The journal focuses on publishing high-quality research and reviews across a wide range of scientific disciplines, including biology, immunology, pharmacology, epidemiology, and public health. It aims to provide an interdisciplinary platform for scholars, researchers, and professionals to share knowledge and advancements in these critical fields. In biology, the journal covers diverse topics such as cell biology, molecular biology, genetics, microbiology, and evolutionary biology, offering insights into fundamental life processes. The immunology section includes cutting-edge research on immune responses, autoimmune diseases, vaccinology, and innovative immunotherapy approaches. Pharmacology is a key area of focus, with emphasis on drug discovery, pharmacokinetics, pharmacodynamics, clinical trials, and toxicology, highlighting advancements in therapeutic solutions and medication safety. The journal also prioritizes epidemiology, addressing disease outbreaks, public health surveillance, health statistics, and the identification of risk factors that influence population health. A strong commitment to public health is evident through the promotion of studies on preventive medicine, global health initiatives, health policies, health promotion, and disease prevention strategies. The journal also explores emerging fields such as biopharmaceuticals, bioinformatics, translational medicine, genomics, proteomics, nanomedicine, systems biology, and environmental health. With its interdisciplinary approach, the journal bridges the gap between basic research and practical applications, fostering collaboration among scientists and practitioners. By focusing on innovative methods and solutions, the journal contributes to advancements in healthcare, disease management, and the improvement of global health outcomes. This description reflects the scope of the journal and ensures optimal visibility in search engines, enhancing discoverability and accessibility for researchers worldwide.
Energy Healing: An Alternative Medicine or an Alternative to Medicine?
For centuries, health and healing have been central to human survival and progress. Modern medicine rooted in scientific inquiry, pharmacology, and advanced technology has undeniably saved millions of lives. Vaccines, antibiotics, surgical procedures, and cutting-edge diagnostics stand as towering achievements of conventional medicine. Yet, alongside this scientific dominance, there persists a parallel stream of healing practices often grouped under the umbrella of alternative medicine.1 Among these, energy healing a practice grounded in the belief that life force or bioenergy can influence health has gained growing attention and controversy alike.1 The question worth examining is whether energy healing should be seen merely as an alternative medicine that complements conventional treatments, or as an alternative to medicine in itself. Alternative medicine, sometimes termed complementary or integrative medicine, encompasses a wide spectrum: herbal therapies, acupuncture, chiropractic care, meditation, yoga, homeopathy, and energy-based practices.2 While some of these modalities have gained partial validation through clinical trials, others remain on the fringe of scientific acceptance. The global rise in interest toward alternative medicine has multiple drivers. Firstly, concerns regarding certain aspects of modern medicine, such as rising costs, the often-impersonal nature of hospital care, and potential side effects are notable at various levels. Second, the cultural revival of traditional knowledge systems, from Ayurveda in India to Traditional Chinese Medicine (TCM), has legitimized practices that were once dismissed as outdated. Third, in an era increasingly defined by general wellness, people seek healing that addresses mind, body, and spirit is something modern biomedicine often overlooks. Energy healing, in particular, has thrived under this wave. Practices such as Reiki, Pranic healing, Qi Gong, and Therapeutic Touch have found adherents across continents, including in highly industrialized nations with advanced healthcare systems.3 Energy healing views humans as more than physical bodies surrounded by refined life forces whose blockages can manifest as illness. By balancing this energy, practitioners aim to restore health and vitality. Traditions describe it as prana in India, qi in China, ki in Japan, and “biofield” in Western thought. Techniques vary Reiki channels energy through hands, Pranic healing cleanses energy centers, and Qi Gong uses movement and breath but all link health with energy balance.4 Various modalities such as sound therapy, sound bowl therapy, Tibetan singing bowls, color therapy, hijama (cupping), and reflexology are widely recognized as useful approaches within the field of energy healing. The greatest challenge is measurability: “refined energy” cannot be directly captured by modern instruments. Critics call it placebo, yet some studies show reduced pain, stress, and improved recovery outcomes. Evidence remains mixed, but benefits in comfort and quality of life are frequently reported. 5 Energy healing is increasingly accepted as a supportive approach, not a replacement.3 Hospitals in the US, Canada, and Europe allow Reiki or Healing Touch in cancer care, surgery, and palliative settings, mainly to reduce stress and pain.6 The Institute of Noetic Sciences (IONS), a nonprofit scientific research center and experiential lab, focuses on exploring the intersection of science and profound human experience. Similarly, the HeartMath Institute offers practical solutions to reduce stress, enhance energy and resilience, and restore mental, emotional, and physical balance. Both serve as recognized examples of organizations working in the field of energy healing technology. Problems arise when healing replaces evidence-based medicine. Choosing Reiki over chemotherapy or Pranic healing over antibiotics can have fatal outcomes. Authorities stress it should support, not substitute, proven treatments. Its scope remains significant. It may reduce stress, anxiety, and depression, provide relief for chronic pain or terminal illness, promote resilience and balance as part of wellness practices, and strengthen cultural and spiritual identity. It is already highlighted that, meditation offers similar benefits by calming the mind, reducing stress, and activating the body’s relaxation response. It enhances emotional balance, focus, and overall well-being, underscoring the importance of integrating mind-body practices into modern life.7 The future lies in integration: rigorous studies, openness to cultural wisdom, and respect for patient autonomy. Energy healing is not a cure-all but can enrich healthcare by addressing body, mind, and spirit. It has value as an alternative medicine but risk as an alternative to medicine. Practiced responsibly alongside modern care, it reminds us that healing is about wholeness—not just eliminating disease.
Copyright (c) 2026 Open Access Journal https://creativecommons.org/licenses/by-nc/4.0
Advancements in Avian Genome Engineering: Strategies, Primordial Germ Cell Manipulation, and Emerging Delivery Techniques
Genome engineering tools have greatly advanced in the past 5 years, enabling scientists to make accurate modulations to the genome. Systems of delivering these new genome editing tools have been improved in addition to the development of the new tools. Genome engineering instruments are typically deposited to the in vitro fertilized single cell embryos, which are then cultured and implanted to a host animal. This holds no true in the avian species and the alternative procedures have been engineered in genome engineering in birds. The most common is in vitro culturing of primordial germ cells (PGCs), which migrate in the embryonic circulatory system to the developing gonad and colonize the gonad, eventually developing into the gonadocytes that produce sperm or ova. The population can be screened and enriched and then transposed into a recipient embryo, although in culture, the PGCs can be engineered to express new transgenes or alterations in genes. The greatest drawback of PGC culture is that culture procedures cannot be easily interpolated between the avian species; therefore, culture procedures are only reliable on a limited number of species which include the chicken. Two additional newer technologies that appear to be less taxing to a wider range of avian species are direct injection and sperm transfection-assisted gene editing (STAGE). The rationale behind the direct injection technique is the injection of the genome engineering tools into the circulatory system of the developing embryo just before the development stage, when the PGCs are migrating to the gonads. This is facilitated by the combination of the genome engineering equipment with transfection reagents and the transfection of the PGCs in vivo can be done. STAGE is a technique that involves the application of sperm transfection to implant genome engineering vectors into the recently fertilized embryo. Early signs are that each of the two methodologies can be scaled down to attempt use in other bird species than the chicken, but more research in this direction is required.
Optimizing Diagnosis of Pediatric Tuberculosis: The Value of Stool Samples for GeneXpert Testing
Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide, afflicting an estimated 10.7 million people in 2024 and causing approximately 1.23 million deaths, despite decades of public health efforts. Of these cases, children under 15 accounted for around 1.2 million, underscoring a persistent global challenge in pediatric TB diagnosis and care. TB disproportionately affects low- and middle-income countries, with eight countries including India, Indonesia, the Philippines, China, and Pakistan—bearing two-thirds of the global burden. Pakistan alone contributed an estimated 6.3 % of total global cases in 2024, ranking among the top five high-burden countries. Pediatric TB is largely underdiagnosed due to nonspecific symptoms and challenges inherent in specimen collection from young children, who often cannot produce sputum. Conventional tools such as sputum smear microscopy fail to detect many pediatric cases due to paucibacillary disease. The GeneXpert MTB/RIF and Xpert Ultra assays have transformed TB diagnostics by enabling rapid nucleic acid amplification with high specificity, significantly improving case detection, especially in smear-negative disease. Because children commonly swallow respiratory secretions containing Mycobacterium tuberculosis, stool samples have emerged as a feasible, non-invasive specimen for GeneXpert testing. Evidence from multiple studies demonstrates that stool GeneXpert yields moderate sensitivity and high specificity, expanding diagnostic opportunities where respiratory specimens are difficult to obtain. This review synthesizes global and national epidemiology, diagnostic performance, operational considerations, and research advances, culminating in recommendations for enhanced implementation and future research to close the pediatric TB detection gap.
Ethambutol-Induced Severe Cutaneous Hypersensitivity: A Case of Recurrent Smear-Negative Pulmonary Tuberculosis in a Poorly Controlled Diabetic Patient
Diabetes mellitus is a well-established risk factor for tuberculosis (TB), influencing disease severity, recurrence, and treatment outcomes. We report a case of recurrent smear-negative pulmonary tuberculosis in a 63-year-old patient with poorly controlled type 2 diabetes mellitus who had completed anti-tubercular therapy five years earlier. Upon re-initiation of standard first-line therapy, the patient developed a severe generalized cutaneous hypersensitivity reaction during the intensive phase. Sequential drug re-challenge identified ethambutol as the causative agent. Withdrawal of ethambutol led to complete resolution of dermatological manifestations, and the treatment regimen was modified accordingly. This case highlights the bidirectional relationship between diabetes and TB, diagnostic challenges of smear-negative disease, and the importance of systematic drug evaluation in anti-tubercular therapy-related adverse reactions.
Smear to GeneXpert; Reassessing Diagnostic Priorities in Tuberculosis Screening
Tuberculosis (TB) remains a leading cause of morbidity and mortality in low- and middle-income countries (LMICs), where socioeconomic barriers, densely populated settings, and limited health resources fuel continued transmission. Despite the advent of novel molecular diagnostics such as GeneXpert MTB/RIF and its derivatives, TB detection in many high-burden settings continues to confront significant challenges related to cost, infrastructure, and diagnostic yield.[1] As global health strategies evolve, there is increasing debate about the over-utilization of GeneXpert as a universal screening tool, and whether policy should shift back to emphasize more cost-effective methods such as smear microscopy, particularly where GeneXpert positivity rates are low among presumptive cases.[2] Acid-fast bacilli smear microscopy, primarily using Ziehl–Neelsen staining, historically served as the backbone of TB screening in resource-limited settings for decades due to its low cost, operational simplicity, and rapid turnaround time. While known to have limited sensitivity, particularly in paucibacillary disease and smear-negative patients, its role in identifying individuals with high bacterial loads often the most infectious has been foundational to TB control programs worldwide. In many developing countries, smear positivity correlates with advanced disease and higher transmission risk, making it a valuable triage tool for immediate initiation of treatment and infection control measures. Although technological advancements have introduced sophisticated diagnostics, AFB smear remains indispensable where laboratory infrastructure is constrained.[1] The introduction of the Xpert MTB/RIF assay marked a significant milestone in TB diagnostics, offering rapid molecular detection of Mycobacterium tuberculosis and rifampicin resistance within hours. Numerous studies highlight its superior sensitivity over microscopy, especially in smear-negative patients, and its capacity to detect drug resistance early in the disease course.[3] For example, GeneXpert can achieve sensitivity rates above 90% in some settings, compared to microscopy’s approximately 70–75% sensitivity when culture is used as gold standard. In Pakistan and other high TB burden regions, local research has further confirmed GeneXpert’s diagnostic strength. A cross-sectional study demonstrated that GeneXpert has high diagnostic accuracy in both smear-positive and smear-negative pulmonary TB, reinforcing its role in early and definitive diagnosis. Additionally, evaluations of GeneXpert MTB/XDR further extend this utility by estimating performance in detecting drug-resistant TB beyond rifampicin alone.[4] However, this performance advantage has come with unintended consequences. GeneXpert’s molecular detection characteristics mean it often identifies non-viable organisms or residual DNA, leading to possible false-positive interpretations in treated patients and overestimation of TB prevalence in large, unchecked screening campaigns. Furthermore, the assay’s high per-test cost, equipment maintenance requirements, and need for stable power and climate-controlled environments place significant strain on health budgets in LMICs. The widespread adoption of GeneXpert as a universal screening tool among all TB suspects has led to diminishing positivity rates in many programs, raising concerns about cost-effectiveness. As resources are finite in LMICs, deploying expensive molecular diagnostics indiscriminately irrespective of pre-test probability can divert funds from other critical TB control activities, such as treatment support, contact tracing, and active case finding.[5] This over-reliance can also yield laboratory bottlenecks. With high numbers of GeneXpert tests requested for routine screening including many patients with low likelihood of TB turnaround times can be delayed, and laboratory capacity stretched thin. This paradoxically undermines one of GeneXpert’s key strengths: rapid diagnosis. The AFB smear microscopy, though less sensitive than GeneXpert, remains a critical, affordable screening tool with several advantages: Cost-effectiveness: Smear microscopy is significantly cheaper than GeneXpert, making it viable for high-volume screening in peripheral health centers where GeneXpert may be unavailable or overburdened. Immediate Results: Smear microscopy yields same-day results without the need for specialized reagents or uninterrupted electricity, making it ideal for rapid triage. Public Health Relevance: Smear positivity generally correlates with higher bacterial burden and increased transmission risk, making it highly relevant for infection control and prioritization. Integration with Diagnostic Algorithms: Combining smear microscopy with symptom screening, chest radiography, and selective GeneXpert use can improve diagnostic yield while conserving resources. While molecular diagnostics enhance sensitivity, smear microscopy’s specificity and simplicity justify its continued use as a frontline test, especially where GeneXpert utilization is financially unsustainable. Given these realities, global and national TB programs should consider policy recalibration that balances cost, access, and diagnostic yield. Possible approaches include: Targeted GeneXpert deployment; prioritizing its use for high-risk groups (e.g., HIV-co-infected individuals, retreatment cases, drug-resistant suspects), while reserving smear microscopy for initial screening in low-risk groups. Algorithm-based diagnostics; initiating evaluation with symptom screening and smear microscopy, followed by GeneXpert only when initial tests are inconclusive or in contexts where resistance detection is critical. Cost-benefit assessment; periodically reviewing national TB data to determine positivity rates and adjusting screening policies to ensure funds are optimized for maximal public health impact. Training and quality assurance; strengthening microscopy quality, ensuring slide reading proficiency, and embedding external quality assessment (EQA) programs to sustain dependable smear performance. The fight against tuberculosis in developing countries must ground itself in evidence-based, context-appropriate diagnostics. While GeneXpert has revolutionized TB detection, its overuse as a blanket screening tool is not financially sustainable in many high-burden settings and can lead to an inflated perception of disease burden with limited added benefit for large swathes of presumptive cases. Re-emphasizing AFB smear microscopy within national screening algorithms — not as a replacement for molecular diagnostics but as a strategic, cost-effective first-line tool — can ensure broader access, improved resource allocation, and sustained public health impact. Policymakers should embrace hybrid diagnostic pathways that leverage the strengths of both technologies while safeguarding the viability of TB control programs in resource-limited environments.
Comparative Effect of Ashwagandha and Basil Seed Tea Bags on Females Suffering from Anxiety
Background: Anxiety is a sensation of unease, such as worry or fear that can be mild or severe. Anxiety and depression in females during the childbearing age are significant complications that have been reported to affect between 20 - 40% of women. Objective: To check the comparative effect of aswagandha and basil tea bags in females suffering from anxiety by using BAI tool. Methods: This study was conducted on females of child bearing age suffering from moderate and severe anxiety from Tehsil Faisalabad. 20 females were selected from the age group of 20-27 years and were randomly divided into two groups. The BAI test was administered to all participants before providing them with the tea bags which established their initial anxiety levels i.e., 16–25 for moderate and 26–63 for severe anxiety. Then the participants were provided with ashwagandha or basil seeds tea bags and were instructed to consume the tea bags once a day. Results: According to this study, nutritional and herbal supplements appear to be an effective strategy to treat anxiety and anxiety-related problems without the danger of severe side effects. Results showed that mean of participant’s age were 24.05±2.012. Percentage of underweight and overweight females was equal i.e 35% whereas 20% female were healthy. 70% participant’s belonged from urban areas. Majority of the female belonged from middle class i.e 50%. Education of 40% of females were graduates and 70% females showed the family history of anxiety. Moreover, the analysis showed that ashwagandha had a greater impact on anxiety symptoms than basil seeds as P-value for majority of symptoms of BAI questionnaire was significant for ashwagandah tea bag. Conclusion: Herbal medicines can help relieve depression and anxiety. Aswagandah sand basil seeds both helped relived the symptoms of anxiety but aswagandah showed more significant results. So, study concluded that aswagandah can help reliving symptoms of anxiety and improving quality of life in patients suffering from anxiety.
Copyright (c) 2025 Open Access Journal https://creativecommons.org/licenses/by-nc/4.0
Prevalence and Severity of Knee Pathologies in Sportsmen and Individuals with Sedentary Lifestyles
Background: Magnetic Resonance Imaging (MRI) is a reliable and noninvasive modality for evaluating knee pain, offering high diagnostic accuracy for meniscal and anterior cruciate ligament (ACL) tears. With a sensitivity exceeding 90% for detecting medial meniscal tears, MRI effectively reduces the need for unnecessary arthroscopies. Objectives: To assess the prevalence and severity of knee pathologies in sportsmen and individuals with sedentary lifestyles. Methods: A cross-sectional analytical study was conducted using MRI. Patients from both Sportsmen’s (Group I N=35) as well as patients with a sedentary lifestyle (Group II, N=32) complaining about knee pain, were recruited after taking informed consent. Patients’ age and gender were noted. The MRI was done using standard operating procedures of the Radiology Department and findings were noted. Demographic and clinical data were analyzed and compared between the two groups. Results: MRI findings revealed that meniscus damage was prevailing. Out of group II, 3 patients (9.4%) had medial collateral ligament, and 3 (9.4%) had lateral collateral ligament damage. Out of group I, 12 patients (34.3%) had damage to anterior cruciate ligament and 3 patients (8.6%) had posterior cruciate ligament damage while 20 of group II patients (62.5%) had damaged anterior cruciate ligament and 2 patients (6.25%) had posterior cruciate ligament damage. Joint effusion was present among both groups. Among group I patients, the number of chondromalacia patellae, baker’s cysts, bone bruises/marrow edema, osteoarthritis and tumor patients were 3(8.6%), 4 (11.4%), 7(20%), 1(2.9%), and 2 (5.7%) respectively. Among the group II patients, the cases of chondromalacia patellae, bone bruises/marrow edema and osteoarthritis were 2(6.5%), 10 (31.3%) and 2 (6.3%) in number, respectively. One patient in group II was found to be normal (3.1%) through an MRI. Conclusion: The prevalence and severity of knee pathologies in sportsmen group was better due to strenuous exercise as compared to individuals with sedentary lifestyles.
Narrative on Self-Cognitive Transformation and Health Behavior Reconstruction in Postoperative Bariatric Surgery in Obese Patients
Obesity has become a global health concern and over the last decade or so, it has increased immensely in low- and middle-income countries; it is also estimated that by 2030, one out of every five women and one in every seven men will be afflicted with obesity, according to the estimates provided by the World Federation. Up to now, the obesity treatment modalities have been ever-increasing and getting better, inclusively dietary therapy, pharmacotherapy, and weight-loss and metabolic surgery; Among them, bariatric and metabolic surgery has the highest effect and is an internationally agreed treatment method for obesity and obesity-related metabolic diseases, through modification of the size or dynamic capacity of the patient stomach and/or intestines, the patient is forced to reduce his food intake or to reduce the intestinal absorption effect of nutrients [1]. The impact of bariatric surgery on self-perception Obesity not only brings about a variety of related metabolic diseases in the patient's body but also has a significant impact on the patient's psychology. Some studies indicate that obesity can have many adverse effects on some of the structures and functions of the brain, which may lead to a decline in the patient's cognitive abilities; attention deficit and cognitive control impairment; dysmnesia; decline in cognitive flexibility and so on. These negative cognitive impairments will have a negative impact on the formation and maintenance of patients' self-awareness [2]. This consequently leads to the patient's impairment of self-awareness. Although bariatric surgery is mainly known for its effectiveness in weight loss and improvement of related metabolic diseases, there is evidence suggesting that it also has an impact on cognitive function. This might also be one of the reasons why the patient's self-perception underwent a significant and positive transformation after the weight loss surgery. Previously, Alosco et al. [3] pointed out that in the short-term and long-term follow-up of patients who underwent Roux-en-Y gastric bypass (RYGB), their memory abilities were significantly better than those of the obese control group; Pearce et al. [4] also found similar results. The impact of bariatric surgery on healthy behaviors Weight loss surgery also has significant positive impacts on patients' health behaviors. These effects are not only reflected in reducing body weight and improving various complications, but also in multiple aspects such as psychology, lifestyle, and behavior. After undergoing bariatric surgery, patients often experience rapid weight loss, which leads to a reduction in the negative emotions caused by obesity. Consequently, the frequency of emotional eating behavior decreases. At the same time, patients hope to continue losing weight and unconsciously restrain their eating behaviors. This helps maintain long-term weight loss. On the other hand, bariatric surgery also has a significant positive impact on patients' exercise behaviors. Studies have shown that within one year after undergoing bariatric surgery, patients' physical activities, such as exercise and leisure activities, have significantly increased, which is also related to their greater weight loss; therefore, it is of utmost importance to provide intervention and support to patients after bariatric surgery such as conducting postoperative exercise training [5]. Application of Social Identity Theory The social identity theory emphasizes that individuals define themselves through their sense of belonging to a social group. Patients often improve their self-perception and promote healthy behaviors by receiving positive social support and gaining group identity after bariatric surgery, and they also enhance their self-management skills [6]. Stronger self-management skills can help patients maintain long-term weight loss after bariatric surgery. Bariatric surgery not only improves the physiological indicators of obese patients, but also has a significant impact on their psychology through the theory of social identity. It leads to remarkable positive changes in patients' self-perception and health behaviors. The social identity theory enhances patients' self-management abilities psychologically. This has significant implications for the actual treatment of obese patients: not only should patients be treated physically, but they should also receive psychological intervention and social support. After bariatric surgery, the self-perception and health behaviors of obese patients have shown significant positive changes, which are closely related to social recognition and social support. For the postoperative recovery and health management of patients, social recognition has a long-term impact. Based on a full understanding of the path of self-cognition transformation in obese patients after surgery, it will provide medical providers with theoretical and practical guidance in guiding patients' postoperative rehabilitation and health management, helping patients better adapt to postoperative life and have a better quality of life.
Artificial Intelligence in Medical Laboratory Technology: A Game Changer for Quality Control & Compliance
The coordination of Artificial Intelligence (man-made intelligence) in clinical research facility innovation has changed the scene of Quality Control (QC) and Quality Assurance (QA). This survey article investigates the uses of man-made intelligence in improving QC and QA in clinical research centers, including prescient support, constant information examination, high level picture examination, and blockchain innovation. The advantages of computer-based intelligence fueled QC and QA, like superior exactness, accuracy, and effectiveness, as well as the difficulties and impediments of carrying out artificial intelligence in clinical research facilities will be focused accordingly. Moreover, the job of research facility experts in embracing man-made intelligence innovation and guaranteeing the respectability of lab results will also be high-lightened. This survey plans to give a complete outline of the present status of artificial intelligence in clinical lab QC and QA, featuring its capability to reform the field and work on understanding results.
Unlocking the Brain — The Transformative Role of High-Density Multielectrode Arrays in Understanding Brain Disorders
The mature human brain is composed of more than 100 billion neurons, with its vast network is estimated to have more than 60 trillion connections, and orchestrates everything from basic reflexes to sophisticated cognitive processes [1]. Despite remarkable advances in imaging and molecular biology, a comprehensive understanding of neuronal interactions within large-scale networks, both in healthy and pathological conditions, remains elusive. Recently, high-density multielectrode arrays (HD-MEAs) have emerged as a groundbreaking technology, significantly advancing our knowledge of neuronal network functions and their alterations in various neurological and psychiatric disorders. HD-MEAs are advanced microfabricated devices containing thousands of electrodes densely packed into a small chip that can boast over 4,000 electrodes. This enables simultaneous recording of extracellular activity from hundreds to thousands of individual neurons with exceptional spatiotemporal precision. Specifically, these arrays capture detailed signals such as action potentials, local field potentials, and network oscillations, providing invaluable insights at the single-neuron and subcellular levels [2][3]. The access to the activity of individual neuron at subcellular resolution is particularly valuable in the context of brain disorders including neurodegenerative disease, neurodevelopmental and psychiatric disorders where network dysfunction often underlies clinical symptoms. For instance, in epilepsy, HD-MEAs can detect seizures, network hyperexcitability, and focal points of origin in in vitro and ex vivo models, aiding in both mechanistic understanding and drug screening [4]. The most promising applications of HD-MEAs lies in their integration with neurons derived from human-induced pluripotent stem cell (hiPSC) [5]. These models enable researchers to study patient-specific neural phenotypes, particularly for complex disorders like autism spectrum disorder (ASD) and schizophrenia, where the pathological changes are subtle and network-based. Additionally, HD-MEAs significantly contribute to research on neurodegenerative diseases such as Alzheimer’s and Parkinson’s, allowing the observation of early changes in neuronal connectivity, synaptic integrity, and firing patterns. These recordings offer potential biomarkers for early diagnosis and serve as valuable platforms for developing targeted therapeutic interventions. HD-MEA recordings from theses disease models allow for real-time monitoring of spontaneous and evoked activity, network bursts, and response to pharmacological agents making them an essential tool for personalized medicine. In addition, HD-MEAs are being paired with machine learning and computational neuroscience models to manage and interpret the massive datasets they generate. These techniques enable the identification of disease-specific neural signatures, classification of neuronal subtypes based on firing patterns, and prediction of network responses to stimuli or treatments [6]. Furthermore, HD-MEAs support long-term recordings, enabling chronic monitoring of neural cultures or brain tissue slices over days and weeks. This is especially relevant for studying the effects of long-acting drugs or progressive disease models. Their compatibility with optogenetics and microfluidics further broadens their application, allowing for precise stimulation and environmental control. In conclusion, HD-MEA technology marks a transformative advancement in neuroscience research. By enabling high-resolution and large-scale recordings of neuronal activity, these arrays bridge the critical gap between single-neuron analysis and system-level brain dynamics. As neurodevelopment and psychiatric disorders become an increasing burden on global health, HD-MEAs offer a promising platform to unravel the complexities of neuronal dysfunction and accelerate the development of effective therapies.
Exploring Quality of Life across Academic Years among MBBS Students: An Online Cross-Sectional Survey
Background: Medical education is demanding and often detrimental to students’ quality of life (QoL), especially in developing countries like Pakistan. Medical students frequently report elevated stress levels, disrupted sleep, and reduced physical and mental well-being, particularly in the initial years of training. Objective: To assess the QoL of medical students across all five years of MBBS education and to identify key trends and challenges in their well-being. Methods: A cross-sectional study was conducted over three months (April–July 2024) at Fatima Jinnah Medical University, Lahore, Pakistan. A total of 283 students (1st to 5th year) participated through purposive sampling. Data was collected using the WHOQOL-BREF questionnaire distributed via Google Forms. QoL was evaluated across six domains: demographic data, general QoL, physical health, psychological well-being, social relationships, and physical activity/mental health. Results: First-year students reported the lowest satisfaction in health status (33.7%), sleep (24.3%), and physical fitness (20.3%), compared to higher satisfaction levels in final-year students (47.5%, 50%, and 32.5% respectively). Extreme academic stress was most prevalent in 2nd (42.6%) and 4th years (44.6%), with 3rd-year students showing the least stress (19.6%). Final-year students demonstrated greater energy, self-satisfaction, and fewer negative emotions, while the 2nd year showed notably low satisfaction with living conditions. Conclusion: QoL generally improves from the first to the final year of medical education. Early-year students face the most significant challenges, indicating a need for targeted institutional support to mitigate stress and enhance well-being throughout the academic journey.
Revolutionizing Diagnostics with Artificial Intelligence: Current Innovations, Challenges, and Future Horizons
Artificial Intelligence (AI) is rapidly transforming the landscape of medical diagnostics, offering unprecedented accuracy, speed, and efficiency in disease detection and decision-making. From image-based analysis in radiology and pathology to predictive analytics in genomics and personalized medicine, AI technologies, particularly machine learning and deep learning, are being increasingly integrated into clinical workflows. These innovations have shown promise in enhancing diagnostic precision, reducing human error, and improving patient outcomes across a wide spectrum of diseases, including cancer, cardiovascular conditions, and infectious diseases. Despite these advancements, the integration of AI into healthcare faces several challenges. Concerns around data privacy, model transparency, algorithmic bias, and clinical validation must be addressed to ensure ethical and reliable deployment. Furthermore, the lack of standardized protocols, regulatory frameworks, and interdisciplinary collaboration hinders the seamless adoption of AI in routine diagnostics. This paper explores the current state of AI in diagnostics, highlights ground-breaking applications already in use, and discusses key limitations that need to be overcome. It also offers insight into future prospects, including explainable AI, integration with wearable technologies, and the potential for AI to support real-time decision-making in point-of-care settings. With continued innovation and responsible implementation, AI holds the potential to revolutionize diagnostic medicine and redefine the future of healthcare.
A Review of the Development of Vaccines for Newly Developing Infectious Illnesses
The emergence and rapid spread of newly developing infectious illnesses, exemplified by the coronavirus disease 2019 (COVID-19) pandemic, has highlighted the critical need for efficient vaccine development and deployment strategies. Historical and recent outbreaks, including dengue, cholera, typhoid, Ebola, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrate the persistent global vulnerability to emerging pathogens, exacerbated by urbanization, globalization, and inadequate public health infrastructures. Vaccine development faces numerous challenges, from virus surveillance and pharmacovigilance to ensuring equitable access, especially in low- and middle-income countries. Traditional vaccine development pathways, often spanning 5-10 years, are inadequate during pandemics, necessitating rapid-response platforms like mRNA and DNA technologies. The unprecedented speed of COVID-19 vaccine development, achieving initial efficacy trials within 300 days, reflects the success of collaborative global efforts, advanced platforms, and funding mechanisms such as CEPI and COVAX. Despite these advancements, hurdles remain in regulatory harmonization, manufacturing scalability, supply chain logistics, and vaccine acceptance. Lessons learned from COVID-19 emphasize the importance of flexible vaccine platforms, proactive investment in research and infrastructure, and global coordination to mitigate future pandemics. Vaccine-induced herd immunity, non-inferiority trials against approved vaccines, and considerations of equitable distribution are essential for comprehensive public health benefits. Standardizing labelling, tracking vaccine safety, and implementing no-fault compensation mechanisms are pivotal in fostering public trust. Ultimately, an integrated approach involving scientists, regulators, health authorities, and funders is imperative to streamline vaccine development and ensure timely and fair access in the face of evolving infectious threats
Assessment of Antibiotic-Resistant Bacterial Contamination in Diverse Drinking Water Sources
Background: Antimicrobial resistance (AMR) poses a significant global public health threat, particularly through environmental routes like drinking water. In low- and middle-income countries, contamination of water sources with antibiotic-resistant bacteria (ARB) is exacerbated by inadequate sanitation and unregulated antibiotic use. Objective: To assess the prevalence and antibiotic resistance profiles of bacteria in various drinking water sources in Lahore, Pakistan. Methods: A cross-sectional study was conducted using 30 drinking water samples from tap, filtered, and bottled water. Microbiological analysis included membrane filtration and pour plate methods. Bacterial identification involved Gram staining, biochemical tests, and Analytical Profile Index (API) kits. Antibiotic susceptibility was assessed using the Kirby-Bauer disk diffusion method with interpretation per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Bacterial contamination was found in 70% of samples, highest in tap water (90%). Common isolates included Escherichia coli (35.4%), Pseudomonas aeruginosa (27.1%), and Staphylococcus aureus (20.8%). High resistance was observed to ampicillin (80.2%) and tetracycline (70.1%). Multidrug resistance (MDR) was identified in 62.5% of isolates, with tap water showing the highest MDR frequency (72.7%). Conclusion: The widespread presence of ARB, especially MDR strains, in drinking water underscores the urgent need for improved water treatment, routine monitoring, and stringent regulation of antibiotic use. These interventions are critical to mitigating AMR risks and ensuring safe water access.
Cellular Senescence as a Barrier to Tissue Engineering
In vitro tissue regeneration requires the expansion of cells in a monolayer culture over extended periods to obtain sufficient cell numbers. However, prolonged monolayer culture conditions often induce cellular senescence, a state characterized by irreversible cell cycle arrest in response to various stressors such as oxidative damage, telomere shortening, and DNA damage. Cellular senescence was historically regarded as an in vitro artifact, it is now recognized as a critical biological process implicated in aging, tissue remodeling, and the pathogenesis of chronic diseases including osteoarthritis, cardiovascular disease, diabetes, and cancer [1]. Senescent cells may play beneficial roles in acute wound healing3 by modulating inflammation and tissue remodeling, however, their accumulation during in vitro expansion is detrimental to tissue engineering applications. This is primarily due to the senescence-associated secretory phenotype (SASP), which involves the release of pro-inflammatory cytokines that can propagate senescence to neighboring cells and compromise regenerative potential [2]. There is growing interest in developing strategies to either prevent the onset of senescence or selectively target and eliminate senescent cells to enhance regenerative outcomes and improve therapeutic efficacy. During in vitro monolayer expansion, cells may undergo senescence via two primary mechanisms: telomerase-dependent and telomerase-independent8 pathways. Telomerase-dependent senescence is driven by progressive telomere shortening, ultimately triggering replicative exhaustion and causes cell cycle arrest. In contrast, telomerase-independent senescence arises from extrinsic or intrinsic signals, such as oxidative damage, oncogenic signals, expression of pro-inflammatory cytokines. This form of senescence is predominantly regulated by canonical pathways, including the p53/p21and p16/Rb pathways, which also enforce irreversible cell cycle arrest [3]. Recent studies have expanded this understanding of senescence by finding additional regulatory factors such as changes in chromatin architecture, mitochondrial dysfunction, and alterations in nuclear structural proteins [4]. Identification of senescent cells remains a major challenge in both research and clinical contexts. Although senescence-associated β-galactosidase (SA-β-gal) activity is a commonly used marker, it lacks specificity and is insufficient as a standalone indicator of senescence. Therefore, a combination of markers is recommended to improve diagnostic accuracy. These include increased expression of p16INK4a, p21CIP1, and p53, as well as changes in chromosomal organization and nuclear components such as nuclear myosin 1β (NM1β) [5]. The heterogeneity of senescent phenotypes and the absence of universal biomarkers make the selective targeting and elimination of senescent cells particularly complex and technically demanding. Senescent cells secrete inflammatory cytokines and convert into a senescence-associated secretory phenotype (SASP). Inflammatory proteins secreted by senescent cells that can damage nearby cells, increase tissue breakdown, and cause chronic inflammation. In addition, these signals promote senescence in the neighbouring healthy cells. This causes an irreversible path and leads to deterioration of the tissues. A variety of strategies are currently being explored to prevent, modulate, or eliminate cellular senescence. These include genetic approaches, such as gene editing aimed at modulating key regulatory genes involved in senescence pathways; senolytic drugs, which selectively induce apoptosis in senescent cells; and senomorphic compounds, which suppress the detrimental effects of the SASP without eliminating the cells themselves [6]. Dasatinib and quercetin are important senolytics and have shown their efficacy in preclinical models and are under evaluation in human clinical trials.14 Metformin which is a widely used antidiabetic agent, has shown senomorphic properties by attenuating SASP-associated inflammatory responses.16 Additionally, peptide-based inhibitors that disrupt critical protein-protein interactions within senescent cells are emerging as potential therapeutic tools. Despite promising effects of all these drugs and inhibitors (senotherapeutics), there are still significant limitations because they all have off-target effects, insufficient specificity, and causing cytotoxicity in healthy cells. Therefore, further improvement in drug design and delivery is necessary to enhance therapeutic selectivity and safety. Senescence is also a major issue in stem cell therapy and tissue engineering. For example, mesenchymal stem cells (MSCs), chondrocytes (cartilage forming cells), nucleus pulposus and annulus fibrosus cells (intervertebral disc forming cells) can become senescent during in vitro monolayer culture. This reduces their ability to form tissues in vitro that resembles the respective native tissue. Strategies to prevent senescence in these cells can result in better tissue formation. Senescence is a complex but exciting area of research. In the body it plays both helpful and harmful roles. With deeper understanding of pathways that regulate senescence, we can get closer to use senescence-targeting therapies to treat age-related diseases, improve stem cell therapies, and possibly extend healthy lifespan. Still, careful testing is needed to make sure these treatments are safe and effective for people.
A Regional Sweep of the Effects of Covid-19 on Students in Gujranwala: The Adverse Effects of Online Education System
Background: COVID-19 pandemic disrupted traditional education worldwide, necessitating a sudden transition to online learning. In Pakistan, particularly in Gujranwala, this shift posed challenges due to limited digital infrastructure, lack of training, and reduced student motivation. Objectives: To evaluate the impact of online education system during the COVID-19 pandemic on the academic performance, adaptability, and satisfaction levels of students in Gujranwala. Methods: A quantitative descriptive design was employed. A stratified random sample of 102 students from intermediate to postgraduate levels, who had experienced both traditional and online education between 2020 and 2021, was surveyed using a 16-item structured Google Forms questionnaire. Secondary data were obtained from BISE Gujranwala to compare academic performance before and after the pandemic. Data analysis was conducted using SPSS version 30. Results: Findings revealed mixed reactions to online education. While 33.3% found it moderately feasible, only 23.5% expressed satisfaction. A majority (55.9%) found it easy to resume pre-pandemic learning, indicating resilience. However, academic data showed a drop in pass percentages post-pandemic: HSSC-1 results declined from 45.79% (2018) to 38.48% (2022), and HSSC-2 from 58.25% (2019) to 56.11% (2023), indicating diminished academic outcomes. Conclusion: Online education during the COVID-19 pandemic adversely affected student performance and satisfaction in Gujranwala. However, it also underscored the potential of hybrid models, prompting the need for blended learning strategies, improved digital infrastructure, and teacher training for future resilience.
In Silico Characterization and Structural Validation of VP39 Methyltransferase as a Potential Antiviral Target against Monkeypox Virus
Background: Monkeypox virus (MPXV) is a zoonotic double-stranded DNA virus of the Poxviridae family. With increasing global outbreaks, especially the 2022 epidemic, MPXV has emerged as a public health concern. Despite its threat, no specific antiviral drugs have been approved. The viral protein VP39 methyltransferase (MTase) plays a vital role in immune evasion, mRNA capping, and viral replication, making it a promising therapeutic target. Objective: To analyze and validate the 3D structure and physiochemical properties of VP39 MTase (PDB ID: 8cer) to evaluate its potential as a drug target for anti-MPXV therapies. Methods: The 3D crystal structure of VP39 MTase was retrieved from the Research Collaboratory for Structural Bioinformatics (RCSB) Protein Data Bank. Structural validation was performed using Error Recognition and Analysis Tool (ERRAT), verify 3D, and PROCHECK via the SAVES v6.1 server. Physiochemical characteristics were assessed using the ExPASy ProtParam tool. Results: The ERRAT analysis revealed a 94.39% overall quality factor. Verify 3D indicated 74.91% of residues had an averaged 3D-1D score ≥ 0.1. The Ramachandran plot showed 93.5% of residues in the most favored regions. The protein has a molecular weight of 38.89 kDa, theoretical pI of 9.47, GRAVY score of -0.395, and an aliphatic index of 88.65, suggesting it is hydrophilic and thermostable. Conclusion: VP39 MTase demonstrates strong structural validity and favorable physiochemical properties, supporting its role as a potential drug target for MPXV. These findings justify further in vitro, in vivo, and molecular dynamics studies for antiviral drug development.
Hepatotoxic Effect of Combined Exposure of Arsenic and Microplastics on Labeo Rohita: An In-Vivo Experimental Study
Background: Arsenic (As) is one of major environmental toxicants that adversely affect living organisms. Microplastics (MPs) are small plastic particles that are hazardous because they may be toxic or conjugate with some toxic elements. Objective: The present research was conducted to assess whether the treatment of As with polystyrene microplastics (PS-MPs) enhance their toxic effects on the hepatic tissues of Labeo rohita. Methods: The experiment was conducted at Government College University, Faisalabad, using 85 healthy Labeo rohita (average 8.91 cm, 7.3 g). Fish were acclimatized and randomly divided into four groups i.e., control group, As treatment group (4.05mgL−1), PS-MPs treatment group (1mgL−1), and As (4.05mgL−1) plus PSMPs (1mgL−1) combined treatment group for 21 days. Blood and liver samples were collected post-treatment for hematological, antioxidant, hepatic, and inflammatory analyses. Enzymatic activities and biomarkers were measured using standard biochemical methods. Results: Exposure to As and PS-MPs, especially their combination, significantly reduced RBCs and hemoglobin, increased WBCs, and suppressed antioxidant enzyme activities (SOD, CAT, GST). Reactive oxygen species (ROS) and Thiobarbituric acid reactive substances (TBARS) levels were elevated, indicating oxidative stress. Liver enzymes (ALT, AST) and inflammatory cytokines (IL-1β, IL-6) were significantly higher in the As+PS-MPs group compared to individual treatments or control. Conclusion: Co-exposure to As and PS-MPs caused severe hematological, oxidative, hepatic, and inflammatory disturbances in L. rohita. Their combined toxicity was greater than individual exposures, indicating a synergistic effect that may lead to pronounced liver damage and physiological dysfunction.
In-silico Analysis of Potential Phytochemicals against VP39 Methyltransferase of Monkeypox virus
Background: Monkeypox virus (MPXV), a zoonotic orthopoxvirus, has emerged as a global health concern, especially after the 2022 outbreak. Despite the rising prevalence, no drug has been specifically designed to treat MPXV. The VP39 methyltransferase (MTase) plays a vital role in mRNA capping, assisting the virus in immune evasion and replication, making it a promising antiviral target. Objectives: This study aimed to identify natural phytochemical inhibitors against VP39 MTase of MPXV using computational drug discovery techniques, including molecular docking and density functional theory (DFT). Methods: The crystal structure of VP39 MTase (PDB ID: 8cer) was obtained and validated using ERRAT, Verify3D, and PROCHECK. A total of 17,967 phytochemicals from the IMPPAT 2.0 database were screened based on ADMET properties and drug-likeness rules (Lipinski’s and Veber’s). Ninety-six compounds passed these filters and were docked using AutoDock Vina. The top ten ligands with the lowest binding energies were selected for further analysis, including interaction profiling and DFT evaluation to determine their chemical reactivity. Results: The VP39 MTase structure was verified to be of high quality, with 93.5% of residues in the most favored regions. Among the 96 screened compounds, Hispidin (PubChem ID: 54685921) showed the lowest binding energy (-7.6 kcal/mol). Interaction analysis revealed multiple favorable interactions with active site residues. DFT analysis demonstrated a low HOMO-LUMO energy gap (ΔE = 0.12726 eV), suggesting high reactivity and potential as an effective inhibitor. Conclusion: Hispidin emerged as a potent phytochemical candidate against VP39 MTase, showing strong binding affinity and favorable electronic properties. These findings provide a promising basis for further in vitro, in vivo, and molecular dynamics studies to develop novel anti-MPXV therapies
Anti-inflammatory and Antioxidant Properties of Herbal Extracts: Mechanism and Therapeutic Potential
Bioactive compounds mostly with potent anti-inflammatory and antioxidant properties that found in herbal extracts, have acknowledged for their various medicinal benefits. Herbal extracts have the ability to suppress pro-inflammatory cytokine, and abundant in bioactive substances like flavonoids, polyphenols, terpenoids, and alkaloids, fight inflammation and oxidative stress in one of the two important elements in the etiology of chronic liver diseases like alcoholic liver disease and non-alcoholic fatty liver disease. Cellular damage results from oxidative stress brought on by drugs, alcohol, and environmental contaminants that throw off the equilibrium of important enzymes like superoxide dismutase, glutathione, and catalase. In addition to restoring these enzymes function, herbal antioxidants also lessen inflammation and lipid peroxidation. In both acute and chronic states, several substances, including curcumin, betaine, and l-theanine, exhibit hepatoprotective properties. Potentially useful anti-inflammatory and antioxidant properties of herbal extracts could pave the way for plant-based, natural remedies for the management and prevention of chronic diseases. Bioactive substances, like carotenoids and polyphenols, have demonstrated anti-atherosclerosis, cancer prevention, and rejuvenation properties. Various compounds and chemicals contribute to synthetic antioxidants and enhance the production of functional foods with potential medicinal uses. Furthermore, the solubility, bioavailability, and therapeutic potential of herbal extracts greatly increased when they are included into nanoparticle delivery systems. This collaboration between technology and nature creates new, less harmful treatment options for inflammatory and oxidative diseases. The use of these phytomedicines' therapeutic potential in a better way, more studies and standardization are required.
Mechanisms, Dissemination, Determinants, and Alternate Strategies for Addressing Antibiotic Activity and Resistance
The use of antibiotics is a commonly used therapeutic approach for the treatment of bacterial diseases in a variety of fields, such as human health, agriculture, cattle breeding, and fish aquaculture. How well antibiotics work depends on four different mechanisms of action, each of which is covered in detail in this review. Antibiotic resistance has become a major obstacle to treating bacterial illnesses, notwithstanding its effectiveness. Antibiotics are no longer effective because bacteria have evolved resistance mechanisms against them. There are several ways that antibiotic resistance can develop among bacteria, making previously vulnerable microorganisms resistant to antibiotics. The abuse of antibiotics by humans is one of several causes contributing to the growing antibiotic resistance dilemma. Alternative strategies put forth to lessen the escalation of antibiotic resistance are also highlighted in this review.
Heavy Metal Exposure and Immune Dysfunction: Mechanistic Pathways in Humans and Animals
In the past few years, contamination of the environment by heavy metals has emerged as a significant global issue. Heavy metals comprise a category of metals and metalloids with an atomic density above 4,000 kg m-3. Heavy metals, including Nickel (Ni), Cobalt (Co), Copper (Cu), Zinc (Zn), and Lead (Pb), are found in the biota. These metals, referred to as traces, are crucial for numerous metabolic activities in organisms such as animals, plants, and microbes. Heavy metals can enter the human body through the use of contaminated drinking water or the ingestion of soil or crops cultivated on polluted land. Heavy metals, including lead, mercury, cadmium, and copper, are cumulative toxins that pose environmental risks and are known to be very harmful. These metals are significant contributors to oxidative stress within cells and play a crucial role in the etiology of various human illnesses, including carcinogenesis. Exposure to heavy metal toxicity results in neurological impairment, intellectual disability, cerebral palsy, lung carcinoma, gastrointestinal disorders, dermatitis, and fetal demise. Numerous metals have been demonstrated to directly alter and/or impair DNA by creating DNA adducts that provoke chromosomal breakage. The unregulated access to the dumpsite allows scavengers to forage for raw materials daily, most of which ultimately reenters neighborhoods as animal feed and even human sustenance. Feral chickens, pigs, goats, dogs, and cats traverse the dumpsite, consuming hazardous waste and becoming carriers of bugs and parasites, which are subsequently transmitted to nearby residences, so inducing diseases in both animals and humans.
Addressing and Battling the Rising Threat of Antimicrobial Resistance
Antimicrobial resistance (AMR) has become one of the biggest concerns to world health in recent decades. AMR, a phenomenon where bacteria, fungi, and other microbes adapt to survive the medications that originally killed them, has long been a source of concern for the World Health Organization (WHO). The capacity to cure infections with antibiotics and antifungals, which was once a major medical breakthrough, is now in danger of going extinct [1]. The Rise of AMR: A Global Crisis AMR affects individuals of all ages worldwide and transcends national boundaries. Once-treatable infections become once again life-threatening as bacteria develop resistance to therapy. Deadly infections could result from even modest surgery, cancer treatments, or organ transplants. Millions of lives are already at risk each year due to the advent of resistant strains of illnesses, including pneumonia, urinary tract infections, and tuberculosis, and the problem is only getting worse [2]. The CDC estimates that every year, around 3 million people in the US alone become infected with drug-resistant germs, which results in over 35,000 fatalities [3]. The situation is significantly worse in low- and middle-income nations, where access to healthcare, especially necessary antibiotics, is more restricted. Misuse of antibiotics, poor diagnostics, and subpar or fake drugs all contribute to the spread of resistant microbes. However, the overuse and abuse of antibiotics in agriculture and human health contribute significantly to the issue, especially in high-income nations. Antibiotic-resistant bacteria have flourished due to the overprescription of antibiotics for viral diseases that they cannot cure and the use of antibiotics in animals to stimulate growth rather than only treat disease [4]. The Silent, Yet Destructive, Consequence of Overuse The overuse and abuse of antibiotics are the main causes of AMR. Antibiotics are frequently prescribed without question for viral illnesses such as the flu or the common cold. Antibiotics, which fight bacteria, don't work against viruses, yet patients still ask for them, and doctors often give in. This leads to a vicious cycle in which new infections grow more difficult to cure and drugs lose their effectiveness [5]. Another important factor in the spread of AMR is agriculture. In livestock husbandry, antibiotics are commonly used to treat disease, prevent disease, and encourage growth in otherwise healthy animals. Animals that get excessive doses of these medications may develop resistant germs, which humans may contract by eating meat, coming into contact with animals, or environmental pollution. The Financial and Humanitarian Expenses There is no way to overestimate the economic impact of AMR. AMR currently has a huge global impact; if current trends continue, projections indicate that it could cause 10 million deaths yearly by 2050. This would be more than the number of cancer-related deaths. Furthermore, the loss of efficient antibiotics could jeopardize necessary procedures, lengthen hospital stays, increase the expense of treatments, and hinder rehabilitation, thus undermining the advancements made in contemporary medicine. The influence on society is equally astounding. AMR disproportionately impacts the most vulnerable, including children, the elderly, those in poverty, and those who already have other health concerns. Access to even the most basic healthcare is still difficult to come by in many regions of the world. Those who are most vulnerable may encounter even more obstacles to treatment and rehabilitation as antibiotics lose their effectiveness, exacerbating health inequities [6]. A Worldwide Appeal for Action An international, coordinated effort is needed to combat AMR. The public, governments, medical professionals, researchers, and the agriculture industry must all contribute. To track and manage the development of resistant illnesses, national health agencies and international organizations like the WHO need to make greater investments in surveillance systems. At the same time, more attention must be paid to teaching the public and medical professionals about the risks of antibiotic abuse and the significance of only using antibiotics and when necessary. Programs like antimicrobial stewardship are crucial in the healthcare industry. These initiatives guarantee that the appropriate medication, dosage, and length of time are used and that antibiotics are only provided when necessary. Stronger laws are also required to limit the use of antibiotics in agriculture, make sure that any usage is carried out under appropriate supervision, and concentrate on reducing resistance. Priority must be given to funding the creation of novel antibiotics and complementary therapies. Innovation in this field has not kept up with the increasing tide of antibiotic resistance, and the pipeline for novel antibiotics has slowed considerably. To encourage the study and development of new antimicrobial drugs and treatments, as well as substitutes like vaccinations and phage therapy, governments and the commercial sector must work together more successfully [7]. Hand sanitizers play a vital preventive role. The study "In Vitro Evaluation of the Antimicrobial Properties of Various Hand Sanitizers" found that imported hand sanitizers were the most effective in maintaining hand hygiene, followed by local chemical, multinational, and local herbal products. These findings highlight the critical need for regulatory oversight to ensure product claims align with verified antimicrobial performance [8]. To combat AMR, significant investments in global health infrastructure will be necessary, particularly in low- and middle-income nations, to provide access to high-quality antibiotics, diagnostics, and infection control techniques. This will lessen the spread of resistant strains and the overuse of antibiotics. Conclusions AMR is not a far-off concern; rather, it is a crisis that is already developing and has serious ramifications for the economy, public health, and the welfare of future generations. Now is the moment to take action. We can only expect to stop the spread of AMR and maintain the efficacy of these life-saving medications by coordinating international efforts, committing to the appropriate use of antibiotics, and investing in research and healthcare infrastructure. All of us—healthcare providers, legislators, academics, and citizens—must take swift, decisive action in the fight against AMR. Never before have the stakes been so high.
Early Skin-To-Skin Contact for Mothers and Their Healthy Newborn Infants
The problem of the study looks to be related with the nursing but it is more significant to the change in social norms of the societies and more significant to the social behaviors and their impact on next generation. Purpose of conducting the research was well explained and idea was taken from animal studies which presented innate behaviors of newborns are shown to be dependent on the habitat and compulsory for their survival .
Perspectives on Patterns of Metastatic Breast Cancer in Punjab Pakistan
Dear Editor, I am writing to express my appreciation for the recently published article titled "Patterns of Metastatic Breast Cancer in Punjab, Pakistan" by Khurram et al. in Chronicles of Biomedical Sciences [1]. The study provides significant insights into the metastatic patterns of breast cancer in the region, a subject of paramount importance given the high prevalence and late-stage diagnosis of the disease in Pakistan. The authors' efforts in compiling and analyzing a large dataset from a tertiary oncology center are commendable. Their meticulous use of histopathological grading, TNM staging, and immunohistochemistry markers (ER, PR, HER2/neu) strengthens the reliability of their findings. The study successfully highlights the alarming frequency of late-stage breast cancer diagnoses in Pakistan and the crucial role of proliferative biomarkers in disease progression. The finding that stage 2 and grade 2 tumors exhibited the highest biomarker expression is particularly noteworthy, underscoring the need for targeted early intervention strategies. The integration of ECOG performance status in correlation with TNM staging adds an additional layer of clinical relevance. However, while the study effectively presents its data, a few critical points warrant further discussion. First, the retrospective nature of the study, coupled with its reliance on hospital-based data, may introduce selection bias, potentially underestimating cases that remain undiagnosed in community settings. A broader, population-based approach could further strengthen the findings. Additionally, the study briefly touches on the late presentation of patients but does not delve into sociocultural factors, which likely play a pivotal role in delayed diagnoses. Future research incorporating patient awareness, healthcare accessibility, and socioeconomic determinants could provide a more comprehensive understanding of this issue. Another important aspect that could enhance this study is the consideration of molecular subtyping beyond ER, PR, and HER2/neu. Given the increasing recognition of triple-negative breast cancer and luminal subtypes as distinct prognostic and therapeutic categories, their inclusion in future analyses would be valuable. Moreover, while statistical significance is well presented, a more detailed discussion on its clinical implications would further enhance the study's translational value. Despite these considerations, the study represents a vital contribution to the ongoing discourse on breast cancer metastasis in Pakistan. It underscores the urgency of early detection programs and tailored therapeutic strategies. I commend the authors for their rigorous approach and the journal for publishing such a relevant study. I look forward to future research building upon these findings.
Hepatitis C and Typhoid Co-Epidemics in Covid-19 Era in Lahore, Pakistan: A Cross-Sectional Research to Rule out Probable Relationelation
Background: Infectious diseases, such as typhoid and hepatitis, alone pose significant challenges to public health in Pakistan. However, when they co-occur with COVID-19, they can intensify health complications and worsen overall outcomes. Objective: To determine the prevalence of typhoid or hepatitis C virus (HCV) infection with COVID-19. Methods: In this cross-sectional survey, demographic data and blood specimens were collected from 199 randomly selected COVID-19 patients hospitalized at a private hospital in Lahore. D-dimer, ferritin, and C-reactive protein (CRP) levels, as well as typhoid and HCV quick diagnostic tests were determined. Chi-square test was used for statistical analysis. Results: Gender segregation of 199 patients revealed that 55% of COVID-19 patients were male and 45% were female. CRP and D-Dimer levels were increased in 132 (66.33%) patients, whereas serum ferritin levels were increased in 92 (46.23%) individuals. Typhoid was detected in 71 out of 199 patients, with 13 (18.3%) patients testing positive for IgM and 58 (81.7 %) patients testing positive for both IgM and IgG. D-dimer, CRP, and ferritin levels were elevated in COVID-19 patients with typhoid co-infection. Additionally, they were positively linked with age in COVID-19 patients with concurrent typhoid illness, with statistical significance (p<0.05). Similarly, 45 (22.6 %) of patients tested positive for HCV, although the results were not statistically significant (p>0.05). Conclusion: Typhoid is frequent, while HCV seropositivity is low in COVID-19 patients. As patients’ age, D-dimer, ferritin, and CRP levels increase concurrently with disease severity and are strongly linked with one another.
Staphylococcus aureus and Atopic Dermatitis: A Complex and Evolving Association
Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with pruritus and epidermal barrier dysfunction. A key contributor to AD pathogenesis is Staphylococcus aureus (S. aureus), which colonizes the skin of affected individuals, exacerbating disease severity through toxin production and immune dysregulation. The microbiota of AD patients is significantly altered, with a reduction in microbial diversity and antimicrobial peptides, leading to an imbalance favoring S. aureus. The bacterium disrupts epidermal integrity, induces inflammasome activation, and promotes apoptosis, further worsening the inflammatory response. Methicillin-resistant S. aureus (MRSA) colonization poses a significant challenge in managing AD due to antibiotic resistance. Multiple factors contribute to S. aureus dominance in AD skin, including genetic predisposition, altered immune responses, and environmental triggers. Th2/Th17 cytokine profiles are elevated in AD patients, leading to increased susceptibility to microbial invasion and inflammation. Filaggrin mutations, a common genetic trait in AD, further compromise the skin barrier, facilitating bacterial colonization. Treatment strategies include topical and systemic antibiotics, monoclonal antibodies, microbiome transplantation, and bacteriophage therapy. However, antibiotic resistance necessitates novel therapeutic approaches, such as targeting virulence factors, modulating immune responses, and restoring microbiome balance. Recent studies emphasize the role of commensal Staphylococcus species in protecting against S. aureus colonization, highlighting the potential of microbiome-based interventions. Future research should focus on developing targeted therapies that restore skin homeostasis while minimizing antibiotic resistance. Understanding the intricate relationship between S. aureus and AD will aid in refining treatment strategies and improving patient outcomes.
Importance of Ethical Decision Making: In Perspective of Case Scenario of a Pregnant Woman
Healthcare organizations are complex environments where ethical decision-making is essential in clinical practice. Physicians, nurses, and paramedical staff frequently face situations requiring ethical choices, especially in critical cases like maternal health emergencies. Ethical decision-making not only ensures patient safety but also upholds institutional reputation while preventing legal and political complications. Preeclampsia, a pregnancy-related hypertensive disorder, significantly contributes to maternal mortality, particularly in underdeveloped regions. The Sustainable Development Goals (SDGs) aim to reduce maternal mortality rates, yet challenges persist due to limited healthcare infrastructure. In this context, nurses play a crucial role in ensuring patient well-being, as their decisions directly influence outcomes. A case scenario highlights the impact of nursing negligence in a patient with preeclampsia. A full-term pregnant woman scheduled for a C-section suffered complications due to inadequate preoperative preparation by a night-shift nurse. The morning shift nurse identified the issue and initiated emergency care, preventing a fatal outcome. However, she faced unwarranted reprimands, raising ethical concerns about professional accountability. Rest’s Four-Component Model—moral sensitivity, moral judgment, moral motivation, and moral character—provides a framework for ethical decision-making. Nurses’ role in patient care necessitates recognition of their decision-making abilities. Addressing ethical dilemmas in healthcare requires institutional support, effective communication, and policies promoting professional integrity. Strengthening ethical education and workplace ethics is vital for improving patient outcomes and sustaining healthcare standards.
Charting New Paths: Standard Growth Charts for Pakistani Children (6-24 Months) using Multiple Indicator Cluster Survey Data
Background: Reliable growth charts are vital for child health monitoring, with chart development based on empirical data and statistical traits. The World Health Organization (WHO) growth standards are used to monitor children's growth worldwide. Recent studies emphasize the need for customized country-specific standards. In Pakistan, reference charts exist, but a standard chart for under-two children is absent due to financial constraints. Objective: This study employs the Novel Case Selection Method (NCSM) to derive variables from Multiple Indicator Cluster Survey (MICS) data for crafting growth charts for children aged 6 to 24 months. Methods: Employing NCSM along with an algorithm for age-appropriate complementary feeding, this study selects 6,085 cases from 28,256 (aged 6-24 months) MICS data, forming the basis for standard growth chart creation. Using GAMLSS models with RefCurve_0.4.2, three families (Box Cox Cole and Green, Box Cox Power Exponential, Box Cox T) and three smoothing techniques (cubic splines, penalized splines, polynomial splines) are compared based on criteria including global deviance, Akaike Information, and Bayesian Information. Two models each for Height-for-Age (H/A) and Weight-for-Age (W/A), categorized by gender, yield standard growth curves compared with WHO 2006 standards. Results: The study's NCSM, combined with considerations for complementary feeding and other WHO criteria, selects 6085 cases from MICS data with 28256 available. Optimal choices for male and female W/A, and female H/A curves are BCPE. Conversely, male H/A curves align with different parameters (BCT). The indigenous standard curves developed for Pakistan show distinct trajectories compared to WHO standards. Conclusion: The necessity of establishing indigenous pediatric growth standards is evident in the observed disparities with WHO standards. These disparities highlight the need for context-specific benchmarks to accurately assess nutritional status and growth in Pakistani children.
Knowledge Attitude and Practices about Typhoid Fever in Adolescents and Adults of Islamabad Pakistan: A Cross-Sectional Study
Background: Typhoid fever, caused by Salmonella Typhi, is a major public health challenge in Pakistan, predominantly due to inadequate sanitation and contaminated food and water. While significant strides have been made in disease surveillance and hygiene promotion, gaps persist in public knowledge, attitude and practice (KAP) regarding its prevention and management. Objective: The study aimed to assess the knowledge, attitude and practices about typhoid fever in adolescents and adults living in Islamabad. Methods: A community-based cross-sectional study was conducted from September to December 2020, involving 283 participants aged 15 and above. Data were collected through structured questionnaires encompassing socio-demographics, knowledge, attitude and hygiene practices. Statistical analyses were performed using SPSS to identify correlations between variables. Results: Most respondents (93.3%) were aware of typhoid fever, yet only 63.3% understood its transmission routes. Hygiene practices were high, with 94.7% acknowledging the role of handwashing in food safety. However, gaps were noted in food handling behaviors, such as sanitizer usage (35.7%). Positive attitudes toward prevention were reflected by 92.2% of participants emphasizing proper cooking methods. Statistical analysis highlighted significant associations between hygiene practices and disease prevention. Conclusion: Despite high awareness and generally positive attitudes, inconsistencies in preventive practices underscore the need for enhanced public health education focusing on proper hygiene and food safety. Strengthening surveillance and targeted interventions could further reduce the burden of typhoid fever in Pakistan.