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DOI: https://doi.org/10.52587/njmhs.v5i1.59 Objective: We primarily aimed to detect, isolate and enumerate circulating tumor cells with the help of a panel of markers in a cohort of breast cancer patients in Pakistani Population. Based on clinical utility of CTCs we build a comparison between level of CTCs before and after at least one cycle of chemotherapy monitoring the therapeutic response by using CTCs as Prognostic marker. Material and Methods: EDTA Blood samples of Breast cancer female patients were collected at two different time’s points of their therapeutic regime. RNA was extracted and cDNA was synthesized. After isolation of CTCs, quantification of CTCs was determined with the help of a panel of markers (EpCAM, KRT & MAM) by using real time PCR during different time’s points of chemotherapy along with the formation of conclusive statistical relationships. Results: Our multi-marker analysis for CTCs on the basis of selected biomarkers is strongly associated with cancer manifestations including treatment efficacy and predicting its potential measures to metastasize. We found increase in expression of the three markers for CTCs in metastatic breast cancer patients as compared to the ones on neo adjuvant and adjuvant chemotherapeutic regimes. Moreover, the level of CTCs varied with molecular subtypes. HER2neu have more CTCs as compared to Luminal classified cancers. Conclusion: It will help the clinicians not only in determining personalized chemotherapeutic regimen but also help in stratifying patients into low and high risk of developing metastasis. It will further help to devise anti-metastatic therapies and improving prognosis. The prospect of CTCs is to be provided with the platform of analysis beyond just enumeration. Keywords: Breast Cancer, CTCs, RT-qPCR, Liquid Biopsy, HER2neu

DOI: https://doi.org/10.52587/njmhs.v5i1.61 Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) with Flavivirus genus of the Flaviviridae family. ZIKV was originated in Africa, but it has become a substantial community health concern. The genus is associated to mosquito or tick-borne viruses of public health interest especially Yellow Fever Virus (YFV), Dengue Virus serotype 1-4 (DENV 1-4), and West Nile virus (WNV). A comparative analysis based on individual structural envelope (E) gene phylogenies is performed to identify the genetic variation and evolutionary configuration. Material and Methods: Molecular evolutionary analyses of zika virus (ZIKV) isolates across the globe were conducted to infer phylogenetic relationships. Twenty-one full genome sequences and one Spondweni virus were downloaded from NCBI GenBank. The evolutionary distances of the sequences were determined by means of three“Neighbor-joining (NJ), Maximum-likelihood (ML), and Maximum-parsimony (MP) methods.” Results: Phylogenetic-constructed trees based on the individual envelope (E) nucleotide along with the sequences of amino acid showed that the globally diverse zika virus (ZIKV) strains belong to the two main lineages which suggested genetic intimacy. The evolutionary history of the E-gene of zika virus (ZIKV) represents a most existing common ancestor observed at the tips of the tree. The topology of the NJ-based phylogeny differed from ML and MP analysis of structural envelop (E) nucleotide gene as supported by strong bootstrap. While the key difference was noted such as the Nigerian strain swapped into the first main lineage in the ML-based amino acid tree. These findings recommend a considerable discrepancy in the evolutionary trajectory of the premeditated gene. Conclusion: In light of the prospect investigation, we propose that evolutionary studies on zika virus (ZIKV) strains ought to be achieved on envelope (E) gene phylogenies. It is suggested that the differences in phylogenetic trees, especially the ML-based amino acid tree, emphasized distinct evolutionary trajectories, such as the unique positioning of the Nigerian strain. Keywords: Envelope gene; phylogenetic; zika virus, West Nile virus, phylogenetic analysis

DOI:https://doi.org/10.52587/njmhs.v5i1.62 Objective: The purpose of this study is to find out the association of BMI with the medial longitudinal arch (MLA) of the foot, and lateral curvature of the spine in school-going children. Material and Methods: This cross-sectional analytical study included 385 number of schools children aged 6-15 years. Their weight status and body mass index were determined. The navicular drop test was used to evaluate the medial longitudinal arch of the foot. Both weight-bearing and non-weight-bearing circumstances were used in the test. Lateral curvature of the spine was assessed by Adam’s forward bend test. Data were analyzed by SPSS version 23.0. Frequency tables, Bar charts, and Mean ± SD were used for descriptive analysis. The p-value for the connection between variables was determined using the chi-square test. Results: Among 385 participated children, there were 217 normal weight children, 82 underweight, 70 overweight and 17 obese children. In determining foot arch, there were 318 number of children having normal arch, 28 with high arch, and 39 with low arch (flat foot). Low medial arch was more prevalent among children with high BMI. While determining the occurrence of lateral curvature of spine, 11 with lateral curvature of spine were found underweight, 2 normal weight, and 1 overweight out of 385 children. These results showed that children with low BMI were more likely to develop scoliosis or lateral curvature of spine. Our findings show that the association of BMI with the medial longitudinal arch of the foot, and lateral curvature of the spine in school-going children is statistically significant with the p-value<0.005. Also, there is a positive weak association of BMI with the medial longitudinal arch of the foot, and lateral curvature of the spine. Conclusion: This study demonstrated that BMI is found to be strongly associated with MLA of the foot, and lateral curvature of the spine in school-going children. Lower medial longitudinal foot arch (flat foot) development is more likely to occur in children who are overweight or exhibit obesity. While children with low body mass index are more likely to develop lateral curvature of the spine (scoliosis). Keywords: Flat foot, Medial arch, Lateral curvature, Scoliosis, BMI, MLA

DOI: https://doi.org/10.52587/njmhs.v5i1.65 Objective: Renal failure is a condition that occurs when renal damage reaches to a severity level and kidneys are unable to filter even the 15% of the waste materials from the blood effectively. Hemodialysis is a sort of renal replacement treatment which clear away waste products from the body circulation such as urea, creatinine, and free water when the kidneys are impaired. Material and Methods: Comparison of urea, creatinine and glomerulus filtration rate (GFR) of pre and post dialysis patients with healthy individuals was done from February to March 2022 from Dialysis Center at Lahore-Pakistan. Venous blood (5mL) was collected from dialysis patients (n= 100) suffering from renal failure and other co-morbid diseases, and from normal volunteers (n= 100) to analyze the serum urea and creatinine level by reference methods. Results: Concentration of urea and creatinine were higher in males than females in both groups. Values of post dialysis urea and creatinine were significantly (p < 0.01) lower than their pre dialysis values but were still significantly higher than health group as urea 27 ± 4.7 mg/dL and 1.5 ± 0.07 mg/dL creatinine. Furthermore, GFR was also increased in patients after dialysis procedure, but it was sill significantly lower than control group. Conclusion: It could be concluded that hemodialysis technique significantly (p<0.05) decreased the urea and creatinine in kidney failure patients, but these constituents are higher at post dialysis phase in compared to healthy group. So, more advancement is required to improve this procedure to improve the life of renal failure patients. Keywords: Renal Failure, Hemodialysis, wastes, GFR, Renal Function Tests

DOI:https://doi.org/10.52587/njmhs.v5i1.63 Objective: Children usually suffered from fever which is one of the main complaints of childhood illnesses, and this is a discomfort for the kids as well as their caregivers. The main objective of the study is to find the efficacy of cooling gel patch versus sponging in febrile children. Material and Methods: This randomized control trial was conducted at Paediatrician Department, Khyber Medical Complex, Peshawar from January 2023 to May 2023. Data were collected from 250 febrile children. Patients presenting with fever were enrolled in the study. Participants were randomly assigned to one of two intervention groups: the cooling gel patch group or the sponging group. Children aged 6 months to 12 years with a documented fever (axillary temperature ≥ 38.0°C) of infectious or non-infectious origin were included in the study.Participants underwent a standardized assessment, including a detailed medical history, physical examination, and baseline temperature measurement. Results: Data were collected from 250 patients according to criteria and designed of the study. Mean age was 6.5±2.1 and 6.3±2.3 years respectively, with a comparable distribution of gender. Weight and height measurements also showed negligible differences between groups. Baseline temperatures averaged 38.5°C in both groups. At 0.5, 1, and 2 hours post-intervention, the cooling gel patch group demonstrated greater temperature reductions compared to the sponging group (1.2°C ± 0.4°C vs. 0.9°C ± 0.3°C, 1.5°C ± 0.5°C vs. 1.2°C ± 0.4°C, and 1.8°C ± 0.6°C vs. 1.4°C ± 0.5°C, respectively), all with p-values < 0.05 Conclusion: It is concluded that cooling gel patches exhibit superior efficacy compared to sponging in reducing fever and achieving fever resolution within a 2-hour timeframe in febrile children. Keywords: Gel patches, Cooling, Efficacy, Febrile, Children.