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This study aimed to evaluate nurses’ knowledge, attitudes, and practices (KAP) regarding pressure ulcer prevention in a tertiary care hospital. A cross-sectional design was employed to assess nurses’ KAP regarding pressure ulcer (PU) prevention. The study was conducted at the Government Hospital of Faisalabad, Pakistan. A purposive sampling method selected 200 registered nurses currently employed at the hospital. The average age was 30.20 ± 5.61 years, with 75% ( n  = 150) married and 92% ( n  = 182) holding a diploma in nursing. Knowledge regarding pressure ulcers was high, with 49.5% ( n  = 98) strongly agreeing and 31.8% ( n  = 61) agreeing that pressure ulcers cause severe illnesses, yielding a Likert score of 4.15. Awareness of the Braden Scale was also high, with 50% ( n  = 99) strongly agreeing and 31.3% ( n  = 62) agreeing, resulting in a score of 4.18. The practice of turning patients every two hours was well-received, with 47.5% ( n  = 94) strongly agreeing, leading to a score of 4.10. Age ( p  = .134), marital status ( p  = .571), and level of education ( p  = .072) were not significant predictors of knowledge scores. However, higher knowledge scores significantly predicted more positive attitudes ( p  < .001) and better practices ( p  < .001) in pressure ulcer prevention. The study highlights significant gaps in nurses’ knowledge, attitudes, and practices regarding PU prevention. The findings underscore the need for continuous education and training to enhance nurses’ competence in PU prevention. Addressing these gaps through targeted interventions can improve patient outcomes and reduce the prevalence of PUs in healthcare settings.

Groundwater depletion has become a major concern all over the world. Recently, the rapid population growth and need for water and food have placed a massive strain on land and water resources. In this study, groundwater depletion resulting from land-use and climate change was investigated in the Faisalabad district, Pakistan, from 2000 to 2015. A Pearson correlation analysis between climatic parameters and land-use indices with groundwater was conducted to explore the major influencing factors. Interpolation maps of groundwater were generated using the inverse distance weighting interpolation (IDW) method. The Normalized Difference Built-up Index (NDBI) of five-year intervals demonstrated a strong increasing trend, whereas the Normalized Difference Vegetation Index (NDVI) presented a declining trend. The results also indicated a significant declining trend in groundwater levels in the region, with the annual average groundwater level decreasing at a rate of approximately 0.11 m/year. Climatic parameters (i.e., precipitation and temperature) further reveal an insignificant increasing trend estimated using the Mann–Kendall test and Sens’s slope. Overall, spatial analysis results showed a statistically significant positive trend in the groundwater level of the Faisalabad district, where the NDBI ratio is high and the NDVI is low, owing to the extensive extraction of groundwater for domestic and industrial use. These findings may be useful for a better understanding of groundwater depletion in densely populated areas and could also aid in devising safety procedures for sustainable groundwater management.

Backgrounds: Tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis that primarily affects the lungs but can also affect other organs of the body. In 2022, World Health Organization (WHO) reported that 202 countries account for more than 99% of TB cases around the world. Pakistan ranks 5th among the countries with the highest burden of tuberculosis. The current study was planned to evaluate the biochemical profile of TB patients coinfected with other infectious and metabolic disorders. Methods: A total of 366 Ziehl Neelsen (ZN) stain positive TB patients were included in the study, along with positive controls who had comorbidities such as diabetes (62), hepatitis C virus (HCV) (46), human immunodeficiency virus (HIV) infection (11), and myocardial infarction (MI) (9). Biochemical parameters were determined photometrically by kit methods. Results: Among the 366 cases, 52% were females and 48% were males, with a mean age of 44 ± 5.803 years. Out of the ZN positive TB patients, 258 were found TB positive through PCR. Among the PCR positive TB patients, these patients were coinfected with diabetes (24%), HCV (17.8%), HIV (4.2%), and myocardial infarction (3.4%). Significant (P < 0.0001) variation in biochemical indices were observed in TB patients alone and those coinfected with diabetes, hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Patients with co-morbidities of TB + Diabetes + HCV showed an increase in the levels of blood glucose, serum urea, creatinine, bilirubin, ALT, AST, ALP, IgG, IgM, potassium, and phosphorous. The group with co-morbidities of tuberculosis, hepatitis C, and HIV showed increases in the levels of ALP, IgG, and IgM. Conclusion: The study concluded that variations in biochemical indices observed in studied population provide useful information for the diagnosis of comorbidities of TB patients with metabolic and infectious diseases.

Contamination of edible oils with aflatoxins (AFs) is a universal issue due to the detrimental effects of aflatoxins on human health and the fact that edible oils are a major source of fungal growth, particularly storage fungi (Aspergillus sp.). The objective of this study was to assess aflatoxin B1 (AFB1) in edible oil used in fried food in order to determine the risk of cancer from AFB1 exposure through cooked food using the FAO/WHO’s and EFSA’s margin of exposure (MOE) quantitative liver cancer risk approaches. Using Mycosep 226 columns and HPLC-FLD, 100 samples of cooking oils (soybean, canola, and sunflower oil) from different food points were analyzed for contamination with aflatoxins. Of all the samples tested, 89% were positive for total aflatoxins and AFB1, with 65% indicating AF concentrations beyond permitted levels. Canola oil was found to contain higher levels of AFB1 and AFs than soybean and sunflower oil. Almost 71 percent of canola oil samples (range of 54.4–281.1 µg/kg) were contaminated with AF levels higher than the proposed limits of the European Union (20 µg/kg). The consumption of canola oil samples used in fried foods had MOE values that were significantly lower as compared to sunflower and soybean oils, indicating that risk reduction is feasible. Additionally, compared to soybean and sunflower oil, canola oil exhibited a greater threat of liver cancer cases linked to AFB1 exposure (17.13 per 100,000 males over 35 and 10.93 per 100,000 females over 35). Using a quantitative liver cancer approach, health risk valuation demonstrated that males and females over the age of 35 are at significant risk of developing liver cancer. The health risk assessment exposed that the males and female over the age of 35 are at considerable risk of liver cancer by using a quantitative liver cancer approach. The innovation of this study lies in the fact that no such study is reported related to liver cancer risk evaluation accompanied with AFB1 exposure from consumed edible oil. As a result, a national strategy must be developed to solve this problem so that edible oil products are subjected to severe regulatory examination.

BACKGROUND/AIMSMalarial infection, caused by Plasmodium parasites transmitted by female Anopheles mosquito, is still a serious public health concern, especially in endemic areas such as Sub-Saharan Africa and Pakistan. The study aims to investigate the frequency of malarial infection in district Faisalabad.MATERIALS AND METHODSA cross-sectional study was conducted across the district Faisalabad to study the frequency of malarial infection. Blood samples were collected from 1460 suspected malaria cases between May 2023 and April 2024 at various government sector hospitals across the six administrative units (tehsil) of district, Faisalabad. For the purpose of the diagnosis of malarial patients, rapid diagnostic tests (RDTs), microscopy, and polymerase chain reaction (PCR) methods were employed.RESULTSRDTs detected 649 (44.4%) positive cases, while microscopy and PCR detected 452 (30.6%) and 459 (31.4%) cases, respectively. Among Plasmodium species, P. vivax was the most frequently detected, followed by P. falciparum and mixed infections. Significant differences were observed in diagnostic outcomes across the three methods. Notably, 55 RDT-positive cases were found to be negative by both microscopy and PCR, indicating potential false positives due to antigen persistence. The highest positivity rate was observed in the 1-15 years age group among males as well as in the months of June and July. These findings highlight the need for confirmatory diagnostics alongside RDTs to improve accuracy and support malaria surveillance and control efforts in endemic regions. Positivity rates varied across municipalities, with Faisalabad city showing the highest burden.CONCLUSIONThis study demonstrates that while RDTs offer rapid malaria detection, they are prone to false positives due to persistent parasite antigens, especially in mixed infections. PCR and microscopy provided more accurate results and revealed significant differences in diagnostic outcomes. Moreover, the study highlights a significant frequency of malaria in district Faisalabad, with P. vivax being the dominant species. The data indicate higher susceptibility among males and children aged 1-15 years, particularly during the peak months of June and July. These findings highlight the need for confirmatory diagnostics to accompany further investigations. RDTs to improve accuracy and support malaria surveillance and control efforts in endemic regions.

The current study was designed to analyze the presence or absence of common adulterants in milk and milk products from six different regions of Faisalabad, Pakistan. Purposely, 54 samples from six different regions of Faisalabad were collected. Results revealed that milk of Faisalabad’s regions was adulterated with water, starch, urea, glucose, cane sugar, soap, synthetic milk and neutralizers. The results for starch, formalin, vegetable fat, artificial color, nitrates, sodium chloride, coal tar dyes, hydrogen peroxide, annatto, detergent, sulphate adulteration was found to be non-significant. The results for soap, synthetic milk, urea, sugar cane, neutralizers and glucose were significant. It was noted that R2 milk samples had more bacterial load (3.92x108 CFU/mL) followed by R1 (3.38x108 CFU/mL). Among milk products, cream samples collected from R6 had the maximum bacterial count (1.74x108 CFU/mL). The milk samples were also analyzed for the presence of added urea by Fourier Transform Infrared Spectroscopy (FTIR).

8∑PAHs in 2- and 4-month-old desi chicken organs collected from Faisalabad district, Punjab, Pakistan, were examined via high-performance liquid chromatography (HPLC). Exposure doses (A V DD) of PAHs with consequential lifetime excess cancer risks (L t ECR) were also estimated in people ingesting laboratory barbecued (L b ) and commercially barbecued (C b ) desi meat organs. The results exposed the presence of 8ΣPAH in 2- and 4-month-old L b and C b chicken organs: drumsticks (D s ), breast (B S ), and wings (W s ) (0.45, 3.10, 0.97 ng g −1 ; 2.52, 4.31, 1.22 ng g −1 ; and 10.09, 15.04, and 9.06 ng g −1 respectively). BαP was found only in C b organs with the highest concentrations (5.08 ng g −1 ) in B s . It was above the EU’s tolerable limit, while it was not detected in all L b organs. The lowest level of 8ΣPAH was found in 2-month-old desi W s . A comparative percentage increase in 8ΣPAH levels between all L b and C b organs was found in the range of 1500–2416.67%. L t ECR for males and adults were ranging from 1.35 × E −13 to 4.49 × E −5 at different consumption rates with A V DD ranging from 1.08 E −6 to 6.01 E −5 . In contrast to 2- and 4- month-old chicken meat, 2-month-old desi meat is better having less PAH load. Comparing different organs, W s of former one displayed abridged PAH levels. In conclusion, L b desi meat is less carcinogenic relative to C b . More PAH levels are due to secondary smoke in C b samples collected from the metropolitan. Ingestion of L b 2-month-old desi chicken organs could be safe to dine as compared with 4-month-old desi and C b organs. Graphical abstract

Background: Breast cancer is the most common malignancy among women worldwide. We aimed to know the past trends of age-specific breast cancer incidence rates in Faisalabad city. Methods: A retrospective study was designed at Allied Hospital Faisalabad (AHF), Pakistan from 2014-2018. Overall, 12742 cancer patients presented throughout these years, out of which 3390 were breast cancer cases. Descriptive statistics were computed and the results were presented as counts and percentage for categorical variables. Means and standard errors were computed for the continuous variables. For testing the association among categorical variables, a chi-square test of independence was used and the p-values less than 0.05 are reported as significant. Results: 84.70% patients were diagnosed with invasive breast carcinoma and 15.30% were all other types reported in the Allied Hospital Faisalabad. The incidence of breast cancer was outrageous in the 40-49 year-old age group (1021 patients, 30.12%) and the mean age is 45 in all years. An increase of 34.86% was observed from 2014 to 2018. The comprehensive four-year data (2015 to 2018) were further analyzed for histology, surgery, staging and grading pattern as 2014 files data was insufficient to discuss. The stage III and grade III were most common throughout the years from 2015 to 2018 with 33.9% and 55.71% respectively. Conclusion: Breast cancer is diagnosed more commonly in women than in any other type of cancers in Faisalabad city. There is a need to upgrade the existing hospital facilities to make the women diagnose the cancer at an earlier stage.

This article details our recommendations for the deadly outbreak of chickenpox to consider the additional referral of the absence of a monitoring system of prevention and control along with poor vaccination system for children in low-resource settings. The recent spread of chickenpox outbreak in Pakistan has claimed dozens of lives. The deaths in this current outbreak in quick successions are beyond understanding. Re-emergence of chickenpox in the area has raised many questions. Keeping in view the spread of chickenpox mainly in Faisalabad and its international reputation in trading, chickenpox breakout needs international attention to control its spread. It should be taken as an eye opener for the Government of Pakistan and government should develop and implement Centralized Infectious Disease Reporting Information Management System that will help to narrow down the pathogens as far as the epidemics are concerned and also for early preventive and countermeasure response.

Industrial effluent discharge has increased due to rapid urbanization and industrialization. Irrational use of this water for irrigation has caused environmental and health issues. The objective of the current study is to evaluate the treated effluents of textile, ghee and chemical industries for major heavy metals (Cd, Cr, Ni, Pb and Fe) and other basic analysis (pH, EC, TSS and TDS). Effluent samples were collected from the discharge of industries entering into main wastewater collecting channel located in Faisalabad city. Heavy metals contents were determined via atomic absorption spectrophotometry. Results showed that the highest pH (11.06) was recorded in textile effluent while EC (7.89mS/cm), TSS (1185.55mg/L) and TDS (6317.33mg/L) were found highest in chemical industrial effluents. Heavy metals contents were determined through atomic absorption spectrophotometer. The mean comparison of heavy metal concentration (mg/L) showed the concentration of Cd, Cr and Ni were within the safe limits; however, Fe and Pb were higher than the safe limits in all industrial effluents. The highest/unsafe concentration of metal Fe was recorded 4.093, 2.979 and 2.959 mg/L in the effluents of chemical, textile and ghee mill respectively. While the highest/unsafe concentration of metal Pb was recorded 0.643, 0.578 and 0.286 mg/L in the effluents of textile, chemical and ghee mill respectively. The permissible limits of heavy metals Fe and Pb is 0.5 and 2 mg/L respectively. We conclude that before discharge into a receiving stream, the effluents must be treated more time with a treatment method that removes Pb and Fe within standard limits else the discharge will pose pollution and health risks to human beings.