Asian Journal of Advances in Medical Science

Neisseria meningitidis Infection: Biological Characteristics, Pathogenesis and Prevention Strategies

2026-03-12T08:16:04+00:00

Neisseria meningitidis is a Gram-negative diplococcus that colonises the human nasopharynx and represents a significant cause of invasive bacterial disease worldwide. Although asymptomatic carriage of N. meningitidis is common in healthy individuals, the organism may occasionally invade the bloodstream and central nervous system, resulting in invasive meningococcal disease (IMD). The most frequent clinical manifestations of IMD include meningitis and meningococcal septicaemia, both of which are associated with rapid disease progression, high mortality rates, and substantial long-term morbidity among survivors. This review provides a comprehensive overview of Neisseria meningitidis as an important human pathogen. It summarises current knowledge regarding the microbiological characteristics, virulence determinants, and pathogenic mechanisms of the organism, as well as host immune responses involved in infection control. The review further examines patterns of asymptomatic carriage and modes of transmission, together with environmental and host-related factors that influence disease spread. In addition, the global epidemiology of meningococcal disease is discussed, highlighting regional variations in disease distribution. Clinical manifestations, diagnostic approaches, and laboratory identification methods are also reviewed. Current therapeutic strategies, including antimicrobial treatment and supportive care, are outlined alongside available vaccination programmes and public health interventions for disease prevention and control. By integrating findings from published scientific literature and public health sources, this review emphasises the continuing global health importance of Neisseria meningitidis. Sustained surveillance, effective vaccination strategies, and ongoing research are essential to reduce the burden of meningococcal disease worldwide.

Advancing Meta-analysis beyond Pooled Estimates: Modern Tools for Reliable Evidence Synthesis and Clinical Decision-making

2026-04-18T10:55:04+00:00

Meta-analysis is the cornerstone of evidence-based medicine, yet its traditional application often fails to translate statistical findings into meaningful clinical decisions. Conventional approaches, largely dependent on pooled estimates, forest plots, and p-values, provide limited insights into heterogeneity, bias, and real-world applicability. As clinical data become increasingly complex, there is a growing need for more sophisticated analytical frameworks that move beyond descriptive synthesis towards decision-oriented interpretation. This review critically examines advanced meta-analytic methodologies-including meta-regression, Bayesian meta-analysis, trial sequential analysis, network meta-analysis, and bias-adjustment techniques that enhance the reliability, interpretability, and clinical relevance of evidence synthesis. These approaches enable deeper exploration of variability, robust control of bias, and improved assessment of evidence sufficiency, thereby supporting more precise and contex-specific treatment decisions. In addition, emerging innovations such as artificial intelligence, living meta-analysis, and individual participant data approaches are transforming evidence synthesis into a dynamic and continuously evolving process. Despite their clear advantages, challenges related to methodological complexity, data accessibility, and implementation remain barriers to widespread adoption. Bridging the gap between statistical evidence and clinical decision-making requires not only methodological advancement but also integration of these tools into routine research and healthcare practice. The adoption of advance meta-analytic approaches is therefore essential to enhance the credibility, applicability and impact of modern clinical research.

Effectiveness of Laser versus Infrared Radiation in Reducing Pain and Improving Quality of Life among IT Professionals: A Narrative Review

2026-04-21T10:44:42+00:00

Background: Trapezitis is an inflammatory disease of the trapezius muscle, which is accompanied by pain and muscle contraction accompanied by myofascial trigger points, which limit neck movement and worsen the functioning of the daily routine. The problem is becoming more common in Information Technology (IT) workers, who tend to work in long fixed postures, spend much time in front of the computer, and make repetitive neck motions that result in overuse of upper trapezius and muscular exhaustion. Laser therapy [LLLT] as well as Infrared radiation [IRR] has independently been found to reduce the intensity of pain and enhance the functioning in a number of musculoskeletal diseases and trapezitis included. Nevertheless, the major part of the evidence is in the form of small clinical trials, and the absence of comparative studies that would directly compare the relative efficacy of both therapies in IT professionals with trapezitis.

Aims: To evaluate the efficacy of Laser Therapy versus Infrared Radiation in reducing pain and improving Quality of Life among IT Professionals.

Objective: To determine the effectiveness of Laser Therapy and Infrared Radiation in reducing pain and improving quality of life among IT Professionals with trapezitis.

Methods: PubMed, Google Scholar, ResearchGate and ScienceDirect were systematically searched to identify studies published within the period of 2014–2025. were selected based on predefined inclusion and exclusion criteria, and a total of 19 studies were included in the final analysis. Combinations of keywords were used: Laser Therapy, Trapezitis, Upper Trapezius, Visual Analogue Scale, NDI Scale, IT Professionals, Quality of Life. Only articles reviewing either Laser or Infrared Radiation interventions in musculoskeletal or trapezius pain were included.

Results: While both techniques had similar benefits in pain relief and improving functional outcomes, laser treatment exhibited superior outcomes with regard to depth of penetration, quickness of pain relief, and tissue repair capacity. Infrared radiation proved effective for improved local circulation and reduced muscle stiffness.

Conclusion: This literature review concludes that Low-Level Laser Therapy and Infrared Radiation Therapy are both useful in pain management and functional outcome improvement in patients with trapezitis. Nonetheless, the absence of high-quality comparative studies does not allow conclusive findings on which modality is better. Additional randomized controlled trials are encouraged to provide direct comparison of the two methods.

Artificial Intelligence in Antimicrobial Stewardship: Predictive Models and the Future of Combating Antimicrobial Resistance

2026-05-09T12:11:40+00:00

Antimicrobial resistance (AMR) represents a growing global health threat, driven by the widespread misuse of antibiotics and the limitations of current stewardship strategies. Conventional approaches to antimicrobial stewardship rely heavily on empirical prescribing and delayed microbiological confirmation, often resulting in suboptimal antibiotic selection and contributing to acceleration of resistance. In this context, artificial intelligence (AI) has emerged as a promising tool to enhance decision-making through predictive and data-driven approaches.

This review explores the role of AI in antimicrobial stewardship, with a focus on its application in predicting antimicrobial resistance, guiding antibiotic selection, and supporting clinical decision-making through integrated systems. Machine learning and deep learning models have demonstrated the ability to analyse complex, multidimensional datasets, including electronic health records, microbiological data, genomic information, and antibiotic usage patterns, to generate early and accurate predictions. These capabilities enable a shift from reactive to predictive care, particularly in high-risk settings such as intensive care units and sepsis management.

Despite these advancements, significant challenges remain. Limitations related to data quality, model generalizability, interpretability, and integration into clinical workflows continue to hinder widespread adoption. Additional barriers include clinician trust, infrastructure constraints, and ethical considerations such as data privacy and accountability. These challenges are further amplified in low-resource settings, where digital infrastructure and access to microbiological diagnostics may be limited.

Future progress will depend on the development of robust datasets, standardized reporting frameworks, and seamless integration of AI tools into healthcare systems. With appropriate validation and implementation, AI has the potential to transform antimicrobial stewardship by enabling more precise, timely, and context-aware antibiotic use. Ultimately, the integration of AI into clinical practice represents a critical step toward addressing the global burden of antimicrobial resistance.

The Efficacy of Proprioceptive Neuromuscular Facilitation in the Management of Hamstring Tightness: A Literature Review

2026-04-27T11:51:44+00:00

Background: Hamstring tightness is a highly prevalent musculoskeletal condition that adversely affects lower limb flexibility, alters normal biomechanical movement patterns, and significantly increases the risk of acute strains and chronic overuse injuries. This condition is commonly observed across diverse populations, including sedentary individuals, competitive and recreational athletes, older adults, and patients with various musculoskeletal or neurological disorders. Proprioceptive Neuromuscular Facilitation (PNF) is a specialized stretching method that sequentially combines muscle contraction and relaxation phases to enhance muscle length, joint range of motion, neuromuscular control, and overall functional performance.

Objective: This systematic literature review aimed to explore, synthesize, and compare the effectiveness of different PNF stretching techniques specifically Hold-Relax (HR), Contract-Relax (CR), and Contract-Relax-Antagonist-Contract (CRAC)in improving hamstring flexibility, reducing muscle stiffness and alleviating pain, and enhancing functional performance relative to other stretching methods, including static stretching, dynamic stretching, ballistic stretching, foam rolling, eccentric training, and muscle energy techniques.

Methods: A comprehensive and systematic literature search was conducted across major electronic databases, including Google Scholar, PubMed, ScienceDirect, and ResearchGate, using predefined keywords and Boolean operators related to PNF stretching and hamstring tightness. A total of 30 peer-reviewed research studies published between 2006 and 2026 were included in this review following strict eligibility criteria. The selected studies comprised randomized controlled trials, comparative studies, systematic reviews, and meta-analyses involving healthy individuals, athletes, older adults, and various clinical populations (e.g., knee osteoarthritis, neurological conditions, office workers with neck pain, and sedentary adults). Primary outcome measures focused on improvements in range of motion (ROM), changes in muscle stiffness (assessed via shear-wave elastography and other objective measures), reduction in pain scores, and overall functional performance.

Results: Most studies consistently demonstrated that PNF stretching significantly improves hamstring flexibility, reduces muscle stiffness, enhances movement efficiency, and improves functional outcomes compared to control conditions or baseline measurements. Among the various PNF techniques, Hold-Relax and Contract-Relax produced the most substantial immediate flexibility gains, with effect sizes ranging from moderate to large across different populations. The CRAC technique showed efficacy in athletic populations, especially runners and sprinters. When compared with other stretching modalities, PNF stretching consistently yielded superior short-term improvements in range of motion and muscle extensibility. However, static stretching was occasionally found to maintain flexibility gains over longer-term follow-up periods of four weeks or more, suggesting complementary roles for different stretching methods. The most favourable outcomes were observed when PNF stretching was combined with other therapeutic approaches, such as Kinesio taping, hip-hinge exercises, or electrical muscle elongation, suggesting that integrated protocols may optimize both immediate and sustained benefits. Gender differences in response to PNF were also identified, with females demonstrating greater flexibility gains than males.

Conclusion: PNF stretching is a safe, evidence-based, and time-efficient therapeutic intervention for managing hamstring tightness and improving lower limb flexibility across diverse populations. When incorporated into rehabilitation protocols, sports training programs, or preventive physiotherapy regimens, PNF stretching significantly contributes to injury prevention, postural correction, enhanced functional performance, and improved quality of movement. While PNF is superior for immediate flexibility gains, combining it with static stretching may optimize long-term outcomes. Future research should focus on standardizing PNF protocols across different populations, investigating long-term retention of flexibility gains, exploring the synergistic effects of combining PNF with other rehabilitation modalities, and examining the neurophysiological mechanisms underlying gender differences in response to PNF stretching.

Assessment of Knowledge, Attitudes, and Practices Regarding Antimicrobial Resistance among Community Pharmacists

2026-03-07T10:30:27+00:00

Background: Antimicrobial resistance (AMR) is a growing global public health threat, with community pharmacies playing a crucial role in antibiotic use. This study assessed the knowledge, attitude, and practice (KAP) regarding AMR among community pharmacists.

Methods: A cross-sectional questionnaire-based study was conducted among community pharmacists. Data on demographics, knowledge, attitudes, and dispensing practices related to antibiotics were collected and analyzed using descriptive statistics, mean scores, and correlation analysis.

Results: Pharmacists demonstrated moderate knowledge of AMR, with gaps in awareness of national guidelines. Attitudes toward rational antibiotic use were largely positive; however, inappropriate practices such as dispensing antibiotics without prescription were common. A positive correlation was observed between knowledge, attitude, and practice scores.

Conclusion: Despite reasonable awareness and favorable attitudes, suboptimal dispensing practices persist, highlighting the need for stronger regulatory enforcement, continuous professional education, and antimicrobial stewardship initiatives in community pharmacy settings.

Evaluation of Antioxidant Status in the Liver, Kidney, and Heart of Formalin-Induced Wistar Rats Treated with Alstonia boonei Extracts

2026-05-05T12:51:42+00:00

Inflammation is frequently accompanied by oxidative stress, which can disrupt antioxidant defenses and promote tissue injury. Alstonia boonei is widely used in traditional medicine, yet comparative evidence on the dose-dependent antioxidant effects of different plant parts under inflammatory conditions remains limited. This study evaluated the effects of aqueous extracts of A. boonei leaf, stem bark, and root bark on oxidative stress biomarkers in a formalin-induced inflammation model in Wistar rats. Rats were allocated to normal and formalin-induced control groups, an indomethacin-treated reference group, and extract-treated groups. Inflammation was induced by subcutaneous injection of 0.1 mL of 2% formalin into the hind paw on days 1 and 3. Extracts were administered orally at 150, 300, or 600 mg/kg body weight for 21 days; indomethacin (10 mg/kg) served as the standard anti-inflammatory control. Body weight was monitored during the study. After treatment, liver, kidney, and heart tissues were harvested and homogenized for biochemical assays. Oxidative status was assessed using malondialdehyde (MDA) as a lipid peroxidation index, alongside antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT). Data were analyzed using appropriate comparative statistics with significance set at p<0.05. Formalin induction elevated oxidative stress, reflected by increased MDA and altered antioxidant enzyme activities across organs. Leaf extract at lower doses generally improved antioxidant profiles by reducing MDA and supporting SOD/CAT activities, whereas higher doses—particularly of stem and root extracts—tended to worsen oxidative indices and/or dysregulate antioxidant enzymes. Overall, A. boonei exhibited dose- and plant-part–dependent effects, supporting cautious preclinical exploration and emphasizing the need for extract standardization and safety evaluation at higher doses.

PCR-Based Detection of Mixed Plasmodium Infections in Asymptomatic Carriers

2026-05-13T12:57:25+00:00

Background: Asymptomatic and mixed Plasmodium infections represent significant but often overlooked challenges to malaria control and elimination, particularly in endemic regions. Conventional diagnostic methods such as microscopy and rapid diagnostic tests (RDTs) have limited sensitivity for detecting low-density parasitemia and mixed-species infections, potentially leading to underestimation of true infection burden. This study aimed to evaluate the effectiveness of polymerase chain reaction (PCR) in detecting asymptomatic and mixed Plasmodium infections and to compare its performance with microscopy and RDTs.

Methods: A cross-sectional study was conducted among individuals in a malaria-endemic setting. Blood samples were collected and analyzed using microscopy, RDTs, and PCR. Diagnostic performance, including sensitivity and specificity, was assessed, and the prevalence of asymptomatic, submicroscopic, and mixed infections was determined.

Results: PCR detected a higher prevalence of malaria infections (28.5%) compared to microscopy (17.3%) and RDTs (19.1%). A substantial proportion of infections (39.2%) were submicroscopic and undetectable by conventional methods. Mixed Plasmodium infections accounted for 9.8% of PCR-positive cases but were largely missed by microscopy and RDTs. While microscopy and RDTs demonstrated high specificity, their sensitivity was significantly lower than that of PCR.

Conclusion: PCR provides superior sensitivity for detecting asymptomatic and mixed Plasmodium infections and reveals a considerable hidden reservoir of malaria transmission. Integrating molecular diagnostic tools into surveillance systems is essential for improving case detection, guiding treatment strategies, and supporting malaria elimination efforts.

Seasonal Dynamics of Intestinal Parasites in Rural vs. Urban Populations

2026-05-18T13:06:56+00:00

Intestinal parasitic infections remain a major public health concern in developing countries, particularly in regions with inadequate sanitation and unsafe water sources. Seasonal climatic variation influences parasite transmission patterns, yet comparative analyses between rural and urban populations remain limited. This study investigated the seasonal dynamics of intestinal parasitic infections among rural and urban populations over a 12-month period. A total of 800 participants (400 rural, 400 urban) were recruited, and stool samples were analyzed using direct wet mount and formalin-ether concentration techniques. Overall prevalence was significantly higher in rural communities (42.5%) compared to urban populations (27.3%) (p < 0.001). Infection rates peaked during the rainy season in both settings, with helminth infections predominating in rural areas and protozoan infections more common in urban environments. Logistic regression analysis identified rural residence (Adjusted OR = 2.1, 95% CI: 1.6–2.9) and rainy season (Adjusted OR = 1.8, 95% CI: 1.3–2.4) as independent predictors of infection. These findings underscore the role of environmental exposure, sanitation disparities, and seasonal factors in shaping intestinal parasite epidemiology.

Assessment of TNF-α Levels and Its Correlation with Lipid Markers in Patients with Psoriasis

2026-05-25T10:12:00+00:00

Psoriasis is a chronic relapsing inflammatory skin disorder that has been associated with dysregulated immune response, and tumor necrosis factor-alpha (TNF-α) has long been accepted as one of the essential contributors to disease pathogenesis. Evidence in favor of a clinical link between psoriasis and dyslipidemia has recently emerged, although previous studies reported conflicting results hampering the establishment of an association. This study was conducted to assess serum TNF-α levels and their relation with lipid profile parameter among psoriatic patients and healthy control. The study design was a case-control clinical study comprising of100 subjects, which were divided in 2 groups, fifty patients of psoriasis (cases) and 50 healthy matched case controls for age, sex and body mass index (BMI). Serum TNF-α was measured by enzyme-linked immunosorbent assay (ELISA) and lipid profiles including total cholesterol (TC), triglycerides (TG),low-density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were performed based on standard enzymatic methods. Statistical analyses were conducted using independent t-tests, Pearson correlation coefficients and multivariate regression models. The serum levels of TNF-α were significantly higher in psoriasis patients (185.42 ± 48.35 pg/mL) than in controls (64.28 ± 18.76 pg/mL, p < 0,01). On the other hand, lipid abnormalities were common in the psoriasis group and its TC (218.64 ± 42.18 mg/dL vs. 182.35 ± 28.47 mg/dL, p < 0.001), TG (168.92 ± 51.23 mg/dL vs. 118.45 ± 32.18 mg/dL, p <0.001) and LDL-C (142·58±36·24 mg/dL vs .108·72±24·35 mg/Dl, p<0 ·001) although HDL-C levels decreased (42·18±9·35mg /dL vs. 52·64±10·28 mg /dl , p<0 ·001). The relationship between TNF-α and TC (r = 0.682, p < 0.001), TG (r = 0.714, p < 0.001), LDL-C (r = 0.658, p < 0.001) was found to be strong positive correlations and the relationship with HDL-C (r = − 0.542; P < 0.001) was a negative correlation. Patients with psoriasis present high levels of TNF-α associated with dyslipidemia. Furthermore, the tight correlations among TNF-α and lipid markers reinforce the interrelationship between inflammation and metabolic dyslipidemia in the pathophysiologic process of psoriasis, demonstrating that comprehensive cardiovascular risk assessment should be applied to all patients with this disease.

Effect of Tiger Nut Extracts on the Intestine Histology of Adult Albino Rats

2026-07-07T09:01:46+00:00

The intestine is essential for digestion, nutrient absorption and immune homeostasis, and its histological integrity is important for normal gastrointestinal function. This study investigated the effect of tiger nut (Cyperus esculentus) extract on the intestinal histology of adult albino rats. Twenty adult albino rats weighing 100–130 g were acclimatised for two weeks and allocated into four groups. Group A served as the control and received normal feed and water, whereas Groups B, C and D received low (0.5 ml), medium (1.5 ml) and high (3 ml) doses of tiger nut extract, respectively, by oral gavage for two weeks. At the end of the experimental period, the animals were sacrificed under chloroform anaesthesia. Intestinal tissues were harvested, fixed in 10% formol saline and processed for routine histological examination using Haematoxylin and Eosin staining. Microscopic evaluation showed normal intestinal architecture in Groups A, B and C, with preserved mucosal organisation, well-defined villi and intact muscularis externa. In contrast, Group D showed mild histopathological alterations, including thinning of the muscularis layer and mild inflammatory cell infiltration. These findings indicate a dose-dependent response of intestinal tissue to tiger nut extract. Low and medium doses did not compromise intestinal architecture, whereas the high dose was associated with mild structural and inflammatory changes. Regulated intake and further evaluation of longer exposure periods are recommended.

Effect of Soursop (Annona muricata) Leaf Extract on Pancreatic Histology in Cadmium-induced Adult Albino Rats

2026-07-11T11:46:09+00:00

Cadmium is a toxic environmental heavy metal associated with oxidative stress and structural injury in metabolically active organs, including the pancreas. This study evaluated the effect of soursop (Annona muricata) leaf extract on pancreatic histology and body weight changes in cadmium-induced adult albino rats. Fifty adult albino rats weighing 100-130 g and aged five weeks were randomly allocated into five groups of ten rats each. Group A served as the control and received food and water only. Groups B, C and D received cadmium at 0.5 mg/kg with Annona muricata leaf extract at 200, 400 and 800 mg/kg, respectively, while Group E received cadmium only at 0.5 mg/kg. All administrations were performed orally for two weeks. Body weights were recorded at the beginning and end of the experiment. After sacrifice under chloroform anaesthesia, pancreatic tissues were excised, fixed in 10% formol saline, processed using standard paraffin techniques and stained with haematoxylin and eosin. Data were analysed using SPSS version 20, with significance set at p < 0.05. The control group showed marked body weight gain, whereas the cadmium-only group showed the least increase in body weight. Rats treated with medium and high doses of Annona muricata demonstrated improved body weight gain compared with the cadmium-only group. Histological findings showed normal pancreatic architecture in the control group, severe pancreatic oedema in the low-dose extract group, normal pancreatic histology in the medium-dose group, normal histological features in the high-dose group and mild pancreatic oedema with inflammatory cell infiltration in the cadmium-only group. These findings indicate that medium and high doses of Annona muricata leaf extract were associated with preservation of pancreatic histology in cadmium-induced rats.