Abbasi Shaheed Hospital

Obesity is a global health challenge associated with substantial cardiometabolic morbidity. Cagrilintide, a long-acting amylin analogue, alone or in combination with semaglutide (CagriSema), has emerged as a novel pharmacologic strategy for weight management. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of cagrilintide-based therapies in adults with overweight or obesity. A systematic review and meta-analysis of randomized controlled trials was conducted according to PRISMA 2020 and AMSTAR 2. Eligible studies enrolled adults with overweight or obesity randomized to cagrilintide or CagriSema versus placebo and reported at least one efficacy or safety outcome. The primary outcome was percent change in body weight. Secondary outcomes included absolute weight change, waist circumference, blood pressure, glycated hemoglobin (HbA1c), and safety outcomes. Random-effects meta-analyses were conducted, and risk of bias was assessed using the Cochrane RoB 2 tool. Four trials including 5,023 participants were pooled. Cagrilintide significantly reduced percent body weight versus placebo (mean difference − 6.08

BACKGROUND Triple-negative breast cancer (TNBC) is an aggressive subtype with limited therapeutic options, primarily relying on chemotherapy, yet often leading to recurrence due to chemoresistance. Cancer stem cells (CSCs) contribute to tumor heterogeneity, resistance, and poor prognosis, but data in Pakistani populations are scarce. This study hypothesizes that a positive CSC phenotype independently predicts reduced pathological complete response (pCR) and inferior survival outcomes. AIM To investigate CSC markers' association with chemotherapy response and survival in Pakistani TNBC patients. METHODS Retrospective cohort study at Institute of Radiotherapy and Nuclear Medicine, Peshawar, Pakistan, including 256 women with TNBC from January 2015 to December 2022. CSC markers (CD44 high, CD24 low, aldehyde dehydrogenase 1 positive) were assessed via immunohistochemistry on pre-treatment biopsies. Outcomes: pCR to neoadjuvant chemotherapy, overall survival, disease-free survival. Data were analyzed with multivariable logistic regression and Cox proportional hazards models, adjusting for age, tumor grade, and stage. RESULTS The CSC-positive phenotype was identified in 26 patients (10.2%). Compared to negative cases, positive cases had lower pCR rates [5.0% vs 51.8%; adjusted odds ratio = 0.05, 95% confidence interval (CI): 0.01-0.39, P = 0.004]. The positive phenotype was associated with poorer overall survival (adjusted hazard ratio = 4.35, 95%CI: 2.43-7.79, P < 0.001), with a median overall survival of 19 months vs 27 months. No association with disease-free survival was observed (hazard ratio = 0.86, 95%CI: 0.43-1.73, P = 0.675). CONCLUSION CSC markers are associated with reduced chemotherapy response and inferior overall survival in Pakistani TNBC patients. These findings suggest their potential as prognostic biomarkers and highlight the need for future research into targeted strategies, such as proteomic profiling and Proteolysis Targeting Chimeras technology, to overcome chemoresistance in this population.

Manganese ferrite (MnFe2O4, MnF) nanoparticles were synthesized via a co-precipitation route and subsequently surface-functionalized with polyethylene glycol (PEG) through a mass titration method. Structural and morphological analyses (SEM, XRD, EDX, FTIR) confirmed a monophasic cubic spinel structure with an average crystallite size of 23 nm and a slight grain growth after PEG modification. DM simulation revealed the homogeneous grafting of PEG without interfering with the parent spinel structure of MnF. Magnetic measurements (VSM, ZFC) revealed superparamagnetic behavior for pristine MnF (M s = 37.25 emu g-1) and a transition to weak ferromagnetism for PEG@MnF (M s = 22.7 emu g-1), attributed to surface modification. Dielectric studies further highlighted the multifunctional nature of the material. Photocatalytic performance was evaluated via the degradation of thiamethoxam, a widely used pesticide. Under optimal conditions (80 min, 10 ppm, 0.04 g catalyst, 65 degrees C), PEG@MnF exhibited significantly enhanced degradation efficiency compared to unmodified MnF, owing to improved dispersibility, reduced agglomeration, and a higher density of active sites imparted by PEG. Degradation intermediates were identified using GC-MS and FTIR, and a plausible degradation pathway was proposed. These results demonstrate that PEG functionalization markedly improves the magnetic, dielectric, and photocatalytic performance of MnF, establishing PEG@MnF as a promising catalyst for sustainable environmental remediation.

Background Peripheral neuropathy is a common and debilitating complication of type 2 diabetes mellitus (T2DM). Objective To evaluate the relationship between plasma homocysteine levels and the severity of peripheral neuropathy in patients with T2DM. Methods A cross-sectional study was conducted at Sahiwal Teaching Hospital, Sahiwal, from November 2024 to July 2025, involving 325 patients with T2DM. Plasma homocysteine levels were measured, and peripheral neuropathy severity was assessed using the Michigan Neuropathy Screening Instrument (MNSI) and nerve conduction studies (NCS). Results Elevated plasma homocysteine levels (>15 μmol/L) were found in 34.5% of patients. The prevalence of neuropathy increased with higher homocysteine levels, with 44.5% of patients with normal homocysteine levels exhibiting neuropathy, compared to 66.7% in those with mild elevation and 85.7% in those with severe elevation. A positive correlation was observed between homocysteine levels and neuropathy severity (r = 0.42, p <0.001). Multivariate regression analysis identified homocysteine as an independent predictor of neuropathy severity (β = 0.38, p<0.001), along with diabetes duration and glycated hemoglobin (HbA1c). Conclusion Elevated plasma homocysteine levels are associated with increased severity of peripheral neuropathy in T2DM patients. These findings suggest that homocysteine may serve as a biomarker for identifying T2DM patients at risk for severe neuropathy, with potential implications for early diagnosis and therapeutic interventions.

This systematic review synthesizes evidence on biomechanical fracture thresholds of the tibia and fibula under axial and multi-axial loading. A comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library identified six studies, including experimental cadaveric, computational, and material testing investigations, comprising 72 postmortem specimens and validated finite element models. Outcomes assessed included axial force, bending moments, failure load, stress distribution, and fracture patterns. Results indicate that tibial fracture thresholds range from ~7.5 kN in female specimens to 11.3 kN under combined axial and bending loads, with fibula contribution increasing axial tolerance by ~10%. Variance and confidence interval measures were not reported in the included biomechanical studies; therefore, findings are presented descriptively. Multi-axial loading consistently reduced fracture tolerance compared with isolated axial loading, and fracture resistance was influenced by specimen gender, load duration, and biomechanical methodology. Risk of bias ranged from low to moderate across studies. These findings provide clinically relevant benchmarks for injury prediction, preclinical testing, and orthopedic device design, emphasizing the importance of multi-axial assessment in understanding lower-limb fracture mechanics.