Development of a novel patient-reported outcome measure (PROM) for evaluation of foot and ankle disorders in the Indian population - the Indian Foot and Ankle Society (IFAS) Score.

UNLABELLED: The present study was conducted to evaluate the effects of Cd contamination in soil on metabolite composition, antioxidant defense system, and antibacterial potential of Mentha arvensis L. leaves. Plants were grown in pots exposed to Cd contamination through soil drenching at the rate of 100 ml pot-1 of solution containing 20 mg Cd L-1 as CdCl2·H2O till the maturity at an interval of seven days. Leaf extracts were prepared using 80% (v/v) methanol and were analysed for metabolite profiling, stomatal and secretory gland, biochemical analyses, and antibacterial activity using high-resolution mass spectrometry, scanning electron microscopy, spectrophotometric assays and disc diffusion method, respectively. The findings revealed a substantial increase in Cd accumulation within the roots and shoots of M. arvensis, by 86% and 93%, respectively, as a result of higher Cd levels in soil. Ultra-high performance liquid chromatography-high-resolution mass spectrometry analysis of the methanol leaf extract indicated a marked reduction in amino acids and their derivatives, alongside elevated levels of phenolic compounds, fatty acids, and lipids. A total of 953 and 792 phytochemicals were found to be upregulated and downregulated, respectively under elevated Cd exposure. Additionally, Cd stress significantly enhanced the levels of malondialdehyde, catalase, glutathione reductase, superoxide dismutase, ascorbate peroxidase, proline, and ascorbic acid in the leaf tissues by 33%, 43%, 100%, 21%, 64%, 80%, and 66%, respectively, as compared to the control plants. Among the tested bacterial strains, methanol leaf extract showed the greatest reduction in inhibition zone against Staphylococcus aureus. Overall, the findings demonstrate that Cd stress induces strong oxidative and metabolic reprogramming in M. arvensis, leading to enhanced antioxidant responses and selective modulation of secondary metabolites. However, excessive Cd accumulation in plant tissues compromises the safety of the raw material for direct medicinal use. These results highlight the need for developing safe extraction technologies and phytoremediation-based strategies to harness stress-induced metabolites of M. arvensis without posing health risks.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12298-026-01724-4.