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Background To evaluate computed tomography (CT) patterns of post-SBRT lung injury in lung cancer and identify time points of serial CT changes. Materials and methods One hundred eighty-three tumors in 170 patients were evaluated on sequential CTs within 29 months (median). Frequencies of post-SBRT CT patterns and time points of initiation and duration were assessed. Duration of increase of primary lesion or surrounding injury without evidence of local recurrence and time to stabilization or local recurrence were evaluated. Results Post-SBRT CT patterns could overlap in the same patient and were nodule-like pattern (69%), consolidation with ground glass opacity (GGO) (41%), modified conventional pattern (39%), peribronchial/patchy consolidation (42%), patchy GGO (24%), diffuse consolidation (16%), “orbit sign” (21%), mass-like pattern (19%), scar-like pattern (15%) and diffuse GGO (3%). Patchy GGO started at 4 months post-SBRT. Peribronchial/patchy consolidation and consolidation with GGO started at 4 and 5 months respectively. Diffuse consolidation, diffuse GGO and orbit sign started at 5, 6 and 8 months respectively. Mass-like, modified conventional and scar-like pattern started at 8, 12 and 12 months respectively. Primary lesion ( n  = 11) or surrounding injury ( n  = 85) increased up to 13 months. Primary lesion ( n  = 119) or surrounding injury ( n  = 115) started to decrease at 4 and 9 months respectively. Time to stabilization was 20 months. The most common CT pattern at stabilization was modified conventional pattern (49%), scar-like pattern (23%) and mass-like pattern (12%). Local recurrence ( n  = 15) occurred at a median time of 18 months. Conclusion Different CT patterns of lung injury post-SBRT appear in predictable time points and have variable but predictable duration. Familiarity with these patterns and timeframes of appearance helps differentiate them from local recurrence.

We sought to quantify contribution of radiomics and SUVmax at PET/CT to predict clinical outcome in lung cancer patients treated with stereotactic body radiotherapy (SBRT). 150 patients with 172 lung cancers, who underwent SBRT were retrospectively included. Radiomics were applied on PET/CT. Principal components (PC) for 42 CT and PET-derived features were examined to determine which ones accounted for most of variability. Survival analysis quantified ability of radiomics and SUVmax to predict outcome. PCs including homogeneity, size, maximum intensity, mean and median gray level, standard deviation, entropy, kurtosis, skewness, morphology and asymmetry were included in prediction models for regional control (RC) [PC4-HR:0.38, p = 0.02], distant control (DC) [PC4-HR:0.51, p = 0.02 and PC1-HR:1.12, p = 0.01], recurrence free probability (RFP) [PC1-HR:1.08, p = 0.04], disease specific survival (DSS) [PC2-HR:1.34, p = 0.03 and PC3-HR:0.64, p = 0.02] and overall survival (OS) [PC4-HR:0.45, p = 0.004 and PC3-HR:0.74, p = 0.02]. In combined analysis with SUVmax, PC1 lost predictive ability over SUVmax for RFP [HR:1.1, p = 0.04] and DC [HR:1.13, p = 0.002], while PC4 remained predictive of DC independent of SUVmax [HR:0.5, p = 0.02]. Radiomics remained the only predictors of OS, DSS and RC. Neither SUVmax nor radiomics predicted recurrence free survival. Radiomics on PET/CT provided complementary information for prediction of control and survival in SBRT-treated lung cancer patients.

An overview of the family Leucospidae (Hymenoptera, Chalcidoidea) is provided for the leucospid fauna of the Arabian Peninsula. Two genera containing four species are identified based on morphometrics and colour patterns. One species, Leucospis ayezae Usman, Anwar & Ahmad, sp. nov. , is described. Leucospis elegans Klug had been previously recorded from Arabia Felix (= Yemen) and is recorded here for the first time from Saudi Arabia. The status of Leucospis aff. namibica from Yemen has been clarified, and this species is placed here in the genus Micrapion Kriechbaumer as M. clavaforme Steffan. An updated key and a map showing the distribution of the family Leucospidae in the Arabian Peninsula is provided. The occurrence and color morphs of all leucospid species that have been recorded so far from the region are briefly discussed.

The families Metapelmatidae and Neanastatidae (Hymenoptera, Chalcidoidea) are recorded for the first time from Saudi Arabia based on the presence of Metapelma mirabile Brues, 1906 and Neanastatus africanus Ferrière, 1938, respectively.

The purpose of the current study was to explore the supplementing effects of Moringa oleifera leaf powder (MOLP) on plasma and milk biochemical indices and productive/reproductive performance of goats. A total of 30 healthy pregnant goats were randomly distributed ( n = 10) into three experimental groups: control (M 0 ) group (basal diet without MOLP), M 2% group (basal diet + 2% MOLP), and M 3.5% group (basal diet + 3.5% MOLP). The experiment started 2 months before parturition and continued till the first month of lactation. The plasma flavonoids were significantly increased in the M 3.5% group during the entire experiment, whereas the total phenolic contents were enhanced only during the lactation period depending on the supplementation percentage. The amount of vitamin C increased significantly in M 2% and M 3.5% groups as compared to the M 0 group. Supplementation of MOLP improved the plasma total antioxidant capacity by declining malondialdehyde concentration and total oxidant status values. The activities of superoxide dismutase and peroxidase enzymes were modified in M 2% and M 3.5% supplemented groups throughout the experiment, while the catalase activity was significantly influenced only during the lactation stage. The protein and lycopene contents in plasma were significantly improved in the M 3.5% group, whereas the total sugars and carotenoid level was increased in both M 2% and M 3.5% groups. Dietary supplementation with 3.5% MOLP more effectively enhanced protease and amylase activities as compared to 2% supplementation. MOLP also improved the biochemical indices and antioxidant status of colostrum and milk. The milk yield, weight gain of the kids, and reproductive performance were high in M 2% and M 3.5% groups in comparison to the M 0 group. These findings disclose that supplementing the diet with 3.5% MOLP improves antioxidant status, milk yield, and reproductive performance in goats.

Fruit peels are largely wasted without knowing their nutritional contents. So, there is a dire need to harness functional components for their biological significance. In this study, fruit peel samples were dried in hot air oven and subjected to nutritional profile using different analytical techniques. This study aimed to investigate the antioxidant, proximate composition, amino acids and mineral profiles from 12 peel samples of fruit varieties which were labelled from V1 to V12. Results revealed that crude protein and crude fat had significantly higher (p < 0.05) levels in V12 fruit peels, whereas crude fibre and ash were reported significantly greater(p < 0.05) in V12 and V4 compared with others. The amino acid results showed that cysteine and methionine had greater levels in V6 samples (p < 0.05), whereas aspartic acid + asparagine was greater (p < .05) in V12 samples compared to other samples. The ascorbic acid TPC, TF, TAC and lycopene had higher contents in V2, V11, V3, V5, V4 and V9 than other peel samples (p < 0.05). Additionally, peel samples of V4, V11, V4 and V3 had higher levels of nitrogen, phosphorus, potassium, magnesium and manganese (p < 0.05). These results conclude that fruit peels could have ramifications as a sustainable, enriched source of functional foods.

Antimicrobial resistance (AMR) presents a major global health threat, driven in part by the inappropriate use of antibiotics including in low- and middle-income countries (LMICs). Improving the quality of antibiotic use is a key rationale for the development of the WHO's AWaRe (Access, Watch and Reserve) system. There is a need to review the uptake of the AWaRe system since its launch to guide future practice. A literature search was conducted between 2017, the launch of AWaRe, and 2024. Inclusion criteria were studies that reported on antibiotic use in LMICs using the AWaRe system. Eighty-five studies were included in the review, of which 56.4% focused on antibiotic use trends, with 28.2% reporting on prescribing patterns; 51.7% of the studies included inpatients. Only 14.1% of studies reported meeting the 2024 United Nations General Assembly (UNGA) AMR recommended target of at least 70% of human antibiotic use being Access antibiotics, with a concerning trend of overuse of Watch antibiotics (68.2% of studies). Dispensing practices revealed significant dispensing of antibiotics without prescriptions especially in Pakistan and Bangladesh. Watch antibiotics were more available but also more expensive than Access antibiotics. Encouragingly, many LMICs are now reporting antibiotic use via the AWaRe system, including in antimicrobial stewardship programmes (ASPs). Wide variation exists in the proportion of AWaRe antibiotics used across LMICs, with overuse of Watch antibiotics. There is an urgent need for targeted AWaRe-based ASPs in LMICs to meet recent UNGA recommendations. Improving the use, availability and affordability of Access antibiotics is essential to combat AMR.

Antimicrobial prophylaxis is effective in reducing the rate of surgical site infections (SSIs) post-operatively. However, there are concerns with the extent of prophylaxis post-operatively, especially in low- and middle-income countries (LMICs). This increases antimicrobial resistance (AMR), which is a key issue in Pakistan. Consequently, we conducted an observational cross-sectional study on 583 patients undergoing surgery at a leading teaching hospital in Pakistan with respect to the choice, time and duration of antimicrobials to prevent SSIs. The identified variables included post-operative prophylactic antimicrobials given to all patients for all surgical procedures. In addition, cephalosporins were frequently used for all surgical procedures, and among these, the use of third-generation cephalosporins was common. The duration of post-operative prophylaxis was 3–4 days, appreciably longer than the suggestions of the guidelines, with most patients prescribed antimicrobials until discharge. The inappropriate choice of antimicrobials combined with prolonged post-operative antibiotic administration need to be addressed. This includes appropriate interventions, such as antimicrobial stewardship programs, which have been successful in other LMICs to improve antibiotic utilization associated with SSIs and to reduce AMR.

PurposeAlcohol and tobacco consumption are significant public health concerns and considered some of the riskiest behaviors among students. Despite strong indications of heavy consumption of these substances, certain sections of the student population remain unexplored regarding their consumption patterns and associated factors, including research scholars pursuing Doctor of Philosophy degrees. This study aims to explore the patterns and correlations of consumption of alcohol and tobacco among doctoral students in three Indian universities.Design/methodology/approachA cross-sectional study was conducted on a total of 530 scholars from three central universities, Aligarh Muslim University, Banaras Hindu University and Jawahar Lal Nehru University, and focused on two substances (alcohol and tobacco) frequently used by students in India. Bi-variate analysis and penalized logistic regressions were applied to analyse the prevalence and associated factors of alcohol, smoking and smokeless tobacco among doctoral students.FindingsTobacco consumption was observed to be the dominant form of substance use among doctoral students. Findings revealed that 34% of scholars smoked and 25% consumed smokeless tobacco daily and around 14% consumed alcohol at least once a week. Major significant correlates of substance consumption among scholars were found to be gender, religion, parental mortality, dissatisfaction with academic performance and stress about future career/employment. Significant variation in substance use patterns was observed among universities.Originality/valueThis study provides first-hand evidence on substance use patterns and the correlates among doctoral students in three Indian universities. Findings indicate the implementation of specific intervention programs for mental health and counselling for this section of students to prevent substance use addiction would be beneficial.

ABSTRACT Objective: To compare platelet rich plasma against local steroid injection in patients with chronic plantar fasciitis in terms of mean pain and functional scores. Study Design: Quasi-experimental study. Place and Duration of study: Armed Forces Institute of Rehabilitation Medicine(AFIRM) Rawalpindi, from May 2016 to Apr 2018. Methodology: A total of 120 patients having chronic plantar fasciitis were included in the study and were split into 2 groups. The group “A”(n=60) patients were injected with a single dose of autologous platelet rich plasma. The group “B”(n=60) patients received a single dose of methylprednisolone added with a local anesthetic agent. Functional and symptomatic evaluation was done using the American foot and ankle score and the visual analog scale respectively at baseline and at 6 months follow-up. Results: Mean visual analogue score was 7.83 ± 0.99 at baseline and 3.43 ± 1.30 at 6 months follow-up in group “A” and 7.90 ± 1.06 and 4.97 ± 1.16, respectively, in group “B”(p<0.001). Mean American Foot and Ankle Score was 39.37 ± 5.93 at baseline and 88.73 ± 5.02 at 6 months follow-up in group “A” and 39.03 ± 5.97 and 80.30 ± 8.03, respectively, in group “B”(p<0.001). Changes in the scores of both the evaluation tools were significantly higher in the group “A”(p<0.001). Conclusion: Platelet rich plasma turns out to be more efficacious compared to steroid injection in terms of pain relief and functional outcome in the management of chronic plantar fasciitis in long term.