Biological and Clinical Sciences Research Journal

Single versus Multiple Mini-tract Percutaneous Nephrolithotomy for Staghorn Renal Stone: A Single-Center Study

Jamil Ahmed Khan — Tue, 30 Sep 2025 00:00:00 +0000

Staghorn stones are difficult to treat, which may cause severe complications in the urinary tract. So surgical intervention is necessary. Objective: This study aimed to determine the outcomes of Single versus multiple mini-tract percutaneous nephrolithotomy for Staghorn Renal Stones. Methods: The present randomized controlled trial was conducted at the Department of Urology, Postgraduate Medical Institute (PGMI), Quetta, from January 2025 to June 2025, following permission from the hospital's ethical committee. Individuals of both genders and different age groups with complete or partial staghorn stones and scattered renal stones involving both renal pelvis and calyces were included. The study participants were divided into two groups: Group A and Group B. Each group has 55 individuals. Group A received a single mini-tract (21-Fr sheath) via the percutaneous method, and Group B required multiple mini-tracts (two). To determine the location, dimensions, and hardness of the stones, as well as the anatomy of the renal collecting system, for continuous variables (such as patient characteristics and perioperative data), an independent-sample t-test was employed. The perioperative findings and postoperative outcomes were compared. Statistical analysis was performed using SPSS. Results: A total of 110 individuals with satghorn stones were enrolled in this study, which were randomly divided into single (A) and multiple (B) tract PCNL groups. In a single tract, the mean stone size was 11.68 ± 8.07, whereas in multiple tracts, it was 16.24 ± 10.50. Consequently, there was a notable variation in stone size between the two groups (P = 0.005). When comparing the two groups' operative times, the mean time for a single tract was 101±11.0 minutes, while the mean time for multiple tracts was 121±23.6 minutes (p-value of 0.005). A single-tract hospital stay lasted 4.20±2.21 days, while a multiple-tract hospital stay lasted 4.21±2.10 days. Likewise, 28% of blood transfusions occurred in a single tract, while 16% occurred in multiple tracts. Clavien-Dindo was assigned to the complication of blood transfusion and bleeding, which were the most serious adverse effects associated with the multiple-tract strategy compared to single-tract therapies. Conclusion: The present study concluded that a safe and effective technique for treating staghorn kidney stones is multiple-tract access during PCNL.

Development and Evaluation of Foxnut and Pea Based Functional Biscuits: Nutritional and Organoleptic Perspective

Tue, 30 Sep 2025 00:00:00 +0000

The growing consumer interest in nutritious and functional snacks has driven innovation in bakery products using unconventional, nutrient-dense ingredients. Foxnut and pea flour are promising plant-based sources of protein, fibre, and antioxidants that can enhance the nutritional profile of bakery products. Objective: To develop and evaluate functional biscuits (fox pea sticks) fortified with foxnut and pea flour, assessing their nutritional, physicochemical, and sensory characteristics. Methods: Three biscuit formulations were prepared: T₀ (control, 100% wheat flour), T₁ (5% foxnut + 5% pea flour), and T₂ (10% foxnut + 10% pea flour), sweetened with 1.5% stevia as a sugar substitute. Proximate composition, texture profile (hardness, chewiness, springiness, cohesiveness, resilience), antioxidant activity, and sensory attributes were analyzed over a 14-day storage period. Data were statistically evaluated using ANOVA, with significance set at p < 0.01. Results: Substitution with foxnut and pea flour significantly improved the nutritional quality of the biscuits. Protein, dietary fibre, and antioxidant activity were notably higher in T₁ and T₂ compared to T₀. Texture profiling showed a significant (p < 0.01) increase in hardness, chewiness, and springiness in T₂, reflecting enhanced structural integrity. Sensory evaluation revealed that T₂ achieved the highest scores for appearance, texture, taste, and overall acceptability, indicating superior consumer preference. The T₂ formulation maintained its quality and palatability throughout storage. Conclusion: Incorporation of foxnut and pea flour into wheat-based biscuits successfully enhanced nutritional and functional properties without compromising sensory appeal. The optimized T₂ formulation demonstrated the best balance of texture, nutrition, and acceptability, establishing foxnut and pea flour as sustainable, functional ingredients for health-oriented bakery products.

Evaluation of Antibacterial, Antioxidant, Anti-Biofilm, and Anti-Cancer Potential of Magnesium Oxide Nanoparticles Against Multidrug-Resistant Klebsiella Pneumoniae

Tue, 30 Sep 2025 00:00:00 +0000

The emergence of multidrug-resistant (MDR) bacterial pathogens such as Klebsiella pneumoniae has intensified the global demand for alternative therapeutic agents. Magnesium oxide nanoparticles (MgO-NPs) possess promising antimicrobial, antioxidant, and anticancer properties, making them potential candidates for addressing resistance-related challenges. This study aimed to evaluate the antibacterial, antioxidant, anti-biofilm, and anticancer activities of MgO-NPs against MDR Klebsiella pneumoniae clinical isolates. Objective: To evaluate the antibacterial, antioxidant, anti-biofilm, and anticancer activities of MgO-NPs against multidrug-resistant Klebsiella pneumoniae clinical isolates. Methods: A laboratory-based experimental study was conducted from February to July 2025 at The University of Faisalabad, in collaboration with the Department of Microbiology, Government College University Faisalabad. Three MDR Klebsiella pneumoniae isolates (K.p1, K.p2, K.p3) were tested. Antibacterial activity was determined using agar well diffusion and broth microdilution methods for MIC and MBC estimation. Antioxidant capacity was evaluated via the DPPH radical scavenging assay. Anti-biofilm potential was assessed using crystal violet microtiter plate assays, and anticancer efficacy was tested on HepG2 liver carcinoma cells using the MTT assay. All experiments were conducted in triplicate, and data were analyzed using SPSS v25.0 with a significance level set at p < 0.05. Results: MgO-NPs demonstrated strong, dose-dependent antibacterial effects against MDR K. pneumoniae isolates, with maximum zones of inhibition of 34 mm at 2 mg/mL and MIC values ranging from 125–250 µg/mL. MBC/MIC ratios of 2 confirmed bactericidal activity. Biofilm inhibition reached 88.9% at 1 mg/mL, while pre-established biofilm reduction exceeded 80% across isolates. The DPPH assay revealed concentration-dependent antioxidant activity, achieving 65.3 ± 1.2% radical scavenging at 200 µg/mL, compared to 93.4% for ascorbic acid. MTT assays indicated significant cytotoxicity in HepG2 cells, with 76.5 ± 2.4% cell death at 500 µg/mL concentration, confirming potent anticancer potential. Conclusion: MgO nanoparticles exhibited significant antibacterial, antioxidant, anti-biofilm, and anticancer activities, highlighting their potential as broad-spectrum bioactive agents. Their bactericidal and cytotoxic effects suggest a promising role in managing MDR bacterial infections and hepatocellular carcinoma. Further in vivo studies are recommended to validate their safety and therapeutic efficacy for clinical application, particularly in regions with high antibiotic resistance such as Pakistan.

Knowledge and Practices of Intensive Care Unit Nurses Regarding Pain Assessment and Pain Management Among Critically Ill Patients

Tue, 30 Sep 2025 00:00:00 +0000

Practical pain assessment and management are critical components of intensive care, directly influencing recovery outcomes in critically ill patients. Despite the availability of validated tools, such as the Critical-Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS), evidence suggests inconsistent utilization by intensive care unit (ICU) nurses, especially in resource-constrained settings like Pakistan. This study aimed to evaluate ICU nurses' knowledge and practices in pain assessment and management for critically ill patients. Methods: A descriptive cross-sectional study was conducted among 245 ICU nurses across five public and private hospitals in Lahore and Multan, Pakistan. Participants were selected through non-probability convenience sampling. Data were collected using a structured, pre-tested questionnaire comprising demographic variables, knowledge-related items (7 domains), and practice-related items (15 domains). Knowledge and practice were scored and categorized as poor, average, or good. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS version 25. Results: Of the 245 nurses, 75.1% were female, and the majority (50.2%) belonged to the 31–35 years age group. Educationally, 45.3% held a Generic BSN degree, while only 2% had an MSN. Nearly 58% had 2–5 years of ICU experience. The mean knowledge score was 4.46 ± 1.29 (range 1–7); only 24.1% demonstrated good knowledge, 52.7% had average knowledge, and 23.3% had poor knowledge. The mean practice score was 8.59 ± 2.10 (range 1–15); 18.8% demonstrated good practices, 65.3% had average practices, and 15.9% had poor practices. Significant gaps were identified in documentation (only 44.9% recorded pain monitoring) and in the use of standardized tools for non-communicative patients (54.7%). Conclusion: The findings reveal that while ICU nurses possess a moderate understanding of pain assessment and management, significant deficiencies persist in both knowledge and practice, particularly in documentation and the utilization of standardized tools. Targeted educational interventions, the integration of pain management modules into nursing curricula, and institutional policies mandating the consistent use of validated assessment tools are urgently needed to strengthen ICU nurses' competencies. Such measures could enhance patient outcomes and align clinical practice with international standards of critical care.

Development and Stability Assessment of Guava-Moringa Sauce with Nutritional, Microbial and Physicochemical Analysis

Tue, 30 Sep 2025 00:00:00 +0000

Moringa (Moringa oleifera), belonging to the Moringaceae family, is a nutrient-dense plant rich in essential phytochemicals that effectively combat malnutrition. Similarly, guava (Psidium guajava L.), often termed the “Apple of the Tropics,” is recognized for its year-round production, affordability, and high nutritional value. The combination of guava and moringa presents an innovative approach to developing a functional food product with enhanced nutritional and sensory attributes. Objective: This study aimed to develop and characterize guava–moringa sauce and to evaluate its shelf stability by analyzing its nutritional, microbial, physicochemical, and sensory properties. Methods: A laboratory-based experimental study was carried out from February to July 2025. Four treatment formulations were prepared: T₀ (100% guava), T₁ (98% guava + 2% moringa), T₂ (96% guava + 4% moringa), and T₃ (94% guava + 6% moringa). The sauce was prepared following the procedure of Ritthiruangdej et al. (2011) with slight modifications. Physicochemical parameters including moisture, ash, fat, crude fiber, crude protein, and color were analyzed on days 0, 7, and 14. Color was determined using a handheld spectrocolorimeter (Lovibond LC-400), and viscosity was measured using a BDV-8S viscometer (No.18DN3270, Shandong Co., Ltd). Microbial stability was assessed through bacterial and mold counts, while sensory evaluation was performed by a trained panel of 10 members using a 9-point hedonic scale. Data were analyzed with Statistix 8.1, and results were considered significant at p < 0.05. Results: The addition of moringa significantly enhanced the crude fiber content in T₂ and T₃ compared with the control (T₀). T₃ exhibited the highest fiber content but had slightly lower sensory scores for taste and texture. T₂ and T₃ demonstrated the most favorable balance between enhanced nutritional quality and acceptable sensory attributes. Throughout the 14-day storage, all formulations remained microbiologically safe. However, T₂ maintained better moisture and texture stability, while T₃ exhibited improved sensory parameters including color and consistency, though with minor flavor alterations as moringa concentration increased. Conclusion: Incorporation of moringa leaves, particularly at 4–6% concentration, improved the nutritional profile and shelf stability of guava-based sauces without compromising sensory acceptability. T₃ showed superior overall sensory quality, including texture, flavor, aroma, and color, suggesting that moringa can serve as a natural stabilizer and functional additive in plant-based sauces, offering both nutritional and gastronomic benefits.

Relationship of Burnout with Mental Stress, Job Satisfaction among Nurses

Muhammad Shahzad, Mehreen Nafees, Sumbal Khizer — Tue, 30 Sep 2025 00:00:00 +0000

Nurses frequently experience high levels of stress due to demanding workloads, emotional strain, and complex healthcare environments, which may contribute to burnout and reduced job satisfaction. Understanding the interplay between mental stress, burnout, and job satisfaction is essential to improving nursing wellbeing and patient care quality. Objective: To evaluate the relationship between mental stress and nurses’ burnout levels and job satisfaction. Methodology: Nurses working in the Nursing Department of the tertiary care hospital were cross-sectionally analyzed from April 2023 to April 2024. A total of 90 nurses working in the hospital for 1 year or more were included in the study.Personal data of nurses including gender and marital status were noted. Mental stress was evaluated by translated version of 28-item questionnaire designed by Bradbury and Graves.Burnout was assessed by 22-item questionnaire designed by Maslash and Jackson.Job satisfaction was determined by 39-item questionnaire designed by Visoki and Chrome on 5 dimensions; job component, promotion, supervisor, payment, colleague. Results: A significant F ratio of 44.818 was recorded between burnout and mental stress. The R2 value showed that a 0.09% change in burnout level can be predicted by emotional intelligence. There was also a significant F ratio of 772.797 between job satisfaction and relationship management, a component of emotional intelligence. A 0.61% change in job satisfaction could be predicted by relationship management.Burnout was significantly associated to all components of emotional intelligence; relationship management (0.363), social awareness (0.213), self-management (0.148) and self-awareness (0.147). Conclusion: Emotional intelligence has a significant impact on level of burnout in nurses with a high EI leading to reduced burnout.

Normal Pressure Hydrocephalus in the Elderly: A Narrative Review of Diagnostic Complexity, Biomarker Potential, and Surgical Outcomes

Thu, 02 Oct 2025 00:00:00 +0000

Normal pressure hydrocephalus (NPH) is a reversible cause of dementia in older adults, characterized by the clinical triad of gait disturbance, cognitive decline, and urinary incontinence. Owing to overlapping symptoms and low cerebrospinal fluid (CSF) Aβ42 levels, NPH is frequently misdiagnosed as Alzheimer's or Parkinson's disease. Objective: To provide a comprehensive narrative review of the pathophysiology, diagnostic challenges, treatment options, and prognostic markers of NPH, with a particular focus on implications for low- and middle-income countries (LMICs). Methods: Relevant literature published between 2000 and 2025 was retrieved from PubMed, Scopus, and Google Scholar using the keywords "normal pressure hydrocephalus," "cerebrospinal fluid dynamics," "ventriculoperitoneal shunting," and "biomarkers." Both clinical and experimental studies addressing NPH's pathophysiology, diagnostic modalities, and treatment outcomes were reviewed, with emphasis on studies applicable to LMIC contexts such as Pakistan. Results: Evidence indicates that disrupted CSF circulation and ventriculomegaly underlie NPH, with diffusion tensor imaging and arterial spin-labelling MRI offering diagnostic refinement. However, limited access to advanced neuroimaging and cultural perceptions of symptoms as "normal aging" contribute to underdiagnosis in LMICs. Ventriculoperitoneal shunting, particularly with fixed-pressure devices, consistently improves gait performance, while cognitive and urinary outcomes are variable. Post-shunt changes in CSF biomarkers (Aβ42, tau) and serum markers (BDNF, TRPV4) demonstrate potential prognostic value. Functional imaging further correlates reduced cerebral blood flow with symptom severity. Conclusion: NPH remains an under-recognized yet treatable neurological disorder. Increasing awareness, developing simplified diagnostic approaches, and ensuring cost-effective treatment strategies are essential to optimizing patient outcomes, particularly in resource-constrained settings.