The aim of the study was to study the microbiological features and the level of antibiotic resistance in patients with urolithiasis on the background of combined traumatic injuries. Materials and methods. A clinical and microbiological study of 126 patients with urolithiasis was conducted, of which 78 patients had combined injuries. Clinical, laboratory, instrumental and microbiological studies were performed. The identification of microorganisms was carried out by bacteriological and molecular genetic methods with determination of sensitivity to antibacterial drugs and assessment of the ability to biofilm formation. Results. Severe infectious and inflammatory complications of the urinary tract prevailed in patients with combined injuries. The structure of pathogens was dominated by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa. A high level of antibiotic resistance to third-generation cephalosporins and fluoroquinolones was revealed. A significant prevalence of extended-spectrum beta-lactamases and carbapenem-resistant strains has been established. More than 68% of clinical isolates had a pronounced ability to biofilm formation. Patients in the main group were significantly more likely to develop urosepsis, septic shock, and other severe complications. Conclusion. The combination of urolithiasis and severe trauma is accompanied by a high prevalence of polyresistant hospital microflora and a severe course of infectious complications. The results obtained confirm the need for continuous microbiological monitoring, rational antibacterial therapy and the introduction of antimicrobial control programs..
The combination of urolithiasis and diabetes mellitus is accompanied by an increased risk of urinary tract infections, changes in the microbiological spectrum of pathogens and an increase in antibiotic resistance. Studying the characteristics of antibiotic sensitivity in this category of patients is important for optimizing empirical antibacterial therapy. To study the microbiological profile of urinary tract infections and determine their sensitivity to antibacterial drugs in patients with urolithiasis complicated by diabetes mellitus. A retrospective study of 120 patients with urolithiasis was conducted, of which 60 patients had concomitant type 2 diabetes mellitus, and 60 formed a comparison group. All patients underwent bacteriological examination of urine with identification of pathogens and determination of sensitivity to antibacterial drugs in accordance with the recommendations of EUCAST. Statistical data processing was performed using the IBM SPSS Statistics 27.0 program. Differences at p < 0.05 were considered statistically significant. The most frequently isolated pathogen was Escherichia coli (41.4% and 52.8%, respectively), however, Klebsiella pneumoniae, Pseudomonas aeruginosa and multidrug-resistant microorganisms were significantly more often detected in patients with diabetes mellitus. The greatest sensitivity of microorganisms was noted to carbapenems (96.6%), fosfomycin (93.1%), amikacin (91.4%) and nitrofurantoin (89.7%). The highest resistance was registered to ampicillin (72.4%), ciprofloxacin (43.1%) and co-trimoxazole (46.6%). In patients with diabetes mellitus, strains producing extended-spectrum beta-lactamases were more often detected, and longer hospitalization was noted. Diabetes mellitus has a significant impact on the microbiological profile of urinary tract infections in patients with urolithiasis and is associated with an increased prevalence of antibiotic-resistant microorganisms. The results obtained confirm the need for a bacteriological study to determine antibiotic sensitivity before prescribing antibacterial therapy and can be used to improve regional algorithms for the treatment of urinary tract infections
Genetics explains a great deal of variation seen in the population when facial deformities and malocclusions are considered. However, genetics is not synonymous of a deterministic concept in which a single gene, segregating in families, determines malocclusion. These monogenic models explain very few cases of malocclusion and the other human diseases, as well as traits such as height, weight, amount of sugar in the circulating blood, blood pressure, intelligence, behavior, and sexual orientation. All these traits, as well as the majority of human diseases and congenital defects, have complex or multifactorial modes of inheritance, which can be influenced by the environment, and determine the presence of the majority of traits and diseases...
Oropharyngeal candidiasis is one of the most common local complications of long-term therapy with inhaled glucocorticosteroids. Despite the high clinical significance of this pathology, the issues of its prevalence, clinical manifestations and species composition of pathogens in patients with chronic respiratory diseases remain insufficiently studied. The purpose of the study. To study the clinical and mycological features of oropharyngeal candidiasis in patients receiving inhaled glucocorticosteroids for a long time. Materials and methods. A single-stage observational study was conducted with the participation of 120 patients who had been receiving inhaled glucocorticosteroids for bronchial asthma and chronic obstructive pulmonary disease for a long time. All the examined patients underwent a clinical examination of the oral and oropharyngeal mucosa, medical history collection and mycological examination of smears followed by identification of fungi of the genus Candida. Statistical data processing was performed using the IBM SPSS Statistics 26.0 program, and differences were considered statistically significant at p < 0.05. Results. Oropharyngeal candidiasis was diagnosed in 34 (28.3%) patients. The most common clinical form was pseudomembranous candidiasis (58.8%). Mycological examination revealed Candida albicans (70.6%) most frequently, Candida glabrata (14.7%), Candida tropicalis (8.8%) and Candida parapsilosis (5.9%) less frequently. It has been established that the development of candidal infection is significantly associated with the use of high doses of inhaled glucocorticosteroids, the duration of therapy for more than five years and non-compliance with preventive measures. The use of a spacer and mouthwash after inhalation were accompanied by a decrease in the incidence of candidiasis. Conclusion. Long-term therapy with inhaled glucocorticosteroids is a significant risk factor for the development of oropharyngeal candidiasis. A comprehensive clinical and mycological examination of patients makes it possible to detect the disease in a timely manner, and compliance with preventive measures helps to reduce the frequency of candidal lesions of the oral and oropharyngeal mucosa
Background: This requires substantial support and resources in chemical waste management and recycling, such as automated technology, chemical data management systems, advanced materials, etc. The growing need for efficiency and sustainability in waste management systems is leading industries to adopt IoT-based applications in monitoring and optimizing chemical waste disposal and recycling systems. For instance, IoT-based techniques are adding real-time tracking, automated segregation, and predictive analytics, which can help make waste management much more efficient. Despite their benefits, myriad challenges remain to the adoption of IoT-enabled systems, including high implementation costs, regulatory inconsistencies, technical expertise gaps, and data security concerns. Tackling these issues is essential to improving waste management practices, ensuring compliance with regulations, and promoting environmental sustainability. Aim: The current paper investigates the trends, problems, and future directions in chemical waste management and recycling optimization with IoT-based approaches. It specifically explores the knowledge, level of use, and perceived effectiveness of IoT-based waste management systems, where it also aims to determine whether there are barriers and factors that influence the widespread implementation of IoT-based waste management systems. The findings of the study will inform the industries, policymakers, and the environmental agencies to encourage or accelerate the adoption of the IoT in waste management and propel the sustainable waste disposed of solutions. Methodology: Based on structured survey interviews with 110 respondents, including representatives from chemical industries, waste management companies, environmental non-government organizations, government agencies, and academic researchers. The study employed a cross-sectional mixed-methods design, integrating both quantitative and qualitative data for a comprehensive evaluation of IoT implementation in chemical waste management. Descriptive and inferential statistical analyses were used to assess awareness levels, adoption rates, challenges, and perceived benefits of IoT-assisted waste management. In order to position the findings in the context of existing literature, a systematic literature review was also conducted focusing on smart waste tracking, hazardous waste management, and IoT use cases for sustainability. Findings: The paper provides important insights to characterize the status of IoT-enabled waste management by finding out the awareness level about the IoT-based waste management along with its adoption barriers. While 58% of the respondents were aware of IoT-enabled waste tracking, only 30% had implemented IoT within their organizations. According to the report, regulatory compliance requirements (50%), cost efficiency (45%), and sustainability goals (40%) were the primary factors driving IoT adoption in waste management. The most important barriers identified were high implementation costs (50%), lack of technical expertise (40%), and concerns around data privacy and security (35%). Respondents believed that 55% of respondents said government incentives like grants and standard regulatory frameworks (48%) would greatly increase adoption rates. Conclusion: But to facilitate broader adoption, we need to solve for the cost, technical and regulatory challenges. The results underscore the role of tailored financial motivations, supportive government laws, and sectoraliszied training initiatives in adopting the use of IoT in waste management. Further work can address cost-benefit analysis, case studies in paradigm shift in implementing IoT-based systems and frameworks on secure, scalable and smart waste management. Transforming chemical waste management into a smart and eco-friendly system will require collaboration across sectors, between industries, policymakers, and technology providers
Nursing is a cornerstone of health systems in diverse countries all over the world functioning as a key interface between patients and an ever-complicated medical care. The profession of nursing has over time evolved to include more than just the traditional bedside care to entail more aspects such as advanced clinical judgement, patient advocacy, health promotion, and evidence-based practice. The long-term presence of nurses in the variety of care environments helps them to meet the clinical and psychosocial needs of patients, which creates a powerful impact on the health outcomes, safety, and patient satisfaction. The reason behind this review is the changing and complex nature of the roles of nursing across the health care continuum, which include acute care, chronic disease management, preventive services, and emergency response. It outlines the role of modern nursing in quality improvement, efficiency, and patient-centered care in hospitals, community settings, and the public health settings. Health-care organizations and policymakers aiming to maximize the delivery of services and attain sustainable improvements in global health outcomes must have a comprehensive understanding and fortification of the nursing role...
Nursing is a significant element that allows the improvement of the care of patients throughout the health-care continuum, which is achieved by direct clinical care, care coordination, education, and advocacy. As health-care systems become more and more complex, nurses are faced with significant challenges of workforce shortages, burnout, increasing patient acuity, job role ambiguity, and the rapid pace of technological change, all of which have the potential to negatively impact patient outcomes. It is a review of the main issues that interfere with nursing practice and questions evidence-based solutions to it such as optimum staffing, lifelong learning, inter professional collaboration, and patient-centred care models that can be used to enhance care quality and safety. Also, the review outlines the latest advancements in the nursing practice, including health information technologies, telehealth services, and advanced nursing roles, which have enabled the expanded access to care, and increased efficiency and continuity. The review highlights the need of continuous investment in nursing education and leadership and positive policy frameworks, which strengthens the nursing workforce and ensures high-quality, safe, and patient-centred delivery of health-care.
Background:Psychological resilience is increasingly recognized as a critical protective factor against stress-related disorders and trauma. Emerging evidence suggests that yoga, as a multidimensional mind-body intervention, promotes adaptive neuroplasticity through modulation of neural, endocrine, and autonomic pathways. However, empirical evidence linking yogic pranayama with resilience, mindfulness, cognitive flexibility, and psychological well-being within a unified neuroplasticity framework remains limited. Aim and Objective:Aim: To evaluate the impact of yogic pranayama on psychological resilience, mindfulness, cognitive flexibility, and subjective well-being among healthy adults. Objective: To assess the overall effectiveness of yogic pranayama in enhancing psychological resilience, mindfulness, cognitive flexibility, and subjective well-being. Methods:A single-group pre-post experimental design was employed involving thirty healthy adult participants (15 males and 15 females). Participants completed a standardized 40-minute yogic pranayama every day for 40 consecutive days, consisting of yogic way of pranayama practices. Psychological outcomes were assessed before and after the intervention using internationally validated instruments including the Connor-Davidson Resilience Scale (CD-RISC-25), Mindful Attention Awareness Scale (MAAS), Cognitive Flexibility Inventory (CFI), and WHO-5 Well-Being Index. Data analysis included descriptive statistics, Shapiro-Wilk normality testing, paired t-tests, Cohen's d effect size estimation, Pearson correlation analysis, and exploratory regression modelling. Results:The 40-day pranayama intervention was completed by all 30 participants, with a 100% completion rate and no dropouts. Positive and statistically significant improvements were observed in resilience (58.47 ± 8.21 to 71.36 ± 6.94), mindfulness (53.28 ± 7.34 to 66.41 ± 6.18), cognitive flexibility (82.91 ± 9.12 to 95.58 ± 7.41), and psychological well-being (57.73 ± 10.25 to 73.52 ± 8.63), with all outcomes showing p < 0.001 and large effect sizes. Strong positive correlations were found among all psychological variables, and regression analysis showed that resilience, mindfulness, and cognitive flexibility significantly predicted psychological well-being, explaining 75.9% of the variance. Conclusion:The findingsof this pilot study provides preliminary evidence that a 40-day yogic pranayama may facilitate psychological resilience through mechanisms consistent with neuroplasticity adaptation. Although direct neuroimaging was not performed, behavioural improvements in resilience, mindfulness, and cognitive flexibility suggest enhanced adaptive functioning. These findings support the integration of yoga into preventive mental health programs and trauma-informed care while highlighting the need for larger randomized controlled trials incorporating neuroimaging biomarkers to validate the neuroplasticity mechanisms underlying yoga-based interventions...
Background and Objective: Pulmonary tuberculosis (PTB) exhibits some parameters of clinical, microbiological, and laboratory variability that can be associated with radiologic involvement of the lungs. These associations can enhance prompt identification and treatment, which is primarily applicable to comorbid patients. Thus, this paper evaluated the radiological distribution of lung involvement in the suspected PTB patients and investigated the correlation among the radiological distribution with the demographic characteristics, clinical manifestations, microbiological findings, blood hematological and fasting blood sugar concentrations. Methodology: This analytical research was undertaken in institute of Basic Medical Sciences (IBMS), Khyber Medical University in a cross-sectional manner. One hundred three (n=103) patients with pulmonary tuberculosis and aged over 18 years were involved and divided into three categories based on the chest radiographs: upper (n = 35), middle (n = 31) and lower (n = 37) zone pulmonary involvement. Demographic information, clinical symptoms, medical history, and comorbidity was noted. Microbiological tests involved the differential counts of bronchoalveolar lavage, cytology, Gramme staining, Ziehl-Neelsen staining and AFB culture. Hematological parameters (TLC and ESR) and fasting blood sugar levels were measured. Continuous variables were analyzed using Kruskal Wallis test, and categorical variables using Chi-square or Fisher’s exact test. Results: The study findings showed that the mean age of patients was an insignificantly associated across the three groups (upper: 49.88 ± 13.6 years; middle: 49.71 ± 13.71 years; lower: 50.0 ± 12.12 years; p=0.981). Cough was reported in 103(100%) and fever was present in 34 (97.1%) patients with upper zone involvement, 30 (96.8%) with middle zone involvement, and 36 (97.3%) with lower zone involvement, showing no significant difference among the groups (p=1.000). Cytology and AFB culture, showing no significant differences among radiological groups. Fasting blood sugar was elevated in 31(83.8%) patients with lower zone involvement, compared to 10(28.6%) in the upper zone and 11(35.5%) in the middle zone (p<0.001). Conclusion: This study concluded that radiological lung involvement in TB is mainly independent of demographic, clinical, microbiological, and hematological parameters, with the exception of a strong association between lower zone disease and diabetes mellitus...
Training plays a crucial role in improving employee performance, particularly in the automobile industry, where technological advancements and quality standards are constantly evolving. This study aims to explore the key factors influencing training effectiveness and their impact on employee performance. The research employs a mixed-method approach, combining surveys and interviews with employees and training managers from leading automobile firms. The findings suggest that structured training programs, management support, technological integration, and continuous learning significantly enhance employee productivity, efficiency, and job satisfaction
Psoriasis is a chronic inflammatory skin disorder characterized by keratinocyte hyperproliferation, oxidative stress, and immune dysregulation. Quercetin, a flavonoid with potent antioxidant and anti-inflammatory properties, holds promise for psoriasis management; however, its topical application is limited by poor water solubility and low skin permeability. This study reports the development of a novel quercetin phytosome-based topical hydrogel designed to enhance quercetin bioavailability and therapeutic efficacy for psoriasis treatment. Phytosome technology facilitates the complexation of quercetin with phospholipids, improving skin penetration and stability. The optimized phytosomal formulation exhibited nanoscale particle size, favorable zeta potential, and high encapsulation efficiency, ensuring effective quercetin delivery. Incorporation into a hydrogel base provided sustained release, improved skin retention, and enhanced antioxidant activity, as confirmed by in vitro and ex vivo analyses. Furthermore, the hydrogel demonstrated significant anti-inflammatory effects by modulating key cytokines and signaling pathways implicated in psoriasis pathogenesis. Preclinical evaluations revealed the hydrogel’s efficacy in reducing epidermal hyperplasia and oxidative stress biomarkers without skin irritation. This innovative quercetin phytosome hydrogel offers a promising, safe, and effective topical strategy for managing psoriasis by targeting both inflammation and oxidative damage...
Adhimantha is a severe Sarvagata Netra Roga described in Ayurvedic classics, characterized by intense churning pain in the eye, progressive diminished of vision, headache, and eventual blindness if not managed timely¹–⁴. The condition is considered a complication of untreated Abhishyanda and shows close clinical correlation with glaucoma, a progressive optic neuropathy leading to irreversible visual field defects. Adhimantha is predominantly a Vata-pradhana Tridoshaja disorder involving Rasa, Mamsa, and Majja Dhatu, resulting in degeneration of optic nerve structures. A 29-year-old female patient diagnosed with glaucoma presented with bilateral progressive diminished of vision, periorbital swelling, headache, and ocular itching for two years despite using topical anti-glaucoma medication. Based on Ayurvedic evaluation, the condition was diagnosed as Adhimantha. The patient was managed with an integrated Ayurvedic approach including Panchtikta Kshir Basti, Marsha Nasya, Tarpana, Shiropichu, Anjana, Aschyotana, and appropriate oral Shamana Aushadhi. After completion of treatment, improvement in visual acuity, reduction in symptoms, and mild increase in retinal nerve fiber layer thickness were observed, indicating stabilization of disease progression. The therapeutic effect can be attributed to pacification of aggravated Vata Dosha, removal of Srotorodha, nourishment of Majja Dhatu, and Chakshushya Rasayana action of the therapies employed⁵–⁷. This case highlights the potential role of Ayurveda in preventing further optic nerve damage and improving quality of life in patients with Adhimantha (glaucoma)
Background: Gestational Diabetes Mellitus (GDM) is associated with maternal metabolic disturbances, particularly insulin resistance, leading to structural and functional alterations in the placenta. These changes can be evaluated through histomorphological and radiological assessment. Objective: To evaluate placental histomorphological and radiological changes in GDM and determine their association with maternal insulin resistance. Methods: This comparative cross-sectional study included 80 pregnant women (40 diagnosed with GDM and 40 normoglycemic controls). Maternal insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Antenatal placental evaluation was performed using obstetric ultrasonography, assessing placental thickness, grading, and vascularity. Placental tissues were collected after delivery and examined histologically for villous immaturity, syncytial knots, fibrinoid necrosis, chorangiosis, and intervillous hemorrhage. Results: Radiological assessment revealed significantly increased placental thickness in the GDM group (4.6 ± 0.7 cm) compared to controls (3.8 ± 0.5 cm, p < 0.001). Advanced placental grading (Grade III before 37 weeks) was observed in 42.5% of GDM cases versus 12.5% of controls (p = 0.002). Increased placental vascularity on Doppler was noted in 60% of GDM cases compared to 22.5% in controls (p < 0.001). Histologically, syncytial knots were present in 72.5% of GDM placentae versus 32.5% of controls (p < 0.001), villous immaturity in 65% vs 27.5% (p = 0.002), chorangiosis in 55% vs 20% (p = 0.001), fibrinoid necrosis in 60% vs 25% (p = 0.003), and intervillous hemorrhage in 47.5% vs 17.5% (p = 0.004). Mean HOMA-IR levels were significantly higher in the GDM group (4.8 ± 1.2) compared to controls (2.1 ± 0.9, p < 0.001). A strong positive correlation was observed between HOMA-IR and placental thickness (r = 0.59), vascularity (r = 0.61), syncytial knot density (r = 0.62), and villous immaturity (r = 0.58), all statistically significant (p < 0.01). Conclusion: GDM is associated with significant radiological and histomorphological placental alterations, strongly correlated with maternal insulin resistance. Combined imaging and histological evaluation provides a comprehensive understanding of placental pathology in GDM and may aid in early identification of high-risk pregnancies and improved maternal-fetal outcomes..
Introduction: Oral health problems, particularly dental caries and poor hygiene, are highly prevalent among school-going children in Pakistan. School-based interventions offer a practical approach to promote preventive oral health behaviors and reduce disease burden at an early age. Methodology: A quasi-experimental study was conducted among 300 children aged 6–12 years in selected schools of Karachi, Pakistan. A multistage sampling technique was used. Baseline data on oral hygiene practices and clinical parameters (DMFT/dmft and OHI-S indices) were collected, followed by a 3-month school-based dental intervention including oral health education, supervised toothbrushing, and screening. Post-intervention assessment was conducted using the same measures. Data were analyzed using SPSS version 26. Descriptive Statistics, Paired t-test, and Chi-square test were applied, with p<0.05 considered significant. Results: Significant improvements were observed in oral hygiene practices, with the proportion of children brushing twice daily increasing from 38% to 76% (p<0.001). Use of fluoride toothpaste increased, while sugary snack consumption decreased significantly (p<0.001). Mean DMFT/dmft scores reduced from 2.84 ± 1.12 to 2.10 ± 1.05, and OHI-S scores improved from 2.35 ± 0.76 to 1.42 ± 0.68 (p<0.001younger There was an increased improvement of behavior in children (p=0.041). Conclusion: School based dental programs have shown to be effective in enhancing oral-hygiene behavior and clinical outcomes among children and needs to be incorporated into the public health initiatives in Pakistan.
Vitamin A which is Retinol Acetate this is simple ,rapid, Quantifying method of vitamin A of different products to make reacting with MBTH reagent at a cold temperature to produce a colored complex which is the basis of an easy-to use and highly sensitive UV-visible spectroscopic approach for the measurement of Vitamin. For colorimetric drug assessment, MBTH Reagent is a chromogenic reagent that contains active methylene groups, phenolic, aromatic amines, and hydroxyl groups. To determine the linearity, precision, robustness, robustness, limit of detection, and limit of quantification, validation was done. A simple, rapid, sensitive methods are used for the determination of Retinol acetate that is added in the food products by using UV-Visible spectroscopy. The method is developed by using chromogenic method (MBTH reagent) according to the ICH Q2(R2) guidelines and With an excellent correlation value (r2) of 0.9988, linear responses were observed in the range of concentrations of 20 µg/ml to 360 µg/ml. The LOD and LOQ were determined at 0.40788 μg/mL & 1.236 µg/ml, respectively.The precision (%RSD ≤ 2) found to be in acceptable limits. The chromogenic method were developed and validated which was extended to food samples that contain high amount of Vitamin A and Quantification of them in food samples
Introduction: Hypertension is a non-communicable disease and a significant risk factor for cardiovascular morbidity and mortality worldwide. The incidence of hypertension in Pakistan is increasing, although community-level statistics about its factors are scarce. This study sought to evaluate the prevalence of hypertension and its related risk factors among individuals in several Pakistani communities. Materials and Methods: A community-based cross-sectional study was performed from January to June 2024. A total of 88 participants aged 18 years and older were recruited by multistage sampling. Information regarding socio-demographic variables, lifestyle practices, medical history, and family history was gathered utilizing a pre-tested structured questionnaire. Blood pressure and anthropometric data were acquired using defined protocols. Hypertension is characterized by a systolic blood pressure of ≥140 mmHg, a diastolic blood pressure of ≥90 mmHg, or the current administration of antihypertensive medication. Data were evaluated utilizing SPSS v25, and logistic regression was employed to ascertain independent risk factors. Results: The total prevalence of hypertension was 34.1% (30 out of 88). It was more prevalent among participants aged 45 years and older, those with a BMI of 25 kg/m² or above, and persons with low levels of physical activity. Smoking and a positive family history were substantially correlated with hypertension in bivariate analysis, although gender exhibited no significant correlation. In multivariable analysis, age ≥45 years (AOR = 3.12), BMI ≥25 kg/m² (AOR = 2.85), and low physical activity (AOR = 2.67) were identified as independent predictors of hypertension, with the total regression model demonstrating statistical significance and accounting for 34% of the variance in hypertension status. Conclusion: Hypertension is prevalent among Pakistani adults, with modifiable risk factors including obesity and inactivity. Community-based screening and lifestyle interventions are essential to reduce its burden, and larger studies are needed to inform targeted prevention strategies..
Rajonivriti Awastha is a natural physiological stage in a woman’s life where menstrual cycle gradually stops due to age-related decline in reproductive function. In modern science, this condition is understood as menopause, usually associated with hormonal changes and symptoms such as hot flushes, mood changes, sleep disturbance, vaginal dryness, fatigue, joint pain, weight gain, and psychological instability. In Ayurveda, Rajonivriti is not described as a disease, but as a natural stage of life occurring mainly due to Jara Awastha, Dhatukshaya, predominance of Vata Dosha, and gradual decline of Artava. The symptoms seen during menopause can be understood through imbalance of Vata Dosha, associated involvement of Pitta Dosha, depletion of Rasa Dhatu, Rakta Dhatu, Meda Dhatu, Asthi Dhatu, and disturbance of Manas. Proper understanding of Rajonivriti Awastha helps in planning preventive, promotive, and supportive care for women during this transitional phase. Ayurveda gives importance to Rasayana, balanced Ahara, proper Vihara, mental relaxation, Abhyanga, Yoga, and lifestyle correction for maintaining health during menopause. This review highlights the Ayurvedic understanding of Rajonivriti Awastha, its relation with menopausal syndrome, probable Samprapti, clinical features, and preventive approach
Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. With advances in radiological imaging techniques, particularly coronary angiography and CT coronary angiography, coronary artery anatomical variations are increasingly recognized as important determinants of cardiovascular outcomes. Objective: To evaluate the association between radiologically detected coronary artery anatomical variations and the risk of CAD in a Pakistani population. Methods: A cross-sectional analytical study was conducted on 220 patients undergoing diagnostic coronary angiography and radiological assessment of coronary anatomy. Coronary artery variations, including anomalies of origin, course, and dominance patterns, were identified through imaging. CAD severity was assessed based on ≥50% luminal stenosis. Statistical analysis included chi-square testing and logistic regression. Results: Coronary artery variations were identified in 34.5% of patients using radiological imaging modalities. The presence of these variations was significantly associated with CAD (p < 0.001). Patients with anatomical variations demonstrated higher odds of significant CAD (OR = 2.38, 95% CI: 1.45–3.91). Conclusion: Radiologically detected coronary artery anatomical variations are significantly associated with increased risk and severity of CAD. Incorporating advanced cardiac imaging techniques into routine evaluation may improve early detection and risk stratification in clinical practice.
Background: Children usually develop significant anxiety before and during the induction of anesthesia because of their separation with parents, unfamiliar environment, and fear of medical processes. High levels of perioperative anxiety can result in ineffective cooperation in the process of anesthesia induction and adverse outcome of behavior after the surgery. The presence of parents at the time of administering anesthesia has been suggested as an adjuvant measure to minimize anxiety in children. Objective: To evaluate the effect of parental presence during anesthesia induction on perioperative anxiety among pediatric patients undergoing elective surgical procedures. Methodology: This is an observational comparative study carried out at Mohi ud Din Teaching Hospital Mirpur, AJK in six months between January 2025 and June 2025. Eighty-two pediatric patients who were electively admitted to undergo general anesthesia surgery were included. The children were split into two categories Group A, the use of parents during induction of anesthesia, and Group B, induction was conducted without the parents. In the preoperative area and the induction period, a scoring system on observational anxiety was used to measure anxiety levels. Inducing behavioral reactions, mask acceptance, emergence agitation and parental satisfaction were also noted. The statistical analysis of data was conducted with the help of proper statistical procedures, and a p-value was used as statistically significant at least 0.05. Results: Children in the parental presence group demonstrated significantly lower anxiety scores during anesthesia induction compared with those in the non-parental presence group. Improved cooperation during mask placement and better behavioral responses were observed among children accompanied by their parents. Furthermore, postoperative agitation was less frequent in the parental presence group, and parental satisfaction scores were significantly higher. Conclusion: Parental presence during anesthesia induction appears to be an effective non-pharmacological strategy to reduce perioperative anxiety in pediatric patients. Incorporating parental support during induction may improve the child’s behavioral response, enhance cooperation during anesthesia administration, and increase parental satisfaction..
Pulmonary disorders, characterized by inflammation and immune dysregulation, represent a significant global health burden with limited effective therapeutic options. This investigation explores the anti-inflammatory and immunomodulatory effects of natural extracts from garlic (Allium sativum), onion (Allium cepa), and lemon (Citrus limon) in pulmonary diseases. Garlic extract, rich in organosulfur compounds such as diallyl trisulfide, exhibits potent suppression of inflammatory pathways including NF-κB and the NLRP3 inflammasome, reducing cytokine production and inflammatory cell infiltration in lung tissues. Similarly, onion extract demonstrates bronchodilatory, antiallergic, and anti-inflammatory properties mediated through cytokine modulation, reduction of Th2 responses, and inhibition of oxidative stress. Lemon extract contributes antioxidative and immune-regulating effects primarily via bioactive flavonoids like hesperidin and eriocitrin, enhancing antioxidant defenses and mitigating inflammatory cytokines in the pulmonary environment. Collectively, these extracts modulate key inflammatory and immunological pathways, including cytokine secretion, inflammasome activation, and oxidative stress, thereby alleviating pulmonary inflammation and enhancing immune homeostasis. This integrative study underscores the therapeutic potential of garlic, onion, and lemon extracts as complementary interventions for pulmonary disorders, warranting further clinical evaluation for safe and effective application in respiratory disease management..
