Development of treatment methods for late-life cognitive disorders, understanding neuroimmune principles requires their consideration. The authors presented a descriptive review of 81 scientific publications on these topics.

The authors of this study suggest that neuroimmune mechanisms are of great importance in the pathogenesis of late-life cognitive disorders. They participate in the formation and maintenance of neuroinflammation.

Background: Understanding vascular anatomy variations is critical across multiple disciplines, including academic research, clinical practice, and various surgical specialties. These variations hold particular relevance in fields such as nephrology, urology, oncology, and vascular surgery, among others. A precise knowledge of anatomical anomalies, especially in the renal vasculature, is essential for advancing educational frameworks, improving diagnostic accuracy, and optimizing surgical outcomes.  The primary aim of this review is to determine the true prevalence of multiple renal arteries within a broad, multiethnic population. By leveraging data from diverse demographic groups, this study seeks to provide a comprehensive perspective that reflects the global diversity in renal vascular anatomy.  In addition to the primary objective, the review also focuses on two key secondary goals. The first is to assess the prevalence of early branching patterns in the renal artery, a variation with significant clinical and surgical implications. The second is to analyze the distribution of these vascular anomalies between the left and right kidneys, providing insights into potential lateralization and its relevance in medical and surgical decision-making.   Material and Methods: This study analyzes the renal arterial anatomy of 21654 kidneys from eighty-one anatomical and radiological studies, retrieved from several well-established and widely respected research databases, including Medline, Pub Med, Embase, Web of Science, and Google Scholar.  Results: Multiple renal arteries (MRA) were present in 20.49% of kidneys examined, with the number of arteries arriving at the hilum ranging from two to six. The most common finding was the presence of two renal arteries, which occurred in 89.32% of cases. This was followed by three renal arteries at 9.82%, four at 0.72%, five at 0.09%, and six at 0.05%, with the latter observed in only two kidneys. Data regarding the lateralization of multiple renal arteries is limited, and no preference for one side over the other was found: multiple renal arteries were identified in 44.23% of right kidneys and 46.56% of left kidneys. Early branching patterns were documented in only one-third of the available literature, appearing in 11.99% of the kidneys studied. This included 4.24% of right kidneys and 4.58% of left kidneys, while 3.17% lacked specific right or left information. Conclusions: The greatest challenge in this study was integrating results from various sources, largely due to the heterogeneity in how anatomical variations were described. This highlights the urgent need for a universally accepted medical nomenclature to ensure more accurate interpretation and communication of findings in clinical practice. Renal anatomical variations carry significant clinical and surgical implications, particularly in procedures such as renal transplantation, correction of hydronephrosis, ablation therapies for refractory hypertension, and endovascular reconstructions. A detailed understanding of these variations is essential for all physicians to optimize patient outcomes and minimize complications across a wide range of medical and surgical interventions.

Introduction: Twin pregnancy is the simultaneous development of two embryos in the uterus. Twins are inherently different from singletons by their very nature and are at higher risk of maternal and fetal complications. AIM: The study aims to assess the perinatal outcomes of the second twin in relation to gestational age, presentation, mode of delivery, and birth weight, and to identify any associations with these variables. Methodology: This study is hospital-based cross-sectional descriptive research conducted in the Department of Obstetrics and Gynecology at S.P. Medical College and Associated Group of Hospitals in Bikaner, Rajasthan, India. Result: In our study, the majority of cases were in the 20-25 years age group (42.50%), with a mean age of 24.94 ± 4.31 years. Most twins were delivered vaginally (49.37%), with a significant percentage (88.7%) having an intertwin delivery interval of less than 10 minutes. Our study highlights the higher perinatal mortality of second twins, emphasizing the need for rigorous intrapartum monitoring, skilled obstetric care, and immediate access to neonatal intensive care to enhance outcomes. Conclusion: Improving perinatal outcomes for second twins requires strict monitoring, skilled obstetric care, and access to neonatal intensive care, emphasizing the importance of birth planning and early ultrasound assessments.

Introduction: Choledocholithiasis is the presence of stones within the common bile duct. AIM: To compare the clinical outcome following early and late cholecystectomy patients after ERCP. Methodology: The study was a hospital-based comparative analysis conducted over a 10-month period at the Department of Surgery, S.P. Medical College and P.B.M Hospital in Bikaner. It aimed to evaluate outcomes in patients undergoing early versus late cholecystectomy following endoscopic retrograde cholangiopancreatography (ERCP). All post-ERCP patients who presented to the Surgery Department during the study period and met the inclusion criteria were included. Result: In our study, early laparoscopic cholecystectomy (Group A) showed significantly fewer intraoperative difficulties and complications, with a mean hospital stay of 1.95 days compared to 3.75 days in the late cholecystectomy group (Group B). These findings align with previous research indicating shorter hospital stays and fewer complications in early cholecystectomy cases. Conclusion: early laparoscopic cholecystectomy after ERCP in the patients of cholelithiasis with coexisting choledocholithiasis was found to be safe

Introduction: Pulmonary function tests (PFTs) play a crucial role in assessing respiratory health by measuring various parameters that reflect the function and efficiency of the lungs. These tests provide valuable insights into the mechanics of breathing, the capacity of the respiratory system, and the presence of any abnormalities or diseases affecting lung function. Spirometry is commonly used in evaluation of certain restrictive and obstructive lung diseases. Development of industrialization and increased population causes tremendous increase in pollution day by day.  Materials And Methods: This is a cross-sectional study was conducted in the Department of Physiology, Index Medical College diagnosed with COPD using Spirometry was recruited for the study.  Details of the subjects collected at one point of time in the study period. Construction Male workers aged 40-80 years were included. Results: The present study was done in 220 participants (study group-n=110, Control group n= 110). In our study, the most of workers age group is 18-30 years i.e., 57 out of 110, followed by 31-40 years, i.e., 41 out of 110 in study group and in control group 18-30 years i.e., 59 out of 110, followed by 31-40 years, i.e., 40 out of 110. In study group out of 110, 67 subjects were male and 43 were female subjects. In control group 68 were male and 42 were female subjects. The most common cardiovascular co-morbidity was hypertension (n= 75, 34.1%), followed by diabetes mellitus (n =32, 14.5%), and dyslipidaemia (n= 40, 18.2%). Conclusion: In the present study, FEV1, FVC, PEFR, MVV values showed highly significant reduction as compare to control groups. The significant decrease in these values is indicative of obstructive type of changes in lung functions. Continuous exposure to dusty environment leads to inflammatory changes in small airways as well as in lung parenchyma leading to development of obstructive type of lung dysfunction

Among wood factory workers, the implementation of regular Pulmonary Function Test (PFTs) can aid in early detection of respiratory abnormalities and facilitate timely interventions to prevent the progression of occupational lung diseases. Monitoring parameters such as FEV1/FVC ratio, PEFR, and Maximum Voluntary Ventilation (MVV) can provide valuable insights into airway obstruction, lung function impairment, and respiratory muscle strength. Studies have shown that wood factory workers exhibit decreased lung function parameters compared to non-exposed populations, indicating the detrimental effects of wood dust exposure on respiratory health. Materials And Methods: This is a cross-sectional study was conducted in the Department of Physiology, Index Medical College diagnosed with COPD using Spirometry was recruited for the study.  Details of the subjects collected at one point of time in the study period. Lung function tests FEV1 (Forced Expiratory Volume in 1 second), PEFR (Peak Expiratory Flow Rate) and FVC (Forced Vital Capacity) for pulmonary impairment of each subject (study group and control group) was performed using a Spiro meter by following standard protocols. Results: The present study was done in 220 participants (study group-n=110, Control group n= 110). In our study, the most of workers age group is 18-30 years i.e., 57 out of 110, followed by 31-40 years, i.e., 41 out of 110 in study group and in control group 18-30 years i.e., 59 out of 110, followed by 31-40 years, i.e., 40 out of 110. In study group out of 110, 67 subjects were male and 43 were female subjects. In control group 68 were male and 42 were female subjects. The Mean weight of participants of study group is 59.4±10 and their mean height is 156±8.3. The Mean weight participants of control group are 61±10.2 and their mean height is 161.6±6.8. The parameters of Pulmonary Function Test were significantly decreased (p < 0.0001) in study group as compare to control group. Different stages of COPD stage I –IV were 14.5%, 45.4%, 30.9%, 9.0% respectively in study Group. Conclusion: We conclude from this study that workers exposed to wood dust have more respiratory symptoms than control subjects and that such exposure increases the risk of airflow obstruction. So, we recommend that workers should learn to use protective facemasks at sites and use other measures to reduce dust flow into the environment.

Probiotics are increasingly recognized for their pivotal role in modulating the immune system, with extensive research focusing on both traditional strains like Lactobacillus and Bifidobacterium, and next-generation probiotics such as Akkermansia muciniphila and Faecalibacterium prausnitzii. Traditional probiotics have been studied extensively for their ability to enhance gut barrier function, regulate cytokine production, and maintain immune homeostasis. In contrast, next-generation probiotics offer novel mechanisms, including the modulation of metabolic pathways and the production of specific metabolites that interact directly with the host immune system. This review compares the immunomodulatory effects of traditional versus next-generation probiotics, exploring their efficacy, mechanisms of action, and clinical implications as immunomodulators. It underscores the emerging trend towards personalized probiotic therapies tailored to individual microbiota compositions and immune responses. The review also examines probiotics' evolving role in oncology, focusing on their potential to boost immune responses, reduce inflammation, and improve treatment by minimizing side effects and enhancing effectiveness. Understanding the intricate interplay between probiotics, the microbiome, and host immunity is crucial for optimizing their application in oncology. Future research endeavours should focus on elucidating the precise mechanisms through which probiotics exert their effects in malignancies, with the ultimate goal of translating these findings into effective clinical strategies that enhance cancer patient outcomes. This comprehensive exploration highlights both the current advancements and the ongoing challenges in probiotic research, paving the way for innovative approaches in healthcare and personalized medicine

Introduction: Intestinal anastomosis are common procedures in both elective and emergency general surgery. AIM: To compare the early and late enteral feeding after intestinal resection and anastomosis in terms of complications, length of hospital stay, morbidity and mortality. Methodology: The study, conducted over 12 months from May 2023 to April 2024 at the Department of Surgery, S.P. Medical College and P.B.M. Hospital in Bikaner, utilized a hospital-based comparative design with convenience sampling. The study focused on patients undergoing intestinal resection and anastomosis. Result: In our study, the early feeding group (Group A) showed significantly quicker resolution of ileus and a shorter hospital stay compared to the late feeding group (Group B). However, both groups had similar rates of tolerance to feeding, with the early feeding group experiencing fewer complications and reoperations. Conclusion: We concluded that early feeding after GI resection and anastomosis had early resolution of ileus with less complications like anastomotic leak and wound infections.

Introduction: The placenta is a vital materno-foetal organ, protects the foetus by preventing immune attacks and blocking the transfer of harmful microorganisms from the mother. AIM: To evaluate the relationship of umbilical cord thickness and cross-sectional area with foetal outcome. Methodology: This study was designed as a cross-sectional observational study conducted at the Department of Obstetrics and Gynaecology, PBM Hospital, Bikaner. The study was carried out over a one-year period, starting in January 2024.Result: In our study, among 300 cases, the majority (60.00%) were in the 19–25 years age group, with a mean age of 24.55 ± 5.6 years. The study found significant associations between umbilical cord thickness and cross-sectional area centiles with various neonatal outcomes, including birth weight, APGAR scores, and NICU admission, highlighting the relationship between abnormal umbilical cord measurements and adverse neonatal outcomes. Conclusion: In conclusion, a larger, more robust study across diverse ethnic groups is needed to standardise cutoffs for umbilical cord thickness and cross-sectional area, allowing their incorporation into routine antenatal screening for improved perinatal outcomes.

Introduction: Induction of labor (IOL) is a prevalent obstetric intervention that initiates labor through artificial means. Aim: The aim of this study is to compare the efficacy of dinoprostone gel for labor induction in patient with vaginal ph <5.5 and ph ≥ 5.5. Methodology: This comparative prospective observational study will be conducted in the Department of Obstetrics and Gynecology at Sardar Patel Medical College, Bikaner, over a six-month period from April 2024 to September 2024. Result: In this study, vaginal pH was significantly associated with labor induction outcomes, with higher pH correlating to more favorable Bishop scores and higher rates of vaginal delivery. Group A, with a lower vaginal pH, required more inductions and had higher NICU admissions compared to Group B, highlighting the importance of vaginal pH in cervical ripening efficacy. Conclusion: The study suggests that assessing vaginal pH before dinoprostone gel induction can predict labor outcomes, with higher pH linked to better Bishop scores and shorter delivery intervals, highlighting its potential to enhance management strategies and improve induction success rates

Aims: This study aims to evaluate the documentation quality of chest drain insertions in a pulmonology department and assess improvements after implementing a standardized pro forma. Methods: This audit was conducted in the pulmonology department of HMC, Peshawar. Documentation quality was assessed over three months, after which a structured pro forma based on NHS guidelines was introduced to improve the documentation process. Results: This audit showed substantial gaps in documentation, with essential information often missing. Implementing NHS-based proforma significantly improved the quality of clinical documentation. Conclusion:  Standardizing documentation with a structured pro forma improves the quality and completeness of chest drain insertion records, which is essential for patient safety and interprofessional communication.

Background: Preeclampsia is one of the most common and life-threatening Alzheimer's disease is the most prevalent type of dementia, which is a broad term encompassing memory loss and other cognitive impairments that significantly disrupt daily activities. The object of this study is to inhibit the enzyme acetylcholinesterase, and the two peptides beta-amyloid 40, beta-amyloid 42, which are responsible for Alzheimer's disease, using rosemarinic acid extracted from the Salvia officinalis plant. The study conducted an in silico analysis of three compounds extracted from salvia officinalis. The compounds were then subjected to drug-likeness prediction using DruLiTo and ADMET prediction to evaluate absorption, distribution, metabolism, excretion, and toxicity using pkCSM online. Molecular docking was performed using the AutoDock 4.2.6 program to targets. and the results were visualized using Discovery Studio Visualizer softwar. In silico studies reveal that the inhibitor ligand rosmarinic acid interacts with 4EY4, forming 6 amino acid bonds with an inhibition constant (Ki) of 25287.99 nm and ∆G = -8.4 kcal/mol. This interaction is found to be more potent than the commercially available product citicoline (Ki= 742253.85 nm).

Glutamate neurotransmitter has a notorious role in various types of neurological disorders and this glutamatergic system make the basis of various anti-epileptic drugs to control the different types of seizures.  The key enzyme in glutamatergic system is cytosolic human branched-chain aminotransferase (hBCATc). Here we exploited the hBCATc identification of potential HITs as the antiepileptic molecules. HTVS based virtual screening using the drug like subset of Zinc13 database and co-crystallized structure of hBCATc was used for the design and discovery of newer antiepileptic molecules. The top scoring molecules were analysed and owing to the structural resemblance with gabapentin and pyridoxal phosphate, we considered the top scoring pyridine derivatives for further study. Compound ZINC69678114 with docking score -7.151 was identified as a potential HIT. MD simulations studies also suggested that ZINC69678114 had the lowest RMSD and RMSF values than gabapentin. In-silico ADME calculation was done to check the drug likeliness properties and CNS related toxicities of identified HIT. The values suggested the ZINC69678114 has the drug-likeness properties with good pharmacokinetic properties. The obtained docking score, lower & stable RMSD, RMSF pattern comparative to gabapentin with good pharmacokinetic properties, indicated that the ZINC69678114 would be the potential HIT for the design and discovery of antiepileptic molecule.

Introduction: Polycystic ovary syndrome (PCOS) is a common cause of ovarian dysfunction in women of reproductive age. AIM: The study aimed to evaluate the levels of 25-hydroxyvitamin D3 in women with PCOS, assess the levels in healthy women, and compare the vitamin D3 levels between women with and without PCOS. Methodology: The study was a hospital-based observational investigation conducted in the Department of Obstetrics and Gynaecology at PBM Hospital, Bikaner, Rajasthan, located in the North-Western part of India. Result: In our study, significant differences were observed between cases and controls in factors like menstrual irregularity, LH/FSH ratio, and vitamin D3 levels, with PCOS cases showing higher LH/FSH ratios and lower vitamin D3 levels. These findings align with previous research, highlighting the importance of these markers in the diagnosis and management of PCOS. Conclusion: This study highlights the significant association between low vitamin D3 levels and PCOS, suggesting that routine screening and correction of vitamin D3 deficiency may help prevent and manage the syndrome.

Background: Preeclampsia is one of the most common and life-threatening complications of pregnancy. It increased future cardiovascular and metabolic risk for mother and newborns. Adiponectin is an adipokine with anti inflammatory and angiogenic and anti athrogenic properties. In current study we hypothesised level of serum adiponectin lower in preeclamptic patients as compared to normotensive pregnant females. Aim: To estimate level of serum adiponectin in preeclampsia patients. Methods: Adiponectin was quantified by enzyme linked immunosorbent assay (ELISA) in controls and preeclamptic patients during pregnancy. (Control: n=45, Preeclampsia: n=45). Two mililtiters of blood sample was drawn antiseptically using 5ml syringe from the median anticubital vein of all cases and control participants into serum separator tubes. Then serum is analysed by using ELISA KIT. Results: Mean age group in group A was 25.52±3.75 and in group B mean age group was 26.82±4.4. Mean BMI in group A was 29.32 ± 3.14 kg/m2 while in group B mean BMI was 24.98 ± 4.64 kg/m2. Mean systolic BP in group A was 160.4 ± 12.18mm of Hg and in group B mean systolic BP was 118.26 ± 10.62mm of Hg and Mean diastolic BP in group A was 98.4 ± 8.81mm of Hg and in group B mean diastolic BP was 76.95 ± 7.76mm of Hg. The mean level of the serum Adiponectin in cases   was 8.21±1.42 pg/ml and in control was mean Serum Adiponectin was 29.1 ± 12.80 pg/ml and this difference was found statistically significant (p<0.005). Furthermore, In preeclampsia patients having more BP were associated with with more low levels of serum adiponectin. Conclusions: lower maternal serum adiponectin levels are significantly lower in preeclamptic patients.

Introduction- Anthropometric characteristic have direct relationship with sex, shape and form of an individual and these factors arelinked with each other. Aim and objectives: To study morphometry of face. To calculate mean facial index, mean facial height and mean facial width in males. Material and Method – Total of 250 subjects were examined, 250 males were taken measurements of morphological facial height, width, facial index as parameterand age ranging from age group 18-25 year. All measurements were measured in centimeter. Result: showed that the facial index was between 85-89.9 . Mean Facial height in our study was11.14. Mean Facial width in our study was 12.77. Discussion: The present study provides valuable data pertaining to facial index and shape of face in adult MP Population. Summary and conclusion: In our study we observed that the dominant type of face are Mesoprosopic face within 63male.

All surgical specialties understand how important accurate and thorough operation notes are to guaranteeing patient care and producing data for auditing and research. The author's institution's orthopedic operation notes were examined for content, completeness, and legibility standards against the Royal College of Surgeons of England's published norms.
For preparing surgical notes, a template tailored to the orthopedic specialty has been suggested. Additionally, it has been suggested that aide memoires be stationed in the OT complex and that all physicians at the registrar level in surgical specialties receive training in writing operative notes.

Herbal medicine practices in Bangladesh have a rich history deeply entrenched in cultural traditions, offering a holistic approach to healthcare. This article explores the integration of traditional herbal remedies with modern pharmacy practices in Bangladesh, highlighting its significance, challenges, and opportunities. Through an examination of current status, regulatory frameworks, research, economic implications and future directions, the paper elucidates the potential benefits of incorporating herbal medicine into mainstream healthcare. While facing challenges such as scientific validation, regulation, and quality control, Bangladesh stands poised to harness the therapeutic potential of its abundant medicinal plant resources. By addressing these challenges through collaboration, innovation, and commitment to quality, Bangladesh can pave the way for a more integrated and effective healthcare system, benefiting both its population and global herbal medicine practices.

This study aimed to evaluate the phytochemicals, membrane stabilizing and thrombolytic activities of the methanolic extract of Boeica filiformis, a plant from the Gesneriaceae family.

The extract inhibited 67.70% haemolysis in hypotonic solution, demonstrating membrane stabilizing potential. In the thrombolytic assay, the plant extract showed 72.89% clot lysis, which was significant compared to the positive control, streptokinase (30,000 IU), and the negative control, normal saline.

Methanolic extract (10 mg/ml) was tested for thrombolytic activity using streptokinase (SK) and human erythrocyte solution. Red blood cell haemolysis inhibition was assessed using hypotonic solution and heat-induced methods, with acetylsalicylic acid also known as Aspirin as a reference (0.10 mg/ml).

In conclusion, the methanolic extract of B. filiformis exhibited promising phytochemical, membrane stabilizing and thrombolytic activities. According to the results, the plant might be a safer substitute for pharmaceutical medications; nevertheless, more pharmacological and chemical research is needed to pinpoint the bioactive ingredients and elucidate the underlying mechanisms

Background: The major public health problem in many countries is trauma. Traumas are of two types that is blunt trauma and penetrating trauma. In penetrating abdominal trauma colon is the second most commonly injured organ after small bowel. Around 60-90% of injuries to colon are due to penetrating injuries and up to 30% are due to stab injuries. During the last century, the management of gut injury has evolved. The surgeons in practice in battle field of World War-II gained a lot of experience in abdominal injuries and put that understanding in civilian practice. Gut  injuries are usually not isolated. Hence there are not specific sign and symptoms. The early development of inflammation of peritonitis with free gas radiology evidence in the peritoneum is the early sign of gut injuries.  Methodology: It was a comparative prospective study which was conducted in DHQ Teaching Hospital KDA Kohat, Khyber Pakhtoon Khwa Pakistan from January 2021 to June 2021.  During the period of study 265 patients were reported in emergency department. Patients who met the inclusive criteria of abdominal penetrating trauma were preferred in this study. Patients were thoroughly examined by the staff on duty. In emergency department the ATLS protocol was strictly followed and patients were resuscitated and stabilized. After that detailed examination from head to toe was done. After this patients was again re-evaluated by senior surgeon who took the final decision to operate. . After securing hemostasis, gut was repair in single layer extra mucosal stitches by using Vicryl 2-0. After 6- liter of warm normal saline was used to wash peritoneal cavity. Results: Out of 265, 245 were males and 20 were females. Minimum age considered was 15 and maximum was 55 with mean and standard deviation of 26.2±9. The other major outcome of this study which is that maximum number of patients showed the uneventful recovery in which mostly were males. Our study showed that only 4% of victims suffered from wound infection. Data was analyzed by SPSS version 17.0. Age and frequency was recorded in mean and standard deviation while gender and results like wound infection and intra-abdominal collection was calculated in percentages Conclusion: The results of our study were analyzed in terms of complication such as wound infection, intra –abdominal collections etc. and uneventful recovery. It is concluded that repair with single layer extra mucosal was simple, easy and less time consuming. The results were beneficial, helpful and can be compared with other national and international studies undergone in similar criteria.

Introduction: Invasive ductal carcinoma (IDC) is the most prevalent subtype of breast cancer, distinguished by diverse clinical manifestations and molecular heterogeneity. Prognostic outcomes are influenced by multiple factors, including the patient’s age at diagnosis, tumor size, histological grade, disease stage, lymph node metastasis (LNM), and hormone receptor status (ER, PR, HER2). This research has highlighted the potential of emerging molecular biomarkers such as Cyclin D1 and β-Catenin in enhancing prognostic precision. Methodology: This retrospective, cross-sectional study analyzed the medical records of female patients diagnosed with IDC. Tumor size, grade, and stage were examined alongside lymph node involvement to assess the extent of disease dissemination. Immunohistochemistry (IHC) was employed to determine the expression of ER, PR, and HER2 receptors. Additionally, emerging biomarkers such as Cyclin D1 and β-Catenin were evaluated to explore their prognostic value. A total of 150 tumor samples were collected from multiple cancer treatment facilities across Rawalpindi, Punjab, Pakistan. Findings and Discussion: The mean age at diagnosis was 50.6 years, with the majority of patients (68%) between 36 and 55 years. Tumor analysis revealed that 76.7% of lesions were <30 mm in size, and 46.7% were classified as grade II. LNM was detected in 39.3% of patients, indicating significant metastatic potential. Regarding receptor expression, 45.5% of tumors were ER-positive, 42.9% PR-positive, and 54.8% HER2-positive, aligning with global incidence trends.  The investigation of molecular markers showed Cyclin D1 overexpression in 60% of cases, predominantly in ER-positive tumors, suggesting better endocrine therapy responsiveness. β-Catenin was detected in 33.3% of samples and correlated with aggressive tumor phenotypes, emphasizing its potential role in identifying high-risk patients. These molecular markers align with globally research. Conclusion: This study emphasizes the significance of early detection and comprehensive molecular profiling in IDC management. Smaller tumors and receptor-positive cases are generally associated with more favorable outcomes. Additionally, emerging biomarkers such as Cyclin D1 and β-Catenin hold promise for refining prognostic models and optimizing individualized treatment plans. Incorporating these biomarkers into clinical practice can further enhance therapeutic decision-making and patient care.

The aim of this study was to examine the diversity, relative abundance and ecology of mosquitoes in district Okara, Pakistan. A total of 2172 adult mosquitoes and 4317 mosquito larvae were collected, in which 13 mosquito species were identified within a single order, a single family and from three genera, Culex, Anopheles, and Aedes were identified. The identified 7 species belonged to the genus Culex, three species to the genus Anopheles and only 3 species belonged to the genus Aedes. The most abundant species was Culex quinquefasciatus with relative abundance of (17.5%), Culex theileri (15%), Culex duttoni (12.01%), Culex pipiens fatigans (10%), Anopheles subpictus (9.2%), and Anopheles annularis (8.13%). In contrast, Culex vagans, Culex sitiens, Anopheles stephensi, Culex tritaeniorhynchus, Aedes aegypti, Aedes albopictus, and Aedes vexans were identified to be the least in number with 5.61%, 5.52%, 4.41%, 4.1%, 3.8%, 3.02%, and 1.7% relative abundance. The Shannon-Weiner diversity index showed that Sardar Chok (H′=1.601) and Company Bagh (H′=1.458) had the greater diversity of mosquitoes, followed by Junior Model School, Green City, and Canal Road, i.e., 1.354, 1.345, and 0.6833. Species evenness has varied among Locations based on diversity, with values of 0.9918 (Sardar Chok), 0.9902 (Canal Road), 0.9679 (Junior Model School), 0.9592 (Green City), and 0.8596 (Company Bagh). The Simpson index (1-D) for Sardar Chok, Company Bagh, Junior Model School, Green City, and Canal Road was 0.7968, 0.7366, 0.7337, 0.7274, and 0.4902 indicating that SC and CB had the maximum Mosquitoes species. According to the results of this study, Okara district is home to a wide variety of mosquito species.

Diabetes as a non – communicable disease is significant public health problem the prevalence rate all the world over is raising. Diabetes mellitus is one of the leading causes of long - term complications and a major health hazard in a developing country like India. Indian Diabetes Risk Score developed by Mohan et al. in 2005 is one of the strongest predictors of incident diabetes in India. Materials & Methods: The present study entitled was conducted in the Department of Physiology IndexMedical College, Hospital & Research center, Malwanchal University Indore. 140 subjects in the age group range of 30 - 60 years attending the different medical OPDs. Results: The mean age of the 70 subjects included in the control group was 42.61 ± 8.70 years & 70 pre-diabetic subjects were 45.43 ± 8.77 years. Maximum numbers of pre-diabetes were in the age group of 40 - 50 years. Conclusion: The results of the study will help to formulate strategies for future preventive efforts and delay the onset of type 2 diabetes.

Background: Surgical site infection is professionally defined as appearance of pain at the site of wound, which is followed by redness, inflammation and site tenderness or presence of puss at infection site. The most common wound clean-contaminated and contaminated in abdominal surgery is that of laparotomy. An infection after surgery occurs in up to 5% of surgical patients. The most common form of bacteria attacking the site of infection includes streptococcus pyogenes, and staphylococcus aureus. . Around 20% infection is caused by Staphylococcus aureus, 14% is caused by Coagulase negative staphylococcus and 12% is caused by Enterococcus Methodolgy: This was a prospective study. The duration of this study was from February to October 2023. This study includes patients of all age groups and both genders. All patients received the same dosage that is 1 gram of Ceftriaxone in adults through intravenous injection and in children less than 12 year 50 gram per kilogram body weight. The deep abdominal wall was closed with the help of non-absorbable, single filament suture number “0” or “1” and with 2/0 in children. The patients were checked on the 5th day, 10th day and 8th day to examine for any complications associated with site infection. The data was collected through questionnaire forms. Results:  Out of 95 surgeries, 55 were emergency based surgeries and 40 were elective surgeries. The peak age was 20 to 30 which was accounted for 50% of patients. The majority of patients were not infected on 28th day of surgery. High number of patients acquired infection between 6th to 10th post operation days. The common complication found in clean-contaminated and contaminated abdominal surgeries site infection comprises of 78.9% Conclusion: This study shows that surgical site infection is most common complication associated with abdominal surgeries and it contributes in a high rate of deaths and complications. This study also determines that an induction of pre-operative prophylactic antibiotics in clean-contaminated and contaminated abdominal surgeries and a good surgical technique can reduces the rate of surgical site infection and its complications

Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains a critical global health challenge, claiming over one million lives annually. Despite substantial progress in reducing TB incidence in developed countries post-World War II, it persists as a major cause of mortality, particularly in low-income populations. Socio-economic disparities significantly contribute to TB prevalence, exacerbating the uneven distribution of resources and healthcare access. Pakistan is among the nations severely impacted by TB, with eradication targets still unmet. All forms of TB are prevalent in the region, presenting symptoms such as fever, chronic cough, chills, and weight loss. This review assesses treatment outcomes and the prevalence of pulmonary TB in diagnosed patients in Pakistan. The airborne transmission of TB significantly drives its global burden. According to the World Health Organization (WHO), 2021 witnessed 1.2 million TB-related deaths and 9.9 million new cases. Diagnostic methods include immunological assays and molecular techniques, requiring sputum and blood sample analyses. Early diagnosis is crucial to prevent the emergence of drug-resistant strains. Pulmonary TB primarily spreads via respiratory pathways, with MTB infecting alveolar macrophages, leading to disease progression. Although studies on genetic susceptibility to TB have been conducted, conclusive evidence remains elusive. Computed Tomography (CT) provides detailed insights into TB manifestations but demands automation due to the high volume of data generated. The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB presents serious challenges to control and treatment. This review offers a comprehensive analysis of the epidemiology, pathogenesis, diagnosis, treatment, and prevention strategies for MDR and XDR TB. It highlights existing research gaps and proposes future directions to address these challenges. Advances in Artificial Intelligence (AI) and Computer Vision (CV) provide novel approaches for automating TB image analysis, facilitating scalable pre-clinical trials and improving disease management.

Cardiology has been greatly affected by the rapid advancements in artificial intelligence (AI) technologies, which have led to innovation and changed clinical practices. This paper provides an in-depth analysis of these AI-driven developments and their potential to improve cardiovascular healthcare. By systematically reviewing scholarly articles and peer-reviewed literature, this study gives a comprehensive overview of AI applications in cardiology. The search was performed systematically using databases such as PubMed/MEDLINE, ScienceDirect, IEEE Xplore, and Web of Science with predefined selection criteria. The selected articles synthesis shows that AI has many applications in cardiology including diagnostic innovations, precision medicine, remote monitoring technologies, drug discovery, and clinical decision support systems. The results indicate that AI is central to the transformation of cardiovascular medicine through diagnostics, treatment strategies, and patient care. Although the research highlights the transformative potential of AI in cardiology it also recognizes ongoing challenges such as algorithm accuracy, interoperability, and integration of AI into clinical workflows. Nevertheless, further development and strategic implementation of AI in cardiology are expected to provide more personalized efficient and effective cardiovascular care leading to improved patient outcomes thus shaping the future practice of cardiology. This paper adds to the existing body of knowledge by providing new insights into how AI is changing the role played by cardiologists today.

The incidence of child trafficking in India is very high. There are multifarious reasons for child trafficking. India has a population of 135 crores according to the latest census. Millions of families are living in below poverty line. Family size of people living in below poverty line is high. They do not have access to nutritious food, proper education to make out their living, house and good health. Parents are forced to send their children to work to contribute to family income. Condition of girl child is worse. She is considered a burden to family and is married in minor age to elder people for pecuniary gains. Some religious practices allow minor girls to marry God and are compelled to live in prostitution. These women are called “Devdasis’”. In some other community minor girls are married to old rich people under the protection of personal law. Minor children are sent to work as domestic servants, farm workers, in hotels and restaurants, shops and small workshops etc. in un-organized sectors. Thousands of children are illegally sent to urban areas every day and are engaged in different works which is known as child labour, beggar. Even traffickers sell children and mutilate their bodies for the purpose of begging. These hapless children are compelled to live in unhygienic condition, starved and also subjected to sexual abuse. After the development of information technology, internet access and social medias are frequently used for child pornography. Specifically, girl children are induced and trafficked to shoot child pornography films. In present day children are most vulnerable to sexual abuse and child trafficking than in past generations due to cyber network. The United Nations General Assembly resolution regarding Universal Declaration of Human Rights in December 1948 and the U.N. Convention on the Rights of the Child are the land mark majors at the world level recognizing and guaranteeing the rights of the child. Government of India in its response adopted the National Policy for Children, 2013. The Constitution of India has in Part III Article 21A guaranteeing right to education to all children up to the age of 14. Article 23 prohibits traffic in human beings and child labour. Article 24      prohibits employment of children in factory, mine and hazardous employment. Government amended the Indian Penal Code to impose deterrent punishment to traffickers. Besides Government enacted several special laws such as the Bonded Labour System (Abolition) Act,1976, the Juvenile Justice ( Care and Protection of Children) Act,2000, the Protection of Children from Sexual Offences Act, 2012 and its Rules,2012, and the Prohibition of Child Marriage Act,2006.  In spite of the Government plan of actions and laws to punish child abusers and offenders of child-trafficking, child abuse and trafficking are continuing. Perhaps there is some laxity in the enforcement agency and judicial process and lack of social awareness about child abuse and trafficking.

Background: Intertrochanteric femur fractures are a frequent orthopedic injury in elderly patients, typically managed with dynamic hip screw (DHS) fixation. Minimally invasive surgery (MIS) has been proposed as a less traumatic alternative to the conventional muscle-reflection approach, with potential benefits in reducing complications and enhancing recovery. This study compares the outcomes of MIS and conventional approaches in terms of infection rates, time to mobilization, complication rates, and functional recovery using the Harris Hip Score. Methods: A total of 98 patients with intertrochanteric fractures were randomly assigned to the MIS group (n=46) or the conventional approach group (n=52). Outcomes assessed included post-operative infection rates, time to mobilization and weight bearing, other complications, and functional outcomes measured by the Harris Hip Score. Statistical analysis was performed to determine significant differences between the groups. Results: The rate of infection was lower in the MIS group (one case) compared to the conventional group (three cases), though the infections were superficial and managed conservatively. Early mobilization and partial weight bearing were initiated in both groups at around two weeks post-operatively, with no significant difference in union rates or time to union. The Harris Hip Score results were comparable, with the MIS group showing slightly more "good" outcomes (58%) compared to the conventional group (56%). Complications were minimal, with one case of early implant failure in the conventional group. Conclusions: The MIS approach for DHS fixation is associated with lower infection rates and similar functional outcomes compared to the conventional approach. Although the differences in post-operative recovery times and complication rates were not statistically significant, the MIS technique offers potential advantages in reducing surgical trauma and enhancing recovery. Further research is needed to confirm these trends.

Hearing impairment in children can significantly impact language development, communication, and overall quality of life. By consolidating current knowledge, this review aims to offer a comprehensive resource for healthcare professionals, researchers, and policymakers, fostering better understanding, early detection, and effective management of pediatric hearing impairment. The evaluation of pediatric hearing loss is a critical endeavour owing to its profound implications on a child's cognitive and social development. Hearing impairment during childhood can lead to academic setbacks, social isolation, and hindered communication skills. This review is prompted by the need for a comprehensive synthesis of existing research, diagnostic techniques, and evolving technologies, all of which contribute to the accurate assessment of hearing loss in children. Furthermore, this review is motivated by the aim to underscore the significance of early intervention. Early identification of hearing loss in children is crucial for implementing timely interventions such as hearing aids, cochlear implants, and therapeutic interventions that can significantly enhance a child's developmental trajectory. By highlighting the importance of comprehensive evaluation protocols, this review seeks to empower healthcare professionals with the knowledge to make informed decisions that positively impact the lives of children affected by hearing impairment. In conclusion, this review serves as a valuable resource for researchers, clinicians, and stakeholders involved in the field of pediatric audiology. By consolidating current knowledge and offering insights into emerging trends, this review contributes to the collective effort of enhancing pediatric hearing loss evaluation, intervention, and the overall well-being of affected children.

Introduction: An uncomplicated urinary tract infection (UTI) is a bacterial infection of the bladder and associated structures. AIM: The primary aim of this study is to evaluate the efficacy and safety of nitrofurantoin and fosfomycin. Methodology: This study was a prospective observational study conducted from Nov 23 to April 24 at the Gynaecology department, Sai samarth hospital and research centre, khargone, MP. It is done by dividing participants into two equal groups of 50. Group A receives nitrofurantoin, while Group B is treated with fosfomycin.  Inclusion criteria, such as having a urinary tract infection, and exclude those with contraindications or severe comorbidities. Result: In our study, Fosfomycin showed slight advantages over Nitrofurantoin in symptom relief, but had higher rates of lower abdominal pain and diarrhea. Nitrofurantoin was associated with more nausea and higher re-infection rates, while both drugs had minimal treatment failures. Conclusion: Nitrofurantoin is effective for uncomplicated UTIs with low resistance, while Fosfomycin is a valuable option for resistant cases but should be used judiciously to prevent resistance development.

Introduction- Acute cholecystitis is defined as an acute inflammation of the gallbladder wall. Acute cholecystitis is one of the most common illnesses seeking emergency general surgery. Therefore, it is important to make the correct diagnosis early in the patient's visit to the emergency room, with an accurate clinical examination and appropriate diagnostic testing. Aim And Objective - To compare diagnostic accuracy of ultrasonography and CT in acute cholecystitis in terms of sensitivity, specificity, negative predictive value and positive predictive value. Material And Method-This study includes clinically diagnosed acute cholecystitis’s 80 cases between June 2023 to July 2024, all patients gone through USG, CT, cholecystectomy, histopathological examination and this study served as comparative study b/w USG and CT for diagnostic accuracy of Acute Cholecystitis. Results-In clinically diagnosed total 80 cases (61 female & 19 male),75 diagnosed on CT and 69 diagnosed on USG as acute cholecystitis, sensitivity of CT was greater than USG (94% and 86% respectively). On Histopathological examination 62 cases diagnosed as acute cholecystitis in which 59 diagnosed on CT and 54 diagnosed on USG. The sensitivity of CT for detecting AC was greater than USG (95% and 87% respectively). Conclusion-CT was diagnosing acute cholecystitis more accurately than USG, CT will improve the diagnostic confidence in acute cholecystitis and will also help in differential diagnosis. Despite of this USG is first line imaging diagnostic modality in acute cholecystitis.

From a simple 'transportation system', ambulance and patient care evolved significantly over time into advanced pre-hospital care systems, which have become an integrated element of emergency medical services. Ambulance services in modern times include ALS and BLS units, each fitted for varying levels of service in medical emergencies. ALS ambulances are staffed with paramedics who have the capacity for medications, advanced airway management, and important scene interventions. On the other hand, BLS ambulances are usually staffed by EMTs who offer essential care, such as CPR, administration of oxygen, and simple wound management, and stabilize patients for transportation to medical facilities. The two most indispensable components of any EMS team are the paramedics and EMTs. Paramedics are greatly intellectually prepared practitioners; they are even able to perform exceptionally complex medical interventions outdoors in very challenging conditions. EMTs play a critical supportive role in ensuring that such care is brought right to the doorstep of the patients even before they reach the hospital. Care given by such health workers becomes of prime importance to ensure the proper outcomes among the patients, especially in life-threatening conditions where time of intervention becomes imperative. First to arrive, or called first to a scene, EMS responders assess a situation, initiate treatment, and determine actions necessary to ensure the best course of action is followed in hospital transport or on-site care. This will be an integrated process that provides timely and appropriate care for patients between the onset of an emergency and definitive treatment at a healthcare facility. In this article, we have attempted to provide more detailed insights into the various facets of ambulance and emergency services in patient care management.

Tuberculosis (TB) is an age-old ailment that continues to provide a significant obstacle in both emerging and developed nations in the present era. Each year, millions of individuals get tuberculosis and millions of lives are lost as a result. This research aimed to assess the frequency of pulmonary and extra-pulmonary tuberculosis cases with positive sputum smear among individuals suspected of having TB. The study was conducted from January 2019 to June 2023 in two tehsils of Okara district, Pakistan. A total of 2079 cases were recorded at THQ hospital Depalpur, with 91.10% being pulmonary tuberculosis patients 8.90% being extrapulmonary tuberculosis patients. At DHQ hospital Okara, a total of 1090 cases were registered, with 80.46% being pulmonary tuberculosis patients and 19.54% being extrapulmonary tuberculosis patients. 650 patients (31.26%) in THQ Hospital Depalpur and 315 cases (28.90%) in DHQ Hospital Okara tested positive for AFB. The disease burden in females was 53.10%, while in males it was 46.90% for TB diagnosis at THQ Hospital Depalpur. At DHQ Hospital Okara, 63.66% of cases were detected in females and 36.34% in males. The age group with the highest frequency was 46-60 years, with a documented rate of 39.50% at THQ Hospital Depalpur. DHQ Hospital Okara had a lower prevalence rate of 32.57%. The present investigation also observed a significant disease burden among individuals aged 46-60 years. The research sheds light on the demographics and clinical symptoms of tuberculosis patients. More research is required to understand the considerable differences reported in particular risk variables and problems associated with tuberculosis management.

The aim of this study is to fully explore and elucidate the ways in which nanosensor technology has transformed drug analysis, emphasizing both its benefits over traditional techniques and its potential to help fulfill the (SDGs) Sustainable Development Goals. The purpose of this study is to fill in the gap in the current literature on the analysis of drugs, which mostly concentrates on traditional techniques. By addressing the drawbacks of conventional approaches, such as their high procedural complexity and low sensitivity, nanosensors provide an innovative approach for drug analysis. This paper examines the benefits of drug analysis using Nanobiosensors, such as their increased sensitivity, quick detection, and possibility for downsizing. Nanosensor-assisted drug analysis can help achieve SDG 12 by lowering the requirement for resource-intensive conventional procedures and SDG 3 by enabling quick, accurate disease diagnosis and treatment. With continuing development, nanosensor technology has the potential to completely change the pharmaceutical analysis field, spurring innovation and enhancing patient outcomes all around the world. Overall, this study emphasizes the importance of drug analysis using Nanosensors/Nanobiosensor and how they can revolutionize the area, resulting in better healthcare results and sustainable development.

This article explores the benefits, medicinal uses, and nutritional value of jujube (Ziziphus jujube). Jujube is a resilient tree that thrives in tropical and subtropical regions of Europe and Asia, including India, China, Iran, Russia, and the Middle East. The fruit of the jujube plant is highly nutritious, rich in proteins, minerals, vitamins, organic acids, and carbohydrates. It also contains various plant chemicals such as polyphenols, flavonoids, triterpenoids, anthocyanins, alkaloids, and carotenoids. Jujube has a long history of traditional medicinal use, particularly in Persian traditional medicine, where it is known for its anti-itch, analgesic, and diuretic properties. In Chinese medicine, jujube is used to stimulate appetite and treat diarrhea and fatigue. The article highlights the chemical components of jujube and their beneficial effects on various organs and tissues, including antioxidant, anticancer, antimicrobial, neuroprotective, heart- and liver-protective properties. Additionally, jujube exhibits health-enhancing properties and anti-aging effects. The article also presents a study on the extraction and analysis of phenols from jujube fruit pulp using high-performance liquid chromatography (HPLC). The identified phenols include catechin, epicatechin, kaempferol, quercetin-3-glucoside, p-Coumaric acid, quercetin, rutin, and procyanidin, which possess significant antibacterial and antimicrobial activities. The findings highlight the potential of jujube as a valuable source of bioactive compounds with diverse medicinal and nutritional applications.