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Glioma, a highly aggressive form of brain cancer, continues to pose significant therapeutic challenges in the field of medicine. Its invasive nature and resistance to traditional treatments make it particularly difficult to combat. This review examines the potential of metformin, a commonly prescribed antidiabetic medication, as a promising new treatment option for glioma. The potential of metformin to target crucial metabolic pathways in cancer cells presents an encouraging approach to improve therapeutic outcomes. The review explores the complexities of metabolic reprogramming in glioma and metformin's role in inhibiting these metabolic pathways. Preclinical studies demonstrate metformin's efficacy in reducing tumor growth and enhancing the sensitivity of glioma cells to chemotherapy and radiotherapy. Furthermore, clinical studies highlight metformin's potential in improving progression-free survival and overall survival rates in glioma patients. The review also addresses the synergistic effects of combining metformin with other therapeutic agents, such as temozolomide and radiotherapy, to overcome drug resistance and improve treatment efficacy.Despite the promising findings, the review acknowledges the need for further clinical trials to establish optimal dosing regimens, understand the molecular mechanisms underlying metforminʼs antitumor effects, and identify patient populations that would benefit the most from metformin-based therapies. Additionally, the potential side effects and the long-term impact of metformin on Glioma patients require careful evaluation.In conclusion, this review underscores the potential of metformin as a repurposed drug in glioma treatment, emphasizing its multifaceted role in targeting metabolic dysregulation. Metformin holds promise as part of a combination therapy approach to improve the therapeutic landscape of glioma and offers hope for better patient outcomes.

Muhammad Nadeem,1 Mumtaz Anwar,2 Shahid Adil,3 Wajid Syed,4 Mahmood Basil A Al-Rawi,5 Ayesha Iqbal6,7 1Department of Economics, University of Education, Lahore, Vehari Campus, Pakistan; 2School of Economics, University of the Punjab, Lahore, Pakistan; 3Punjab Resource Improvement and Digital Effectiveness (PRIDE) Project, Planning and Development Board, Government of the Punjab, Punjab, Pakistan; 4Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 5Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 6Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham UK; 7Faculty of Medicine and Dentistry, University of Alberta, Edmonton, CanadaCorrespondence: Muhammad Nadeem, Email muhammad.nadeem@ue.edu.pkBackground: Access to safe drinking water, sanitation, and hygiene (WASH) facilities is crucial for health and human rights, impacting nutrition and weight.Methods: Multiple Indicators Cluster Survey (MICS) 2017– 18 has been used in this study to examine the association between WASH and underweight, alongside other factors. Analysis included descriptive statistics, association tests, logistic regression, and population-attributable fractions (PAF).Results: According to results child were 1.8, 1.1 and 1.04 times less likely to be underweight if they had access to improved source of drinking water, improved sanitation and hygiene facilities respectively. The likelihood of child being underweight reduces by 1.4, 1.89, 2.01 and 2.55 times if the household wealth status increases from poorest to second, middle, fourth and richest wealth quintiles, respectively. As the mothers’ education level increases from no schooling to primary, middle, secondary, and higher level, the possibility of child being underweight reduces by 1.22, 1.24, 1.60 and 2.01 times, respectively. Moreover, the likelihood of a child being underweight decreases as the education level of the household head improves. If maternal age is less than 20 or more than 35 years the likelihood of the child being underweight is increased by 1.074 and 1.121 times, respectively. A child is 1.1 times more likely to be underweight if birth spacing is less than 2 years. A child’s risk of being underweight decreases by 1.1 times if they have not experienced diarrhea. A child who has never been breastfed has 1.3 times higher risk of being underweight. The results of Population Attributable Fraction (PAF) indicate that holding the other factors constant, approximately 36.46% burden of underweight was preventable by access to improved drinking water, sanitation, and hygiene practices.Conclusion: Comprehensive strategy is needed that focuses on improving access to safe drinking water, sanitation infrastructure, and hygiene behaviors.Keywords: water, sanitation, hygiene, children, underweight, Pakistan, WASH

Abstract Background One of the main limitations of radiation therapy is the resistance of tumor cells. This study aimed at evaluating the relationship between the expression of epidermal growth factor receptor (EGFR) and echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) and tumor radiosensitivity in patients with non-small cell lung cancer. Methods Medical case files, pathological results for EGFR and EML4-ALK, and computerized tomography scans of patients with NSCLC treated with thoracic radiation therapy were analyzed. Results The sample size was 101 patients with mean age 58.43 ± 9.89 years. Statistically significant differences were observed in the mean reduction of long tumor diameter during the early treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04) and in short tumor diameter during the late treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04). Conclusion Patients with overexpression of EGFR mutations are more radiosensitive during the early treatment phase, and EML4-ALK mutations were less radiosensitive regardless of phases.

Ali Hakami,1 Mohammed Badedi,2 Mohammed Elsiddig,1 Mohammed Nadeem,1 Nada Altherwi,1 Raed Rayani,1 Akram Alhazmi1 1Kidney Center, King Fahad Central Hospital, Jazan Health Affairs, Jazan, Saudi Arabia; 2Administration of Research & Studies, Jazan Health Affairs, Jazan, Saudi ArabiaCorrespondence: Ali Hakami Tel +966 505797663Email alialhakami2003@yahoo.comBackground: The prognosis of the novel coronavirus disease 2019 (COVID-19) may be poor in patients with end-stage kidney disease (ESKD). Limited information is available on the clinical characteristics and outcomes of such patients in Arab countries. The present study aimed to address this gap.Methods: This retrospective cohort study included 101 patients with ESKD who were hospitalized for COVID-19 between May 1, 2020 and December 31, 2020 at King Fahad Central Hospital (single center), Jazan Province, Saudi Arabia. Chi-square test, independent samples t-test, Mann–Whitney U-test, and Cox regression were performed in the statistical analysis.Results: Of the 101 hospitalized COVID-19 patients with ESKD, 20 patients died (19.8%). Patients aged ≥ 65 years had a significant mortality risk. Mortality was higher in male patients (70%) than in female patients (30%). The most common comorbidities were hypertension (88%), diabetes mellitus (47%), and heart disease (17%). The presence of diabetes and cardiovascular diseases along with ESKD increased the mortality risk [relative risk (RR) = 6.5 and RR = 3.8, respectively]. The most frequently reported clinical symptoms were fever (50%), shortness of breath (41%), and cough (35%). In total, 17% of the patients were admitted to the intensive care unit and required mechanical ventilation. Most patients had bilateral lung infiltrates (88%). Hemoglobin levels and platelet counts were significantly lower in the deceased patients than in the surviving ones. Moreover, compared with the surviving patients, higher degree of lymphocytopenia, neutrophilia, ferritin, D-dimer, blood urea nitrogen, and aspartate transaminase were detected in the deceased patients. Septic shock (20%) and respiratory failure (19%) were the most prevalent complications resulting in death.Conclusion: COVID-19 patients with ESKD have an increased risk of poor outcomes and mortality. The mortality risk increases with an increase in age and the presence of other comorbidities, such as diabetes and cardiovascular disease. Elevated levels of inflammatory markers correlate with disease severity and are associated with in-hospital mortality in this population.Keywords: COVID-19, SARS-CoV-2, end-stage kidney disease, ESKD

Muhammad Nadeem,1 Ramsha Khan,1 Komal Afridi,1 Akhtar Nadhman,1 Sana Ullah,2 Sulaiman Faisal,1 Zia Ul Mabood,1 Christophe Hano,3 Bilal Haider Abbasi2 1Institute of Integrative Biosciences, CECOS University of IT and Emerging Sciences, Peshawar 25100, KPK, Pakistan; 2Department of Biotechnology, Quaid I Azam University, Islamabad 45320, Pakistan; 3Laboratoire de Biologie des Ligneux et des Grandes Cultures (LBLGC), Plant Lignans Team, INRAE USC1328, Université d’Orléans, Eure Et Loir Campus, Chartres F28000, FranceCorrespondence: Muhammad Nadeem Email m.nadeem@cecos.edu.pkAbstract: During the last decade green synthesized cerium oxide nanoparticles (CeO2 NPs) attracted remarkable interest in various fields of science and technology. This review, explores the vast array of biological resources such as plants, microbes, and other biological products being used in synthesis of CeO2 NPs. It also discusses their biosynthetic mechanism, current understandings, and trends in the green synthesis of CeO2 NPs. Novel therapies based on green synthesized CeO2 NPs are illustrated, in particular their antimicrobial potential along with attempts of their mechanistic elucidation. Overall, the main objective of this review is to provide a rational insight of the major accomplishments of CeO2 NPs as novel therapeutics agents for a wide range of microbial pathogens and combating other diseases.Keywords: nanotechnology, green synthesis, cerium oxide, nanoparticles, antimicrobial, infections, biomedical

Muhammad Shafiq,1 Muhammad Nadeem,2 Zeeshan Sattar,3 Sohaib Mohammad Khan,2 Sheikh Muhammad Faheem,4 Irfan Ahsan,5 Rabia Naheed,6 Tahir Mehmood Khattak,2 Shahzad Akbar,7 Muhammad Talha Khan,3 Muhammad Ilyas Khan,1 Muhammad Zubair Khan8 1Department of Internal Medicine, Khyber Teaching Hospital, University Town, Peshawar, 2Department of General Surgery, Nishtar Medical College and Hospital, Dera Ghazi Khan, Punjab, 3Department of Internal Medicine, Khyber Medical College, University Campus, Peshawar, 4Department of Neurology, King Edward Medical University, Anarkali, Lahore, Pakistan; 5Department of Internal Medicine, Mayo Hospital, Phoenix, AZ, USA; 6Department of Internal Medicine, Fatima Memorial Hospital, Lahore, 7Department of Internal Medicine, Lady Reading Hospital, Andar Shehr, Peshawar, 8Department of Internal Medicine, Hayatabad Medical Complex, Hayat Abad, Pakistan Background: Hepatitis B and C need immediate worldwide attention as the infection rates are too high. More than 240 million people have chronic (long-term) liver infections. Every year, about 600,000 people die globally due to the acute or chronic consequences of hepatitis B and more than 350,000 people die from hepatitis C-related liver diseases. Methods: Our study was designed as a case-control, descriptive study. It was conducted through formal interviews by using structured questionnaires. A total of 100 cases were included, with four controls for each case. Results: This study confirms household contact, history of dental work, history of surgery, sexual contact, and history of transfusion (blood and its components) as the main risk factors which are responsible for the increased prevalence of hepatitis. Conclusion: The important risk factors, responsible for the high prevalence of hepatitis B and C in our society are household contact, history of dental work, history of surgery, sexual contact, and history of transfusion (blood and its components). The odds ratio of probability for these risk factors are: 4.2 for household contact history, 4.1 for history of dental work, 3.9 for sexual contact, 2.7 for history of surgery, and 2.1 for history of transfusion. Associations of other predictor variables (diabetes status, education level, profession, contact sports, intravenous drug abuse, residence, immunosuppression, and skin tattoos) were not statistically significant. Keywords: hepatitis B, hepatitis C, IV drug abuse, transfusion, dental work, surgery, sexual contact

Despite progressive research being done on drug therapy to treat breast cancer, the number of patients succumbing to the disease is still a major issue. Combinatorial treatment using different drugs and herbs to treat cancer patients is of major interest in scientists nowadays. Doxorubicin is one of the most used drugs to treat breast cancer patients. The combination of doxorubicin to other drugs such as tamoxifen has been reported. Nevertheless, the combination of doxorubicin with a natural product-derived agent has not been studied yet. Morinda citrifolia has always been sought out for its remarkable remedies. Damnacanthal, an anthraquinone that can be extracted from the roots of Morinda citrifolia is a promising compound that possesses a variety of biological properties. This study aimed to study the therapeutic effects of damnacanthal in combination with doxorubicin in breast cancer cells. Collectively, the combination of both these molecules enhanced the efficacy of induced cell death in MCF-7 as evidenced by the MTT assay, cell cycle, annexin V and expression of apoptosis-related genes and proteins. The effectiveness of doxorubicin as an anti-cancer drug was increased upon addition of damnacanthal. These results could provide a promising approach to treat breast cancer patients.

An exact solution of steady state, electroosmotic, transient magnetohydrodynamic (MHD) flow, and heat transfer of a viscous and incompressible electrically conducting nanofluid consists of water and Cu metal, through a microparallel channel under the combined effect of pressure and vertically acting magnetic field is found. An exact solution is calculated through Laplace transform using the software of Mathematica to find the steady velocity and temperature field depending on many dimensionless parameters. The electromagnetic couple effect, the volumetric generation of heat caused by the Joule heating effect, and viscous dissipation are considered to analyze the thermally fully formed heat flow problem based on the steady part of the velocity field. The exact result of the temperature field is obtained by taking the uniform boundary heat flux. The significant parameter of heat flow known as the Nusselt number, depending on the height of the microtube, is defined. At last, the entropy generation of MHD temperature flow is analyzed. The interpretation of variations that occurred in internal and external entropy generations is given and consequences are explained. [ABSTRACT FROM AUTHOR]

Effective herbicide resistance management in Avena fatua is a crucial challenge to sustain wheat production. Using classic bioassay confirmed fenoxaprop-P-ethyl resistance in A. fatua biotypes in four districts of Punjab, Pakistan (Khushab, Mianwali, Bhakkar, and Sargodha). The efficacy testing of herbicide mixtures comprising clodinafop-propargyl plus metribuzin, pinoxaden plus sulfosulfuron, pinoxaden plus metribuzin, and sulfosulfuron plus clodinafop-propargyl had concentrations at 100%, 75%, and 50% of the recommended dose for each herbicide to control A. fatua resistant to fenoxaprop-P-ethyl. Results indicated that A. fatua displayed widespread resistance to fenoxaprop-Pethyl, ranging from 4.12 to 5.49, in all the surveyed districts. Every mixture of herbicides demonstrated 100% mortality at 100% and 75% of the authorized dose, demonstrating high efficacy in suppressing the weeds. At 100% and 75% of the recommended dose, every tested herbicide mixture showed 100% mortality, indicating high efficacy in controlling weeds. At 50% doses, clodinafop-propargyl plus metribuzin exhibited higher efficacy in controlling weeds than other herbicide mixtures. It is the first report of A. fatua from Punjab, Pakistan, stating resistance to fenoxaprop-P-ethyl. The improved herbicide combinations will be beneficial in minimizing the possible emergence of cross-resistance, decreasing wheat production losses, and efficiently managing A. fatua. [ABSTRACT FROM AUTHOR]