Journal of Biomolecules, Pathogenesis and Therapeutics
Journal of Biomolecules, Pathogenesis and Therapeutics (JBPT) is an international, double blind peer-reviewed, open-access quarterly publishing biomedical journal. JBPT primarily publishes the scientific knowledge and quality researches based on Molecular Biology, Pathogenesis and Health Therapeutics related to Clinical Advancements in all areas of Medical, Health and Life Sciences. JBPT follows "CC BY NC creative commons" licensing https://creativecommons. org/licenses/by-nc/4.0/. Quarterly Issues are published in the months of March, June, September and December of every year. JBPT also invites Special Issues call on Selective Scientific Advancements. JBPT mainly publishes Original Articles, Research Articles, Meta-Analysis, Systematic Reviews, Narrative Reviews, Case Studies and Experimental Evidences. Other submissions including Scientific Communications, Technical Updates, View Points and Editorials are also invited allowing contributors to share novel insights and discoveries within Journal scope. JBPT declares no APCs policy till 2027 December. All Researchers are encouraged to prepare manuscripts in strict compliance with Authors guidelines to avoid desk rejections or potential delays. For details: https://jbptjournal.org/index.php/jbpt/preparation-of-manuscript All kinds of submissions undergo the Initial Screening for novelty and quality check by Internal Editor, double-blind peer review and Editor's recommendations for further revisions, acceptance or rejection. The peer-review period is 04-08 weeks. The overall process from Submission to Editor's Decision takes 08-12 weeks. Accepted articles are published in one of the forthcoming Issues. Authors seeking Fast Tracks are requested to seek alternative suitable journal. JBPT focusses on the interface of biomolecular sciences, disease mechanisms, and therapeutic developments. The journal provides an international platform for studies that advance the molecular understanding of human diseases and translate these insights into clinical diagnostic, preventive medicine, and therapeutic applications. JBPT publishes basic, translational, and clinical research focusing on biomolecules such as proteins, nucleic acids, glycans, lipids, and immune mediators involved in infectious, inflammatory, metabolic, genetic, and neoplastic disorders. Emphasis is placed on mechanistic investigations, host–pathogen interactions, biomarker discovery, molecular diagnosis and the evaluation of emerging therapeutic strategies. Authorships roles are recommended as per ICMJE. Authorship credit should be based solely on substantial contributions to each of the following components: Concept and design of the study, or acquisition of data, or analysis and interpretation of data Drafting the paper or revising it critically for important intellectual content Final approval of the version to be published Agreement to be accountable for all aspects of the work For details: http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html Additionally, JBPT fosters interdisciplinary collaboration and supports the global research community by providing timely updates on emerging scientific trends. The journal mainly serves researchers, clinicians, biotechnologists, pharmaceutical scientists, and healthcare professionals working in molecular medicine, immunology, microbiology, and drug discovery. JBPT is currently owned and independently published by the JBPT Editorial Office Lahore Pakistan, and operates with full editorial independence while adhering to ethical publishing standards in accordance with the principles of the Committee on Publication Ethics (COPE).
Journal of Biomolecules, Pathogenesis and Therapeutics (JBPT) follows the Attribution Creative Commons-Non commercial (CC BY-NC) license which allows the users to copy and redistribute the material in any medium or format, remix, transform and build upon the material. The users must give credit to the source and indicate, provide a link to the license, and indicate if changes were made. However, the CC BY-NC license restricts the use of material for commercial purposes (Further details are available at website. The Editorial Board of the JBPT endeavors to ensure the accuracy, integrity, and quality of all published content. However, the responsibility of opinions, interpretations, and conclusions expressed in the published articles rests entirely with the authors and do not necessarily reflect the views of the Editorial Board, publisher, or affiliated institutions.
Copyright (c) 2026 Authors https://creativecommons.org/licenses/by-nc/4.0/
Expression profiling of TP53 and diagnostic utility in Breast Cancer: clinical and molecular Perspectives
Copyright (c) 2026 Maryum Qayyum, Kashif Shahbaz, Khadija Ahmed, Mubeen Anjum (Author) https://creativecommons.org/licenses/by-nc/4.0/
Treatment adherence and clinical outcomes among patients with Chronic Kidney Disease
Copyright (c) 2026 Mehmona Inam, Habib Ullah (Author) https://creativecommons.org/licenses/by-nc/4.0/
Knowledge, patterns, and therapeutic factors associated with self-medication practices among adult patients attending outpatient healthcare facilities
Copyright (c) 2026 Esha Khalid, Ahmed Ikram (Author) https://creativecommons.org/licenses/by-nc/4.0/
Awareness of fall prevention strategies among Nurses caring for older Adults
Copyright (c) 2026 Kiran Khalid, Mahnoor Khan, Momina Rehmat (Author) https://creativecommons.org/licenses/by-nc/4.0/
Biosafety Cabinet handling practices and PCR laboratory SOP compliance among undergraduate Medical students: Implications for Laboratory safety and biomolecular training
Copyright (c) 2026 Muhammad Akram, Shumaila, Kinza Ahmed (Author) https://creativecommons.org/licenses/by-nc/4.0/
Infection prevention insights into knowledge scores, improved hand hygiene and personal protective equipment compliance among nurses at tertiary healthcare
Background: Infection prevention and control (IPC) is a vital program to minimize the risk of health care-associated infections (HAIs) and keep healthcare workers safe and healthy for patients. Nursing staff are in close and continuous contact with patients so present study was set to evaluate the knowledge and compliance of the nursing staff with IPC measures and to find the associated factors. Methods: A cross sectional study was conducted in 150 nursing staff of various clinical departments of tertiary care hospitals. Structured self-administered questionnaire data collected on socio-demographic characteristics, IPC knowledge, hand hygiene, PPE use, waste disposal and standard precautions. The total knowledge and compliance score were obtained and then divided into poor, moderate and good. Data was analyzed in SPSS version 26.0. Result: The mean knowledge score was 78.4 ± 11.2 and the mean compliance score was 74.6 ± 12.8. The participants' knowledge about the topic was good in 58.0%, moderate in 32.0% and poor in 10.0%. The percentage of nurses that reported good compliance was 54.0% and 33.3% reported moderate compliance. There was significant association between knowledge level and compliance (p < 0.001); and there was positive correlation between compliance score and knowledge score (r = 0.64, p < 0.001). Knowledge and IPC training as well as professional experience, were significant predictors of compliance. Conclusion: Nursing staff had good knowledge and compliance with IPC. There was positive correlations between higher knowledge and IPC training and compliance. Recommendations include regular education and monitoring for strengthening IPC practices.
Copyright (c) 2026 Fatima Javed, Rimsha Awan, Zehra Qasim (Author) https://creativecommons.org/licenses/by-nc/4.0/
Host Immune Recognition, Pattern Recognition Receptor Signaling, and Antigen Presentation Pathways Initiating Chronic Host–Pathogen Interactions
Background: The spread of chronic viral diseases like Hepatitis B (HBV) and Human Immunodeficiency Virus (HIV) became a significant health issue in the world. Pattern recognition receptor (PRR) signaling, antigen presentation pathways (APP), and host immune recognition (HIR) were the key pathways of host immune response that were often dysregulated to allow viral persistence. This study aimed at synthesizing available literature on the dysregulation of PRR signaling, HIR and APP pathways in the development and persistence of chronic HBV and HIV infections. Methods: This study was performed according to PRISMA 2020 guidelines. Research was conducted in PubMed, Scopus, Web of Science, and Google Scholar from 2014 to 2024. Those studies included that involved PRR (e.g. TLRs), HIR (e.g. T cell subsets), and APP (e.g. dendritic cell function) interactions in the chronic HBV and HIV. Non-English articles, reviews, and studies without quantitative data were excluded. Statistical analyses were performed using MetaAnalysisOnline tool. The risk of bias was assessed using appropriate tools, and the certainty of evidence was evaluated using the GRADE framework. Results: The analysis of twelve studies revealed downregulation of TLR7 (SMD: -1.92, 95% CI: -3.19 to -0.66) and reduction of CD3⁺ T cells (SMD: -1.95, 95% CI: -3.36 to -0.55) in patient cohorts versus controls, whereasTLR2, TLR4, CD4⁺, CD8⁺ T, and dendritic cell markers showed no statistically association. Overall risk of bias was evaluated to be moderate, whereas the certainty of evidence was low. Conclusion: Chronic infections were characterized by parallel dysfunctions across PRR signaling, adaptive HIR, and APP.
Copyright (c) 2026 Ejaz Ahmed, Faiza Azhar, Muhammad Akhter (Author) https://creativecommons.org/licenses/by-nc/4.0/
Normalizing the Abnormal: Is Remodeling the TME the Next Frontier in Cancer Care Therapy?
The Tumor Microenvironment (TME) is a complicated ecosystem that consists of cancer cells, stromal components, immune infiltrates, and vascular networks, which determine tumor progression, metastasis, and resistance to treatment. Historically, the treatment of cancer has been aimed directly at malignant cells without considering the contribution of the deviant microenvironment that provides sustenance to the tumors. Recent observations have highlighted that by reprogramming or re-establishing vascular integrity, immune cell homeostasis, and metabolic and stromal signaling, the TME can be reconfigured to become tumor restraining. Different therapeutic approaches that are aimed at aberrant angiogenesis, hypoxia, immune suppression, and extracellular matrix (ECM) remodeling have shown synergistic effects in association with chemotherapy or immunotherapy. There is, however, an intrinsic heterogeneity and dynamic adaptation of the TME, which is a major issue in clinical translation. The present review brings into the limelight the recent concept of TME normalization as a paradigm shift in therapy, which offers a pathway to sustainable and complete cancer management.
Copyright (c) 2026 Asma Ali (Author) https://creativecommons.org/licenses/by-nc/4.0/
From Silent Tumors to Molecular Signals: The Future of Pre-Symptomatic Cancer Detection
The latest developments in molecular oncology are revolutionizing the world of cancer diagnosis as they create an opportunity to detect tumor-related signals way before they have clinical effects. The circulating tumor DNA (ctDNA), which is released into the blood by cancer cells, can now be detected at very low levels by ultra-sensitive technologies based on next-generation sequencing. Recent retrospective studies on archived plasma samples have also shown the existence of cancer-specific mutations over three years before standard diagnosis, and this highlights the high sensitivity of current genomic technologies. Multi-cancer early detection schemes incorporating mutation profiling, epigenetic methylation signature, and fragmentomic studies also improve the detection accuracy and tissue-of-origin identification. Despite of their great potential, there are still issues of analytical sensitivity, false-positive interpretation, clinical management pathways, and cost-effectiveness. The research highlights that pre-symptomatic molecular detection represents a transformative shift towards predictive and preventive oncology with the potential to increase therapeutic windows, enhance survival rates, and alter the conceptualization of population-based cancer screening.
Copyright (c) 2026 kainat Zafar, Irshad Sana Ullah (Author) https://creativecommons.org/licenses/by-nc/4.0/
Liquid Biopsy in Cancer Monitoring: Beyond Circulating Tumor DNA
Liquid biopsy has become a potent, least invasive way of detecting, monitoring, and treating cancer by studying cancer-causing biomarkers in body fluids. The circulating tumor DNA (ctDNA) has long been the foundation of the liquid biopsy as it has the capability of measuring tumor-specific genetic changes. New developments have made it possible to identify and characterize a wide range of circulating analytes, such as ctDNA, extracellular vesicles, circulating RNA, tumor-educated platelets, and circulating proteins and metabolites. These biomarkers are associated with tumor viability, transcriptional activity, metastatic potential, and metabolic reprogramming. Innovations in next-generation sequencing, microfluidics, proteomics, and single-cell analysis have led to the detection platforms of many multi-analytes being immensely sensitive and reliable. Integrative liquid biopsy platforms can help to assess the evolution and therapeutic resistance of tumors in a holistic manner through the integration of genomic, transcriptomic, and proteomic and cellular data. Moreover, data interpretation has also been improved with the implementation of artificial intelligence and machine learning, resulting in reliable classification of the disease, risks stratification, and predict the response to treatment. Although significant progress has been made, complications such as, variability in analysis, absence of standardized protocols, high cost of operation, and biological heterogeneity, restrict the extensive clinical implementation. Technological advancement and interdisciplinary cooperation will continue to intensify the role of liquid biopsy in achieving the possibility of early detection, real-time monitoring, and optimal cancer management.
Copyright (c) 2026 Hajra Ahmad, Irshad Ali, Mubashra Khadim (Author) https://creativecommons.org/licenses/by-nc/4.0/
Therapeutic Vaccines: Why Have They Succeeded in Some Diseases and Failed in Others?
Therapeutic vaccines generate or restore antigen-specific immunity, providing a unique clinical approach as compared to prophylactic vaccination. Although therapeutic vaccines have intermittent efficacy in different diseases, their optimistic response is reported in some infectious diseases whereas, insignificant efficacy in many chronic and immune-dysregulated malignancies. This questions the underlying biological and translational determinants and seek scientific explanations for these divergent outcomes. Therapeutic vaccines have been linked with well-characterized conserved target antigens, partially preserved immune competence, and disease settings that allow effective immune activation., which predetermines the success of therapeutic vaccines. In contrast, failure of these vaccines is often associated with antigenic variability, immune exhaustion or tolerance, prevailing immunosuppressive mechanisms, and recalcitrant disease microenvironments that impair effective immune interactions. Additional complications include vaccine platforms, poor adjuvants as well as concerns related to design of clinical trials like poor endpoints and poor patient stratification. Immunology, biomolecular profiling and vaccine engineering technologies have elucidated these challenges and identified ways of overcoming them. The translational efficacy can be improved by integrating therapeutic vaccines with immune-modulating factors, selection of targeted antigens, and the use of biomarkers to guide the clinical process. It is essential to define success and failure to guide the development of next-generation therapeutic vaccines rationally.
Copyright (c) 2026 Mubashra Inam, Kiran Rehman, Rabiya Atta (Author) https://creativecommons.org/licenses/by-nc/4.0/
Evaluating the role of Salivary α-Amylase and Associated Enzymes in Carbohydrate Digestion and Gastrointestinal Function: A Comprehensive Systematic Review Perspective
Background: Salivary α-amylase, sucrase, lactase, and maltase enzymes demonstrate an important role in carbohydrate metabolism and gastrointestinal function. Changes in enzymatic activity impact starch digestion, gut fermentation, insulin sensitivity, and digestive health. This systematic review aimed to evaluate how salivary α-amylase, sucrase, lactase, and maltase levels influence metabolic outcomes, carbohydrate digestion, and gastrointestinal functions. Methods: This systematic review followed PRISMA guidelines 2020. Research was conducted in PubMed, Scopus, Web of Science, and Google Scholar from 2016 to 2025. The studies involving salivary α-amylase, sucrase, lactase, and maltase activities in relation to metabolic and gastrointestinal outcomes were included. Non-human research or studies lacking outcome measurements were excluded. The appropriate tools were used for evaluating risk of bias according to the study designs whereas, quality of study was evaluated using GRADE approach. Results: The included eleven studies revealed that higher levels of salivary α-amylase, sucrase, lactase, and maltase were linked to improved gastrointestinal functions, such as greater insulin sensitivity and a lower risk of obesity. The risk of bias of most studies was measured as low to moderate and GRADE rated certainty of evidence as moderate. Conclusion: Salivary α-amylase, sucrase, lactase, and maltase activities might be useful indicators of metabolic health and digestion. Additional research is needed to clarify their use in clinical applications and personalized nutrition.
Copyright (c) 2026 Ehsan Khan, Sabeeha Saddique, Syeda Maira Gillani, Sitara Ejaz, Sidra Anwar, Uday Shree Akkala (Author) https://creativecommons.org/licenses/by-nc/4.0/
Cognitive Behavioral Therapy Versus Antidepressant Medication in Generalized Anxiety Disorder: A Prospective & Novel Approach
Background: Generalized Anxiety Disorder (GAD) is a condition which causes impairment in affected individuals. The conventional treatment includes the application of Cognitive Behavioral Therapy (CBT) or antidepressants. The prospective study compares the CBT and pharmacological therapy in terms of their effects on the reduction of symptoms and functional improvements. Methods: This prospective study (January to July 2024) included 100 individuals with GAD diagnosis, aged 20-50 years according to DSM-5 criteria. Respondents were put in two groups where a structured CBT therapy was administered during 12 weeks in one group and the other group received a standard dose of Selective Serotonin Reuptake Inhibitors. The symptoms, quality of life, and patient self-evaluation were measured using the GAD-7 scale before and after the intervention for comparative analysis. Paired t-tests, independent t-tests, correlation analysis, and estimation of effects size were used for statistical analysis. Results: The GAD-7 scores were significantly reduced in CBT group, and participants showed better performance in terms of functional activities and quality of life measurements (p = 0.02), with high levels of patient satisfaction. The data indicated that there was a moderate positive correlation between symptom reduction and treatment adherence (r = 0.45, p = 0.003). Conclusion: The CBT therapy showed better treatment results as compared to antidepressants in terms of patient satisfaction and functional outcome of the GAD treatment. The results indicated that CBT therapy should be applied as a primary treatment with integration of research into personal treatment plans covering symptoms of anxiety.
Copyright (c) 2026 Faiza Ehsan, Zafar Junaid (Author) https://creativecommons.org/licenses/by-nc/4.0/
Regulated Cerebral Capacity: Insights into Biophysical and Metabolic Boundaries of Neural Networks-A Narrative Review
The human beings have an amazing brain capacity but it is limited at the biological, cellular and network level. Common assertions that people use only a minor part (10%) of their brains are not scientifically proven and ignore the complicated control that governs brain activity. Cerebral capacity is the optimal performance of neural systems under physiological conditions, which does not follow any theoretical activation limit. At cellular level, ion channels and refractory periods limit neuronal excitation, whereas receptor concentrations, plasticity exhaustion, and neurotransmitter cycling all limit synaptic communication. On network level, synchronized coordination is required to process information but it is intrinsically restricted to avoid instability and dysfunction. The functional specialization includes selective recruitment of different brain parts according to task demands rather than maximum usage to meet some hypothetical maximized level. Neuroimaging research tends to misinterpret task specific activations as the only functional regions of brain, whereas background neural activity is omnipresent to ensure homeostasis, preparedness, and metabolic stability. The unused brain myth disregards the evolutionary and energetic needs of preservation of metabolically active and functionally necessary structures. This review combines molecular, cellular, and systems neuroscience to explain how cerebral capacity is naturally controlled. By providing historical, conceptual and mechanistic perspectives, it suggests that neural activity does not work for maximum functionality, instead stability, efficiency and adaptability of the system is ensured through biological regulation. Moreover, it discredits the brain capacity related myths and offers fundamental understanding about constraints of human brain capacity, from neurons to large-scale networks.
Copyright (c) 2026 Naveera Mazhar, Maha Aslam khan, Arslan Majeed, Kainat Zafar (Author) https://creativecommons.org/licenses/by-nc/4.0/
Perioperative Patient Safety: Are We Doing Enough in Resource-Limited Settings?
The perioperative safety is a core issue in surgery and anesthesia, but resources-constrained environments face a number of difficulties to ensure perioperative safety. The lack of skilled specialists, poor infrastructure, and inadequate access to monitoring and medications contribute extensively to the risk that could be prevented in patients. Although international checklists and safety guidelines are available, their application is frequently hampered by structural and personnel inadequacy. The costs and cultural restrictions also complicate the application of safe practices, especially to vulnerable communities in rural and low-income neighborhoods. Although the use of innovative solutions and multi-national partnerships has proven to be effective, the ongoing discrepancy between global guidelines and domestic realities has continued to undermine patient outcomes.
Copyright (c) 2026 Tayyaba Rafiq (Author) https://creativecommons.org/licenses/by-nc/4.0/
Global Floods and Public Health: Anticipating Outbreaks of Vector-Borne and Waterborne Diseases in Vulnerable Countries
Floods create insidious epidemics within the public health that are usually discovered too late. Floods are not mere natural tragedies; they cause eruption of water borne diseases and virus carrying diseases 1. Unless we are able to plan and respond in time, the human cost of flooding will be far greater than drowned villages and forced families. The 2022 flood in Pakistan affected 33 million lives 2. The recent 2025 flood, which have yet to be actively recorded in literature, have alarmingly trends. Stagnant water provided the breeding grounds to the mosquitoes leading to the outbreaks of malaria and dengue 3. The contaminated water sources caused a large-scale eruption of diarrhea and cholera particularly among those children under the age of five 4. According to the World Health Organization (WHO), over 8 million people sought medical help in Pakistan in just a few months because of flood-related diseases 5. These figures are rather grim: as the floods could not be stopped, and only time can tell the damage it will cause to public health. Pakistan is not the lone sufferer of flood associated miseries. Other countries have also experienced similar catastrophes, such as the 2014 Southeastern Europe floods, the 2018 Kerala floods, in India, and the 2020 Yangtze River basin floods, in China 6. These disasters reveal that most nations are unprepared and that international cooperation is needed in efforts to save lives. In 1998, after extensive flooding in South Asia, a huge epidemic of cholera was witnessed in several countries with limited healthcare facilities due to the lack of water and sanitation 7. The message is simple: floods and epidemics cannot be separated because of the situation where water, sanitation infrastructure, and health systems are weak. This can be seen far beyond South Asia. In Sub-Saharan Africa, malaria is commonly fueled by recurrent floods 8. Mozambique has repeatedly faced malaria epidemics, alongside outbreaks of respiratory illnesses and diarrhea 9. Likewise, in Nigeria and Sudan, floodwater is usually contaminated, thereby triggering epidemics of cholera, leptospirosis, typhoid, and hepatitis A 10. Flooding increases the pre-existing deficits and transforms natural risks into long-term social health catastrophes. Climate change worsens this problem every year. Floods are becoming common and adverse due to changes in temperature and the distribution of rain. The Intergovernmental Panel on Climate Change (IPCC) has warned that countries with fragile infrastructure and limited resources will bear the greatest impact of floods by the climate change 11. Moreover, disease epidemics do not follow geographical boundaries. The devastations of the floods in Pakistan, the cholera outbreak in Bangladesh and the malaria pandemic in Africa are lessons that apply across the board. Regardless of these evidences, during flood response planning there is a tendency that public health is a secondary concern. The first response of relief is usually centered on food distribution, shelter, and rebuilding of infrastructure. These priorities are necessary but often delay the urgent medical interventions. A cholera epidemic can roll back decades of child health advances; a malaria outbreak can bring whole neighborhoods to their knees; a diarrheal epidemic can wipe out malnourished communities. Unless addressed, the results of these health impacts may be even deadlier than the floods themselves 12. Governments, humanitarian agencies, and international donors need to change their priorities in order to address this issue. Flood response needs to involve strong public health management, such as developing prompt disease surveillance systems in flood-prone regions to monitor the outbreak of malaria, dengue, cholera, and diarrhea 13. A delivery of safe drinking water, chlorine tablets, and temporary sanitation facilities to displaced people. By providing mosquito nets, insecticides, and other preventive strategies against the transmission of water-borne diseases 14. Educating communities about hygiene, water purification, and mosquito prevention 15. These measures are not optional rather a guide plan for flood recovery initiative. The well-being of the survivors is not just a will-have-it-fast, but the basics on which recovery relies 16. A society ravaged by disease is unable to resettle houses, reconstruct lives, and school its children. Floods bring disasters that are more damaging to human lives than to the infrastructure in Pakistan, Bangladesh, and Mozambique. They create openings which allow diseases to spread, and enhance the pain while paralyze the healing. To deal with floods without laying stress on the health of the people is like fixing fences when the frame is broken. In case we are ready to lower the human price of floods, the forecasting and prevention of the public health crisis should be regarded as the primary priority. Only at that point can the communities in question really get back on their feet, not just in terms of roadways and bridges, but also lives, health, and dignity.
Copyright (c) 2026 Babar Hayat (Author) https://creativecommons.org/licenses/by-nc/4.0/
Beyond PD-1/PD-L1: TME-Targeted Therapies in the Era of Immunotherapy Resistance
Blockade of PD-1/PD-L1 axis has revolutionized the cancer treatment, but clinical responses are often compromised by acquired resistance. Recent data suggested that tumor microenvironment (TME) is a key contributor of immunotherapy failure due to its ability to suppress immune reactions, place metabolic limitations, alter cytokine signaling, and extracellular matrix remodeling. This editorial identifies some of the TME-mediated resistance mechanisms and explains how new therapeutic approaches could be transformed beyond PD-1/PD-L1. Strategies such as myeloid cell reprogramming, regulatory T-cell regulation, metabolic therapy, neutralization of cytokines, targeting of extracellular matrix, and nanotechnology-mediated drug delivery are discussed as new promising perspectives in the context of immunotherapy resistance to restore antitumor immunity.
Copyright (c) 2026 Asma Khawaja, Abdul Mannan Jehangir (Author) https://creativecommons.org/licenses/by-nc/4.0/
Exploring the Role of Oxidative Stress-Related Molecular Biomarkers in Cardiovascular Disease Progression and Therapeutic Modulations: A Systematic Analysis
ABSTRACT Background: Oxidative stress plays a significant role in the pathogenesis of cardiovascular diseases (CVD), endothelial dysfunction and hypertension. The purpose of this study was to synthesize the evidence on the role of critical oxidative stress biomarkers in the etiology of associated diseases to determine their therapeutic potential. Methods: PRISMA 2020 guidelines were followed to conduct this study. Reported literature was searched using PubMed, Scopus, Web of Science, and Google Scholar from 2014 to 2025. Those studies that investigated certain biomarkers of oxidative stress (ROS,), glutathione peroxidase (GPx), malondialdehyde (MDA)) in the pathophysiology of CVD, endothelial dysfunction and hypertension were included. Non-English articles and studies without mechanistic or therapeutic outcomes were excluded. The risk of bias was evaluated with the help of Newcastle-Ottawa Scale, Cochrane risk of bias-2, and SYRCLE tool, and certainty of evidence was measured with help of the GRADE approach. Results: Findings of twelve studies were included in this review, which demonstrated that high level of mitochondrial ROS and MDA, and low activity of SOD and GPx were major contributor to endothelial dysfunction, hypertension and CVD. Melatonin, resveratrol, NAD precursors and mitochondrial-targeted antioxidants proved to be effective therapeutic agents. Risks of bias among included studies ranged from low to high, and the confidence of the evidence ranged from low to moderate. Conclusion: Oxidative stress biomarkers are critical in cardiovascular disease pathogenesis and hold significant therapeutic potential. Further extensive trials are needed to validate these indicators as diagnostic tools and convert targeted antioxidant therapy into successful precision medicine.
Copyright (c) 2026 Jannat Ikram, Sadia Akram (Author) https://creativecommons.org/licenses/by-nc/4.0/
Role of Post-Translational Modifications in Pathogenesis of Rheumatoid Arthritis and Therapeutic Targeting: A Comprehensive Systematic Review
Background: Post-translational modifications (PTMs) such as phosphorylation, acetylation, and ubiquitination played a critical role in pathogenesis of inflammatory diseases including rheumatoid arthritis (RA). This systematic review aimed to synthesize evidence of principal role of PTMs in RA and to evaluate the therapeutic potential of agents targeting these dysregulated modification pathways. Methods: This systematic review followed PRISMA guidelines 2020. Research was conducted in PubMed, Scopus, Web of Science, and Google Scholar from 2015 to 2025. The studies which explored the role of particular PTMs in the RA pathophysiology and their therapeutic potential, were considered. Articles and reviews that were not written in English and where mechanistic or therapeutic outcomes were not described were excluded. The JBI Critical Appraisal Checklist, Newcastle-Ottawa Scale, and SYRCLE tool were used for evaluating risk of bias whereas, quality of study was evaluated using GRADE approach. Results: The findings of twelve studies demonstrated that dysregulation of PTMs played a substantial role in RA immunopathology. Mechanistically, acetylation, ubiquitination, and phosphorylation are involved in dysregulated T-cell metabolism, Th17/ Treg imbalance, synovial fibroblast activation, and pro-inflammatory signaling. Preclinical studies supported the therapeutic potential of targeting associated regulatory enzymes. The risk of bias of most studies was measured as moderate and certainty of evidence was found to be low. Conclusion: Phosphorylation, ubiquitination, and acetylation played a critical role in the pathogenesis of RA and could be exploited as potential therapeutic targets.
Copyright (c) 2026 Kashaf Asghar, Rameesha Ashraf, Muhammad Taimoor, Aqeel Ahmed, Hamdan Khalid (Author) https://creativecommons.org/licenses/by-nc/4.0/
Molecular Inflammatory, Oxidative Stress, and Angiogenic Pathways in Diabetic Foot Ulcer Pathogenesis: A Systematic Review and Meta-Analysis
Background: Diabetic foot ulcer (DFU) is a serious health condition in diabetes mellitus and a primary reason of non-traumatic amputations of lower-limb worldwide. This study aimed to investigate the combined effect of inflammation, oxidative stress, and pathological angiogenic pathways in DFU. Methods: The extensive literature search included the use of PubMed, Web of Science, Google Scholar, and Scopus, from 2019 to 2025. Researches based on human subjects with DFUs were incorporated when they have quantitative data of inflammatory, oxidative stress or angiogenic biomarkers. Studies conducted in animal, or in vitro studies, and those without quantitative data were excluded. Funnel plot symmetry and Newcastle-Ottowa scale (NOS-adapted) was used to determine publication bias and risk of bias respectively. Results: Total seven studies fulfilled the inclusion criteria and meta-analyses were done in terms of a random-effects inverse-variance model. DFU pooled analyses showed significantly higher tumor necrosis factor-alpha (TNF-α) (SMD = 3.52; 95% CI: 2.22-4.83, p = 0.0001) and malondialdehyde (MDA) (SMD = 3.07; 95% CI: 1.67-4.48, p = 0.0001) levels in DFU when compared with controls whereas, the pooled analyses of vascular endothelial growth factor (VEGF) suggested similar pattern between the compared groups (SMD = 0.39; 95% CI: - 3.41 to 4.19, p = 0.84). Substantial heterogeneity was found (I2 > 90%). There was moderate risk of bias among included studies and certainty of evidence was also moderate according to GRADE assessment. Conclusion: High TNF-α and MDA concentrations could be utilized as molecular predictors for risk stratification by DFU and disease severity.
Copyright (c) 2026 Nimra Asghar, Fatima Ali, Muhammad Akram, Ejaz Ehsan Khan, Khaleeq Ullah (Author) https://creativecommons.org/licenses/by-nc/4.0/
Copyright (c) 2025 Authors https://creativecommons.org/licenses/by-nc/4.0/
Cardiac Dose Risk Stratification and Determinants of Radiation Exposure in Breast Cancer Patients Undergoing Advanced Radiotherapy
Background: Cardiac exposure during breast cancer radiotherapy is one of the well-known causes of late cardiovascular morbidity. The present secondary analysis was conducted with the aim of stratifying the risk of exposure to cardiac radiations and defining clinical and treatment specific determinants of increased cardiac dose among patients with breast cancer using three-dimensional conformal radiotherapy (3D-CRT). Methods: The treatment planning data of 126 female breast cancer patients given 3D-CRT in a tertiary cancer center was performed and the Cardiac exposure was classified as being of low-, moderate-, and high-dose groups depending on clinically significant mean heart dose (MHD) exposure thresholds. The chi-square test, independent t-tests, and one-way ANOVA were used to test associations between cardiac dose category, laterality, surgical procedure and patient age with the level of statistical significance (p<0.05). Results: In general, patients who were classified within the moderate-high levels of cardiac exposure were 38.1%. The association between cardiac dose risk and left-sided breast cancer was significant as more than 85% of all the high-risk patients were identified to have left-sided treatment (p < 0.001). The type of surgery influences cardiac exposure since radical mastectomy was found to have a higher dose of risk than breast-conserving surgery (p < 0.001). Conclusion: This secondary review illustrates that there is no homogeneous distribution of cardiac radiation exposure during 3D-CRT but highly dependent on the tumor laterality and method of surgery as opposed to patient age. The cardiac dose in the form of risk-based interpretation may offer more clinically useful evidence as compared to absolute mean dose alone, endorsing personalized radiotherapy planning for managing cardiovascular risk.
Copyright (c) 2025 Vareesha Hassan (Author) https://creativecommons.org/licenses/by-nc/4.0/
Perioperative Modulation of Recovery Kinetics and Analgesic Efficiency in Minimally Invasive Abdominal Surgery
Background: The use of perioperative analgesic interventions in addition to opioid dose reduction has an impact on postoperative recovery in minimally invasive abdominal surgery. Measuring recovery dynamics and analgesic performance gives a systems perspective of postoperative time courses as opposed to drug comparison. Methods: Perioperative data on 300 adult patients were included in this analytical study. The recovery kinetics were evaluated based on time-dependent outcomes as long as extubation latency, early postoperative pain slope and accumulated opioid exposure divided by pain burden. A combination of opioid intake and 24 hours serial pain assessment was used to create an Analgesic Efficiency Score (AES). The patients were stratified to high- and low-efficiency recovery profiles. Determinants of the accelerated recovery were analyzed using multivariate regression and recovery curve modeling. Results: High-efficiency recovery patients had significantly lower opioid-to-pain ratios (0.42 ± 0.11 vs. 0.61 ± 0.15, p < 0.001) and followed faster early recovery kinetics, which involve fewer extubation latency differences (mean difference -1.9-minutes, p<0.001). The relationship between the intensity of pain and pain resolution after surgery in efficient recovery was steeper with a higher decrease in the level of pain during the initial 24 hours after surgery. Multivariate analysis found that the analgesic efficiency was an independent predictor of faster recovery kinetics (adjusted R2 = 0.38) regardless of the demographics or the duration of the surgery. Conclusion: Recovery-oriented analysis proves that analgesic efficiency with opioid reduction is a major determinant of postoperative kinetics of recoveries in the case of minimally invasive abdominal surgery.
Enhanced Recovery After Surgery (ERAS) Protocols
Copyright (c) 2025 Iqra Rehman, Huzaifa K Khaliq (Author) https://creativecommons.org/licenses/by-nc/4.0/
Evaluating the Antibiotic Therapy in Diabetic Patients in diverse Clinical Settings
Background: Diabetic foot infections (DFIs) are considered a complicated combination of microbial pathogenicity, dysfunction of metabolic processes in the hosts, and response to therapy. This study reevaluated the microbial distribution in DFIs based on resistance-based measures to direct optimal empirical therapy. Methods: The study (n=77) included patients with diabetic foot ulcers and getting treatment at a tertiary healthcare. The organisms were categorized as Gram-negative or Gram-positive and antibiotic susceptibility data were re-evaluated to calculate multidrug resistance (MDR) frequency and a resistance burden index (RBI). Chi-square and independent t-tests were used to support descriptive statistics with comparative analysis. The significance cut off of p was < 0.05. Results: Escherichia coli (21.6%) and Klebsiella pneumoniae (10.8%) were the most common Gram-negative (≥60%) and methicillin-resistant Staphylococcus aureus (MRSA) was of the most common Gram-positive pathogen (10.8%). Overall, 38.9% of the isolates passed multidrug resistance criteria. Mean resistance burden index was higher among Gram-negative organisms as opposed to Gram-positive isolates (p < 0.05). The highest sensitivity score (22.9%) was observed for Cefotaxime followed by imipenem and colistin, whereas fluoroquinolones had least effectiveness. Resistant burden was not statistically significantly related to any of the patient comorbidities (hypertension, obesity; p > 0.05). Conclusion: Significant antimicrobial resistance burden within DFIs, which is largely mediated by Gram-negative pathogens was observed. Quantitative resistance profiling serves the purpose of supporting the necessity of locally-constrained empirical regimens and endorsing cefotaxime-based strategies as well as reinforcing the imperative to practice antimicrobial stewardship.
Copyright (c) 2025 Muhammad Khizar, Imran Ali (Author) https://creativecommons.org/licenses/by-nc/4.0/
Laboratory Workflow Determinants Affecting Glucose Integrity: A Secondary Analysis of Pre-Analytical Errors
Background: Laboratory inaccuracies are mainly caused by pre-analytical errors, which have a major influence on the estimation of glucose. Continuous in vitro glycolysis contributes to glucose testing being very sensitive to specimen handling and processing delay particularly in a resource constrained environment. The purpose of this research was to establish the rate and predictors of pre-analytical errors in glucose tests, especially delayed specimen handling. Methods: The study (n=225) included venous blood samples obtained as routine glucose estimation and pre-analytical errors were evaluated including delayed handling, hemolysis, inadequate sample volume, improper centrifugation and labeling errors. Demographic variables were summarized in descriptive form. Chi-square tests were used to assess associations between age, gender and error occurrence, and binary logistic regression was used to determine independent predictors. The p-value below 0.05 was taken as statistically significant. Results: The average age of the participants was 40.72 years and females constituted 135 (60 %) of the group. In 45 (20%) of the samples, pre-analytical errors were found. The most common mistake was delayed specimen processing, which occurred in 9.3 % of the total number of samples and 46.7 % of the cases with an error. Higher error rates were significantly related to increasing age (≥40 years) and male gender. The independent predictors (aOR = 1.9; 95% CI: 1.1-3.3; p = 0.026) and delayed processing (p = 0.001) were confirmed using logistic regression. Conclusion: The major cause of pre-analytical errors in glucose testing was delay in processing of specimens and the age of patients also contributed to the presence of errors.
Copyright (c) 2025 Asma Hafiz, Misbah Hafeez (Author) https://creativecommons.org/licenses/by-nc/4.0/
Impact of Periodontal Therapy on Systemic Inflammation and Renal Function in Chronic Kidney Disease: A Cohort Analysis
Background: Periodontal disease is a preventable inflammatory load; however, there is a lack of evidence that support the therapeutic effects of periodontal disease after periodontal intervention in CKD individuals. The study is focused on assessing the impact of non-surgical periodontal therapy on the functions of the kidneys and inflammatory markers in the human system in patients with CKD. Methods: The secondary cohort study was based on a retrospective study of CKD patients with past periodontal disease case. The therapeutic evaluation involved forty patients which underwent scaling and root planing (SRP). Parameters of renal function (estimated glomerular filtration rate (eGFR), serum creatinine), systemic inflammatory [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and periodontal clinical were evaluated in preintervention and postintervention (3 months) time. Results: After completion of periodontal therapy, there was a significant increase in the renal function, as the mean eGFR improved significantly with a value of 42.3 ± 8.6 to 48.7 ± 7.9 mL/min/1.73 m 2 (p = 0.031) and serum creatinine declined to 2.1 ± 0.5 to 1.8 ± 0.4 mg/dL (p = 0.028). The level of systemic inflammation decreased from 6.1 ± 1.8 to 4.3 ± 1.4 mg/L (p = 0.019) of CRP, IL-6 from 5.4 ± 1.5 to 3.7 ± 1.2 pg/mL (p = 0.014), TNF-α from 6.8 ± 2.2 to 4.5 ± 1.9 pg/mL (p = 0.022). Conclusion: Increased systemic inflammation is significantly decreased by non-surgical periodontal therapy and it improves renal functioning in patients with CKD.
Copyright (c) 2025 Amna Ehsan, Muneeba Ashraf, Muhammad Ikram, Kanwal Ehsan (Author) https://creativecommons.org/licenses/by-nc/4.0/
Ultraweak Photon Emission in the Brain: Mechanisms and Prospects for Non-invasive Neural Monitoring
Ultraweak photon emission (UPE) or biophoton emission is a spontaneous emission of low intensity photons by living cells as a byproduct of metabolic and oxidative activities. According to recent research, the brain being a high metabolism and oxidative environment is a significant source of UPE. Though the amount of these emissions is nowhere near the threshold that the human eye can sense, the emissions can be sensed with a sensitive photomultiplier tube or charge-coupled device, which offers a potential non-invasive look at the functioning of the neuron and systemic oxidative stress. In this view, the mechanistic basis of the brain UPE with a particular focus on its connection with the reactive oxygen species production, mitochondrial activity, and cellular signaling pathways is explored. We will talk about the possible relationship between UPE intensity and changes in neuronal metabolic states, neuroinflammatory conditions, and oxidative burden and present a possible biomarker of neurological activity and disease. Moreover, the article addresses the theoretical consequences of UPE in brain monitoring, such as the opportunities of optical-based neuroimaging, the early diagnosis of neurodegenerative diseases, and real-time evaluation of the treatment mode. The problems of measuring such as signal-noise constraints, standardization of detection procedures and environmental interference are also identified to guide future studies. Given that such synthesis of current evidence and conceptual frameworks, this perspective will be used to offer a foundation to integrate brain UPE into experimental and clinical neuroscience. Further development of the given field could eventually allow new methods of diagnostics and monitoring, as well as allow us to learn more about the physiology and pathophysiology of the brain under the influence of non-invasive optical signals.
Copyright (c) 2025 Samreen Memon, Seemya kaya, Hafiz Muhammad Haseeb Khaliq (Author) https://creativecommons.org/licenses/by-nc/4.0/
Neuroinflammatory and Structural Brain Changes Associated with Nonalcoholic Fatty Liver Disease: A Systematic Review
Background: Over recent years, physicians have increasingly acknowledged NAFLD as a widespread medical condition with effects that extend beyond liver dysfunction. High-quality research now indicates that NAFLD causes meaningful alterations in brain structure and function, which may be responsible for cognitive decline. Objective: A systematic review with meta-analysis examined the connection between NAFLD and adverse brain outcomes through a focused investigation of imaging data and cognitive performance, and systemic inflammatory markers. Methodology: The study followed methods based on PRISMA 2020 guidelines, conducting a comprehensive search of literature through PubMed, Scopus, and Embase databases. This analysis included observational, preclinical, and MR studies based on ten research publications that made it through the eligibility process. A random-effects model was used to perform meta-analysis. Risk of bias was also assessed using appropriate tools. Results: A moderate but significant effect of NAFLD on brain alterations was found with an effect size of -0.56 points (95% CI -0.68 to -0.45; p < 0.0001). The research found that brain volume was reduced, cortical brain areas diminished, and lower scores on tests of cognitive ability. Both MR and animal studies showed the cause and effect for this inflammation as the middle point. Conclusion: Structural brain changes are caused in research results by NAFLD, thus supporting the liver-brain connection. Clearly, the need for integrated management strategies is for both liver health and brain health.
Copyright (c) 2025 Ehsan Khan, Sabeeha Saddique, Syeda Maira Gillani, Sidra Anwar, Uday Shree Akkala (Author) https://creativecommons.org/licenses/by-nc/4.0/