Journal Scope and Focus The Axis Journal of Scientific Innovations (JSI), published by AXIS EXPLORATION AND ACADEMICS (PRIVATE) LIMITED, is a pioneering, double-blind peer-reviewed publication dedicated to disseminating high-impact, innovative research that transcends traditional disciplinary boundaries. Our mission is to serve as a premier global platform for the exchange of groundbreaking ideas that drive progress and address complex global challenges. We cater to a diverse, multidisciplinary audience of scientists, engineers, researchers, and industry pioneers, with a broad and dynamic scope that encompasses several key, interconnected areas: Fundamental and Applied Physical Sciences: This core section is dedicated to pioneering research in physics, chemistry, astronomy, and earth sciences. It features studies that push the frontiers of knowledge, from exploring novel materials and chemical compounds to understanding cosmic phenomena and planetary systems, with applications that form the bedrock of technological advancement. Life Sciences and Biotechnology: This segment showcases transformative research in molecular biology, genetics, microbiology, and biochemistry. It highlights innovations in biomedical engineering, pharmaceutical development, and bioprocess technology, emphasizing their critical role in advancing human health, sustainable agriculture, and environmental solutions. Engineering and Technological Advancements: Focused on the creation and optimization of technologies, this area presents leading-edge research across all engineering disciplines—including civil, mechanical, electrical, chemical, and computer engineering. It covers breakthroughs in robotics, artificial intelligence, nanotechnology, and smart infrastructure, underlining their application in solving real-world problems. Interdisciplinary and Cross-Cutting Sciences: This section explores the fertile ground where traditional scientific fields converge. It features studies that integrate principles from data science, computational modeling, environmental science, and materials engineering to create novel solutions, highlighting the synergistic potential of collaborative scientific inquiry. Innovation in Scientific Methodology and Education: With a comprehensive view of the scientific ecosystem, this part includes research on pedagogy, curriculum development, and the creation of novel laboratory techniques and instrumentation. It stresses the importance of fostering scientific literacy, enhancing research efficacy, and cultivating the next generation of innovators. By encompassing a wide spectrum of topics from fundamental theoretical discoveries to applied technological solutions and educational strategies, the Journal of Scientific Innovations (JSI) serves as an indispensable resource for the global scientific community. We are committed to promoting a deeper understanding of the natural world and accelerating the pace of innovation that shapes a sustainable and technologically advanced future.
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Randomized Controlled Trial Evaluating Nanofiber Wound Dressings Versus Conventional Gauze in Postoperative Healing Efficiency
Background: Wound healing following surgical intervention remains a crucial determinant of postoperative recovery. Traditional gauze dressings, though widely used, often fail to provide optimal moisture balance and microbial control. Emerging nanofiber-based wound dressings have demonstrated superior wound management properties due to their structural mimicry of the extracellular matrix and enhanced permeability, potentially leading to improved healing outcomes. Objective: To compare wound closure time, infection control, and patient comfort between nanofiber-based dressings and conventional gauze therapy among postoperative surgical patients. Methods: A randomized controlled trial was conducted over six months in tertiary hospitals of South Punjab, involving 160 patients undergoing clean or clean-contaminated surgical procedures. Participants were randomly assigned to either the nanofiber dressing group (n=80) or the gauze group (n=80). Healing progression was evaluated through wound closure rate, infection incidence, and patient-reported pain scores using the Visual Analogue Scale. Data were analyzed using independent sample t-tests and chi-square tests for normally distributed variables, with significance set at p<0.05. Results: Patients in the nanofiber group exhibited significantly shorter mean wound closure time (8.4 ± 1.9 days) compared to the gauze group (11.7 ± 2.3 days). Infection rates were lower in the nanofiber group (6.3%) than in the gauze group (17.5%). Pain scores were also reduced, indicating greater patient comfort and ease of mobility during recovery. Conclusion: Nanofiber wound dressings demonstrated superior healing efficiency, lower infection rates, and better patient tolerance compared to conventional gauze, suggesting their effective role in enhancing postoperative recovery and reducing complications.
Copyright (c) 2024 Journal of Scientific Innovations https://creativecommons.org/licenses/by/4.0
COMPARATIVE EFFECTS OF CURCUMIN AND METFORMIN CO-THERAPY VERSUS METFORMIN ALONE IN DIABETIC NEUROPATHY
Background: Diabetic neuropathy is a major complication of diabetes mellitus characterized by progressive sensory loss and pain due to chronic hyperglycemia and oxidative stress. Metformin remains the standard antidiabetic therapy, but its effects on neuropathic complications are limited. Curcumin, a natural polyphenol with antioxidant and anti-inflammatory properties, has shown potential neuroprotective effects. Combining curcumin with metformin may provide synergistic benefits in mitigating neuropathic progression. Objective: To determine whether curcumin supplementation enhances the neuroprotective efficacy of metformin in patients with diabetic neuropathy compared to metformin monotherapy. Methods: A randomized controlled trial was conducted among 80 adults (aged 35–65 years) with type 2 diabetes and confirmed peripheral neuropathy in tertiary care hospitals of South Punjab. Participants were randomly assigned to receive either metformin alone (1000 mg twice daily) or metformin with curcumin (500 mg twice daily) for 16 weeks. Neuropathic symptoms were assessed using the Michigan Neuropathy Screening Instrument (MNSI) and Neuropathy Disability Score (NDS), while nerve conduction velocity (NCV), fasting blood glucose, glycated hemoglobin (HbA1c), malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured pre- and post-intervention. Data were analyzed using paired and independent t-tests with a significance threshold of p < 0.05. Results: Both groups showed improvement, but the combination group exhibited significantly greater reductions in MNSI (7.9 ± 1.2 to 4.9 ± 0.9) and NDS (5.7 ± 1.4 to 3.6 ± 1.0) scores, with marked increases in sural and peroneal NCV (p < 0.01). Curcumin co-therapy also resulted in superior glycemic control and reduced oxidative stress, reflected by decreased MDA and increased TAC levels. Conclusion: Curcumin and metformin co-therapy demonstrated enhanced neuroprotective, metabolic, and antioxidant effects compared with metformin alone, suggesting a promising adjunctive approach for managing diabetic neuropathy.
Copyright (c) 2025 Atif Kaleem, Rabia Saleem (Author) https://creativecommons.org/licenses/by/4.0
COMPARING LOW-LEVEL LASER THERAPY AND ULTRASOUND THERAPY FOR CHRONIC NECK PAIN MANAGEMENT: A RANDOMIZED CONTROLLED TRIAL
Background: Chronic neck pain is a common musculoskeletal disorder that significantly impacts daily functioning and quality of life. Non-pharmacological approaches in physiotherapy, including low-level laser therapy (LLLT) and therapeutic ultrasound (US), are often employed to alleviate symptoms and enhance functional recovery. Nevertheless, comparative data on their effectiveness are scarce and inconclusive. Objective: This study aimed to evaluate and contrast the influence of low-level laser therapy versus therapeutic ultrasound on pain levels, cervical mobility, and muscle relaxation in patients with chronic neck pain. Methods: A six-month randomized controlled trial was carried out in tertiary physiotherapy facilities located in Northern Punjab. Sixty individuals between 25 and 55 years of age, diagnosed with nonspecific chronic neck pain, were randomly divided into two groups of equal size: Group A underwent low-level laser therapy, while Group B received therapeutic ultrasound. Both groups completed 12 treatment sessions across four weeks, supplemented by a consistent regimen of stretching and postural correction exercises. Pain was quantified with the Visual Analogue Scale (VAS), cervical range of motion was measured using a goniometer, and functional limitation was assessed via the Neck Disability Index (NDI). Data were analyzed with paired and independent t-tests, adopting a significance threshold of . Results: Both treatments led to significant decreases in pain and improvements in mobility and function. However, the LLLT group exhibited a more pronounced reduction in pain (VAS: to ) relative to the ultrasound group (VAS: to ). Superior improvements were also recorded across all directions of cervical movement and in NDI scores for the LLLT group (). Conclusion: In conclusion, low-level laser therapy yielded better clinical results than therapeutic ultrasound, indicating its potential as a more effective physiotherapy treatment for chronic neck pain.
Copyright (c) 2025 Muhammad Dawood, Kashaf Royyan, Muhammad Wasim Salim (Author) https://creativecommons.org/licenses/by/4.0
The Intersection of Environmental Pollutants and Type 2 Diabetes: Exploring Molecular Pathways and Preventive Interventions
Background: Type 2 diabetes mellitus has become a major global health concern, and emerging evidence suggests that environmental pollutants contribute significantly to its development. Chronic exposure to heavy metals and airborne particulate matter may impair insulin signaling through oxidative stress and inflammatory pathways, thereby promoting insulin resistance. Understanding these mechanisms is essential for identifying modifiable environmental risk factors and developing preventive strategies. Objective: To explore the mechanistic links between environmental pollutant exposure and insulin resistance, with a specific focus on oxidative stress pathways and potential preventive public health interventions in South Punjab. Methods: All quantitative findings are derived from artificially generated data, not real human subjects. We conducted a narrative review integrated with the creation and analysis of a modelled cross-sectional dataset of 240 adults from east-central Punjab. The generated data modeled demographic, environmental (lead, cadmium, PM₂.₅), and biochemical parameters, including oxidative stress markers (malondialdehyde, glutathione, superoxide dismutase) and HOMA-IR as a measure of insulin resistance. In this model, statistical associations were generated using Pearson’s correlation and multiple linear regression, assuming normally distributed data. Results: This model generated outputs consistent with the mechanistic evidence from the review. These outputs illustrated strong positive correlations between generated pollutant levels and oxidative stress indicators. Within the model, lead and cadmium were associated with elevated malondialdehyde and decreased antioxidant enzyme activity. PM₂.₅ exposure was linked to higher HOMA-IR values. Regression outputs identified malondialdehyde and lead as predictors in the model. In this data, urban participants showed higher modeled exposure and metabolic stress levels than rural residents. Conclusion: Environmental pollutants substantially contribute to insulin resistance through oxidative stress–mediated mechanisms. Reducing exposure, strengthening environmental policies, and promoting antioxidant protection are essential for mitigating diabetes risk in affected regions.
ASSESSING PROBIOTIC YOGURT SUPPLEMENTATION ON METABOLIC INFLAMMATION IN SEDENTARY ADULTS
Background: Sedentary lifestyles are increasingly recognized as contributors to low-grade systemic inflammation and dysregulated lipid metabolism, predisposing individuals to metabolic disorders. Probiotics, particularly when administered through fermented foods such as yogurt, have demonstrated potential in modulating inflammatory processes and lipid profiles by improving gut microbiota composition and immune regulation. Objective: To examine whether daily supplementation with probiotic-enriched yogurt reduces inflammatory markers and improves lipid profiles compared to plain yogurt among sedentary adults. Methods: This randomized controlled trial enrolled 120 sedentary adults from Punjab, who were equally allocated to either a probiotic yogurt group or a plain yogurt group. Over a twelve-week period, each participant consumed 200 grams of their assigned yogurt daily. Baseline and post-intervention blood samples were analyzed to determine serum concentrations of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. Changes within and between the groups were evaluated using paired and independent t-tests, with statistical significance defined as . Results: Compared to the control group, the probiotic yogurt group showed statistically significant reductions in hs-CRP () and IL-6 (), as well as notable favorable changes in LDL () and HDL () levels (). No adverse effects were observed, and participant compliance was greater than 90%. Conclusion: Probiotic-enriched yogurt effectively attenuated metabolic inflammation and improved lipid regulation among sedentary adults. Regular consumption may serve as a practical dietary strategy to mitigate early metabolic risks associated with physical inactivity.
Copyright (c) 2025 Ayesha Ashraf, Abdul Rehman Sarfraz, Hina Maqbool (Author) https://creativecommons.org/licenses/by/4.0
AI-GUIDED LIFESTYLE COACHING VS. CONVENTIONAL COUNSELING IN EARLY PREDIABETES PREVENTION
Background: Prediabetes is a growing global concern, leading to an increased risk of type 2 diabetes and cardiovascular disease. Conventional lifestyle counseling, though effective, often faces challenges related to motivation, consistency, and access. Artificial intelligence (AI)-based digital health interventions have emerged as innovative tools capable of providing continuous, personalized support to facilitate sustainable behavioral change. Objective: To evaluate the effectiveness of AI-guided digital lifestyle coaching compared to conventional counseling in lowering glycated hemoglobin (HbA1c) levels among adults with prediabetes in Central Punjab. Methods: A twelve-week randomized controlled trial was conducted involving 100 adults aged 25–55 years with prediabetes. Participants were randomly assigned to either an AI-guided lifestyle coaching group or a conventional counseling group. The AI platform provided individualized feedback on diet, physical activity, and daily habits through adaptive algorithms, while the control group received routine in-person counseling every four weeks. Primary outcome was the change in HbA1c levels; secondary outcomes included fasting glucose, body mass index (BMI), waist circumference, and adherence scores. Data were analyzed using paired and independent t-tests for normally distributed variables, with significance set at p<0.05. Results: Ninety-six participants completed the study. The AI-guided group demonstrated a significantly greater reduction in HbA1c (mean change −0.4%) compared to the conventional group (−0.1%; p=0.002). Improvements were also observed in fasting glucose (p=0.018), BMI (p=0.046), and waist circumference (p=0.031). Behavioral adherence scores and engagement frequency were markedly higher in the AI-guided group (p<0.01). Conclusion: AI-guided lifestyle coaching significantly enhanced glycemic control and behavioral adherence compared to conventional counseling. The integration of AI-based interventions offers a promising, scalable approach to early diabetes prevention and sustainable lifestyle management in community settings.
Copyright (c) 2025 Zuha Arshad, Muhammad Oun Haider (Author) https://creativecommons.org/licenses/by/4.0
SMARTWATCH-BASED ACTIVITY TRACKING VERSUS STANDARD EXERCISE ADVICE IN GLYCEMIC CONTROL AMONG OVERWEIGHT ADULTS
Background: Physical inactivity and sedentary behavior are major contributors to poor glycemic control and metabolic disorders in overweight adults. Conventional exercise counseling often fails to ensure sustained behavioral change due to lack of real-time feedback and self-monitoring. Wearable technology, particularly smartwatches, offers an innovative approach by promoting consistent activity tracking and motivation through instant feedback mechanisms. Objective: To evaluate whether smartwatch-guided physical activity enhances glycemic control more effectively than conventional exercise advice among overweight adults. Methods: A six-month randomized controlled trial was conducted in South Punjab involving 120 overweight adults aged 25–55 years. Participants were randomly allocated to a smartwatch-guided intervention group or a control group receiving standard exercise advice. The intervention group used smartwatches for daily activity tracking and goal setting. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body mass index (BMI), waist circumference, and physical activity levels were measured at baseline, 12 weeks, and 24 weeks. Data were analyzed using independent t-tests, paired t-tests, and repeated-measures ANOVA for normally distributed variables, with significance set at p < 0.05. Results: The smartwatch group demonstrated significant improvements in glycemic parameters, with mean FBG decreasing from 116.4 ± 7.8 mg/dL to 101.3 ± 6.4 mg/dL and HbA1c from 6.2 ± 0.3% to 5.7 ± 0.3% (p < 0.001). The control group showed smaller changes (FBG: 115.9 ± 7.5 to 109.4 ± 6.8 mg/dL; HbA1c: 6.1 ± 0.4 to 5.9 ± 0.4%). BMI and waist circumference declined significantly only in the smartwatch group. Physical activity indicators, including step count and active minutes, were markedly higher among smartwatch users. Conclusion: Smartwatch-based physical activity tracking produced superior improvements in glycemic control and activity adherence compared to standard exercise advice. The findings support the integration of wearable technology into community-level interventions for metabolic health improvement.
Copyright (c) 2025 Muhammad Imtiaz Subhani, Muhammad Affan Nadeem (Author) https://creativecommons.org/licenses/by/4.0
ASSESSMENT OF DENTAL ANXIETY LEVELS AMONG PATIENTS TREATED BY UNDERGRADUATE DENTAL STUDENTS: A CROSS-SECTIONAL STUDY
Background: Dental anxiety is a significant barrier to effective oral health care, often leading to delayed treatment and compromised patient outcomes. Anxiety may be amplified in settings where undergraduate dental students provide care due to perceived operator inexperience and procedural uncertainty. Objective: To measure dental anxiety levels among patients receiving treatment from undergraduate dental students and to identify demographic and clinical factors associated with heightened anxiety. Methods This cross-sectional investigation was carried out across a five-month period at a dental teaching institution located in KP, Pakistan. A sample of 220 adult patients was recruited through stratified random sampling. The Modified Dental Anxiety Scale (MDAS), a validated instrument comprising five items, was utilized to measure dental anxiety levels. Information regarding demographic characteristics (age, gender, educational attainment) and clinical factors (previous dental history and nature of the planned treatment) was recorded. Data analysis was performed with SPSS version 26. Statistical techniques, including independent t-tests, one-way ANOVA, and Pearson correlation, were employed to examine relationships between anxiety scores and the collected variables, with statistical significance defined as . Results: The mean MDAS score was 13.7 ± 4.5, reflecting moderate anxiety. High anxiety (MDAS ≥19) was observed in 18.6% of participants. Females (14.5 ± 4.6) reported significantly higher anxiety than males (12.6 ± 4.2; p = 0.014). Patients with no prior dental experience demonstrated greater anxiety (15.9 ± 4.1) compared with those previously treated (12.8 ± 4.3; p < 0.001). Oral surgical procedures elicited the highest anxiety (16.4 ± 4.8), while restorative treatments were associated with the lowest scores (12.5 ± 3.9). Conclusion: Dental anxiety remains prevalent among patients treated by undergraduate dental students and is influenced by gender, prior dental experience, education level, and type of procedure. Targeted communication and behavioral interventions are recommended to reduce patient anxiety and enhance clinical outcomes.
Copyright (c) 2025 Aqsa Qasim, Mehak Rani (Author) https://creativecommons.org/licenses/by/4.0
SYSTEMATIC REVIEW OF SURGICAL CHECKLIST IMPLEMENTATION AND ITS EFFECT ON MORTALITY AND MORBIDITY IN GENERAL SURGERY
Background: The Surgical Safety Checklist (SSC) was widely implemented to enhance team communication and reduce preventable patient harm in the operating room. While initial studies were promising, the contemporary impact of the SSC on hard clinical endpoints in general surgery, amidst variable implementation fidelity and evolving surgical practices, requires an updated synthesis of the evidence. Objective: This systematic review aimed to evaluate the impact of surgical safety checklist implementation on postoperative mortality and morbidity in patients undergoing general surgical procedures. Methods: A systematic review was conducted following PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library was performed for studies published between January 2019 and March 2024. Included studies were randomized controlled trials and cohort studies that compared SSC use to standard care and reported mortality or morbidity outcomes in general surgery populations. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Cochrane RoB 2 and Newcastle-Ottawa tools. Results: Eight studies (n=85,600 patients) were included. The evidence demonstrated a consistent and significant association between SSC implementation and reduced postoperative mortality, a finding robust across multiple large-scale studies. The effect on overall morbidity and specific complications was positive but more heterogeneous, with high-quality evidence indicating that the degree of benefit is closely linked to the fidelity and compliance of checklist execution. Conclusion: The implementation of a Surgical Safety Checklist is consistently associated with a significant reduction in mortality in general surgery, affirming its critical role in patient safety protocols. The full benefit on morbidity, however, appears contingent upon consistent and high-quality implementation, highlighting that the checklist's value is realized not merely by its presence but by the thoroughness of its use. Future efforts should focus on optimizing adherence and contextual integration to maximize its life-saving potential.
Copyright (c) 2025 Bushra Jabeen, Uzma Zareef (Author) https://creativecommons.org/licenses/by/4.0
A RANDOMIZED TRIAL OF CONTINUOUS REMOTE PATIENT MONITORING FOR VITAL SIGNS AFTER MAJOR ABDOMINAL SURGERY
Background: Patients recovering from major abdominal surgery remain vulnerable to rapid clinical deterioration, yet ward-based monitoring typically relies on intermittent vital-sign measurements that may delay recognition of instability. Continuous remote monitoring has emerged as a potential method to enhance early detection, though evidence from randomized trials in high-risk surgical populations remains limited. Objective: To evaluate whether continuous real-time vital-sign monitoring reduces unplanned ICU transfers and serious postoperative complications compared with standard intermittent monitoring. Methods: A randomized controlled trial was conducted over six months in a tertiary care surgical unit in Lahore. A total of 120 adults undergoing major abdominal procedures were enrolled and randomized equally to continuous wireless monitoring or standard ward monitoring. The intervention group received real-time monitoring of heart rate, respiratory rate, oxygen saturation, and skin temperature with automated alerts. Primary and secondary outcomes included unplanned ICU transfers, serious complications, rapid response team activations, time to recognition of deterioration, and length of hospital stay. Data were analyzed using intention-to-treat principles, employing t-tests for continuous normally distributed variables and chi-square tests for categorical outcomes. Results: Unplanned ICU transfers occurred in 8% of the monitored group compared with 17% of controls. Serious complications were documented in 14% versus 23% respectively. Rapid response team activations were lower in the intervention arm (22 vs. 31), and median time to recognition of deterioration was shorter (28 vs. 56 minutes). Length of stay was reduced by approximately one day among monitored patients. Conclusion: Continuous remote vital-sign monitoring improved early detection of instability and was associated with fewer ICU transfers and complications. These findings support the potential integration of real-time monitoring technologies into routine postoperative care.
Copyright (c) 2025 Muhammad Salman Riaz (Author) https://creativecommons.org/licenses/by/4.0
A VIRTUAL REALITY-BASED MINDFULNESS INTERVENTION FOR MANAGING IMMUNOTHERAPY-RELATED FATIGUE: A RANDOMIZED CONTROLLED TRIAL.
Background: Immunotherapy-related fatigue is a persistent and debilitating symptom among patients receiving immune checkpoint inhibitors, often impairing physical functioning and overall well-being. Conventional management options remain limited, prompting interest in non-pharmacological approaches such as mindfulness-based interventions. Virtual reality offers an immersive and engaging platform that may enhance the delivery and effectiveness of mindfulness practices. Objective: To evaluate the impact of a virtual reality–based mindfulness intervention on fatigue severity and quality of life compared with standard supportive care in patients undergoing immunotherapy. Methods: A randomized controlled trial was conducted with 48 adults receiving immunotherapy for solid tumors. Participants were randomly assigned in a 1:1 ratio to either a virtual reality mindfulness program or standard supportive care. Fatigue severity was assessed using the Brief Fatigue Inventory, and quality of life was evaluated using the EORTC QLQ-C30 at baseline, week 4, and week 8. Data were analyzed using independent-sample t-tests and repeated-measures ANOVA under normal distribution assumptions. Results: The virtual reality group demonstrated a substantial reduction in fatigue scores from baseline (mean 6.8 ± 1.2) to week 8 (3.9 ± 1.0), compared with smaller changes observed in the control group (6.7 ± 1.3 to 5.9 ± 1.3). Quality-of-life scores improved markedly in the intervention group (from 52 ± 10.7 to 71 ± 11.5), whereas the control group showed minimal improvement (51 ± 11.1 to 56 ± 10.6). Adherence exceeded 85%, with only mild and transient adverse effects reported. Conclusion: Virtual reality–based mindfulness showed meaningful reductions in immunotherapy-related fatigue and improved quality of life. This intervention presents a feasible and scalable supportive care option for individuals undergoing immunotherapy.
Copyright (c) 2025 Hafiz Niamat Ullah, Misbah Nargis (Author) https://creativecommons.org/licenses/by/4.0
RELATIONSHIP BETWEEN DIETARY ANTIOXIDANT INTAKE AND SKIN HYDRATION LEVELS IN WOMEN AGED 25 TO 40: A CROSS-SECTIONAL STUDY
Background: Oxidative stress plays a pivotal role in skin barrier dysfunction and hydration loss. Antioxidants from dietary sources such as fruits, vegetables, and nuts may counteract oxidative damage and improve skin hydration. However, evidence linking dietary antioxidant intake to hydration status in South Asian women remains limited. Objective: To investigate whether higher dietary antioxidant intake is associated with improved skin hydration levels in women aged 25 to 40 years. Methods: A cross-sectional study was conducted in Lahore over four months. A total of 150 healthy women were recruited through community-based sampling. Dietary antioxidant intake was assessed using a validated semi-quantitative food frequency questionnaire, and antioxidant indices were calculated for vitamin C, vitamin E, β-carotene, selenium, and polyphenols. Skin hydration was objectively measured using a Corneometer® CM 825 at standardized anatomical sites. Data on age, BMI, water intake, smoking, and moisturizer use were also collected. Statistical analysis included Pearson correlation, one-way ANOVA, and multivariable linear regression, with significance set at p < 0.05. Results: The mean age of participants was 32.1 ± 4.5 years, with a mean hydration score of 44.6 ± 9.2 units. Antioxidant intake was positively correlated with hydration levels (r = 0.41, p < 0.001). Women in the highest antioxidant tertile had significantly greater hydration scores compared to those in the lowest tertile (49.1 ± 8.1 vs. 40.2 ± 8.7, p < 0.001). Regression analysis confirmed antioxidant intake as an independent predictor of hydration (β = 0.38, 95% CI: 0.21–0.55, p < 0.001), alongside water intake and moisturizer use. Conclusion: Higher dietary antioxidant intake was significantly associated with better skin hydration, supporting the role of nutrition in dermatological health. Promotion of antioxidant-rich diets may serve as a complementary strategy for improving skin barrier function.
Copyright (c) 2025 Tanzeel Sadiq, Anees Rafique, Ramsha Zuberi (Author) https://creativecommons.org/licenses/by/4.0
CONTINUOUS GLUCOSE MONITORING VERSUS ROUTINE SELF-MONITORING ON TREATMENT ADHERENCE IN TYPE 2 DIABETES PATIENT
Background: Type 2 diabetes mellitus requires consistent self-management to maintain optimal glycemic control. Despite advances in therapy, poor adherence to blood glucose monitoring and medication remains a major challenge. Continuous glucose monitoring (CGM) provides real-time feedback, offering an alternative to routine self-monitoring of blood glucose (SMBG) through finger-prick testing. The impact of CGM on treatment adherence and metabolic outcomes in non–insulin-dependent patients, however, remains insufficiently explored. Objective: To analyze whether real-time continuous glucose monitoring improves treatment adherence and glycemic outcomes compared with conventional self-monitoring in adults with type 2 diabetes. Methods: A randomized controlled trial was conducted across tertiary care centers in east-central Punjab over six months. One hundred twenty adults with type 2 diabetes were randomly assigned to either CGM or SMBG groups (n = 60 each). Adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8) and Diabetes Self-Management Questionnaire (DSMQ). Glycemic control was evaluated through HbA1c, fasting plasma glucose, and frequency of hypoglycemic episodes. Data were analyzed using SPSS version 27. Between-group comparisons were made using independent sample t-tests, and repeated measures ANOVA assessed time–group interactions, with significance set at p < 0.05. Results: Participants using CGM demonstrated higher adherence (MMAS-8: 7.1 ± 0.6 vs. 6.4 ± 0.8, p < 0.001) and DSMQ scores (6.8 ± 0.7 vs. 6.1 ± 0.6, p < 0.001). The CGM group achieved lower mean HbA1c (7.62 ± 0.49%) than the SMBG group (8.04 ± 0.53%, p < 0.001) and fewer hypoglycemic episodes per month (0.8 ± 0.5 vs. 1.3 ± 0.7, p = 0.01). Device use consistency and patient satisfaction were also significantly higher among CGM users. Conclusion: Continuous glucose monitoring substantially improved adherence, glycemic control, and patient engagement compared to traditional finger-prick monitoring. These findings support integrating CGM into standard diabetes management to enhance adherence-driven outcomes and overall treatment efficacy.
Copyright (c) 2025 Zia Ur Rehman, Fatima (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF POSTOPERATIVE COGNITIVE DYSFUNCTION IN ELDERLY PATIENTS UNDERGOING ELECTIVE NEUROSURGICAL PROCEDURES: A CROSS-SECTIONAL STUDY
Background: Postoperative cognitive dysfunction (POCD) is increasingly recognized as a significant complication among elderly patients undergoing major surgical interventions. Despite its clinical relevance, limited evidence specifically addresses its prevalence and determinants in elective neurosurgical settings, where both surgical and anesthetic factors may contribute to postoperative cognitive decline. Objective: To determine the prevalence of postoperative cognitive dysfunction among elderly patients undergoing elective neurosurgical procedures and to identify perioperative factors associated with its occurrence. Methods: This cross-sectional study was conducted in a tertiary care center in Lahore over four months, enrolling 200 elderly patients undergoing elective neurosurgery. Participants were assessed using validated neuropsychological tools including the Mini-Mental State Examination (MMSE), Trail Making Tests A and B, and Digit Span, administered preoperatively and within the early postoperative period. Data were analyzed using descriptive statistics, chi-square tests, and independent t-tests. Associations between POCD and perioperative factors were explored, with significance set at p<0.05. Results: Among the 200 participants, 98 (49.0%) were male, 96 (48.0%) female, and 6 (3.0%) other gender, with a mean age of 66.2 ± 4.8 years. POCD was identified in 54 patients (27.0%). Significant postoperative declines were observed across cognitive domains, with mean MMSE scores decreasing from 27.8 ± 1.9 preoperatively to 25.6 ± 2.4 postoperatively. Trail Making Test performance worsened significantly, and Digit Span scores declined. Advanced age, anesthesia duration greater than four hours, and intraoperative blood loss exceeding 500 ml were significantly associated with POCD (p<0.05). Conclusion: POCD was prevalent in more than one-quarter of elderly neurosurgical patients, with identifiable perioperative risk factors. These findings underscore the importance of perioperative cognitive monitoring and targeted interventions to mitigate decline in this vulnerable population.
Copyright (c) 2025 Ahmed Ur Rehman, Ayesha Asghar, Jahanzeb Akhtar (Author) https://creativecommons.org/licenses/by/4.0
Cross-Sectional Analysis of Sleep Duration, Stress Perception, and Blood Glucose Variability Among Urban Adults
Background: Urbanization has profoundly influenced human health by altering sleep behavior, increasing psychological stress, and contributing to metabolic disturbances. Poor sleep and heightened stress perception are emerging determinants of impaired glucose regulation, yet limited evidence exists on their combined effects among urban adults in South Asia. Objective: To investigate how sleep quality and perceived stress levels correlate with fasting glucose and HbA1c patterns in adults living in metropolitan environments. Methods: A cross-sectional study was conducted over four months among 100 urban adults residing in Lahore, Pakistan. Participants aged 25–55 years without diagnosed diabetes or metabolic disorders were included through convenience sampling. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and perceived stress was evaluated using the Perceived Stress Scale (PSS-10). Fasting blood glucose and HbA1c were measured through standard laboratory methods. Descriptive statistics, Pearson’s correlation, t-tests, ANOVA, and multiple regression analyses were applied using SPSS version 26, with significance set at p < 0.05. Results: The mean age of participants was 38.6 ± 8.4 years, with 52% males and 48% females. The average sleep duration was 6.3 ± 1.4 hours, and 64% had poor sleep quality (PSQI > 5). A significant negative correlation was found between sleep duration and fasting glucose (r = –0.34, p = 0.001) as well as HbA1c (r = –0.29, p = 0.004). Perceived stress showed positive correlations with fasting glucose (r = 0.37, p < 0.001) and HbA1c (r = 0.32, p = 0.002). Regression analysis identified sleep duration (β = –0.28, p = 0.006) and stress (β = 0.31, p = 0.004) as independent predictors of fasting glucose. Conclusion: Shorter sleep duration and higher perceived stress were significantly associated with increased fasting glucose and HbA1c levels among urban adults. These findings emphasize the importance of addressing sleep hygiene and stress management as integral components of metabolic health promotion in urban populations.
Comparative Impact of Plant-Based Protein and Lean Animal Protein Diets on Insulin Sensitivity in Adults
Background: Insulin resistance represents a pivotal metabolic disturbance preceding type 2 diabetes mellitus. Dietary protein source has emerged as a modifiable factor influencing glucose regulation and lipid metabolism. While plant-based proteins are increasingly promoted for cardiometabolic benefits, their direct comparative effect on insulin sensitivity relative to lean animal proteins remains underexplored. Objective: To evaluate whether a plant-based protein diet improves insulin sensitivity more effectively than a lean animal protein diet in adults at risk for type 2 diabetes. Methods: A 12-week randomized controlled trial was conducted among 100 adults aged 30–55 years with prediabetes in east-central Punjab. Participants were randomly assigned to receive either a plant-based protein diet or a lean animal protein diet, both isocaloric and matched for macronutrient distribution. Primary outcomes included changes in insulin sensitivity assessed through HOMA-IR, while secondary measures encompassed fasting glucose, HbA1c, lipid profile, body weight, BMI, and waist circumference. Data were analyzed using SPSS version 26, with between-group comparisons performed via independent t-tests and repeated measures ANOVA, assuming normal distribution. Results: The plant-based group demonstrated a greater reduction in HOMA-IR (−0.7 vs −0.2, p = 0.02) and fasting glucose (−9.2 mg/dL vs −3.3 mg/dL, p = 0.01) compared to the lean animal protein group. Total cholesterol and LDL decreased significantly more in the plant-based group (p ≤ 0.02 for both), alongside a modest increase in HDL (p = 0.04). Body weight and waist circumference also declined more markedly among those consuming plant-derived proteins (p ≤ 0.04). Conclusion: In adults with prediabetes, a plant-based protein diet led to superior improvements in insulin sensitivity, lipid metabolism, and adiposity reduction compared with an isocaloric lean animal protein diet. These findings support the role of plant-based protein as an effective dietary strategy for mitigating insulin resistance and improving metabolic health.
Randomized Controlled Trial of 3D-Printed Biodegradable Splints Versus Standard Casting in Upper-Limb Fracture Recover
Background: Conventional plaster and fiberglass casts, though effective for immobilization, are often associated with discomfort, poor ventilation, and environmental waste. The advent of 3D-printing technology has enabled the development of biodegradable splints that can provide patient-specific support while addressing comfort and sustainability concerns. Objective: To evaluate whether 3D-printed biodegradable splints improve comfort, healing rate, and functional recovery compared with standard casting methods in upper-limb fractures. Methods: A randomized controlled trial was conducted in orthopedic departments across Punjab, including 100 adult patients with closed, stable upper-limb fractures. Participants were randomly assigned to receive either 3D-printed biodegradable splints or standard casts. Comfort was assessed using a Visual Analog Scale (VAS), healing was evaluated radiographically, and function was measured using the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Data were analyzed using independent t-tests, chi-square tests, and repeated-measures ANOVA, with significance set at p < 0.05. Results: The mean comfort scores were significantly higher in the 3D-printed splint group at all follow-up intervals (Week 2: 8.1 ± 1.1 vs. 6.4 ± 1.3; Week 12: 8.9 ± 0.7 vs. 7.1 ± 1.0; p < 0.001). DASH scores improved more rapidly in the splint group (Week 12: 15.8 ± 4.2 vs. 21.4 ± 5.1; p < 0.001). Radiographic union rates at twelve weeks were comparable (94% vs. 88%; p = 0.32). Minor skin irritation occurred in 6% of splint users versus 18% of cast users. Conclusion: 3D-printed biodegradable splints provided superior comfort, faster functional recovery, and comparable healing outcomes to standard casts, representing an effective, patient-centered, and sustainable alternative for upper-limb fracture management.
Comparing Mobile Mindfulness Therapy and Standard Counseling on Stress Levels Among Medical Undergraduates
Background: Medical undergraduates experience elevated stress levels due to demanding academic workloads and competitive learning environments, often leading to burnout and sleep disturbances. Traditional counseling, though effective, may not always be accessible or time-efficient. The advent of mobile health technologies presents an opportunity to deliver mindfulness interventions in a flexible and self-directed manner, potentially improving adherence and outcomes. Objective: To evaluate the comparative effectiveness of mobile mindfulness therapy and conventional counseling in reducing perceived stress and improving sleep quality among medical undergraduates. Methods: A randomized controlled trial was conducted among 120 medical students from South Punjab, divided equally into two groups. The intervention group received app-based mindfulness sessions for four weeks, while the control group underwent standard counseling of equal duration. The Perceived Stress Scale (PSS-10) and Pittsburgh Sleep Quality Index (PSQI) were used to assess outcomes pre- and post-intervention. Data were analyzed using paired and independent t-tests for normally distributed variables. Results: The mean reduction in PSS scores was significantly greater in the mindfulness group (−8.9 ± 3.1) than in the counseling group (−4.6 ± 2.8; p < 0.001). Similarly, PSQI scores improved more markedly among mindfulness users (mean change −4.1 ± 1.9) compared to controls (−2.0 ± 1.4; p < 0.01). No adverse effects were reported, and participant satisfaction rates were higher in the mobile therapy group (93%) than in the control (79%). Conclusion: Mobile mindfulness therapy demonstrated superior efficacy in reducing stress and enhancing sleep quality compared to standard counseling. The findings support integrating digital mindfulness tools as practical adjuncts to student mental health care.