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Genomic Surveillance Elucidates Persistent Wild Poliovirus Transmission During 2013-2015 in Major Reservoir Areas of Pakistan.

BACKGROUND: Despite tremendous efforts in the fight against polio, Pakistan bears the highest proportion of poliomyelitis cases among the 3 endemic countries including Afghanistan and Nigeria. Apart from insecurity and inaccessibility challenges, the substantial shift of unimmunized children from North Waziristan due to recent military operations was presumed to favor the widespread poliovirus infection in Pakistan. METHODS: To better understand the current epidemiological situation, we analyzed the virologic data of wild poliovirus type 1 (WPV1) strains detected in Pakistan during 2013-2015.…

Extraction of saponins and toxicological profile of Teucrium stocksianum boiss extracts collected from District Swat, Pakistan.

BACKGROUND: The current era is facing challenges in the management of neoplasia and weeds control. The currently available anti-cancer and herbicidal drugs are associated with some serious side effects. Therefore numerous researchers are trying to discover and develop plant based alternative particularly for the rational management of cancer and weed control. Teucrium stocksianum possess antioxidant and analgesic activities. The current study was designed to evaluate crude saponins (CS), methanolic extract and sub-fractions of T. stocksianum for cytotoxic and phytotoxic potentials. CS, methano

A multicenter matched case control study of breast cancer risk factors among women in Karachi, Pakistan.

BACKGROUND: Breast cancer (BC), the most common female cancer in Pakistan, is associated with a very high mortality. However, the roles of individual risk factors for BC among Pakistani women are still controversial. To assess potential risk factors for BC, a matched case-control study was conducted in two tertiary care hospitals of Karachi, Pakistan. MATERIALS AND METHODS: The study population included 297 pathologically confirmed incident cases of BC patients diagnosed between January 2009 and December 2010. 586 controls without any history of BC were matched on a hospital basis, within 5 y…

Effectiveness of Vi capsular polysaccharide typhoid vaccine among children: a cluster randomized trial in Karachi, Pakistan.

BACKGROUND: Typhoid fever is endemic in Karachi, with an incidence among children ranging from 170 to 450 per 100,000 child-years. Vaccination strategies are important for prevention, and the Vi capsular polysaccharide (ViCPS) vaccine has been shown to be effective in reducing the burden of typhoid fever. METHODS: A cluster randomized trial was conducted in three low socioeconomic urban squatter settlements in Karachi, Pakistan between 2002 and 2007. Subsamples were followed up for assessment of immune response and adverse events after vaccination. RESULTS: The study participants were simila…

Predictors of oral tobacco use among young adult patients visiting family medicine clinics in Karachi, Pakistan.

Prevalence of cancers associated with the use of oral tobacco (OT) is rising very rapidly and prevention of use is the best option to tackle this scenario. This cross-sectional study estimated the proportion of OT use and predictors associated with its initiation and determined the knowledge, attitude and practices of OT users. A total of 231 young adult patients (15-30 years age) were interviewed by medical students in family practice clinics in Karachi, Pakistan. OT use was considered as usage of any of the following: betel quid (paan) with tobacco, betel nuts with tobacco (gutkha), and snuf…

Virulence factors profile of drug-resistant Escherichia coli isolates from urinary tract infections in Punjab, Pakistan.

Escherichia coli is considered to be the main causative agent of urinary tract infections (UTIs). The primary objective of this study was to investigate the spectrum of five virulence factors among drug-resistant clinical E. coli isolates associated with pyelonephritis and cystitis. A total of 101 samples were positive for E. coli (42 from pyelonephritis cases and 59 from cystitis cases) out of 457 urine samples of patients. Among toxins, haemolysin and secreted autotransporter toxin are found more frequently in isolates causing pyelonephritis (p < 0.020) than cystitis (p < 0.083). The frequen

Temporal trends in hepatitis B and C infection in family blood donors from interior Sindh, Pakistan.

BACKGROUND: Hepatitis B (HBV) and C (HCV) infections are a serious global and national public health problem. Earlier studies have reported increasing rates of hepatitis infection in Pakistan, particularly in rural areas. Pakistan has no active surveillance program to monitor trends of these infections. The objective of this study was to verify this trend in blood donors from the rural Sindh area of the country. METHODS: The study analysed the data of blood donors of interior Sindh who donated blood at JPMC blood bank from January 1, 2004 to September 15, 2007. HBsAg status was determined by …

Associations between adverse childhood experiences and breastfeeding initiation and duration: a longitudinal birth cohort study in Pakistan.

RATIONALE: Prior studies have found that a history of adverse childhood experiences (ACEs) is associated with breastfeeding initiation and d … tiation and exclusive breastfeeding at 3 and 6 months postpartum among a cohort of women from rural Pakistan. METHODS: The prospective cohort analysis included 869 women 18-45 years of age from the Bachpan Cohort Study. Multivariable modified log-Poisson regression models were used to assess the relationship between any ACE exposure with breastfeeding ini …

Medication non-adherence among heart failure patients: a multi-hospital, multi-dimensional analytical study in Punjab, Pakistan.

BACKGROUND: Heart failure (HF) has been a significant health problem among the population, with a significant impact on morbidity, mortality, and health care expenditure across the world. In Pakistan, HF-specific non-adherence data are limited, which restricts clinicians to come up with interventions that can be used to address the at-risk population. Accordingly, the newly-conducted study intended to determine the incidence of medication non-adherence and predictors at various levels (sociodemographic, clinical, treatment-related, and behavioral) among heart failure patients. METHODS: This s…

Baseline Hematological and Biochemical Reference Values for Wild Mus musculus and Rattus rattus From Southern Punjab, Pakistan.

Baseline hematological and oxidative stress data for wild rodents are scarce despite their importance in wildlife health assessment and disease surveillance. This study aimed to generate baseline hematological and markers of oxidative stress reference values for wild Mus musculus and Rattus rattus trapped from southern Punjab, Pakistan, and to evaluate sex-related differences in these physiological parameters. Twenty-seven Mus musculus (14 males, 13 females) and 28 Rattus rattus (18 males, 10 females) were trapped from Dera Ghazi Khan District in Punjab, Pakistan between February 2022 and Janu…

We know what we need: Older adults' and stakeholders' perspectives on ageing, health, and wellbeing in Pakistan.

The rapid increase in the older adult population worldwide, especially in low- and middle-income countries (LMICs) like Pakistan, raises critical challenges for healthcare, social support, and policy planning. Older adults in LMICs, especially in culturally diverse regions like Sindh, Pakistan, often face limited access to healthcare, economic insecurity, and social isolation. These challenges highlight the need to understand ageing in this context and explore potential solutions at multiple levels of the socio-ecological model. This qualitative descriptive study used focus group discussions (…

Real world lessons on tyrosine kinase inhibitor response and resistance in CML from a developing country Pakistan.

OBJECTIVES: This study aimed to evaluate treatment responses, resistance and molecular characteristics of CML patients on TKI therapies to identify factors associated with suboptimal outcomes. METHODOLOGY: A retrospective observational study was conducted between January 2022 to December 2025 on 209 CML patients recruited at Mayo Hospital Lahore. Patients who achieved DMR and MMR were included. Minimum required duration of DMR was three years. RESULTS: A total of 209 patients; 187 (89.4%) were in chronic phase, 12 (5.7%) in accelerated phase, and 10 (4.7%) in blast crisis. The majority were

Unlocking wheat yield potential through evaluation of high-performing hybrid lines in semiarid conditions of northern Pakistan.

Wheat (Triticum aestivum L.) yield in Pakistan has remained stagnant over the past two decades mainly due to the narrow genetic diversity of cultivated varieties. To overcome this limitation and explore new genetic resources for improved productivity, twelve Chinese wheat hybrid lines were evaluated in comparison with two local cultivars at the Agronomy Research Farm, the University of Agriculture Peshawar, Pakistan over two seasons (2021-2022, 2022-2023). Results showed that early emergence occurred in the hybrid lines 20 BH 37 and 20 BH 53 (12.5 days). Wheat lines 20 BH 53 and 20 BH 56 produ…

Biochemical and molecular characterization of Xanthomonas citri pv. mangiferaeindicae causing bacterial black spot of mango in Pakistan.

Bacterial black spot (BBS) disease of mango (Mangifera indica L.) is associated with Xanthomonas citri pv. mangiferaindicae (Xcm) and can cause substantial production and fruit-quality losses in susceptible orchards. This study was investigated to isolate and characterize Xcm associated with symptomatic mango samples from major mango-growing areas of South Punjab, Pakistan, using phenotypic, biochemical, pathogenicity, PCR, sequencing, and phylogenetic approaches. Symptomatic mango samples were collected from surveyed orchards, and Xcm isolates were obtained, purified, and characterized based …

Prevalence of Cancer Cachexia Among Breast Cancer Patients in Pakistan, Assessed Using the Mini-CASCO Scoring System.

OBJECTIVE: This study aimed to estimate the prevalence, severity, and multidomain impact of cancer cachexia among Pakistani breast cancer patients, using the validated Mini-CASCO scoring system. METHODS: We conducted an observational, cross-sectional study from February to December 2024 at Fauji Foundation Hospital (FFH), Rawalpindi. Eligible participants were female patients aged 18 years or older, with stage I-III breast cancer, receiving chemotherapy. Cachexia was assessed using the Mini-CASCO, which encompasses body composition, inflammation, anorexia, physical performance, and quality of…

Cost impact of culture reversion in extensively drug-resistant tuberculosis in Pakistan: a multi-center retrospective study.

Culture reversion among extensively drug-resistant tuberculosis (XDR-TB) patients leads to treatment prolongation and imposes a substantial economic burden on national tuberculosis programs; however, evidence quantifying this burden in high-burden countries such as Pakistan remains limited. This study aimed to quantify the additional treatment costs attributable to culture reversion and reconversion among XDR-TB patients managed under Pakistan's Programmatic Management of Drug-Resistant Tuberculosis (PMDT) program. This retrospective multicenter observational study used routinely collected dat…

Epidemiology of cancer in Khyber Pakhtunkhwa (KP), Pakistan, 2020-2023: a retrospective, province-wide, multicentre observational study.

BACKGROUND: The province of Khyber Pakhtunkhwa (KP), located in the northwestern region, is the third most populous province in Pakistan, with a population estimated at 41 million. OBJECTIVES: To determine the cancer counts and age-standardised incidence rates (ASIRs) per 100 000 population over a 4-year period for KP, 2020-2023, and to compare them with those available for two districts of Pakistan and nearby areas. DESIGN: A retrospective, province-wide, multicentre observational study. SETTING: Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore, as the collaborating ce…

Breaking barriers in health surveillance: privacy-preserving techniques for tracking vaccine hesitancy and disease outbreaks in Pakistan.

BACKGROUND: Precise measurement of sensitive public health outcomes is often limited by underreporting, stigma, and social desirability bias. These challenges can affect estimates of COVID-19 infection and vaccine hesitancy, leading to incomplete evidence for surveillance and public health decision-making. This study examined the use of privacy-preserving stratified randomized response models (SRRMs) to improve the estimation of sensitive health information in a population-based setting. METHODS: We conducted a cross-sectional quantitative survey in Punjab, Pakistan, during June-August 2021. …

Molecular detection of carbapenemase genes in WHO priority pathogens from blood cultures of sepsis patients in Pakistan.

AIMS: This study aimed to assess the antibiogram patterns of CR-GNB and to characterize carbapenemase-encoding genes among isolates obtained from patients with sepsis. METHODS: A total of 3,746 blood culture samples were collected from patients with suspected septicemia and samples were processed using the BACTEC blood culture system, and all positive cultures were sub-cultured onto blood agar and MacConkey agar plates for isolation. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK 2 compact system following CLSI guidelines. Detection of antimic

Факторы риска и результаты новой инфекции моноцитогенов листерии в Пакистане: понимание из больницы третичной медицинской помощи.

Listeria monocitogenes — грэм-положительный стержень, ответственный за листериоз. Она стала одним из основных патогенов, передающихся через пищевые продукты, и была причастна к многочисленным вспышкам во всем мире, часто встречающимся с бактерией, и может привести к серьезным проявлениям, таким, как менингоэнцефалит, особенно у лиц с иммунокомпромиссом и у пожилых людей. Инфекция материнства связана с худшими последствиями беременности. Цель этого исследования заключается в оценке факторов риска, клинических особенностей и результатов лечения пациентов, инфицированных моноцитогенами Листерии,

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BACKGROUND: Listeria monocytogenes is a Gram-positive rod responsible for listeriosis. It has emerged as a significant foodborne pathogen an … es of patients admitted with Listeria monocytogenes infection at a tertiary care Centre in Karachi, Pakistan. METHODS: A retrospective study was conducted over 7 years and included all patients with culture-proven listeriosis. Comorbid conditions, clinical presentation, treatment, and outcomes were recorded and analyzed. RESULTS: A total of 63 patients d …