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Abstract Background In the intricate tapestry of food security, wild food species stand as pillars, nourishing millions in low-income communities, and reflecting the resilience and adaptability of human societies. Their significance extends beyond mere sustenance, intertwining with cultural traditions and local knowledge systems, underscoring the importance of preserving biodiversity and traditional practices for sustainable livelihoods. Methods The present study, conducted between February 2022 and August 2023 along the Line of Control in India’s Kashmir Valley, employed a rigorous data collection encompassing semi-structured interviews, focus group discussions, and specific field observations facilitated through a snowball sampling technique. Results and discussion The comprehensive inventory includes 108 edible plant and fungal species from 48 taxonomic families, with Rosaceae (N = 11) standing out. Young and soft leaves (N = 60) are an important component of various culinary preparations, with vegetables (N = 65) being the main use, followed by fruits (N = 19). This use is seasonal, with collection peaks in March–April and June–August (N = 12). The study also highlights the importance of use value (UV), with Portulaca oleracea standing out as the plant taxon (UV = 0.61), while Asyneuma thomsoni has the lowest use value (UV = 0.15). Many species such as Senecio chrysanthemoides, Asperugo procumbens, Asyneuma thomsoni, and Potentilla nepalensis were classified as new for gastronomic use. Furthermore, the study underlines the great cultural importance of mushrooms such as Morchella esculenta and Geopora arenicola in influencing social hierarchies within the community. However, the transmission of traditional knowledge across generations is declining in the region. At the same time, the conservation of endangered plant species on the IUCN Red List, such as Trillium govanianum, Taxus wallichiana, Saussurea costus, and Podophyllum hexandrum, requires immediate attention. Conclusion Conservation measures should be prioritized, and proactive remedial action is needed. Further research into the nutritional value of these edible species could pave the way for their commercial cultivation, which would mean potential economic growth for local communities, make an important contribution to food security in the area under study, and contribute to scientific progress.

The study aims to assess the health-related Quality of Life (HRQOL) and its association with socio-demographic factors among the Afghan refugees residing in Quetta, Pakistan. For this purpose, a cross-sectional, descriptive study design by adopting Euro QOL five dimensions questionnaire (EQ-5D) for the assessment of HRQOL was conducted by approaching Afghan refugees from the camp and other areas of Quetta, Pakistan. Furthermore, this study also involved descriptive analysis to expound participant's demographic characteristics while inferential statistics (Kruskal-Wallis and Mann-Whitney test, P < 0.05) were used to compare EQ-5D scale scores. All analyses were performed using SPSS v 20. Herein, a total of 729 participants were enrolled and were subsequently (n = 246, 33.7%) categorized based on their age of 22-31 years (31.30 ± 15.40). The results of mean EQ-5D descriptive score (0.85 ± 0.20) and EQ-VAS score (78.60 ± 11.10) indicated better HRQOL in the current study respondents as compared to studies conducted in other refugee camps around the globe. In addition, demographic characteristics including age, marital status, locality, years of living as refugees, life as a refugee residing out of Pakistan, place of residence in Afghanistan, educational qualification, occupation, and arrested for crime were the statistically significant predictors (P < 0.05) of EQ-5D index scores. However, gender, living status, monthly income, preferred place of treatment were non-significant predictors (P > 0.05). The results of current study provided evidence for a model that correlated with participant's socio-demographic information and HRQOL. Moreover, this study also revealed a baseline assessment for the health status of Afghan refugees, interestingly, these results could be applied for improving HRQOL of the given participants. In conclusion, the HRQOL of Afghan refugees residing in Quetta, Pakistan can largely be improved by providing adequate healthcare facilities, education and employment opportunities, mental and social support, and providing adequate housing and basic necessities of life.

Background: Ivabradine is a selective inhibitor of (If) channels in the sinoatrial node and a pure bradycardic agent with no deleterious effect on other aspects of cardiac function nor on blood pressure. This study was conducted to evaluate the effect of Ivabradine on controlling tachycardia in sepsis patients as compared to placebo. Methods: A total of 100 patients admitted to the Medical Intensive Care Unit (MICU) were recruited in this randomized controlled trial. A total of 50 patients were randomly allocated to either Group A (the Ivabradine group) or Group B (the control group). Heart rate (HR) was recorded for all patients at baseline, 12, 24, 48, 72, 96, and 120 hours. Mean arterial pressure (MAP), ejection fraction (EF), and change in Norepinephrine (NE) dosage were recorded at baseline and post-intervention (120 hours). A mortality rate was recorded for both groups. Results: The patients had a mean age of 32.49 + 16.22 years. There were 56 males and 44 females in the study. Epilepsy (n = 12, 12%) and tetanus (n = 11, 11%) were the most common primary diagnosis. Ventilator Associated Pneumonia (n = 60) was found to be the most common infection. Patients in Group A (23.2 + 11.02 beats per minute) had a significantly greater heart rate reduction at 120 hours in mean heart rate as compared to Group B patients (8.92 + 30.46 beats per minute, p = 0.002). The increase in mean MAP for Group A (1.68 + 2.44 mm Hg) was also significantly greater than that for Group B (0.54 + 2.46 mm Hg, p = 0.022). There was no difference in the mean change in NE dosage between Groups A (0.63 + 0.25 units/minute) and B (-0.34 + 0.36 units/minute, p = 0.106). A significantly greater increase in EF was found for Group A (1.16 + 1.5%), in comparison to Group B (0.30 + 1.69 %, p = 0.009). There were 22 (44%) deaths reported in Group A as compared to 24 (48%, p = 0.688) in Group B. Conclusion:Ivabradine has a significantly greater effect on controlling heart rate as compared to placebo in sepsis patients. The use of Ivabradine should be included in clinical guidelines for managing sepsis patients in ICU settings. Doi: 10.28991/SciMedJ-2023-05-01-04 Full Text: PDF

The prevalence and burden of mental health disorders are on the rise in conflict zones, and if left untreated, they can lead to considerable lifetime disability. Following the repeal of Article 370, political unrest spread quickly, forcing the Indian government to impose safety precautions such as lockdowns and communication ban. Consequently, the region of Kashmir experienced a marked rise in anxiety as a result of these lifestyle changes. Machine learning has proven useful in the early diagnosis and prognosis of certain diseases. Therefore, this study aims to classify anxiety problems early by utilising a pre-clinical mental health dataset collected after the abrogation of article 370 in Kashmir. The first part of the paper aims at developing and implementing a prediction model based on classification into one of the five pre-clinical anxiety stages, i.e., Stage 1: minimal anxiety, Stage 2: mild anxiety, Stage 3: moderate anxiety, Stage 4: severe anxiety, and Stage 5: very severe anxiety. The second part offers recommendations for those suffering from anxiety disorders. Feature selection and prediction are used to predict the correct stage of anxiety for best possible medical intervention. Three different algorithms: Support Vector Machine(SVM), Multilayer Perceptron (MLP), and Random Forest (RF), are employed for predicting anxiety stages. Among them, random forest (RF) achieved 98.13% accuracy. A forecasted likelihood condition was assessed to provide a suitable recommendation. Further, accuracy and kappa statistics are used to assess the performance of the suggested model, which offers a significant addition to predicting anxiety early, and exhibits high prediction and recommendation accuracy. This study aims to assist mental health professionals and experts in making quick and accurate choices.

BackgroundThe storage of antimicrobials at home is frequently in-practice in various developing countries, resulting an irrational use, antibiotic resistance, and toxicities. This condition may worsen more in conflict zones where health facilities are limited. This study aimed to determine the storage and use of leftover antibiotics among households (HHs) along with knowledge and awareness about antibiotics and antibiotic resistance (ABR).MethodsA descriptive cross-sectional study design was employed. Members of HHs were invited to participate in the survey while using a convenient sampling technique. The data were obtained using a validated questionnaire and analyzed through SPSS.ResultsA total of 96 HHs were randomly selected from two districts (n = 50, n = 46), with most of the participants being men between the ages of 18 and 28 (n = 45, 46.9%) years. The majority of HHs (n = 32, 33.3%) had six to eight total family members, with one to two chronic diseases (n = 63, 65.6%), individual families (n = 60, 62.5%), and with (n = 35, 36.5%) LRTIs (lower respiratory tract infections). The HHs were aware of the word “antibiotic” (n = 59, 61.5%) and gave correct replies to amoxicillin as an antibiotic (n = 42, 43.8%); on the other hand, HHs also thought of paracetamol as an antibiotic (n = 45, 47.9%). They identified the most common brands of antibiotics easily, and a majority of them (n = 69, 71.9%) had never heard of ABR before and had lower levels of awareness. The most stored antibiotic at home (n=38, 39.6%) was azithromycin (J01FA10). In addition, they had multiple needless (1–2, n = 62, 64.6%; 3–4, n = 29, 30.2%) and antibiotics in their houses. Age had a strong association (p = 0.017, H = 12) affected the mean knowledge scores related to antibiotic use. Association of education levels (p = 0.001, H = 52.8) and occupation (p = 0.04, H = 10) with proper antibiotics use were found to be significant. However, family members with more than one chronic illness (p = 0.09, H = 0.8) showed a significant relationship with their awareness of antibiotics.ConclusionParticipants generally stored various antibiotics of different classes in their homes. Lack of knowledge related to the appropriate usage of antibiotics, use of leftover antibiotics, and awareness related to ABR were unknown to the participants.

The traditional use of Mirabilis jalapa L. roots to enhance male sexual performance prompted us to assess the in silico, in vitro, and in vivo aphrodisiac activities of its hydroethanolic extract using normal male rats. Spectroscopic characterization indicated the presence of ß-D-glucopyranoside, methyl-1,9-benzyl-2,6-dichloro-9H-purine, and Bis-(2-ethylhexyl)-phthalate; these compounds have a significant inhibitory effect on the phosphodiesterase-5 (PDE-5) enzyme in silico evaluation and minerals (including zinc, cadmium, and magnesium). Other phytochemical analyses revealed the presence of phenolic compounds and flavonoids. These phytochemicals and minerals may contribute to the aphrodisiac activities of the extract. Additionally, the in vivo study revealed that the administration of M. jalapa root extract (300 mg/kg) significantly enhanced (p < 0.01, p < 0.03) mount, intromission, and ejaculation frequencies while significantly (p < 0.05) decreasing the mount and intromission latencies, as well as the post-ejaculatory interval time, in comparison with the standard drugs sildenafil and ginseng, resulting in enhanced erection and sexual performance in the rats. Furthermore, the extract significantly (p < 0.05) increased penile reflexes and also elevated the levels of testosterone and luteinizing hormones. Extract (300 mg/kg) significantly (p < 0.05) inhibited the PDE-5 enzyme in an in vitro study. Concludingly, the comprehensive findings of this study suggest that a standardized herbal extract derived from M. jalapa roots alleviates erectile dysfunction and premature ejaculation in male rats. M. jalapa root extract proved to be an alternative treatment for erectile dysfunction and premature ejaculation.

Background: Antibiotics misuse is a global challenge, and the situation is likely to deteriorate in conflict zones with insufficient health services. The misuse of antibiotics is not only associated with antimicrobial resistance but may also lead to serious consequences. This study was aimed to investigate the knowledge, attitude, and practices on antibiotic consumption, antibiotic resistance (ABR), and related suggestions among residents of conflicted zones in Pakistan.Methods: Semi-structured interviews were conducted at community pharmacies between June 2020 and January 2021. The primary findings were ascertained through thematic content analysis. Themes, sub-themes, and categories were drawn from the final analysis. Data analysis was carried out in six steps from getting to know the data to final report development.Results: A total of 20 consumers were interviewed with a mean interview duration of 25.4 min. The average age of participants was 35.1 years, and most of them were males. ABR was unfamiliar to the participants. Most of the participants understood the term “antibiotics,” but they did not know how to use them properly. The participants were unable to distinguish between bacterial and viral illnesses. Thirteen participants believed that antibiotics have a faster effect than any other drug. Most of the participants perceived that every antibiotic could cause diarrhea, and pharmacy staff sometimes prefer other medicines such as multivitamins. Consumer practices regarding antibiotic usage and ABR were found to be poor. Most participants recommended that health officials must ensure qualified staff at pharmacies with strict regulations. Five participants said that a leaflet with antibiotic instructions in Urdu (national language) is usually beneficial, especially when making solutions from powder.Conclusions: This study underscored poor knowledge, attitude, and practices among residents of conflicted zones towards antibiotics and ABR. Low literacy rate, unavailability of healthcare facilities, absence of pharmacists at community pharmacies, and uncontrolled sales of antibiotics are some factors attributed to serious hazards, ABR, and irrational use of drugs.

Antibiotics dispensing without a prescription is an irrational practice and can increase the risk of antibiotic resistance, which is a significant public health concern around the globe. This study was aimed to determine the extent to which antibiotics are supplied without prescription in the community pharmacies (CPs) at Hazara Division from November 2020 to February 2021. The simulated client method (SCM) was used, and the data were gathered, recorded, and analyzed through different statistical methods with descriptive and inferential techniques. The antibiotic dispensing was observed in CPs (90.5%), the most dispensed antibiotics were azithromycin (29.4%) and ciprofloxacin (46.5%) respectively. Furthermore, visited medical stores/ drug outlets, 9.5% of the visited stores denied dispensing of antibiotics because they preferred a referral to visit physicians (23. 9%) and (12.8%) did not had the antibiotics at the time of visits. Antibiotics were more obtainable in retail medical stores (AOR = 8.6, 95 percent Cl: 3.0-24.7; p = 0.001) than in pharmacies. In rural areas antibiotics dispensing was more (p = 0.004) as compared to urban areas. Staff members also had asked about patient's (17.7%) symptoms and drug allergies (12.3% and 3.9%), and (1.5%) they consoled them about their medications. The findings of this study indicate that nonprescription antibiotic sales are very common, despite national rules prohibiting this activity. When the simulated Client requested for any medication to relieve his or her discomfort, many antibiotics were given out without a prescription. Pharmacies/medical stores in Hazara Division selling antibiotics without a prescription are worrying and need immediate action by regulators.

Background: Antibiotic resistance (ABR) is one of the major issues around the globe. Timely education and awareness of pharmacy students regarding the appropriate use of antibiotics, ABR, and antimicrobial stewardships are required.Methods: The present study was first conducted in 12 (public and private sector) universities among undergraduate pharmacy students (UGPS) (n = 414) irrespective of their study year through a validated questionnaire, and the insights of pharmacy teachers were taken through in-depth semi-structured interviews in the second phase. For the quantitative data, different statistical methods were used, and data were presented in tabulated form, whereas inductive thematic interpretation was used to categorize themes and derive conclusions from qualitative evidence.Results: The majority of the students were males (n = 223, 54%) with the mean age group 19–23 years, and 20 faculty members were interviewed with a mean duration of 15 min. Students have good knowledge about antibiotics use and the majority purchased antibiotics through prescription (n = 277, 66.9%) during the last month and strongly agreed to stop unnecessary household storage (n = 183 44.2%). Most of the students have heard the terminologies related to antimicrobial resistance through social media while unaware (n = 104, 25.1%) of a Pakistan national action plan against AMR (antimicrobial resistance). Overall, respondents have a somewhat good understanding of the ABR. Regular use of antibiotics without consultation of a physician can lead to ABR and some wrong answers were observed (162, 39.1%; p > 0.05). The majority of the students (n = 198, 47.8%) and teachers believe that the current pharmacy syllabus must be swiftly updated with the new subjects related to ABR and AMS (antimicrobial stewardship) in Pakistan. The UGPS have emphasized (n = 220, 53.1%; Median = 1, IQR = 2) establishing a link between academia and hospitals. The ABR issue has been highlighted by pharmacy faculty members, who have urged students to take practical efforts toward ABR and AMS knowledge.Conclusion: The UGPS knowledge related to ABR and AMS must be updated. Students at the undergraduate level must get training in order to encourage the sensible use of antibiotics. Courses on ABR and AMS should be included in present pharmacy curricula.

Medicinal plants are utilized around the globe for the treatment of a wide range of ailments. This study is an attempt to document the utilization of medicinal plants across the four different cultural groups residing in the rural and remote villages of the northern districts of the Union territory of Jammu and Kashmir, India. To gather information related to medicinal plants and health care practices among the local folk, field surveys were conducted from February 2018 to May 2021. The ethnomedicinal information was gathered through semi-structured interviews and group discussions. During the study, a total of 109 plant species belonging to 35 families were recorded as commonly utilized by the local population, with Asteraceae reported as the dominant family. The most common growth form was herbs, with a percentage contribution of 86%. Leaves (38%) were the most commonly used plant part for the preparation of traditional remedies, and most of the remedies were prepared as paste and applied topically. The highest use value of 0.30 was reported for Capsella bursa-pastoris. Greater similarity (14% species) in the usage of plants was shown by Bakerwal, Gujjar, and Pahadi ethnic groups, whereas the least similarity (1%) was observed between Bakerwal and Kashmiri ethnic groups. Based on the results obtained in the present study, further phytochemical and pharmacological analysis of plants is recommended to confirm the efficacy and safety of the remedies used and to possibly elucidate candidates for the development of new drugs.

Freshwater lakes present an ecological border between humans and a variety of host organisms. The present study was designed to evaluate the microbiota composition and distribution in Dal Lake at Srinagar, India. The non-chimeric sequence reads were classified taxonomically into 49 phyla, 114 classes, 185 orders, 244 families and 384 genera. Proteobacteria was found to be the most abundant bacterial phylum in all the four samples. The highest number of observed species was found to be 3097 in sample taken from least populated area during summer (LPS) whereas the summer sample from highly populated area (HPS) was found most diverse among all as indicated by taxonomic diversity analysis. The QIIME output files were used for PICRUSt analysis to assign functional attributes. The samples exhibited a significant difference in their microbial community composition and structure. Comparative analysis of functional pathways indicated that the anthropogenic activities in populated areas and higher summer temperature, both decrease functional potential of the Lake microbiota. This is probably the first study to demonstrate the comparative taxonomic diversity and functional composition of an urban freshwater lake amid its highly populated and least populated areas during two extreme seasons (winter and summer).

Ni(II) porphyrins having fused –NH group were synthesized and characterized by various spectroscopic techniques. The fused porphyrins 1 and 2 were used to detect species of opposite polarity. 1 was used to sense toxic anions viz. cyanide and fluoride ions whereas 2 was used for detecting some selective metal ions including toxic mercury(II) ions. 1 is having acidic –NH proton, which detects anions via hydrogen bonding interactions followed by anion-induced deprotonation. On the other hand, 2 senses the metal species via weak charge transfer interactions from oxygen atom of the formyl group to the added metal ions. The limit of detection was calculated in case of 1 as 2.13 and 3.15 ppm for cyanide and fluoride ions, respectively. Similarly, the detection limit was found to be 0.930, 2.231, and 0.718 ppm for Cu(II), Fe(III), and Hg(II) ions, respectively, for probe 2. The probes were recovered and reused for several cycles.

Background: In the intricate tapestry of food security, wild food species stand as pillars, nourishing millions in low-income communities, and reflecting the resilience and adaptability of human societies. Their significance extends beyond mere sustenance, intertwining with cultural traditions and local knowledge systems, underscoring the importance of preserving biodiversity and traditional practices for sustainable livelihoods. Methods: The present study, conducted between February 2022 and August 2023 along the Line of Control in India's Kashmir Valley, employed a rigorous data collection encompassing semi-structured interviews, focus group discussions, and specific field observations facilitated through a snowball sampling technique. Results and discussion: The comprehensive inventory includes 108 edible plant and fungal species from 48 taxonomic families, with Rosaceae (N = 11) standing out. Young and soft leaves (N = 60) are an important component of various culinary preparations, with vegetables (N = 65) being the main use, followed by fruits (N = 19). This use is seasonal, with collection peaks in March–April and June–August (N = 12). The study also highlights the importance of use value (UV), with Portulaca oleracea standing out as the plant taxon (UV = 0.61), while Asyneuma thomsoni has the lowest use value (UV = 0.15). Many species such as Senecio chrysanthemoides, Asperugo procumbens, Asyneuma thomsoni, and Potentilla nepalensis were classified as new for gastronomic use. Furthermore, the study underlines the great cultural importance of mushrooms such as Morchella esculenta and Geopora arenicola in influencing social hierarchies within the community. However, the transmission of traditional knowledge across generations is declining in the region. At the same time, the conservation of endangered plant species on the IUCN Red List, such as Trillium govanianum, Taxus wallichiana, Saussurea costus, and Podophyllum hexandrum, requires immediate attention. Conclusion: Conservation measures should be prioritized, and proactive remedial action is needed. Further research into the nutritional value of these edible species could pave the way for their commercial cultivation, which would mean potential economic growth for local communities, make an important contribution to food security in the area under study, and contribute to scientific progress. [ABSTRACT FROM AUTHOR]

Relationship marketing together with perceived switching costs are seen as a distinguished strategic approach to customer loyalty. Relationship marketing practices enable the firms to comprehend and satisfy the customer needs, while the perceived switching costs raise the bar for rivals to grab the gullible customers and helps the firms to ensure the loyalty of low satisfied customers. In view of this, present study aims to investigate the impact of relationship marketing practices on customer loyalty with a mediating role of perceived switching costs. The study utilized 736 complete questionnaires collected from the bank customers, by using one-stage cluster sampling, to validate the measurement and structural models through partial least-square structural equation modeling (PLS-SEM). Results revealed that there is significant positive effect of relationship marketing practices on customer loyalty. Furthermore, perceived switching costs have significant positive effect on customer loyalty. Bootstrapping approach to mediation analysis revealed that perceived switching costs, in unison, partially mediate the relationship between relationship marketing practices and customer loyalty. The study suggests that banks should invest more in relationship marketing practices to strengthen the perceived switching costs to keep the customers loyal to the organization. [ABSTRACT FROM AUTHOR]