The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the tec... more The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the technological and digital revolution. A number of different innovations have taken place during this time period, from inventions of newer types of medicines, innovative surgical procedures, in-depth investigative methods, and advanced technological devices. In the 1980s, a number of technological innovations took place including the emergence of the first commercial MRI scanner, personal glucose meter, and cochlear implants. There were surgical advancements like laser cataract surgery, the invention of surgical robot, and, the intravascular stent. There was development of newer types of medications like the invention of Human Insulin and the first commercial hepatitis B vaccine. Polymerase chain reaction (PCR)and automated DNA sequencer were invented and DNA fingerprinting was done for the first time during this decade. In the 1990s, Human Genome Project began and Dolly, the sheep became the first mammal cloned. Newer treatment modalities began like cancer immunotherapy and targeted cancer therapy. Combination drug therapy for HIV (HAART) extended HIV survival. The first human embryonic stem cell line was created and Q-switched lasers, DNA microarray, and bionic limbs were invented during this decade. The 2000s witnessed the completion of the Human Genome Project with the completion of sequencing of the human genome. The first full-face transplant and first telesurgery were also done during this time period. Capsule endoscopy got FDA approval during this decade and there was invention of HPV vaccination. In the 2010s, the first successful synthetic cell, first artificial pancreas, and the first 3D-printed heart using human cells were created. The first skull transplant was done. Bionic Eye was invented, TAVR and eTNS System were given FDA approval. The first cancer vaccine (sipuleucel-T), first Ebola vaccine, and a new drug called Sofosbuvir with a 95% cure rate for Hepatitis C were FDA approved. Checkpoint inhibitor therapy was invented and the first gene therapy and CART cell therapy were given FDA approval. Genome Guided Solid Tumor Diagnosis began and the use of Artificial Intelligence initiated especially in preventative and diagnostic healthcare. During the COVID-19 pandemic, different COVID-19 vaccinations were given FDA or WHO emergency use authorization in 2020 and 2021 including Pfizer-BioNTech, Moderna, Janssen, AstraZeneca, Sinopharm, Sinovac, and COVAXIN. These innovations have opened up possibilities that were previously unimaginable in earlier decades, and have also paved the way for future advancements in medical research and delivery of healthcare.
It is usually assumed that written word is dependent upon spoken word and in aphasia and similar ... more It is usually assumed that written word is dependent upon spoken word and in aphasia and similar disorders, speech and written components are equally affected. But there are many cases where it can be seen that its not always the same and speech and written components are many a times differently affected. Obligatory phonological mediation hypothesis and orthographic autonomy hypothesis represent these conflicting perspectives. According to the obligatory phonological mediation hypothesis, written language necessarily involves phonological mediation and is entirely dependent upon spoken language. The semantic system activates the phonological form of a word, which then activates the corresponding orthographic representation. In contrast, the orthographic autonomy hypothesis posits that the lexical orthographic representations of words can be accessed without any necessary phonological mediation and can be directly activated from the semantic system. The obligatory phonological mediation and orthographic autonomy hypotheses predicts differently the possible effects of brain damage on written naming. On the basis of the phonological mediation hypothesis, an impairment at the level of the phonological lexicon should always affect both spoken and written naming and in double naming tasks, the word selected for a written response should always correspond to the one selected for a spoken output. But on the basis of orthographic autonomy hypothesis, the orthographic lexicon can be accessed directly from semantics therefore it should be possible to observe cases with impaired spoken naming due to damage to the phonological lexicon with no written naming deficit and double naming tasks in spoken and written modalities may give rise to lexically inconsistent responses. In support of this view, a number of cases showing dissociation in phonological lexical forms and orthographic forms including spared knowledge of orthographic forms despite an impairment affecting phonological lexical forms with intact articulatory abilities or lexically inconsistent responses in consecutive double naming tasks in different modalities of writing and speech have been reported across a number of languages. Here, different case studies showing dissociation in phonological lexical forms (spoken speech) and orthographic forms (writing) are reviewed providing evidence that access to the orthographic form of words can occur independently.
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory s... more Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The earliest case of this infection is dated back to 17 November 2019 in Wuhan, China. The virus later spread to other countries all over the world through human-to-human transmission. On 11th March 2020 the WHO declared it a pandemic. SARS-CoV-2 is a positive-sense single-stranded RNA virus that is contagious in humans. It is the successor to SARS-CoV-1, the strain that caused the 2002-2004 SARS outbreak. The case fatality ratio for COVID-19 has been much lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll. The virus is primarily spread between people during close contact, most often via small droplets produced by coughing, sneezing, and talking. On 26th February, Pakistan confirmed its first two cases of the coronavirus. Lockdown was announced by different provincial governments on 21st march and it remained till 9th of may all over the country. In early June, case numbers began rising far faster. As of June 22nd 2020, Pakistan has 185,034 confirmed cases, Sindh has the highest number of confirmed cases at 71,092 closely followed by Punjab at 68,308. Khyber Pakhtunkhwa has 22,633 cases, Islamabad capital territory has 11,219 cases, Balochistan has 9,587 cases, Gilgit Baltistan has 1326 cases, and Azad Kashmir has 869 cases. Major cities in Pakistan have the highest number of COVID-19 cases. Males have comparatively high COVID-19 incidence and mortality in Pakistan at 74.06% and 73.92% respectively. The comparatively higher COVID-19 incidence in males seems related to lack of social distancing measures. COVID-19 incidence is highest in 20-40 age group in both genders and 45% of confirmed cases belong to this age group. Also this age range usually lags behind following social distancing measures. Mortality is comparatively less in this age group but this age range can still transmit infection to more vulnerable age groups. Although the age group of 50-69 makes up only 21.61% of COVID-19 confirmed cases, this age range has the highest mortality and constitutes 55.14% of COVID-19 associated deaths as older people and people with pre-existing medical conditions are more vulnerable to becoming severely ill with the virus. Since early June, after the relaxation of lockdown measures there is a sharp increase in COVID-19 cases in Pakistan, which also relates to lack of precautionary measures by citizens. The best way to prevent COVID-19 is to avoid being exposed to this virus by maintaining good social distance and proper sanitization.
Pancreatic cancer is one of the most lethal cancer and there is innate resistance to standard che... more Pancreatic cancer is one of the most lethal cancer and there is innate resistance to standard chemotherapy regimens in pancreatic cancer. Gemcitabine was approved in 1996 for the chemotherapeutic treatment of metastatic pancreatic cancer. FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) and gemcitabine plus nab-paclitaxel combination therapies have shown superiority to gemcitabine monotherapy but are more toxic than gemcitabine monotherapy. Therefore, gemcitabine monotherapy is still one of the standard treatments for pancreatic cancer for patients who can't tolerate the toxicity of other chemotherapeutic regimens. The effectiveness of standard chemotherapeutic drugs is limited in pancreatic cancer due to drug resistance, and undesirable side effects. There is a likelihood that the combination of standard chemotherapy with natural compounds having anti-cancer potential like curcumin will increase the effectiveness of treatment as well as reduce the toxic side effects of standard chemotherapeutic agents. Curcumin is a polyphenolic compound isolated from the rhizome of Curcuma longa (turmeric) and is considered a promising anticancer agent. Here, a review is presented about the potential use of curcumin with standard chemotherapy in pancreatic cancer as there is a potential in different combination regimens of curcumin in pancreatic cancer to increase median survival in pancreatic cancer in comparatively less toxic, novel ways. Also, curcumin combination chemotherapy may lead to the improvement of cancer and chemotherapy-related symptoms. The poor bioavailability of curcumin has been the major obstacle for its clinical application. To overcome this problem, several curcumin preparations have been developed including cost-effective preparation methods to increase the bioavailability of curcumin. Different studies have shown that gemcitabine curcumin combination regimen can effectively increase survival with less toxicity in patients who are resistant to gemcitabine and can't even tolerate the toxicity of other chemotherapeutic combination regimens. Although clinical trials are needed, Paclitaxel and curcumin cobound albumin nanoparticles also have the potential to become another alternative chemotherapeutic regimen for pancreatic cancer. For those patients who can tolerate gemcitabine paclitaxel regimen toxicity, there can also be a future possibility of using paclitaxel and curcumin cobound albumin nanoparticles with gemcitabine and this triple therapy may have enhanced therapeutic effects with comparatively less toxic effects. Curcumin has shown its effectiveness with the constituents of FOLFIRINOX in other types of cancers, therefore there is a need for curcumin FOLFIRINOX combined clinical trials in pancreatic cancer as curcumin has the potential to increase the effectiveness of FOLFIRINOX as well as reduce its toxic side effects.
Pancreatic adenocarcinoma is not the most frequent cancer, but it is one of the deadliest cancers... more Pancreatic adenocarcinoma is not the most frequent cancer, but it is one of the deadliest cancers. The 5-year survival rate is 9% only. It is usually diagnosed at a later stage when surgical resection is not possible and metastases have already spread to other parts of the body. Developing early screening tools can help in diagnosing pancreatic cancer at initial and earlier stages when surgical resection is still a possibility leading to more years of survival and a potential cure. Different studies show the importance of identification of pancreatic carcinoma before large growth in tumor size. Recurrence after surgery is late if serum tumor marker level is comparatively less, tumor size is small and it is localized with no lymph node or vascular invasion and so according to different studies, early detection of tumor lead to more median survival time. There are many pancreatic carcinoma serum tumor markers, but most of them do not improve upon CA19-9 which is considered a gold standard pancreatic carcinoma serum marker although CA 19-9 also does not have perfect sensitivity and specificity. Because of less than 100% sensitivity and specificity, screening tests, using serum markers are mostly not recommended for the general population, although they are recommended for high-risk populations. Here we present a brief review about Ca 19-9 and some other pancreatic adenocarcinoma serum tumor markers including THBS2, MIC-1, sTRA, CEACAM1, CA 494, Span-1 and PAM4 which show some improvement over CA19-9. CA 19-9 is considered the standard pancreatic adenocarcinoma serum tumor marker but there are other pancreatic adenocarcinoma serum tumor markers with comparatively better sensitivity and specificity. THBS2 has comparatively less sensitivity but better specificity compared to CA 19-9. PAM4 has comparatively less or equal sensitivity but better specificity compared to CA 19-9. CEACAM1 and CA 494 have comparatively better sensitivity and specificity compared to CA 19-9. Span-1 has comparatively better sensitivity but less or equal specificity compared to CA19-9. MIC-1 has comparatively better sensitivity but less specificity compared to CA 19-9. sTRA has comparatively better sensitivity and equal specificity, also it is secreted by pancreatic adenocarcinoma cells which are different from those which secrete CA19-9. There is a possibility that a combination of these serum markers in screening tests may yield more sensitive and specific results that can be used for screening high risk as well as the general population.
KDP, Editor: Clemens Willemsen, ISBN: 979-87-0587-803-1, 2021
What was an innovation at one time, like the first personal computer, is nowadays ‘commercial of ... more What was an innovation at one time, like the first personal computer, is nowadays ‘commercial of the shelf’ and we take this for granted. The use of computers for business and private life has had a big impact on society during the last four decades in the way we work and communicate as well as the interaction between people and machines. No longer is it just man who controls a process by using a machine as the machine has become more or less independent and controls the process where man is supervising. Computers and machines are more and more integrated i.e. printing this book ‘on demand’ starts at a website where you order the book, payment is taken care of, the command to print is given to the printer anywhere in the world and delivery at home will follow. Man is ‘only’ involved in the final step of driving the delivery truck to your home and even this last step could be done by a drone. This is just an example of how information technology has greatly influenced our lives these last forty years and what this book is all about. Information technology is regarded in this book as the way data is electronically processed in interaction with humans. A variety of international authors show their involvement on developments of information technology and innovations during the last four decades. Many authors have come together for this book to write about their experience and knowledge in this timespan focusing on their expertise. They come from The Netherlands, Israel, The Philippines and Pakistan. The authors are experts in their field and or attached to universities in Europe, the USA and Asia. These are academics as well as professionals in their own field who want to share the developments they have witnessed with any laymen. Most of the chapters can be read individually and in any order. You can find out more on subjects like soft & hardware, machine language, search engines, medical, DNA, et cetera
Pancreatic cancer is one of the most lethal cancer. Developing early screening tools can help in ... more Pancreatic cancer is one of the most lethal cancer. Developing early screening tools can help in diagnosing pancreatic cancer at earlier stages when surgical resection is still a possibility leading to more years of survival and a potential cure. Here a review is presented about CA 19-9 and some other pancreatic adenocarcinoma serum tumor markers including THBS2, MIC-1, sTRA, CEACAM1, CA 494, Span-1, and PAM4 that show some improvement over CA19-9. A combination of these serum markers in screening tests may yield more sensitive and specific results that can be used for screening high risk as well as the general population. The effectiveness of chemotherapeutic drugs is limited in pancreatic cancer. There is a likelihood that the combination of standard chemotherapy with natural compounds having anti-cancer potential like curcumin will increase the effectiveness of treatment as well as reduce the toxic side effects of standard chemotherapeutic agents. Another review is presented about the potential use of curcumin with standard chemotherapy in pancreatic cancer to increase median survival in pancreatic cancer in comparatively less toxic, novel ways.
Cancer is a leading cause of death globally, accounting for around one in six deaths worldwide. T... more Cancer is a leading cause of death globally, accounting for around one in six deaths worldwide. This highlights the need to find effective prevention and recovery strategies. Physical activity, encompassing all bodily movements that consume energy, is significantly linked to cancer risk and survival. 28% of adults are insufficiently active, making physical inactivity the fourth leading risk factor for global mortality. Approximately one-third of cancer deaths are due to low physical activity and a poor diet. This narrative review explores the relationship between physical activity and cancer prevention, recovery, and recurrence. The findings indicate that adhering to recommended physical activity levels can significantly reduce the risk of various cancers, including breast, endometrial, kidney/renal, colon, rectal, liver, lung, bladder, head and neck cancer, gastric cardia, esophageal adenocarcinoma, myeloma, myeloid leukemia, and non-Hodgkin lymphoma. Physical activity aids in cancer recovery by reducing treatment side effects, enhancing physical fitness, mental health, and quality of life, and reducing recurrence risk. It influences cancer progression by controlling genomic instability, metabolic regulation, hormonal balance, and mitochondrial and immune function enhancement. Despite the known benefits, integrating physical activity into cancer care is not widespread due to barriers like pain, fatigue, a lack of motivation, and insufficient information. In conclusion, increasing physical activity across all life domains can markedly reduce cancer's burden and improve well-being. Personalized physical activity goals are recommended for individuals of all ages, including children with cancer. The study also recommends further research into different types of physical activities and their impact on various cancer types This is crucial for developing targeted interventions and comprehensive care strategies to harness the full potential of physical activity in cancer control.
Mental disorders are prevalent worldwide, often causing significant distress and impairment acros... more Mental disorders are prevalent worldwide, often causing significant distress and impairment across various life domains. Furthermore, they may lead to psychosocial disabilities exacerbated by stigma, discrimination, and social exclusion that hinder full societal participation and frequently result in human rights violations denying access to education, work, high-quality health, and reproductive rights. Therefore, a comprehensive and coordinated response to mental health requires a biopsychosocial approach and the integration of holistic promotion, prevention, support, care, and rehabilitation. Effective interventions need to be recovery-focused and should include social interventions. This editorial discusses the social interventions that can be utilized to address psychosocial disabilities in individuals with severe mental disorders. There is a need for developing innovative strategies, tools, and digital solutions, the provision of psychoeducation and caregiver support, along with conducting recovery-oriented research and provider training. Furthermore, the focus should be more on strengths instead of pathology and on cultivating a mental health-promoting environment. This requires inclusive policies, increased advocacy to decrease stigma and promote human rights, redirecting funds to community-based services from long-stay mental hospitals, and a multisectoral collaboration between different sectors such as employment, education, health, housing, social, and judicial sectors to provide support across different life stages, facilitate access to human rights, and attain equal opportunities to help individuals with severe mental disorders reach their full potential and live a meaningful life.
Background Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockd... more Background Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale—21 Items (DASS-21) for mental health assessment, and th...
The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the tec... more The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the technological and digital revolution. A number of different innovations have taken place during this time period, from inventions of newer types of medicines, innovative surgical procedures, in-depth investigative methods, and advanced technological devices. In the 1980s, a number of technological innovations took place including the emergence of the first commercial MRI scanner, personal glucose meter, and cochlear implants. There were surgical advancements like laser cataract surgery, the invention of surgical robot, and, the intravascular stent. There was development of newer types of medications like the invention of Human Insulin and the first commercial hepatitis B vaccine. Polymerase chain reaction (PCR)and automated DNA sequencer were invented and DNA fingerprinting was done for the first time during this decade. In the 1990s, Human Genome Project began and Dolly, the sheep became the first mammal cloned. Newer treatment modalities began like cancer immunotherapy and targeted cancer therapy. Combination drug therapy for HIV (HAART) extended HIV survival. The first human embryonic stem cell line was created and Q-switched lasers, DNA microarray, and bionic limbs were invented during this decade. The 2000s witnessed the completion of the Human Genome Project with the completion of sequencing of the human genome. The first full-face transplant and first telesurgery were also done during this time period. Capsule endoscopy got FDA approval during this decade and there was invention of HPV vaccination. In the 2010s, the first successful synthetic cell, first artificial pancreas, and the first 3D-printed heart using human cells were created. The first skull transplant was done. Bionic Eye was invented, TAVR and eTNS System were given FDA approval. The first cancer vaccine (sipuleucel-T), first Ebola vaccine, and a new drug called Sofosbuvir with a 95% cure rate for Hepatitis C were FDA approved. Checkpoint inhibitor therapy was invented and the first gene therapy and CART cell therapy were given FDA approval. Genome Guided Solid Tumor Diagnosis began and the use of Artificial Intelligence initiated especially in preventative and diagnostic healthcare. During the COVID-19 pandemic, different COVID-19 vaccinations were given FDA or WHO emergency use authorization in 2020 and 2021 including Pfizer-BioNTech, Moderna, Janssen, AstraZeneca, Sinopharm, Sinovac, and COVAXIN. These innovations have opened up possibilities that were previously unimaginable in earlier decades, and have also paved the way for future advancements in medical research and delivery of healthcare.
The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the tec... more The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the technological and digital revolution. A number of different innovations have taken place during this time period, from inventions of newer types of medicines, innovative surgical procedures, in-depth investigative methods, and advanced technological devices. In the 1980s, a number of technological innovations took place including the emergence of the first commercial MRI scanner, personal glucose meter, and cochlear implants. There were surgical advancements like laser cataract surgery, the invention of surgical robot, and, the intravascular stent. There was development of newer types of medications like the invention of Human Insulin and the first commercial hepatitis B vaccine. Polymerase chain reaction (PCR)and automated DNA sequencer were invented and DNA fingerprinting was done for the first time during this decade. In the 1990s, Human Genome Project began and Dolly, the sheep became the first mammal cloned. Newer treatment modalities began like cancer immunotherapy and targeted cancer therapy. Combination drug therapy for HIV (HAART) extended HIV survival. The first human embryonic stem cell line was created and Q-switched lasers, DNA microarray, and bionic limbs were invented during this decade. The 2000s witnessed the completion of the Human Genome Project with the completion of sequencing of the human genome. The first full-face transplant and first telesurgery were also done during this time period. Capsule endoscopy got FDA approval during this decade and there was invention of HPV vaccination. In the 2010s, the first successful synthetic cell, first artificial pancreas, and the first 3D-printed heart using human cells were created. The first skull transplant was done. Bionic Eye was invented, TAVR and eTNS System were given FDA approval. The first cancer vaccine (sipuleucel-T), first Ebola vaccine, and a new drug called Sofosbuvir with a 95% cure rate for Hepatitis C were FDA approved. Checkpoint inhibitor therapy was invented and the first gene therapy and CART cell therapy were given FDA approval. Genome Guided Solid Tumor Diagnosis began and the use of Artificial Intelligence initiated especially in preventative and diagnostic healthcare. During the COVID-19 pandemic, different COVID-19 vaccinations were given FDA or WHO emergency use authorization in 2020 and 2021 including Pfizer-BioNTech, Moderna, Janssen, AstraZeneca, Sinopharm, Sinovac, and COVAXIN. These innovations have opened up possibilities that were previously unimaginable in earlier decades, and have also paved the way for future advancements in medical research and delivery of healthcare.
It is usually assumed that written word is dependent upon spoken word and in aphasia and similar ... more It is usually assumed that written word is dependent upon spoken word and in aphasia and similar disorders, speech and written components are equally affected. But there are many cases where it can be seen that its not always the same and speech and written components are many a times differently affected. Obligatory phonological mediation hypothesis and orthographic autonomy hypothesis represent these conflicting perspectives. According to the obligatory phonological mediation hypothesis, written language necessarily involves phonological mediation and is entirely dependent upon spoken language. The semantic system activates the phonological form of a word, which then activates the corresponding orthographic representation. In contrast, the orthographic autonomy hypothesis posits that the lexical orthographic representations of words can be accessed without any necessary phonological mediation and can be directly activated from the semantic system. The obligatory phonological mediation and orthographic autonomy hypotheses predicts differently the possible effects of brain damage on written naming. On the basis of the phonological mediation hypothesis, an impairment at the level of the phonological lexicon should always affect both spoken and written naming and in double naming tasks, the word selected for a written response should always correspond to the one selected for a spoken output. But on the basis of orthographic autonomy hypothesis, the orthographic lexicon can be accessed directly from semantics therefore it should be possible to observe cases with impaired spoken naming due to damage to the phonological lexicon with no written naming deficit and double naming tasks in spoken and written modalities may give rise to lexically inconsistent responses. In support of this view, a number of cases showing dissociation in phonological lexical forms and orthographic forms including spared knowledge of orthographic forms despite an impairment affecting phonological lexical forms with intact articulatory abilities or lexically inconsistent responses in consecutive double naming tasks in different modalities of writing and speech have been reported across a number of languages. Here, different case studies showing dissociation in phonological lexical forms (spoken speech) and orthographic forms (writing) are reviewed providing evidence that access to the orthographic form of words can occur independently.
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory s... more Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The earliest case of this infection is dated back to 17 November 2019 in Wuhan, China. The virus later spread to other countries all over the world through human-to-human transmission. On 11th March 2020 the WHO declared it a pandemic. SARS-CoV-2 is a positive-sense single-stranded RNA virus that is contagious in humans. It is the successor to SARS-CoV-1, the strain that caused the 2002-2004 SARS outbreak. The case fatality ratio for COVID-19 has been much lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll. The virus is primarily spread between people during close contact, most often via small droplets produced by coughing, sneezing, and talking. On 26th February, Pakistan confirmed its first two cases of the coronavirus. Lockdown was announced by different provincial governments on 21st march and it remained till 9th of may all over the country. In early June, case numbers began rising far faster. As of June 22nd 2020, Pakistan has 185,034 confirmed cases, Sindh has the highest number of confirmed cases at 71,092 closely followed by Punjab at 68,308. Khyber Pakhtunkhwa has 22,633 cases, Islamabad capital territory has 11,219 cases, Balochistan has 9,587 cases, Gilgit Baltistan has 1326 cases, and Azad Kashmir has 869 cases. Major cities in Pakistan have the highest number of COVID-19 cases. Males have comparatively high COVID-19 incidence and mortality in Pakistan at 74.06% and 73.92% respectively. The comparatively higher COVID-19 incidence in males seems related to lack of social distancing measures. COVID-19 incidence is highest in 20-40 age group in both genders and 45% of confirmed cases belong to this age group. Also this age range usually lags behind following social distancing measures. Mortality is comparatively less in this age group but this age range can still transmit infection to more vulnerable age groups. Although the age group of 50-69 makes up only 21.61% of COVID-19 confirmed cases, this age range has the highest mortality and constitutes 55.14% of COVID-19 associated deaths as older people and people with pre-existing medical conditions are more vulnerable to becoming severely ill with the virus. Since early June, after the relaxation of lockdown measures there is a sharp increase in COVID-19 cases in Pakistan, which also relates to lack of precautionary measures by citizens. The best way to prevent COVID-19 is to avoid being exposed to this virus by maintaining good social distance and proper sanitization.
Pancreatic cancer is one of the most lethal cancer and there is innate resistance to standard che... more Pancreatic cancer is one of the most lethal cancer and there is innate resistance to standard chemotherapy regimens in pancreatic cancer. Gemcitabine was approved in 1996 for the chemotherapeutic treatment of metastatic pancreatic cancer. FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) and gemcitabine plus nab-paclitaxel combination therapies have shown superiority to gemcitabine monotherapy but are more toxic than gemcitabine monotherapy. Therefore, gemcitabine monotherapy is still one of the standard treatments for pancreatic cancer for patients who can't tolerate the toxicity of other chemotherapeutic regimens. The effectiveness of standard chemotherapeutic drugs is limited in pancreatic cancer due to drug resistance, and undesirable side effects. There is a likelihood that the combination of standard chemotherapy with natural compounds having anti-cancer potential like curcumin will increase the effectiveness of treatment as well as reduce the toxic side effects of standard chemotherapeutic agents. Curcumin is a polyphenolic compound isolated from the rhizome of Curcuma longa (turmeric) and is considered a promising anticancer agent. Here, a review is presented about the potential use of curcumin with standard chemotherapy in pancreatic cancer as there is a potential in different combination regimens of curcumin in pancreatic cancer to increase median survival in pancreatic cancer in comparatively less toxic, novel ways. Also, curcumin combination chemotherapy may lead to the improvement of cancer and chemotherapy-related symptoms. The poor bioavailability of curcumin has been the major obstacle for its clinical application. To overcome this problem, several curcumin preparations have been developed including cost-effective preparation methods to increase the bioavailability of curcumin. Different studies have shown that gemcitabine curcumin combination regimen can effectively increase survival with less toxicity in patients who are resistant to gemcitabine and can't even tolerate the toxicity of other chemotherapeutic combination regimens. Although clinical trials are needed, Paclitaxel and curcumin cobound albumin nanoparticles also have the potential to become another alternative chemotherapeutic regimen for pancreatic cancer. For those patients who can tolerate gemcitabine paclitaxel regimen toxicity, there can also be a future possibility of using paclitaxel and curcumin cobound albumin nanoparticles with gemcitabine and this triple therapy may have enhanced therapeutic effects with comparatively less toxic effects. Curcumin has shown its effectiveness with the constituents of FOLFIRINOX in other types of cancers, therefore there is a need for curcumin FOLFIRINOX combined clinical trials in pancreatic cancer as curcumin has the potential to increase the effectiveness of FOLFIRINOX as well as reduce its toxic side effects.
Pancreatic adenocarcinoma is not the most frequent cancer, but it is one of the deadliest cancers... more Pancreatic adenocarcinoma is not the most frequent cancer, but it is one of the deadliest cancers. The 5-year survival rate is 9% only. It is usually diagnosed at a later stage when surgical resection is not possible and metastases have already spread to other parts of the body. Developing early screening tools can help in diagnosing pancreatic cancer at initial and earlier stages when surgical resection is still a possibility leading to more years of survival and a potential cure. Different studies show the importance of identification of pancreatic carcinoma before large growth in tumor size. Recurrence after surgery is late if serum tumor marker level is comparatively less, tumor size is small and it is localized with no lymph node or vascular invasion and so according to different studies, early detection of tumor lead to more median survival time. There are many pancreatic carcinoma serum tumor markers, but most of them do not improve upon CA19-9 which is considered a gold standard pancreatic carcinoma serum marker although CA 19-9 also does not have perfect sensitivity and specificity. Because of less than 100% sensitivity and specificity, screening tests, using serum markers are mostly not recommended for the general population, although they are recommended for high-risk populations. Here we present a brief review about Ca 19-9 and some other pancreatic adenocarcinoma serum tumor markers including THBS2, MIC-1, sTRA, CEACAM1, CA 494, Span-1 and PAM4 which show some improvement over CA19-9. CA 19-9 is considered the standard pancreatic adenocarcinoma serum tumor marker but there are other pancreatic adenocarcinoma serum tumor markers with comparatively better sensitivity and specificity. THBS2 has comparatively less sensitivity but better specificity compared to CA 19-9. PAM4 has comparatively less or equal sensitivity but better specificity compared to CA 19-9. CEACAM1 and CA 494 have comparatively better sensitivity and specificity compared to CA 19-9. Span-1 has comparatively better sensitivity but less or equal specificity compared to CA19-9. MIC-1 has comparatively better sensitivity but less specificity compared to CA 19-9. sTRA has comparatively better sensitivity and equal specificity, also it is secreted by pancreatic adenocarcinoma cells which are different from those which secrete CA19-9. There is a possibility that a combination of these serum markers in screening tests may yield more sensitive and specific results that can be used for screening high risk as well as the general population.
KDP, Editor: Clemens Willemsen, ISBN: 979-87-0587-803-1, 2021
What was an innovation at one time, like the first personal computer, is nowadays ‘commercial of ... more What was an innovation at one time, like the first personal computer, is nowadays ‘commercial of the shelf’ and we take this for granted. The use of computers for business and private life has had a big impact on society during the last four decades in the way we work and communicate as well as the interaction between people and machines. No longer is it just man who controls a process by using a machine as the machine has become more or less independent and controls the process where man is supervising. Computers and machines are more and more integrated i.e. printing this book ‘on demand’ starts at a website where you order the book, payment is taken care of, the command to print is given to the printer anywhere in the world and delivery at home will follow. Man is ‘only’ involved in the final step of driving the delivery truck to your home and even this last step could be done by a drone. This is just an example of how information technology has greatly influenced our lives these last forty years and what this book is all about. Information technology is regarded in this book as the way data is electronically processed in interaction with humans. A variety of international authors show their involvement on developments of information technology and innovations during the last four decades. Many authors have come together for this book to write about their experience and knowledge in this timespan focusing on their expertise. They come from The Netherlands, Israel, The Philippines and Pakistan. The authors are experts in their field and or attached to universities in Europe, the USA and Asia. These are academics as well as professionals in their own field who want to share the developments they have witnessed with any laymen. Most of the chapters can be read individually and in any order. You can find out more on subjects like soft & hardware, machine language, search engines, medical, DNA, et cetera
Pancreatic cancer is one of the most lethal cancer. Developing early screening tools can help in ... more Pancreatic cancer is one of the most lethal cancer. Developing early screening tools can help in diagnosing pancreatic cancer at earlier stages when surgical resection is still a possibility leading to more years of survival and a potential cure. Here a review is presented about CA 19-9 and some other pancreatic adenocarcinoma serum tumor markers including THBS2, MIC-1, sTRA, CEACAM1, CA 494, Span-1, and PAM4 that show some improvement over CA19-9. A combination of these serum markers in screening tests may yield more sensitive and specific results that can be used for screening high risk as well as the general population. The effectiveness of chemotherapeutic drugs is limited in pancreatic cancer. There is a likelihood that the combination of standard chemotherapy with natural compounds having anti-cancer potential like curcumin will increase the effectiveness of treatment as well as reduce the toxic side effects of standard chemotherapeutic agents. Another review is presented about the potential use of curcumin with standard chemotherapy in pancreatic cancer to increase median survival in pancreatic cancer in comparatively less toxic, novel ways.
Cancer is a leading cause of death globally, accounting for around one in six deaths worldwide. T... more Cancer is a leading cause of death globally, accounting for around one in six deaths worldwide. This highlights the need to find effective prevention and recovery strategies. Physical activity, encompassing all bodily movements that consume energy, is significantly linked to cancer risk and survival. 28% of adults are insufficiently active, making physical inactivity the fourth leading risk factor for global mortality. Approximately one-third of cancer deaths are due to low physical activity and a poor diet. This narrative review explores the relationship between physical activity and cancer prevention, recovery, and recurrence. The findings indicate that adhering to recommended physical activity levels can significantly reduce the risk of various cancers, including breast, endometrial, kidney/renal, colon, rectal, liver, lung, bladder, head and neck cancer, gastric cardia, esophageal adenocarcinoma, myeloma, myeloid leukemia, and non-Hodgkin lymphoma. Physical activity aids in cancer recovery by reducing treatment side effects, enhancing physical fitness, mental health, and quality of life, and reducing recurrence risk. It influences cancer progression by controlling genomic instability, metabolic regulation, hormonal balance, and mitochondrial and immune function enhancement. Despite the known benefits, integrating physical activity into cancer care is not widespread due to barriers like pain, fatigue, a lack of motivation, and insufficient information. In conclusion, increasing physical activity across all life domains can markedly reduce cancer's burden and improve well-being. Personalized physical activity goals are recommended for individuals of all ages, including children with cancer. The study also recommends further research into different types of physical activities and their impact on various cancer types This is crucial for developing targeted interventions and comprehensive care strategies to harness the full potential of physical activity in cancer control.
Mental disorders are prevalent worldwide, often causing significant distress and impairment acros... more Mental disorders are prevalent worldwide, often causing significant distress and impairment across various life domains. Furthermore, they may lead to psychosocial disabilities exacerbated by stigma, discrimination, and social exclusion that hinder full societal participation and frequently result in human rights violations denying access to education, work, high-quality health, and reproductive rights. Therefore, a comprehensive and coordinated response to mental health requires a biopsychosocial approach and the integration of holistic promotion, prevention, support, care, and rehabilitation. Effective interventions need to be recovery-focused and should include social interventions. This editorial discusses the social interventions that can be utilized to address psychosocial disabilities in individuals with severe mental disorders. There is a need for developing innovative strategies, tools, and digital solutions, the provision of psychoeducation and caregiver support, along with conducting recovery-oriented research and provider training. Furthermore, the focus should be more on strengths instead of pathology and on cultivating a mental health-promoting environment. This requires inclusive policies, increased advocacy to decrease stigma and promote human rights, redirecting funds to community-based services from long-stay mental hospitals, and a multisectoral collaboration between different sectors such as employment, education, health, housing, social, and judicial sectors to provide support across different life stages, facilitate access to human rights, and attain equal opportunities to help individuals with severe mental disorders reach their full potential and live a meaningful life.
Background Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockd... more Background Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale—21 Items (DASS-21) for mental health assessment, and th...
The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the tec... more The field of Medicine has advanced at a very fast pace during the last 40 years thanks to the technological and digital revolution. A number of different innovations have taken place during this time period, from inventions of newer types of medicines, innovative surgical procedures, in-depth investigative methods, and advanced technological devices. In the 1980s, a number of technological innovations took place including the emergence of the first commercial MRI scanner, personal glucose meter, and cochlear implants. There were surgical advancements like laser cataract surgery, the invention of surgical robot, and, the intravascular stent. There was development of newer types of medications like the invention of Human Insulin and the first commercial hepatitis B vaccine. Polymerase chain reaction (PCR)and automated DNA sequencer were invented and DNA fingerprinting was done for the first time during this decade. In the 1990s, Human Genome Project began and Dolly, the sheep became the first mammal cloned. Newer treatment modalities began like cancer immunotherapy and targeted cancer therapy. Combination drug therapy for HIV (HAART) extended HIV survival. The first human embryonic stem cell line was created and Q-switched lasers, DNA microarray, and bionic limbs were invented during this decade. The 2000s witnessed the completion of the Human Genome Project with the completion of sequencing of the human genome. The first full-face transplant and first telesurgery were also done during this time period. Capsule endoscopy got FDA approval during this decade and there was invention of HPV vaccination. In the 2010s, the first successful synthetic cell, first artificial pancreas, and the first 3D-printed heart using human cells were created. The first skull transplant was done. Bionic Eye was invented, TAVR and eTNS System were given FDA approval. The first cancer vaccine (sipuleucel-T), first Ebola vaccine, and a new drug called Sofosbuvir with a 95% cure rate for Hepatitis C were FDA approved. Checkpoint inhibitor therapy was invented and the first gene therapy and CART cell therapy were given FDA approval. Genome Guided Solid Tumor Diagnosis began and the use of Artificial Intelligence initiated especially in preventative and diagnostic healthcare. During the COVID-19 pandemic, different COVID-19 vaccinations were given FDA or WHO emergency use authorization in 2020 and 2021 including Pfizer-BioNTech, Moderna, Janssen, AstraZeneca, Sinopharm, Sinovac, and COVAXIN. These innovations have opened up possibilities that were previously unimaginable in earlier decades, and have also paved the way for future advancements in medical research and delivery of healthcare.
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory s... more Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The earliest case of this infection is dated back to 17 November 2019 in Wuhan, China. The virus later spread to other countries all over the world through human-to-human transmission. On 11th March 2020 the WHO declared it a pandemic. SARS-CoV-2 is a positive-sense single-stranded RNA virus that is contagious in humans. It is the successor to SARS-CoV-1, the strain that caused the 2002–2004 SARS outbreak. The case fatality ratio for COVID-19 has been much lower than SARS of 2003, but the transmission has been significantly greater, with a significant total death toll. The virus is primarily spread between people during close contact, most often via small droplets produced by coughing, sneezing, and talking. On 26th February, Pakistan confirmed its first two cases of the coronavirus. Lockdown was announced by different provincial governments on 21st ma...
Pancreatic cancer is one of the most lethal cancer and there is innate resistance to standard che... more Pancreatic cancer is one of the most lethal cancer and there is innate resistance to standard chemotherapy regimens in pancreatic cancer. Gemcitabine was approved in 1996 for the chemotherapeutic treatment of metastatic pancreatic cancer. FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) and gemcitabine plus nab-paclitaxel combination therapies have shown superiority to gemcitabine monotherapy but are more toxic than gemcitabine monotherapy. Therefore, gemcitabine monotherapy is still one of the standard treatments for pancreatic cancer for patients who can’t tolerate the toxicity of other chemotherapeutic regimens. The effectiveness of standard chemotherapeutic drugs is limited in pancreatic cancer due to drug resistance, and undesirable side effects. There is a likelihood that the combination of standard chemotherapy with natural compounds having anti-cancer potential like curcumin will increase the effectiveness of treatment as well as reduce the toxic side effects o...
Pancreatic adenocarcinoma is not the most frequent cancer, but it is one of the deadliest cancers... more Pancreatic adenocarcinoma is not the most frequent cancer, but it is one of the deadliest cancers. The 5-year survival rate is 9% only. It is usually diagnosed at a later stage when surgical resection is not possible and metastases have already spread to other parts of the body. Developing early screening tools can help in diagnosing pancreatic cancer at initial and earlier stages when surgical resection is still a possibility leading to more years of survival and a potential cure. Different studies show the importance of identification of pancreatic carcinoma before large growth in tumor size. Recurrence after surgery is late if serum tumor marker level is comparatively less, tumor size is small and it is localized with no lymph node or vascular invasion and so according to different studies, early detection of tumor lead to more median survival time. There are many pancreatic carcinoma serum tumor markers, but most of them do not improve upon CA19-9 which is considered a gold stan...
It is usually assumed that written word is dependent upon spoken word and in aphasia and similar ... more It is usually assumed that written word is dependent upon spoken word and in aphasia and similar disorders, speech and written components are equally affected. But there are many cases where it can be seen that its not always the same and speech and written components are many a times differently affected. Obligatory phonological mediation hypothesis and orthographic autonomy hypothesis represent these conflicting perspectives. According to the obligatory phonological mediation hypothesis, written language necessarily involves phonological mediation and is entirely dependent upon spoken language. The semantic system activates the phonological form of a word, which then activates the corresponding orthographic representation. In contrast, the orthographic autonomy hypothesis posits that the lexical orthographic representations of words can be accessed without any necessary phonological mediation and can be directly activated from the semantic system. The obligatory phonological media...
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