Pakistan BioMedical Journal

Association Analysis of CYP2A6 Gene Variant (rs1801272A>T) with Nicotine Metabolism and Smoking Tendency among Pakistani Youth

Mon, 30 Jun 2025 00:00:00 +0000

Cytochrome P450 2A6 (CYP2A6) is a key enzyme in nicotine metabolism, with its genetic variants playing a role in smoking behavior. Particularly, g.40848628A>T is significantly associated with nicotine metabolism and smoking tendency in different populations. Objectives: To examine the genetic diversity of this locus and association analysis within smokers and non-smokers cohorts among Pakistani youth. Methods: The allele-specific ARMS PCR genotyping technique was applied to examine a total of 100 samples as a case-control study of n=50 from each cohort. Results: From the sampled individuals, 92% were found to be homozygous wild-type (AA), 7% were heterozygous (AT), and 1% were homozygous mutant (TT). PLINK software was used for the Chi-square test yielded, χ² (1, n=100) =2.91, p=0.088, suggesting a non-significant trend towards association, where alternative allele frequencies were calculated as 0.07 and 0.02 in cases and control cohorts, respectively. Similarly, Hardy-Weinberg Equilibrium (HWE) p=0.1714 indicates genotype frequencies did not significantly deviate from HW expectations and no error or selection in the overall samples. The carriers of the alternative allele have 3.688 times higher odds of being affected by the condition compared to non-carriers with the reference allele. Conclusions: It was concluded that future studies with a larger sample size may help to clarify the population structure of the subject locus. Genome-wide association studies using next-generation sequencing may also aid in predicting nicotine metabolism and resistance to smoking cessation in the Pakistani population.

Review article Pulmonary Tuberculosis Rehabilitation: Evidence-Based Physiotherapy and Technological Advancements for Sustainable Development Goal Achievement, a Narrative Review

Mon, 30 Jun 2025 00:00:00 +0000

Pulmonary tuberculosis (PTB) remains a leading cause of global morbidity and mortality, with over 10 million new cases annually and 155 million survivors worldwide. Many TB survivors suffer from post-TB lung disease (PTLD), including chronic airflow obstruction, fibrosis, and bronchiectasis, leading to persistent respiratory symptoms and reduced quality of life. This review summarizes the evidence-based physiotherapy interventions and technological advancements in pulmonary rehabilitation (PR) for TB survivors, and highlights their potential contribution to Sustainable Development Goal (SDG) 3 (Good Health and Well-being) by improving lung function, physical capacity, and overall health outcomes. A comprehensive review of recent studies (2015–2025) was conducted, encompassing randomized controlled trials, quasi-experimental studies, and pilot programs investigating PR interventions and technology-assisted rehabilitation for PTLD. Evidence supports the effectiveness of airway clearance techniques (e.g. postural drainage, percussion, breathing exercises), exercise training (aerobic and resistance), and multicomponent PR programs in improving lung function (FEV₁, FVC), exercise tolerance (6-minute walk distance), and quality of life. Technological innovations such as wearables, AI-based monitoring, and virtual reality (VR) platforms enhance remote supervision, adherence, and engagement. AI algorithms show promise in predicting rehabilitation response, personalizing training, and detecting early deterioration, while telerehabilitation platforms facilitate access to PR in low-resource settings. Evidence-based physiotherapy interventions, supported by technological advancements, offer effective rehabilitation strategies for TB survivors with PTLD. Integration of wearable sensors, AI, and VR into PR programs can improve adherence, exercise capacity, and health outcomes, contributing to SDG 3 by promoting inclusive, equitable health services.

Ultra Processed Foods, Metabolic Syndrome, and the Pharmaceutical Burden: A Global Paradox

Muhammad Irfan Bashir — Mon, 30 Jun 2025 00:00:00 +0000

The increasing prevalence of metabolic syndrome worldwide presents a paradox: while lifestyles and their associated health risks are becoming well recognised, pharmacological interventions are still on the rise. An increased consumption of ultra-processed foods (UPFs) is a major factor in this public health issues. These highly processed foods contain very less quantity of actual nutrients.

These processed foods are sole dietary sources in many countries. A previous prospective cohort study conducted in 2025 demonstrated that increasing use of UPFs is significantly linked with an elevated risk of hypertension, cardiovascular disease, and all lead to mortality [1]. Findings suggested that these foods are associated with metabolic disorders such as obesity, insulin resistance, and type 2 diabetes.

At the same time, the pharmaceutical industry has rapidly expanded the new drugs for the treatment of metabolic syndrome. Among them statins, antihypertensives, metformin, and GLP-1 receptor agonists are widely used as first line therapy. According to market survey, the global market for such treatments will exceed US$120 billion by 2029 [2]. These approaches are only for the treatment of disease not to prevent it. Mostly physicians recommend to treat diabetes through medicines but some healthcare providers still guide patients for reversal of diabetes by removing processed foods from their life.

The paradox that these two industries expand in relation to each other’s influence offers important ethical and policy implications. One profits from selling unhealthy foods, while the other profits from putting a band-aid on the resulting problems. The absence of a concerted regulatory response has allowed this cycle to continue, especially in jurisdictions where public health policy is under-resourced or poorly enforced.

The economic fallout is no less grave. A recent modelling report showed that if obesity-associated conditions are not mitigated, the global economy could lose GDP by as much as USD 2.76 trillion per annum by 2050 [3]. This anticipated burden exceeds that of many communicable diseases and calls for a new global health focus.

Preventions, we must focus. Such policies include fiscal measures (sugar and UPF taxes), front-of-pack labelling, food reformulation mandates, and subsidies for whole, nutrient-dense foods. Healthcare professionals, particularly pharmacists and general practitioners, could also play a positive role by advising patients on diet and lifestyle before initiating long-term drug treatment.

In summary, the blossoming of metabolic disease despite progress in medical practice demands that we re-examine our food systems and health policies. A successful response will require more than better drugs; rather, it calls for bold policies that encourage healthier dietary patterns and wean people off ultra-processed products. Shifting our emphasis away from treating disease and toward preventing it isn’t just scientifically justified—it’s economically and ethically necessary.