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Objective To estimate the cost-effectiveness of craniotomy, compared with decompressive craniectomy (DC) in UK patients undergoing evacuation of acute subdural haematoma (ASDH).Design Economic evaluation undertaken using health resource use and outcome data from the 12-month multicentre, pragmatic, parallel-group, randomised, Randomised Evaluation of Surgery with Craniectomy for Patients Undergoing Evacuation-ASDH trial.Setting UK secondary care.Participants 248 UK patients undergoing surgery for traumatic ASDH were randomised to craniotomy (N=126) or DC (N=122).Interventions Surgical evacuation via craniotomy (bone flap replaced) or DC (bone flap left out with a view to replace later: cranioplasty surgery).Main outcome measures In the base-case analysis, costs were estimated from a National Health Service and Personal Social Services perspective. Outcomes were assessed via the quality-adjusted life-years (QALY) derived from the EuroQoL 5-Dimension 5-Level questionnaire (cost-utility analysis) and the Extended Glasgow Outcome Scale (GOSE) (cost-effectiveness analysis). Multiple imputation and regression analyses were conducted to estimate the mean incremental cost and effect of craniotomy compared with DC. The most cost-effective option was selected, irrespective of the level of statistical significance as is argued by economists.Results In the cost-utility analysis, the mean incremental cost of craniotomy compared with DC was estimated to be −£5520 (95% CI −£18 060 to £7020) with a mean QALY gain of 0.093 (95% CI 0.029 to 0.156). In the cost-effectiveness analysis, the mean incremental cost was estimated to be −£4536 (95% CI −£17 374 to £8301) with an OR of 1.682 (95% CI 0.995 to 2.842) for a favourable outcome on the GOSE.Conclusions In a UK population with traumatic ASDH, craniotomy was estimated to be cost-effective compared with DC: craniotomy was estimated to have a lower mean cost, higher mean QALY gain and higher probability of a more favourable outcome on the GOSE (though not all estimated differences between the two approaches were statistically significant).Ethics Ethical approval for the trial was obtained from the North West—Haydock Research Ethics Committee in the UK on 17 July 2014 (14/NW/1076).Trial registration number ISRCTN87370545.

Background The epidemiology of traumatic brain injury (TBI) is unclear – it is estimated to affect 27–69 million individuals yearly with the bulk of the TBI burden in low-to-middle income countries (LMICs). Research has highlighted significant between-hospital variability in TBI outcomes following emergency surgery, but the overall incidence and epidemiology of TBI remains unclear. To address this need, we established the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry, enabling recording of all TBI cases requiring admission irrespective of surgical treatment. Objective The GEO-TBI: Incidence study aims to describe TBI epidemiology and outcomes according to development indices, and to highlight best practices to facilitate further comparative research. Design Multi-centre, international, registry-based, prospective cohort study. Subjects Any unit managing TBI and participating in the GEO-TBI registry will be eligible to join the study. Each unit will select a 90-day study period. All TBI patients meeting the registry inclusion criteria (neurosurgical/ICU admission or neurosurgical operation) during the selected study period will be included in the GEO-TBI: Incidence. Methods All units will form a study team, that will gain local approval, identify eligible patients and input data. Data will be collected via the secure registry platform and validated after collection. Identifiers may be collected if required for local utility in accordance with the GEO-TBI protocol. Data Data related to initial presentation, interventions and short-term outcomes will be collected in line with the GEO-TBI core dataset, developed following consensus from an iterative survey and feedback process. Patient demographics, injury details, timing and nature of interventions and post-injury care will be collected alongside associated complications. The primary outcome measures for the study will be the Glasgow Outcome at Discharge Scale (GODS) and 14-day mortality. Secondary outcome measures will be mortality and extended Glasgow Outcome Scale (GOSE) at the most recent follow-up timepoint.

Objective: To determine the relationship of High-Resolution Computed Tomography Chest Severity Scores with disease severity in COVID-19 patients. Study Design: Cross-sectional study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Oct to Dec 2021. Methodology: The study included 173 symptomatic patients with positive COVID polymerase chain reaction. All patients underwent high-resolution computed tomography chest scans and were given severity scores (from 0 to 40) based on the number of lung segments involved. Disease severity was assessed based on oxygen saturation at room air, C-reactive protein levels, and morality on the 21st day. High-resolution chest computed tomography scores were compared with parameters of disease severity. Results: Out of a total of 173 patients, 139(80%) were male, and 34(20%) were female, with a mean age of 62.79±13.87 years (17- 92 years). Chest computed tomography severity scores were positively correlated with C-reactive protein levels and mortality on the 21st day (p

Abstract Antibiotic-resistant bacterial strains and the consequent surge in infections caused by them have become major public health concerns. Silver nanoparticles (AgNPs) exhibit antibacterial properties and have wide applications in biomedical sciences. In this study, AgNPs were synthesized in the presence of antibiotics: Ceftazidime (Cft), Cefotaxime (Cef), Ceftriaxone (Cfx), and Cefepime (Cpm), along with the extract of Mentha longifolia. Mentha longifolia-based AgNPs were kept as the control for all experiments. The associated metabolites, structural properties, surface charges, and antibacterial activity of the AgNPs were also evaluated. Overall, a blue-shift of SPR peaks was observed for control AgNPs (λmax = 421 nm, 422 nm, 426 nm, and 406 nm for Cft-AgNPs, Cef-AgNPs, Cfx-AgNPs, and Cpm-AgNPs, respectively), compared to the control (λmax = 438 nm). Fourier-transform infrared spectroscopy showed that antibiotic-based AgNPs had distinct peaks that corresponded to the respective antibiotics, which were not observed in the control. XRD analysis showed that there were observed changes in crystallinity in antibiotic-based AgNPs compared to the control. TEM images revealed that all samples had spherical nanoparticles with different sizes and distributions compared to the control. The Zeta potential for extract-based AgNPs was − 33.6 mV, compared to -19.6 mV for Cft-AgNPs, -2 mV for Cef-AgNPs, -21.1 mV for Cfx-AgNPs, and − 24.2 mV for Cpm-AgNPs. The increase in the PDI value for antibiotic-based AgNPs also showed a highly polydisperse distribution. However, the antibiotic-AgNPs conjugates showed significantly higher activity against pathogenic bacteria. The addition of antibiotics to AgNPs brought significant changes in structural properties and antibacterial activities.

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, attention to the region in Global Surgery and Global Health is limited. Here, we assess the status of SOTA care in South Asia. We summarize the evidence on SOTA care indicators and planning. Region-wide, as well as country-specific challenges are highlighted. We also discuss potential directions—initiatives and innovations—toward addressing these challenges. Local partnerships, sustained research and advocacy efforts, and politics can be aligned with evidence-based policymaking and health planning to achieve equitable SOTA care access in the South Asian region under the South Asian Association for Regional Cooperation (SAARC).

In this study, we employed aqueous ginger extract as an eco-friendly approach for the synthesis of chitosan nanoparticles (CsNPs), silver nanoparticles (AgNPs), and chitosan/silver nanocomposites (Cs/AgNCs). Using spectroscopic and microscopic techniques, we thoroughly characterized the physicochemical properties of these nanomaterials, confirming their desirable attributes. The AgNPs displayed a spherical morphology with an average diameter of 19 nm, while the Cs/AgNCs exhibited a size of approximately 28 nm. To assess their antibacterial efficacy, we investigated the activity of both AgNPs and Cs/AgNCs against Gram-negative pathogenic bacteria. Remarkably, these nanomaterials demonstrated significant antibacterial properties. To further enhance their antibacterial capabilities, we conjugated the nanocomposite with tobramycin using Sulfo NHS and EDC, resulting in a four-fold increase in antibacterial activity compared to tobramycin alone. Moreover, we explored the ability of AgNPs, CsNPs, Cs/AgNCs, and Cs/AgNCs/tobramycin (Cs/AgNCs/tbn) to degrade DNA and generate reactive oxygen species (ROS) in the presence of Pseudomonas aeruginosa. Encouraging results were obtained, highlighting their potential applications in antimicrobial strategies. Furthermore, we conducted a comprehensive toxicity assessment of AgNPs, CsNPs, Cs/AgNCs, and Cs/AgNCs/tob using zebrafish embryos. The findings revealed low to moderate levels of toxicity for these nanomaterials, with Cs/AgNCs/tbn demonstrating no observable toxic effects. Our study demonstrates the immense potential of utilizing aqueous ginger extract as a green synthesis method to produce AgNPs and Cs/AgNCs with robust antibacterial properties and minimal toxicity. These findings pave the way for the development of innovative nanomaterials for various biomedical applications.

ABSTRACT Purpose: Exploring the role of business companies in facilitating trade between Pakistan and Africa, this paper focuses in particular on Kenya and South Africa . It examines the impact of these companies on bilateral trade relations, lessons learned from the trade facilitation experiences of Pakistan's business community in Kenya and South Africa and their implications for future trade partnerships.

With the unpleasant occurrences of climate change and global warming, there is an inevitable need to generate energy from renewable sources. Energy generation from burning coal, extracting fuel, ignition of CO2, exploiting tar sands, or any other environmentally unfriendly resources are hazardous to our planet. Therefore, the world needs to switch towards renewable sources. Wind energy has developed across the globe due to being the most eco-friendly, comparatively efficient, and affordable. Thailand has a higher potential for wind energy because of the median height of 287 m above sea level with a soaring altitude of 2565 m above sea level. In addition to this, Thailand has a higher energy wind potential are of 550 km2. Regarding this, Thailand has realized wind energy is a strong potential renewable energy resource that needs to be developed. To fulfill energy demands, the prospect of particular provinces concerning wind power and the capacity of electrical energy acquired from wind energy has been studied. Consequently, with the data derived from the specific regions, consisting of 13 different stations at 10 m height and 10 min interval, the wind energy potential has been evaluated for each region in the WASP (Wind Atlas Analysis and Application Program). In addition, 7 stations data was processable among 13 stations. In this program, the wind data acquired from the study area consists of Chiang Rai, Lamphun, Mae Hong Son, Mae Sa Riang, Pha Yao, Theon, and Thung Chang with the latitude and longitude through meteorological stations and entered as an input to the WASP. WAsP simulation software was used to analyze the data generated, which is considered to be among the best simulation applications worldwide. As a result, the potential areas for electricity generation are identified. This study supports the generation of renewable energy in particular northern regions of Thailand and accordingly the purpose is to provide guidelines and contributions to the researchers and related organizations to further dig into which can substitute the conventional methods and economically provide energy.

Background: The epidemiology of traumatic brain injury (TBI) is unclear – it is estimated to affect 27–69 million individuals yearly with the bulk of the TBI burden in low-to-middle income countries (LMICs). Research has highlighted significant between-hospital variability in TBI outcomes following emergency surgery, but the overall incidence and epidemiology of TBI remains unclear. To address this need, we established the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry, enabling recording of all TBI cases requiring admission irrespective of surgical treatment. Objective: The GEO-TBI: Incidence study aims to describe TBI epidemiology and outcomes according to development indices, and to highlight best practices to facilitate further comparative research. Design: Multi-centre, international, registry-based, prospective cohort study. Subjects: Any unit managing TBI and participating in the GEO-TBI registry will be eligible to join the study. Each unit will select a 90-day study period. All TBI patients meeting the registry inclusion criteria (neurosurgical/ICU admission or neurosurgical operation) during the selected study period will be included in the GEO-TBI: Incidence. Methods: All units will form a study team, that will gain local approval, identify eligible patients and input data. Data will be collected via the secure registry platform and validated after collection. Identifiers may be collected if required for local utility in accordance with the GEO-TBI protocol. Data: Data related to initial presentation, interventions and short-term outcomes will be collected in line with the GEO-TBI core dataset, developed following consensus from an iterative survey and feedback process. Patient demographics, injury details, timing and nature of interventions and post-injury care will be collected alongside associated complications. The primary outcome measures for the study will be the Glasgow Outcome at Discharge Scale (GODS) and 14-day mortality. Secondary outcome measures will be mortality and extended Glasgow Outcome Scale (GOSE) at the most recent follow-up timepoint.

This study examines Pakistan's security relations with Kenya, South Africa and Nigeria, specifically focusing on the influence of geopolitical, economic and cultural factors. Three main research questions guide the research: a) what are the similarities and differences in Pakistan's security relations with these three countries? b) How do geopolitical factors shape Pakistan's security relations with each country? c) What roles do cultural and economic ties play in shaping these security relationships? The study identifies and compares similarities and differences in security relations among these countries, highlighting the unique historical, geopolitical, and cultural factors through a multidimensional approach, drawing insights from Realism, Constructivism and Neoliberal Institutionalism. The findings underscore the significance of considering power dynamics and cultural influences in understanding security relations. Furthermore, the study sheds light on the potential of international institutions in promoting cooperation and building trust between Pakistan and its African counterparts. Bibliography Entry Khan, Tariq. 2023. "Pakistan's Security Relations with Kenya, South Africa and Nigeria: A Comparative Analysis." Margalla Papers 27 (1): 123-137.

By far, human language is an effective means of communication, while linguistic choices assist in interpreting and understanding the meaning and message of the words used by the writers. In unison, linguistic deviation brings a telling diversity and evocative defamiliarisation to human interest. The present position paper attempts to analyze the semantic deviations in The Three Strangers, a short story by Thomas Hardy. Since figurative speech changes the meaning of an actual word. The present study will explain why writers opt for such deviations in writing. The data is examined through foregrounding theory, as Mukarovsky (1975) propounded. Thus, the present study aims to highlight and evaluate the semantic deviation (not confused with semantic evasion) in the selected sample. The study's findings and results reveal that the writer has employed the given stylistic technique in similes, metaphors, and personifications to help the reader have portrayed a vivid and vibrant visualization of the storyline. Further research on stylistic deviations such as phonetic (e.g., alliteration, rhyme), morphological (e.g., word formation), and grammatical (e.g., inversion, ellipsis) levels can be done.

Introduction: One of the most common urological emergency conditions is acute scrotum. Scrotal pain is commonly seen in early adults in the emergency departments with an association of different pathologies. The aim of this study was to determine the comparison of high-resolution sonography and colour Doppler flow imaging in patients presenting with acute scrotum. Material & Methods: A descriptive study was conducted at the Department of Radiology, Lady Reading Hospital, Peshawar, Pakistan. This study enrolled a purposive sample of emergency department patients presenting with acute scrotal pain. The pattern of blood flow, peak systolic velocity, resistive index, pulsatility index, mean and standard deviation were calculated for the continuous variables. Descriptive analyses were performed to investigate the distribution of data. Results: A total of 72 patients were enrolled in our study. The mean age of patients was recorded 36.33±11.66 years. The most common scrotal pathologies that associated with scrotal pain was hydrocele 31(38.8%), followed by varicocele 22(27.5%), testicular torsion 9(11.3%), cyst 8(10.0%), epididymo-orchitis 7(8.8%), pyocele 6(7.5%), orchitis 4(5.0%), increase scrotal wall thickness 3(3.8%), undescended testis 3(3.8%), inguinoscrotal hernia 1(1.3%), testicular atrophy 1(1.3%), rete testis 1(1.3%), hemangioma 1(1.3%), hematoma 1(1.3%), scrotal mass 1(1.3%), testicular microlithiasis 1(1.3%), and normal scrotal sonography 4(5.0%) of cases respectively. Conclusion: High-resolution ultrasonography along with colour and power Doppler should be used as 1st line imaging modality in patients presenting with acute scrotal pain.

Nano-fertilizers are superior to conventional fertilizers, but their effectiveness has not yet been adequately explored in the field of agriculture. In this study, silver nanoparticles using leaves extract of an Alnus nitida plant were synthesized and further doped with urea to enhance the plant biomass and metabolic contents. The synthesized Alnus nitida silver nanoparticles (A.N-AgNPs) and urea-doped silver nanoparticles (U-AgNPs) were characterized using Scanning Electron Microscopy, Transmission Electron Microscopy, Powder X-ray Diffraction, and Energy Dispersive X-ray. The wheat seeds were grown in media under controlled conditions in the plant growth chamber. The effectiveness of nanoparticles was studied using different A.N-AgNPs and U-AgNPs concentrations (0.75 μg/ml, 1.5 μg/ml, 3 μg/ml, 6 μg/ml, and 15 μg/ml). They were compared with a control group that received no dose of nanoparticles. The plant biomass, yield parameters, and wheat quality were analyzed. The effect of silver nanoparticles and U-AgNPs were examined in developing wheat seeds and their potency in combating biotic stresses such as nematodes, herbivores, fungi, insects, weeds and bacteria; abiotic stresses such as salinity, ultraviolet radiation, heavy metals, temperature, drought, floods etc. In the seedlings, six possible phytochemicals at a spray dose of 6 μg/ml of U-AgNPs were identified such as dihydroxybenzoic acids, vanillic acid, apigenin glucosidase, p-coumaric acid, sinapic acid, and ferulic acid whereas in other treatments the number of phenolic compounds was lesser in number as well as in concentrations. Moreover, various parameters of the wheat plants, including their dry weight and fresh weight, were assessed and compared with control group. The findings of the study indicated that A.N-AgNPs and U-AgNPs act as metabolite elicitors that induced secondary metabolite production (total phenolic, flavonoid, and chlorophyll contents). In addition, U-AgNPs provided a nitrogen source and were considered a smart nitrogen fertilizer that enhanced the plant biomass, yields, and metabolite production.

Multi-drug resistant bacteria sometimes known as "superbugs" developed through overuse and misuse of antibiotics are determined to be sensitive to small concentrations of silver nanoparticles. Various methods and sources are under investigation for the safe and efficient synthesis of silver nanoparticles having effective antibacterial activity even at low concentrations. We used a medicinal plant named Salvia moorcroftiana to extract phytochemicals with antibacterial, antioxidant, and reducing properties. Three types of solvents; from polar to nonpolar, i.e., water, dimethyl sulfoxide (DMSO), and hexane, were used to extract the plant as a whole and as well as in fractions. The biosynthesized silver nanoparticles in all extracts (except hexane-based extract) were spherical, smaller than 20 nm, polydispersed (PDI ranging between 0.2 and 0.5), and stable with repulsive force of action (average zeta value = -18.55±1.17). The tested bacterial strains i.e., Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis were found to be sensitive to even small concentrations of Ag-NPs, especially P. aeruginosa. The antibacterial effect of these Ag-NPs was associated with their ability to generate reactive oxygen species. DMSO (in fraction) could efficiently extract antibacterial phytochemicals and showed activity against MDR bacteria (inhibition zone = 11-12 mm). Thus, the antibacterial activity of fractionated DMSO extract was comparable to that of Ag-NPs because it contained phytochemicals having solid antibacterial potential. Furthermore, Ag-NPs synthesized from this extract owned superior antibacterial activity. However, whole aqueous extract-based Ag-NPs MIC was least (7-32 μg/mL) as compared to others.

Green synthesis of nanoparticles is becoming a method of choice for biological research due to its environmentally benign outcomes, stability and ease of synthesis. In this study, silver nanoparticles (AgNPs) were synthesized using stem (S-AgNPs), root (R-AgNPs) and mixture of stem and root (RS-AgNPs) of Delphinium uncinatum. The synthesized nanoparticles were characterized by standardized techniques and evaluated for their antioxidant, enzyme inhibition, cytotoxic and antimicrobial potentials. The AgNPs exhibited efficient antioxidant activities and considerable enzyme inhibition potential against alpha amylase, acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) enzymes. S-AgNPs showed strong cytotoxicity against human hepato-cellular carcinoma cells (HepG2) and high enzyme inhibitory effect (IC50 values 27.5μg/ml for AChE and 22.60 μg/ml for BChE) compared to R-AgNPs and RS-AgNPs. RS-AgNPs showed significant inhibition of Klebsiella pneumoniae and Aspergillus flavus and exhibited higher biocompatibility (

Introduction: Severe global shortages in neurosurgery, surgery, and healthcare in general have been documented, especially in low- and middle-income countries (LMICs). Research question: In LMICs, how do we expand both neurosurgery and overall healthcare? Material and methods: Two different approaches to improving neurosurgery are presented. Author EW convinced a private hospital chain that neurosurgical resources were important throughout Indonesia. Author TK established a consortium (Alliance Healthcare) to obtain financial support for healthcare in Peshawar, Pakistan. Results: The expansion over 20 years in neurosurgery (throughout Indonesia) and in healthcare (for Peshawar and Khyber Pakhtunkhwa (KP) province, Pakistan) is impressive. In Indonesia, neurosurgery centers have expanded from one in Jakarta to over 40 throughout the islands of Indonesia. In Pakistan, two general hospitals, schools of medicine, nursing, and allied health professions, and an ambulance service have been established. Recently US$11 million has been awarded to Alliance Healthcare by the International Finance Corporation (the private sector arm of the World Bank Group) to further expand healthcare infrastructure in Peshawar and KP. Discussion and conclusion: The enterprising techniques described here can be implemented in other LMIC settings. Three keys to success both programs utilized: (1) educating the community (population at large) of the need for surgery in particular to improve overall healthcare; (2) being entrepreneurial and persistent in seeking the community support and the professional and financial support needed to advance both neurosurgery and overall healthcare through the private sector; (3) creating sustainable training and support institutions and policies for young neurosurgeons.

Aim: To study WDR36 gene polymorphism (rs10038177 , rs1971050) and its association with clinical parameters in patients of primary open angle glaucoma. Methods: A cross sectional study conducted on 105 cases of POAG to study its association with WDR36 gene polymorphisms (rs 10038177, rs 1971050). The study subjects underwent complete ophthalmic examination, slit lamp examination, IOP measurement by Goldmann’s Applanation Tonometer, gonioscopy, fundus evaluation by 90D lens. RNFL thickness was measured using cirrus 500 OCT by Carl Zeiss. Peripheral blood samples were collected in EDTA-anticoagulant tubes, then DNA was extracted using the genomic DNA extraction and genotyped by PCR-RFLP by using (AluI) enzyme.Data analysis by SPSS, version 21.0. Chi-square and Independent sample ‘t’-tests used for comparison. Results: The association of genotypic expression of rs10038177 polymorphism with different clinical variables in POAG patients, and the mean IOP (31.66 + 5.88) and CDR (0.72+ 0.15) for heterozygous genotype TC was significantly higher as compared to homozygous de33eeeee4(p

Researchers are now looking to nanomaterials to fight serious infectious diseases that cause outbreaks and even pandemics. SARS-CoV-2 brought chaos to almost every walk of life in the past 2 years and has challenged every available treatment method. Although vaccines were developed in no time against it, the most pressing issue was the emergence of variants of concern arising because of the rapidly evolving viral strains. The higher pathogenicity and, in turn, the higher mortality rate of infections caused by these variants renders the existing vaccines less effective and the effort to produce further vaccines a costly endeavor. While several techniques, such as immunotherapy and repurposed pharmaceutical research, are being studied to minimize viral infection, the fundamentals of nanotechnology must also be considered to enhance the anti-SARS-CoV-2 efforts. For instance, silver nanoparticles (AgNPs) have been applied against SARS-CoV-2 effectively. Similarly, nanomaterials have been tested in masks, gloves, and disinfectants to aid in controlling SARS-CoV-2. Nanotechnology has also contributed to diagnoses such as rapid and accurate detection and treatment such as the delivery of mRNA vaccines and other antiviral agents into the body. The development of polymeric nanoparticles has been dubbed a strategy of choice over traditional drugs because of their tunable release kinetics, specificity, and multimodal drug composition. Our article explores the potential of nanomaterials in managing the variants of concern. This will be achieved by highlighting the inherent ability of nanomaterials to act against the virus on fronts such as inhibition of SARS-CoV-2 entry, inhibition of RNA replication in SARS-CoV-2, and finally, inhibition of their release. In this review, a detailed discussion on the potential of nanomaterials in these areas will be tallied with their potential against the current and emerging future variants of concern.

Introduction: Adequate amniotic fluid level is required for the normal fetal physiology. A decreased level of amniotic fluid is known as Oligohydramnios. Oligohydramnios leads to many complications. Most common complication of Oligohydramnios is premature and stillbirth. This study was designed to determine maternal complications in patients presented with and without Oligohydramnios. Material & Methods: This cross-sectional study was conducted at the department of Radiology Jinnah Hospital Lahore. The duration of study was 4 months (August 2019 to November 2019). A total of 80 females in the 3rd trimester of pregnancy participated in the study. Oligohydramnios and its severity were assessed by measuring amniotic fluid index, using ultrasonography. Relevant information was recorded and analysed statistically. Results: A total of 80 females at the 3rd trimester of pregnancy participated in the study. All participants were adults with age ranges (18-39, average= 27.5 ± 3.0 years). Oligohydramnios patients show a high trend of preterm deliveries and delivery complications like caesarean section. Conclusion: Our study concluded that various obstetric complications occur in Oligohydramnios patients.

Objective: To develop a Bayesian inversion framework on longitudinal chest CT scans which can perform efficient multi-class classification of lung cancer. Methods: While the unavailability of large number of training medical images impedes the performance of lung cancer classifiers, the purpose built deep networks have not performed well in multi-class classification. The presented framework employs particle filtering approach to address the non-linear behaviour of radiomic features towards benign and cancerous (stages I, II, III, IV) nodules and performs efficient multi-class classification (benign, early stage cancer, advanced stage cancer) in terms of posterior probability function. A joint likelihood function incorporating diagnostic radiomic features is formulated which can compute likelihood of cancer and its pathological stage. The proposed research study also investigates and validates diagnostic features to discriminate accurately between early stage (I, II) and advanced stage (III, IV) cancer. Results: The proposed stochastic framework achieved 86% accuracy on the benchmark database which is better than the other prominent cancer detection methods. Conclusion: The presented classification framework can aid radiologists in accurate interpretation of lung CT images at an early stage and can lead to timely medical treatment of cancer patients.

Silybum marianum L. commonly known as milk thistle is a medicinally potent plant with a multitude of pharmacological applications. The present investigations demonstrated the effects of Zinc Oxide nanoparticles (ZnO NPs) on callus growth and biosynthesis of silymarin in milk thistle under various light conditions. The callus cultures developed on Murashige and Skoog (MS) basal media containing ZnO NPs (0.15 mg/L), under the dark condition maintained for two weeks, followed by transference into normal light produced the maximum callus fresh weight (2294 mg/L FW). Further, the metabolite profiling revealed that ZnO NPs significantly augmented the production of silymarin and upregulated the antioxidant system in the callus cultures. Maximum TPC (total phenolic content: 37 ± 0.20 mg/g DW), TFC (total flavonoid content: 8.9 ± 0.023), DPPH antioxidant activity (91.5 ± 1.75%), Superoxide dismutase activity (SOD: 4.1 ± 0.045 nM/min/mg FW) and the highest silymarin content (14.6 ± 0.023 mg/g DW) were recorded in the callus cultures developed on MS media supplemented with solitary ZnO NPs (0.15 mg/L). While the callus culture evolved in presence of only PGRs (2,4 D and BA: 2 mg/L, each) accumulated the lesser fresh weight (562 mg/L FW). A higher concentration of ZnO NPs (0.15 mg/L) enhanced the secondary metabolite accumulation and silymarin content in the callus of Silybum marianum. This is the first standardized protocol to be applied on the industrial level for the production of silymarin.

Background: Bell’s palsy is a common nerve disorder. The annual incidence of Bell’s palsy in the world is around 11-40 cases per 100,000 people. Both genders' prevalence rate seemed to be the same in their thirties. Conservative methods were used to treat Bell’s palsy. Therefore, further research is required which provides more results in less time with less disability. Objective: To evaluate the effects of mirror therapy in improving facial movements, symmetry, and the prevention of synkinesis. Methodology: This study was a randomized clinical trial, conducted in Madina teaching hospital, Aziz Fatima hospital, and DHQ hospital Faisalabad, Pakistan from Feb 2019 to July 2019. A convenient sampling technique was used and 30 patients were randomly allocated into two groups by lottery method. Group A (n=15) received Conventional therapy (electrical muscle stimulation and facial exercise) while group B(n=15) received mirror therapy in which after application of EMS, exercises were performed in front of a mirror. Twelve treatment sessions were given in four weeks on alternative days. The duration of the study was 6 months. Pre-treatment and post-treatment measurements were taken. The Questionnaires, House-Brackmann scale, and Sunnybrook facial grading system were used as data collection tools. Results: The patients’ mean age was 35.27 ± 7.611 years with 14 (46.7%) males and 16 (53.3%) females. Mirror therapy shows improvement on Sunnybrook facial grading system score as a mean value 70.67 ± 11.127. The result shows both groups are significant as with a p-value

This paper examines the potential role of literature and the Communicative Approach in teaching a second language (SL). This paper mainly focuses on digging out the prospective role of literature and Communicative Approach in teaching SL. Analysis of past studies indicate that teacher usually recourse to Grammar Translation Method for teaching of English language, for this method needs little endeavor and supplementary materials[1]. The reviewed literature has found that this method is ineffective and futile. To critically examine the potential role of literature in combination with Communicative Approach in teaching SL, this paper tries to unearth the current literature and investigates the relevant research works carried out on the importance of exploiting Literature and Communicative Approach for teaching of English language. The present paper found that using literature and communicative approach for teaching of SL is more effective and productive than GTM. In the light of findings of this study, it is recommended that teachers of L2 need to exploit literature and employ Communicative Approach for teaching of second language.

Financial, cultural, and managerial hurdles have made biosafety and biosecurity measures difficult in resource-constrained countries like Pakistan. Because of increasing awareness of biorisk management, diagnostic and research laboratories have made major advances in biosafety and biosecurity in the recent decade. As a result, identifying and addressing gaps in biorisk management has never been more critical. The purpose of this study was to assess the current situation of personal protective equipment (PPE), biosafety behavior, waste management, biosafety and biosecurity measures, training and safety, and health services in diagnostic and research laboratories across Pakistan's Khyber Pakhtunkhwa (KP) province. We adapted the WHO Laboratory Assessment tool (2012) and CWA 15793 (Biorisk management guidelines) for conducting a cross-sectional survey, which was distributed among various laboratories in KP. The survey included 30 laboratories, including 11 diagnostic and 19 research laboratories. In comparison to diagnostic laboratories, biorisk management practices in research laboratories were better in terms of PPE, biosafety behavior, waste management, biosafety measures, biosecurity measures, trainings, and safety and health services. KP laboratories' biorisk management practices have improved over time, according to our findings. However, we were able to identify inadequacies that would require considerable improvements to the current setups based on the WHO and CWA 15793 recommendations. Organizations can tailor their biosafety measures and training to address identified gaps using the presented KP snapshot.

Background: Worldwide, neurological disorders are the leading cause of disability-adjusted life years lost and the second leading cause of death. Despite global health capacity-building efforts, each year, 22.6 million individuals worldwide require neurosurgeon's care due to diseases such as traumatic brain injury and hydrocephalus, and 13.8 million of these individuals require surgery. It is clear that neurosurgical care is indispensable in both national and international public health discussions. This study highlights the role neurosurgeons can play in supporting the global health agenda, national surgical plans, and health strengthening systems (HSS) interventions.Methods: Guided by a literature review, the authors discuss key topics such as the global burden of neurosurgical diseases, the current state of neurosurgical care around the world and the inherent benefits of strong neurosurgical capability for health systems.Results: Neurosurgical diseases make up an important part of the global burden of diseases. Many neurosurgeons possess the sustained passion, resilience, and leadership needed to advocate for improved neurosurgical care worldwide. Neurosurgical care has been linked to 14 of the 17 Sustainable Development Goals (SDGs), thus highlighting the tremendous impact neurosurgeons can have upon HSS initiatives.Conclusion: We recommend policymakers and global health actors to: (i) increase the involvement of neurosurgeons within the global health dialogue; (ii) involve neurosurgeons in the national surgical system strengthening process; (iii) integrate neurosurgical care within the global surgery movement; and (iv) promote the training and education of neurosurgeons, especially those residing in Low-and middle-income countries, in the field of global public health.

Resistance among pathogenic bacteria to the existing antibiotics is one of the most alarming problems of the modern world. Alongwith reducing the use of antibiotics, and antibiotic stewardship, an alternative to antibiotics is much needed in the current scenario to combact infectious diseases. One alternative is to produce nanomaterials, especially, silver nanoparticles (AgNPs) against antibiotic-resistant bacteria. AgNPs are the most vital and fascinating nanoparticles because of their unique structural and functional properties and application against pathogenic bacteria. However, the synthesis of AgNPs remains a problem because of the chemicals and energy requirements and the byproducts of the reactions. Concerns have been raised about using chemically and physically synthesized nanoparticles because of their potential risks to the human body, animals, and environment. Green synthesis of these nanoparticles is a better alternative to physical and chemical approaches. Plant-based synthesis in turn is a method which can provide AgNPs that are cost-effective and eco-friendly as well as biocompatible. The specific features of size, morphology and shape of plant-based AgNPs give them the potency to fight multi-drug resistant bacteria. A detailed look into mechanistic aspects of the action of AgNPs against resistant bacteria with a focus on characteristic properties of AgNPs is required. This review discusses in detail these aspects and the potential of plant-based AgNPs as a solution to antibiotic resistance.

Abstract Fagonia indica is a widely known medicinal plant. The extracts of Fagonia species contain secondary metabolites such as flavonoids, phenolic compounds, and terpenoids. Silver nanoparticles are known for antibacterial properties. In this study, AgNPs were synthesized using the callus extract of F. indica as a reducing agent. Characterization through different techniques suggests that the AgNPs absorbed light and gave SPR peaks at 414 nm while in case of ciprofloxacin supplemented callus mediated AgNPs the peak were recorded at 419 nm. Furthermore, FTIR analysis revealed the role of amides, acyl group, nitro group of callus extract of F. indica, and some functional groups of the ciprofloxacin in the reduction process as well as the capping and stabilization of AgNPs. Similarly, X-Ray Diffraction analysis indicate the structure of AgNPs as face-centered cubic crystalline particles. The antibacterial activity of AgNPs and ciprofloxacin and callus extract as control against resistant bacteria such as Escherichia coli, Citrobacter amalonaticus, Shigella sonnei, and Salmonella typhi was studied. The combination of AgNPs and antibiotic showed better antibacterial activity as compared to AgNPs alone and ciprofloxacin alone. Maximum inhibition zone of E. coli, C. amalonaticus, S. sonnei, and S. typhi in response to AgNPs and ciprofloxacin was 38.5 mm, 35.5 mm, 33 mm, and 35.5 mm, respectively. It can, therefore, be suggested that the AgNPs along with Ciprofloxacin might have worked in interaction and resulted in better antibacterial activity against all the tested pathogens.

The current pandemic has caused chaos throughout the world. While there are few vaccines available now, there is the need for better treatment alternatives in line with preventive measures against COVID-19. Along with synthetic chemical compounds, phytochemicals cannot be overlooked as candidates for drugs against severe respiratory coronavirus 2 (SARS-CoV-2). The important role of secondary metabolites or phytochemical compounds against coronaviruses has been confirmed by studies that reported the anti-coronavirus role of glycyrrhizin from the roots of Glycyrrhiza glabra. The study demonstrated that glycyrrhizin is a very promising phytochemical against SARS-CoV, which caused an outbreak in 2002–2003. Similarly, many phytochemical compounds (apigenin, betulonic acid, reserpine, emodin, etc.) were isolated from different plants such as Isatis indigotica, Lindera aggregate, and Artemisia annua and were employed against SARS-CoV. However, owing to the geographical and seasonal variation, the quality of standard medicinal compounds isolated from plants varies. Furthermore, many of the important medicinal plants are either threatened or on the verge of endangerment because of overharvesting for medicinal purposes. Therefore, plant biotechnology provides a better alternative in the form of in vitro culture technology, including plant cell cultures, adventitious roots cultures, and organ and tissue cultures. In vitro cultures can serve as factories of secondary metabolites/phytochemicals that can be produced in bulk and of uniform quality in the fight against COVID-19, once tested. Similarly, environmental and molecular manipulation of these in vitro cultures could provide engineered drug candidates for testing against COVID-19. The in vitro culture-based phytochemicals have an additional benefit of consistency in terms of yield as well as quality. Nonetheless, as the traditional plant-based compounds might prove toxic in some cases, engineered production of promising phytochemicals can bypass this barrier. Our article focuses on reviewing the potential of the different in vitro plant cultures to produce medicinally important secondary metabolites that could ultimately be helpful in the fight against COVID-19.

Objective: To evaluate the comparative effects of two manual techniques (1) ischemic compression and (2) deep friction massage on myofascial trigger points in the area of the neck and upper back and determine its effects in managing pain, disability and ROM. Materials and Methods: This study was a randomized clinical trial conducted in TUF (The University of Faisalabad), GCUF (Government College University Faisalabad), and AUF (Agriculture University Faisalabad), Pakistan from January 2017 to June 2017. Based on inclusion criteria, total of 36 female students of different universities were selected and randomly allocated into two groups by lottery method. One group received ischemic compression therapy and the second group received deep friction massage. Twelve treatment sessions were given in four weeks on alternative days. The duration of the study was 6 months. Pre-treatment and post-treatment measurements were taken. Results: The greatest improvement has shown by ischemic compression therapy with NPRS mean 1.17±1.098and NDI mean 16.67±5.531respectively with a Pvalue=0.00at the end of treatment while the cervical ROM was equally enhanced in both treatment groups. Conclusion: This research concludes that IC (ischemic compression) is more effective than the DFM (deep friction massage) in patients with MTrP's in the neck and upper back for decreasing pain and disability. But for increasing cervical ROM, both therapeutic approaches are equally useful.

Background: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018–January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. Results: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). Conclusions: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs. Key words: Global health, Global neurosurgery, LMIC, Neurotrauma, Task sharing, Task shifting, Workforce

Background: Because nearly 23,000 more neurosurgeons are needed globally to address 5 million essential neurosurgical cases that go untreated each year, there is an increasing interest in task-shifting and task-sharing (TS/S), delegating neurosurgical tasks to nonspecialists, particularly in low- and middle-income countries (LMICs). This global survey aimed to provide a cross-sectional understanding of the prevalence and structure of current neurosurgical TS/S practices in LMICs. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care in LMICs with a Web-based survey link via electronic mailing lists of continental societies and various neurosurgical groups, conference announcements, e-mailing lists, and social media platforms. Country-level data were analyzed by descriptive statistics. Results: The survey yielded 127 responses from 47 LMICs; 20 countries (42.6%) reported ongoing TS/S. Most TS/S procedures involved emergency interventions, the top 3 being burr holes, craniotomy for hematoma evacuation, and external ventricular drain. Most (65.0%) believed that their Ministry of Health does not endorse TS/S (24.0% unsure), and only 11% believed that TS/S training was structured. There were few opportunities for TS/S providers to continue medical education (11.6%) or maintenance of certification (9.4%, or receive remuneration (4.2%). Conclusions: TS/S is ongoing in many LMICs without substantial structure or oversight, which is concerning for patient safety. These data invite future clinical outcomes studies to assess effectiveness and discussions on policy recommendations such as standardized curricula, certification protocols, specialist oversight, and referral networks to increase the level of TS/S care and to continue to increase the specialist workforce. Key words: Capacity, Global health, Global neurosurgery, LMIC, Task-sharing, Task-shifting, Workforce

The role of a teacher is crucial for language learning specifically in English language classrooms. An important variable in this regard is the gender of students. This study investigates the impact of gender on language learning motivations of students studying at the undergraduate level in the City University of Science and IT and Institute of Management Sciences, Peshawar. Questionnaire data were collected from 175 students. The variables of the study include gender and its relationship with language attitudes and motivation. The results revealed that there exists the relationship between gender differences in variables under consideration. Female students had more expectations as compared to their male fellows. The study has useful pedagogical implications.

Trauma/stroke centres optimise acute 24/7/365 surgical/critical care in high-income countries (HICs). Concepts from low-income and middle-income countries (LMICs) offer additional cost-effective healthcare strategies for limited-resource settings when combined with the trauma/stroke centre concept. Mass casualty centres (MCCs) integrate resources for both routine and emergency care—from prevention to acute care to rehabilitation. Integration of the various healthcare systems—governmental, non-governmental and military—is key to avoid both duplication and gaps. With input from LMIC and HIC personnel of various backgrounds—trauma and subspecialty surgery, nursing, information technology and telemedicine, and healthcare administration—creative solutions to the challenges of expanding care (both daily and disaster) are developed. MCCs are evolving initially in Chile and Pakistan. Technologies for cost-effective healthcare in LMICs include smartphone apps (enhance prehospital care) to electronic data collection and analysis (quality improvement) to telemedicine and drones/robots (support of remote regions and resource optimisation during both daily care and disasters) to resilient, mobile medical/surgical facilities (eg, battery-operated CT scanners). The co-ordination of personnel (within LMICs, and between LMICs and HICs) and the integration of cost-effective advanced technology are features of MCCs. Providing quality, cost-effective care 24/7/365 to the 5 billion who lack it presently makes MCCs an appealing means to achieve the healthcare-related United Nations Sustainable Development Goals for 2030.

The present position paper explores to examine Rajaa al-Sanea’s“Girls of Riyadh” (2005) from the Islamic feminist perspective. Also, the study highlights the model of western feminism epitomised in the narrative under reference, vis-à-vis the Islamic concept of feminism. Islamic feminism grants equal rights to women and ensures its implementation in the Islamic state and society, whereas Western-sponsored feminism dwells on the archetype of women’s liberalism. That, in turn, leads to an anarchic and chaotic society, because of its believing in bringing women not only equal to men but superseding them in socio-cultural positioning. In the existing situation, the novel decries phallocentric society of Saudi Arabia and aiming at replacing it by the sensate-secular feminism that believes in the undue autonomy of the women. In order to investigate the presence of overwhelming patrilineal mores, the study pursues Islamic feminism as a theoretical model and employs reader’s response technique as a methodology. More far the findings of the research are concerned, the researchers conclude that replacing the patriarchal autonomy in the said society by Islamic feminism is befitting and benefitting than to replace it by the western feminism.

Jatropha curcas (JC), as a biofuel plant, has been reported to have various desired characteristics such as high oil content seeds (27–40%), fast-growth, easy cultivation, drought tolerance, and can be grown on marginal soil and wasteland, requiring fewer nutrients and management and does not interfere with existing food crops, insects, and pest resistance. This investigation was the first study of its type to use climatological data, blue/green water footprints, and JC seed production to identify suitable sites for JC bioenergy plantation using the AquaCrop FAO model across the Khyber Pakhtunkhwa province in northwest Pakistan. The JC seed yield (10 ton/ha) was at a maximum in the districts of Bannu, Karak, Hangu, Kurram, North Waziristan, Lakki Marwat, South Waziristan, and Dera Ismail Khan, in addition to its frontier regions, Tank, Peshawar, Mohmand, Orakzai, Khyber, Kohat, Charsadda, Mardan, Swabi, and Nowshera, respectively. Green water footprint (264 m3/ton of JC seed) and blue water footprint (825 m3/ton) was less in these areas. Furthermore, the results revealed that, depending on climatological circumstances, the southern part of the Khyber Pakhtunkhwa province is more appropriate for JC bioenergy plantation than the northern region. The districts of Bannu, Karak, Hangu, Kurram, North Waziristan, Lakki Marwat, South Waziristan, Dera Ismail Khan, and its frontier regions, Tank, Peshawar, Mohmand, Orakzai, Khyber, and Kohat, in Khyber Pakhtunkhwa province were identified to be the most ideal places for JC bioenergy plantation. As a result, under the Billion Tree Afforestation Project (BTAP) and the Green Pakistan Project, the Forest Department of Khyber Pakhtunkhwa should consider planting JC species in the province’s southern region. Furthermore, this research will provide scientific information to government and private sector officials for better management and optimum yield of the JC biofuel crop, as well as for the promotion of energy forestry in Pakistan.

Fagonia indica is a rich source of pharmacologically active compounds. The variation in the metabolites of interest is one of the major issues in wild plants due to different environmental factors. The addition of chemical elicitors is one of the effective strategies to trigger the biosynthetic pathways for the release of a higher quantity of bioactive compounds. Therefore, this study was designed to investigate the effects of chemical elicitors, aluminum chloride (AlCl3) and cadmium chloride (CdCl2), on the biosynthesis of secondary metabolites, biomass, and the antioxidant system in callus cultures of F. indica. Among various treatments applied, AlCl3 (0.1 mM concentration) improved the highest in biomass accumulation (fresh weight (FW): 404.72 g/L) as compared to the control (FW: 269.85 g/L). The exposure of cultures to AlCl3 (0.01 mM) enhanced the accumulation of secondary metabolites, and the total phenolic contents (TPCs: 7.74 mg/g DW) and total flavonoid contents (TFCs: 1.07 mg/g DW) were higher than those of cultures exposed to CdCl2 (0.01 mM) with content levels (TPC: 5.60 and TFC: 0.97 mg/g) as compared to the control (TPC: 4.16 and TFC: 0.42 mg/g DW). Likewise, AlCl3 and CdCl2 also promoted the free radical scavenging activity (FRSA; 89.4% and 90%, respectively) at a concentration of 0.01 mM, as compared to the control (65.48%). For instance, the quantification of metabolites via high-performance liquid chromatography (HPLC) revealed an optimum production of myricetin (1.20 mg/g), apigenin (0.83 mg/g), isorhamnetin (0.70 mg/g), and kaempferol (0.64 mg/g). Cultures grown in the presence of AlCl3 triggered higher quantities of secondary metabolites than those grown in the presence of CdCl2 (0.79, 0.74, 0.57, and 0.67 mg/g). Moreover, AlCl3 at 0.1 mM enhanced the biosynthesis of superoxide dismutase (SOD: 0.08 nM/min/mg-FW) and peroxidase enzymes (POD: 2.37 nM/min/mg-FW), while CdCl2 resulted in an SOD activity up to 0.06 nM/min/mg-FW and POD: 2.72 nM/min/mg-FW. From these results, it is clear that AlCl3 is a better elicitor in terms of a higher and uniform productivity of biomass, secondary cell products, and antioxidant enzymes compared to CdCl2 and the control. It is possible to scale the current strategy to a bioreactor for a higher productivity of metabolites of interest for various pharmaceutical industries.

Natural products from plants contain many interesting biomolecules. Among them, quercetin (Q), gallic acid (GA), and rutin (R) all have well-reported antileishmanial activity; however, their exact mechanisms of action are still not known. The current study is a step forward towards unveil the possible modes of action of these compounds against Leishmania donovani (the causative agent of visceral leishmaniasis). The selected compounds were checked for their mechanisms of action against L. donovani using different biological assays including apoptosis and necrosis evaluation, effects on genetic material (DNA), quantitative testing of nitric oxide production, ultrastructural modification via transmission electron microscopy, and real-time PCR analysis. The results confirmed that these compounds are active against L. donovani, with IC50 values of 84.65 µg/mL, 86 µg/mL, and 98 µg/mL for Q, GA, and R, respectively. These compounds increased nitric oxide production and caused apoptosis and DNA damage, which led to changes in the treated cells’ ultrastructural behavior and finally to the death of L. donovani. These compounds also suppressed essential enzymes like trypanothione reductase and trypanothione synthetase, which are critical for leishmanial survival. The selected compounds have high antileishmanial potentials, and thus in-vivo testing and further screening are highly recommended.

The present study involved the bio-fabrication of silver nanoparticles (AgNPs) by using the Euphorbia helioscopia L. leaves aqueous extract to improve the production of secondary metabolites in industrially important sunflower (Helianthus annuus L.) plants. Phyto-fabrication of AgNPs was confirmed by using spectrophotometry, SEM imaging and X-ray diffraction analysis. The morphological and optical characterization manifested that the AgNPs are crystalline and exist in the size range of 30–100 nm. Various concentrations (10, 20, 40, 60, 80 and 100 mg/L) of AgNPs were applied in combinations on sunflower seeds and crop plants. The effects of biosynthesized AgNPs were evaluated for agro-morphological parameters (plant height, flowering initiation and seed weight), biochemical metabolites (chlorophyll, proline, soluble sugar, amino acid and protein contents) and enzymatic activities (superoxide dismutase and ascorbate peroxidase) in sunflower and 60 mg/L concentration of AgNPs on sunflower seeds and foliar sprays on plants in combination were found to be effective to elicit biochemical modifications to improve secondary metabolites. It was also observed experimentally that 60 mg/L concentration of AgNPs improved the biochemical, fatty acid and enzymatic attributes of sunflower plants, which in turn improved the plant agro-morphological parameters. Near-infrared spectroscopic analysis results confirmed the improvement in the seed quality, oil contents and fatty acid composition (palmitic acid, oleic acid and linoleic acid) after the applications of AgNPs. The findings of the present investigation confirm the exogenous applications of bio-fabricated AgNPs in combinations on seeds and plants to improve the plant yield, seed quality and secondary metabolite contents of the sunflower plants.

Antimicrobial resistance is mushrooming as a silent pandemic. It is considered among the most common priority areas identified by both national and international agencies. The global development of multidrug-resistant strains now threatens public health care improvement by introducing antibiotics against infectious agents. These strains are the product of both continuous evolution and unchecked antimicrobial usage (AMU). The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) are the leading cause of nosocomial infections throughout the world. Most of them are now multidrug-resistant, which pose significant challenges in clinical practice. Understanding these bacteria’s resistance mechanisms is crucial for developing novel antimicrobial agents or other alternative tools to fight against these pathogens. A mechanistic understanding of resistance in these pathogens would also help predict underlying or even unknown mechanisms of resistance of other emerging multidrug-resistant pathogens. Research and development to find better antibacterial drugs and research on tools like CRISPER-Cas9, vaccines, and nanoparticles for treatment of infections that can be further explored in the clinical practice health sector have recognized these alternatives as essential and highly effective tools to mitigate antimicrobial resistance. This review summarizes the known antimicrobial resistance mechanisms of ESKAPE pathogens and strategies for overcoming this resistance with an extensive overview of efforts made in this research area.

Pakistan possesses the fourth largest irrigation network in the world, serving 20.2 million hectares of cultivated land. With an increasing irrigated area, Pakistan is short of freshwater resources and faces severe water scarcity and food security challenges. This is the first comprehensive study on the water footprint (WF) of crop production in Peshawar Basin. WF is defined as the volume of freshwater required to produce goods and services. In this study, we assessed the blue and green water footprints (WFs) and annual blue and green water consumption of major crops (maize, rice, tobacco, wheat, barley, sugarcane, and sugar beet) in Peshawar Basin, Pakistan. The Global Water Footprint Assessment Standard (GWFAS) and AquaCrop model were used to model the daily WF of each crop from 1986 to 2015. In addition, the blue water scarcity, in the context of available surface water, and economic water productivity (EWP) of these crops were assessed. The 30 year average blue and green WFs of major crops revealed that maize had the highest blue and green WFs (7077 and 2744 m3/ton, respectively) and sugarcane had the lowest blue and green WFs (174 and 45 m3/ton, respectively). The average annual consumption of blue water by major crops in the basin was 1.9 billion m3, where 67% was used for sugarcane and maize, covering 48% of the cropland. The average annual consumption of green water was 1.0 billion m3, where 68% was used for wheat and sugarcane, covering 67% of the cropland. The WFs of all crops exceeded the global average. The results showed that annually the basin is supplied with 30 billion m3 of freshwater. Annually, 3 billion m3 of freshwater leaves the basin unutilized. The average annual blue water consumption by major crops is 31% of the total available surface water (6 billion m3) in the basin. Tobacco and sugar beet had the highest blue and green EWP while wheat and maize had the lowest. The findings of this study can help the water management authorities in formulating a comprehensive policy for efficient utilization of available water resources in Peshawar Basin.

Purpose: The purpose of this paper is to identify the factors determining students' attitude toward using newly emerged artificial intelligence (AI) tool, Chat Generative Pre-Trained Transformer (ChatGPT), for educational and learning purpose based on technology acceptance model. Design/methodology/approach: The recommended model was empirically tested with partial least squares structural equation modeling using 375 student survey responses. Findings: The study revealed that students have a favorable view of the instructional use of ChatGPT. Usefulness, social presence and legitimacy of the tool, as well as enjoyment and motivation, contribute to a favorable attitude toward using this tool in a learning environment. However, perceived ease of use was not found to be a significant determinant in the adoption and utilization of ChatGPT by the students. Practical implications: This research is intended to benefit enterprises, academic institutions and the global community by offering light on how students perceive the ChatGPT service in an educational setting. Furthermore, the application enhances confidence and interest among learners, leading to improved literacy and general awareness. Eventually, the outcome of this research will help AI developers to improve their product and service delivery, as well as benefit regulators in regulating the usage of AI-based bots. Originality/value: Due to its novelty, the current research on AI-based ChatGPT usage in the education sector is rather restricted. This study provides the adoption aspects of ChatGPT, a new AI-based technology for students, thereby contributing significantly to the existing research on the adoption of advanced education technologies. In addition, the literature lacks research on the adoption of ChatGPT by students for educational purposes; this study addresses this gap by identifying adoption determinants of ChatGPT in education.

N-heterocyclic carbene (NHC) precursors (2a–i), their pyridine-enhanced precatalyst preparation stabilization and initiation (PEPPSI)-themed palladium N-heterocyclic carbene complexes (3a–i) and palladium N-heterocyclic triphenylphosphines complexes (4a–i) were synthesized and characterized by elemental analysis and 1H NMR, 13C NMR, IR, and LC–MS spectroscopic techniques. The (NHC)Pd(II) complexes 3–4 were tested against MCF7 and MDA-MB-231 cancer cells, Escherichia coli, methicillin-resistant Staphylococcus aureus (MRSA), Candida albicans microorganisms, Leishmania major promastigotes and amastigotes, Toxoplasma gondii parasites, and Vero cells in vitro. The biological assays indicated that all compounds are highly active against cancer cells, with an IC50 < 1.5 µg mL−1. Eight compounds proved antibacterial and antileishmanial activities, while only three compounds had strong antifungal activities against C. albicans. In our conclusion, compounds 3 (b, f, g, and h) and 4b are the most suitable drug candidates for anticancer, antimicrobial, and antiparasitical.

Oxidative stress-mediated neuroinflammatory events are the hallmark of neurodegenerative diseases. The current study aimed to synthesize a series of novel succinamide derivatives and to further investigate the neuroprotective potential of these compounds against scopolamine-induced neuronal injury by in silico, morphological, and biochemical approaches. The characterization of all the succinamide derivatives was carried out spectroscopically via proton NMR (1H-NMR), FTIR and elemental analysis. Further in vivo experiments showed that scopolamine induced neuronal injury, characterized by downregulated glutathione (GSH), glutathione S-transferase (GST), catalase, and upregulated lipid peroxidation (LPO). Moreover, scopolamine increased the expression of inflammatory mediators such as cyclooxygenase2 (COX2), nuclear factor kappa B (NF-kB), tumor necrosis factor (TNF-α), further associated with cognitive impairment. On the other hand, treatment with succinamide derivatives ameliorated the biochemical and immunohistochemical alterations induced by scopolamine, further supported by the results obtained from molecular docking and binding affinities.

The rising burden of cancer worldwide calls for an alternative treatment solution. Herbal medicine provides a very feasible alternative to western medicine against cancer. This article reviews the selected plant species with active phytochemicals, the animal models used for these studies, and their regulatory aspects. This study is based on a meticulous literature review conducted through the search of relevant keywords in databases, Web of Science, Scopus, PubMed, and Google Scholar. Twenty plants were selected based on defined selection criteria for their potent anticancer compounds. The detailed analysis of the research studies revealed that plants play an indispensable role in fighting different cancers such as breast, stomach, oral, colon, lung, hepatic, cervical, and blood cancer cell lines. The in vitro studies showed cancer cell inhibition through DNA damage and activation of apoptosis-inducing enzymes by the secondary metabolites in the plant extracts. Studies that reported in vivo activities of these plants showed remarkable results in the inhibition of cancer in animal models. Further studies should be performed on exploring more plants, their active compounds, and the mechanism of anticancer actions for use as standard herbal medicine.

Piper species are aromatic plants used as spices in the kitchen, but their secondary metabolites have also shown biological effects on human health. These plants are rich in essential oils, which can be found in their fruits, seeds, leaves, branches, roots and stems. Some Piper species have simple chemical profiles, while others, such as Piper nigrum, Piper betle, and Piper auritum, contain very diverse suites of secondary metabolites. In traditional medicine, Piper species have been used worldwide to treat several diseases such as urological problems, skin, liver and stomach ailments, for wound healing, and as antipyretic and anti-inflammatory agents. In addition, Piper species could be used as natural antioxidants and antimicrobial agents in food preservation. The phytochemicals and essential oils of Piper species have shown strong antioxidant activity, in comparison with synthetic antioxidants, and demonstrated antibacterial and antifungal activities against human pathogens. Moreover, Piper species possess therapeutic and preventive potential against several chronic disorders. Among the functional properties of Piper plants/extracts/active components the antiproliferative, anti-inflammatory, and neuropharmacological activities of the extracts and extract-derived bioactive constituents are thought to be key effects for the protection against chronic conditions, based on preclinical in vitro and in vivo studies, besides clinical studies. Habitats and cultivation of Piper species are also covered in this review. In this current work, available literature of chemical constituents of the essential oils Piper plants, their use in traditional medicine, their applications as a food preservative, their antiparasitic activities and other important biological activities are reviewed.