze the mutations as harmful and deleterious. The recurrence of V456A and tactically conserved locality of K464E are evidence of their potential role in CBAVD patients and in male infertility. The data can contribute in developing genetic testing and treatment of CBAVD.

Background: Kynotherapy is a form of contact therapy in which trained and certified dogs are used for the purpose of rehabilitation of people. Therapist has a significant role in planning and maintaining therapy session as well as engaging patient in session, the incorporation of animals (dog) in session totally depends on the therapist. Kynotherapy has several beneficial effects in various conditions as psychological wellbeing, communication, socialization, autism spectrum disorders, pain relieving, reduces stress and it improves mobility. Objective: The objective of this study was to know the perception of physical therapists regarding kynotherapy. Methodology: A Questionnaire-based survey was conducted in which 169 physical therapists of Hyderabad participated. Purposive sampling technique was used. A closed ended questionnaire was used which was comprised of 20 positive and negative statements regarding kynotherapy. The study was held from July 2022 to December 2022. The data was analyzed by using the SPSS version22. Results: The mean age of participants was 27.21±3.95. 23.10% were males and 76.90% were females in this study. The participants with a total mean value of 27.62 showed positive perception regarding hypnotherapy, out of which physical therapist with a total mean value of 8.49, 9.18 and 9.59 were academicians, clinicians and the participants who provided services in both the academic side and clinical side, respectively. Conclusion: A limited number of participants have positive perception regarding kynotherapy as very few physical therapists had heard about kynotherapy. Keywords: Kynotherapy, Physical Therapists, Perceptions, Rehabilitation, Animal-assisted Therapy.

In the contemporary era of information technology, copious amounts of data are ubiquitous, generated across various sectors on a daily basis. Analyzing every unit of data is impractical due to constraints such as limited resources in terms of time, labor, and cost. In such scenarios, survey sampling becomes a recommended approach for extracting information about population parameters. The primary goal of this study is to devise an estimation method for acquiring information about population parameters. We propose an optimal estimator for an improved estimation of the population mean in stratified random sampling by leveraging the information from two auxiliary attributes. The proposed estimator's bias, mean squared error (MSE), and minimum mean squared error are determined up to the first-order approximation. It is demonstrated that, under the derived conditions, the proposed estimator theoretically outperforms existing estimators. Four population are utilized to evaluate both the performance and applicability of the proposed estimator. The percentage relative efficiency (PRE) of proposed estimator for all the populations is 178.389, 142.881, 181.383, and 152.679 respectively. The suggested estimator superior to existing estimators, as demonstrated by the numerical examples.

Objective: To determine frequency of clinical and laboratory markers in the early stage of dengue infection. Methods: From July 13, 2023 to October 12, 2023, this descriptive cross-sectional study was carried out in the department of Medicine at PNS RAHAT Hospital, Karachi. Subjects were enrolled in accordance with eligibility criteria and informed verbal and written consent were taken. A physical examination, clinical history, demographic information, and pertinent baseline investigations were completed. Clinical markers were recorded during the course of illness and endorsed in proforma. All patients were laboratory evaluated for dengue NS-1 antigen and IgM by ELISA method. For data analysis, SPSS software, version 20, was utilized. Results: A total number of 106 patients were recruited. When clinical markers of acute dengue infection were assessed, 40 (37.9%) had vomiting, 49 (46.5%) had Myalgia and 44 (41.75%) had Petechiae. When laboratory markers of acute dengue infection were assessed, 92 (87%) had Leucopenia, 89 (84%) had Thrombocytopenia and 94 (88.9%) had AST/ALT > 1.5. Conclusion: Clinicians still face difficulties in diagnosing dengue infection in its early stages so this study findings may help in establishing early diagnosis and can help clinicians to make rational clinical decisions during evaluation of a patient with suspected DF in resource-poor setups, where facility of detection of serum NS1 antigen is not available.

Objective: The objective of the study was to determine the reasons affecting career choice for post-graduation and decision of studying abroad among undergraduate students in a medical university of Karachi. Methods: A cross-sectional study was conducted among students of 1stto 5th year MBBS program of Baqai Medical University, Karachi from March 2022 to August 2022. A questionnaire was filled by students who voluntarily wished to participate. Statistical Package for Social Sciences version 21 was used for data analysis. Results: The most common clinical fields of choice for post-graduation of medical students were cardiothoracic surgery (14.3%), followed by general surgery (13.6%), whereas the most common non-clinical fields of choice were medical education (53.3%) followed by research (20.0%). A majority of students (54.5%) wished to pursue post-graduation abroad. Among those opting for staying in Pakistan, almost half of them wished to work in rural areas (n=69, 50.4%) and the remaining in urban areas (49.6%). Conclusion: The most popular clinical fields of choice for post-graduation among medical students turned out to be cardiothoracic surgery whereas the non-clinical career switch was mostly towards medical education. Moreover, a majority of students wished to pursue their post-graduation abroad. Key words: Career Choice, Specialty, Medical, Emigration, Students, Medical

Although batteries are a highly popular energy source in biosensors, batteries can be an economic limitation for low‐cost sensing applications and pose significant challenges in miniaturization, biocompatibility, and disposal. To surmount such issues, “self‐powered sensors” gain the spotlight thanks to their energy harvesting from the environment through embedded miniaturized systems. In this review, the recent developments in self‐powered devices are summarized with a specific focus on the integration of supercapacitors with sensors and biosensors. The working principles of microsupercapacitors, fabrication methods, their integration with biosensors, and their ultimate applications (i.e., biomedical monitoring and analytical biomarker detection) are described. Different energy harvesting systems are summarized and their integration with self‐powered sensors or biosensors is highlighted. The limitations and challenges of the existing approaches and the future of supercapacitor‐integrated sensing systems are also critically discussed.

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) prevalence has doubled in the last 20 years and is becoming a vital health concern due to its increasing prevalence. Lean patients having normal-weight central obesity with NAFLD may have increased morbidity and all-cause mortality and thus form an important target for lifestyle modifications and preventive strategies. Objective: To determine frequencies of NAFLD and Metabolic Syndrome in lean individuals. Methods: The present cross-sectional study was undertaken at the Medicine Department, Pakistan Ordinance Factories Hospital, Wah Cantonment Pakistan from July 2018 to June 2020 enrolling 230 patients aged 20 to 70 years, of both sex. Demographic information, co-morbid conditions, BMI, and waist circumference were recorded. An abdominal ultrasound was performed to determine hepatic fatty infiltration. Blood samples were collected for serum HDL-cholesterol (HDL-C) and serum triglyceride estimation. SPSS 22.0 was used for data entry and analysis. Results: Mean age was 45.7+12.5 years with male predominance at 130 (56.5%). Diabetes mellitus was present in 104 (45.2%) and 102 (44.3%) were hypertensive. The mean BMI was 23.4+3.6 kg/m2. The mean serum triglyceride level was 209+10.1 mg/dl and elevated at 141 (61.3%). The mean serum HDL-C level was 23.1+4.2 mg/dl and was reduced by 142 (61.8%). NAFLD was seen in 38 (16.5%) patients and 24 (10.4%) had Metabolic Syndrome. Among the 38 lean NAFLD patients, 21 (55.3%) had Metabolic Syndrome. Conclusion: NAFLD was seen in almost one-fifth of lean patients enrolled. Metabolic syndrome was reported in more than one-half of these lean NAFLD patients

Abstract ADAMTS13, a disintegrin and metalloprotease with a thrombospondin type 1 motif, member 13, regulates the length of Von Willebrand factor (VWF) multimers and their platelet-binding activity. ADAMTS13 is constitutively secreted as an active protease and is not inhibited by circulating protease inhibitors. Therefore, the mechanisms that regulate ADAMTS13 protease activity are unknown. We performed an unbiased proteomics screen to identify ligands of ADAMTS13 by optimizing the application of BioID to plasma. Plasma BioID identified 5 plasma proteins significantly labeled by the ADAMTS13-birA* fusion, including VWF and plasminogen. Glu-plasminogen, Lys-plasminogen, mini-plasminogen, and apo(a) bound ADAMTS13 with high affinity, whereas micro-plasminogen did not. None of the plasminogen variants or apo(a) bound to a C-terminal truncation variant of ADAMTS13 (MDTCS). The binding of plasminogen to ADAMTS13 was attenuated by tranexamic acid or ε-aminocaproic acid, and tranexamic acid protected ADAMTS13 from plasmin degradation. These data demonstrate that plasminogen is an important ligand of ADAMTS13 in plasma by binding to the C-terminus of ADAMTS13. Plasmin proteolytically degrades ADAMTS13 in a lysine-dependent manner, which may contribute to its regulation. Adapting BioID to identify protein-interaction networks in plasma provides a powerful new tool to study protease regulation in the cardiovascular system.

Omar W Althomali,1,&ast; Junaid Amin,1,&ast; Daria Hussain Shaik,1 Wael Alghamdi,2 Ahmed Abdelmoniem Ibrahim,1,3 Hisham M Hussein,1,4 Raheela Kanwal1 1Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, 2440, Saudi Arabia; 2Department of Nursing, College of Applied Medical Sciences, AlBaha University, AlBaha, 1988, Saudi Arabia; 3Department of Physical Therapy, Cairo University Hospitals, Giza, Egypt; 4Department of Basic Sciences for Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Egypt&ast;These authors contributed equally to this workCorrespondence: Junaid Amin, Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, 2440, Saudi Arabia, Tel +966-580931017, Email Junaid768@hotmail.comBackground: Prior research has revealed notable declines in health-related quality of life (HRQoL) and substantial psychological impacts among individuals infected with COVID-19. However, there is a noticeable gap in studies addressing the enduring long-term effects of COVID-19 on HRQoL and psychological well-being.Objective: The current study investigated and compared short and long-term effects of COVID-19 on HRQoL and psychological outcomes among the Saudi population.Methods: The Arabic version of the SF-36 questionnaire was used to assess HRQoL while Anxiety and depression were evaluated by the Hamilton Anxiety (HAM-A) and Depression Scales (HDRS). Participants (n=292) were categorized into three groups: the “never-been-infected” group (n=134), the “one-year infected group” (n=43), and the “more than one year infected” group (n=115). Descriptive statistics were presented using numerical values and frequencies. To compare the groups, a one-way analysis of variance (ANOVA) test was used.Results: Most SF-36 domains exhibited lower values while HAM-A and HDRS values were higher in individuals infected during last year compared to those who never infected. Social functioning subscale of the SF-36 showed a significant difference between the groups (F (2.289) = 6.094, p = 0.01) and the effect size was d = 0.95. Pairwise comparison showed a significant reduction in the social functioning component of SF-36 in “one-year group” compared to both groups “never-been-infected” group (mean difference − 13.58 (4.40– 22.76) p < 0.01) and “more than one year infected” group (mean difference − 10.80 (1.44– 20.16) p = 0.02). HAM-A and HDRS scores showed mild levels of anxiety (< 17 score) and depression (8 to 16 score) in all groups.Conclusion: The influence of COVID-19 on psychological well-being and HRQoL is significant regardless of whether individuals infected with the virus. Overall, the consistent presence of mild anxiety and depression across all groups highlights the need for a holistic approach to mental health.Plain Language Summary: In this study, we looked at how COVID-19 infection affected the quality of life and mental well-being of people in Saudi Arabia in both the short and long term. We used surveys to measure quality of life, anxiety, and depression among 292 participants, categorizing them based on whether they had never been infected, were infected within the last year, or were infected more than one year ago. The results showed that individuals who were infected in the last year had lower scores in various aspects of quality of life and higher levels of anxiety and depression compared to those who had never been infected.Although mild levels of anxiety and depression were found in all groups. The study suggests that there is an impact on mental health in individuals even one year post-infection compared to never infected individuals. This highlights the importance of ongoing mental health support for individuals who have experienced the virus. Overall, the study emphasizes the need for a comprehensive approach to mental health care that considers both those who have been infected and those who have not.Keywords: anxiety, COVID-19, depression, quality of life, SF-36

Introduction: Chemodynamic therapy (CDT) holds great promise in achieving cancer therapy through Fenton and Fenton-like reactions, which generate highly toxic reactive species. However, CDT is limited by the lower amount of catalyst ions that can decompose already existing intracellular H2O2 and produce reactive oxygen species (ROS) to attain a therapeutic outcome. Objectives: To overcome these limitations, a tailored approach, which utilizes dual metals cations (Ag+, Fe2+) based silver pentacyanonitrosylferrate or silver nitroprusside (AgNP) were developed for Fenton like reactions that can specifically kill cancer cells by taking advantage of tumor acidic environment without used of any external stimuli. Methods: A simple solution mixing procedure was used to synthesize AgNP as CDT agent. AgNP were structurally and morphologically characterized, and it was observed that a minimal dose of AgNP is required to destroy cancer cells with limited effects on normal cells. Moreover, comprehensive in vitro studies were conducted to evaluate antitumoral mechanism. Results: AgNP have an effective ability to decompose endogenous H2O2 in cells. The decomposed endogenous H2O2 generates several different types of reactive species (•OH, O2•−) including peroxynitrite (ONOO−) species as apoptotic inducers that kill cancer cells, specifically. Cellular internalization data demonstrated that in short time, AgNP enters in lysosomes, avoid degradation and due to the acidic pH of lysosomes significantly generate high ROS levels. These data are further confirmed by the activation of different oxidative genes. Additionally, we demonstrated the biocompatibility of AgNP on mouse liver and ovarian organoids as an ex vivo model while AgNP showed the therapeutic efficacy on patient derived tumor organoids (PDTO). Conclusion: This work demonstrates the therapeutic application of silver nitroprusside as a multiple ROS generator utilizing Fenton like reaction. Thereby, our study exhibits a potential application of CDT against HGSOC (High Grade Serous Ovarian Cancer), a deadly cancer through altering the redox homeostasis.

Environmental exposure to heavy metals, particularly lead (Pb) and nickel (Ni), is implicated in chronic metabolic diseases, including diabetes mellitus (DM). This cross-sectional study assessed the Pb and Ni levels in groundwater using ICP-OES and urine samples collected from 2688 participants using ICP-MS. We aimed to establish the associations between Pb and Ni exposure and risk factors for DM and metabolic disorders. Groundwater analysis revealed the elevated levels of total dissolved solids, electrical conductivity, hardness, turbidity, Ni, and Pb, exceeding the WHO guidelines. The mean concentration of Pb in groundwater samples of study area was 0.025 mg/L which was higher than the WHO permissible limit of 0.01 mg/L. Similarly the mean concentration of Ni in groundwater samples of study area was 0.038 mg/L which was also higher than the WHO permissible limit of 0.02 mg/L. In human study, participants, categorized into Pb-detected and Ni-detected groups, exhibited significantly higher Pb and Ni levels and non-exposed non-diabetic groups. Ni-detected diabetics showed elevated Ni levels compared to non-exposed non-diabetics. Similarly, Pb-detected diabetics showed elevated Pb levels compared to non-exposed non-diabetics. These findings suggest a potential contribution of Pb and Ni exposure to DM development. The study also identified associations between heavy metal exposure and disruptions in various biomarkers related to DM, lipid profile, inflammation, oxidative stress, liver function, and kidney function. Pb-detected diabetics demonstrated elevated levels of glycemic index biomarkers, including fasting blood glucose (P

This study explores the impact of financial inclusion on CO2 emissions in G7 and E7 countries over the period 2004 to 2020. Through fuzzy set qualitative comparative analysis (fsQCA), the research reveals that financial inclusion interacts with key factors such as income levels, energy consumption, urbanization, and foreign direct investment, shaping emissions outcomes in these countries. Trade openness is identified as a significant driver of environmental degradation, further complicating the relationship between financial systems and ecological impact. Despite these interactions, the study finds a clear gap in policies that directly connect financial inclusion with CO2 reduction efforts. The findings emphasize the need for governments to align financial inclusion strategies with environmental policies to foster more sustainable economic and ecological development.

Objective: The current study aimed to observe hypertension educational intervention's effect on general physicians (GPs) to improve blood pressure control and patient outcomes indirectly. Methods: This randomized control trial includes 42 GPs divided into 2 groups. GPs in group 1 receive face-to-face education with structured educational material on hypertension management strategies by a senior cardiologist. GPs in group 2 receive the print version of education material. The data was collected from six major cities in Pakistan. GPs with at least three years of experience in the broad primary care disciplines, with ages above 18 years, were included in the study. Results: A total of 42 physicians (21 from each group) completed questionnaires, while out of 420 hypertension patients, 105 newly diagnosed and already diagnosed patients enrolled under physicians of both groups. The educational material did just as well at informing clinicians as the face-to-face group intervention did and both the interventions had a significant effect on knowledge and BP control. Conclusion: After the 3-month follow-up, both interventions, including face-to-face and educational approaches, demonstrated significant effectiveness in improving knowledge and blood pressure control. Innovation: The study shows that hypertension educational intervention's effect on general physicians indirectly improves blood pressure control and patient outcomes. And emphasize for developing a hypertension educational program targeted at general physicians.

IntroductionInconsistent results observed in recent phase III trials assessing chimeric antigenic receptor T (CAR-T) cell therapy as a second-line treatment compared to standard of care (SOC) in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) prompted a meta-analysis to assess the effectiveness of CAR-T cell therapy in this setting.MethodsRandom-effects meta-analysis was conducted to pool effect estimates for comparison between CAR-T cell therapy and SOC. Mixed treatment comparisons were made using a frequentist network meta-analysis approach.ResultsMeta-analysis of three trials with 865 patients showed significant improvement in event-free survival (EFS: HR: 0.51; 95% CI: 0.27-0.97; I2: 92%), progression-free survival (PFS: HR: 0.47; 95% CI: 0.37-0.60; I2: 0%) with CAR-T cell therapy compared to SOC. Although there was a signal of potential overall survival (OS) improvement with CAR-T cell therapy, the difference was not statistically significant between the two groups (HR 0.76; 95% CI: 0.56 to 1.03; I2: 29%). Mixed treatment comparisons showed significant EFS benefit with liso-cel (HR: 0.37; 95% CI: 0.22-0.61) and axi-cel (HR: 0.42; 95% CI: 0.29-0.61) compared to tisa-cel.DiscussionCAR-T cell therapy, as a second-line treatment, appears to be effective in achieving higher response rates and delaying the disease progression compared to SOC in R/R DLBCL.

This investigation portrays the phytochemical screening, green synthesis, characterization of Fe and Zn nanoparticles, their antibacterial, anti-inflammation, cytotoxicity, and anti-thrombolytic activities. Four dissimilar solvents such as, n-hexane, chloroform, ethyl acetate and n-butanol were used to prepare the extracts of Phlomis cashmeriana Royle ex Benth. This is valued medicinal plant (Family Lamiaceae), native to mountains of Afghanistan and Kashmir. In the GC-MS study of its extract, the identified phytoconstituents have different nature such as terpenoids, alcohol and esters. The synthesized nanoparticles were characterized by SEM, UV, XRD, and FT-IR. The phytochemical analysis showed that the plant contains TPC (total phenolic content) 297.51 mg GAE/g and TFC (total flavonoid content) 467.24 mg CE/g. The cytotoxicity values have shown that the chloroform, n-butanol and aqueous extracts were more toxic than other extracts. The anti-inflammatory potential of n-butanol and aqueous extracts was found higher than all other extracts. Chloroform and n-hexane extracts have low MIC values against both E. coli and S. aureus bacterial strains. Chloroform and aqueous extracts have great anti-thrombolytic potential than all other extracts. Overall, this study successfully synthesized the nanoparticles and provides evidence that P. cashmeriana have promising bioactive compounds that could serve as potential source in the drug formulation.

Objectives The study aimed to compare the risk of gastrointestinal infections among patients with and without metabolic dysfunction-associated fatty liver disease (MAFLD).Methods This was a population-based, retrospective, observational study using data from the National Inpatient Sample (NIS), the largest all-payer US inpatient care database.Setting Hospitalisation of adults aged ≥18 years old admitted in 2020 was identified using the NIS. Patients were stratified by the presence and absence of MAFLD.Participants 26.4 million adults aged ≥18 years old were included in the study. Patients younger than 18 and those with missing demographic or mortality data were excluded.Primary and secondary outcomes Primary outcome was to assess the overall risk of gastrointestinal infections in patients with and without MAFLD. Secondary outcomes were demographics and comorbidities stratified by the presence or absence of gastrointestinal infection, and the risk of specific gastrointestinal pathogens.Results Of 26.4 million patients admitted in 2020, 755 910 (2.85%) had the presence of MAFLD. There was a higher prevalence of bacterial gastrointestinal infections in patients with MAFLD than those without (1.6% vs 0.9%, p

Background: Childhood Recurrent Abdominal Pain results in the one of the adulthood complications i.e., irritable bowel syndrome, which is a gastro-intestinal disease. The stomach’s acidic environment is the growth site for Helicobacter Pylori, a pathogenic Gram-negative bacterium with rod shape. It is the main reason for chronic gastritis, gastric adenocarcinoma, peptic ulcers, non-ulcer dyspepsia and mucosa-associated lymphoid tissue (MALT) lymphoma. According to one estimate, 50% of people in world are infected with Helicobacter Pylori. Currently the developing countries are on the hit list of Helicobacter Pylori. The objective of this study was to determine the frequency of Helicobacter pylori infection in the children having recurrent abdominal pain. Materials and Methods: It was a cross-sectional study. This research was carried out during 1.1.2018 to 1.6.2018 in the D.H.Q hospital Mirpur AJK. The sample was consisted of 200 participants among them the proportion of Helicobacter was 8% in patients with Recurrent Abdominal Pain. Results: The mean age of the patients was 12.43 ± 1.23 years. Mostly the age of the sample group was between 8 to16 years. The 4.23 ± 0.47 months was the mean time period of abdominal pain. Helicobacter pylori was found in 47% of patients. Conclusion: In paediatric population, Helicobacter pylori is very common with Recurrent Abdominal Pain. It is a severe problem in children and further study is recommended to explore the risk element associated with this increase trouble of Helicobacter Pylori.

Aims Patients with opioid dependence seek treatment for the discomforting withdrawal symptoms. Accurate clinical assessment is essential as medications are optimized based on these withdrawal symptoms. However, subjective reporting can present challenges. Heart rate variability (HRV) can enhance clinical assessment and has taxonomic and therapeutic implications. This study aimed to explore the correlation between HRV and subjective withdrawal in patients with opioid dependence and to compare the HRV parameters in patients undergoing detoxification to those maintained on opioid agonist treatment and healthy controls. Methods 3 groups of adult male participants were included. Group 1 included 40 patients with opioid dependence undergoing inpatient detoxification. Group 2 included 40 patients with opioid dependence receiving stable doses of buprenorphine on outpatient basis. Group 3 included 49 healthy controls. The Subjective Opiate Withdrawal Scale (SOWS) was used for withdrawal symptoms. For Group 1 and Group 2, HRV was assessed twice – before administration of morning dose of buprenorphine, and then 2 hours post administration. For Group 3 HRV was assessed once. Results At baseline, resting heart rate differed significantly between the 3 groups (p < 0.001), it was highest for Group 2 (92.4) and lowest for Group 3 (79.4). In time domain parameters of HRV, the beat-to-beat variability was highest for Group 1 with standard deviation of all normal RR intervals (SDNN) = 134.8, root mean square of successive differences between normal heartbeats (RMSSD) = 181.7 and RR tri index = 8.9 (p < 0.005). In frequency domain parameters of HRV, total power was highest for Group 1 (98334.1, p < 0.001) while relative power did not differ significantly among the groups. The SOWS had a weak negative correlation with RMSSD in Group 2 (r = -0.312, p < 0.05) but did not have any correlation with HRV parameters in Group 1. Post administration of morning buprenorphine, the HRV parameters did not show a significant change in either of the groups (except reduction in very low frequency percentage in Group 1 from 12.013 to 7.196, p < 0.05). Conclusion A higher degree of subjective withdrawal is associated with lower beat-to-beat variability in patients on stable doses of buprenorphine. However, this exploratory study did not find a robust relationship between HRV and subjective withdrawal symptoms. Higher RMSSD (representative of higher vagal tone) in patients undergoing detoxification may suggest greater physiological adaptation to withdrawal symptoms. This study provides additional insights into HRV in patients with opioid dependence.

In crops like wheat, terminal drought is one of the principal stress factors limiting productivity in rain-fed systems. However, little is known about root development after heading, when water uptake can be critical to wheat crops. The impact of water-stress on root growth was investigated in two wheat cultivars, Scout and Mace, under well-watered and post-anthesis water stress in three experiments. Plants were grown outside in 1.5-m long pots at a density similar to local recommended farming practice. Differences in root development were observed between genotypes, especially for water stress conditions under which Scout developed and maintained a larger root system than Mace. While under well-watered conditions both genotypes had shallow roots that appeared to senesce after heading, a moderate water stress stimulated shallow-root growth in Scout but accelerated senescence in Mace. For deep roots, post-heading biomass growth was observed for both genotypes in well-watered conditions, while under moderate water stress, only Scout maintained net growth as Mace deep roots senesced. Water stress of severe intensity affected both genotypes similarly, with root senescence at all depths. Senescence was also observed above ground. Under well-watered conditions, Scout retained leaf greenness (i.e. stay-green phenotype) for slightly longer than Mace. The difference between genotypes accentuated under moderate water stress, with rapid post-anthesis leaf senescence in Mace while Scout leaf greenness was affected little if at all by the stress. As an overall result, grain biomass per plant (‘yield’) was similar in the two genotypes under well-watered conditions, but more affected by a moderate stress in Mace than Scout. The findings from this study will assist improvement in modelling root systems of crop models, development of relevant phenotyping methods and selection of cultivars with better adaptation to drought.

Background: Oral Submucous Fibrosis (OSMF) is defined as severe submucosal fibrosis and decreased vascularity, resulting in a compromised blood supply leading to hypoxia of tissues. The key biomarker involved is Hypoxia Inducible Factor-1α (HIF-1α). The objective of this research was to analyze the expression of HIF-1α in saliva samples of individuals across the clinical stages of OSMF and healthy controls. Methods: This case-control study consisted of 120 participants, 60 patients had different clinical stages of OSMF and 60 healthy controls. Samples of saliva were collected and quantification of salivary samples was done using ELISA. Kolmogorov-Smirnov test assessed data normality. Kruskal Wallis test was applied to assess the association between salivary HIF-1α levels and clinical stages of OSMF. The Kendall Tau correlation test was used to assess the relationship between different stages of OSMF and salivary HIF-1α levels. Results: The comparison of HIF-1α expression in different stages of OSMF and healthy controls was done. In comparison, it was found that HIF-1α expression increased significantly (p=0.00) in patients than controls. The expression was increased with stages, stage I (16.84 ± 9.74), stage II (19.51 ± 7.99), stage III (24.43 ± 7.49), and stage IV (28.92 ± 5.12), respectively. The odd ratio indicates for every progressive stage, the odds for high salivary HIF-1α levels increase by 1.63 times. Conclusion: Levels of salivary HIF-1α showed increased expression with the progressive stages of OSMF. This variation in the levels of salivary HIF-1α suggests its possible role as an early non-invasive detective marker in the assessment of disease progression.

Background: Gout is the most prevailing type of inflammatory arthropathy and its incidence has risen in recent decades. As previously no such research was found through an extensive literature survey, the current study aimed to evaluate gout patients residing in Lahore, Pakistan. Methods: To conduct this cross-sectional study, n=203 responses were obtained by a simple and objective-oriented questionnaire devised for the collection of data. Dependent variables association was measured by the Pearson Chi-square. A p-value

Oral submucous fibrosis (OSMF) is a premalignant condition, which involves the oral cavity as well as pharynx and upper third of the esophagus. It is a predominant disease of South and South-East Asian population. OSMF has the highest rate of malignant transformation among the other oral premalignant disorders (OPMD) that is 7-30% with a prevalence of about 0.03% to 6.42%. OSMF is described by extensive fibrosis of submucosa and reduced vascularity, which results in compromised blood supply guiding to hypoxia of tissue. This tissue hypoxia brings about the transcription of a set of genes associated with angiogenesis, breakdown of iron/glucose, cell division and cell stability. Hypoxia Inducible Factor-1α (HIF-1α) is the main biomarker intervening in this reaction. The alteration of cells to hypoxia emerges to be mediated through hypoxia inducible factor, which is said to be linked with malignant transformation of epithelium. Research-based studies covered on the probable mechanism of HIF-1α were explored using PubMed and Google Scholar. In this review, we analyzed over 40 articles from the years 2004-2021, which were published regarding the structure and function of HIF-1α, and its association with OSMF. Research articles in which HIF-1α is used separately or in combination with other biomarkers in oral submucous fibrosis have been selected. Keywords: Biomarker; Oral Submucous Fibrosis; Esophagus; Hypoxia.

Background: Oral submucous fibrosis (OSMF), a chronic debilitating condition distinguished by juxtaepithelial fibrosis or extensive fibrosis of submucosa and reduced vascularity, results in compromised blood supply causing tissue hypoxia. This brings about the transcription of a set of genes associated with angiogenesis, breakdown of iron/glucose, cell division and cell stability. Hypoxia Inducible Factor-1α (HIF-1α) is the main biomarker intervening in this reaction. The aim of research was to measure the salivary levels of HIF-1α in OSMF patients and healthy controls. Methods: This study included 60 participants (30 Oral submucous fibrosis cases and 30 healthy controls). The consecutive sampling technique was used for the recruitment of the study participants. The enzyme-linked immunosorbent assay (ELISA) was used to evaluate HIF-1α levels in saliva. In order to determine data normality, the Kolmogorov-Smirnov test was used. Independent t test was applied to compare salivary levels of HIF-1α between cases and controls and p-value of less than 0.05 was considered statistically significant. Results: The mean salivary HIF-1α value for the oral submucous fibrosis group was 20.18±7.78, compared to healthy controls 13.62±8.86. A statistically significant difference was seen between levels of HIF-1α in the OSMF and control group (p=0.003). The mean mouth opening for cases was 22.94±9.51 mm and for controls 42.00±5.19 mm. There was no correlation among salivary levels of HIF-1α in both the case and control groups (-0.059, -0.030) respectively. Conclusion: Higher levels of HIF-1α were seen in the OSMF group in comparison to healthy individuals suggesting that HIF-1α may play a role in malignant transformation of OSMF. Keywords: Oral Submucous Fibrosis; Saliva; Hypoxia Inducible Factor-1α.

Background: Regenerative medicine is a collaborative field that applies combined concepts of tissue engineering and cell biology to promote regeneration. Tissue regeneration initiate the emergence of remedies that can replace and revive tissues and loss of organs through illness and injury and reduce dependency on organ transplantation. The objective was to isolate a homogenous population of human amniotic epithelial stem cells (hAECs) and to determine their phenotype under a live-cell imaging microscope at 1st, 3rd and 8th-day intervals. Methods: This was an experimental in-vitro study conducted on human placenta (amniotic epithelial stem cells) at Ziauddin Hospital and University. The 22 human placenta were collected from patients with age 20-30 years having healthy full-term pregnancies, with a preference for elective cesarean sections. In vitro isolation of human amniotic epithelial stem cells was used after manual removal of the amniotic membrane from the chorionic membrane of human term placenta via single-step enzymatic digestion. The morphology of the attached cells was analyzed at different magnifications i.e., 10X, 20X and 40X. Results: The isolated human amniotic epithelial stem cells on day 3 started forming colonies and attained a characteristic cuboid epithelial shape and exhibited a confluent single layer on day 8. Morphologically resembled cobblestones with a characteristic of fully vacuolated cytoplasm were found uncontaminated with spindle-shaped human amniotic mesenchymal stem cells (MSCs). Conclusion: The isolated population of hAESCs were highly proliferative and not contaminated with MSCs. Therefore, this optimized protocol may be used for the isolation and the biobanking of hAESCs for future cellular transplantation. Keywords: Human Amniotic Epithelial Stem Cells (hAESCs); Regenerative Medicine; Perinatal Stem Cells; Placental Membrane; Amniotic Membrane.

Skin cancer is a pervasive and potentially life-threatening disease. Early detection plays a crucial role in improving patient outcomes. Machine learning (ML) techniques, particularly when combined with pre-trained deep learning models, have shown promise in enhancing the accuracy of skin cancer detection. In this paper, we enhanced the VGG19 pre-trained model with max pooling and dense layer for the prediction of skin cancer. Moreover, we also explored the pre-trained models such as Visual Geometry Group 19 (VGG19), Residual Network 152 version 2 (ResNet152v2), Inception-Residual Network version 2 (InceptionResNetV2), Dense Convolutional Network 201 (DenseNet201), Residual Network 50 (ResNet50), Inception version 3 (InceptionV3), For training, skin lesions dataset is used with malignant and benign cases. The models extract features and divide skin lesions into two categories: malignant and benign. The features are then fed into machine learning methods, including Linear Support Vector Machine (SVM), k-Nearest Neighbors (KNN), Decision Tree (DT), Logistic Regression (LR) and Support Vector Machine (SVM), our results demonstrate that combining E-VGG19 model with traditional classifiers significantly improves the overall classification accuracy for skin cancer detection and classification. Moreover, we have also compared the performance of baseline classifiers and pre-trained models with metrics (recall, F1 score, precision, sensitivity, and accuracy). The experiment results provide valuable insights into the effectiveness of various models and classifiers for accurate and efficient skin cancer detection. This research contributes to the ongoing efforts to create automated technologies for detecting skin cancer that can help healthcare professionals and individuals identify potential skin cancer cases at an early stage, ultimately leading to more timely and effective treatments.

This study investigates the role of transactional leadership as a pivotal antecedent to employee knowledge hiding, specifically focusing on tacit and explicit forms. Drawing on social learning theory, the study proposes and examines the indirect effect of transactional leadership on both tacit and explicit knowledge hiding through the mediation of perceived competition. Additionally, the study introduces leader knowledge hiding as a potential boundary condition to these relationships. Data were collected from university employees in Pakistan using a time-lagged design. The study employed structural equation modeling, utilizing AMOS 23, to rigorously test the proposed hypotheses. The results reveal that transactional leadership significantly encourages tacit and explicit knowledge hiding, with perceived competition as the underlying mechanism. However, the hypothesized moderating effect of leader knowledge hiding is not supported. This study is a pioneering effort to understand the nuanced relationship between transactional leadership, perceived competition, and the distinct forms of knowledge hiding—tacit and explicit. Incorporating leader knowledge hiding as a potential boundary condition adds a unique dimension to the existing literature, contributing novel insights. Our findings hold implications for knowledge management and transactional leadership literature. Practitioners can glean valuable insights from the study's results to inform strategies to mitigate knowledge hiding behaviors within organizational settings.

Abstract Rheumatoid arthritis (RA) is a systemic self-inflicted inflammatory disease that primarily affects middle-aged women. Globally, 1% of people live with RA. This review aims to provide updated information on the different aspects of RA, including its epidemiology, pathophysiology, diagnosis, treatment, and management. A web-based literature search was conducted through various databases, including PubMed, Google Scholar, and Science Direct, to identify the most relevant studies. Epidemiological studies have suggested that the prevalence and occurrence of RA have remained inconsistent across geographical areas in different periods. Many factors such as age, gender, inheritances, and environmental exposure can contribute to the severity of the disease. The acute form of RA usually presents with pain, and if left untreated, it can result in joint deformities and influence a patient's quality of life (QoL). RA diagnosis is usually based on the manifestation of pain with inflammation. Currently, many therapeutic strategies are available for the cure of RA. The management of daily routine activities is required with treatment to curtail the damage, avoid future deformities, and ultimately minimize the aching trouble of the patient.

Sustainable and water-wise cities maintain an eco-friendly urban hydrological cycle (UHC). Regrettably, the UHC of Pakistani cities is not consistently eco-friendly. Pakistan is situated within the influential area of the world's largest monsoon weather system. Cities like Lahore face simultaneous vulnerabilities to urban flooding and water scarcity due to extreme climate change events. Therefore, Pakistan's urban areas necessitate Urban Water Infrastructural Transformation (UWIT), achievable only after identifying suitable Rainwater and Stormwater Harvesting Potential Sites (RSWHPS) in Lahore. Hence, we conducted spatial analysis to pinpoint these RSWHPS within Lahore city for 2020, utilizing the World View Water Index (WV-WI). The results indicate 85.54 km2 of available areas for rain and stormwater harvesting potential during monsoon rains in Lahore. The area with the highest potential in Lahore is Wagha town, featuring 19.96 km2 of stagnant water. Additionally, RSWHPS is classified into four categories based on potential: high, medium, low, and water bodies in Lahore. Urgent transformation is required for the identified storm and rainwater harvesting sites. Consequently, this study will serve as a snapshot for policymakers to systematically address water shortage and urban flooding, making Lahore's hydrological cycle eco-friendly and sustainable. HIGHLIGHTS The study addresses the importance of sustainable and water-wise cities in maintaining an eco-friendly urban hydrological cycle.; Recognizing the pressing need for change, the research emphasizes the requirement for urban water infrastructural transformation in Pakistan's urban areas.; The study is a valuable resource for policymakers, providing insights to systematically address water shortages and urban flooding.;

Background: Hepatitis C, caused by the Hepatitis C Virus (HCV), is the second most common form of viral hepatitis. The geographical distribution of HCV genotypes can be quite complex, making it challenging to ascertain the most prevalent genotype in a specific area. Methods: To address this, a review was conducted to determine the prevalence of HCV genotypes across various provinces and as a whole in Pakistan. The scientific literature regarding the prevalence, distribution, genotyping, and epidemiology of HCV was gathered from published articles spanning the years 1996–2020. Results: Genotype 1 accounted for 5.1% of the patients, with its predominant subtype being 1a at 4.38%. The frequencies of its other subtypes, 1b and 1c, were observed to be 1.0% and 0.31% respectively. Genotype 2 had a frequency of 2.66%, with the most widely distributed subtype being 2a at 2.11% of the patients. Its other subtypes, 2b and 2c, had frequencies of 0.17% and 0.36% respectively. The most prevalent genotype among all isolates was 3 (65.35%), with the most frequent subtype being 3a (55.15%), followed by 3b (7.18%). The prevalence of genotypes 4, 5, and 6 were scarce in Pakistan, with frequencies of 0.97%, 0.08%, and 0.32% respectively. The prevalence of untypeable and mixed genotypes was 21.34% and 3.53% respectively. Estimating genotypes proves to be a productive method in assisting with the duration and selection of antiviral treatment. Different HCV genotypes can exhibit variations in their response to specific antiviral treatments. Different genotypes may have distinct natural histories, including variations in disease progression and severity. Some genotypes may lead to more rapid liver damage, while others progress more slowly. Conclusions: This information can guide screening and testing strategies, helping to identify individuals at higher risk of developing severe complications. Studying the distribution of HCV genotypes in a population can provide valuable insights into the transmission dynamics of the virus.

Abstract 5G technology continues to evolve, and its potential to revolutionize various aspects of society is becoming increasingly evident. However, the successful adoption and utilization of 5G technology depends on various factors, particularly among consumers expected to be early adopters and critical drivers of technological advancements. This study investigates the effect of social influence, environmental awareness, and safety affordance on Chinese university students' actual use of 5G (AU5G) technologies. It also analyzed the mediating role of trustworthiness and intention to use 5G (ITU5G) between them and the moderating role of facilitation conditions between trustworthiness and ITU5G. Data was collected from university students (n = 364) in Beijing and was examined employing the structural equation modelling (SEM) approach. The outcomes confirm that trustworthiness and ITU5G significantly mediate the relationship between social influence, environmental awareness, and safety affordance on AU5G technologies among Chinese students. Further, the supportive facilitation conditions strengthen the relationship between trustworthiness and ITU5G. These findings are backed by UTAUT2 models that support the technology acceptance and adoption among the users. The study outcomes can help policymakers design strategies to address potential barriers and encourage greater uptake of 5G services among university students.

Abstract Neurons and their connecting axons gradually degenerate in neurodegenerative diseases (NDs), leading to dysfunctionality of the neuronal cells and eventually their death. Drug delivery for the treatment of effected nervous system is notoriously complicated because of the presence of natural barriers, i.e., the blood-brain barrier and the blood cerebrospinal fluid barrier. Palliative care is currently the standard care for many diseases. Therefore, treatment programs that target the disease’s origin rather than its symptoms are recommended. Nanotechnology-based drug delivery platforms offer an innovative way to circumvent these obstacles and deliver medications directly to the central nervous system, thereby enabling treatment of several common neurological problems, i.e., Alzheimer’s, Parkinson’s, Huntington’s, and amyotrophic lateral sclerosis. Interestingly, the combination of nanomedicine and gene therapy enables targeting of selective mutant genes responsible for the progression of NDs, which may provide a much-needed boost in the struggle against these diseases. Herein, we discussed various central nervous system delivery obstacles, followed by a detailed insight into the recently developed techniques to restore neurological function via the differentiation of neural stem cells. Moreover, a comprehensive background on the role of nanomedicine in controlling neurogenesis via differentiation of neural stem cells is explained. Additionally, numerous phytoconstituents with their neuroprotective properties and molecular targets in the identification and management of NDs are also deliberated. Furthermore, a detailed insight of the ongoing clinical trials and currently marketed products for the treatment of NDs is provided in this manuscript. Graphical abstract