Antimicrobial resistance transmission in the environmental settings through traditional and UV-enabled advanced wastewater treatment plants: a metagenomic insight.

Background: Municipal wastewater treatment plants (WWTPs) are pivotal reservoirs for antibiotic-resistance genes (ARGs) and antibiotic-resistant bacteria (ARB). Selective pressures from antibiotic residues, co-selection by heavy metals, and conducive environments sustain ARGs, fostering the emergence of ARB. While advancements in WWTP technology have enhanced the removal of inorganic and organic pollutants, assessing ARG and ARB content in treated water remains a gap.

Longitudinal Management of Progressive Femoral Deformities in a Pediatric Patient: A Case Study on Adaptative Surgical Interventions and Outcomes.

Introduction: Pediatric femoral deformities present unique challenges in orthopedics, requiring careful management to accommodate ongoing growth and development in young patients. This case report illustrates the longitudinal treatment of a child who experienced multiple complications following an initial femoral neck fracture in a cystic lesion, highlighting the complexity of managing such conditions over time.

Case Report: A 4-year-old child presented in 2016 with a femoral neck fracture and a cystic lesion in the proximal femur, initially managed with valgus osteotomy and dynamic compression plate fixation.

A Case of "Subtle" Missed Complex Elbow Dislocation - Learning from Mistakes Made on Plain Radiography.

Introduction: Chronic elbow dislocation is a profoundly debilitating condition characterized by severe instability, limited elbow function, and significant pain. The term "neglected dislocation of the elbow" refers to a traumatic elbow dislocation that has gone untreated for three weeks or longer. Successfully treating this condition presents a challenge, as it involves restoring elbow stability and achieving a decent range of motion, which can be particularly complex.

A comprehensive insight of innovations and recent advancements in nanocarriers for nose-to-brain drug targeting.

Central Nervous System (CNS) disorders are the leading cause of illness and affect the everyday lives of people all around the globe and are predicted to increase tremendously in the upcoming decades. Traditional methods of delivering drugs to the CNS face considerable limitations. Nose-to-brain targeting offers a promising alternative that bypasses the blood-brain barrier (BBB), enabling targeted drug administration to the central nervous system (CNS).

Transgenerational gut dysbiosis: Unveiling the dynamics of antibiotic resistance through mobile genetic elements from mothers to infants.

Objectives: The initial microbial colonization of the gut is seeded by microbes transmitted from the mother's gut, skin, and vaginal tract. As the gut microbiome evolves, a few transmitted microbes persist throughout life. Understanding the impact of mother-to-neonate gut microbiome and antibiotic resistance genes (ARGs) transmission is crucial for establishing its role in infants' immunity against pathogens.

Less Is More: Evaluating the Benefits of Minimally Invasive Spinal Surgery.

This review aims to explore the evolution, techniques, and outcomes of minimally invasive spine surgery (MISS) within the field of neurosurgery. We sought to address the increasing burden of spine degeneration in a rapidly aging population and the need for optimizing surgical management. This review explores various techniques in MISS, drawing upon evidence from retrospective studies, case series, systematic reviews, and technological advancements in neurosurgical spine treatment.

Chromatin regulator HELLS mediates SSB repair and responses to DNA alkylation damage.

The SNF2 family chromatin remodeler HELLS has emerged as an important regulator of cell proliferation, genome stability, and several cancer pathways. Significant upregulation of HELLS has been reported in 33 human cancer types. While HELLS has been implicated in DNA damage response, its function in DNA repair is poorly understood.

A Cross-Sectional Evaluation of Opioid Dispensing Competencies in Final-Year Pharm-D Students: A Multicenter Study from Punjab, Pakistan.

Background: The opioid crisis continues to be a public health concern worldwide due to the high rates of misuse and associated mortality. Opioid dispensing competencies are critical for pharmacy graduates to promote the rational use of opioids.

Purpose: To evaluate the opioids dispensing competencies among the final year Pharm-D students in Punjab, Pakistan.

The Hematological and Social Factors Affecting Length of Stay in Acute Stroke Patients: A Quality Assessment Study From a Single Institute.

Introduction: Stroke is one of the common causes of mortality. The length of stay (LOS) for a stroke is a quality indicator and affects mortality. However, there are no large studies evaluating the LOS in an acute inpatient setting for stroke patients, mainly hematological and social parameters.

Novel homozygous SPAG17 variants cause human male infertility through multiple morphological abnormalities of spermatozoal flagella related to axonemal microtubule doublets.

Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella (MMAF). Distinct projections encircling the central microtubules of the spermatozoal axoneme play pivotal roles in flagellar bending and spermatozoal movement. Mammalian sperm-associated antigen 17 ( SPAG17 ) encodes a conserved axonemal protein of cilia and flagella, forming part of the C1a projection of the central apparatus, with functions related to ciliary/flagellar motility, skeletal growth, and male fertility.

Anti-Ro-Positive Dermatomyositis Presenting as a Clinical Mimic of Guillain-Barré Syndrome: A Case Report.

Dermatomyositis is a multi-system, connective tissue immune-mediated inflammatory condition characterised by myositis and distinct skin manifestations, with a higher prevalence in women. Symptoms typically appear in adulthood, though a juvenile form exists. Early signs may include Gottron's papules and heliotrope rash, with proximal muscle weakness as the second most common initial symptom.

Securing consensus in fractional-order multi-agent systems: Algebraic approaches against Byzantine attacks.

This paper investigates the behavior of fractional-order nonlinear multi-agent systems subjected to Byzantine assaults, specifically focusing on the manipulations of both sensors and actuators. We employ weighted graphs, both directed and undirected, to illustrate the system's topology. Our methodology combines algebraic graph theory with fractional-order Lyapunov techniques to develop algebraic requirements for leader-following consensus, providing a robust framework for analyzing consensus dynamics in these complex systems.

Isolation, characterization and pharmacological investigations of secondary metabolites from experimental and computational techniques.

Fungal metabolites are known for their broad therapeutic effects. In this context, the fungal strain of (FCBP-DNA-1266) was examined for its secondary metabolites and activities. This led to the isolation of naphtho-gamma-pyrone (aurasperone B) and a sterol (ergosterol), characterized using advanced spectroscopic techniques such as H NMR and C NMR.

evaluation of favipiravir-associated potential new drugs against polymerase enzyme of SARS-CoV-2.

Millions of lives have been lost to the deadly SARS-CoV-2 virus. Vaccines and antiviral drugs are essential scientific tools in combating viral infections. This study focused on the RdRp inhibitor favipiravir, exploring new analogs by substituting the fluorine atom on the pyrazine ring with both homocyclic and heterocyclic moieties.

Evaluating the Quality of Primary Transurethral Resection of Bladder Tumor: A Nine-Year Review at a Tertiary Healthcare Center.

Objective: This study aimed to assess the quality of primary transurethral resection of bladder tumor (TURBT) procedures performed at Aga Khan University Hospital (AKUH) over nine years, focusing on proper documentation, completeness of tumor resection, quality of histopathology reports, complication rates, and adherence to European Association of Urology (EAU) guidelines.

Materials And Methods: A retrospective analysis of patients aged 25-75 who underwent primary TURBT at AKUH between 2010 and 2019 was done. Patients with incomplete records, concomitant procedures, or those who underwent emergency TURBT were excluded.

Peripherally-restricted recurrent infection by engineered E. coli strain modulates hippocampal proteome promoting memory impairments in a rat model.

Commensal bacteria that breach endothelial barrier has been reported to induce low grade chronic inflammation producing disease symptoms in major peripheral tissues. In this study, we investigated the role of genetically modified cellular invasive form of commensal E. coli K12 (SK3842) in cognitive impairment.

Urinoma: A Rare but Potential Differential of Acute Abdomen.

Urinoma is an encapsulated collection of extravasated urine in the retroperitoneal space. This rare and potentially dangerous event can occur spontaneously or iatrogenically varying from asymptomatic cases to acute abdomen. The initial diagnostic modality is ultrasound.

Malignant peripheral nerve sheath tumour presenting as pathological fracture of proximal femur in neurofibromatosis type-1: a case report with brief literature search.

Neurofibromas, in association with NF-1, can undergo a malignant transformation, giving rise to Malignant peripheral nerve sheath tumours (MPNSTs), a relatively rare entity. Clinically, it presents with non-specific symptoms like pain and numbness, distinguishing it from other nerve lesions difficult. There is a lack of data on the occurrence of MPNST in NF-1 in children and adults, and distant metastasis to the brain and bones is reported only in a few cases.

Orbital Lesions: A bird's eye view of series of 2068 cases in 27 years in a tertiary care hospital in Pakistan.

Objective: To determine the relative frequency of orbital lesions based on the site of origin and histopathology at a Tertiary care hospital (Mayo Hospital, Lahore Pakistan) from 1996 till 2022 (27 years).

Methods: This descriptive case series included 2651 patients of all age groups presenting with orbital lesions who initially got enrolled at Institute of Ophthalmology Mayo Hospital, Lahore from 1996 till 2022. Of these, 583 patients left against medical advice.

Improving Shape-Sensing Robotic-Assisted Bronchoscopy Outcomes with Mobile Cone-Beam Computed Tomography Guidance.

Background: Computed tomography to body divergence (CTBD) is one of the main barriers to bronchoscopic techniques for the diagnosis of peripherally located lung nodules. Cone-beam CT (CBCT) guidance is being rapidly adopted to correct for this phenomenon and to potentially increase diagnostic outcomes. In this trial, we hypothesized that the addition of mobile CBCT (m-CBCT) could improve the rate of tool in lesion (TIL) and the diagnostic yield of shape-sensing robotic-assisted bronchoscopy (SS-RAB).

Effectiveness of bedaquiline containing all oral longer regimens in treating multidrug/rifampicin resistant tuberculosis in Pakistan.

Background: Despite the introduction of bedaquiline (Bdq) containing all-oral regimens for treating patients with rifampicin resistant/multidrug resistant tuberculosis (MDR/RR-TB) in 2019, data on its effectiveness in Pakistan, which has the fifth highest MDR-TB burden, is lacking. This study evaluates treatment outcomes and identifies factors associated with unsuccessful outcomes among MDR/RR-TB patients treated with an all-oral longer treatment regimen (LTR).

Methods: This retrospective record review included all microbiologically confirmed pulmonary MDR/RR-TB patients treated with an all-oral LTR between August 2019 and February 2021 across nine PMDT centres in Pakistan.