The use of electronic cigarettes, or vapes, as a substitute to conventional smoking has surged noticeably among young individuals in recent years. Because they believe it is more secure or less dangerous, many people utilize it.1,2 Studies have, however, demonstrated how vaping is contributing to hidden oral health problems and damaging young smiles.According to a cross-sectional study conducted on high school students in California, vaping use is a risk factor for xerostomia. Through a 12-months follow-up, The study assessed how e-cigarettes, cannabis, and tobacco affected young adults. The findings pointed out that 54% of the sample who consumed these resources reported regular xerostomia (consumption >5 days/month) and sporadic complaints of dry mouth (consumption <5 days/month).3The findings of a systematic review that reviewed eight human case controls studies on the link between vaping and periodontitis indicate that e-cigarette users had more deposits of plaque, deeper pockets, less marginal bone, and less bleeding on inspection (a common sign of gum disease-which may delay early detection and treatment) than non-smokers.4 Similarly, another study reported poorer oral hygiene indices, higher plaque accumulation, and increased gingival bleeding among vapers, further supporting the adverse impact of e-cigarette use on periodontal health.1Propylene glycol, found in e-liquids, along with sweeteners and flavorings,5 can reduce saliva production, cause halitosis and xerostomia, lower mouth pH, and promote harmful bacteria like Streptococcus mutans to grow, leading to tooth damage.4Nicotine in vape smoke constricts oral blood vessels, reducing oxygen flow.6 It also creates harmful reactive oxygen species. Depending on the brand, producers say a cartridge can deliver anywhere from 10 to 250 puffs, or five to thirty cigarettes.7 Vapors (temperature reaching 40-65°C) can thicken the oral mucosa, leading to lesions. Vaping disrupts saliva production due to toxic ingredients.8According to a recent research in Saudi Arabia, more than half of students recognized that e-cigarettes could lead to nicotine dependence, but 62% of them thought they were fashionable substitutes for regular cigarettes.9 These views imply that peer-driven ideas of image and lifestyle, in addition to marketing, influence the allure of e-cigarettes.In conclusion, many young people are attracted to vaping because of its perceived social appeal, often without recognizing its potential oral health consequences. Dental curricula rarely address vaping-related oral pathology in depth, leaving future dental professionals inadequately prepared to identify and manage these conditions. Furthermore, vaping history is frequently omitted from routine dental records, potentially delaying diagnosis and intervention. Greater awareness enhanced dental education, and systematic screening for vaping behaviors are needed to protect the oral health of young populations.
Dear Editor Pakistan is one of the countries where gender inequality is a major issue impacting all walks of life, from nutrition to healthcare and education to employment.1 In the context of the medical field, every year almost 80% of the medical graduates in Pakistan are females, out of which 50% are unable to practice medicine after completing their degrees.2 A study shows that 6 out of 10 female post graduates are unemployed. Another survey by the Labour Force states that compared to 64% males, only 18% females are employed. The statistics might be misleading to the disappointment that female doctors do not focus on their careers but one should not forget that the decision to quit career isn't always made out of free will.3 Despite years of hard work and continuous efforts to excel academically, women find themselves shackled by the traditional norms which assign them gender roles restricting their medical practice. Certain cultural norms act as barriers for Pakistani female doctors to practice medicine, including early marriage, cultural expectations, family responsibilities, gender discrimination at workplaces and challenges in work life balance.4 Traditionally, women are expected to perform their assigned gender roles, and that means to put their careers on hold. This gender disparity not only wastes the career potential of female doctors but also deprives the healthcare system of many health professionals.3 In a developing country like Pakistan, where medical sector is already suffering, this loss adds up to the problems exponentially. The government spends about 2.5 million rupees on each medical student. According to a report, state had lost around 200 billion rupees because 35,000 female doctors quit their medical practice. A multifaceted approach is required to tackle this issue. Firstly, families need to be educated about the importance of pursuing careers for women and how it can help financially in this inflation. Flexible working hours and telemedicine opportunities can be provided to facilitate work life balance for doctors. At national level, policies should be introduced requiring doctors who have studied in government medical colleges to work in public healthcare institutions until they've paid off the subsidy received for their education. In conclusion, fostering a supportive environment for female doctors to focus on their careers will be a great step towards women empowerment as well as improved healthcare services and accessibility.
Musculoskeletal disorders remain a major contributor to injury, functional limitation, and long-term disabilityworldwide. This viewpoint explores emerging approaches to soft tissue mobilization, with a particular focus on sound-assisted soft tissue mobilization (SASTM) as a novel physiotherapy intervention. A broad review of the literature was undertaken, encompassing all available forms of evidence on soft tissue mobilization techniques without restrictions on study design or database source. Instrument-assisted soft tissue mobilization (IASTM), SASTM, manual cross-fiber massage, and related techniques are widely integrated into contemporary rehabilitation programs. Both IASTM and SASTM operate on similar biomechanical principles, applying controlled mechanical forces to soft tissues to disrupt adhesions, enhance local circulation, and facilitate tissue healing. While IASTM employs steel-based instruments to detect and treat soft tissue restrictions through tactile feedback, SASTM utilizes ceramic polymer tools that identify tissue irregularities through sound-based feedback. Although each modality has defined indications and contraindications, SASTM may offer greater specificity in targeting adhesions. Nevertheless, its application should remain adjunctive, used alongside established therapeutic interventions and only by appropriately trained practitioners in accordance with prevailing professional regulations and state bylaws.
Objectives: To investigate the neuroprotective effects of resveratrol against combined neurotoxicity induced by aluminum (Al), lead (Pb), and arsenic (As) were randomized into three groups (n=10 each): control, metal mixture (Al+As+Pb; 25 mg/kg/day, oral), and metal mixture plus resveratrol (20 mg/kg/day in feed) for 60 days. Cognitive performance was assessed using the Ymaze and Morris water maze (MWM). Gene expression of synaptophysin, postsynaptic-density-protein-95 instead if and CaMKIV in cortex and hippocampus was evaluated by qPCR using the 2<^>-Delta Delta CT method. In-silico target prediction and network pharmacology were performed using Swiss Target Prediction, CTD, and GeneCards; intersecting targets were analyzed via STRING and Cytoscape, followed by GO/KEGG enrichment (DAVID/ShinyGO). Molecular docking (AutoDock Vina) assessed binding of resveratrol with IL6, TNF, IL1-(3, synaptophysin, CaMKIV, and PSD-95. Results: Network pharmacology identified 269 intersecting targets; hub genes included IL6, TNF, and IL1-(3. Enrichment analysis highlighted pathways related to inflammation, apoptosis regulation, PI3K-Akt, MAPK, and neurodegeneration. Docking showed strong affinity with CaMKIV (-8.1 kcal/mol) and moderate affinity with IL6 (-6.8), IL1-(3 (-6.9), and PSD-95 (-6.5). In-vivo, the metal mixture impaired memory in Y-maze and MWM, while resveratrol significantly improved performance. Metal exposure downregulated synaptophysin, PSD-95, and CaMKIV expression in cortex and hippocampus; resveratrol partially to markedly restored expression. cognitive performance and synaptic gene expression, potentially through multitarget modulation of inflammatory and neurodegenerative pathways.
Objective: To estimate age-specific incidence patterns and trends in breast cancer molecular subtypes in a local hospital-based population. Methods: This retrospective cross-sectional study was conducted at Akbar Niazi Teaching Hospital, Islamabad, from August 2022 to August 2024. One hundred women aged >= 20 years with biopsy-proven breast cancer were included through convenience sampling. Male patients, lobular carcinoma, phyllodes tumors, sarcoma/lymphoma, and cases with missing age data were excluded. Demographic, clinical, pathological, and treatment data were extracted from hospital records. Tumors were classified into luminal A, luminal B, human epidermal growth factor receptor-2 (HER2)-enriched, and triple-negative subtypes using immunohistochemistry and Fluorescence in situ hybridization where required. Statistical analysis was performed using SPSS v25. Chi-square test assessed associations between age groups and tumor subtypes, while linear regression estimated age-related incidence trends. Results: Mean age was 50.5 +/- 12.0 years (range: 20-75). Breast cancer occurred in 47% of women aged <= 50 years and 53% in those >50 years. Luminal A was the most frequent subtype (55%), followed by triple-negative (25%), luminal B (15%), and HER2-enriched tumors (5%). Hormone receptor status showed no significant association with age (p>0.05). A significant association was observed between age groups and molecular subtypes (p=0.043), driven primarily by the luminal A subtype after Bonferroni correction. Age was not an independent predictor of breast cancer on regression analysis. Conclusion: Nearly half of breast cancer cases occurred in women aged <= 50 years. Luminal A was the predominant subtype and showed significant age-related variation, emphasizing the need for age-stratified screening and subtype-focused management strategies.
