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Understanding the variation of soil salinity across time and space provides critical information for soil salinity management. This study presents two models using Bayesian Hierarchical Modelling (BHM) and Random Forest Regression (RFR) to predict soil electrical conductivity of a saturated soil extract (ECe) in a coastal area in south Sindh (9707 km2), Pakistan, annually from 2014−15 to 2020−21. Both models were developed using remote sensing imagery and Digital Elevation Model (DEM) data as predictors based on 195 soil salinity samples (N = 65 for each 0–20 cm, 20–40 cm, 40–60 cm layer). Predictive accuracy, prediction uncertainty, predictor effects and other aspects of BHM and RFR were compared before being used for salinity mapping. Results show that BHM and RFR had similar and moderate accuracy in soil salinity prediction in the leave-one-location-out cross-validation (R2 = 0.45–0.51 for BHM and R2 = 0.48–0.52 for RFR); however, the prediction uncertainty was generally smaller in BHM than in RFR. Both models had good agreement with predictor effects, with the vegetation-based index summarising annual biomass accumulation (the integrated area under the EVI time series; AUC_EVI) identified as the most important predictor for all soil layers. Sensitive predictors for explaining soil salinity varied between the surface layer (0–20 cm) and the root zone (20–40 cm and 40–60 cm). The annual average predicted soil salinity maps from BHM and RFR showed a clear spatial variation. Importantly, the uncertainty in salinity prediction in the main agricultural area was also evident and spatially variable, and having this uncertainty insight improves the credibility of the salinity maps. About 34.9–54.5 % of the land in the main agricultural area has been affected by salinity at different levels of severity from 2014−15 to 2020−21. The modelling approach proposed in this study provides informative annual salinity maps using solely publicly available data in a process that requires minimal human intervention. Its adoption would significantly benefit how salinity is managed in south Sindh.

IntroductionInitiated in June 2019, this collaborative effort involved 15 public and private sector hospitals in Pakistan. The primary objective was to enhance the capacity for pediatric neuro-oncology (PNO) care, supported by a My Child Matters/Foundation S grant.MethodsWe aimed to establish and operate Multidisciplinary Tumor Boards (MTBs) on a national scale, covering 76% of the population (185.7 million people). In response to the COVID-19 pandemic, MTBs transitioned to videoconferencing. Fifteen hospitals with essential infrastructure participated, holding monthly sessions addressing diagnostic and treatment challenges. Patient cases were anonymized for confidentiality. Educational initiatives, originally planned as in-person events, shifted to a virtual format, enabling continued implementation and collaboration despite pandemic constraints.ResultsA total of 124 meetings were conducted, addressing 545 cases. To augment knowledge, awareness, and expertise, over 40 longitudinal lectures were organized for healthcare professionals engaged in PNO care. Additionally, two symposia with international collaborators and keynote speakers were also held to raise national awareness. The project achieved significant milestones, including the development of standardized national treatment protocols for low-grade glioma, medulloblastoma, and high-grade glioma. Further protocols are currently under development. Notably, Pakistan's first pediatric neuro-oncology fellowship program was launched, producing two graduates and increasing the number of trained pediatric neuro-oncologists in the country to three.DiscussionThe initiative exemplifies the potential for capacity building in PNO within low-middle income countries. Success is attributed to intra-national twinning programs, emphasizing collaborative efforts. Efforts are underway to establish a national case registry for PNO, ensuring a comprehensive and organized approach to monitoring and managing cases. This collaborative initiative, supported by the My Child Matters/Foundation S grant, showcases the success of capacity building in pediatric neuro-oncology in low-middle income countries. The establishment of treatment protocols, fellowship programs, and regional tumor boards highlights the potential for sustainable improvements in PNO care.

The world is facing an acute water shortage. The present irrigation techniques used in the Hyderabad district, Pakistan, are not demand-driven. The present study was carried out to determine the crop water requirement (CWR), irrigation water requirement (IWR), and irrigation scheduling for major crops grown in the Hyderabad district using the CROPWAT model based on climatic, soil, and crop data. The analysis revealed that the total CWR for the entire growing season for sugarcane, banana, cotton, and wheat were 3,127.0; 2,012.3; 1,073.5; and 418.9 mm, respectively. However, the IWR for sugarcane, banana, cotton, and wheat for the entire growing season was found to be 2,964.0; 1,966.7; 1,052.7; and 407.6 mm, respectively. However, the contribution of rainfall was 163.0, 45.6, 20.8, and 11.3 mm during sugarcane, banana, cotton, and wheat, respectively. The CWR and IWR were higher during the dry season due to high temperatures and low relative humidity. However, the IWR of each crop was low in the initial stage which increased with the growing stage until the peak at the full growth stage. The study recommends the use of CROPWAT to investigate the irrigation water requirements with accuracy. HIGHLIGHTS Investigation for crop water requirement (CWR) for wheat, cotton, banana, and sugarcane.; Investigation for irrigation water requirement (IWR).; Investigation for irrigation scheduling.; Use of climatic, soil, and crop data.; Use of scientific tools, i.e., CROPWAT and CLIMAT models.;

Due to climate change impacts, seawater intrusion is a major issue in various river deltas around the globe, including the Indus delta, Pakistan. The seawater intrusion has severely affected the freshwater resources as well as the livelihood of the people living in the Indus delta. Thus, this study was aimed to evaluate the subsurface seawater intrusion into the Indus delta based on the groundwater quality data. Around 180 groundwater samples, randomly collected from the study area, were analyzed for chloride, carbonate, and bicarbonate concentrations. Based on these concentrations, the indication of subsurface seawater intrusion was determined using Simpson’s ratio and ionic analysis, such as the ratio of chloride to bicarbonate. Also, an interpolated map using the analysis results of these ratios was developed using ArcGIS 10.5. Overall, the present study revealed that about 88% of the Indus delta is affected by the subsurface seawater intrusion. Also, the impact of subsurface seawater intrusion was observed in the wells near the Thatta and Sujawal towns of the study area. However, about 12% of the delta is still unaffected by the subsurface seawater intrusion. Various factors such as reduction in freshwater flow into the delta, climate change, sea-level rise are potential causes of subsurface seawater intrusion in the study area. This study may be taken as a baseline by the policymakers to start mitigation measures against the degradation of the delta to save the environment from further deterioration. Also, further an isotopic analysis of subsurface seawater intrusion in the study area is recommended.

Due to seawater intrusion into the Indus delta, Pakistan under changing climate scenarios, the local communities of the delta are under threat of land and livelihood. The present study was initiated to analyze community perceptions about the social and ecological climate change vulnerability in the Indus delta, Pakistan. About 500 permanent residents of the delta were interviewed using a well-structured questionnaire. The IBM SPSS software was used to analyze the data based on the Pearson chi-square, Goodman, Kruskal's analyses, and Foster Greer Thorbeck (FGT) techniques. Analysis of the data revealed that the people in the delta had poor infrastructure and living standards, and limited social activities. Most of the people were illiterate, and the average family size was 11. On average, 4.7 members lived in a single room, and most of the houses were made of wood. Based on FGT techniques, about 88.4% of the population were living below the poverty line. The statistical analysis identified seawater intrusion and climate change as the most significant parameters affecting soil fertility, water quality, vegetation, mangroves, and livelihood. A large portion of the respondents strongly demanded the ensured freshwater flow to save the ecosystem, water resources, and the livelihood of the delta communities. HIGHLIGHTS Statistical assessment for impact of seawater intrusion and climate change.; Community-based perceptions.; Application of Pearson chi-square and Goodman, Kruskal's analyses, and Foster Greer Thorbeck techniques.; To prompt responsible policymakers to devise strategies for mitigation.;

Introduction MicroRNAs are a noncoding RNA involved in affecting several transcription and translation pathways. Their use has been discussed as potential predictors of several tumors. Their use as potential biomarker in glioma patients is still controversial. The purpose of this meta-analysis is to explore the possible role of such microRNAs in glioma patients. Methods After an extensive literature search done on PubMed and Embase, 20 studies were chosen for our analyses with the 9 discussing 11 tumor promoting microRNAs and 11 studies discussing 11 tumor suppressing microRNAs. The data needed was extracted from these studies including the hazard ratio that was used as the effect size for the purpose of our analysis. The needed analysis was performed using Stata and Excel. Results The pooled hazard ratio for our analysis with patients having a lower microRNA expression for tumor promoting microRNAs came to be 2.63 (p

Ramsar sites are important habitats for the locals as well as for migratory birds that visit these sites across the borders every year. Langh and Drigh lakes were selected as the study area for this research. Drigh Lake is one of the important Ramsar sites, and Langh Lake is an important wildlife sanctuary of national importance. For the past few decades, these lakes are degrading due to anthropogenic activities. To quantify these variations, present study was carried out to detect the land use and land cover change in these lakes and their surrounding areas from 1988 to 2020. Level-2 imageries of Landsat 5, 7, and 8 were downloaded and analyzed using hybrid classification, and results were mapped in ArcMap. Accuracy assessment of the results of selected years was done to check the accuracy of results using the Kappa coefficient. Kappa coefficient resulted between 0.82 and 0.95 for this study. Classification results depicted a significant increase in the vegetation area which is 72% and 32% for langh and drigh lakes respectively since 1988. Results show an increase in the buildup area and a decrease in the barren land. The presence of dense vegetation in the lakes near their boundaries verifies encroachment of lakes by the local farmers.

The riparian zone is an ecological corridor for the rivers, forests, and lakes where the transition of water occurs between flora, fauna, and alluvial soil. It functions as a barrier to protect the riparian cities from floods, a retainer to hold the sediments transported in the water body, and a purifier in an order to adsorb the harmful dissolved solids present in the river flow. At some rivers, where the riparian zone has been degraded, the natural vegetation is observed to be under-functioning, consequently decreasing the water quality. The anthropogenic activities on river beds e.g agriculture are a reason for riparian degradation. In this study, the riparian zone of River Indus’s reach between the Sukkur and Kotri barrages is observed to identify the varying land covers and land temperature ranges due to agricultural invasion that could threaten the river ecosystem and sustainability. In a low flood period, less moisture on the river bed facilitates the detection of mature Rabi crops through the Landsat satellite. Acquired Imageries were classified for natural vegetation and agricultural area using the Visible bands. Land Surface Temperature (LST) was calculated from the pixels of the Thermal band. The images for 1999, 2003, 2010, 2015, 2018, and 2019 for February were utilized for the processing. Results demonstrated that in 1999, the 45.4% area of the Sukkur-Kotri reach was under the natural vegetation cover and decreased up to 14.2% area in 2019. In 1999, 22.5% of the reach area was under agricultural farming and increased up to 60% of the area in 2019. Analysis of surface temperature demonstrated that the areas having high temperatures are under natural vegetation cover, which is being reduced. And the areas having low temperatures are under agricultural farming, which is being increased inside the riparian zone.

Introduction: Multiple primary brain tumors are a rare occurrence that are often accounted for by a complex process of tumorigenesis involving irradiation and possibly the association of residual embryonic tissue turning neoplastic. In this case study, we report a case of coexisting sub ependymoma and oligodendroglioma in a patient. Case: A 32-year-old female was referred to our hospital with a history of seizures for the past 6 months and intact sensorimotor functions. Her Magnetic Resonance Imaging (MRI) revealed a lesion in the parieto-occipital lobe along with perilesional edema which resulted in the effacement of the left lateral ventricle. A second lesion was noted at frontal horn of the right lateral ventricle attached to the septum pellucidum with tiny cystic spaces. The left parieto-occipital lesion (oligodendroglioma) was excised using a supratentorial craniotomy approach and an interhemispheric anterior transcollosal approach was used for debulking the intraventricular tumor (subependymoma). The patient was put on Temozolomide but only took 4 cycles of chemotherapy and refused radiation therapy. She currently has stable disease and is being followed with MRI scans every 6 months. Conclusion: The most commonly reported concomitant tumors are meningioma with glioma followed by schwannoma and pituitary adenoma. The discovery of a second tumor is often done pre-operatively, intraoperatively, years after resection of the first tumor and even during postmortem examinations. We report for the first time, the co-existence of an oligodendroglioma and a sub ependymoma.

Background: New data collection in established longitudinal population studies provides an opportunity for studying the risk factors and sequelae of the novel coronavirus disease 2019 (COVID-19), plus the indirect impacts of the COVID-19 pandemic on wellbeing. The Extended Cohort for E-health, Environment and DNA (EXCEED) cohort is a population-based cohort (N>11,000), recruited from 2013 in Leicester, Leicestershire and Rutland. EXCEED includes consent for electronic healthcare record (EHR) linkage, spirometry, genomic data, and questionnaire data. Methods: Between May 2020 and July 2021, a new questionnaire was deployed in EXCEED, which captured COVID-19 symptoms, general physical and mental health, plus socioeconomic and environmental factors during the pandemic. An online system was developed to invite new participants to join EXCEED, with informed consent being provided online. New and existing participants then completed the COVID-19 questionnaire online. A subset of the new questionnaire respondents were invited to participate in COVID-19 serology substudies, using home antibody testing kits. Results: In total, 3,693 participants provided COVID-19 infection status (median age 62.9 (IQR 54.7-69.2), 58.9% female). Trends of monthly incidence proportions of COVID-19 in EXCEED (self-report or symptom-predicted) approximated local and national figures. Regression analysis of 2,768 participants with linked EHR data showed no obvious monotonic relationship between number of chronic diseases (of 16 pre-specified diseases) and COVID-19 infection. There were 2,144 participants with valid results from a kit allowing differentiation between antibodies due to vaccination or infection. Of these, 8.5% had results consistent with previous COVID-19 infection, and 85.9% had evidence of COVID-19 vaccination, but without evidence of infection. Conclusions: Enriching EXCEED with a new COVID-19 questionnaire and serology data may improve understanding of the risk factors, clinical sequelae and broader impacts of the COVID-19 pandemic in the general population. Controlled access to these data for bona fide researchers is via application to the EXCEED study.

Under the current scenario of diminishing Indus River flows and changing the climate, the Indus Delta, the world’s 5th largest delta which has undergone rapid changes in water bodies and vegetative cover since last few decades, is under serious risk of losing its ecological functions. Assessing the temporal variation in vegetative cover and water bodies of the Indus Delta is essential for the future planning and ecosystem management in this region. The present study quantified the temporal patterns of the surface water bodies and vegetation cover, including crops, mangroves and other natural vegetation in the Indus Delta, by using field survey and remote sensing technique during the last 27 years. Results showed that the area covered by vegetation declined from 3002.35 km2 (22.98% of the entire delta) to 2817.03 km2 (21.56%) from 1990 to 2017, within which the area covered by mangrove forests declined from 1032.49 km2 (7.90%) to 812.55 km2 (6.22%). However, the area of water bodies increased from 1611.67 km2 (12.39%) to 3007.15 km2 (23.8%) in the same period. The reduction in freshwater flow to the delta, surface and subsurface seawater intrusion from the Arabian Sea and irrigation waters are the potential causes. The study would be helpful for policymakers to mitigate negative impacts and protect the ecosystem of the Indus Delta.

To date, information on the management of specific neurosurgical tumors, such as glioma, in Pakistan remains scattered and scarce. Our review synthesizes the predicaments of glioma management routinely presented to the neurosurgery, medical oncology, radiation oncology, and radiology departments in Pakistan. Expert opinions were integrated from each of the relevant fields in the form of personal citations. The data presented in our review were collected from various PubMed and non-PubMed indexed articles, coupled with various health reports from the Government of Pakistan along with the World Health Organization. Through these data, it was postulated that the utilization of innovative and instrumental technologies is a constant struggle for neurosurgeons in Pakistan, considering the cost-effectiveness. Hence, this results in significant limitations for surgeons to provide the best outcome for their patients. As most Pakistanis (74%) pay out of pocket, measuring cost-effectiveness is extremely crucial. It was found that significant differences in intra-operative and postoperative care existed among various centers. Public sector institutions fared much worse. The role of diagnostics in glioma surgery is severely limited across centers in Pakistan and as such, research and training need to be addressed promptly. In order to achieve success in glioma management, the data in our article demonstrate various facets of health care that need to be addressed simultaneously and swiftly. Surgical access needs to be improved; only then, optimal management of glioma can be accomplished in Pakistan.

Isolated prolongation of activated partial thromboplastin time (aPTT) is an exceedingly rare finding in the event of a snakebite from a haemotoxic snake. Herein, we present the case of a 25-year-old asymptomatic female following snakebite. Laboratory testing revealed prolonged aPTT which persisted inspite of administration of 30 vials of antisnake venom. Further diagnostic testing eventually led to the diagnosis of antiphosholipid syndrome.

Objective: To assess and find out the events of medication errors and to classify the medication error in the diabetology and general medicine department. Study Design: The longitudinal cohort prospective observational study. Place and Duration of Study: Diabetes and general medicine department of Chandka Medical College Hospital larkana from Jan 2017 to May 2017. Material and Methods: Data was gathered from 1255 prescriptions of both inpatient and outpatient department of diabetology and general medicine after ensuring the ethical approval. This prospective observational study was made in tertiary care chandka medical college hospital larkana. Results: Male 730 (58.10%) and 525 (41.8%) Females and medication error recorded was 513 to both genders .In male 289 (56.3%) errors and in females 224 (43.7%) prescriptions were found. Conclusion: From the present study the conclusion can be made that there is huge ratio of medication error in practice and the possible contributors of medication deviation are incorrect dosage forms, incorrect strengths, lack of diabetes counseling and others. Pharmacist is the key role to prevent such errors.

The effluent water brought by RBOD (Right Bank Outfall Drain) is not only threat to the aquatic life of Manchar Lake but also the fertile agricultural lands which are being cultivated by use of lake water through Danastar Wah are at risk of salinization. The farming community of the area is scary of continual use of irrigation waters received through the Danastar Wah; they are of the view that the constant use of this water will ruin their fertile lands into salt-affected soils. Thus, keeping in view the fears of the farmers of the command area of Danastar Wah, a study was carried out to investigate the water quality of the Manchar Lake, RBOD MNV (Main Nara Valley) drain and Danastar Wah, and to examine soil salinity status of the area using Geo-referenced field and satellite imagery data for Kharif season of the year 2015. The results of the study showed that the EC (Electrical Conductivity) of the Danastar Wah water was below 1.2 dS/m. Thus, the water was suitable for irrigation purpose. In all the water samples, Na+, Ca2+ + Mg2+ and CO3 concentrations were found within the permissible limits, while no concentration of HCO3 was found in any of the water samples. In the command area, clay texture was dominant down to a depth of 60 cm soil profile. In the area about 37, 28, and 30% of the soils were normal (non-saline), saline and sodic, respectively; while only 5% of soils were saline-sodic. The cotton crop was identified as the major Kharif crop, occupying about 13.76% (2,844 ha) of the total command area, followed by rice crop grown on about 5.21% (1,078 ha) of the command area. The overall accuracy of image classification was 90% with a kappa coefficient of 0.86. Based on this study, it can be concluded that the water of the Danastar Wah can be used for irrigation purpose during Kharif season only with the condition that adequate land drainage is maintained. It is also suggested that before using the water of Manchar Lake, RBOD and Danastar Wah for Rabi season, analysis for water quality be conducted. GeoInformatics (GIS and RS) tools can be employed for spatial and temporal monitoring of water quality of the Manchar Lake.

Access to safe and affordable drinking water for all is an important goal of SDGs (Sustainable Development Goals). Degradation of water quality of coastal aquifers is a major concern throughout the world including the Indus River delta. Looking at the present changing climate scenario, the study was conducted to assess and map the spatial variation in the groundwater quality of district Thatta using GIS (Geographic Information System). The groundwater samples from hundred (100) randomly selected hand pumps of the district were collected such that all union councils of the district were sampled. The water samples were analyzed for different physicochemical parameters, i.e. taste, color, odor, pH, turbidity, EC (Electrical Conductivity), calcium, magnesium, total hardness, chloride, total dissolved solids, and arsenic using standard laboratory techniques. The results of water analysis revealed that 85% of the groundwater samples had TDS (Total Dissolved Solids) concentration beyond the permissible limit described by WHO (World Health Organization). Whereas, all the groundwater samples had chloride concentration beyond permissible limit of 250 mg/l. Analysis for arsenic revealed that only 20% of groundwater samples had a concentration higher than the safe limit of 10 ppb. The study indicated that in most of the areas, the groundwater quality was not as per drinking standards prescribed by WHO, hence was not suitable for drinking purpose. The GIS maps of groundwater quality parameters were prepared using spatial interpolation Kriging tool. These maps provide the visual analysis and interpretation of spatial variability of different groundwater quality parameters, hence are supportive in monitoring and managing the vulnerability of groundwater contamination.

Heterogeneity in clinical manifestations is a well-known feature in Long QT Syndrome (LQTS). The extent of this phenomenon became evident in families wherein both symptomatic and asymptomatic family members are reported. The study hence warrants genetic testing and/or screening of family members of LQTS probands for risk stratification and prediction. Of the 46 families screened, 18 probands revealed novel variations/compound heterozygosity in the gene/s screened. Families 1–4 revealed probands carrying novel variations in KCNQ1 gene along with compound heterozygosity of risk genotypes of the SCN5A, KCNE1 and NPPA gene/s polymorphisms screened. It was also observed that families- 5, 6 and 7 were typical cases of “anticipation” in which both mother and child were diagnosed with congenital LQTS (cLQTS). Families- 16 and 17 represented aLQTS probands with variations in IKs and INa encoding genes. First degree relatives (FDRs) carrying the same haplotype as the proband were also identified which may help in predictive testing and management of LQTS. Most of the probands exhibiting a family history were found to be genetic compounds which clearly points to the role of cardiac genes and their modifiers in a recessive fashion in LQTS manifestation.

Pre-harvest reliable and timely yield forecast and area estimates of cropped area is vital to planners and policy makers for making important and timely decisions with respect to food security in a country. The present study was conducted to estimate the wheat cropped area and crop yield in Hyderabad District, Pakistan from the Landsat 8 satellite imagery for Rabi 2013-14 and ground trothing. The required imagery of district Hyderabad was acquired from GLOVIS and was classified with maximum likelihood algorithm using ArcGIS 10.1. The classified image revealed that in district Hyderabad wheat covered 10,210 hectares (9.74% of total area) during Rabi season 2013-14 against 15,000 hectares (14.3% of total area) reported by Crop reporting Services (CRS), Sindh which is 30% less than that of reported by CRS. A positive linear relation between the wheat crop yield and the peak NDVI with coefficient of determination R2 = 0.91 was observed. Crop area and yield forecast through remote sensing is easy, cost effective, quick and reliable hence this technology needs to be introduced and propagated in the concerned government departments of Pakistan

Background: Autosomal recessive Long QT syndrome is characterized by prolonged QTc along with congenital bilateral deafness depends on mutations in K+ channel genes. A family of a Long QT syndrome proband from India has been identified with novel indel variations. Methods: The molecular study of the proband revealed 4 novel indel variations in KCNQ1. In-silico analysis revealed the intronic variations has led to a change in the secondary structure of mRNA and splice site variations. The exonic variations leads to frameshift mutations. DNA analysis of the available family members revealed a carrier status. Results and Conclusion: It is thus predicted that the variations may lead to a change in the position of the splicing enhancer/inhibitor in KCNQ1 leading to the formation of a truncated S2–S3 fragment of KCNQ1 transmembrane protein in cardiac cells as well as epithelial cells of inner ear leading to deafness and aberrant repolarization causing prolonged QTc.

As the pioneering study from Pakistan, our research distinctly focuses on validating the roles of autophagy-associated genes and MicroRNAs (miRs) in the unique context of our population for glioma prognosis. The study delves into the nuanced interplay of autophagy within a miR-modulated environment, prompting an exploration of its potential impact on glioma development and survival. Employing real-time PCR (qPCR), we meticulously assessed the expression profiles of autophagy genes and miRs in glioma tissues, complemented by immunohistochemistry on Formalin-fixed paraffin-embedded tissues from the same patients. Our comprehensive statistical analyses, including the data normality hypothesis Shapiro-Wilk test, the Mann-Whitney U-test, Spearman correlation test, and Kaplan-Meier survival analysis, were tailored to unravel the intricate associations specific to low- and high-grade glioma within our population. Clinicopathological analysis revealed a predominance of male patients (66%) with a median age of 35 years. Glioblastoma (32%) and Astrocytoma (36%) were the most prevalent histopathological subtypes. Molecular analysis showed significant correlations between prognostic markers (Ki-67, IDH-1, p53) and clinicopathological factors, including age, histological type, radiotherapy, and chemotherapy. In high-grade glioma, increased expression of AKT and miR-21, coupled with reduced ULK2 and LC3 expression was distinctly observed. While correlation analysis identified a strong positive correlation between ULK2 and UVRAG, PTEN, miR-7, and miR-100 in low-grade glioma, unveiling distinctive molecular signatures unique to our study. Furthermore, a moderate positive correlation emerged between ULK2 and mTOR, miR-7, miR-30, miR-100, miR-204, and miR-374, also between miR-21 and miR-126. Similarly, a positive correlation appeared between ULK2 and AKT, LC3, PI3K, PTEN, ULK1, VPS34, mTOR, Beclin1, UVRAG, miR-7 and miR-374. AKT positively correlated with LC3, PI3K, PTEN, ULK1, VPS34, mTOR, Beclin1, UVRAG, miR-7, miR-30, miR-204, miR-374, miR-126 and miR-21 weakly correlated with AKT and miR-30 in high-grade glioma, providing further insights into the autophagy pathway within our population. The enrichment analysis for miR-21, miR-126, and miR-374 showed MAPK pathway as a common pathway along with Ras, PI3K, and mTOR pathway. The low ULK2, UVRAG, and miR-374 expression group exhibited significantly poor overall survival in glioma, while miR-21 over-expression indicated a poor prognosis in glioma patients, validating it in our population. This study provides comprehensive insights into the molecular landscape of gliomas, highlighting the dysregulation of autophagy genes ULK2, and UVRAG and the associated miR-21, miR-126 and miR-374 as potential prognostic biomarkers and emphasizing their unique significance in shaping survival outcomes in gliomas within the specific context of the Pakistani population. [ABSTRACT FROM AUTHOR]