Management Of Disease Research Articles

Exploring machine learning approaches for early diabetes risk prediction: A comprehensive examination of health indicators and models

Background: The increased prevalence of morbidity and mortality associated with Type 2 diabetes is due to changing lifestyles, demanding improved disease management measures. To tackle this, scientists are increasingly looking to technological advances, notably machine learning, for illness prevention and management, particularly in non-communicable diseases. The emphasis is on establishing an early detection system to identify Type 2 diabetes risk factors, enabling prompt treatments and preventative steps to reduce the disease’s rising prevalence. Materials and methods: The research aimed to assess the association of diabetes class with health indicators. Five machine learning models were employed with cross-validation techniques to predict early diabetes risk. The performance matrices of the models were evaluated and compared with the existing work. Results: In multivariate analysis, we found polyuria (β=3.492; Aor=32.872; 95% CI=11.09,97.35; p<0.001), polydipsia (β=-4.100; Aor=60.378; 95%CI=18.28,199.37; p<0.001), polyphagia (β=1.181; Aor=3.25; 95%CI=1.23,8.57; p=0.017), genital thrush (β=1.08; Aor=2.96; 95%CI=1.26,7.53; p=0.023), irritability (β=2.28; Aor=9.82; 95%CI=3.41,28.26; p<0.001), and partial paresis (β=1.2406; Aor=3.45; 95% CI=1.35,8.79; p=0.009) are the potential health risk indicators for positive diabetes class. Conclusion: Using an interpretable feature learning approach for early diabetes prediction improves the use of global health data. This method forecasts hazards correctly and gives insights into influential aspects. As a result, a more proactive healthcare strategy is implemented, allowing for more prompt treatments and encouraging a more hopeful future by improving patient outcomes and lowering the total burden of diabetes on individuals and healthcare systems.

Tissue Culture in Banana Cultivation: A Review of its Impact on Disease Management, Yield Improvement, and Sustainable Production

In several tropical and subtropical areas, bananas (Musa spp.) are an important food source and commercial crop. Disease transmission and production uncertainty are common problems with traditional propagation techniques such as suckers. By supplying consistent, high-quality, and disease-free planting material, tissue culture, known as micro propagation, represents a potential alternative. The application of tissue culture has greatly enhanced disease management in banana cultivation. Reducing the incidence of ailments like Fusarium wilt, bacterial wilt, and Banana Bunchy Top Virus (BBTV), pathogen-free plantlets are grown in controlled conditions. This strategy lessens the demand for artificial fertilizers while also promoting healthier crops and lessening the impact on the environment. Micropropagated banana plants demonstrated consistent growth, early fruiting, and increased yield in contrast to conventionally propagated plants. Tissue-cultured plants exhibit strong development and genetic uniformity, which contribute to these advantages and more consistent and dependable harvests. By promoting efficient land use and reducing the need for chemical inputs, tissue culture enhances sustainability in the production of bananas. The growing demand for bananas may be met without requiring the increase of agricultural land thanks to tissue culture techniques, which enable the large-scale production of enhanced banana cultivars at a quick rate. Furthermore, using planting material free of disease lowers input costs and crop losses, supporting more environmentally friendly farming methods.

Rapid lateral flow test for Mycobacterium tuberculosis complex and non-tuberculous mycobacteria differentiation.

The diagnosis of mycobacterial infections, including both the Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM), poses a significant global medical challenge. This study proposes a novel approach using immunochromatographic (IC) strip tests for the simultaneous detection of MTBC and NTM. Traditional methods for identifying mycobacteria, such as culture techniques, are hindered by delays in distinguishing between MTBC and NTM, which can affect patient care and disease control. Molecular methods, while sensitive, are resource-intensive and unable to differentiate between live and dead bacteria. In this research, we developed unique monoclonal antibodies (mAbs) against Ag85B, a mycobacterial secretory protein, and successfully implemented IC strip tests named 8B and 9B. These strips demonstrated high concordance rates with conventional methods for detecting MTBC, with positivity rates of 93.9% and 85.9%, respectively. For NTM detection, the IC strip tests achieved a 63.2% detection rate compared to culture methods, considering variations in growth rates among different NTM species. Furthermore, this study highlights a significant finding regarding the potential of MPT64 and Ag85B proteins as markers for MTBC detection. In conclusion, our breakthrough method enables rapid and accurate detection of both MTBC and NTM bacteria within the BACTEC MGIT system. This approach represents a valuable tool in clinical settings for distinguishing between MTBC and NTM infections, thereby enhancing the management and control of mycobacterial diseases. KEY POINTS: • Panel of mAbs for differentiating MTB versus NTM • IC strips for diagnosing MTBC and NTM after the BACTEC MGIT • Combined detection of MTP64 and Ag85B enhances diagnostic accuracy.

Pregnancy outcomes among women with inflammatory bowel disease: A UK tertiary centre experience.

Optimal management of inflammatory bowel disease (IBD) in pregnancy is associated with better pregnancy outcomes. We describe management of IBD during pregnancy and maternal and fetal outcomes of patients from a tertiary UK IBD centre. This is a retrospective observational cohort study of all pregnancies occurring between 2015 and 2021 in a large tertiary IBD centre in the UK. IBD activity and management prior to, during and after pregnancy were recorded along with pregnancy and neonatal outcomes. Associations between IBD-focused interventions and any adverse pregnancy outcomes, as well as the association between IBD severity and treatments and adverse maternofetal outcomes were assessed. Pregnancies in 130 women with IBD were included for analysis. The mean maternal age at delivery was 30.5 (± 4.7) years. At conception, 73 women (56.2%) were in clinical remission and 24 (18.4%) were treated with a biologic agent. Active disease during pregnancy, measured by physician global assessment, was less frequent in women who were in clinical remission at conception, compared to those not in remission at conception (16/73 21.9% vs. 39/49 79.6%; data insufficient for eight women). Active IBD at conception was associated with pre-term birth (p = 0.04). Maternal corticosteroid use in any trimester was associated with low birth weight (T1 p = 0.02; T2 p = 0.005; T3 p = 0.007). Active disease (p = 0.008) and steroid use in the third trimester (p = 0.05) were both associated with neonatal infections up to sixmonths after birth. Women in clinical remission at the time of conception have favorable outcomes, consistent with prospective observational studies. Our observations emphasize the importance of high quality IBD care for women pre and post-partum in line with international recommendations.

Influence of weather parameters on rice blast disease progression in Tamil Nadu, India

Rice cultivation in Madurai district, Tamil Nadu, spans distinct cropping seasons: Kar (May – Jun), Semi-dry (Jul – Aug), Samba/ Late Samba (Aug – Sep), and Navarai (Dec – Jan), each with unique weather conditions and rice varieties. This study explores the correlation between weather parameters temperature, rainfall, humidity, sunshine hours, and wind speed and rice blast disease severity from 2021 to 2023. Using multiple linear regression with ordinary least squares (OLS), the analysis achieves high predictive accuracy (R² = 0.98). Results show that the maximum temperatures correlated negatively with disease severity (r = -0.869 to -0.892), while rainfall (r = 0.768 to 0.804) and wind speed (r = 0.766 to 0.938) correlated positively during the semi-dry season. Relative humidity exhibits varying impacts across seasons. These findings underscore the importance of tailored disease management strategies, such as targeted fungicidal applications during warmer seasons and optimized water management in others. By elucidating these dynamics, the study enhances understanding of weather-disease interactions, providing actionable insights to optimize disease management and enhance crop resilience in Madurai district.

Drug Delivery and Monitoring through Wearable Devices with Microneedles in the Field of the Health Care System

Abstract: Microneedles represent a revolutionary advancement in drug delivery and diagnostics, offering a minimally invasive approach to accessing the intricate biological environment of the human body. These micron-sized needles, typically ranging from 25 to 1000 micrometers in length, penetrate the outermost layer of the skin, creating microchannels that facilitate the transdermal administration of therapeutics or the extraction of interstitial fluid for analysis. This innovative technology holds great promise for enhancing patient compliance, reducing side effects, and improving the overall efficiency of drug delivery. Integrating microneedles with wearable devices further amplifies their potential impact. Wearable devices provide a seamless interface for monitoring and controlling microneedle-based systems, fostering real-time data collection and personalized healthcare. Such devices can be designed to administer precise drug doses at predetermined intervals, adapting treatment regimens to individual patient needs. Additionally, the combination of microneedles and wearable devices enables continuous monitoring of biomarkers through the extraction of interstitial fluid, offering a non-invasive method for disease diagnosis and management. The review also provides a detailed overview of the mechanisms, types, fabrication techniques, applications, and patents for integrating microneedles with wearable devices. This symbiotic relationship between microneedles and wearables opens new paths for patient-centric healthcare, with the potential to transform chronic disease management and streamline therapeutic interventions. As these technologies continue to evolve, their integration may pave the way for personalized, on-demand healthcare solutions, accompanying a new era of patient well-being and treatment efficacy.

Impact of COVID-19 Pandemic on Chronic Obstructive Pulmonary Disease Healthcare Use, Exacerbations, and Mortality: A Population Study.

Rationale: Existing work suggests that patients with chronic obstructive pulmonary disease (pwCOPD) presented less frequently to the emergency department and were less likely to be hospitalized during the coronavirus disease (COVID-19) pandemic, but it is unclear if this was due to improved health and disease management or to increased barriers and/or avoidance of health care. Objectives: The objective of this study was to determine the impact of the pandemic on inpatient and outpatient healthcare use, disease incidence, and mortality rates in pwCOPD. Methods: A retrospective population-based analysis using linked administrative datasets from Alberta, Canada 18 months before and after March 12, 2020 was conducted to measure hospitalization, emergency department and outpatient visits, and COPD outpatient exacerbations during these time periods. Mortality data were also analyzed before versus after the pandemic, taking confirmed COVID-19 infection within 30 days into account. Subgroup analysis based on COPD exacerbation risk stratification was undertaken to determine if healthcare use differed based on exacerbation risk. Finally, sex-based analysis of healthcare use during the pandemic was also completed. Results: Hospitalization or emergency department visits and outpatient treatment for acute exacerbations of COPD dropped, whereas total outpatient COPD visits, including both virtual and in person, increased during the pandemic for pwCOPD. The mortality rate increased even after adjusting for COVID-19-associated deaths. Sex-based subgroup analysis showed a greater drop in acute care use for females, but the rise in mortality was seen for both sexes, with men experiencing a greater rate of mortality than women. Conclusions: Overall, pwCOPD accessed acute care resources less during the pandemic, which may have contributed to a rise in non-COVID-19 all-cause mortality.

Synergistic effects of mycorrhiza, effective microorganisms, compost tea, and mineral fertilizers on potato growth and disease management

Synergistic effects of mycorrhiza, effective microorganisms, compost tea, and mineral fertilizers on potato growth and disease management

Inhalable explosive nanosensor for real-time visual monitoring of therapeutic effects of lung cancer

Lung cancer, as one of the major diseases that endanger human health, has a very high fatality rate. Consequently, effective evaluation of clinical treatment outcomes for lung cancer is crucial for the formulation of subsequent treatment plans for patients. In this work, we utilized amorphous calcium carbonate nanoparticles (CaCO3 NPs) as sources of calcium ions (Ca2+) to develop CPs (CaCO3@PDA) core–shell nanoprobes. Concurrently, we functionalized the surface of gold nanoparticles with Cy5.5-peptide, AS1411, and (4-aminosulfonylphenyl) boronic acid (4-APBA) to produce APAAs (Au NPs@pep-AS1411-(4-APBA)), which were further assembled with CPs using PEG to construct an innovative explosive nanosensor, CPAs (CaCO3@PDA-APAAs). The CPs component of the nanosensor could cause the release of a substantial amount of Ca2+ in response to the tumor microenvironment (TME), which in turn induced cellular Ca2+ overload and subsequent apoptosis. This event triggers caspase-3 activation, causing the cleavage of a specific peptide sequence (DEVD), resulting in the fluorescence signal being reinstated. Additionally, the 4-APBA moiety on the probe interacted with H2O2 resulting in alterations in surface-enhanced Raman spectroscopy (SERS) signals, which aided in the detection of reactive oxygen species (ROS) during the physiological processes. By utilizing atomization, the nanoprobes were strategically deposited in the affected lung regions to enhance the fluorescence imaging capabilities and effectively mirror the therapeutic outcomes. Overall, the CPAs explosive nanosensor has a potential in advancing the non-invasive visual monitoring of lung cancer prognosis and can be a valuable tool in ongoing efforts to improve the management of this challenging disease.

Exercise improves surrogate measures of liver histological response in metabolic dysfunction-associated steatotic liver disease.

Exercise is recommended for the management of metabolic dysfunction-associated steatotic liver disease (MASLD), yet effects on liver histology remain unknown, especially without significant weight loss. We aimed to examine changes in surrogate measures of liver histological response with exercise training. We conducted a post hoc pooled analysis of three randomised controlled trials (duration: 12-20 weeks) comparing aerobic exercise interventions with controls. The primary outcome measure was a ≥30% relative reduction in (MRI-measured) liver fat, as a surrogate measure of liver histological response (the threshold necessary for fibrosis improvement). Secondary outcome measures were changes in other biomarkers of liver fibrosis, anthropometry, body composition and aerobic fitness. Eighty-eight adults (exercise: 54, control: 34; male: 67%) were included with mean (SD) age 51 (11) years and body mass index 33.3 (5.2) kg/m2. Following the intervention, exercise had ~5-fold (OR [95%CI]: 4.86 [1.72, 13.8], p = .002) greater odds of ≥30% relative reduction in MRI-measured liver fat compared with control. This paralleled the improvements in anthropometry (waist and hip circumference reduction), body composition (body fat, visceral and subcutaneous adipose tissue) and aerobic fitness (V̇O2peak, ventilatory threshold and exercise capacity). Importantly, these effects were independent of clinically significant body weight loss (<3% body weight). Exercise training led to clinically meaningful improvements in surrogate serum- and imaging-based measures of liver histological change, without clinically meaningful body weight reduction. These data reinforce the weight-neutral benefit of exercise training and suggest that aerobic training may improve liver fibrosis in patients with MASLD.

Identification of phase angle and Triglyceride-Glucose index as biomarkers for prediction and management of diabetic foot disease

Identification of phase angle and Triglyceride-Glucose index as biomarkers for prediction and management of diabetic foot disease

Improving the management of chronic kidney disease in primary care by enhancing laboratory reports with additional information and follow-up procedures

Identifying people at risk for progressive chronic kidney disease and connecting them with recommended care is crucial for providing timely and optimal treatment. The ASSIST-CKD (A programme to Spread eGFR [estimated glomerular filtration rate] graph Surveillance for the early identification, Support and Treatment of people with progressive CKD [chronic kidney disease]) trial evaluated the effect of graphical eGFR reporting to primary care physicians on late presentation to a nephrologist in the United Kingdom. Trial data were obtained from the UK Renal Registry. Although the results were neutral, the data generated from the ASSIST-CKD trial are informative and provide useful estimates of the intervention effect. The trial also provides valuable insights into the challenges of implementing complex interventions in busy health care environments, which can be used to guide the designs of future interventions.

Comparative pathogenicity and histopathological analysis of Edwardsiella anguillarum intraperitoneal infection in milkfish (Chanos chanos), Nile tilapia (Oreochromis niloticus) and Asian seabass (Lates calcarifer).

Edwardsiella anguillarum, a highly virulent species within the Edwardsiella genus, causes significant mortality in milkfish farms in Taiwan. This study aimed to investigate the comparison of milkfish susceptibility, a newly identified host species in Taiwanese aquaculture, with other species Nile tilapia (Oreochromis niloticus) and Asian seabass (Lates calcarifer), to E. anguillarum, elucidating its pathogenicity across both seawater and freshwater aquaculture environments. The results showed milkfish exhibited the highest mortality rate of 85% within 48 h of infection, whereas Nile tilapia exhibited a mortality rate of 70% between the second- and tenth-day post challenge, and seabass exhibited a mortality rate of 25% between the second- and sixth-day post challenge. Gross lesions observed in milkfish included splenomegaly and haemorrhage, whereas Nile tilapia exhibited signs of ascites, exophthalmia and brain haemorrhage. Seabass displayed spleen granulomas and haemorrhage at the injection site. Histopathological analysis revealed common features across all three species, including multifocal necrosis, bacterial presence in the necrotic areas, serositis and oedema. Asian seabass also exhibited chronic lesions in the form of splenic granulomas. This study highlights the high susceptibility of milkfish and Nile tilapia to E. anguillarum, emphasizing the urgent need for further investigation into targeted vaccine development for these fish species. These results not only deepen our understanding of the differing levels of pathogenicity among the three species but also offer valuable insights for improving disease prevention and management strategies in aquaculture, including those applied within polyculture systems and for the maintenance of aquaculture water environments.

Progress in genomic-driven breeding for improving the disease and insect pest resistance in black gram (Vigna mungo)

Urdbean or black gram (Vigna mungo) is a short-duration pulse crop with a high nutritional profile, and its main cultivation areas are in South and Southeast Asia, including India. The production of black gram is constrained by various biotic stresses, particularly diseases like yellow mosaic disease, leaf crinkle disease, and powdery mildew. Additionally, insect pests like bruchids and pod borers also affect black gram production. These biotic stresses cause significant losses in yield and reduce yield quality. Breeding for resistance is the most desirable and economical approach for the management of diseases and insect pests. In the past, conventional approaches used in black gram breeding contributed to improving resistance to biotic stress in black gram, but the success was not at the desired level. Therefore, to enhance biotic stress resistance, the black gram breeding programs shifted their focus toward genomics. Recently, several genomics resources, including genome and transcriptome sequences, DNA markers, and genetic linkage maps, have been developed exclusively for the black gram. However, the progress of improving black gram resistance to biotic stress using these genomic resources is still very slow. In this review, we discuss the black gram genomic resources and their use in breeding programs for developing biotic stress resistance. In addition, we discuss the existing research gaps and offer our view on future research on combating the biotic stress in black gram.

Introduction and temporospatial tracing of piscine orthoreovirus-1 (PRV-1) in Norwegian farmed Atlantic salmon (Salmo salar) after local fallowing.

Piscine orthoreovirus-1 (PRV-1) is a prevalent agent in Atlantic salmon (Salmo salar) and the causative agent of heart and skeletal muscle inflammation (HSMI), an important disease in farmed Atlantic salmon. Investigations into the introduction and dissemination routes of PRV-1 in a field setting have been limited. This study aimed to better understand PRV-1 infections and HSMI-associated mortality under field conditions. We tracked introduction and spread of PRV-1 over one production cycle in a geographically isolated region in Norwegian aquaculture. From five sites, a total of 32 virus isolates were sequenced and genogrouped. The results indicated multiple introductions of PRV-1 to the area, but also revealed a high level of genetic homogeneity among the virus variants. The variants differed from that of the previous production cycle at two out of three sites investigated, suggesting that synchronized fallowing can be a useful tool for preventing dissemination of PRV-1 between generations of fish. Exposure to PRV-1 at the freshwater stage was identified as a potential source of introduction. A low level of HSMI-associated mortality was observed at all sites, with the onset of mortality showing some variation across PRV-1 genogroups. However, the study highlighted the complexity of associating viral genogroups with mortality in a field setting. Overall, this study contributes valuable insights into PRV-1 dynamics in a real-world aquaculture setting, offering potential strategies for disease management and prevention.

US cost-utility model of lenacapavir plus optimized background regimen (OBR) vs fostemsavir plus OBR and ibalizumab plus OBR for people with HIV with multidrug resistance.

Heavily treatment-experienced (HTE) people with HIV (PWH) have limited treatment options owing to multidrug resistance (MDR). Lenacapavir (LEN) is indicated, in combination with other antiretrovirals, for the treatment of adults with MDR HIV-1 experiencing failure of their current antiretroviral regimen because of resistance, intolerance, or safety considerations. To evaluate the cost-utility of LEN in combination with an optimized background regimen (OBR) vs alternative recently approved treatments for HTE PWH, fostemsavir (FTR)+OBR and ibalizumab (IBA)+OBR, for the treatment of PWH with MDR, from a mixed US health care payer perspective. A Markov state-transition model with a lifetime time horizon was developed. Transition probabilities between viral load categories were based on individual participant data from the CAPELLA trial for LEN+OBR and on relative efficacy parameters obtained from indirect treatment comparisons for comparators. Health state utilities were sourced from the literature. Costs included drug acquisition costs, drug administration costs, disease management costs, adverse event costs, AIDS-related event costs, and treatment switching costs and were sourced from red book costs, Medicare and Medicaid fees, and the literature. Costs and outcomes were discounted at 3% annually. The model was used to estimate total and incremental costs, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. A deterministic and a probabilistic sensitivity analysis, as well as scenario analyses, were performed to address elements of uncertainty in the model and to explore the robustness of the results. Over a lifetime time horizon, LEN+OBR was associated with the highest absolute QALYs (9.41) and the greatest number of LYs (12.09) compared with FTR+OBR (QALYs: 8.75; LYs: 11.26) and IBA+OBR (QALYs: 8.36; LYs: 10.78). LEN+OBR was also associated with the lowest total lifetime costs of the 3 interventions (LEN+OBR: $1,441,122 [US dollars]; FTR+OBR: $1,504,986; IBA+OBR: $1,524,396) and therefore was dominant over both comparators in the base case. LEN+OBR remained dominant vs FTR+OBR and IBA+OBR across the range of scenarios tested and LEN+OBR had a 99% probability of being cost-effective compared with FTR+OBR and IBA+OBR in the probabilistic sensitivity analysis at a willingness-to-pay threshold of $50,000/QALY. This economic evaluation demonstrated that LEN+OBR provides meaningful increases in QALYs and LYs, and is dominant over a lifetime time horizon, compared with FTR+OBR and IBA+OBR for the treatment of PWH with MDR in the United States.

Do time preferences predict diabetes outcomes? A combined survey and register-based study.

Identifying determinants of heterogeneity in health outcomes continues to be a focus in the health economic literature. In this study, we analyze whether time preferences predict health outcomes in individuals with type 1 diabetes (T1D) who use insulin pump therapy to manage their condition. We collect data on time preferences using a hypothetical matching task and estimate aggregate as well as individual-level discounting parameters using the exponential, hyperbolic, and quasi-hyperbolic discounting models. These parameters are then regressed against essential diabetes-related health outcomes obtained from registries and medical records, including glycemic control, kidney function, BMI, and number of hospital contacts. Our analyses indicate that all three discounting models fit the data equally well. Except for hospital contacts, we find robust evidence that impatience, as reflected by higher discounting, predicts worse health outcomes. Additionally, present bias is associated with worse kidney function. Our findings suggest that time preferences can explain some of the heterogeneity in health among individuals with T1D and call for increased attention on the role of time preferences in the design of disease management programs for individuals with chronic conditions.

A Narrative Review of Alzheimer Dementia in African American and Hispanic Populations: The Health Care Provider's Role

African Americans and Hispanics, especially those of advanced age living with chronic diseases, have a higher risk of developing Alzheimer dementia (AD). Poor control of chronic diseases, such as diabetes, lack of awareness of increased risk factors by health care providers, or fragmented provider care can lead to missed opportunities to adopt early assessment strategies that can mitigate the effects or onset of AD. Nurse practitioners and other health care providers can play a crucial role in implementing chronic disease management strategies and educating patients who are at risk for AD among African Americans and Hispanics.

Prevalence and determination of species distribution of Eimeria in poultry from the Swabi district, Pakistan

Background and Aim: Coccidiosis, caused by protozoan parasites of the genus Eimeria, is a significant concern in poultry farming, leading to substantial economic losses worldwide. In Pakistan, poultry is a major component of the agricultural sector, with both broiler and egg-laying chickens playing crucial roles in meeting the country’s protein needs. Despite the importance of the poultry industry, there is limited data on prevalence and species distribution of Eimeria in different types of chickens in District Swabi, Khyber Pakhtunkhwa, Pakistan. This study aims to estimate the prevalence and determine the distribution of Eimeria species in broiler and egg-laying chickens in this region. Materials and Methods: Nine hundred fecal samples were collected from broiler (380) and egg-laying domestic chickens (520) in District Swabi, Pakistan. Microscopic analysis was used to identify Eimeria parasites in all samples. After microscopic examination for positive identification, Eimeria species were determined using polymerase chain reaction (PCR) assays. Results: Microscopic examination identified Eimeria oocysts in 44.4% (400/900) of the samples. Eimeria parasite infection significantly varied based on chicken type, age, and gender (p &lt; 0.05). The study found that broiler chickens (52.63%, 235/450), young chickens (4–6 weeks) (55.5%, 285/500), and females (52.2%, 200/380) were more infected with Eimeria spp. than egg-laying domestic chickens (38.5%, 200/520), adults (above 6 weeks) (28.8%), and males (36.7%, 165/450). PCR indicated a distribution rate of 42.5% (170/400) Eimeria tenella, 26.25% (105/400) Eimeria acervulina, 20% (80/400) Eimeria maxima, and 11.25% (45/400) Eimeria mitis. None of Eimeria necatrix, Eimeria brunetti, or Eimeria praecox was found in the study. Conclusion: This study underlines the essential requirement for targeted interventions due to the prevalence and predominance of E. tenella among identified Eimeria species. Future research should focus on refined sampling strategies and investigate the clinical significance of these parasites for effective disease management in the local poultry industry. Keywords: coccidiosis, domestic chickens, Eimeria species, microscopic and molecular identification, Pakistan, prevalence.

A Systematic Review of Herbal Interventions for the Management of Cardiovascular Diseases.

Cardiovascular diseases represent a significant global health burden, necessitating diverse approaches for effective management. Herbal interventions have gained attention as potential adjuncts or alternatives to conventional therapies due to their perceived safety and therapeutic potential. This structured abstract provides a comprehensive review of herbal interventions for the management of CVDs, summarising key findings, mechanisms of action, and clinical implications. This systematic review aims to evaluate the impact of various herbal interventions employed for managing cardiovascular diseases. We conducted an extensive literature search across electronic databases, including PubMed, Scopus, and Web of Science, from inception to 2022. Studies were included if they investigated the use of herbal remedies for preventing or treating CVDs. Data extraction and synthesis focused on botanical sources, active compounds, mechanisms of action, and clinical outcomes. Numerous herbal interventions have demonstrated promising cardiovascular benefits. A number of medicinal herbs well identified to treat CVD are Moringaoleifera, Ginseng, Ginkgo biloba, Celosia argentea, Gongronematrifolium, Gynostemmapentaphyllum, Bombaxceiba, Gentianalutea, Allium sativum, Crataegusspp, Curcuma longa, Camellia sinensis, and Zingiberofficinale. Mechanistic insights reveal that herbal interventions often target multiple pathways involved in CVD pathogenesis. These mechanisms encompass anti-inflammatory, antioxidant, anti-thrombotic, anti-hypertensive, and lipid-lowering effects. Additionally, some herbs enhance endothelial function, promote nitric oxide production, and exert vasodilatory effects, contributing to improved cardiovascular health. Clinical studies have provided evidence of the efficacy of certain herbal interventions in reducing CVD risk factors and improving patient outcomes. However, more rigorous, large-scale clinical trials are needed to establish their long-term safety and effectiveness. It is crucial to consider potential herb-drug interactions and standardise dosages for reliable therapeutic outcomes. This comprehensive review highlights the potential of herbal interventions as valuable adjuncts or alternatives for managing cardiovascular diseases. Herbal remedies offer diverse mechanisms of action, targeting key CVD risk factors and pathways. While promising, their clinical utility warrants further investigation through well-designed trials to establish their safety and efficacy, paving the way for integrated approaches to cardiovascular disease management. Healthcare providers and patients should engage in informed discussions about the use of herbal interventions alongside conventional therapies in the context of CVD prevention and treatment.