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A Sorghum flour (SF) is a leading and prominent food source for humans in African countries. Recently extensive studies have been conducted on Sorghum bread (SB) or sorghum composite bread (SCB), covering various aspects. However, there are many technical challenges in the formation of SF and sorghum composite flour (SCF) that impact the quality of the bread and fail to meet the consumer’s desires and expectations. This review primarily focuses on the characteristics of SF, SCF, SB, and SCB, with discussions encompassing the rheological and morphological properties of the dough, improvement strategies, and bread quality. Moreover, a comprehensive analysis has been conducted to investigate the behavior of SF and SCF along with a discussion of the challenges affecting bread quality and the strategies applied for improvement. The significant demand for nutrients-rich and gluten-free bread indicates that sorghum will become one of the most vital crops worldwide. However, further comprehensive research is highly demanded and necessary for an in-depth understanding of the key features of SF and the resulting bread quality. Such understanding is vital to optimize the utilization of sorghum grain in large-scale bread production.

Lactic acid bacteria have been considered to be a very important species during sourdough fermentation. In order to explore the effects of bifidobacteria fermentation on thermal, physico-chemical and structural properties of wheat starch during dough fermentation, starch granules were separated from the fermented dough at different fermentation times, including 0 h, 2 h, 6 h, 9 h and 12 h. The results showed that the morphology of starch granules was destroyed gradually as the fermentation time increased, which appeared as erosion and rupture. With the increase in fermentation time, the solubility showed a significant increase, which changed from 8.51% (0 h) to 9.80% (12 h), and the swelling power was also increased from 9.31% (0 h) to 10.54% (12 h). As for the gelatinization property, the enthalpy was increased from 6.77 J/g (0 h) to 7.56 J/g (12 h), indicating a more stable thermal property of fermented starch, especially for the longer fermentation. The setback value was decreased with short fermentation time, indicating that the starch with a longer fermentation time was difficult to retrograde. The hardness of the gel texture was decreased significantly from 50.11 g to 38.66 g after fermentation for 12 h. The results show that bifidobacteria fermentation is an effective biological modification method of wheat starch for further applications.

Sorghum flour was milled and fractionated into three particle-size classes, 215–181 µm, 181–96 µm, and <96 µm, then blended with wheat flour at a 30:70 (sorghum:wheat) ratio. The composite flours were evaluated to determine the effects of sorghum particle size on dough-sheet properties and the quality of the resulting noodles. Reducing particle size increased pasting and farinograph parameters, and dough rheological properties improved. The findings indicate that replacing wheat flour with sorghum flour fractions increased gelatinization temperature and gelatinization enthalpy. In addition, the moisture distribution of the dough showed that with the addition of sorghum flour fractions, the closely bound water content of the dough increased. A reduction in particle size led to a significant increase (p < 0.05) in glutenin macropolymer (GMP) content and induced changes in the protein secondary structure of the dough sheets. Noodle quality improved as sorghum particle size decreased, as confirmed by scanning electron microscopy (SEM). Finer particle sizes were associated with lower cooking loss and higher water absorption. Furthermore, the ultra-fine sorghum–wheat composite noodle (WC) attained the highest sensory acceptance after the wheat control (W). Overall, reducing the particle size of sorghum flour markedly improved the functional quality of sorghum–wheat composites. Finer fractions enhanced dough microstructure and gluten network stability, increased thermal stability and pasting robustness, and the resulting noodles exhibited improved cooking performance and sensory scores while retaining favorable texture.

Inadequate access to medicines affected by un-controlled prices is a major concern in developing countries, including Pakistan, which lacks comprehensive data on medicine prices. Thus, the objective of this study was to evaluate the prices, availability and affordability of essential medicines in Lahore division, Pakistan. The survey was undertaken from November, 2016 till March, 2017 by including 50 medicines, 14 from the WHO/HAI core list and 36 supplementary medicines from national essential medicine list (NEML) at public (n = 16) and private (n = 16) health facilities. The prices, availability and affordability of selected medicines were measured using a variant of the WHO/HAI standard methodology available on HAI website and WHO/HAI manual. A questionnaire was used for data collection from Lahore division. The prices were compared to International reference prices (IRPs) and the daily wage of a lowest paid unskilled government worker was used to calculate medicine affordability. Data suggested poor availability of originator brands (OB) in public and private sector facilities, i.e., 6.8% and 55.0%, respectively. Similarly, low availability was observed for lowest price generics (LPGs), both in public (35.3%) and private sector (20.3%) facilities-far below the WHO global action plan targets of 80% availability of essential medicines by 2025. In private sector, 53% OB and 38% LPG medicines were found excessively priced. The cost of standard treatment with OBs was unaffordable, i.e., above a single daily wage (1.4 day's wages) was demanded to purchase the standard treatment for the selected diseases in case of OBs medicines. Whereas, the cost of LPGs medicine required to purchase the standard treatment of the selected diseases was 0.6 day's wage (median), below a single daily wage. In conclusion, access to essential medicines, especially at public sector facilities was affected by low availability, particularly of OBs in comparison to LPGs. Thus, the better availability of LPGs might be a rational basis of transition into a generic system of prescribing that may improve the availability and accessibility of essential medicines in Lahore division. Medicine prices in Lahore division were found higher in comparison to IRPs. Thus, the efforts must be made to formulate patient's pocket friendly drug pricing policy that favors price cuts and improves affordability.

The increasing demand for novel and healthy food options is largely driven by the rise in lifestyle diseases and the global challenges of climate change. Annually, wheat by-products (WBP) production surpasses 150 million tons, with an anticipated growth of 10 million tons per year from 2021 to 2027. This surge has attracted researchers’ interest in leveraging WBP as sustainable food resources that promote human health. This review evaluates the effects of thermal and emerging nonthermal processing technologies on WBP, focusing on enzyme activity, antinutritional factors, bioactive compounds, antioxidant activity, and functional properties. Notably, thermal degradation poses significant challenges due to the heat sensitivity of WBP’s nutritional components. Therefore, nonthermal techniques like high-intensity ultrasound, radiofrequency, and cold plasma are being explored for their potential to enhance nutritional quality and extend shelf life. Further investigation is crucial to comprehensively understand the effects of these innovative treatments on WBP. Such research could facilitate the incorporation of treated WBP into the food industry, leading to new health-promoting products.

Voriconazole (VRC) is a broad-spectrum antifungal agent belonging to BCS class II (biopharmaceutical classification system). Despite many efforts to enhance its solubility, this primary issue still remains challenging for formulation scientists. Transethosomes (TELs) are one of the potential innovative nano-carriers for improving the solubility and permeation of poorly soluble and permeable drugs. We herein report voriconazole-loaded transethosomes (VRCT) fabricated by the cold method and followed by their incorporation into carbopol 940 as a gel. The prepared VRCT were evaluated for % yield, % entrapment efficiency (EE), surface morphology, possible chemical interaction, particle size, zeta potential, and polydispersity index (PDI). The optimized formulation had a particle size of 228.2 nm, a zeta potential of −26.5 mV, and a PDI of 0.45 with enhanced % EE. Rheology, spreadability, extrudability, in vitro release, skin permeation, molecular docking, antifungal, and antileishmanial activity were also assessed for VRCT and VRC loaded transethosomal gel (VTEG). Ex-vivo permeation using rat skin depicted a transdermal flux of 22.8 µg/cm2/h with enhanced efficiency up to 4-fold. A two-fold reduction in inhibitory as well as fungicidal concentration was observed against various fungal strains by VRCT and VTEG besides similar results against L-donovani. The development of transethosomal formulation can serve as an efficient drug delivery system through a topical route with enhanced efficacy and better patient compliance.

Background Hepatitis C virus (HCV) antibody self-testing (HCVST) may help expand screening access and support HCV elimination efforts. Despite potential benefits, HCVST is not currently implemented in Pakistan. This study aimed to assess the usability and acceptability of HCVST in a high HCV prevalence informal settlement in Karachi, Pakistan. Methods We performed a cross-sectional study in a hepatitis C clinic from April through June 2023. Participants were invited to perform a saliva-based HCVST (OraSure Technologies, USA) while following pictorial instructions. A study member evaluated test performance using a standardized checklist and provided verbal support if a step could not be completed. Perceived usability and acceptability were assessed using a semi-structured questionnaire. The HCVST was considered successful if the participant was able to complete all steps and correctly interpret test results. Overall concordance and positive and negative agreement were estimated in comparison with the HCVST result read by the study member (inter-reader concordance and agreement) and result of a second rapid HCV test (Abbott Diagnostics Korea Inc, South Korea) performed by a trained user (inter-operator concordance and agreement). Results The study included 295 participants of which 97 (32%) were illiterate. In total, 280 (95%, 95% CI 92–97%) HCVSTs were successful. Overall, 38 (13%) people performed the HCVST without verbal assistance, 67 (23%) needed verbal assistance in one step, 190 (64%) in two or more. Assistance was most often needed in managing the test buffer and test reading times. The inter-reader concordance was 96% and inter-operator concordance 93%. Inter-reader and inter-operator positive percent agreement were 84 and 70%, respectively. All participants reported they would use HCVST again and would recommend it to friends and family. Conclusion Saliva-based HCVST was very well accepted in this clinic-based setting. However, many people requested verbal support in several steps, highlighting the need for clear instructions for use and test devices that are simple to use, particularly in low literacy settings. Moderately low positive percent agreement with the results of a rapid test performed by a trained user highlights potential uncertainty in the accuracy of HCVST in the hands of lay users.

[This corrects the article DOI: 10.1371/journal.pmed.1003818.].

The issue of quality of medicine is a worldwide phenomenon and counterfeit, substandard, spurious, and adulterated (CSSA) drugs are a substantial threat to public health. This issue is rampant in the context of low-middle-income countries such as Pakistan. The current study involved a phenomenology-based qualitative approach to explore these drugs' perception, knowledge, practice, and issues in combating this menace. A semi-structured interview guide was developed. Eleven drug law experts were interviewed through a purposive sampling technique. All interviews were audio recorded, transcribed verbatim, and analysed using a framework analysis approach, yielding seven distinct themes. The results showed that CSSA drugs are a serious public health threat and drug law experts confirmed its prevalence in the market. They indicated shortcomings in legislation up to the extent of undue amendments, failure to interpret and implement the law by regulators, ineffective law enforcement machinery, the sub-optimum performance of quality control boards, drug testing laboratories, and courts, and the dubious role of rogue middlemen and wholesalers in drug supply chain and corruption were salient issues highlighted. The study revealed that proper drug surveillance, ensuring the presence of a pharmacist, enforcing the law, securing the supply chain, infrastructure for a drug control regime, and training regulators can help tackle this problem.

Post-operative surgical site infections (SSI) present a serious threat and may lead to complications. Currently available dressings for SSI lack mucoadhesion, safety, efficacy and most importantly patient compliance. We aimed to address these concerns by developing a bioactive thiolated chitosan-alginate bandage embedded with zinc oxide nanoparticles (ZnO-NPs) for localized topical treatment of SSI. The FTIR, XRD, DSC and TGA of bandage confirmed the compatibility of ingredients and modifications made. The porosity, swelling index and lysozyme degradation showed good properties for wound healing and biodegradation. Moreover, in-vitro antibacterial activity showed higher bactericidal effect as compared to ZnO-NPs free bandage. In-vivo wound healing in murine model showed significant improved tissue generation and speedy wound healing as compared to positive and negative controls. Over all, thiolated bandage showed potential as an advanced therapeutic agent for treating surgical site infections, meeting the required features of an ideal surgical dressing.