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Pakistan Journal of Medical & Cardiological Review

ISSN 3007-2379, 3007-2387Since 2025Pakistan
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Pakistan Journal of Medical & Cardiological Review on SciRah

Papers published
1,613
Citations
1,164
h-index
1
2-yr mean citations
0.00
Open access
96%

Most cited

Landmark papers in Pakistan Journal of Medical & Cardiological Review

  1. Analyzing nitrogen dioxide to nitrogen oxide scaling factors for data-driven satellite-based emission estimation methods: A case study of Matimba/Medupi power stations in South Africa

    Hakkarainen, Janne, Kuhlmann, Gerrit, Erik Franciscus Maria Koene, Diego Santaren +8 more

    2016Pakistan Journal of Medical & Cardiological Review1,157 citations Open access

    'C' shape yielding devices (C-devices) are effective tools for introducing supplemental sources of energy dissipation by hysteresis. Studies have shown that C-devices made of mild steel can be successfully applied as integral parts of seismic retrofitting schemes. However, explicit modelling of these devices can become cumbersome, expensive and time consuming. The device under study in this article has been previously used in non-invasive dissipative bracing for seismic retrofitting. The device is cut from a mild steel plate and has an overall shape that resembles that of a rectangular portal frame with circular interior corner transitions to avoid stress concentration and to control the extension of the dissipative region of the device. A number of inelastic finite element (FE) analyses using either inelastic 2D plane stress elements or inelastic fibre frame elements are reported and used to calibrate a 1D equivalent inelastic spring model that effectively reproduces the cyclic response of the device. The more elaborate FE model accounts for the frictional forces developed between the steel plate and the bolts used to connect the C-device to structural members. FE results also allow the visualization of the inelastic regions of the device where energy dissipation is expected to occur. FE analysis results are in a good agreement with experimental observations.

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  2. Efficacy of Eccentric Training in the Rehabilitation of Hamstring Strain Injuries: A Randomized Controlled Trial

    Unzila Sadaq, Muhammad Hamza Khalid, Syed Meeran Hasnain, Bahadur Kanwer

    2026Pakistan Journal of Medical & Cardiological Review1 citations Open access

    Background: Hamstring injuries are among the most common musculoskeletal injuries in athletes and physically active individuals, often associated with prolonged recovery and high recurrence rates. Eccentric training has gained attention as an effective intervention for improving muscle strength and reducing injury risk; however, its role in rehabilitation and recovery remains less clearly defined. Objective: This study aimed to evaluate the effect of eccentric training on hamstring injury recovery, focusing on pain reduction, muscle strength, flexibility, functional performance, and time to return to activity. Methods: A randomized controlled trial was conducted involving 40 participants aged 18–40 years with clinically diagnosed Grade I or II hamstring strains. Participants were randomly assigned to either an experimental group (eccentric training) or a control group (conventional rehabilitation), with 20 individuals in each group. The intervention period lasted 6–8 weeks. Outcome measures included pain intensity (Visual Analog Scale), hamstring strength (dynamometer), flexibility (sit-and-reach test), and functional performance scores. Data were analysed using descriptive and inferential statistics, including paired and independent t-tests, with significance set at p ≤ 0.05. Results: Both groups showed significant improvements in all outcome measures (p < 0.001). However, the experimental group demonstrated significantly greater improvements compared to the control group in pain reduction (2.1 ± 0.8 vs. 3.9 ± 1.0), strength (25.6 ± 2.8 kg vs. 21.2 ± 2.6 kg), flexibility (28.7 ± 3.5 cm vs. 24.1 ± 3.2 cm), and functional performance (82.4 ± 5.2 vs. 70.3 ± 6.0). Additionally, the eccentric training group achieved a faster return to activity (24.3 ± 3.5 days vs. 30.8 ± 4.2 days, p < 0.001). Conclusion:Eccentric training is a highly effective intervention for hamstring injury rehabilitation, significantly enhancing recovery outcomes and reducing recovery time. Its integration into standard rehabilitation protocols is recommended to optimize functional recovery and potentially reduce reinjury risk.

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  3. Microplastic Contamination and Species-Specific Vulnerability of Freshwater Fish in Sardaryab Stretch of the Kabul River, Pakistan

    Zahoor Khan*, Muhammad Kamran, Hina Tariq, Ayesha +4 more

    2026Pakistan Journal of Medical & Cardiological Review1 citations Open access

    Microplastic (MP) pollution has emerged as a critical environmental concern in freshwater ecosystems, particularly in developing countries where untreated waste discharge is common. This study evaluates the susceptibility of selected fish species Clupisoma naziri (Sher Mahi), Cyprinus carpio, Cirrhinus mrigala, Garra gotyla, Crossocheilus diplocheilus, and Barilius vagra to microplastic contamination in the Sardaryab region of the Kabul River, Pakistan. Water, sediment, and fish gastrointestinal tract samples were analyzed using digestion and microscopy techniques. Results indicated a higher abundance of microplastics in sediments (ranging from 210±45 to 610±140 MPs/kg) than in water (150±40 to 510±130 MPs/m³), with fibers and fragments being the dominant morphological types (80-92% fibers across matrices). Bottom-feeding fish exhibited significantly higher microplastic ingestion compared to pelagic species. Clupisoma naziri showed elevated contamination due to trophic transfer, with overall fish contamination ranging from 6±2 to 18±9 MPs/individual. The progressive downstream increase in microplastic concentrations underscores the cumulative impact of urbanization, agricultural runoff, and recreational activities along the river corridor. Sediment acting as a long-term reservoir of microplastics poses a chronic exposure risk to benthic organisms and facilitates continuous recontamination of the water column through resuspension events. The predominance of fibrous microplastics in fish gastrointestinal tracts raises concerns about physical blockage, reduced nutrient absorption, and potential translocation to muscle tissues consumed by humans. Furthermore, the detection of microplastics in multiple commercially valuable species highlights the urgent necessity for developing dietary exposure assessments and implementing source-specific mitigation strategies to safeguard both aquatic ecosystem integrity and public health in the region. The findings highlight ecological risks and potential human health concerns due to consumption of contaminated fish. This study emphasizes the urgent need for pollution control and species-specific monitoring strategies in the Kabul River basin. Keywords: Microplastics; Benthic feeders; Trophic transfer; Sediment contamination; Aquatic pollution; Bioaccumulation.

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  4. Green Synthesis of Silver Nanoparticles Using Medicinal Plant Extracts: Characterization and Biomedical Potential

    Kashaf Shehzadi, Aasma Akram, Z. H. Shar, Syed Muhammad Zafar Iqbal Shah +2 more

    2026Pakistan Journal of Medical & Cardiological Review1 citations Open access

    Green synthesis of silver nanoparticles (AgNPs) using medicinal plant extracts has emerged as a sustainable and eco-friendly approach for producing biologically active nanomaterials. This study investigated the biosynthesis, characterization, and biomedical potential of AgNPs derived from selected plant extracts. The nanoparticles were synthesized via a simple reduction process, and their formation was confirmed through ultraviolet–visible (UV–Vis) spectroscopy. Morphological and structural analyses were performed using scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared (FTIR) spectroscopy. The synthesized nanoparticles exhibited predominantly spherical shapes with an average particle size of 18–35 nm and crystalline face-centered cubic structures. Functional group analysis revealed the involvement of plant-derived phytochemicals in nanoparticle stabilization. The biomedical potential of the biosynthesized AgNPs was evaluated through antibacterial, antioxidant, and cytotoxicity assays. The results demonstrated broad-spectrum antimicrobial activity against Gram-positive and Gram-negative bacteria, significant concentration-dependent free radical scavenging activity, and moderate dose-dependent cytotoxic effects on mammalian cells, indicating biocompatibility at lower concentrations. These findings highlighted the multifunctional nature of green-synthesized AgNPs and their potential applications in antimicrobial therapy, oxidative stress mitigation, and wound healing. Overall, the study validated the efficacy of plant-mediated green synthesis as a cost-effective and environmentally sustainable approach to producing nanomaterials with promising biomedical relevance.

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  5. IMPACT OF BURNOUT OF HEALTHCARE PROFESSIONALS ON PATIENT CARE UNDER MEDIATION OF WORK RELATED ANXIETY AND MODERATION OF SELF COMPASSION

    Shakra Hameed, Gulzar Ahmed Khan, Zeenat Ullah

    2025Pakistan Journal of Medical & Cardiological Review1 citations Open access

    Burnout is a growing dilemma of the healthcare organizations. The healthcare workers are routinely face the multiple factors such as work overload, patient influx, sexual harassment, physical harassment at workstation which could increase their burnout conditions while performing there clinical practices. The burnout of the healthcare providers is a psychological state, which may cause the least intention toward their professional obligation turning into the deteriorated patient care. The aim of concurrent research study was to identify the impact of burnout on patient care under mediation of work related anxiety and moderation of self-compassion. To achieve the desired objective of this research study, a quantitative correlational research study was planned. The total research sample of this research study was 352 individuals working in private institutions of Rawalpendi and Islamabad. The data was analyzed to through a statistical package of social sciences after collecting with the convenient sampling technique. It was analyzed that burnout negatively impacts the patient care. Statistic concluded that burnout negatively impacts the patient care with beta coefficient of - 0.189 and devalue 2.382 and p value 0.017. Similarly, it was concluded that the work related anxiety of the healthcare professional is increased due to the burnout with beta coefficient is 0.95, t value 15.58 and p value 0.00 which in turn can decrease the patient care with - 1.48 and t value - 9.04 and p value 0.000. Similarly, it was concluded that the work related anxiety significantly mediates the relationship between burnout and patient care. However, it was identified that the self-compassion moderates to change the negative impact of work related anxiety on patient care from - 1.48 to significant value of 0.283 with the t value 7.129 and p value 0.000. It was concluded on the statistical analysis that burnout is an organizational dilemma which can affect the healthcare professionals to pay least attention towards their professional obligation and serve the patients with deteriorated level of patient care. Similarly, the work related anxiety is another organizational factor which strengthens the negative impact of burnout on the patient care. However, the healthcare professionals have coping intrinsic factors such as self-compassion. The self-compassion factor is a factor which can neutralize the negative impact of work related anxiety on the patient care because the health care professionals are considering their job as a noble profession.

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  6. Synthesis and Catalytic Activity Studies of Silver Nanoparticles Stabilized in Polymeric Hydrogel

    Asadullah, ASHRAF SHAHEEN et al, Rashid Mahmood

    2025Pakistan Journal of Medical & Cardiological Review1 citations

    This study reports the successful synthesis of silver nanoparticles (AgNPs) stabilized within a crosslinked polymeric hydrogel network. The hydrogel matrix serves as a micro-reactor, effectively controlling the nucleation and growth of AgNPs while preventing their aggregation. The synthesized hydrogel-AgNP composite was comprehensively characterized using UV-Visible Spectroscopy, Fourier-Transform Infrared (FTIR) Spectroscopy, X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), and Transmission Electron Microscopy (TEM). The results confirmed the formation of well-dispersed, spherical AgNPs with an average diameter of 10-15 nm embedded within the porous hydrogel structure. The catalytic efficacy of this composite was evaluated using the reduction of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP) as a model reaction. The reaction followed pseudo-first-order kinetics with a high-rate constant (k) of 0.123 min⁻¹. Furthermore, the hydrogel-AgNP catalyst demonstrated excellent stability and reusability, maintaining over 95% of its initial catalytic activity even after five consecutive cycles. This work presents a simple, cost-effective, and green approach to fabricating a robust nano catalyst with significant potential for applications in environmental remediation and organic synthesis.

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  7. Understanding Mental Processes in a Noisy World: Attention, Distraction, Fatigue, and Mindfulness

    Sabira Sultana, Aisha Sethi, Shehla Akbar, Faheem Hadi +5 more

    2025Pakistan Journal of Medical & Cardiological Review1 citations Open access

    The human mind is continuously inundated with information, diversions, and demands for attention in an increasingly complicated and overstimulating environment. The functioning and adaptation of mental processes, including perception, attention, memory, and decision-making, under contexts marked by cognitive noise and information overload are examined in this article. We investigate the processes that allow the brain to filter pertinent stimuli, suppress irrelevant information, and sustain goal-directed activity in the face of chaos, drawing on recent findings in cognitive psychology, neuroscience, and behavioral sciences. The essay explores the idea of cognitive load and how working memory and executive function may be impacted by too much input. The function of selective attention and attention bottlenecks is also covered, emphasizing how humans inadvertently rank information according to emotional importance, past experiences, and contextual signals. In order to comprehend how technology is changing how we receive and remember information, the effects of digital media, multitasking, and the contemporary attention economy are also critically examined. The study also explores individual differences in cognitive resilience, examining why some people perform well under pressure while others suffer from burnout or mental exhaustion. The relationship between stress, cognition, and decision-making is examined, with a focus on the ways that long-term overstimulation exposure might exacerbate mental health issues including anxiety, cognitive exhaustion, and poor emotional control. This article provides a thorough understanding of how the mind works in the presence of both literal and metaphorical noise by combining results from experimental research, observations from everyday life, and new theories in cognitive science. Additionally, it suggests useful methods for enhancing attention and cognitive clarity in daily life, such as digital hygiene, mindfulness exercises, and cognitive offloading tactics. The ultimate goal of this work is to offer a comprehensive understanding of the adaptable and susceptible facets of human cognition in the context of our contemporary, distraction-filled environment.

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  8. Effectiveness of Acceptance and Commitment Therapy for type 2 Diabetes. A Systematic Review

    Faiza Batool, Anila Sadaf Mubashir

    2025Pakistan Journal of Medical & Cardiological Review1 citations Open access

    Background: Type 2 diabetes mellitus (T2DM) is a metabolic condition with chronic uncontrolled treatment that comes with other psychological problems like diabetes distress, low self-efficacy, and self-care practices. ACT Acceptance and Commitment Therapy (ACT), third-wave behavioral treatment, has also been singled out due to its commitment to psychological flexibility and value-explicit conduct, which could be helpful to patients with T2DM. Aim: The aim of the review was to determine the extent to which ACT could enhance diabetes distress, self-care behaviors, psychological flexibility, self-efficacy, and glycemic control (HbA1c levels) among adults with type 2 diabetes. Method: Systematic review has been performed on randomized controlled studies (RCTs) with a search of five databases, including PubMed, Scopus, PsycINFO, ScienceDirect, and Google Scholar, including research papers published between 2014 to 2024. A synthesis of 10 studies meeting the inclusion criteria was done, and the quality was evaluated by using an assessment matrix. The final review was composed of ten RCTs with various delivery formats and different intervention length. Results: The results were always in line that ACT had a powerful impact in decrease of diabetes distress and advancement of mental adaptability, self-care actions and self-efficacy. Moderate declines in the levels of HbA1c were also reported in several studies. Actual and virtual ACT interventions were identified to be possible, but retention was not consistent. In comparison treatment, the studies indicated that ACT was not inferior to the other interventional procedures like mindfulness-based therapy and emotion-focused therapy. Conclusion: The study seems to suggest that ACT is a not only effective but also versatile psychological intervention among T2DM adults with emotional and behavioral outcomes. It is advised that larger scale trials should be done in future to establish long term benefits. Keywords: Type 2 diabetes, Acceptance and Commitment Therapy, psychological flexibility, diabetes distress, self-care, self-efficacy, HbA1c, RCT.

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  9. Efficacy of Pethidine and Dexamethasone Combination in Managing Postoperative Shivering (Cesarean) Section

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Background: Postoperative shivering is a common complication after the spinal anesthesia particularly in the cesarean section patients. Effective management strategies, including the use of Pethidine and Dexamethasone, have been explored to reduce shivering. Objective: To evaluate the efficacy of the combination of pethidine and dexamethasone in controlling postoperative shivering in patients undergoing cesarean section under spinal anesthesia. Methodology: A randomized controlled trial was conducted with 100 patients undergoing cesarean section, assigned to either Pethidine or Pethidine + Dexamethasone groups. Shivering severity, duration, recurrence, and complications were assessed postoperatively. Results: The combination therapy of Pethidine + Dexamethasone significantly reduced shivering severity (mean = 0.56), duration (mean = 1.74 minutes), and recurrence (14.0%) compared to Pethidine alone (severity mean = 1.91, duration mean = 5.25 minutes, recurrence 43.9%). The combination group also had fewer complications (18.6%). Conclusion: Pethidine combined with Dexamethasone is more effective and safer than Pethidine alone in managing postoperative shivering in cesarean section patients under spinal anesthesia.

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  10. Efficacy And Safety Of Combination Diuretic Therapy In Patients With Heart Failure: A Systematic Review And Meta-Analysis

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Background: Persistent fluid overload is one of the hardest problems in heart failure (HF) care. Giving two or more diuretic classes together, for example metolazone with furosemide, has been suggested as a way to boost fluid removal and improve outcomes. Objective: To judge the benefits and risks of combination diuretic strategies in patients with HF. Methods: PubMed, the Cochrane Library, Embase and Web of Science were searched, yielding 61 records. Seven randomised controlled trials (RCTs) satisfied the eligibility criteria. Information on mortality, rehospitalisation, symptoms, electrolyte disturbance, kidney function and adverse events was extracted. Risk of bias was appraised with standard tools, and pooled estimates were produced with RevMan 5.4.0 using fixed- or random-effects models according to heterogeneity. Results: Combination therapy produced a statistically significant fall in body weight (P = 0.001) but no meaningful difference in mortality (risk ratio [RR] 0.99; 95% CI 0.90–1.09) or rehospitalisation (RR 1.05; 95% CI 0.98–1.12) relative to control. Electrolyte disturbances (low or high sodium, low potassium) and worsening kidney function were reported in the combination arms of several trials, whereas serious adverse events were reported more often in control arms. The pooled difference in Kansas City Cardiomyopathy Questionnaire (KCCQ) score was 2.43 points (95% CI 0.95–3.92). Heterogeneity was low for most outcomes (I² below 50%), and funnel plots suggested limited publication bias. Conclusions: Combination diuretics reduce fluid burden and weight but do not change mortality or readmission. Because they can disturb electrolytes and kidney function, close monitoring and individualised prescribing are essential. Future work should refine which combinations and doses are best

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Latest

Recently published

  1. Efficacy of Pethidine and Dexamethasone Combination in Managing Postoperative Shivering (Cesarean) Section

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Background: Postoperative shivering is a common complication after the spinal anesthesia particularly in the cesarean section patients. Effective management strategies, including the use of Pethidine and Dexamethasone, have been explored to reduce shivering. Objective: To evaluate the efficacy of the combination of pethidine and dexamethasone in controlling postoperative shivering in patients undergoing cesarean section under spinal anesthesia. Methodology: A randomized controlled trial was conducted with 100 patients undergoing cesarean section, assigned to either Pethidine or Pethidine + Dexamethasone groups. Shivering severity, duration, recurrence, and complications were assessed postoperatively. Results: The combination therapy of Pethidine + Dexamethasone significantly reduced shivering severity (mean = 0.56), duration (mean = 1.74 minutes), and recurrence (14.0%) compared to Pethidine alone (severity mean = 1.91, duration mean = 5.25 minutes, recurrence 43.9%). The combination group also had fewer complications (18.6%). Conclusion: Pethidine combined with Dexamethasone is more effective and safer than Pethidine alone in managing postoperative shivering in cesarean section patients under spinal anesthesia.

    OpenAlex
  2. Efficacy And Safety Of Combination Diuretic Therapy In Patients With Heart Failure: A Systematic Review And Meta-Analysis

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Background: Persistent fluid overload is one of the hardest problems in heart failure (HF) care. Giving two or more diuretic classes together, for example metolazone with furosemide, has been suggested as a way to boost fluid removal and improve outcomes. Objective: To judge the benefits and risks of combination diuretic strategies in patients with HF. Methods: PubMed, the Cochrane Library, Embase and Web of Science were searched, yielding 61 records. Seven randomised controlled trials (RCTs) satisfied the eligibility criteria. Information on mortality, rehospitalisation, symptoms, electrolyte disturbance, kidney function and adverse events was extracted. Risk of bias was appraised with standard tools, and pooled estimates were produced with RevMan 5.4.0 using fixed- or random-effects models according to heterogeneity. Results: Combination therapy produced a statistically significant fall in body weight (P = 0.001) but no meaningful difference in mortality (risk ratio [RR] 0.99; 95% CI 0.90–1.09) or rehospitalisation (RR 1.05; 95% CI 0.98–1.12) relative to control. Electrolyte disturbances (low or high sodium, low potassium) and worsening kidney function were reported in the combination arms of several trials, whereas serious adverse events were reported more often in control arms. The pooled difference in Kansas City Cardiomyopathy Questionnaire (KCCQ) score was 2.43 points (95% CI 0.95–3.92). Heterogeneity was low for most outcomes (I² below 50%), and funnel plots suggested limited publication bias. Conclusions: Combination diuretics reduce fluid burden and weight but do not change mortality or readmission. Because they can disturb electrolytes and kidney function, close monitoring and individualised prescribing are essential. Future work should refine which combinations and doses are best

    OpenAlex
  3. AntimicrobialResistanceinaChangingClimate:Evidence,CausalPathways, and Prevention Strategie

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Background: Antimicrobial resistance (AMR) and climate change are both significant global health threats increasingly recognized as mechanistically interconnected. This review critically synthesises evidence on the potential for climate-related hazards (temperature, heatwaves, flooding and drought) to alter and intensify AMR via biological, environmental and health-system pathways, and evaluates the causal strength and implications for prevention. Methods: This critical narrative review involved a structured literature-identification and updating process, critically appraising systematic and scoping reviews, primary ecological and genomic studies, modelling analyses, and authoritative One Health reports through August 2026, organized by hazard and pathway rather than paper by paper. Results: Association of temperature with AMR is one of the most consistent and replicated findings across ecological studies in the United States, Europe and China, and is supported by a large multi-country genomic analysis of Salmonella resistance genes. This relationship is not generalizable: at least one adjusted analysis found no significant temperature-resistance association, highlighting the organism- and context-specific nature of the relationship. Resistant pathogens and resistance genes are mobilized in the environment during flooding, but there is limited direct evidence of this leading to increased clinical infection. Ecological study design, residual confounding and limited data availability in South Asia, including Pakistan, limit causal inference across hazards. Evidence assessing climate-specific AMR prevention interventions remains limited. Conclusions: Climate change must be considered as a potential contributing and amplifying factor for AMR, rather than a proven independent cause. Climate-informed surveillance is a priority for LMICs, including Pakistan, for One Health AMR strategies.

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  4. Decoding Early Placental Dysfunction Through Maternal Biomarker Patterns: A Novel Approach to Predicting Pregnancy Complications

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Placental dysfunction is a major contributor to adverse pregnancy outcomes, including pre-eclampsia, fetal growth restriction, small-for-gestational-age birth, stillbirth, and medically indicated preterm delivery. These complications are frequently preceded by abnormal placental development, impaired trophoblast invasion, altered angiogenesis, and reduced uteroplacental perfusion. Because clinical manifestations often emerge after placental pathology has progressed, early prediction remains a key objective in obstetric research and clinical practice. This research paper examines the potential of maternal biomarker patterns for identifying early placental dysfunction and predicting pregnancy complications. A literature-based research approach was used to evaluate evidence concerning pregnancy-associated plasma protein-A, placental growth factor, soluble fms-like tyrosine kinase-1, the sFlt-1/PlGF ratio, mean arterial pressure, and uterine artery Doppler indices. The findings indicate that low placental growth factor and pregnancy-associated plasma protein-A, together with elevated soluble fms-like tyrosine kinase-1 and sFlt-1/PlGF ratios, are associated with increased risk of pre-eclampsia and fetal growth restriction. The evidence further suggests that predictive performance improves when maternal biomarkers are integrated with clinical risk factors, obstetric history, blood-pressure measurements, and ultrasound findings. This integrated approach may support earlier risk stratification, targeted surveillance, and personalized antenatal care. Further prospective multicenter studies are needed to validate standardized, cost-effective, and equitable biomarker-based prediction models.

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  5. In Silico Screening and Structural Analysis of Thermostable Enzymes for Industrial Biotechnology

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Thermostable enzymes are increasingly important for industrial biocatalysis because their enhanced structural stability enables catalytic activity under elevated temperatures and other demanding process conditions. In this study, an integrated computational framework was developed to identify and characterize potential thermostable lipases from large-scale metagenomic and enzyme sequence resources. Candidate enzymes were initially screened using sequence-composition characteristics and thermophilic structural signatures, followed by structural homology analysis using Foldseek. Potentially promising candidates were further evaluated through molecular dynamics simulations to assess conformational stability at elevated temperatures. Additional structural analyses focused on hydrophobic-core packing, disulfide bridge formation, hydrogen-bonding interactions, and local flexibility as potential determinants of thermostability. Computational stability assessment using PROSS and Rosetta-based energetic analysis was incorporated to evaluate structural integrity and favorable residue interactions while preserving catalytic-site architecture. Machine-learning-based prediction was additionally considered for identifying potentially destabilizing substitutions and refining the candidate pool. The screening pipeline identified three promising lipase candidates, designated LIP-01, LIP-04, and LIP-09, with predicted melting temperatures exceeding the predefined 85°C threshold and conserved catalytic residues. Molecular dynamics analysis over 200 ns indicated stable structural behavior at 50°C, while structural examination suggested that enhanced hydrophobic packing, disulfide connectivity, and persistent hydrogen-bonding interactions contributed to the predicted thermal robustness of the candidates. The R209 region, together with interactions involving H198 and N247, emerged as a potentially important structural feature in Thermomyces lanuginosus lipase variants. Collectively, these findings demonstrate the potential of an integrated sequence-, structure-, simulation-, and machine-learning-based strategy for prioritizing thermostable lipases for subsequent experimental validation and industrial biocatalytic applications.

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  6. Targeted Delivery of Losartan Using a Biodegradable Polymeric Nanocarrier for the Management of Hypertension-Associated Vascular Remodeling

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Background: Hypertension manifests through endothelial dysfunction, oxidative stress, and vascular remodeling. Angiotensin II–AT1 receptor signaling contributes to these processes, supporting the role of angiotensin-receptor blockade in vascular disease management. Losartan is an established AT1 receptor blocker, while biodegradable polymeric nanocarriers may allow for extended drug release and altered pharmacokinetics. [1,3,4] Objective: The present study aims to characterize antihypertensive treatment patterns and record vascular or cardiovascular findings among 120 patients with hypertension who received care in selected tertiary-care hospitals in Punjab, Pakistan. This observational study will also establish the framework for subsequent evaluation of a losartan-loaded biodegradable polymeric nanocarrier. Methods: The observational part of this study will involve retrospective extraction of demographical, blood-pressure, comorbidity, laboratory, prescription, treatment modification, adherence, and vascular or cardiovascular imaging data. A prospective experimental program will also be designed, which will entail formulation and characterization of a biodegradable losartan nanocarrier, followed by in-vitro release trials, pharmacokinetic assessment, and safety and efficacy studies prior to clinical investigations. Results: Please note that the results section cannot be generated without the actual data extracted from the 120 patient records. For this reason, the present manuscript provides the framework for observational analyses without presenting hypothetical findings. Similarly, the proposed biodegradable nanocarrier for losartan delivery is a concept that requires extensive preclinical and clinical investigations before safety and efficacy can be established. Conclusion: Hospital records represent a valuable source of real-world evidence regarding treatment patterns and clinical outcomes associated with specific therapeutic approaches. The present study will generate practice-level insights and support the design of a future nanomedicine program for hypertension. Specifically, a biodegradable polymeric nanocarrier for losartan delivery will require extensive physicochemical, toxicological, pharmacokinetic, preclinical, and clinical evaluations before it can be considered a viable therapeutic option.

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  7. Effectiveness Of Various Types Of Face Mask In Preventing Air Borne Diseases

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Masks have long been regarded to be an efficient tool for combating with external factors. They are utilized to protect the respiratory system from harmful respiratory droplets and fumes such as viruses and contamination particles. Droplets can be pollutants in the air or infectious aerosolized viruses spread by sick people's coughing and sneezing. Because of the varying sizes, patterns, and characteristics of the droplets, the filtering efficacy of numerous masks against such pollutants tends to vary. As a consequence, the goal is to develop more effective filtration masks to reduce permeability ratios in the most extreme situations. To fully understand this concept, one must first understand the mechanics of airborne particle permeation through masks under various effective environmental factors. The related techniques of aerosol permeation through masks are described in this paper. The effect of the surroundings on infiltration and construction effectiveness is investigated

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  8. Doppler Assessment Of Umbilical Blood Flow In 2nd And 3rd Trimester Pregnancies Of Women With Primary Hypertension

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Background: Primary hypertension during pregnancy is a significant risk factor for adverse maternal and fetal outcomes. Doppler ultrasound assessment of umbilical blood flow and amniotic fluid index (AFI) provides information regarding fetoplacental hemodynamics and fetal well-being. Objective: To evaluate Doppler assessment of umbilical blood flow in second- and third-trimester pregnancies of women with primary hypertension. Methods: A cross-sectional comparative study included 120 pregnant women between 20 and 39 weeks of gestation, divided equally into a primary-hypertension group (n=60) and normotensive controls (n=60). Umbilical artery RI, PI, S/D ratio and AFI were assessed using Doppler ultrasound. Results: Mean AFI was lower in the hypertensive group (9.38 ± 0.89) than controls (12.84 ± 1.23; p<0.001). Umbilical artery RI, PI and S/D ratio were higher in hypertensive pregnancies: 0.72 ± 0.07 vs 0.58 ± 0.05, 2.81 ± 0.64 vs 1.24 ± 0.38, and 3.58 ± 0.48 vs 2.46 ± 0.38, respectively; all were statistically significant. Conclusion: Primary hypertension was associated with reduced AFI and elevated umbilical artery Doppler indices, consistent with increased fetoplacental vascular resistance.

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  9. Statistical Digital Twins with Explainable AI: A Machine Learning Framework for Dynamic Prediction and Risk Intelligence

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Digital twins increasingly combine sensor streams, engineering models, simulation, and machine learning to support diagnosis, prognosis, optimization, and risk-sensitive operational decisions. Current standards and research, however, increasingly emphasize that a trustworthy digital twin must also provide credible uncertainty, lifecycle traceability, interoperability, and interpretable decision support. NIST identifies synchronized operation, model credibility, interoperability, and VVUQ as important requirements for advanced-manufacturing digital twins, while the ISO 23247 family supplies manufacturing-specific principles, digital-thread guidance, and composition mechanisms. [12] This paper proposes a Statistical Digital Twin with Explainable AI (ST-XAI) framework for dynamic prediction and risk intelligence. The architecture represents latent asset health probabilistically; integrates multivariate telemetry, operating context, asset metadata, event history, and optional physics/simulation outputs; applies causal multi-scale temporal feature engineering; supports classical, ensemble, sequence, Bayesian, and hybrid prognostic models; quantifies uncertainty through heteroscedastic estimation and conformal calibration; converts prognostic outputs into horizon-specific event probabilities; and integrates global, local, and temporal explanations using SHAP-family methods. The design is intended to make prediction, uncertainty, risk, explanation, and provenance parts of a single synchronized decision system rather than separate analytical products. A two-track experimental design is defined. NASA C-MAPSS is adopted as the proposed open-source external RUL benchmark; NASA describes the dataset as four turbofan degradation simulations under different combinations of operating conditions and fault modes with multiple sensor channels. [10] A second, fully controlled synthetic dataset is executed to permit known degradation dynamics, ablation experiments, calibration tests, and uncertainty stress analysis. The executed dataset contains 120 run-to-failure assets, 18,871 observations, and 79 causal predictors. Asset-level 60/20/20 train/validation/test splitting prevents trajectory leakage. On the synthetic locked test set, the validation-selected predictor achieves RMSE 5.842 cycles, MAE 4.039 cycles, and R² 0.9756. For failure within 30 cycles, calibrated risk prediction achieves AUROC 0.9971 and AUPRC 0.9861, while isotonic calibration lowers expected calibration error from 0.0192 to 0.00935. Removing rolling temporal features increases XGBoost RMSE by approximately 9.9%, demonstrating their value in the controlled experiment. Normalized split-conformal intervals nevertheless under-cover on unseen assets, with nominal 90% coverage yielding 84.0% empirical coverage. The latter finding illustrates why calibration and distribution-shift monitoring must be intrinsic capabilities of a statistical digital twin. The study concludes that a decision-grade digital twin should be regarded as a continuously updated statistical belief-and-decision system. Trustworthy operation requires explicit modeling of uncertainty, probability calibration, time-aware explanations, data/model lineage, distribution-shift detection, human oversight, and continuous VVUQ not point prediction alone.

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  10. Optimization and production of bacterial cellulose from food waste

    Pakistan Journal of Medical & Cardiological Review

    2026Pakistan Journal of Medical & Cardiological Review0 citations Open access

    Bacterial cellulose (BC) is a biodegradable and biocompatible biomaterial with distinctive properties, including high crystallinity, mechanical strength, porosity, and water-retention capacity. However, the relatively high cost of conventional culture media remains a major limitation to its large-scale production. This study aimed to investigate the potential of food and agricultural waste as low-cost substrates for bacterial cellulose production and to compare the resulting BC with that produced using standard Hestrin–Schramm (HS) medium. Sugarcane bagasse and utilized tea were evaluated as alternative carbon and nitrogen sources, respectively, using a SCOBY culture as the inoculum. Fermentation was conducted under static conditions at 30 °C, and bacterial cellulose formation was assessed using different substrate combinations and concentrations. The pH and wet weight of the produced BC were measured, while Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and field-emission scanning electron microscopy (FE-SEM) were used for characterization. Bacterial cellulose formation was observed with several substrate combinations, with the 1500 mL bagasse-water and utilized-tea medium producing the highest recorded wet weight (55.4854 g), compared with 15.7408 g obtained from the standard HS medium. The pH of the production media after inoculation ranged from 4.0 to 4.5. FTIR spectra of BC produced from bagasse and utilized tea were comparable to those of BC produced using HS medium, indicating similar characteristic functional groups. XRD analysis showed comparable cellulose characteristics between bagasse-derived BC and the standard, while glucose-derived BC showed differences that may be associated with impurities. FE-SEM revealed a densely packed fibrous network with irregularly arranged fibrils in the bagasse-derived BC. Overall, the findings demonstrate the potential of sugarcane bagasse and utilized tea as inexpensive alternative substrates for bacterial cellulose production and food-waste valorization. Further optimization, purification, and scale-up studies are required to establish their industrial feasibility.

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