Trends in Medical and Biological Sciences
Trends in Medical and Biological Sciences (TMBS) is an international, peer-reviewed, open-access journal dedicated to advancing knowledge in medical, biological, and health sciences. The journal serves as a multidisciplinary platform for researchers, clinicians, academicians, and healthcare professionals to publish original research articles, systematic reviews, clinical studies, and case reports that contribute to evidence-based practices and innovation.
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Individual and Healthcare System Factors Affecting Antenatal Care Utilization in Pakistan
Antenatal care is a primary aspect in maternal and infant health and is critical in the prevention of pregnancy-related complications and reduction of maternal and infant mortality. Nevertheless, despite the availability of ANC services in Pakistan, their utilization is suboptimal, particularly among poor, rural, and marginalized populations. The aim of this study was to explore individual and healthcare system factors in relation to utilization of antenatal care services in Pakistan. The descriptive cross-sectional study design was employed for data collection. The participants in this study were pregnant women who utilized antenatal care services in a tertiary care hospital. Data collection tools included a structured questionnaire to gather data on socio-demographic factors, maternal health literacy, individual factors, and healthcare system factors. Descriptive statistics, reliability analysis, and regression analysis were employed to analyze data. The findings revealed that individual factors such as education level, health literacy, parity, and perceptions of pregnancy played a significant role in the utilization of ANC services. The factors of the healthcare system, including accessibility, the behavior of healthcare providers, communication, and waiting time, were found to have a pivotal role in influencing ANC utilization. Women with high levels of awareness and healthcare experiences were found to have attended the recommended ANC visits and avoided missing appointments. The study concludes that improving maternal health literacy and strengthening healthcare system responsiveness are essential to enhance ANC utilization in Pakistan. Targeted interventions addressing both individual and system-level barriers are necessary to improve maternal and neonatal health outcomes and achieve Sustainable Development Goal 3.
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Family-Based Screening of Thalassemia: A Study of Relatives of Diagnosed Children
Thalassemia is a dangerous inherited blood disorder that poses a significant health risk, particularly in regions where the gene is prevalent. This study screened 320 members of families of children diagnosed with thalassemia to identify carriers. Findings revealed that 25.6% of participants were carriers, indicating a substantial genetic risk. This highlights the importance of cascade screening and structured genetic counseling to prevent transmission in future generations. Disseminating knowledge and supporting families can reduce new cases and empower informed reproductive decisions.
Developing Aptasensors for Periodontitis associated Biomarkers Detection in Saliva: A Systematic review
This study aimed to evaluate the effectiveness of Aptasensors in detecting salivary biomarkers linked to periodontitis.The literature search for this systematic review was conducted using the keywords "Aptasensors/Biosensors," "oral biomarkers," "oral diseases," "saliva," and "Aptamers" in the 'PubMed' and 'Google Scholar' databases for articles published between 2015 and 2025. The initial search yielded 249 publications relevant to the selected 10-year period of the study. After a thorough systematic review and application of the inclusion criteria, 13 studies were included.This reviewhas demonstrated that Aptasensors had achieved exceptional sensitivity for periodontitis associated biomarkers, analyzing ODAM at 1.63 nM, HBD-2 at 6.8 nM, and cortisol in the low nanomolar range. Aptamerspecific for Tannerella forsythiahad also showngreat specificity with minimal cross-reactivity. These innovative approaches had been successfully applied for periodontitis diagnosis, with aversatile multi-platform technique for ODAM (Lateral Flow, SPR, GO-FRET), a wearable smartwatch for cortisol analysis, and flow cytometry for periodontitis associated microbes’ identification. The integration of Aptamers into Biosensors had enabled detection of periodontal disease and its associated stress conditions, in saliva and gingival crevicular fluid respectively, facilitating real-time analysisand early, chair-side diagnosis. Aptasensors are highly sensitive and specific, offering real-time analysis of underlying conditions by examining targeted biomarkers in saliva.
Frequency of Enteric Fever in Pediatric Patients With Acute Febrile Illness
Background: Acute febrile illness (AFI) is a leading cause of pediatric healthcare utilization in low- and middle-income countries, where enteric fever remains endemic. While the burden of enteric fever in older children is well recognized, data focusing on infants and toddlers presenting with AFI are limited. This study aimed to determine the frequency of enteric fever among children aged 6–24 months presenting with acute febrile illness and to examine its association with selected demographic and clinical characteristics. Methods: A cross-sectional study was carried out at one 2024 at one of the the Children Hospital and Institute of Child Health (ICH) in Peshawar. Sampling was conducted through consecutive sampling on children aged 624 months with acute febrile illness. Baseline demographics and clinical data were obtained and to establish the enteric fever, the blood cultures were done by the BACTEC system. The data were analyzed based on descriptive statistics and stratified analyses and the association was evaluated against the Chi-square test or Fisher test. Results: A total of 200 children participated, with a mean age of 14.02 ± 4.86 months; 56.0% were male. Enteric fever was diagnosed in 44 children, resulting in a frequency of 22.0%. No statistically significant correlations were found between enteric fever and age group, gender, nutritional status, duration of fever, or recent antibiotic usage (p > 0.05 for all). Significantly, 41.0% of children had been administered antibiotics before presentation, indicating prevalent empirical antimicrobial utilization. Conclusions: This study found that enteric fever contributed to one in five cases of acute febrile infections occurrences among children aged between 6 and 24 months of age, highlighting why enteric fever continues to be of public health importance among this vulnerable population. The inability to provide reliable clinical or demographic indicators contributes to the drawbacks of symptom-based diagnosis and the need to introduce regular laboratory validation, which will help to provide timely and proper care. The improvement of diagnostic abilities, the promotion of the use of antibiotics rationally, and the introduction of preventive strategies, including vaccination, plays an essential role in reducing the burden of diseases and resistance to antimicrobials in endemic conditions.
Nursing Internship Students Perception of Clinical Learning Practice in Private Sector Hospital in Peshawar, Pakistan
Background: Clinical education is vital for nursing students to apply theoretical knowledge and develop critical skills. Effective mentorship, supportive environments, and cooperation between clinical teachers and nurses interne enhance learning, while inadequate supervision hinders progress. Private hospitals offer unique opportunities but pose challenges due to high workloads and efficiency demands. Clinical instructors play a crucial role in guiding students and fostering professional growth. Tailoring clinical education to student needs is essential for preparing confident, competent nurses for the healthcare industry. Method: A quantitative Descriptive Cross-sectional study was conducted at Kuwait Teaching Hospital, Prime Teaching Hospital, Mercy Teaching Hospital, Naseer Teaching Hospital and Rahman Teaching Institute Hospital. Non-probability convenient sampling was used based on a 95% confidence interval, 50% response distribution and 5% margin of error. The sample size is calculated to be 152 samples through Rao software. Data was collected face to face from person through an adopted modified questionnaire from Student Clinical Learning Culture Survey having calculated reliability of Cronbach’s alpha of (0.76). Data was analyzed through Software SPSS version 25 for statistical analysis. Results: Total males were 65.8% and females 34.2% respectively. We had calculated the whole mean and standard deviation of the whole population and study level. We had also found the mean and standard deviation of all the questions. The mean for gender was 1.34 and standard deviation was .475 and for the study level mean was 68.73 and standard deviation was 10.43. Conclusion: The internee student perception about the clinical environment and clinical instructor was not satisfied. There are more Effective and supportive environments, and cooperation are need between clinical teachers and nurses interne to enhance learning.
Predictors of Health-Related Quality of Life among Decompensated Chronic Liver Disease Patients in Peshawar
This study aims to evaluate the overall health-related quality of life among patients with decompensated chronic liver disease and to identify clinical factors (e.g., severity of liver disease, comorbidities) and demographic factors that significantly predict health-related quality of life.This descriptive cross sectional study was conducted in Khyber teaching hospital during a period of October to December 2024. A pre designed questionare was used to gather data Data were collected using an interviewer-administered structured questionnaire which was adopted from the Medical Outcomes Study (MOS) 36-item SF-36 health survey. Data was analyzed using spss and Microsoft excel software.Among the total subjects, 61 (61.0%) were male and 39 (39.0%) were female. The average age was 68.6 ± 16.5 years ranging from 41 to 95 years. Among the subjects, about more than half of the subjects had acute complications, i.e. spontaneous bacterial peritonitis in 61 (61.0%) and 61 (61.0%) had porto-systemic encephalopathy Health-Related Quality of Life (HRQoL) with their mean scores and standard deviations, reflecting individuals' physical, emotional, and social well-being. It shows moderate scores for physical functioning, energy, and role limitations, while emotional well-being and general health are lower. The overall HRQoL score is also relatively low, indicating a generally poorer quality of life in this sample. There is a pressing need to develop better healthcare measures that can address the needs of patients with liver diseases, especially older and uneducated patients with severe comorbidities. There is a need to manage socioeconomic barriers and enhance the level of patient education to improve health outcomes and QoL.
Antioxidant and Anti-Cancer Insights of Phyla Nodiflora Against Cox-2 Domains Through Conformational Molecular Dynamic Simulations
Cancer is one of the most mortal illnesses in the world. Cancer patients showed elevated levels of COX-2 enzyme and prostaglandin. This points towards the potential target of this enzyme in order to inhibit its enzymatic activity and thus lower prostaglandin. Phyla nodiflora was also reported to trigger apoptosis and cell cycle progression in MCF-7 breast cancer cells with augmented expression of tumorigenesis-inducing transcription factors. The increased antioxidant activity in Ehrlich-Lettre ascites carcinoma (EAC-bearing) mice may be responsible for anticancer activity. We decided to conduct experimental DPPH assays and in silico studies, including molecular docking, molecular dynamic simulation, drug-likeness, ADME, and toxicity, to find therapeutic agents to validate the anticancer and antioxidant activity of the plant. The antioxidant activity of the methanolic extract of the leaf was 42.69% when a 1mg dose of the leaf extract was used, while it increased to 64.49% when the dose of the leaf was increased to 7mg. Molecular docking shows that plant compounds like 8-methoxyluteolin (-8.8 kcal/mol), 8-methoxyapigenin (-8.3 kcal/mol), and 3-methylherbacetin (-9.1 kcal/mol) are ideal possible drug candidates since they have the highest binding affinities and follow Lipinski’s rule of five. Molecular dynamic simulation, RMSD, and RMSF values show that they have good binding interaction with the receptor and are stable, hence showing that these compounds may act as novel therapeutic agents against cancers.
A Review of Recent Advancement in Biosensors Development and their Applications
processes with biological recognition components to detect biomolecules, infections, and environmental pollutants with extreme sensitivity. Innovations in nanomaterials engineering, the integration of artificial intelligence, and downsizing technologies that enable wearable and point-of-care applications have driven recent advancements. This thorough analysis examines state-of-the-art developments in biorecognition techniques, nanomaterial-enhanced signal amplification, sensor transduction principles, and the integration of biosensing with artificial intelligence for real-time data analytics. We emphasize detection limitations spanning from atto-molar to picomolar concentrations by rigorously analyzing the performance metrics of electrochemical, optical, and piezoelectric biosensors across a variety of sample matrices. This study also includes substantial translation obstacles, such as biofouling, standardization difficulties, regulatory procedures, and commercial viability. Prospects for next-generation intelligent biosensing systems are explored along with new applications in environmental surveillance, food safety, customized medicine, and continuous health monitoring. This study offers researchers a thorough road map for developing biosensor technology from lab prototypes to clinical and commercial realities.
Diagnostic Accuracy of Transvaginal Ultrasound for Detecting Endometrial Polyps in Women with Abnormal Uterine Bleeding: A Cross-Sectional Study
Background: Abnormal uterine bleeding (AUB) is a widespread gynecological complaint with endometrial polyps as an underlying cause. Although hysteroscopy with histopathology is a resource-intensive and invasive diagnostic tool, it is also the gold standard. Transvaginal ultrasonography (TVS) is a noninvasive option, but its diagnostic accuracy is not consistent Objective: To evaluate the diagnostic accuracy of transvaginal ultrasound (TVS) in detecting endometrial polyps in women with AUB, using histopathology as the reference standard. Methods: This cross-sectional study was conducted on 150 women aged 18 to 45 years with AUB in the Department of Diagnostic Radiology, Lahore General Hospital/PGMI, Pakistan, who underwent TVS and then hysteroscopic histopathology. The diagnostic parameters of TVS sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Subgroup analysis was conducted according to menopausal status. Results: TVS had a sensitivity of 69.2, specificity of 53.2, PPV of 23.7, NPV of 89.2%, and total accuracy of 56.0. False positives were primarily proliferative or secretory endometrium, focal hyperplasia, and submucosal fibroids, while false negatives were mainly small sessile polyps or due to poor imaging. There was no significant difference in the diagnostic performance between premenopausal and perimenopausal women. The polyp was benign in most cases, and no malignant or atypical lesions were detected. Conclusion: TVS is moderately sensitive and has a high NPV; therefore, it is a good noninvasive method for excluding endometrial polyps in women with AUB. Positive results must be validated by histopathology. Color Doppler and timing optimization of imaging can be used to improve the diagnostic quality. TVS is also affordable, available, and easy to use in resource-restricted environments.
Recent progress in materials development of denture tissue conditioner-A systematic review
Denture tissue conditioners play essential role in treating damaged oral mucosa, improving the comfort of patients, and providing effective adaptation of prostheses. Innovations in materials science over the past few decades have produced better formulations that have improved mechanical, antibacterial, and physical properties. This systematic review aims to assess and summarize the most recent data on improvements in denture tissue conditioners, emphasizing on material improvements, clinical performance, and antimicrobial efficiency. A complete literature search was undertaken using electronic databases such as PubMed, science direct, Cochrane and Medline, with publications published between 2011 and 2025. Predetermined exclusion and inclusion criteria were used to select papers, with a focus on randomized controlled trials, in vitro, and in vivo studies on newer experimental tissue conditioner materials. Data has been gathered and evaluated for bias. In total, 41 studies fulfilled the inclusion criteria. Major advances include the addition of antibacterial agents (such as silver nanoparticles, essential oils and fluorescent carbon), improved mechanical properties and increased conditioner longevity. Numerous studies found considerable reductions in microbial colonization while maintaining integrity of material. Modifications made with organic compounds and biocompatible resins have also showed promise in terms of mucosal healing and clinical results. The clinical performance and therapeutic capacity of denture tissue conditioners have been significantly improved by recent advances. Yet, to confirm these results and encourage broad clinical adoption, further extensive long-term clinical investigations are required. Future studies should concentrate on maximizing the harmony of antibacterial efficacy, patient comfort, and material performance.
Expression of Salivary Interleukin 17A in Chronic Periodontitis
Background: A wide range of cytokines contribute significantly to the development and progression of numerous inflammatory conditions, such as diabetes, psoriasis, arthritis, and periodontal disease. Diabetes and periodontitis have been linked to elevated serum interleukin IL-17A, concentrations. This study will look at the levels of salivary interleukin 17A in patients with chronic periodontitis (CP), type 2 diabetes, and healthy controls. Methodology: This cross-sectional study was conducted at the Institute of Pathology and Diagnostic Medicine (IP&DM), Khyber Medical University (KMU) Peshawar and in the periodontology department of Saidu College of Dentistry, Swat among 96 individuals of 30-to-50-year age group including both male & female. After obtaining informed consent and completing the questionnaire, periodontal assessments including periodontal index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), and clinical attachment loss (CAL)—were recorded to evaluate the presence and severity of periodontal disease. Blood sugar levels were assessed for known diabetic patients. Saliva was collected using resting drooling method. ELISA was done for IL-17A using standard kits. Result: Mean and standard deviation values of salivary IL-17A concentrations observed in Non-diabetic CP were 8.854±0.975 (pg/ml), in diabetic CP group were 9.815± 1.094(pg/ml), in periodontal healthy group were 3.878± 0.9090(pg/ml). Concentration of salivary IL-17A for moderate and poor oral health statuses in diabetics CP are 8.96(pg/ml) and 10.43(pg/ml) respectively. Whereas in non-diabetics CP the concentration of IL-17A levels for moderate and poor oral hygiene cases were 8.62 & 10.02(pg/ml) respectively. The mean values in the healthy control (diabetics and non-diabetics non-CP) observed were 3.18(pg/ml) and 4.07(pg/ml) respectively. A P value of 0.001 was observed, signifying that the alterations in mean IL-17A levels are statistically significant when associated within each group. The mean concentration observed in both diabetic and non-diabetic CP was higher than the healthy control non-CP. Conclusion: Within the limitations of this investigation, it may be concluded that elevated levels of IL-17A in the saliva of people suffering from untreated chronic periodontitis may function as a suggestive noninvasive biomarker for periodontal disease. Salivary IL-17A levels were highly related with periodontitis. This finding highlights the potential for salivary IL-17alpha to be used as a diagnostic marker, offering a non-invasive way to gauge the severity of periodontal diseases
High-Resolution CT Characterization of Radiologic Phenotypes among COPD Patients in Sindh, Pakistan
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries (LMICs), where environmental exposures and limited healthcare access exacerbate disease burden [1–3,4]. COPD exhibits marked structural and clinical heterogeneity, with emphysema and chronic bronchitis as its principal phenotypes. High-resolution computed tomography (HRCT) offers detailed visualization of structural lung changes, aiding phenotypic characterization and prognosis [10–13]. Objective: To characterize radiologic phenotypes of COPD among patients in Sindh, Pakistan, and examine their distribution across different age groups using HRCT in conjunction with clinical assessment, spirometry, and chest radiography. Methods: A cross-sectional observational study was conducted at the Department of Respiratory Medicine, NRIGH, Sindh, Pakistan, enrolling 90 consecutive patients aged 35–75 years with confirmed COPD. Patients underwent detailed clinical evaluation, pulmonary function testing, chest radiography, and HRCT imaging. HRCT scans were analyzed to identify emphysema subtypes, small airway disease, and other structural abnormalities. Age-related differences in phenotypes were assessed using Z-tests for proportions. Results: The mean age of participants was 54.8 years, with 75.6% aged 41–60 years. Predominant emphysema was observed in 56.7% of patients, chronic bronchitis in 36.7%, and mixed patterns in 6.6%. Chronic bronchitis was more frequent in patients ≤50 years, whereas emphysema predominated in those >50 years (p < 0.05). HRCT revealed centrilobular emphysema (46.7%), small airway disease (40.0%), panacinar (16.7%) and paraseptal emphysema (8.9%), with occasional ground-glass opacities, interstitial lung disease, and mass lesions. Spirometry confirmed persistent airflow limitation with minimal bronchodilator reversibility, and radiographic findings correlated with structural phenotypes. Conclusion: COPD in this cohort demonstrates significant structural and phenotypic heterogeneity, with emphysema predominating in older adults and chronic bronchitis in younger patients. HRCT is a valuable adjunct to spirometry and radiography for accurate phenotypic characterization, early detection of comorbidities, and individualized management. These findings highlight the importance of imaging-based phenotyping to inform clinical decision-making in resource-limited LMIC settings.
Assessment and Prevalance of Musculoskeletal Problems in Elderly in University Campus Peshawar
Objectives: To assess and treat musculoskeletal disorders in older adults aged 60 and up who live on the Peshawar University campus. Materials and Methods: Between January and April 2023, 103 elderly people (60 years of age and older) were randomly recruited from the university campus in Peshawar to participate in this community-based descriptive cross-sectional survey. While joint stiffness was assessed by palpation and inspection as part of a thorough physical examination, musculoskeletal diseases were investigated using history-based inquiries about joint and muscle discomfort. A non-stretchable measuring tape was used to determine the circumference of the leg. The information was gathered via semi-structured questionnaires. Microsoft Excel 2013 and SPSS version 20 were used to enter and analyze the data. To characterize the sociodemographic and morbidity characteristics, we used descriptive statistics. Results: In the study population, 88% of people had musculoskeletal issues (91/103).. The musculoskeletal problems were almost equal in both the sexes. Of the total population, 66.99% (69/103) were facing difficulties in routine activities due to musculoskeletal problems. The females were having more problems in daily activities than males. The combined mean leg circumference of the total was 14.38 inches (SD 1.57 inches, 95% CI 14.08-14.69).
Association between Glycated Hemoglobin Level and Sorting Nexin 19 Gene Polymorphism in Individuals with Type 2 Diabetes
Background: Sorting Nexin 19 gene has an important role in different diseases and controls the transport of different hormones and peptides. But his role in type 2 diabetes is still not explored. The Sorting Nexin 19 gene is associated with insulin signaling. Therefore, the current study was conducted to investigate the association between the Sorting Nexin 19 gene and HbA1c levels in individuals with type 2 diabetes Methods: This prospective cohort study was conducted at the Institute of Pharmaceutical Sciences, Khyber Medical University, and endocrinology department of Hayatabad Medical Complex, Peshawar. A total of 60 type 2 diabetes individuals were enrolled, and blood samples were collected from each participant. Non-probability purposive sampling was used. Blood was collected at baseline to measure HbA1c levels, DNA extraction, and conduct Sanger sequencing. After three months of follow-up, blood sample was collected to determine HbA1c level. Results: The mean age of patients was 54.37±11.61±SD. There was no Sorting Nexin 19 rs431825173 gene mutation among the selected patients. Notably, other Sorting Nexin 19 polymorphisms on a flanking region of rs431825173, specifically rs3751036 (C>G), were detected. Out of the total 60 samples, 2 were of the CC wild type, 41 were GG homozygous, and 17 were heterozygous GC. It has been observed that rs431825173 mutation is not deleterious and has no clinical significance in type 2 diabetes. Conclusion: The study concluded that no association was found between sorting nexin 19 gene polymorphisms and HbA1c levels and clinical outcome in type 2 diabetes patients.
Behind the Bullet: Forensic Analysis of Firearm Injury Patterns and Demographic Trends in Peshawar
Background: Violent injuries rank among the top ten causes of death worldwide. Violence has been identified as a major global issue. Firearm injury is a global issue that poses a significant challenge in a developing country like ours, where poverty and violence are prevalent. Aside from being a cause of mortality, firearm injuries can result in substantial morbidities, psychological and physical problems for individuals and communities. Objective: the objective of the study is to assess pattern of injury along with manner of death and its associated demographic factors in firearm injuries in Peshawar. Methods: The descriptive cross-sectional study was done from July 1, 2024, and December 31, 2024, in the Forensic Medicine and toxicology Department Khyber Medical College, Peshawar. All firearm deaths presented to department during said period was included in the study and cases with incomplete documentations and referred from other districts were excluded from study. Results: The study included 398 individuals, with 94.6% males and 5.3% as female. The mean age of the participants were 36.6 years, with a standard deviation of 13.6. A significant majority of casualties (87.8%) were from urban regions, with the most prevalent injuries impacting the lungs (54.6%), heart (36.0%), and brain (33.2%). Majority of victims suffered from multiple injuries (79.7%), and the majority of fatalities (94.2%) were immediate, with homicide identified as the predominant cause. Suicides represented merely 2.4% of the overall total. Conclusion: Our results showed that most victims were men. The majority of them were having an age between 16 and 30. Most victims sustained multiple injuries. Homicide was the leading cause of death, and the lungs were the most frequently injured organ.
Unlocking Therapeutic Potential of Alkaloids Inhibiting Acetylcholine Esterase: A Comparative Molecular Docking and MD Simulation Analysis with Known Drugs of Galantamine and Physostigmine
Alzheimer's disease is characterized by the degeneration of neurons in the central nervous system. Patients with Alzheimer's disease experience cognitive problems like memory loss and reasoning impairments, which are brought on by a decrease in neuronal activity and a drop in the levels of neurotransmitters in the intersynapse. The Fritillaria genus, which comprises a variety of culinary and medicinal plants from the Liliaceae family, is extensively cultivated and has a long history in Xinjiang, China. been used in Chinese traditional medicine. The primary component of this plant is alkaloids, of which there are over 40 known varieties. . Most of Alkaloids are the main important compounds used in treatment of different disease, so it will have an effective role in the treatment of Alzheimer’s as well. Insilico approach including molecular docking, ADME, Toxicity, bioactivity check and Molecular Dynamic Simulation was applied for evaluation of their potential to treat Alzheimer’s disease.Computationalfindings of the current study reveals thatHuperzine A (-9.6kcal/mol), Berberine (-10.6kcal/mol) andPiperine (-9.6kcal/mol) may act as a drug candidate as they follow all five guidelines of Lipinski,high binding affinities and having equal or less than 3Å of RMSF value in average, which indicates the stability of complexes.