Comparative Outcomes of Warfarin vs. Direct Oral Anticoagulants (DOACs) in Anticoagulant-Related Gastrointestinal Bleeding: A Single-Center Study.

Background: The management of thromboembolic risk and the necessity for timely hemorrhage control make anticoagulant-related gastrointestinal (GI) bleeding clinically challenging.

Objective: This study aimed to evaluate clinical outcomes (such as bleeding control and mortality) and the effectiveness of anticoagulation reversal techniques in patients with anticoagulant-related GI bleeding in emergency settings.

Methodology: This prospective, observational study conducted at Lady Reading Hospital, Peshawar, from January to December 2023, included patients aged 18 or older with GI bleeding on warfarin or direct oral anticoagulants (DOACs).

Integrated Multidisciplinary Approach to Acute Chest Pain: Perspectives From Family Medicine, Emergency Medicine, and Internal Medicine.

Background: Acute chest discomfort is a common clinical problem that has to be well understood and managed collaboratively by specialists from many fields of medicine.

Objective: This study aimed to explore and evaluate the perspectives of healthcare professionals in family, emergency, and internal medicine regarding the management of acute chest pain, with a specific focus on diagnostic practices, interdisciplinary collaboration, and protocol adherence to establish best practices for a unified approach.

Methodology: This cross-sectional study, conducted from June 2022 to July 2024, included 218 healthcare professionals with over a year of experience in family, emergency, and internal medicine, selected through convenient sampling from hospitals such as Lady Reading Hospital, Hayatabad Medical Complex, Mardan Medical Complex, and Government Mian Meer Hospital.

Factors Responsible for Worse Outcomes in STEMI Patients With Early vs Delayed Treatment Presenting in a Tertiary Care Center in a Third World Country.

The aim of the study is to compare the outcomes among ST-segment elevation myocardial infarction (STEMI) cases with early treatment vs delayed treatment. It was a prospective comparative study on 186 patients with consecutive (nonprobability) sampling. Two groups of cases were made as per their time to get admitted to the hospital (ie, within 2 hours of symptom onset = Group A; after 2 hours of symptom onset = Group B).

Surface water quality, public health, and ecological risks in Bangladesh-a systematic review and meta-analysis over the last two decades.

Water quality has recently emerged as one of the utmost severe ecological problems being faced by the developing countries all over the world, and Bangladesh is no exception. Both surface and groundwater sources contain different contaminants, which lead to numerous deaths due to water-borne diseases, particularly among children. This study presents one of the most comprehensive reviews on the current status of water quality in Bangladesh with a special emphasis on both conventional pollutants and emerging contaminants.

A Comparative Study Between Use of Topical Honey and Edinburgh University's Solution of Lime (EUSOL) Dressing in Necrotizing Fascitis Wounds.

Introduction Necrotizing soft tissue infection is potentially life-threatening and involves subcutaneous fascial planes, later involving overlying skin and, eventually, underlying muscles. Early diagnosis and prompt treatment are necessary for this disease's management to avoid significant morbidity and fatality. After resuscitation and optimization, early surgical debridement is followed by serials of dressing.

Effect of Consumption Value on Consumer Willingness to Consume GM Food: A Post-COVID-19 Analysis.

In this research, we debate the critical challenges posed by the COVID-19 pandemic such as food scarcity, by examining the influence of consumption values on consumers' willingness to consume genetically modified (GM) food in the presence of consumer food attitudes, animosity, and ethnocentrism, which could be the one possible option to deal with the food scarcity problem. The proposed relationship could help to understand the complex societal problem of food scarcity and import dependency in the food sector before and after the crisis. Therefore, based on the theory of consumption values, we investigated government actions, consumer attitudes, and their willingness to consume GM food through 1340 valid USA responses and 1065 Chinese responses.

Pollen morphology of selected melliferous plants and its taxonomic implications using microscopy.

This research aimed to explore the melliferous bee flora pollen from arid zones of District Attock, Islamabad Capital and Rawalpindi. Morpho-palynological features has provided key information for the classification and help to explain the taxonomy of several genera and species. Therefore, in this work, we examined the morphological characters of pollen potentially to be used for the species delimitation of bee flora.

Clinical efficacy of iodine complex in SARS-CoV-2-infected patients with mild to moderate symptoms: study protocol for a randomized controlled trial.

Background: Coronavirus disease 2019 (COVID-19) caused by the novel coronavirus-infected millions globally. Despite a wide range of advised options for the treatment of COVID-19, a single strategy to tackle this pandemic remains elusive, thus far. That is why we are conducting a clinical trial to find out the efficacy of iodine complex to clear a viral load of severe respiratory syndrome coronavirus-2 (SARS-CoV-2) along with a reduction in time taken to alleviate symptoms.

Prophylactic potential of honey and Nigella sativa L. against hospital and community-based SARS-CoV-2 spread: a structured summary of a study protocol for a randomised controlled trial.

Objectives: Considering the therapeutic potential of honey and Nigella sativa (HNS) in coronavirus disease 2019 (COVID-19) patients, the objective of the study is defined to evaluate the prophylactic role of HNS.

Trial Design: The study is a randomized, placebo-controlled, adaptive clinical trial with parallel group design, superiority framework with an allocation ratio of 1:1 among experimental (HNS) and placebo group. An interim analysis will be done when half of the patients have been recruited to evaluate the need to adapt sample size, efficacy, and futility of the trial.

Knowledge, attitude, and practice of clinicians about antimicrobial stewardship and resistance among hospitals of Pakistan: a multicenter cross-sectional study.

Considering that antimicrobial resistance (AMR) is a global challenge, there is a dire need to assess the knowledge, attitude, and practice (KAP) of clinicians in AMR endemic countries. The current multicenter, cross-sectional study aimed at highlighting gaps in antimicrobial (AM) stewardship and AMR among practicing doctors working in public tertiary care teaching hospitals of Lahore, Pakistan. A KAP survey, based on a self-administered questionnaire containing 45 questions, was distributed among 336 clinicians in 6 randomly selected hospitals.

Anti-COVID property of subcutaneous ivermectin in synergy with zinc among midlife moderately symptomatic patients: a structured summary of a study protocol for a randomised controlled trial.

Objectives: The study objective is to quantify the effectiveness of ivermectin (subcutaneous/oral IVM) in the presence or absence of zinc (Zn) for clinical and radiological improvement in coronavirus disease 2019 (COVID-19) patients with moderate severity.

Trial Design: This quadruple-blinded, placebo-controlled randomized clinical trial will be a multiarmed multi-centered study with superiority framework.

Participants: Quinquagenarian and sexagenarian patients with moderate COVID-19 symptoms and positive severe respiratory syndrome coronavirus -2 (SARS-CoV-2) PCR will be included.

COVID-19: A Potential Trigger for Thyroid Dysfunction.

Subacute thyroiditis (SAT) is a self-limiting thyroid dysfunction of viral origin. Relatively little is known about its occurrence in SARS CoV-2 infected COVID-19 patients. Herein, we report a case of SAT in a 58-year-old patient that was apparently triggered by infection with SARS CoV-2.

Implication of scanning electron microscopy in the seed morphology with special reference to three subfamilies of Fabaceae.

The current research work was aimed to determine the morphological variation in the seeds of subfamilies Caesalpinioideae, Mimosoideae, and Papilionoideae using scanning electron microscope to investigate the different seed features including; Seed length, width, weight, hilum shape, position, fracture line pattern, pleurogram shape, texture crudeness, ornamentation wall, and surface ornamentation. A total of 12 species were collected. The study reveals that the seed types alters from psilate to rugose, pleurogram shape from lunar to U shape, hilum shape from elliptical to depressed, hilum position from terminal to subterminal, fracture line pattern from reticulate irregular ridges to psilate with regular ridges, texture crudeness from fine to coarse, surface ornamentation from reticulate to psilate, and ornamentation wall also varies from thin to thick.

Microscopic implication and evaluation of herbaceous melliferous plants of southern Khyber Pakhtunkhwa-Pakistan using light and scanning electron microscope.

The aim of the present study is to investigate the pollen morphology of melliferous plant taxa of Southern Khyber Pakhtunkhwa-Pakistan. Using light microscope (LM) and scanning electron microscope (SEM), the palynological study of 18 species of melliferous plants namely Calendula arvensis, Cenchrus pennisetiformis, Citrullus colocynthis, Cucumis melo subsp. agrestis var.

A quadruple blinded placebo controlled randomised trial to evaluate the effectiveness of an Iodine complex for patients with mild to moderate COVID-19 in Pakistan (I-COVID-PK): A structured summary of a study protocol for a randomised controlled trial.

Objectives: The objective of the study is to measure the efficacy of ionic-iodine polymer complex [1] for clinical and radiological improvement in coronavirus disease 2019 (COVID-19) patients.

Trial Design: The trial will be closed label, randomized and placebo-controlled with a 1:1:1:1 allocation ratio and superiority framework.

Participants: All PCR confirmed COVID-19 adult patients including non-pregnant females, with mild to moderate disease, will be enrolled from Shaikh Zayed Post-Graduate Medical Complex, Ali Clinic and Doctors Lounge in Lahore (Pakistan).

GM trust shaped by trust determinants with the impact of risk/benefit framework: the contingent role of food technology neophobia.

The present study is comparative in natures that focus on understanding the factors that influence the GM food trust level in the BRA framework and food technology neophobia in China and the USA. For this purpose, we collected 300 and 350 valid responses, respectively, through a structured questionnaire. By carefully evaluating the above relationships, we found that trust determinants such as institutional trust, technology trust, information revealed with GM food vary across both datasets.

Microscopic investigation of pollen morphology of Brassicaceae from Central Punjab-Pakistan.

The intention of the current study is to provide an account on the palynological features of Brassicaceae from Central Punjab-Pakistan as a basis for future studies. Different morpho-palynological characteristics both qualitative and quantitative were analyzed during this research which includes shape of pollen, diameter of pollen, P/E ratio, exine sculpturing, thickness of exine, type of pollen, shape and size of lumens, and thickness of murus. Taxonomic keys were also constructed based on pollen morphological characters for correct identification of species.

The psychological perspective on the adoption of approved genetically modified crops in the presence of acceptability constraint: the contingent role of passion.

This study contributes to the literature on genetically modified crops by examining the impact of psychological distance on farmer adoption. The existing body of literature suggests that some farmers have the conservative perception to adopt genetically modified crops because of controversies regarding the side effects and profitability. To understand these social problems, we have relied upon construal-level theory which argues farmer passion about dynamics like here and now, likely or unlikely and the near or far from self are vital for the adoption of approved genetically modified crops.

Potential of soil amendments (Biochar and Gypsum) in increasing water use efficiency of Abelmoschus esculentus L. Moench.

Water being an essential component for plant growth and development, its scarcity poses serious threat to crops around the world. Climate changes and global warming are increasing the temperature of earth hence becoming an ultimate cause of water scarcity. It is need of the day to use potential soil amendments that could increase the plants' resistance under such situations.

Extraordinary photoluminescence and strong temperature/angle-dependent Raman responses in few-layer phosphorene.

Phosphorene is a new family member of two-dimensional materials. We observed strong and highly layer-dependent photoluminescence in few-layer phosphorene (two to five layers). The results confirmed the theoretical prediction that few-layer phosphorene has a direct and layer-sensitive band gap.

3-Hydr-oxy-1,2,3,9-tetra-hydro-pyrrolo[2,1-b]quinazolin-4-ium chloride dihydrate: (+)-vasicinol hydro-chloride dihydrate from Peganum harmala L.

The title compound, C(11)H(13)N(2)O(+)·Cl(-)·2H(2)O, the dihydrate of (+)-vasicinol hydro-chloride, is a pyrrolidinoquinazoline alkaloid. It was isolated from the ethyl acetate fraction of the leaves of Peganum harmala L. The pyrrolidine ring has an envelope conformation with the C atom at position 2 acting as the flap and the C atom at position 3, carrying the hydroxyl substituent, has an S configuration.