Aim and Scope

DOI: https://doi.org/10.52587/njhms.v6i1.81 Objective: The present study was conducted with the aim to determine plasma expression levels of metastatic genes like E-cad, MMP-2, MMP-9, TIMP-1, TIE-2 in peripheral blood of breast cancer patients to establish if they could be used as potential biomarkers for breast cancer metastasis assessment in relation to clinicopathological association. Materials and Methods: Blood samples of 86 Breast cancer patients and 24 healthy females were obtained, their RNA was extracted, reversed transcribed into cDNA and then analyzed using RT-qPCR. A correlation was observed among angiogenic and metastatic factors according to classical clinical-pathological risk factors. Results: The plasma metastatic (E-cad, TIE-2, MMP-2, MMP-9 and TIMP-1) biomarkers levels were significantly elevated. TIE-2 and MMP-9 expression levels were significantly increased in tumor Grade 3. TIMP-1 overexpression in advanced stage disease seemed independent of MMP-2 and MMP-9 expression. MMP-2 and MMP-9 expression was increased by aggressive molecular subtypes. Observed elevations were in significant association with well-known clinicopathological variables. Conclusion: The studied genes showed potential to be used as gene signature for determining the metastatic potential of breast tumor and E-cad, MMP-2, MMP-9 and TIMP-1 can be used as prognostic biomarkers in Breast cancer patients in order to design personalized therapeutics. Key Words: Breast Cancer, Metastasis, Expression Profiling, Biomarkers, Therapeutics

DOI: https://doi.org/10.52587/njhms.v6i1.85 Objective: Diarrhea remains a leading cause of morbidity and mortality among children under five years old worldwide, particularly in low- and middle-income countries. The basic aim of the study is to find the knowledge and practices on the prevention and management of diarrhea in children under-5 years in Pakistan. Material and Methods: This cross-sectional study was conducted at Lady Reading Hospital MTI, Peshawar during August 2022 to May 2023. Data were collected from 230 children under-5 years suffering from diarrhea. Participants were selected based on the criterion that they had at least one child under the age of five who had experienced diarrhea in the past six months. Healthcare providers included pediatricians, general practitioners, nurses, and community health workers involved in child health services. Results: The study comprised 180 participants, with a majority being female (70%) and the rest male (30%). Most participants were aged between 20 and 29 years (50%), followed by those aged 30-39 years (40%), and a smaller group aged 40-49 years (10%). The mean age of their children was 3.5±1.2 years. The participants' knowledge on various aspects of diarrhea was evaluated, with significant awareness shown in certain areas. Regarding the causes, 65% (117 participants) identified poor sanitation, while 55% (99 participants) recognized contaminated water as a cause. Conclusion: It is concluded that targeted educational interventions are needed to bridge knowledge gaps among parents, particularly regarding the importance of exclusive breastfeeding and recognizing danger signs of severe diarrhea. Adherence to recommended practices, such as proper oral rehydration salts (ORS) preparation and timely healthcare seeking, should be emphasized to improve child health outcomes. Socioeconomic factors must be addressed to ensure equitable access to healthcare services and support for vulnerable populations. Keywords: Knowledge, Practices, Prevention, Diarrhea

DOI: https://doi.org/10.52587/njhms.v6i1.77 Objective: Diabetes mellitus (DM) is a metabolic disorder with increase prevalence around the globe and linked with multiple complications. Diabetic foot ulcer is most lethal complication of diabetes mellitus (DM). The aim of this study is to determine the microbiology profile of diabetic foot ulcers and the antimicrobial susceptibility of Cinnamomum zeylanicum (Darchini) against isolated bacteria. Material and Methods: This study was conducted on 100 patients with diabetic foot ulcer from different diabetic centers of Lahore, Punjab. Samples were obtained from wound using sterilized techniques. Different microbiological techniques like colony morphology, specific media, gram staining and biochemical parameters were used to isolate and identified the bacteria. Disc diffusion and well-diffusion methods were performed for antimicrobial susceptibility of standards antibiotics and cinnamon extract. Results: Various bacteria like S. aureus (78), P. aeruginosa (50), E. coli (44), K. pneumonia (28) P. mirabilis (14), S. epidermidis (17) were identified on the base of colony morphology, gram staining and biochemical testing. . Antibacterial analysis revealed sensitivity of the C. zeylanicum extract against S. aureus (12mm), P. aeruginosa (50), E. coli (44), K. pneumonia (28) P. mirabilis (14), S. epidermidis (17). Selected extracts against isolates showed significant (p<0.05) antimicrobial activity comparable to synthetic antibiotics. Conclusion: The lemon extract showed moderate antibacterial activity against S. epidermidis (8mm), P. aeruginosa (10mm) Bacillus (10mm), and P. mirabilis (11mm). Similarly, pomegranate also showed moderate sensitivity against all isolated bacteria. Jamun leaf extract showed antibacterial activity against S. epidermidis (12mm), K. pneumonia (10mm), E. coli (12mm), S. aureus, (11mm) and P. mirabilis (10mm). Hence plants may be used as an alternative to synthetic antibiotics with modifications to achieve better results. Keywords: Diabetic foot, Bacterial profile, C. zeylanicum, Antibacterial Potential

DOI: https://doi.org/10.52587/njhms.v6i1.86 Objective: This study aims to investigate the factors associated with knowledge, attitude, and practice (KAP) in relation to antibiotic use and antimicrobial resistance (AMR) prevention among nurses in secondary and tertiary care hospitals in Multan, Pakistan. Materials and Methods: A cross-sectional survey was conducted from March 2023 to January 2024 using a self-administered, semi-structured questionnaire. The questionnaire included demographic characteristics and selected components on antibiotic use and AMR prevention. Results: A total of 341 nurses, predominantly female (86.8%), participated and completed the questionnaires. Regarding knowledge, 59.3% of nurses were unaware that antibiotics cannot treat viral infections. Additionally, 68% of nurses did not know about the association between antibiotic efficacy and resistance. Overall, 54.8% of nurses had a moderate level of knowledge regarding antibiotic resistance, 26.9% had good knowledge, and 18.1% had poor knowledge. In terms of attitude, participants scored a mean of 2 on a scale of 1 to 5 regarding self-administration of antibiotics for general flu symptoms and a mean score of 2.1 for using antibiotics without a prescription. The results revealed a non-significant association (p>0.05) between knowledge and attitude (r=0.021 and p=0.169) of nurse regarding antimicrobial resistance Conclusion: The findings of this study highlight the urgent need for tailored educational interventions, antibiotic stewardship, and training programs for healthcare providers in Pakistan. Keywords: Antibiotic Abuse, Antimicrobial Resistance, Prevention, Nurses

DOI: https://doi.org/10.52587/njhms.v6i1.84 Objective: The objective of the study was to analyze the association of breakfast skipping with social, academic, emotional behavior and cognitive health of school-going children of 7-14 years of age in a cross-sectional study. Material & Methods: In a descriptive cross-sectional study, data were collected from 200 participants via a structured questionnaire. The breakfast skipping questionnaire consisted of 4 items; never skippers, sometimes skippers, often skippers, and always skippers. Cognitive ability was assessed using the Mini-Mental State Examination (MMSE) (an 11-item scale). Social, academic, and emotional behavior were measured using The Social, Academic and Emotional Behaviour Risk Screener (SAEBRS) (a 19-item global screening tool). Results: There was a statistically significant (0.05) correlation between breakfast skipping (BS) with Social Behaviour (SB; -0.346), Academic Behaviour (AB; -0.571), Emotional Behaviour (EB; -0.776) and with Cognitive Performance (CP; -0.213). SB, AB, EB, and CP of children who skipped breakfast (Always Skippers) had lower mean scores as compared with Never Skippers and Sometimes Skippers and these differences were statistically significant (p=0.000). Conclusion: The study concluded that breakfast skipping is negatively associated with social behavior, academic behavior, emotional behavior, and cognitive health of school-going children of 7-14 years of age. Keywords: breakfast skipping, social behaviour, academic performances, psychological aspects, cognitive aspects

Background: Achieving full knee extension within the first few weeks following total knee replacement (TKR) is crucial, and physical therapy plays a pivotal role in the rehabilitation process. However, the compliance of current physical therapy practices in Pakistan with international guidelines remains uncertain. Objective: This study aimed to evaluate the physiotherapy practices for patients undergoing total knee replacement in Pakistan. Additionally, it sought to determine whether these practices are aligned with contemporary international standards. Methodology: A descriptive cross-sectional study was conducted, employing a convenience sampling technique to collect data from 259 physical therapists. A questionnaire was developed based on standard guidelines for total knee replacement rehabilitation. Results: The majority of participants were male (60%), with a mean age of 33 ± 4 years and an average clinical experience of 5 years. In preoperative rehabilitation, the most commonly used modalities were ultrasound (42.67%) and strengthening exercises (40.67%). During postoperative Phase I, cryotherapy (42.67%) was favoured, along with a regimen that included an active range of motion exercises, gait training, and continuous passive motion. In Phase II, hot packs were the preferred modality, while electrical muscle stimulation (EMS) was utilized in Phase III. Strengthening exercises and functional training were the primary postoperative exercise regimens in both Phases II and III. Conclusion: In Pakistan, modalities were favoured over exercises in every phase of rehabilitation following total knee replacement. In contrast, international guidelines emphasize exercises over modalities. Keywords: Total Knee Replacement, Preoperative Rehabilitation, Postoperative Rehabilitation