Khyber Medical University

In this study, the efficacy of dihydropyrimidine (DHPM) derived nanoparticles (NPs) was evaluated against pathogenic/resistant microorganisms. Nanoparticles of ethyl 6-methyl-4-(3-nitrophenyl)-2-oxo-3,4-dihydrodropyrimidine-5-carboxylate (DHPM 1) were synthesized using the emulsification-solvent-evaporation method and were characterized by dynamic light scattering, ζ potential, and scanning electron microscopy techniques. The efficacy of the parental compound DHPM 1 and its NPs was determined against the multidrug-resistant (MDR) bacteria. It was observed that the DHPM 1 compound exhibited stronger bactericidal effects at a concentration of 5 mg/mL in both the agar-well diffusion and broth microdilution (BMD) assays. However, the bactericidal activity of the corresponding nanoparticles (NPs; 200–260 nm) exhibited markedly higher activity, showing potent antimicrobial effects at substantially lower concentrations (≤ 1.25 mg/mL) against all tested bacterial strains. NPs formation of the DHPM 1 resulted in nearly 3.5-fold reduction in MIC (from ≥ 4.5 mg/mL for the parent compound to ≤ 1.25 mg/mL for the NPs), indicating significantly augmented antibacterial activity compared to the parent compound. This enhanced activity of the dihydropyrimidine-derived nanoparticles relative to their parent compound suggests their potential usefulness in the chemotherapy of pathogenic and drug-resistant microorganisms.

When it comes to root canal therapy, the right working length (WL) must be established in order to minimize material extrusion and the resulting post- procedure pain. Although electronic apex locators (EALs) are a radiation-free, time-saving substitute for conventional or digital radiography techniques, but their impact on postoperative pain has been controversial. This systematic review was registered in PROSPERO (CRD420251247626) and adhered to PRISMA 2020 guidelines. Randomized controlled trials (RCTs) comparing EAL versus radiographic WL determination, with postoperative pain as an outcome, were searched in PubMed, Cochrane CENTRAL, and ScienceDirect from January 2000 to November 17, 2025. Only peer-reviewed RCTs involving permanent teeth were considered. Bias risk was evaluated using Cochrane RoB 2.0. Four RCTs (total n = 414 patients) met the inclusion criteria. Four RCTs (2014–2024) showed no statistically significant difference in postoperative pain incidence, intensity (measured by VAS or 4-point verbal rating scale), analgesic consumption, or time to pain resolution between EAL and radiographic groups at any time point (4 h to 7 days). Pain levels were generally low to moderate and resolved within 72 h in both groups. One three-arm trial demonstrated significantly lower early pain (6–48 h) with a simultaneous/hybrid EAL plus radiographic technique compared with either method alone. No flare-ups or serious adverse events were reported. Based on limited evidence from four RCTs with methodological concerns (including risks in randomization, blinding, and subjective pain assessment) and very low certainty, electronic apex locators and radiographic methods may yield similar postoperative pain outcomes in single-visit root canal treatment of vital teeth. A combined method of both techniques showed preliminary indications of early pain alleviation in one small trial on symptomatic conditions, but this requires confirmation. EALs may represent a radiation free alternative or supplement to radiography that does not appear to increase pain, though the evidence is insufficient to draw firm conclusions.

A chronic disease like diabetes can have long lasting complications if not managed well by the patients. The aim of this study was to explore the relationship between Type D personality and self-management of diabetes. A pilot cross-sectional study was conducted in Qazi Hussain Ahmed medical complex, Nowshera, Pakistan. 42 diabetic patients were enrolled; they were interviewed using standard Type D personality and Diabetes self-management Questionnaire. Chi square test and Pearson correlation were used to find the association between Type D personality and Diabetes self-management. A total of 42 (83.3

Virulence factors can vary between Shigella (S.) flexneri serotypes. The current study characterized virulence genes among 199 S. flexneri from different serotypes in Peshawar, Khyber Pakhtunkhwa Province, Pakistan, by sequence analysis. Moreover, using the homology model, the 3D protein structure of the serine autotransporter toxin (sat) from S. flexneri was examined for the first time to determine structural changes in the mutant sat protein. Interestingly, the present study reported that ial(spa29/spaR) gene has not shown any relationship to the previously known sequence of S. flexneri, but it has a striking resemblance to previously reported cases that were identified in Shigella dysenteriae and Escherichia coli. Furthermore, 15 strains of S. flexneri, all of which are members of serotype 7a, were found to carry the single-point mutation (G246A) in sat, which resulted in an exchange of amino acid (Gly82Arg). Preliminary data reveal a potential link between the sat gene mutation and severe clinical illness patients; however additional study is needed to verify this relation. Overall, the results of the mutant sat proteins homology model validation showed a slight, but not significant, alteration in protein structure.

Abstract Traumatic brain injury (TBI) remains a leading cause of death and long-term disability worldwide, and in severe TBI sustained intracranial hypertension is a major driver of secondary injury; decompressive craniectomy (DC) is widely used to control refractory intracranial pressure, yet optimal timing remains controversial, partly because studies often conflate primary DC performed during index evacuation of a focal mass lesion with secondary (rescue) DC performed for refractory intracranial hypertension after maximal medical therapy. This systematic review synthesised contemporary evidence on DC timing/strategy and outcomes while separating adult and paediatric findings and considering surgical intent. After screening 874 records and assessing 139 full texts, seven cohort studies were included (sample size range 89–2,032) from the USA, China, India, Jordan, Germany, and a multinational collaboration; study quality was moderate-to-high (Newcastle–Ottawa Scale 5–6). In adults, early and/or primary DC generally showed lower mortality and modestly higher favourable functional recovery (GOS 4–5), with the largest cohort reporting reduced mortality for early versus late DC (22.4% vs 28.1%; RR 0.80) and higher favourable recovery at 6 months (41.2% vs 36.8%). Primary-versus-secondary comparisons in adult cohorts demonstrated consistent directional trends favouring primary DC, though precision was limited in smaller studies. In paediatric cohorts, findings diverged, with early DC associated with higher mortality in one study and registry analysis identifying timing as prognostic. Early/primary DC was also associated with shorter ICU and hospital length of stay and fewer ventilator days in the largest adult cohort, while overall complication rates were broadly similar but with differing profiles (more haemorrhagic events in early/primary cohorts and more infection/hydrocephalus reporting in late/secondary cohorts). Overall, adult data support early/primary DC when aligned with appropriate indications, whereas paediatric evidence supports physiology-guided individualisation and caution with rigid time thresholds.