Global Challenges of Enteric Fever: Gaps, Hurdles, and Hope
Methods Adhering to PRISMA guidelines, an extensive literature search was performed utilizing PubMed and Scopus databases from 2015 to 2024. Eligible studies were randomized controlled trials (RCTs) involving preterm infants (26–34 weeks gestation) who received olfactory stimulation (e.g., milk, vanilla, rose odors) compared to standard care. The primary outcome was the number of days required to achieve full oral feeding. Data were synthesized using a random-effects meta-analysis model, and methodological quality was assessed using the Cochrane RoB 2 tool and GRADE framework. Results Out of 1,029 identified records, five RCTs met inclusion criteria. Meta-analysis showed that olfactory stimulation significantly reduced the time to full oral feeding (mean difference = -1.37 days; 95% CI: -2.36 to -0.39; p = 0.006), with high heterogeneity (I² = 98%). Subgroup analyses indicated the greatest benefit in studies using milk odor and in smaller cohorts. Conclusion A safe and non-invasive strategy, olfactory stimulation appears to facilitate a quicker transition to full oral feeding in preterm infants. However, future research, particularly large-scale studies, is required to ascertain its long-term efficacy and refine intervention protocols. Keywords: Enteral Nutrition; Feeding Behavior; Infant, Premature; Olfactory Stimulation; Randomized Controlled Trial
None of Us Is as Smart as All of Us
Imagine Mrs. XYZ, a 69-year-old woman living in a remote area with her son’s family. One evening, she was brought to the hospital after a minor fall. Upon examination, her blood pressure was low, and she had a small fracture in her hip. The medical doctor admitted her for observation and pain management. During her care, the nurse noticed she seemed more confused than expected. During a medication review, the pharmacist realized she was taking two different medications prescribed by different doctors for the same condition, which were lowering her blood pressure, which might have led to the fall. A physiotherapist noticed that her muscle strength was poor for her age and suspected early frailty. The public health specialist spoke with her family and found out that Mrs. XYZ had a sedentary lifestyle with poor eating habits. The psychologist uncovered that she was grieving her husband’s recent death and suffering from undiagnosed depression. She was feeling like a burden to her family. If all these professionals had not spoken up or only worked in silos, Mrs. XYZ would’ve been discharged as ‘stable’, only to return weeks later with a major depressive episode, a serious injury or even something irreversible.
Enteral to Oral Feeding Progression by Olfactory Stimulation In Preterm Infants – A Systematic Review
Methods Adhering to PRISMA guidelines, an extensive literature search was performed utilizing PubMed and Scopus databases from 2015 to 2024. Eligible studies were randomized controlled trials (RCTs) involving preterm infants (26–34 weeks gestation) who received olfactory stimulation (e.g., milk, vanilla, rose odors) compared to standard care. The primary outcome was the number of days required to achieve full oral feeding. Data were synthesized using a random-effects meta-analysis model, and methodological quality was assessed using the Cochrane RoB 2 tool and GRADE framework. Results Out of 1,029 identified records, five RCTs met inclusion criteria. Meta-analysis showed that olfactory stimulation significantly reduced the time to full oral feeding (mean difference = -1.37 days; 95% CI: -2.36 to -0.39; p = 0.006), with high heterogeneity (I² = 98%). Subgroup analyses indicated the greatest benefit in studies using milk odor and in smaller cohorts. Conclusion A safe and non-invasive strategy, olfactory stimulation appears to facilitate a quicker transition to full oral feeding in preterm infants. However, future research, particularly large-scale studies, is required to ascertain its long-term efficacy and refine intervention protocols. Keywords: Enteral Nutrition; Feeding Behavior; Infant, Premature; Olfactory Stimulation; Randomized Controlled Trial
Perception of Smile Attractiveness Based on Gingival Display and Smile Arc Among Dentists, Dental Students, and Laypersons
Introduction A smile is widely recognized as a non-verbal communicative cue that signifies positive affect and plays a pivotal role in human social interaction1 . Its significance in dental esthetics arises from its impact on perceptions of health, confidence, and sociability, making it a central consideration in contemporary dental practice2. Modern dentistry has increasingly emphasized esthetic outcomes in response to patient-driven demand, moving beyond the traditional curative model to embrace functionally and visually optimized dental care3. Esthetic dentistry distinguishes itself from cosmetic dentistry by focusing on long-term oral function and natural replication of dentition, rather than solely enhancing appearance through elective procedures4.Smile attractiveness is a complex construct influenced by several morphological variables, including tooth alignment, gingival display, and smile arc configuration5. Among these factors, gingival display defined as the extent of gingiva visible during smiling and the smile arc referring to the curvature alignment of the upper anterior teeth with the lower lip have emerged as key determinants of esthetic preference5. Evidence from systematic reviews indicates that excessive gingival display, commonly referred to as a "gummy smile," is generally rated as less attractive, though cultural and individual differences play a moderating role6. Cultural variations are further supported by studies showing that aesthetic ideals regarding gingival display differ significantly across ethnic and regional populations7. Additionally, the influence of digital platforms on aesthetic perception is increasingly recognized, particularly among younger demographics who are frequent users of social media8. Social platforms such as Instagram and TikTok amplify exposure to digitally enhanced smiles and curated dental aesthetics, potentially shaping user expectations and fueling demand for cosmetic procedures like veneers, whitening, and orthodontic interventions 8 .Despite the global proliferation of research on smile esthetics, limited data is available from South Asia particularly Pakistan that integrates professional and lay perspectives on gingival display and smile arc9. Existing regional studies often focus on isolated populations and lack the methodological integration of realistic visual stimuli and multi-group evaluation6. This study aims to address this gap by examining perceptions of smile attractiveness among dentists, dental students, and laypersons in Pakistan, using digitally modified images to systematically vary gingival display and smile arc configurations9.
Design and Evaluation of Protein Inhibitors Against the KRAS G12D Mutation in Colorectal Cancer via Computer-Aided Drug Design Techniques
Despite the critical role of KRAS in colorectal cancer progression, efforts to directly inhibit the G12D mutation have been met with limited success. This study employs a flexible docking approach, leveraging CABS-dock to capture dynamic peptide-protein interactions. Binding free energy calculations confirmed the stability of selected inhibitors, with Ligand 3 exhibiting the lowest energy (-57.59 kcal/mol). These findings underscore the potential of peptide-based strategies in overcoming the long-standing challenges of targeting mutant KRAS and advancing personalized cancer therapies.
Learning Pharmaceutics from YouTube: A Valuable Tool for Undergraduate Students
Objective: Pharmaceutics is a crucial subject in pharmacy education, covering the principles of drug formulation, delivery, and stability. Traditional teaching methodologies, including lectures and laboratory experiments, have long been the cornerstone of education. However, the digital revolution has introduced alternative learning approaches, such as online video platforms. YouTube has emerged as a widely used supplementary educational resource due to its accessibility, visual appeal, and engaging content. This study explores the role of YouTube in learning pharmaceutics among undergraduate students, analyzing its effectiveness, student preferences, and limitations. Materials and Methods: A cross-sectional study was conducted among pharmacy students using an online survey to assess their use of YouTube for learning pharmaceutics. Results: The results indicate that a majority of students rely on YouTube for concept reinforcement, particularly for complex topics such as drug formulation and biopharmaceutics. While students appreciate the accessibility and clarity provided by YouTube videos, concerns regarding content credibility and lack of structured learning pathways remain. Conclusion: The study concludes that YouTube is a valuable tool in pharmacy education but should be used in conjunction with verified resources and instructor guidance.
Assessment of Pain Symptoms in Primary Care Physiotherapy: Insights from Patient-Reported Data
Abstract Introduction Musculoskeletal (MSK) pain is a leading cause of disability, significantly affecting quality of life and work productivity. Many individuals initially rely on self-medication and home remedies, leading to delayed physiotherapy intervention. Understanding patient-reported pain characteristics is essential for optimizing physiotherapy management strategies. This study aims to analyze pain distribution, intensity, symptom duration, and recurrence among patients seeking primary care physiotherapy. Methods A cross-sectional observational study was conducted across primary care physiotherapy clinics in the Middle East, using a systematic random sampling approach. Data from 1,600 patients were collected via validated self-reported questionnaires before their initial consultation. Pain characteristics, including primary symptom site, co-occurring pain sites, intensity (0–10 Numeric Rating Scale), symptom duration, and recurrence, were analyzed. Descriptive and inferential statistics, including multivariate logistic regression, were used to identify predictors of chronic pain. Results The lower back (38.5%) was the most common primary symptom site, followed by the knee (22.1%) and shoulder (14.3%). Co-occurring pain was reported in 47.8% of cases. The mean pain intensity was 6.7 (SD = 1.9), with 50.4% experiencing chronic pain (>12 weeks). Higher pain intensity (OR = 2.3, p < 0.001) and multiple pain sites (OR = 1.9, p < 0.001) were significant predictors of chronic pain. Conclusion MSK pain is highly prevalent, with many patients experiencing chronic and recurrent symptoms. Early physiotherapy intervention should be prioritized for individuals with high pain intensity and multisite pain to prevent long-term disability. Future research should explore multifactorial contributors and assess treatment efficacy in physiotherapy settings. Keywords: chronic; data; experience; muscle; skeleton
Prevalence and Risk Factors of Backache Among Dental Auxiliaries: A Cross-Sectional Study
Background: Occupational health issues, particularly musculoskeletal disorders (MSDs), are prevalent worldwide. Dental auxiliaries are prone to backache due to prolonged static postures and repetitive movements, affecting their productivity and quality of life. Objective: To determine the prevalence of backache among dental auxiliaries in Islamabad and Rawalpindi and analyze the associated risk factors. Methods: A cross-sectional study was conducted using a self-administered, validated questionnaire distributed among 80 dental auxiliaries in hospitals and private clinics. The variables assessed included work posture, specialty, working hours, years in practice, and absenteeism due to pain. Data were analyzed using SPSS version 17, with chi-square tests applied to determine associations between back pain and independent variables. Results: Out of 80 distributed questionnaires, 60 (75%) were completed. Among participants, 78.3% were males and 21.7% females. The overall prevalence of back pain was 65%. Among affected participants, 58.3% reported bearable pain, 1.7% experienced severe pain, and 5% did not specify. The only factor significantly associated with back pain was specialty (endodontics/operative department, p = 0.04). Other factors, including posture, years in practice, working hours, and exercise, did not show significant associations. Conclusion: A high prevalence of back pain was observed among dental auxiliaries in Pakistan. Ergonomic interventions, targeted training, and workplace modifications are essential to mitigate occupational health risks.
Novel Biomarkers for the Early Detection of Myocardial Infarction
Early detection of myocardial infarction (MI) is essential, yet traditional biomarkers like Troponin and CK-MB have limited sensitivity in the initial hours after symptom onset. Emerging biomarkers such as miRNA-208, miRNA-499, and Copeptin show promise for earlier diagnosis, particularly within the first 3 hours. Additionally, markers like GDF-15, sST2, suPAR, H-FABP, sLOX-1, and various RNAs (including N1LR, SNHG1, TTTY15, and HULC) offer potential for improved MI detection and prognostic assessment. Integrating these novel biomarkers could enhance early diagnosis and management of MI, ultimately leading to better patient outcomes.