Biological and Clinical Sciences Research Journal

Aloe vera is a well-known medicinal plant used in many therapeutic purposes. Naturally it is composed of many useful compounds that have ability to use for treatment of many diseases. The active compounds reported in this plant are saponins, sugar, enzymes, vitamins, aloesin, aloeemodin, aloin, acemannan aloemannan, aloeride, methylchromones, flavonoids, naftoquinones, sterols, minerals, anthraquinones, amino acids, lignin and salicylic acid and other different compounds including fat-soluble and water-soluble vitamins, enzymes, minerals, simple/complex sugars, organic acid and phenolic compounds. In this study aloe vera is used for antibacterial and antifulgal activity against different strains of bacteria and pathogenic fungal strains. Ethanol extract of Aloe vera leaves and roots is applied on these bacterial and fungal strains in different concentrations (15, 20, 25, 30µl). Bacillus cereus, Bacillus subtitis, Bacillus megaterium, Streptococcus pyogenes, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, and some other bacterial strains are used for this study. Escherichia coli and Agrobacterium tumefacins shows zone of inhibition around 18mm which consider as good result. Bacillus subtitis and Bacillus megaterium also shows good result around 16mm. Proteus mirabilis and Pseudomonas aeruginosa shows minimum zone of inhibition which is around 11mm. among all used fungal strains (fuserium oxysporum, Candida albicans, Aspergillus fumigatus, Aspergillus niger) fuserium oxysporum and Aspergillus niger shows excellent results around 19mm both against root extract and leaves extract.

The field of biotechnology has extraordinary influence on science, law, the administrative condition social insurance, and business throughout the world. As the starting of agriculture, people have been manipulating crops to improve the yield and quantity. Product yields throughout the world are essentially diminished by the activity of herbivorous insects, pathogens, and parasites. Natural environmental stresses make this circumstance significantly worse. Biotechnology can be used to increase the yield of food crops, to improve biotic and abiotic stress tolerance, to modify the traits of the plant (e.g. oil content, percentage of lignin, cell structure), to make the conversion to liquid biofuels more efficient. Various genes have been discovered for biotic and abiotic stress tolerance. The genes discovered for biotic stress are aryloxyalkanoate, dioxygenase, enzymes (aad-1), nitrilase, Cry1Ac, Cry2AB, GTgene, AFP (anti-freezing protein gene) gene, Chitinase II and III gene, and Rps1-k. The genes discovered for abiotic stress are SgNCED1, SgNCED1, USP2, HSP70, BADH, and ALO, PVNCED1, HVA1, LeNCED1. CRISPRs (clustered regularly interspaced short palindromic repeats) are the short DNA sequences present in bacteria and archaeal genomes which are now currently used by researchers to edit the genome. In different plant species (calli, leaf discs) protoplasts have been successfully used to edit their genome through CRISPR/Cas9 system. The aims of the applications are to increase resistance to abiotic or biotic stress, to engineer metabolic pathways, and to increase grain yield. Incorporation of modern biotechnology, with regular traditional practices in a sustainable way, can fulfill the objective of achieving food security for the present and as well as in future.

The present study was carried out to determine the potential for phytoremediation of water hyacinth (Eichhornia crassipes) plant for Cadmium (Cd), Arsenic (Ar), and Mercury (Hg) absorption. The samples were collected from Dhamthal, Zafarwal and Narowal. The plant samples were cut into their parts and dried at room temperature for 25-30 days until they were fully dried. The change in fresh weight and dry weight was examined. The data of collected samples was recorded and statistically analyzed, which revealed the significance of results for different localities. The lower coefficient of variation was recorded for all studied traits which revealed that there was consistency among the results for different localities. For our study the plant's percentage removal of metals was determined using atomic absorption spectroscopy in plant sample as well as water sample. Metal uptake happened at variable degrees. The water hyacinth uptake the largest metal uptake per dry weight of water hyacinth was 166.25ppm for cadmium and the smallest 0.032ppm was for mercury. In water sample highest amount of metal was 177.25ppm for cadmium and lowest 0.012ppm was for arsenic. It was found from our study that the water hyacinth (Eichhornia crasssipes) uptake cadmium (cd) metal from sewage water in highest amount as compare to arsenic and mercury. It was suggested that the use of water hyacinth plant may be helpful to remove heavy metals from waste water to minimize the heavy metal pollution of water.

Gastrointestinal, skin, pulmonary and cardiovascular problems have been reported all over the world on massive scale. The treatment of these problems has become tough due to genetically modified bacterial strains and fungal infections. The present studied was conducted to evaluate the antimicrobial activities of Citrullus colocynthis plant extract. The ethanolic extract of dried fruit pulp, seed, and root was evaluated with respect to anti-bacterial and anti-fungal properties. The anti-microbial profile studied against four bacterial strains (2 Gram negative and 2 Gram positive) while anti-fungal profile studied against four fungal species. All the bacterial and fungal strains used in the study showed sensitivities against the respective extracts. The zones of inhibition ranged between 7 mm to 23 mm, and 6 mm to 23 mm in against bacterial and fungal strains, respectively. The extract of seed found to be less effective against both the organisms. It was suggested from our study that the extract of Citrullus colocynthis may be used in medicines to cure bacterial diseases.

Due to the versatile application of plants the utilization of plants and their inferred substances builds up day by day for the revelation of new curative agents. Conocarpus erectus has placed in the family Combretaceae, in one of the two species of Conocarpus genus and ordinarily exists in tropical and subtropical regions of the world. In some countries it is used as folk medicine for fever, anemia, diabetes, catarrh, diarrhea and conjunctivitis. The current study was carried out to investigate the antibacterial and anticancer properties of the plant. The four defatted methanol extracts of C. erectus different parts (leaves, stems, fruits and bark) showed high antibacterial and anticancer activity even with small quantity of dose. Antimicrobial assay was used to check out the antibacterial activity against 6 bacterial strains Escherichia coli, Staphylococcus Aureus and Klebstella Pneumoniae. The results show that gram positive bacteria show more sensitivity and zone of inhibition as compared to gram negative bacteria. For anticancer activity, MTT assay was performed on HepG2 cells for this purpose. Plant extorts show anticancer activity with a minute quantity. For phytochemical screening defatted methanol extract of Conocarpus erectus was subjected to the silica gel glass column go behind by (RP-HPLC–UV–ESI-MS). It contains phenol such as tannin and flavinoid as major component. Plant contain Ellagic acid; di-hexahydroxy diphenyl, Vascalgin isomer as foremost tannin component. Gallic Acid, Kaempferol on the base of mass spectra and time of retention. The extract of Conocarpus erectus (leaves, shoot, bark & fruit) parts shows high antibacterial, antioxidant and hepta-protective activities due to phenolic content. Tannin has high antibacterial activity than other compound. C.erectus is notable for its folkloristic curative potential. More in vivo and in vitro phytochemical studies are needed to use the plant for prevention and treatment of many diseases.

Garlic (Allium sativum L.) has medicinal value but also an important dietary component for centuries. It belongs to the family of Liliaceae, which is mostly grown and found in Ethiopia and Africa. Ethiopian garlic has been mostly used in traditional medicines. Inhibitory activity of garlic extract has been reported by various researchers for Lactobacillus acidophilus, Staphyloccocus aureus, Nocardia asteroids, pseudomonas aeruginosa, actinomyces viscosus, veillonella alcaligens bacterial strains. The garlic paste and lime was used for mouth sore, sore throat and also can be used in toothpaste to prevent dental caries. The present review describes the potential of garlic phytochemicals for the improvement of the immune system against diseases in humans.

The present research experiment was conducted in the greenhouse of the Institute of Molecular Biology and Biotechnology, The University of Lahore for determining the possible involvement of salicylic acid (SA) in seed priming and affects on the seedling growth and development under NaCl treatments in wheat variety ANAJ-2017, Shafaq-2006 and Galaxy-2013. The data was collected for various seedling traits and statistically analyzed, which revealed the significance of results for treatments, salt applications, genotypes and the interactions between salt treatments and genotypes. The lower coefficient of variation was recorded for all studied traits which revealed that there was consistency among the results for salicylic acid applications and salt or NaCl treatments. It was concluded from our study that the application of salicylic acid (SA) under salt (NaCl) stress conditions helps wheat seedlings to withstand and compete with stressful conditions. The study revealed that the seed priming with salicylic acid helps to improve root length, shoot length, seedling moisture percentage and fresh seedling weights. The application of NaCl caused to increase the root length, number of roots and shoot length of wheat while salicylic acid (SA) was applied in foliar spray. The use of water priming shows medium effects for the seedling growth of wheat under salt stress environmental conditions. The wheat variety Galaxy-2013 has shown good performance for most of the studied traits of seedlings under salt stress conditions. It was suggested from our study that the variety Galaxy-2013 may be used under salt stress conditions or salt affected soils to improve grain yield of wheat.

Wheat is an important cereal crop which has been consumed as food crop throughout the globe. Present study discusses change in different morphological traits of six most common wheat varieties in Pakistan under the effect of salt stress. We have used two salt solutions; 10 dS/m NaCl and 15 dS/m NaCl concentrations were used in our research. Data collected during research indicates that all morphological traits decrease under salt treatments except that of two trait viz., root length and carotenoids level. It was noted that under the effect of both salt concentrations carotenoids content increased in significant amount in leaves and roots along with root length which was also increased. The outcomes from analysis of variance demonstrated that there was higher leaf caroteniods for genotype 5 (Ujala-16) that was 998.32 mg/g of fresh leaf weight trailed by genotype 1 (Inqalab-91) 995.99 mg/g of fresh leaf weight) while lower carotenoids were found for genotype 2(Shafaq-06) that was 825.65 mg/g of fresh leaf weight. Highest root weight was found in Shafaq-06 under treatment of 15dS/m NaCl. While pooled all Pairwise comparison test revealed highest root length in genotype 4 (Galaxy-13). While linear regression suggests that carotenoids content contribute least in plant height. Genetic heritability was found highest for photosynthetic pigments i.e. 99.99% for chlorophyll b except that of carotenoids. Genetic advance was recorded higher for fresh stem weight (309.870%). Higher heritability and genetic advance revealed that from our study that the selection of salt stress wheat genotypes on the basis of root length may be help to develop salt stress tolerance wheat genotypes with higher grain yield.

Wheat (Triticum aestivum L.) is an important cereal crop of the world. It is one of the staple foods for major portion of world population. There are various biotic and abiotic factors responsible for low production of wheat in our country. Among these factors, soil salinity is major problem playing an important role in soil degradation, thus consequently reducing wheat production and quality. This study was conducted to evaluate the effect of various salinity and heavy metal levels against three wheat cultivars fir salinity resistance. Three different varieties of wheat were screened against the salinity under controlled conditions in the laboratory of tissue culture, University of Lahore. Seeds of three wheat varieties (Anaj-2006, Faisalabad-2008 and Inqalab-91) were sown in seedling trays. NaCl and CuSO4 were applied as salinity and heavy metal treatment upon wheat cultivars. In order to evaluate, hazardous effects of salinity and heavy metal on wheat certain growth parameters were observed i.e. leaf length and width, leaf area, stem and root length, fresh and dry weight of leaf, stem and root, root shoot length ratio and photometry of leaf, stem and root was measured. Results depicts salinity and heavy metal application has negative correlation with growth parameters of wheat particularly combine application of NaCl and CuSo4 have led to impose major detrimental effects on wheat cultivars. Regarding varietal comparison, “Anaj-2006” proved to be comparatively better in context of less salt’s residual accumulation in leaf, stem and roots along with lower root to shoot length ratio thus exhibiting a strong genetic potential to keep surviving and maintain healthy growth. However, it was concluded that salinity and heavy metal have adversely affected growth and yield potential of “Faisalabad-2008”. So conclusively, there is dare need to screen out indigenous and exotic wheat germplasm available throughout the country for finding some suitable genetic resources having moderate to high resistance levels against salinity and heavy metal which can be further used for breeding purpose in varietal improvement program.

The Lepidium draba or white tope also known as hoary cress belongs to family Brassicaceae, has been known as one of the perennial herbs which grow normally from seeds and also produced horizontal long creeping roots. It normally grows as a weed plant in farm fields. The present study was conducted to find out the antibacterial and antioxidant activities along with the plant traits of Lepidium draba. The shoot, root and inflorescence extracts were taken through using ethanol, water and n-hexan as extraction solvents. It was found from our studies that the plant extracts were heaving alkaloids, saponins, flavonoids, coumarins, anthocyans, quinons, steroids, sterols and terpenoids as potential phenolic compounds. The bacterial strains including Escherichia coli, Klebsiella pneumonia and Staphylococcus aureus were cultured to access the antibacterial activities of plant extracts. The higher antibacterial activity was reported from n-hexan extract which indicate that the n-hexan extract may be used for extracting phytochemicals to be used as potential antibacterial biomedicines. The water extract showed higher antioxidant activities as compared with ethanol and n-hexan extracts which indicated that the use of water extract may be as a useful antioxidant under stress conditions, may also have anticancer activities. The lower coefficient of variation was recorded for all of the studied traits which indicated the consistency of results and reliability of selecting plants from various locations. There was significant and positive correlation among plant height with inflorescence weight, leaf area and leaf length, the inflorescence weight showed positive correlation with plant height, lea length and leaf area. There was higher contribution of plant height while leaf area contributed lower and negatively towards fresh plant weight. We have concluded from our study that the Lepidium draba plant extract showed antibacterial and antioxidant activities through using ethanol, water and n-hexan as extraction solvents. The significant correlation and regression associations indicated that the plants can tolerate harsh environmental conditions.

Effective nurse-patient communication is essential to timely triage, accurate diagnosis, and safe therapeutic response in the emergency department (ED), yet this communication is frequently compromised by structural, relational, and contextual pressures, particularly in high-volume, resource-limited public tertiary care settings. Despite substantial international evidence on this issue, nurse-patient communication barriers had not been formally investigated in the Emergency Department of Government Teaching Hospital, Shahdara, Lahore. Objective: To identify the nurse-patient communication barriers perceived by registered nurses in the Emergency Department. Methods: A descriptive, cross-sectional study was conducted among 124 registered nurses, selected through convenience sampling in the Emergency Department of Government Teaching Hospital, Shahdara, Lahore, Pakistan, over a six-month period from January to June 2026. Data were collected using the validated 27-item Barriers in Communication Questionnaire, assessing six domains: demographic, knowledge-related, environmental, social, economic, and psychological factors. Data were analyzed using SPSS version 26; descriptive statistics summarized demographic characteristics and domain- and total-level barrier scores, and reliability was assessed using Cronbach's alpha. Results: All participants were female, with a mean age of 31.4 ± 6.2 years and mean clinical experience of 5.8 ± 3.9 years. The overall barrier score was 70.8% (SD = 12.76), placing the sample at the threshold of the high-barrier category; 57.3% of nurses reported moderate barriers and 39.5% reported high barriers, while only 3.2% reported good communication. Environmental factors were the most heavily endorsed domain (81.5%), followed by knowledge-related (72.1%) and economic factors (71.8%), all falling within the high-barrier range; psychological factors were also elevated (69.2%), while social (66.2%) and demographic factors (64.2%) fell within the moderate-barrier range. The questionnaire demonstrated good internal consistency (Cronbach's alpha = 0.841). Conclusion: Nurse-patient communication barriers were highly prevalent and multidimensional among ED nurses in this public tertiary care hospital, with environmental, workload-related, knowledge, and economic factors emerging as the most prominent. Multi-level interventions addressing staffing, training, remuneration, and psychological support are recommended to strengthen communication and, by extension, patient safety.

Nurses working in high-acuity units of resource-constrained public tertiary care hospitals routinely manage operational crises, including mass-casualty presentations, supply shortages, and infrastructure failures, that extend well beyond standard nursing training, yet the crisis management competencies nurses develop informally in such settings remain poorly documented. Objective: To identify the crisis management skills employed by nurses in their daily practice within the Emergency Department, surgical and medical wards, and intensive care units of Mayo Hospital, Lahore. Methods: A descriptive, cross-sectional study was conducted among 222 registered nurses, selected through convenience sampling from January to June 2026 at Mayo Hospital, Lahore, Pakistan. Data were collected using an adapted, validated 32-item Crisis Management Competency Questionnaire assessing four domains: technical, cognitive, behavioral, and underlying-characteristics competencies. Data were analyzed using SPSS version 26; descriptive statistics summarized demographic characteristics and domain- and total-level competency scores, and reliability was assessed using Cronbach's alpha. Results: Most nurses were female (75.7%), with a mean age of 29.8 ± 5.6 years and mean clinical experience of 5.4 ± 3.7 years. The overall crisis management competency score was 71.2% (SD = 12.55), placing the sample in the high-competency category; 50.9% of nurses were classified as having high competency and 46.4% moderate, while only 2.7% were classified as low. Behavioral Competencies were the most strongly endorsed domain (73.3%), followed by Cognitive Competencies (72.5%) and Underlying Characteristics (71.0%), while Technical Competencies were comparatively lower (68.6%). The questionnaire demonstrated good internal consistency (Cronbach's alpha = 0.867). Conclusion: Nurses at Mayo Hospital, Lahore demonstrated substantial crisis management competency, developed largely through sustained informal clinical exposure rather than formal training, with a comparative gap in technical competencies suggesting a specific, actionable target for structured training interventions.

Disaster preparedness and triage are essential competencies for nurses, particularly because they frequently serve as frontline responders during disasters and mass-casualty incidents. Undergraduate nursing education is expected to develop these competencies before graduation; however, evidence regarding their combined assessment among nursing students in Pakistan remains limited. Objective: To assess knowledge regarding disaster preparedness and triage principles among undergraduate nursing students at the College of Nursing, University of Child Health Sciences, The Children’s Hospital, Lahore, and to determine the relationship between these two competencies. Methods: An analytical cross-sectional study was conducted from January to June 2026 among 249 undergraduate nursing students. Participants were selected through proportionate stratified random sampling across all four professional years. Triage knowledge was assessed using the 18-item Triage Knowledge Scale, while disaster preparedness knowledge was evaluated using the 47-item Disaster Preparedness Evaluation Tool (DPET). Data were analyzed using SPSS version 26. Spearman’s correlation was applied to determine the relationship between triage and disaster preparedness scores, while independent-samples t-tests and one-way ANOVA were used to compare mean scores across demographic and academic characteristics. Results: The mean Triage Knowledge Scale score represented 72.7% of the maximum possible score, with 96.8% of students demonstrating moderate or high triage knowledge. The mean DPET score represented 65.2% of the maximum possible score; 78.7% of students demonstrated moderate disaster preparedness knowledge, while only 6.0% achieved a high level. A statistically significant positive correlation was observed between triage knowledge and disaster preparedness scores (r=0.240, p<0.001). Higher scores on both scales were significantly associated with prior disaster-related training, previous disaster experience, completion of an emergency department clinical rotation, and higher professional year. Conclusion: Undergraduate nursing students demonstrated relatively stronger knowledge of triage principles than disaster preparedness, although the two competencies were significantly related. Incorporating structured and dedicated disaster nursing education, simulation-based training, and practical disaster-response exercises into undergraduate curricula may strengthen preparedness before graduation.

Kidney stone disease is a common urological condition influenced by modifiable factors such as inadequate hydration, dietary habits, and lifestyle practices. Adequate patient knowledge is essential for prevention, early recognition, and appropriate management; however, misconceptions regarding kidney stone risk factors and treatment remain common. Objective: To assess knowledge regarding kidney stones among patients attending Mayo Hospital, Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted at Mayo Hospital, Lahore, from October to December 2025. A total of 75 adult participants were recruited through convenience sampling. Data were collected using a structured questionnaire comprising demographic and clinical characteristics and 15 knowledge items covering symptoms, risk factors, dietary factors, preventive measures, and treatment options. Knowledge scores were categorized as poor (0–5), moderate (6–10), and good (11–15). Data were analyzed using SPSS version 27 and summarized using frequencies and percentages. Results: All 75 participants were female; 48.0% had degree-level education, 52.0% were employed in non-medical professions, and 80.0% resided in urban areas. Previous kidney stone disease was reported by 32.0%, while 26.7% had a family history of kidney stones. Sharp back or flank pain was recognized as a symptom by 93.3% of participants, and 86.7% recognized an association between dietary habits and stone formation. High sodium intake was identified as a risk factor by 93.3%, while 65.3% recognized the contribution of protein intake and 66.7% considered citrus fruits or juices protective. However, only 48.0% identified inadequate fluid intake as a major risk factor, 66.7% incorrectly believed that calcium restriction prevents kidney stones, and 85.3% believed that kidney stones could not be treated without surgery. Overall, 59 (78.7%) participants had moderate knowledge and 16 (21.3%) had poor knowledge; none demonstrated good knowledge. Conclusion: Patients demonstrated moderate but incomplete knowledge regarding kidney stones, with substantial misconceptions concerning hydration, dietary calcium, climatic influences, and non-surgical treatment options. Structured patient education focusing on evidence-based dietary practices, adequate hydration, modifiable risk factors, and available treatment options is warranted to improve kidney stone prevention and self-care.

Improving wheat productivity depends on identifying genotypes that combine high grain yield with substantial genetic variability and reliable selection response. Genetic parameters and mixed-model approaches can improve the identification of promising breeding material for advancement. Objective: To evaluate genetic variability, heritability, genetic advance, and mixed-model grain yield performance among advanced spring bread wheat genotypes. Methods: A field experiment was conducted during the 2023–2024 Rabi season at the Wheat Research Institute, Ayub Agricultural Research Institute, Faisalabad, Pakistan. Fifty advanced spring bread wheat genotypes from the 25th High Rainfall Wheat Yield Trial (25HRWYT) were evaluated in a randomized complete block design with two replications. Days to heading, vegetative canopy temperature, normalized difference vegetation index (NDVI), plant height, days to maturity, tillers per plant, leaf rust severity, yellow/stripe rust severity, spot blotch/blight score, and grain yield were assessed. Data were analyzed using analysis of variance, Fisher’s protected least significant difference, variance components, broad-sense heritability, genetic advance, and best linear unbiased prediction (BLUP). Results: Genotypic effects were significant for days to heading (P=.012) and NDVI (P=.013) and highly significant for grain yield (P<.001), while canopy temperature, plant height, days to maturity, and tillers per plant showed no significant differences. Mean grain yield was 2,774 kg ha⁻¹, ranging from 1,720 to 3,970 kg ha⁻¹. Genotypic variance for grain yield (252,363 kg² ha⁻²) exceeded residual variance (127,661 kg² ha⁻²). Grain yield exhibited high entry-mean broad-sense heritability (H²=0.798), with genotypic and phenotypic coefficients of variation of 18.11% and 20.27%, respectively. Genetic advance was 925.87 kg ha⁻¹, corresponding to 33.38% of the trial mean. G26 and G25 recorded the highest grain yield BLUPs (3,644.8 and 3,596.9 kg ha⁻¹, respectively), followed by G50, G1, G30, and G28. Conclusion: Grain yield exhibited substantial genetic variability, high heritability, and a high expected response to selection, indicating strong potential for genetic improvement. G26, G25, G50, G1, G30, and G28 emerged as promising genotypes for advancement. Further multi-location and multi-season evaluation is required to confirm their yield stability and wider adaptation.

Pelvic inflammatory disease (PID) is an important cause of female reproductive morbidity and infertility. Sexually transmitted infections and vaginal microbial dysbiosis may contribute to reproductive tract inflammation and impaired fertility. Objective: To identify microorganisms associated with PID and evaluate their relationship with infertility among reproductive-age women. Methods: This comparative cross-sectional study was conducted at Maryam Nawaz Health Clinic, Nat Klan, Wazirabad, from June 2025 to May 2026. A total of 60 women diagnosed with PID were included, comprising 30 with infertility and 30 without infertility. Sexually transmitted microorganisms were detected using nucleic acid amplification tests (NAATs), while bacterial vaginosis was assessed using Nugent scoring. Associations with infertility were evaluated using odds ratios, Fisher’s exact test, and exploratory multivariable logistic regression. Results: The mean age was 30.2 ± 4.3 years. Mycoplasma genitalium was the most frequently detected sexually transmitted microorganism (13.3%), followed by Chlamydia trachomatis (8.3%), Trichomonas vaginalis (6.7%), and Neisseria gonorrhoeae (3.3%). Bacterial vaginosis was identified in 43.3% of participants. STI positivity was significantly higher among infertile women than non-infertile women (40.0% vs. 13.3%; OR=4.33; p=0.039), as was bacterial vaginosis (60.0% vs. 26.7%; OR=4.13; p=0.018). Detection of either STI microorganisms or bacterial vaginosis was associated with infertility (OR=5.50; 95% CI: 1.81–16.68; p=0.004). However, these associations remained inconclusive after multivariable adjustment. Conclusion: Sexually transmitted microorganisms and bacterial vaginosis were more frequently detected among women with PID-associated infertility. These findings support comprehensive microbiological assessment, although larger prospective studies are required to establish independent associations.

The neutrophil-to-lymphocyte ratio (NLR) is a readily available inflammatory marker that may help predict disease severity and postoperative outcomes in patients with acute appendicitis. Objective: To evaluate the association between preoperative NLR and appendicitis severity, operative duration, hospital stay, and postoperative complications among patients undergoing appendectomy. Methods: This prospective observational study was conducted at a tertiary care teaching hospital in Lahore, Pakistan, from January to June 2026. A total of 150 patients aged 18–65 years undergoing emergency appendectomy were enrolled through consecutive sampling. Patients were categorized into low-NLR (<5) and high-NLR (≥5) groups. Histopathological findings, operative duration, hospital stay, and postoperative complications were compared. Statistical significance was set at p<0.05. Results: The mean age was 31.8 ± 11.4 years, and 62.7% of patients were male. Complicated appendicitis was significantly more frequent in the high-NLR group than in the low-NLR group (52.2% vs. 22.4%; p<0.001). Elevated NLR was associated with higher odds of complicated appendicitis (OR 3.78; 95% CI: 1.80–7.92). Patients with NLR ≥5 had longer operative durations (66.5 vs. 54.2 minutes; p<0.001) and hospital stays (4.6 vs. 2.8 days; p<0.001). Overall postoperative complications were also more frequent in the high-NLR group (29.3% vs. 8.6%; p=0.003), with increased odds of postoperative morbidity (OR 4.40; 95% CI: 1.59–12.22). Conclusion: Elevated preoperative NLR was significantly associated with complicated appendicitis, prolonged operative duration, longer hospitalization, and increased postoperative morbidity. NLR may serve as a simple, inexpensive adjunct for preoperative risk assessment.

Diabetic foot care is a critical aspect of diabetes management, as poor foot care can lead to ulcers, amputations, and mortality. Despite its importance, many patients with diabetes lack adequate knowledge, attitude, and practice (KAP) regarding foot care. Objectives: This study aimed to assess the level of knowledge, attitude, and practice regarding diabetic foot care among type-II diabetic patients of a tertiary care hospital, and to determine the association between patients' demographic and clinical characteristics and their KAP. Methods: An analytical, cross-sectional study was conducted among 150 type-II diabetic patients at Lahore General Hospital, Lahore from January 2026 to June 2026, using convenience sampling. Data were collected using a structured, pre-tested questionnaire (Cronbach's alpha = 0.76) covering demographics, knowledge, attitude, and practice. Data were analyzed in SPSS version 27 using descriptive statistics (frequencies, percentages, mean, standard deviation) and, to test for associations, the Chi-square test. Results: Overall, 62.7% (n = 94) of patients had good knowledge, 64.0% (n = 96) had a positive attitude, and 36.7% (n = 55) had good practice regarding diabetic foot care (45.3%, n = 68, had poor practice). The Chi-square test showed that duration of diabetes, HbA1c (glycemic control), and having previously received foot-care education were significantly associated with knowledge, attitude, and practice categories (all p < .05). Age, gender, and treatment modality showed no significant association with any KAP domain (all p > .05). Conclusion: While patients generally demonstrated good knowledge and a positive attitude, practice regarding diabetic foot care remained suboptimal. Patients with a longer duration of diabetes, better glycemic control, and prior foot-care education demonstrated significantly better KAP, highlighting the value of early, sustained patient education, particularly for newly diagnosed and poorly controlled patients.

Electronic health records have improved access to clinical information and continuity of care; however, excessive documentation demands and inefficient digital systems may increase documentation burden and contribute to technology-related burnout among nurses. Objective: To assess digital burnout and electronic documentation burden among hospital nurses and identify documentation- and system-related factors associated with high digital burnout. Methods: This analytical cross-sectional study was conducted at a tertiary-care hospitals in Kuwait from July to December 2025. A total of 100 registered nurses routinely using electronic systems for clinical documentation were recruited through non-probability consecutive sampling. Data were collected using a structured questionnaire assessing demographic and professional characteristics, electronic documentation workload, system-related factors, documentation burden, and digital burnout. Data were analyzed using appropriate inferential tests, correlation analysis, and multivariable binary logistic regression to identify factors independently associated with high digital burnout. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported, and p<0.05 was considered statistically significant. Results: The mean age of participants was 30.7±6.1 years, and 67 (67.0%) were female. Nurses spent a mean of 3.1±1.2 hours per shift on electronic documentation, with 44 (44.0%) spending >3 hours. Duplicate documentation, system-related interruptions, and after-duty documentation were reported by 58 (58.0%), 63 (63.0%), and 55 (55.0%) nurses, respectively. High documentation burden was observed in 39 (39.0%), while 42 (42.0%) experienced high digital burnout. Documentation burden showed a moderate positive correlation with digital burnout (r=0.58, p<0.001). High documentation burden (aOR=3.42, 95% CI: 1.43–8.19), documentation >3 hours per shift (aOR=2.61, 95% CI: 1.10–6.20), and frequent system-related interruptions (aOR=2.47, 95% CI: 1.02–5.98) were independently associated with high digital burnout. Conclusion: Digital burnout was common among hospital nurses and was independently associated with greater documentation burden, prolonged documentation time, and frequent system-related interruptions. Optimizing electronic documentation workflows and system efficiency may help reduce technology-related occupational strain among nurses.

Nursing students face multiple academic, clinical, and interpersonal challenges during their training, often resulting in elevated stress levels. Excessive stress can hinder skill acquisition, impair decision-making, and compromise patient care. Objective: To identify key stressors affecting nursing students during clinical practice and to evaluate the relationship between stress levels and clinical performance. Methods: A cross-sectional study was conducted among 107 nursing students at the College of Nursing, Children's Hospital, Lahore from December 2025 to May 2026., using a simple random sampling technique. The Perceived Stress Scale (PSS) was employed to assess stress levels, and a structured clinical performance questionnaire evaluated self-reported competence. Data were analyzed using SPSS version 26; the Chi-square test was used to determine associations between stress and categorical variables. Results: More than half of participants (51.4%) reported moderate stress, while 23.4% experienced high stress. Higher stress levels were significantly associated with lower confidence in basic procedures, poorer documentation, reduced infection-control adherence, weaker medication administration, less effective communication and teamwork, poorer decision-making, weaker professionalism and ethical practice, and poorer time management (p < 0.05 for all). Students aged 20-25 years and those in their 4th year of study reported significantly higher stress than their peers (p = 0.003 and p < 0.001, respectively), while clinical placement area showed no significant association. Conclusion: Stress is prevalent among nursing students and is closely linked to reduced clinical performance across nearly every domain examined. Integrating stress-management training, simulation-based learning, and structured mentorship into nursing curricula may enhance students' competence, confidence, and professional readiness.