The Electronic Journal of Medical Research (EJMR) is an open-access, peer-reviewed journal that covers all aspects of medical sciences, including clinical studies, laboratory research, and data analysis. The EJMR follows a quarterly publication schedule (February, May, August, November). The journal publishes articles that are at the forefront of modern medical research, covering innovative developments in healthcare. The Journal strictly adheres to the guidelines of the Higher Education Commission (HEC), Pakistan, and the International Committee of Medical Journal Editors (ICMJE). Article publishing charges (APC) At the current stage, there is no article submission or publication fee for this journal. All of the articles will be made freely available to the readers. Authors are encouraged to review the APC policy carefully before submission. The Editorial Office remains committed to maintaining fairness and transparency while ensuring high-quality open-access publication. Review this journal's open access policy.
Vitamin C status and associated biochemical alterations in tuberculosis patients: A cross-sectional study
Tuberculosis (TB) remains a major global public health concern and is among the leading causes of mortality from infectious diseases worldwide. Ascorbic acid (vitamin C) plays an important role in host defense through its antioxidant properties, immune modulation, and protective activity against pathogenic infections. The present cross-sectional study was conducted to evaluate the impact of tuberculosis infection on serum vitamin C levels and selected biochemical parameters in TB patients. Serum ascorbic acid concentrations and other biochemical markers were measured using standard biochemical techniques. The results demonstrated significantly reduced levels (p < 0.005) of vitamin C (0.24 ± 0.01 mg/dL), total cholesterol (124.94 ± 0.80 mg/dL), high-density lipoprotein cholesterol (34.50 ± 0.40 mg/dL), low-density lipoprotein cholesterol (71.28 ± 0.61 mg/dL), very-low-density lipoprotein cholesterol (19.78 ± 0.17 mg/dL), triglycerides (99.88 ± 0.81 mg/dL), total serum proteins (6.75 ± 0.05 g/dL), and albumin (2.78 ± 0.03 g/dL) in tuberculosis patients compared with healthy controls. In contrast, serum globulin levels (3.97 ± 0.04 g/dL) were significantly elevated in TB patients. These findings indicate that tuberculosis infection is associated with marked alterations in vitamin C status and biochemical parameters, which may contribute to disease-related complications. Monitoring and correction of these biochemical disturbances may be important for improving clinical management and outcomes in patients with tuberculosis.
Copyright (c) 2026 Kainat Iqbal, Talha Saleem https://creativecommons.org/licenses/by-nc-nd/4.0
A correlative study of alkaline phosphatase and calcium in osteoarthritis patients
Osteoarthritis is a degenerative joint disorder characterized by progressive cartilage breakdown and altered bone metabolism. This study aimed to evaluate the correlation between serum alkaline phosphatase (ALP) activity and serum calcium levels in patients with osteoarthritis and to compare these parameters with those of healthy controls to identify deviations from normal biochemical values. A total of 100 osteoarthritis patients (61% male and 39% female), aged 45 years and above, attending the outpatient department of Teaching Hospital Shahdara were included in the study. Serum samples were analyzed for ALP activity and calcium concentration using standard biochemical methods. The results demonstrated significantly elevated serum ALP activity in osteoarthritis patients, while serum calcium levels were comparatively reduced. An inverse correlation was observed between serum ALP activity and serum calcium levels. These findings suggest that alterations in ALP and calcium metabolism are associated with osteoarthritis progression. Measurement of serum ALP and calcium may serve as simple, cost-effective biochemical biomarkers for assessing disease severity in patients with osteoarthritis.
Copyright (c) 2026 Sameer Ashraf, Madiha Naheed, Talha Saleem, Sidra Hasnain https://creativecommons.org/licenses/by-nc-nd/4.0
Risk factors and lifestyle factors in the development and prevention of cancer: A literature review
Cancer represents a major global health challenge, with steadily increasing incidence rates worldwide. A hallmark of cancer development is metabolic reprogramming, whereby cancer cells alter their metabolic behavior to meet the demands of energy production, biosynthesis, and redox homeostasis, distinguishing them from normal cells. Numerous environmental, behavioral, and biological factors contribute to cancer risk, including alcohol consumption, tobacco use, frequent intake of fast foods, exposure to environmental pollutants, viral infections such as human immunodeficiency virus (HIV), psychological stress, and dysregulation of key metabolic pathways involving glucose, amino acids, and fatty acids. Cancer progression involves the transformation of normal cells into highly malignant and invasive tumors, often accompanied by genomic instability. Emerging evidence suggests that modifiable lifestyle factors play a crucial role in both the development and prevention of cancer. Adoption of healthy dietary patterns, calorie restriction, regular physical activity, cessation of smoking and alcohol use, and avoidance of obesity-promoting behaviors such as excessive consumption of fatty foods and hot beverages can help regulate metabolic alterations and significantly reduce cancer risk. This review highlights the interplay between risk factors, metabolic changes, and lifestyle interventions in cancer development and prevention.
Copyright (c) 2026 Mahnoor, Zia Ud Din, Faheem Akhtar, Muhammad Yaseen Sufyan, Noshad Ali Sajid https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of kidney functions in diabetic patients: A mini review
Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia resulting from insufficient insulin production, impaired insulin action, or both. In autoimmune-mediated diabetes, pancreatic β-cells are progressively destroyed, leading to disrupted glucose metabolism. Prolonged hyperglycemia causes damage to small blood vessels and contributes to serious complications, including diabetic nephropathy, which may progress to end-stage renal disease requiring dialysis or kidney transplantation. The reported incidence of kidney failure ranges from 30-40% in patients with type 1 diabetes and 10-40% in those with type 2 diabetes. Early and accurate assessment of renal function is therefore essential for reducing morbidity and mortality among diabetic patients. This mini review focuses on the commonly used methods for evaluating kidney function in diabetes, with particular emphasis on glomerular function. Various biochemical and clinical approaches are discussed, including renal function tests, urine analysis, albumin-to-creatinine ratio (ACR), and estimation of glomerular filtration rate (GFR) using endogenous and exogenous markers such as inulin. Blood-based assays assessing protein concentrations and urine-based measurements of solute clearance, combined with mathematical models, remain fundamental tools for estimating GFR. Early detection of renal impairment through appropriate diagnostic strategies can significantly reduce the risk of renal complications in diabetic patients and improve long-term clinical outcomes.
Copyright (c) 2026 Muhammad Anas, Samuel Emmanuel, Hafiz Ayaz Ahmad, Sadaf Ahmed https://creativecommons.org/licenses/by-nc-nd/4.0
Correlation of C-reactive protein, Antinuclear antibodies and Anti-cyclic citrullinated peptide with Rheumatoid Arthritis: A Mini Review
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder affecting approximately 0.5-1% of the global population and is characterized by persistent inflammation and progressive joint damage. This review aims to examine the association between RA and key inflammatory and autoimmune biomarkers, including C-reactive protein (CRP), anti-cyclic citrullinated peptide (anti-CCP) antibodies, and antinuclear antibodies (ANAs), and to evaluate their clinical relevance in RA patients. Relevant peer-reviewed literature was analyzed to assess the role of these biomarkers in disease activity, diagnosis, and systemic involvement in RA. CRP, a highly conserved acute-phase protein synthesized by the liver, increases in response to pro-inflammatory cytokines and correlates with disease activity; serum CRP levels typically decline with effective treatment and rise during clinical deterioration. Anti-CCP antibodies, directed against citrullinated proteins, are highly specific for RA and are valuable for early diagnosis and prognostic assessment, while ANAs are present in a subset of patients, reflecting overlapping autoimmune features. Although RA primarily affects synovial joints, extra-articular manifestations occur in approximately 40% of patients and may involve multiple organ systems. Biomarkers such as CRP, anti-CCP antibodies, and ANAs play a critical role in the diagnosis, monitoring, and prognostication of rheumatoid arthritis, particularly given the challenges associated with early disease detection.
Copyright (c) 2026 Rimsha Irshad, Hira Yaseen, Tasra Bibi, Talha Saleem, Zubair Sharif https://creativecommons.org/licenses/by-nc-nd/4.0
Evaluation of Diagnostic and Prognostic Accuracy of Serum C-Reactive Protein and Blood Cultures from Acute Infective Endocarditis Patients
Risk identification and early diagnosis in infective endocarditis patients are considered limited approaches due to their poor microbiological outcomes and slow diagnostic accuracy. To reduce these risks, a rapid identification marker is needed. The current study was designed with the objective of assessing C-Reactive Protein (CRP) efficiency as a means of evaluating the diagnosis of infective endocarditis and its prognostic ability, as well in comparison with blood cultures. CRP was performed using a sandwich-based enzyme-linked immunosorbent assay (ELISA), while the blood cultures were performed using a bacterial culture technique. Antibiotic susceptibility testing was performed to ascertain potential antibiotics to treat infective endocarditis. A total of 1789 patients with suspected endocarditis were recruited, of whom 381 were diagnosed as having infective endocarditis. All the serum samples were tested for CRP, and the blood samples were processed for blood cultures. CRP with less than 1.0 mg/dl was considered negative. Out of 1627 patients, a total of 381 had a positive or higher CRP serum level. The blood culture of 139 patients was positive, with Staphylococcus aureus being the most predominant (n = 46) pathogen. Hospital death was seen in 23 patients with a significantly high CRP level. During treatment, the responsive interventions showed a 20% decrease in disease severity; however, at the end of the treatment, after eradication of symptoms, CRP level varied in 59 patients. The current study concluded that CRP after the first week of treatment is a significant predictor of clinical outcome and can be used as a good prognostic marker.
Copyright (c) 2025 Sameer Zafar, Muhammad Khizar Siddique https://creativecommons.org/licenses/by-nc-nd/4.0
A Performance Assessment Study of Different Respiratory Samples for the Diagnosis of Pulmonary Tuberculosis (TB) using GeneXpert, Smear Staining, and TB Cultures
Tuberculosis (TB) is one of the major re-emerging diseases. An increase in disease burden and subsequent misuse of anti-tuberculosis drugs has made the situation worse. Early diagnosis followed by antibiotic susceptibility testing can lower the increase in occurrence of multidrug-resistant (MDR). Conventional methods of diagnosing TB are laborious and time-consuming, so the present study was designed to evaluate the relative efficacy of conventional methods, including Ziehl-Neelsen (ZN) stain, fluorescent stain, BD Mycobacteria growth indicator tube (MGIT) liquid culture system, and molecular diagnosis via GeneXpert, using different respiratory samples. Results of the present study showed that A total of 642 samples were found positive via the BD MGIT Liquid cultures method, 483 using the ZN staining technique, 507 with the fluorescent staining technique, and 663 for GeneXpert, respectively. It was evident from the results that out of the samples tested, GeneXpert has a higher sensitivity than AFB smear microscopy and liquid culture methods in respiratory samples. GeneXpert can be a useful tool for early diagnosis of patients with high clinical suspicion of pulmonary TB. Positive GeneXpert, but culture-negative results should be read cautiously and well correlated with the clinical and treatment history of the patient. The other major advantage of GeneXpert is that it simultaneously detects Rifampicin (Rif) resistance and is especially beneficial in patients with MDR tuberculosis, and should be studied further. As False negative or false positive cases cause overuse of anti-TB drugs, leading to the emergence of MDR-TB. So, timely and accurate diagnosis is the key factor in the management of the disease, especially in countries like Pakistan with limited resources.
Copyright (c) 2025 Muhammad Naveed Aslam, Hussna Khan https://creativecommons.org/licenses/by-nc-nd/4.0
Application of CRISPR-based Technology in Infectious Diseases: A Review on its Potential Therapeutic and Diagnostic Aspects
CRISPR-based technology is an interesting gene-editing technology that has created a remarkable position in the world of biology. The ability of CRISPR to detect a specific pathogen in the living cell, destroying that pathogen by on-target cleavage, is the main reason for its popularity. Due to the specificity associated with this system, its low-cost availability and high efficacy, it is a vital landmark in the biomedical field. Interestingly, it has been applied in the treatment of several viral infections like HIV, COVID-19, some bacterial infections, and fungal infections. The treatment includes the use of molecular scissors to cleave the DNA at a specific location of mutation. The removal of the mutated part provides outstanding results. Production of an enormous number of CRISPR-based therapeutics has gained attention because of their high effectiveness. But more research and clinical trials still need to be done to explore the CRISPR-Cas9 system and enhance its effectiveness. From the time of its discovery till now, almost 6 types and 22 subtypes of CRISPR systems have been discovered. Moreover, CRISPR diagnostic tools like SHERLOCK are used, and diagnostic tests are performed with the help of simple reagents. Many preclinical trials and clinical trials are going on to enhance its features. CRISPR systems have a broad range of applicability, and in the near future, various therapies and diagnostic tools will be discovered.
Copyright (c) 2025 Aatiqa Masoom, Mohsin Rasheed https://creativecommons.org/licenses/by-nc-nd/4.0
Inverse Relationship Between Serum Alkaline Phosphatase and Calcium in Osteoarthritis Patients
Osteoarthritis (OA) is a progressive degenerative joint disorder characterized by biochemical and structural alterations in cartilage and surrounding tissues. This study aimed to evaluate the correlation between serum alkaline phosphatase (ALP) activity and serum calcium levels in osteoarthritis patients compared with healthy controls to identify deviations from normal physiological ranges. A total of 100 clinically diagnosed OA patients (61% male, 39% female), aged 45 years and above, were recruited from the outpatient department of Teaching Hospital Shahdara, and their serum samples were analyzed for ALP and calcium concentrations. Findings revealed elevated serum ALP levels and comparatively lower serum calcium levels in OA patients. An inverse relationship was observed between these two biochemical parameters, suggesting their potential utility as inexpensive and accessible biomarkers for assessing osteoarthritis severity.
Copyright (c) 2025 Sameer Ashraf, Zeeshan Abbas https://creativecommons.org/licenses/by-nc-nd/4.0
Correlation of Body Mass Index with Glycemic Control in Type II Diabetes Patients Experiencing Respiratory Infection
Deficient glycemic control among patients with type 2 diabetes mellitus (T2DM) represents a major public health concern. This study aimed to determine the relationship between body mass index (BMI) and glycemic control (HbA1c) in T2DM patients who experienced COVID-19 infection in the rural population of Central Punjab. An observational cross-sectional study was conducted among male and female patients aged 35 years and above attending the outpatient clinic at the Rural Health Center, Awan Dhai Wala, Lahore, from 1 October 2021 to 31 March 2022. BMI and HbA1c levels were analyzed using the Pearson correlation coefficient (r). A total of 300 patients were included, with a mean age of 49.76 ± 8.81 years (median: 51; range: 35–65). The mean BMI was 24.37 ± 4.11 (median: 24; range: 17.5–36). A statistically significant difference (p = 0.001) was observed between mean BMI in patients with good glycemic control (21.81 ± 3.15) and those with poor glycemic control (25.22 ± 4.05). BMI category stratification also showed a significant association with glycemic control (p = 0.001). The Pearson correlation coefficient demonstrated a moderate positive correlation between BMI and HbA1c (r = 0.40), indicating that higher BMI is associated with poorer glycemic control. Overall, the findings suggest that elevated BMI contributes to inadequate glycemic control in T2DM patients previously infected with COVID-19 in rural Central Punjab.
Copyright (c) 2025 Shah Rukh Arshad Chaudhary, Muhammad Hassan Riaz, Amna Yaseen Chaudhary https://creativecommons.org/licenses/by-nc-nd/4.0
Epstein-Barr Virus and Nasopharyngeal Carcinoma: A Review on Virology, Oncogenic Mechanisms, and Clinical Implications
Epstein-Barr virus (EBV) is a ubiquitous human gammaherpesvirus with the unique ability to establish lifelong latency and drive oncogenic transformation in several malignancies, including nasopharyngeal carcinoma (NPC). This review summarizes the essential virology of EBV, highlighting its structural components, infection mechanisms, and latent gene expression programs that facilitate immune evasion and cellular transformation. A strong epidemiological and molecular correlation exists between EBV infection and the development of NPC, particularly in endemic regions. EBV exhibits a tropism for epithelial cells lining the nasopharynx, where it invades through receptor-mediated entry and establishes latent infection. Key viral oncogenes such as latent membrane protein 1 (LMP1), LMP2, and EBNA1 activate multiple oncogenic pathways including NF-κB, JAK/STAT, PI3K/AKT, and MAPK, promoting proliferation, resistance to apoptosis, and genomic instability. Additional biomarkers such as circulating EBV DNA and serological antibodies offer diagnostic and prognostic value. The review also outlines the current staging system for NPC, which guides clinical management and treatment decisions. Understanding the interplay between EBV virology, host immune responses, and molecular drivers provides critical insights into NPC pathogenesis and highlights potential targets for early detection, prevention, and therapeutic intervention.
Copyright (c) 2025 Yaqeen Rjoub, Sabal Adel Ali Rahaifeh https://creativecommons.org/licenses/by-nc-nd/4.0
The impact of oral health on high recurrences of long-COVID-19
The severity of the symptoms for Coronavirus Disease-2019 (COVID-19) varies according to the infection's clinical stage. The oral lesions of COVID-19 individuals include a wide variety of lesions and infection locations. Understanding the whole range of clinical COVID-19 symptoms, including oral manifestations, is crucial if one is to comprehend the infection's potential long-term implications as well as its negative side effects. The oral symptoms of Long-COVID-19 can be exacerbated by the three direct causes of SARS-CoV-2 infection: an immune system, an oral mucosa imbalance, and poor oral hygiene.
Copyright (c) 2025 Mai Abdel Haleem Abusalah, Maryam Shafaati https://creativecommons.org/licenses/by-nc-nd/4.0
The 30-bp Deletion in the LMP1 Oncogene as a Diagnostic and Prognostic Biomarker in Nasopharyngeal Carcinoma: A scoping review
Nasopharyngeal carcinoma (NPC) is a malignancy with a distinct geographical and ethnic distribution, strongly associated with the Epstein-Barr virus (EBV). The latent membrane protein 1 (LMP1) is a key EBV oncogene critical in the pathogenesis of NPC. A common 30-base pair (bp) deletion in the LMP1 gene has been identified and is postulated to enhance the oncogenic potential of the virus. This review aims to synthesize and evaluate the existing evidence on the clinical significance of the 30-bp deletion in LMP1 as a potential diagnostic and prognostic biomarker. Current evidence indicates a high prevalence of the LMP1 30-bp deletion variant in NPC tumors. The literature suggests that this genetic variant is associated with more advanced tumor stages, increased risk of metastasis, and poorer overall survival, underscoring its strong prognostic value. The accumulated data robustly position the LMP1 30-bp deletion as a highly promising molecular biomarker for NPC. Its integration into the clinical workflow could significantly improve risk stratification, guide personalized treatment strategies, and enhance patient management.
Copyright (c) 2025 Aseel Yousef Moussa Al-Hussien, Abdulrahman Alrayyes https://creativecommons.org/licenses/by-nc-nd/4.0
Role of CT Angiography and Doppler Ultrasound in the Evaluation of Peripheral Vascular Diseases: A Review on Diagnostic Challenges and Insights from Special Populations
Peripheral Vascular Diseases (PVD) are a group of diseases that damage or block the blood vessels present outside the heart and brain. The arteries and veins that are affected by these diseases are responsible for carrying blood to the limbs and other peripheral parts of the body. Blood flow is reduced, commonly in the lower body parts, and symptoms such as pain, cramping, numbness, and in severe cases, tissue damage or gangrene result due to these diseases. Atherosclerosis, diabetes, smoking, and hypertension are associated with PVD, and now it has become a threat to public health worldwide. Improved quality of life and reduced risk of cardiovascular events can be achieved by early diagnosis and proper management, and complications can also be prevented. Many individuals are affected by PVD, and it contributes to morbidity and mortality, so it is a global challenge. Doppler Ultrasound and Computed Tomography Angiography (CTA) are the available imaging techniques for evaluating vascular anatomy and hemodynamics, and these are the most widely used external diagnostic methods. The current review provides an overview of the role of CTA and Doppler ultrasound for the evaluation of PVD with special focus on diagnostic challenges in the special population.
Copyright (c) 2025 Waleed Sultan, Jamshaid Ahmad, Parsa Kanwal https://creativecommons.org/licenses/by-nc-nd/4.0
Antimicrobial resistance mechanism among Gram-negative bacteria: A mini review
Antimicrobial resistance (AMR) has emerged as a pressing global health issue, primarily fueled by the inappropriate and excessive use of antimicrobial agents, along with the limited progress in developing new and innovative antibiotics. According to the World Health Organization, AMR ranks among the ten most significant threats to global public health. The cell membranes of Gram-negative bacteria play an essential role in their survival and adaptation to different environments. These membranes not only determine the surface characteristics of the bacteria but also serve as protective and functional barriers. Structurally, Gram-negative bacteria possess dual membranes, with the outer membrane comprising proteins and additional components. In many cases, this outer membrane prevents harmful substances such as antibiotics from penetrating, which poses a major challenge in eliminating Gram-negative bacterial infections using both conventional and newly developed antimicrobial agents.
Copyright (c) 2025 Muhammad Talha Ali, Hamna Masoom https://creativecommons.org/licenses/by-nc-nd/4.0
Attitude and awareness regarding organ donation among medical students and patients in Lahore, Pakistan
A cross-sectional study was conducted to investigate the awareness, attitudes, and willingness regarding organ donation among medical students and hospital patients in Lahore, Pakistan, and to identify key socio-demographic factors influencing these perspectives. Data were collected from 200 participants, selected via analytical sampling, using a structured interview protocol (proforma). The findings indicate that 65.5% of the local sample were aware of organ donation, versus a global benchmark of 72.8%. Willingness to donate was higher among medical students (25%) than patients (15%). Knowledge of organ donation was significantly associated with educational attainment and socioeconomic status. Willingness to donate was significantly linked to gender and the extent of prior organ donation education. While a baseline awareness of organ donation exists in Lahore, there is a significant gap in willingness to donate, particularly among patients. Educational interventions, tailored to address socio-economic and gender-specific factors, are crucial to improving organ donation rates.
Copyright (c) 2025 Shakeel Ahmad, Muhammad Umair Khan, Sadaf Ahmed, Talha Saleem, Sidra Hasnain, Zubair Sharif https://creativecommons.org/licenses/by-nc-nd/4.0
Clinicopathological presentation of COVID-19 patients presented at the rural healthcare center
The current observational cross-sectional study was conducted to determine hematological anomalies in young (below 50 years old) and elderly (above 50 years old) patients that were suffering from coronavirus diseases-2019 (COVID-19) reported at an outpatient clinic in the rural healthcare center from 1st May 2021 to 31st August 2021. A total of 100 patients reported in the above-mentioned time frame were included in the current study, which were confirmed with diagnosis of COVID-19 infection by real time polymerase chain reaction (RT-PCR) using a nasopharyngeal swab (NPS). Data were collected on demographic factors, sign & symptoms, comorbidity status, and hematological parameters. A total of 100 COVID-19 positive patients were enrolled in this study with a mean age 49 years. The majority 66 (66%) of participants were male with a mean body mass index (BMI) of 26. In addition, the cough was the most prevailing symptom 74 (74%), followed by fever 68 (68%), shortness of breath 60 (60%), and absence of taste/smell 3 (3%), respectively. Also, diabetes was the most prevalent comorbidity 44 (44%), after that hypertension 33 (33%), ischemic heart disease 17 (17%), urinary tract infection 8 (8%), and chronic kidney disease 1 (1%), respectively. The bifurcations of hematological factors of COVID-19 positive patients with respect to age groups were also presented. This work determined that the hematological, coagulative, and inflammatory markers are the utmost important parameters in predicting the management, treatment, and prognostication of COVID-19 infection.
Copyright (c) 2025 Shah Rukh Arshad Chaudhary, Kirnpal Kaur Banga Singh, Ali A. Rabaan https://creativecommons.org/licenses/by-nc-nd/4.0
Scientific prominence of Epstein-Barr Virus (EBV) Concomitant with Nasopharyngeal carcinoma
Nasopharyngeal carcinoma (NPC) is rare malignancy worldwide, yet it is prevalent in South part of China, North, Southeast part of Asia and Arctic. The core components in arrears to this exceptional topographical dispersion stay obscure. Although Epstein-Barr virus (EBV) contamination already appeared as per an imperative cause intended for undistinguishable NPC, the EBV itself isn't adequate to the actual cause of carcinoma. Additionally, co-factors, for example, environmental factors & genetic vulnerability might be related with EBV to commence a share in NPC carcinogenesis. Endurance amounts contrast amongst the patients of NPC at the beginning and last phases. Because of nearby relationship among EBV contamination and risk associated with NPC, Biomarkers related with EBV have been utilized for primary position and NPC evaluation in a couple of extraordinary-occurrence regions. Many vaccines and therapeutic trials also have been performed on patients with NPC. The most recent clinical updates and therapeutic trials have been discussed in this review article.
Copyright (c) 2025 Anam Yousaf, Jawaria Pervaiz, Anam Farzand, Muneeb Ahmad https://creativecommons.org/licenses/by-nc-nd/4.0
DNA replication: causes of replication stress and DNA damage response pathways
DNA replication is a crucial cellular mechanism that enables proper genetic information to be duplicated and subsequently transferred to the daughter cells. Several perturbations, whether endogenous or external, can impede the accurate advancement and completion of the replication process, endangering genomic integrity, known as replication stress. Secondary DNA structures like alternative non-B form at common fragile sites, oncogenes (RAS, MYC, Cyclin E and CDC6) induction, ribonucleotides (precursors of RNA) incorporation into DNA, RNA:DNA hybrids and other factors have serious implications on cell survival, genome stability and human diseases like carcinogenesis. Cellular DNA damage response as well as DNA repair are crucial for ensuring accurate synthesis of genetic material and preserving genome integrity in case of replication stress. This review aims to highlight the major causes of replication stress as well as the DNA damage response mechanisms that are induced to maintain genomic stability during DNA replication.
Copyright (c) 2025 Anam Yousaf (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Unconventional Presentation of Smoldering Multiple Myeloma: A Case Study
Haematological malignancy multiple myeloma (MM) affects elderly people and causes abnormal plasma cell development in the bone marrow. Despite its low prevalence, MM causes severe illness and death. Patients often experience anaemia, bone discomfort, and renal failure. Acute kidney injury (AKI) and myeloma cast nephropathy result in significant renal complications that require quick identification and treatment. This 52-year-old woman originally resembled smoldering multiple myeloma (SMM) but later had acute renal failure due to myeloma cast nephropathy. Haemodialysis continued despite timely chemotherapy initiation since renal function did not improve. Hypercalcemia and lytic bone lesions were absent in our patient, making the diagnosis difficult. SMM has a much lower incidence than MM, according to the literature. Early identification and treatment are crucial for high-risk SMM patients who develop MM. Our report illustrates the diagnostic difficulty of atypical MM, especially when traditional indicators are normal or absent. A primary symptom of renal involvement can delay identification and therapy. This case shows that MM diagnosis and treatment require strong clinical suspicion and full assessment, including a kidney biopsy when necessary. Clinicians must report unexpected MM presentations and consider it a diagnosis in patients with significant symptoms.
Copyright (c) 2025 Samiya Abbas, Sarah Nisar, Kamran Naseem, Maryam Samad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Pulmonary Tuberculosis and COVID-19 Co-infections in Lahore, Pakistan: A retrospective cohort study
Tuberculosis (TB) and Coronavirus disease-2019 (COVID-19) are two major re-emerging diseases that poses significant health issues. Increase in disease burden and subsequent misuse of anti-TB drugs has become a serious health challenge. Early diagnosis followed by antibiotic susceptibility testing can lower the increase in occurrence of multidrug resistant TB. The present study was designed to compare the performance of GeneXpert and microscopy to the gold standard (culture) in sputum and broncho-alveolar lavage samples (n = 2862) and to check the prevalence of COVID-19 coinfections among the TB patients in Lahore, Pakistan. Results of the present study showed that, a total of 642 samples were found positive for TB via BD MGIT Liquid cultures method, 483 using Ziehl-Neelsen staining technique, 507 with fluorescent staining technique and 663 using GeneXpert respectively. In overall, 23% prevalence of TB was seen in the current study. The positive ratio of TB using GeneXpert in broncho alveolar lavage samples (24.56%) was more as compare to the Sputum (23.07%). Out of these 663 TB positive patients, a total of 197 were having COVID-19 like symptoms and were tested for COVID-19 using PCR. Among these 197 cases, 13 were found positive for COVID-19, from which 3 were resistant to Rifampicin (Rif). The diagnostic tests like GeneXpert have made improvements in the rapid diagnosis of TB and has high specificity and sensitivity.
Copyright (c) 2025 Muneeb Ahmad, Muhammad Umer Saeed, Mavra Hafeez, Sara Masood Cheema, Jawaria Pervaiz https://creativecommons.org/licenses/by-nc-nd/4.0
Welcome to the Electronic Journal of Medical Research
The Editorial Board of Electronic Journal of Medical Research (JMR) is excited to invite submissions for upcoming issues covering a broad range of topics within the field of medical research. As the journal continues to foster a platform for cutting-edge research, we aim to serve as a premier forum for cutting-edge research across all fields of medicine and healthcare, with a special emphasis on innovations in medical laboratory technology, diagnostic methodologies, and translational research. This invitation is open to researchers, clinicians, medical laboratory professional and scholars to join us in fostering innovation, collaboration, and evidence-based knowledge dissemination.
Copyright (c) 2025 Naveed Ahmed (Author) https://creativecommons.org/licenses/by-nc-nd/4.0