Health and Medical Discoveries (HMD) is a peer-reviewed, open-access journal published twice a year by SYNERGY EDUCATIONAL LEARNING INSTITUTE (SMC-PRIVATE) LIMITED. The journal is dedicated to advancing scientific knowledge and innovation in the fields of health and medicine. HMD provides a platform for groundbreaking research, clinical studies, and comprehensive reviews across all areas of medical science. It aims to foster interdisciplinary dialogue and offer fresh insights into novel treatments, diagnostic methods, public health policies, and emerging medical technologies that impact global health. The journal covers a wide range of topics, including but not limited to: Clinical trials and experimental therapies Public health and epidemiology Disease prevention and health promotion Medical ethics and policy Biomedical engineering and innovations in medical technology Healthcare systems and administration Mental health, psychology, and psychiatry Medical genetics and personalized medicine Regenerative medicine and stem cell research Innovations in drug development and pharmacology Health and Medical Discoveries publishes original research articles, clinical case studies, reviews, opinion pieces, and editorials that spotlight critical advancements and their real-world applications. The journal encourages contributions from researchers, healthcare professionals, policymakers, and institutions worldwide. By providing open access to high-quality research, Health and Medical Discoveries aims to support the global health community in improving patient care, advancing medical science, and addressing the most pressing health challenges of our time.
SYNERGY EDUCATIONAL LEARNING INSTITUTE (SMC-PRIVATE) LIMITED
Minimally Invasive Surgical Techniques and Postoperative Outcomes: A Systematic Literature Review
Laparoscopic and robotic-assisted surgical procedures, referred to as minimally invasive surgical (MIS), have revolutionized the practice of surgery in the present era by minimizing traumas to the tissues and improving the postoperative outcomes. Although widespread, there is still controversy on their long-term oncological safety, complication rates and cost-effectiveness in different surgical specialties. The purpose of this systematic review and meta-analysis was to synthesize up-to-date evidence on a comparison of minimally invasive and open surgery regarding perioperative outcome, postoperative morbidity, oncolog safety at the long-term, and healthcare utilisation. According to PRISMA, the electronic databases such as PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched to find the studies published between 2000 and 2025. Randomised controlled trials, cohort studies, systematic reviews and meta-analyses that assessed the postoperative outcomes of laparoscopic and robotic-assisted surgery were considered. Study selection, data extraction and quality appraisal were conducted by two independent reviewers using validated appraisal tools. The quantitative synthesis was applied where methodological homogeneity was allowed.There were 108 studies that met the inclusion criteria with 64 included in the meta-analysis. Minimally invasive procedures were found to be linked to much less intraoperative blood loss, reduced hospital stay, lower postoperative pain scale, and less rate of surgical site infection as compared to the open surgery. Complication rates in the minimally invasive cohorts were lowered up to about 3045 percent overall. Robotic surgery was also shown to be more precise and had a lower rate of conversion in complex pelvic surgery, but had a longer operative time and a higher direct cost of the procedure. There were no significant differences between the extremely minimal invasive and open procedures in long-term oncological outcome, such as disease-free and overall survival, in colorectal and urologic malignancies; nevertheless, the selected cases of cervical cancer justify caution. In most clinical settings, surgical methods offer advantages of minimally invasive operations that offer better short-term perioperative outcomes and lower morbidity at the expense of cancer safety. Despite the technical benefits of robotic systems in complicated procedures, the cost implications and oncological concerns associated with the procedure make the use of patient selection and institutional experience very critical. Further randomized trials and long-term outcome data, which are of high quality, are necessary to further direct surgical decision-making and maximize patient-centered care.
Postoperative outcomes, Surgical complications
Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
NEURO-OPHTHALMIC CORRELATES OF OPTIC NERVE PATHOLOGIES: AN MRI-BASED STUDY
This MRI-based investigation examined the structural and functional neuro-ophthalmic correlates associated with diverse optic nerve pathologies, aiming to identify measurable biomarkers that enhance diagnostic precision and clinical decision-making. A multi-center prospective design was employed, integrating high-resolution MRI modalities—including T2-weighted imaging, diffusion-weighted imaging, and quantitative neuro-ophthalmic indices—to evaluate patients presenting with ischemic, demyelinating, inflammatory, and compressive optic neuropathies. The findings revealed significant associations between MRI-derived structural changes and functional visual outcomes. Increased T2 hyperintensity correlated strongly with delayed visual evoked potential (VEP) latency, while reduced apparent diffusion coefficient (ADC) values were prominently observed in compressive and ischemic neuropathies. Additionally, lesion topography mapping demonstrated distinct spatial clustering patterns, particularly in the intracanalicular and intracranial optic nerve segments, suggesting segment-specific vulnerability influenced by vascular and anatomical factors. Multidimensional integration of MRI markers into a composite Neuro-Ophthalmic Severity Index (NOSI) provided reliable grading of pathology severity and aligned closely with clinical symptom scores. These results underscore the value of MRI-based structural and functional profiling as a non-invasive, high-precision diagnostic approach, offering clinicians a more comprehensive foundation for early detection, staging, and prognostic predictions in optic nerve disorders. The study highlights the importance of multimodal imaging analytics and supports their routine incorporation into neuro-ophthalmic diagnostic pathways.
Copyright (c) 2025 Salman Javed, Amina Rashid (Author) https://creativecommons.org/licenses/by/4.0
COMPARATIVE EFFICACY OF NEPHROPROTECTIVE AGENTS IN CHRONIC KIDNEY DISEASE WITH UROLOGICAL COMORBIDITIES
Chronic Kidney Disease (CKD) complicated by urological comorbidities presents a complex clinical challenge, as impaired renal function is often exacerbated by recurrent obstruction, infection, or structural abnormalities of the urinary tract. This comparative study evaluated the therapeutic effects of ACE inhibitors, SGLT2 inhibitors, and antioxidant therapy across a 24-week intervention period in patients with CKD stages 2–4. Quantitative analyses revealed significant improvements in renal functional markers—including serum creatinine, eGFR, and albuminuria—with SGLT2 inhibitors demonstrating the greatest nephroprotective effect, particularly in patients with recurrent obstructive pathology or metabolic stone disease. Antioxidant therapy showed moderate yet consistent benefits in reducing oxidative stress–associated markers such as NGAL, KIM-1, and IL-18, while ACE inhibitors remained effective in stabilizing glomerular hemodynamics but produced comparatively smaller reductions in biomarker indices. Correlation analyses indicated strong inverse relationships between eGFR and NGAL, suggesting that biomarker-based monitoring can enhance early detection of subclinical injury in CKD patients with urological complications. Additionally, reductions in urological complication rates—such as stone recurrence, urinary retention, or reflux episodes—were more prominent in the SGLT2 inhibitor group, highlighting secondary benefits beyond renal filtration. Overall, the findings demonstrate that nephroprotective strategies must be tailored not only to renal stage but also to associated urological pathology to optimize clinical outcomes. This study reinforces the need for integrated nephrology-urology therapeutic models to improve long-term renal preservation and reduce progression to end-stage kidney disease.
Copyright (c) 2025 Sadia Shahid, Usman Qureshi (Author) https://creativecommons.org/licenses/by/4.0
POSTOPERATIVE REHABILITATION PROTOCOLS AND FUNCTIONAL RECOVERY IN ATHLETES FOLLOWING ACL RECONSTRUCTION
Anterior cruciate ligament (ACL) reconstruction remains one of the most common procedures performed in athletes, yet postoperative functional recovery varies widely depending on rehabilitation progression, neuromuscular adaptation, and individual biomechanical responses. This multi-center prospective study evaluated postoperative rehabilitation protocols and their impact on functional outcomes across 120 competitive athletes following ACL reconstruction. Quantitative measures—including strength symmetry indices, hop performance metrics, range of motion (ROM) progression, and Functional Recovery Index (FRI) scores—were collected over a 12-week period, complemented by qualitative assessments of athlete-reported pain, confidence, and return-to-sport (RTS) readiness. Results demonstrated significant improvements in quadriceps strength symmetry, dynamic stability, and hop distance by Weeks 6 to 10, with athletes achieving measurable gains in knee flexion and extension ROM. FRI scores showed consistent upward trajectories, indicating progressive restoration of functional capacity. Pain levels decreased substantially, whereas psychological readiness improved, emphasizing the role of both physical and mental rehabilitation components in recovery. Correlation analysis revealed strong associations between strength symmetry, ROM gains, hop performance, and overall functional recovery. Athletes who followed structured, phase-based rehabilitation protocols demonstrated superior outcomes compared to those with inconsistent adherence. These findings highlight the critical importance of early neuromuscular training, progressive loading, and standardized RTS criteria in optimizing postoperative recovery. The study reinforces that comprehensive, evidence-based rehabilitation protocols not only accelerate functional gains but also enhance long-term athletic performance and reduce reinjury risk. Overall, this research advances the understanding of postoperative ACL rehabilitation by identifying key functional predictors, highlighting effective recovery strategies, and providing data-driven recommendations for clinical and sports-performance settings.
Copyright (c) 2025 Umair Saeed, Hiba Qureshi (Author) https://creativecommons.org/licenses/by/4.0
CLINICAL PREDICTORS OF MORTALITY IN ACUTE RESPIRATORY DISTRESS SYNDROME PATIENTS IN INTENSIVE CARE SETTINGS
Acute Respiratory Distress Syndrome (ARDS) remains one of the leading causes of mortality among critically ill patients admitted to intensive care units (ICUs). This multi-center prospective study aimed to identify and validate clinical, physiological, and biochemical predictors of mortality in ARDS patients using a mixed-method quantitative framework. Data from 420 patients across four tertiary ICUs were analyzed using logistic regression and ROC curve modeling to determine the most significant predictors of adverse outcomes. The findings revealed that age, SOFA score, APACHE II score, and serum lactate levels were the strongest independent predictors of mortality, while PaO₂/FiO₂ ratio served as a crucial indicator of oxygenation status. Patients with severe ARDS (PaO₂/FiO₂ < 100 mmHg) exhibited a significantly higher mortality rate compared to those with moderate and mild forms. ROC analysis demonstrated excellent predictive accuracy (AUC = 0.87), confirming the robustness of the identified model. Additionally, inter-center variability highlighted differences in mortality patterns associated with institutional protocols and mechanical ventilation practices. These findings suggest that early recognition of high-risk indicators and implementation of standardized, data-driven management strategies can substantially improve survival outcomes. The study underscores the importance of integrating clinical scoring systems with biochemical markers to develop precision-based critical care models for ARDS management. Overall, this research contributes to advancing evidence-based ICU protocols and offers a validated predictive framework to enhance clinical decision-making and resource optimization in critical respiratory care.
Copyright (c) 2025 Muhammad Asadullah Usman, Irum Habib (Author) https://creativecommons.org/licenses/by/4.0
MATERNAL AND NEONATAL OUTCOMES IN HIGH-RISK PREGNANCIES: A MULTI-CENTER PROSPECTIVE ANALYSIS
This study investigates the maternal and neonatal outcomes associated with high-risk pregnancies through a multi-center prospective analysis, integrating clinical, biochemical, and demographic variables. The research aimed to identify key maternal risk factors influencing neonatal health and to develop predictive associations using statistical and computational modeling. Data were collected from multiple healthcare centers encompassing diverse maternal profiles including preeclampsia, gestational diabetes mellitus, multiple gestations, and intrauterine growth restriction. Quantitative analysis demonstrated significant correlations between maternal hypertension, advanced age, and abnormal biochemical markers with adverse neonatal outcomes such as low birth weight, reduced Apgar scores, and increased NICU admissions. Regression and correlation models indicated that maternal systolic blood pressure and creatinine levels were the most predictive parameters for neonatal complications. The inclusion of visual analytics such as line, bar, scatter, and hybrid plots enhanced understanding of data variability across gestational stages and care settings. The findings highlight disparities in maternal care quality across centers, suggesting that standardized protocols and early intervention strategies could substantially improve perinatal outcomes. Overall, this research emphasizes the importance of integrated monitoring systems, data-driven predictive tools, and interprofessional collaboration for reducing morbidity and mortality in high-risk pregnancies. The results establish a scientific foundation for precision obstetrics—bridging clinical insight with machine-assisted prediction to ensure safer maternal and neonatal health trajectories.
Copyright (c) 2025 Rabia Nasir, Shahzad Rafiq (Author) https://creativecommons.org/licenses/by/4.0
MOLECULAR MECHANISMS OF NEUROINFLAMMATION IN ALZHEIMER'S DISEASE: UNDERSTANDING THE INTERPLAY BETWEEN MICROGLIA, CYTOKINES, AND SYNAPTIC DYSFUNCTION
Neuroinflammation is one of the major pathological hallmarks in AD, and it is primarily the result of microglial activation, dysregulated cytokines, and synaptic dysfunction. This review discusses the molecular mechanisms of neuroinflammatory response at AD while focusing on microglia, astrocytes, and the complement system in synapse elimination and cognitive deficit as they relate to synaptic loss and cognitive impairment. It offers an insight into microglia-mediated complement activation C1q and C3 and their contribution to excessive pruning of synapses, resulting in neuronal loss. Similarly, neurodegeneration is exacerbated through impairment of synaptic plasticity and neurotransmitter disbalance by cytokines like IL-1β, TNF-α, and IL-6. TREM2 is one of the prime microglial receptors involved in modifying immune responses and clearing amyloid-beta (Aβ); however, TREM2 mutations impair its function and put neurons at risk of inflammation and damage. Astrocytes further add to neuroinflammation through the release of proinflammatory mediators and the disruption of glutamate homeostasis. Although imaging and modern artificial intelligence tools have conveyed some understanding of microglial dynamics, considerable gaps remain regarding microglial subtype heterogeneity and long-term results of neuroinflammatory pathway targeting in this aspect. Thus, attention should be focused on the modulation of TREM2 activation, complement inhibition, and cytokine modulation in upcoming therapeutic strategies to achieve neuroinflammation-based action without compromising critical immune functions. Such knowledge on the part of neuroinflammation and its role in synaptic dysfunction in AD will enlighten the basis for intervention in slowing down disease progression while preserving cognitive function.
Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0
TARGETED DRUG DELIVERY SYSTEMS IN CANCER THERAPY: NANOTECHNOLOGY-DRIVEN APPROACHES FOR ENHANCING THERAPEUTIC EFFICACY
The growing sophistication of cancer and its resistance to standard therapies calls for innovations in drug delivery systems to improve therapeutic results. This review looks at the state of the art in targeted cancer therapy employing nanotechnology with a focus on new developments that seek to boost treatment modalities efficacy and precision. New developments in liposomes, dendrimers, polymeric nanoparticles, and metallic nanoparticles are analyzed for their use in target site specific controlled delivery and release of chemotherapeutics, which reduces systemic toxicity and increases drug retention at the target region. This review further analyzes the use of these nanotechnologies for integrated diagnostic and therapeutic functions termed as theragnostic, which allow personalized treatment plans to be crafted for specific patient profiles and tumor traits. Furthermore, we analyze the contemporary clinical application of these technologies, describe important issues such as biocompatibility, immunogenicity, regulatory issues, and avenues of future research. Our result analysis suggests that while great strides have been made on the application of nanotechnology for treating cancer, quantitatively significant effort. It has been concluded that the commissioning of nanotechnology into the targeted delivery system has made a huge impact on cancer treatment. That highlight includes mostly the ability to release the drug in a highly specific, controlled, and stimuli-responsive manner and reduces systemic toxicity. Future research will focus on the challenges of nanoparticle bio-distribution, tumor heterogeneity, and drug resistance to make possible future developments toward true personalized nanomedicine.
HARNESSING CRISPR-CAS9 GENE EDITING FOR TARGETED THERAPY IN SOLID TUMORS: CHALLENGES AND FUTURE DIRECTIONS
The possibilities of using advanced gene editing technologies, specifically CRISPR-Cas9, for developing therapies in oncology are truly remarkable. Solid tumors, which are immensely complex and highly diverse genically, are often some of the most difficult tumors to treat, making them ideal candidates for precise targeted therapies. This review looks into the existing studies related to the research of CRISPR-Cas9 for solid tumors, analyzing the key technological bottlenecks in the field, such as delivery systems, off-target effects, and immune evasion. Furthermore, we discuss recent progress toward achieving these goals and overcoming ethical and regulatory barriers and suggest areas for further investigation and practice. Ultimately, we wish to determine the levels of CRISPR-Cas9 gene editing and immunotherapy that can be deployed for solid tumors, anticipating the dawn of a new generation in precision oncology. It has been concluded that incorporation of CRISPR-Cas9 in the treatment of solid tumors is a dynamic, evolving arena of research that promises revolutionizing oncology through more precise and personalized therapies. The obstacles are enormous—technological, ethical and regulator ones. Yet, continued advances in CRISPR technology and deepening understanding of tumor biology can open possibilities for highly effective novel cancer treatments that are, both in safety and efficacy, superior to existing modalities in the future.
EPIGENETIC REPROGRAMMING IN CANCER: EXPLORING THE ROLE OF DNA METHYLATION AND HISTONE MODIFICATIONS IN TUMORIGENESIS
Epigenetic modifications are key regulators in maintaining appropriate gene expression and cellular identity. DNA methylation and histone modification are epigenetic modifications that actively participate in tumorigenesis through the modification of chromatin accessibility and transcriptional activity. Dysregulation of these processes can thus lead to carcinogenesis, tumor progression, and resistance to therapy. This review will focus on DNA methylation and histone modification and their roles in cancer, including mechanisms, consequences on gene expression, and therapeutic approaches. Insights into epigenetic remodeling occurring in tumors may therefore serve as the basis for developing novel epigenetic therapies to reverse aberrant modifications and restore normal gene functioning. Gastrointestinal cancer development follows an important trajectory because of specific epigenetic reprogramming mechanisms that cause DNA methylation and histone changes. The modification process creates prominent changes in gene expression patterns of cancer-related elements. Gastrointestinal cancers exhibit interesting epigenetic characteristics that involve DNA hypermethylation in IGCs and global hypomethylation in their genome. The gastrointestinal malignancies experience erroneous gene activation and gene dysfunction when histone modifications become abnormal. Research should emphasize that DNA methylation functions jointly with histone modifications during molecular processes. Various research proves these two molecular forces cooperate to affect chromatin accessibility and silence in stomach cancer patients.
TARGETING TUMOR METABOLISM: EXPLOITING CANCER CELL METABOLIC PATHWAYS FOR NOVEL THERAPEUTIC APPROACHES
To ensure their rapid growth, survival, and resistance to treatment, tumor cells modify their metabolism. Unlike normal cells, cancerous cells tend to ‘shift’ their metabolism toward aerobic glycolysis (known as the Warburg effect), glutaminolysis, and lipid biosynthesis. This way, they fulfill their bioenergetic and biosynthetic needs. There is high potential for cancer therapies that target these metabolic processes. This review article outlines the major targetable metabolic pathways in tumor cells, describes new therapeutic interventions being developed to target these metabolic processes, and points out the gaps and future prospects in therapies targeting metabolism. The combination of metabolic inhibitors with the traditional treatment could prove to be an effective solution to drug resistance, thus enhancing the outcome for the patient.
MOLECULAR MECHANISMS OF IMMUNE EVASION IN TUMOR MICROENVIRONMENTS: INSIGHTS INTO CANCER PROGRESSION AND THERAPEUTIC STRATEGIES
The ability of tumors to escape immunological detection and destruction serves cancer progression and metastasis. The tumor microenvironment (TME) can suppress the antitumor immune response of the host through multilevel immune evasion, which includes immune checkpoints activation, regulatory T (Treg) cell expansion, tumor-associated macrophages (TAMs), immune exosome modulation, and metabolic reprogramming. The overwhelming of these mechanisms allows malignant tumor cells to sustain and expand unchecked. The mechanisms that are at work facilitating immune evasion are crucial for the formulation of new immunotherapeutic methods of treating cancer. As the general approaches of solving the formulated problem, as well as diagnosing and correcting the cancer treatment, are set forth in this review by examining one of the most important aspects of the TME, the immune evasion mechanisms, their contribution to the cancer disease, and new treatment methods focused on immune evasion prevention are presented in the most recent publications. It has been concluded that Immune evasion will take place in the TME, which faces the effects of tumor progression and metastasis. Targeting the immune checkpoint, modulating the components of TME, or reversing the changes that occurred in metabolism all show promise and avenues for treating cancers. Therefore, having a better understanding of these mechanisms will create a room for advancement in the process of developing more effective interventions in immunotherapy to improve patient outcomes.
THE APPLICATION OF CRISPR TECHNOLOGY IN TRANSLATIONAL RESEARCH: CURRENT CHALLENGES AND FUTURE DIRECTIONS
CRISPR-Cas9 technology has revolutionized the landscape of genetic engineering by enabling highly precise, efficient, and programmable genome editing. Originally derived from bacterial immune systems, CRISPR has emerged as a pivotal tool in translational research with broad applications in genetic therapies, disease modeling, and agricultural biotechnology. Despite its transformative potential, real-world deployment of CRISPR faces significant scientific, regulatory, and ethical barriers.This study systematically evaluates the clinical and agricultural applications of CRISPR, employing a mixed-methods approach that includes gene-editing efficiency analyses, delivery system optimization, and off-target profiling. Mechanistic investigations were also conducted to compare editing precision across Cas9 and next-generation systems such as Cas12 and Cas13.The results demonstrate that CRISPR-Cas9 achieves over 85% target-specific efficiency across diverse gene targets, with significantly reduced off-target effects using high-fidelity variants. Delivery success rates vary across vector types, with lipid nanoparticles and electroporation outperforming viral vectors in safety and specificity. In agricultural models, the technology enhanced crop resilience and nutrient content while maintaining genetic stability across generations. Further, editing success was highest in ex vivo somatic cell contexts, highlighting its near-term feasibility in personalized medicine.These findings underscore CRISPR’s readiness for controlled deployment in clinical and agricultural settings, particularly when integrated with precision delivery and validation protocols. Nonetheless, the study highlights unresolved issues including the ethical implications of germline editing, public trust, and unequal access to gene therapies. As CRISPR advances toward routine therapeutic and agricultural use, addressing regulatory harmonization, biosafety, and equity concerns will be essential. This research provides a foundational assessment of the technology’s current capabilities and outlines future directions for responsible integration into translational practice.
EPIGENETICS IN CANCER: TRANSLATING MOLECULAR MECHANISMS INTO TARGETED THERAPIES
Even nowadays cancer remains one of the most frequent causes of death and diseases all over the world. That is due to epigenetics and genetic changes that are caused by genetic mutations which regulate the expression of genes, but do not alter the sequence of DNA. The most significant tumour starting factors include DNA methylation, changes in histone and non-coding RNAs among others.The paper takes a closer view of the molecular basis of epigenetic regulation in cancer and evaluates the prospect of such epigenetic treatments to become real-life. Studying the gene silencing and activation processes example by example, the work demonstrates the impact of changes in the DNA methylation patterns, the architecture of histone modifications, and non-coding RNA profiles on them. We even examined the efficacy of targeted epigenetic drugs in effecting various cancerous cells and within various treatment environments. These are DNA methyltransferase inhibitors (DNMTis), histone deacetylase inhibitors (HDACis) and EZH2 inhibitors.The findings indicate that certain epigenetic drugs are quite effective in activating the tumour suppressor genes switched off and inhibiting cancer-causing pathways. Case studies reveal that the administration of epigenetic medicines alone or in combination could increase the rate of survival, reduce the amount of tumours, and make the tumours sensitive to chemotherapy and immunotherapy. Nevertheless, these drugs cannot be applied in most clinical scenarios due to issues such as acquired resistance, off-target toxicity, the unconsciousness of prognostic biomarkers.To conclude, epigenetic medicines are a turning point, and reversible method of treating cancer, and that it may be customized to the unique epigenome of an individual. We should continue to study the discovery of biomarkers, combination approaches, and epigenetic editing of the next generations to make the best use of epigenetic therapy in oncology.
INNOVATIONS IN SURGICAL PROCEDURES: A COMPREHENSIVE REVIEW
The field of surgery is undergoing a transformative shift fueled by advancements in technology, resulting in greater precision, reduced patient trauma, and improved postoperative outcomes. Innovations such as minimally invasive techniques, robotic-assisted systems, 3D printing, precision surgery, and artificial intelligence (AI) are redefining traditional surgical practices.This comprehensive review synthesizes clinical, technological, and scientific literature to evaluate the effectiveness, applications, and future potential of these surgical innovations. The methodology involves a structured analysis of contemporary surgical technologies across various specialties, emphasizing their comparative performance, integration challenges, and clinical utility.The findings demonstrate that minimally invasive procedures significantly reduce recovery times and complication rates, while robotic-assisted surgeries enhance dexterity and visualization. 3D printing offers patient-specific modeling and prosthetic solutions, improving anatomical accuracy and surgical planning. Precision surgery, guided by genomic profiling, allows for individualized treatment strategies with increased efficacy. AI and machine learning tools support surgical decision-making and predictive outcome modeling, showing high accuracy and reliability across preoperative, intraoperative, and postoperative phases.These technological advances collectively contribute to more personalized, efficient, and safe surgical interventions. However, the review also underscores critical challenges, including cost barriers, limited accessibility in low-resource settings, and ethical concerns related to data security and genetic modification. Addressing these issues will be vital for the equitable and widespread adoption of such innovations.In conclusion, the integration of advanced technologies into surgical practice marks a significant milestone in modern medicine. With continued interdisciplinary collaboration, clinical validation, and policy reform, these innovations hold immense promise for improving global surgical care and patient outcomes.
HEALTH EDUCATION AND AWARENESS: KEY TO PREVENTING EPIDEMICS
Epidemics pose a recurrent threat to public health, especially in developing nations where inadequate infrastructure and limited health literacy create conditions conducive to rapid disease transmission. In countries like Pakistan, empowering communities through health education has emerged as a crucial strategy to mitigate such public health crises. This study explores the role of structured health education initiatives in epidemic prevention, focusing on community outreach, healthcare worker engagement, media-based awareness, and policy-level interventions.A multi-dimensional methodological framework was employed, integrating quantitative assessments, simulated modeling, and visual analytics to evaluate the effectiveness of various health education strategies. Key components included community-based campaigns, mass media utilization, digital platforms, and institutional support from governmental and non-governmental organizations.The findings reveal significant improvements in vaccination rates, hygiene practices, and health literacy following the implementation of targeted education programs. Notably, community engagement and personalized outreach methods demonstrated higher behavioral impact compared to generalized institutional campaigns. Digital tools such as mobile health applications and social media also played a transformative role in disseminating timely and accessible information. However, the persistence of cultural barriers, misinformation, and infrastructural limitations continues to impede the full potential of health education.In conclusion, this research confirms that health education is a foundational element in epidemic prevention and public health resilience. A synergistic approach—combining community empowerment, professional guidance, digital innovation, and institutional collaboration—can effectively reduce disease incidence and promote long-term public health outcomes. Future interventions must focus on integrating education into school systems, expanding digital access, and addressing sociocultural resistance to maximize the reach and impact of health education across vulnerable populations.
DEVELOPMENT OF NOVEL BIOPHARMACEUTICALS: CHEMICAL ENGINEERING APPROACHES IN PROTEIN DRUG PRODUCTION AND DESIGN
Biopharmaceuticals have revolutionized contemporary medicine, where particular treatments for several diseases, such as cancer, autoimmune diseases, and genetic diseases, are attainable. Manufacturing of biopharmaceuticals is discussed here with emphasis on host expression systems, bioreactor technology, and purification steps. The study highlights the significance of mammalian cell lines, for example, CHO cells, in realizing high-yielding protein production and perfusion bioreactors' role in reducing production time.Also, advancements in downstream processing like multi-column chromatography and nanoparticle drug delivery have played a crucial role in enhancing formulation stability and therapeutic effectiveness. Despite these, most challenges such as glycosylation variability, high production costs, and stringent regulatory requirements persist in large-scale biopharmaceutical production. The discussion calls for the significance of process analytical technologies (PAT) and continuous manufacturing strategies in ensuring product uniformity and keeping production costs to a minimum. Besides, single-use bioreactor advancements and excipient optimization have extended drug shelf life and improved protein stability. Future studies must aim at host cell engineering extension, purification technique enhancement, and incorporation of advanced formulation strategies to enhance biopharmaceutical access and affordability. The results of this study highlight the importance of ongoing collaboration among industry, regulatory agencies, and scientists to enhance innovation and optimize biopharmaceutical development.
INFLAMMATORY PATHWAYS IN FIBROMYALGIA: A CYTOKINE PROFILING STUDY
Fibromyalgia is a multifactorial chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, cognitive dysfunction, and mood disturbances. While central sensitization is widely accepted as a core mechanism, emerging evidence suggests that systemic inflammation may also play a crucial role in the pathophysiology of fibromyalgia. This study aimed to investigate the cytokine profile in fibromyalgia patients and its correlation with clinical symptom severityIncluded in the study were 20 healthy women referred to as controls and 40 patients with a fibromyalgia diagnosis. Using multiplex immunoassay, it was possible to measure the serum amounts of cytokines such as IL-1β, IL-6, IL-8, TNF-α, IFN-γ, IL-10 and TGF-β1. Included in the clinical assessments were the Visual Analogue Scale for pain, the Hospital Anxiety and Depression Scale and the Fibromyalgia Impact Questionnaire-Revised. The study investigated the relationships between levels of cytokines and the various symptoms. Levels of cytokines IL-6, IL-1β, IL-8, TNF-α and IFN-γ as well as TGF-β1 were much higher in patients with fibromyalgia than in controls. The patients with fibromyalgia were found to have lower anti-inflammatory IL-10 levels. The results showed reduced functioning (FIQR = 59.5), increased psychological stress (HADS-Anxiety = 11.5 and HADS-Depression = 10.1) and reported severe pain (VAS = 7.8). On the other hand, although IL-6 was closely linked to higher VAS and FIQR scores, IL-10 was negatively linked to a person’s feelings of melancholy and anxiety.
Copyright (c) 2025 Humayun Ali, Asad Ullah (Author) https://creativecommons.org/licenses/by/4.0
INVESTIGATING CHRONIC MYOFASCIAL PAIN SYNDROME USING ADVANCED EMG
Chronic Myofascial Pain Syndrome (CMPS) is a complex musculoskeletal condition characterized by myofascial trigger points, persistent pain, and neuromuscular dysfunction. The lack of objective diagnostic tools has contributed to underdiagnosis and ineffective treatment. Advanced electromyography (EMG) techniques offer new opportunities to characterize the underlying pathophysiological mechanisms.This study aimed to investigate neuromuscular and autonomic biomarkers associated with CMPS using high-density surface EMG, intramuscular EMG, and physiological monitoring to provide an objective assessment of muscle and autonomic dysfunction.Sixty participants were enrolled, including 40 patients with CMPS and 20 healthy controls. Tests were made for pain intensity (VAS), pressure pain threshold, muscle unit action potential (MUAP) amplitude and duration, frequency of the EMG signal, muscle coherence, endplate noise, heart rate variability (HRV), and skin conductance. The EMG signals were studied using both time-frequency and wavelet methods. There was a difference in pain severity, which was significantly higher in CMPS patients (mean VAS = 6.5) than in people without CMPS. In the CMPS group, the muscle activity was different since the MUAP amplitude and duration were increased and the EMG signal mean frequency was reduced. The scores for coherence indicated that the patients’ motor control strategies were affected. In CMPS patients, endplate noise seems to increase due to independent muscle activity around the trigger points. Moreover, there was a reduction in HRV and an increase in skin conductance, suggesting the sympathetic nervous system was in control. A relationship was found between pain severity and EMG parameters, coherence, and markers related to the autonomic nervous system. There were differences in both the nervous system and the autonomic nervous system between CMPS patients and normal controls. This supports the value of EMG for clinical work and opens opportunities to adjust medical care in a manner appropriate for every patient.
Copyright (c) 2025 Shahzad Rafiq, Shazia Khalid (Author) https://creativecommons.org/licenses/by/4.0
IDENTIFYING BIOMARKERS OF MUSCLE WASTING IN CANCER CACHEXIA
Cancer cachexia is a multifactorial syndrome characterized by progressive muscle wasting, systemic inflammation, and metabolic disturbances, significantly impacting patient survival and quality of life. Early detection and monitoring of muscle loss remain critical challenges in oncology, emphasizing the need for reliable, non-invasive biomarkers.This study aimed to identify and evaluate clinical, molecular, and circulating biomarkers associated with muscle wasting in cancer cachexia across patients with colorectal, lung, gastric, and pancreatic cancers. The study consisted of one hundred patients with cancer experiencing cachexia. Certain factors like weight loss, fist grip strength, SMI, testosterone, IGF-1, IL-6, TNF-α, CRP, myoglobin, CTCs, and miR-206 were analyzed. To check how cachexia is related to the other examined factors and classify its severity, correlation matrices, subgroup analysis, and visual representations were used. Most often, doctors diagnosed patients with colorectal cancer, after which pancreatic, stomach, and lung cancer were found. It was common for patients to lose 8% of their weight, and the loss was even greater for people with gastric or pancreatic tumours. Both CRP and IL-6 showed particularly high inflammatory markers in everybody in the group. Patients who lost a lot of weight had CTC levels that were higher. The relationship between IL-6 and CRP was positive, yet miR-206 correlated with worse muscle mass/function. Those subgroups whose brains displayed the highest rates of biomarker changes were those with SMI <30 cm²/m² and >10% weight reduction. The study found that miR-206, IL-6, and CRP were reliable biomarkers for spotting and evaluating muscle loss in cancer cachexia. Data from these findings support testing in routine clinical practice and applying biopsy and molecular profiling to therapy for cachexia.
Copyright (c) 2025 Muska Hayat, Hassan Yar Mahsood (Author) https://creativecommons.org/licenses/by/4.0
UNDERSTANDING VENTRICULAR REMODELING IN PATIENTS WITH CHRONIC HEART FAILURE
Ventricular remodelling is a critical determinant in the progression of chronic heart failure (CHF), encompassing a spectrum of structural, cellular, and molecular changes that impair cardiac function over time. This study offers a comprehensive investigation into the mechanisms underlying ventricular remodelling, with a particular emphasis on the interplay between inflammation, metabolic shifts, extracellular matrix alterations, and myocardial fibrosis. Our findings underscore that remodelling is initiated by primary cardiac insults such as ischemic injury or hypertensive stress, which trigger compensatory responses including cardiomyocyte hypertrophy and extracellular matrix expansion.Stimulating the heart for a long time can cause thickening of the chambers, hardening of the tissue, and both bulging and weakening of the heart. We discovered that NF-κB and TGF-β govern collagen deposition and cellular responses of fibroblasts, which later contributes to scar formation and ventricular hardening. The process from acute heart damage to eventual scarring in the far parts of the heart could be clearly seen in the investigation of phases of heart damage following a heart attack. There is also a strong emphasis in the study on how obesity, diabetes, and COPD speed up diastolic dysfunction. Scientists examined the usefulness of cardiac MRI, echocardiography, and measurements of NT-proBNP and troponin in assessing the extent of remodelling in the heart. It appears that drugs such as beta-blockers and ACE inhibitors have helped to slow remodeling, but the disease’s fibrosis still progresses to some extent. In addition, even though LVADs are helpful for patients with heart failure, they have a high chance of complications and hospitalizations. This research suggests that developing tailored therapies to treat the inflammation and scarring in CHF is necessary. More effective treatments for stopping or reversing remodelling in the heart may be developed based on a better understanding of these pathways.
ROLE OF MITOCHONDRIAL DYSFUNCTION IN STATIN-INDUCED MYOPATHY
Statins are highly effective lipid-lowering agents used for cardiovascular disease prevention, but their clinical utility is sometimes limited by the onset of myopathy, a condition ranging from mild muscle pain to severe rhabdomyolysis. Mitochondrial dysfunction has emerged as a key contributor to statin-induced myopathy, though the precise mechanisms remain underexplored.This study aimed to investigate the role of mitochondrial impairment in statin-induced myopathy by evaluating mitochondrial bioenergetics, oxidative stress, apoptotic signaling, and muscle damage markers following statin exposure. C57BL/6 mice and skeletal muscle cells were given atorvastatin, simvastatin and rosuvastatin. OCR, the process of ATP synthesis, maximum respiration, the membrane potential in mitochondria, reactive oxygen species (ROS), levels of coenzyme Q10 (CoQ10), caspase-3 activity and creatine kinase in the serum were all important factors under study. The reasons for mitochondrial dysfunction contributing to myopathy were explored using ANOVA and correlation analysis. Treatment with statins led to significant declines in OCR, ATP production and respiration, significantly more by simvastatin than by other statins which may reflect impaired mitochondrial function. It was found that all types of statins caused a strong decrease in both mitochondrial function and the level of CoQ10, while increasing reactive oxygen species. The rise in caspase-3 confirmed that the mitochondria were causing apoptosis. People treated with the medicine all had higher serum CK levels, indicating muscle damage. By analyzing the data, a correlation was found between levels of ROS and CoQ10, CK and CoQ10 and CK and ATP. This shows that statins cause oxidative stress, kill cells and harm muscles by interfering with mitochondria. When all parameters were considered, simvastatin had the most obvious benefits. The findings support prescribing specific statin medication for individuals and suggest that taking CoQ10 and monitoring mitochondrial function may be helpful for patients prone to statin myopathy.
Copyright (c) 2025 Sajjad Mehdi, Jawad Ali (Author) https://creativecommons.org/licenses/by/4.0
SOCIAL DETERMINANTS OF HEALTH: UNDERSTANDING THE BEHAVIORAL ASPECTS
Social determinants of health (SDH), including economic stability, education, and healthcare access, significantly influence population health outcomes and exacerbate existing health disparities. In low- and middle-income countries like Pakistan, where structural inequities persist, the behavioral dimensions of SDH—such as smoking, poor diet, and lack of physical activity—are increasingly recognized as critical mediators of disease burden.This study employed a mixed-method framework to analyze the interrelationship between SDH domains and behavioral risk factors. Quantitative data were synthesized into a composite Risk Index using weighted determinants, while visual modeling and region-specific analyses identified patterns of vulnerability across rural and urban contexts.The results reveal that individuals from lower socioeconomic strata experience higher levels of behavioral risk due to limited access to education, healthcare services, and supportive environments. Health literacy, income inequality, gender norms, and environmental degradation were found to significantly shape behavioral outcomes. Additionally, rural populations demonstrated a disproportionate burden of chronic diseases associated with structural deprivation and inadequate healthcare infrastructure.The study concludes that addressing SDH through multi-sectoral interventions is essential for reducing health inequities and improving long-term public health outcomes. Policy efforts must integrate education, healthcare, urban planning, and community-based behavioral interventions to ensure equitable health access. A shift toward prevention-oriented, socially informed public health strategies is not only cost-effective but critical to fostering sustainable health equity in Pakistan.
Copyright (c) 2023 Muhammad Inam Farooq, Syeda Iram Batool (Author) https://creativecommons.org/licenses/by/4.0
THE ROLE OF MENTAL HEALTH IN PREVENTING CHRONIC DISEASE
The growing global burden of chronic diseases such as cardiovascular disorders, diabetes, and respiratory illnesses demands a comprehensive understanding of their multifactorial origins. Among these, mental health has emerged as a critical yet under-addressed determinant, exerting both direct physiological and indirect behavioral effects on chronic disease onset and progression. This study explores the intricate, bi-directional relationship between mental health and chronic disease development, with a particular emphasis on stress, depression, and anxiety as modifiable risk factors.A narrative synthesis approach was employed, supported by statistical modeling, correlation analysis, and comparative evaluation of intervention outcomes. Key variables included stress biomarkers (e.g., cortisol, CRP), mental health status indicators, and clinical metrics such as blood pressure, glucose levels, and treatment adherence. The study further incorporated an integrated visualization framework to evaluate the effects of Cognitive Behavioral Therapy (CBT), mindfulness, and resilience-based interventions across diverse patient cohorts.Results indicate that individuals with unmanaged mental health conditions demonstrated elevated inflammatory markers, reduced treatment compliance, and higher rates of comorbidity across chronic disease categories. Conversely, those engaged in structured psychological interventions exhibited measurable improvements in physiological markers and self-reported health status. Gender-based differences and behavioral correlations further underscored the need for targeted mental health support in chronic care models.In conclusion, the integration of mental health interventions into standard chronic disease management protocols yields significant clinical and public health benefits. The findings advocate for a paradigm shift toward holistic healthcare delivery that addresses both mental and physical dimensions. By embedding psychological support within preventive and therapeutic strategies, healthcare systems can substantially reduce chronic disease burden while enhancing patient quality of life and long-term resilience.
Copyright (c) 2023 Younas Rehman (Author) https://creativecommons.org/licenses/by/4.0
HEALTH BEHAVIOR AND ITS INFLUENCE ON PREVENTIVE HEALTHCARE PRACTICES
The growing burden of preventable diseases in developing countries like Pakistan underscores the critical importance of promoting proactive health behavior. Preventive healthcare encompassing regular screenings, vaccinations, and healthy lifestyle practices relies heavily on individual behavioral choices shaped by social, cultural, economic, and psychological factors.This study investigates the influence of lifestyle behaviors, health awareness, and socio-demographic characteristics on the uptake of preventive healthcare services in Pakistan. Using a cross-sectional analytical approach, data were collected through behavioral assessment tools, regression modeling, and visual analytics to evaluate how variables such as diet, physical activity, sleep, and awareness correlate with preventive engagement.The results indicate that individuals with higher health behavior scores characterized by balanced diets, adequate sleep, and regular physical activity exhibit significantly greater participation in preventive services. Preventive engagement was also found to be positively associated with awareness levels and socioeconomic status, while smoking, misinformation, and psychological barriers such as fear and denial were negatively correlated with proactive health behaviors.The findings further reveal gender disparities, with female participants reporting higher health awareness and service utilization than males, and rural populations displaying lower engagement due to infrastructural and cultural constraints. Additionally, digital health campaigns and education-based outreach programs emerged as impactful tools in raising awareness, particularly among youth and urban populations.In conclusion, the study highlights the need for multidimensional strategies that address behavioral, structural, and informational barriers to preventive healthcare. By promoting health literacy, expanding access, and designing culturally relevant interventions, Pakistan can enhance preventive healthcare uptake, reduce disease burden, and foster a more health-conscious population aligned with sustainable public health goals.
Copyright (c) 2023 Humayun Ali, Jawad Ali (Author) https://creativecommons.org/licenses/by/4.0
BEHAVIORAL INTERVENTIONS FOR MANAGING CHRONIC ILLNESSES: A REVIEW OF PAKISTANI LITERATURE
The rising prevalence of non-communicable diseases (NCDs) such as diabetes, hypertension, and cardiovascular conditions poses a serious threat to public health in Pakistan. Behavioral interventions have emerged as effective, patient-centered strategies to improve clinical outcomes and promote long-term lifestyle changes in chronic illness management.This study critically reviews and synthesizes evidence from Pakistani literature on four primary behavioral strategies: cognitive-behavioral therapy (CBT), motivational interviewing (MI), mindfulness-based interventions, and structured lifestyle modification programs. A comparative methodology was employed, analyzing the impact of these interventions on various health outcomes such as glycemic control, medication adherence, perceived pain, blood pressure, and weight loss, with effect size calculations supporting the clinical significance.Results indicate that CBT significantly improves both psychological well-being and metabolic indicators, while MI enhances patient motivation and treatment adherence. Mindfulness-based techniques are associated with reductions in stress and pain perception, and lifestyle programs contribute to measurable improvements in blood pressure and body weight. Across all interventions, culturally adapted models—especially those involving family participation—demonstrated stronger patient engagement and better adherence outcomes.The findings underscore the critical importance of culturally sensitive, scalable, and integrative behavioral health models within Pakistan’s healthcare system. Despite proven efficacy, challenges such as health literacy, gender norms, and lack of trained professionals persist. The study concludes by advocating for the integration of behavioral health into primary care, expansion of digital therapeutic tools, and community-based program delivery to improve reach and sustainability. Emphasizing preventive care and patient empowerment, behavioral interventions offer a promising pathway to mitigating the burden of chronic diseases in resource-constrained settings like Pakistan.
Copyright (c) 2023 Sajjad Mehdi, Shazia Khalid (Author) https://creativecommons.org/licenses/by/4.0
EVALUATING THE EFFICACY OF INDUCED PLURIPOTENT STEM CELLS (IPSCS) IN PROMOTING FUNCTIONAL RECOVERY IN SPINAL CORD INJURY MODELS: MECHANISMS OF REPAIR AND LONG-TERM OUTCOMES
Among severe neurological conditions spinal cord injury (SCI) holds the position as the most serious because it produces permanent motor and sensory deficits while minimally limiting treatment options. The goal of this study explored how NPCs derived from iPSCs provided therapeutic support towards SCI tissue repair and improved functional outcomes. Laboratory personnel utilized particular growth factors to produce iPSCs from adult rat somatic cells before converting them into NSCs. The researchers evaluated these NPCs regarding their impact on tissue restoration and cell connection as well as their influences on motor function during various time periods (4, 8 and 12 weeks after transplantation) in a contusive spinal cord injury model. The iPSC-transplanted rats demonstrated substantial improvements in motor control based on test outcomes that showed superior BBB motor scores than the control group. Rats received CMpi and displayed an average score of 10.5 four weeks after cell transplants were performed but the control group averaged 3.2. The derived scores from iPSC transplantation remained at 11.2 at week 8 before increasing to 11.5 by week 12. The transplanted neural stem cells successfully merged into the spinal cord tissue of recipients and generated oligodendrocytes and functioning neurones according to histological inspections. Evidence showed both axonal projections that went past the lesion area and tissue remyelination. Experiment results showed a marked decrease in the glial scar formation process that normally impedes neural regeneration. This research demonstrates that neural stem cells derived from iPSCs could aid healing processes following spinal cord injuries and restore spinal cord function.
Copyright (c) 2023 Hamais Murtaza, Muhammad Tanzeel Akhtar (Author) https://creativecommons.org/licenses/by/4.0
EARLY DETECTION OF BREAST CANCER: INNOVATIVE SCREENING METHODS
Breast cancer remains the most common cancer among women worldwide, with significant morbidity and mortality. Early detection is crucial for improving prognosis, reducing treatment costs, and enhancing survival rates. Traditional screening methods, such as mammography, have been widely used, but their limitations, including radiation exposure and false positives, highlight the need for innovative techniques. This article reviews current and emerging screening methods for early breast cancer detection, focusing on advances in imaging technologies, molecular diagnostics, and genetic screening. Innovations such as digital breast tomosynthesis (DBT), magnetic resonance imaging (MRI), and liquid biopsy are examined for their potential to improve early detection rates and accuracy. The article also discusses the challenges, such as accessibility, cost, and patient acceptance, in implementing these innovative methods globally.
Copyright (c) 2023 Hassan Yar Mahsood, Abdul Ghaffar (Author) https://creativecommons.org/licenses/by/4.0
EXPLORING THE GENETIC FACTORS OF ALZHEIMER'S DISEASE
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and behavioral changes. It is the most common form of dementia, affecting millions of individuals worldwide. While environmental and lifestyle factors contribute to the onset of AD, growing evidence suggests that genetic factors play a pivotal role in its development and progression. This article explores the genetic underpinnings of Alzheimer's disease, focusing on the identification of key genetic risk factors, including the amyloid precursor protein (APP), presenilin 1 and 2 (PS1, PS2), and apolipoprotein E (APOE). The article further discusses the implications of these genetic factors in understanding the disease mechanisms and developing potential therapies. Additionally, we explore how genetic research, including genome-wide association studies (GWAS), is contributing to the identification of new biomarkers and therapeutic targets for AD.
Copyright (c) 2023 Fatima Rehman (Author) https://creativecommons.org/licenses/by/4.0
ADVANCES IN PEDIATRIC ONCOLOGY: TARGETED THERAPIES AND PERSONALIZED TREATMENT
Pediatric oncology has seen remarkable advances over the past few decades, resulting in increased survival rates and improved quality of life for children diagnosed with cancer. Traditional chemotherapy and radiation therapies, though effective, often come with long-term side effects that impact children's growth and development. Recent advances in targeted therapies and personalized medicine have significantly improved treatment outcomes, allowing for more precise, effective, and less toxic interventions. This article reviews the latest developments in pediatric oncology, with a focus on targeted therapies and personalized treatments. It explores the role of genetic and molecular profiling in tailoring treatment plans, the emergence of targeted therapies such as monoclonal antibodies, small molecule inhibitors, and immune checkpoint inhibitors, and the challenges associated with their application in pediatric populations. Furthermore, the article discusses the ongoing efforts to overcome resistance mechanisms, improve early diagnosis, and optimize treatment regimens for various pediatric cancers.
Copyright (c) 2023 Sami Ullah (Author) https://creativecommons.org/licenses/by/4.0