Over the past few decades, gene therapy has gained immense importance in medical research as a promising treatment strategy for diseases such as cancer, AIDS, Alzheimer’s disease, and many genetic disorders. When a gene needs to be delivered to a target cell inside the human body, it has to pass a large number of barriers through the extracellular and intracellular environment. This is why the delivery of naked genes and nucleic acids is highly unfavorable, and gene delivery requires suitable vectors that can carry the gene cargo to the target site and protect it from biological degradation. To date, medical research has come up with two types of gene delivery vectors, which are viral and nonviral vectors. The ability of viruses to protect transgenes from biological degradation and their capability to efficiently cross cellular barriers have allowed gene therapy research to develop new approaches utilizing viruses and their different genomes as vectors for gene delivery. Although viral vectors are very efficient, science has also come up with numerous nonviral systems based on cationic lipids, cationic polymers, and inorganic particles that provide sustainable gene expression without triggering unwanted inflammatory and immune reactions, and that are considered nontoxic. In this review, we discuss in detail the latest data available on all viral and nonviral vectors used in gene delivery. The mechanisms of viral and nonviral vector-based gene delivery are presented, and the advantages and disadvantages of all types of vectors are also given.

Water plays an important role in power generation, fuel manufacturing, and processing. This has been valid for several decades, but lately, primarily due to climate change, the limitations and insecurity related to water energy connections have become more prominent. The article is a quantitative review study conducted to evaluate the water–energy nexus in the Middle East and North Africa (MENA) region. Information about the review was generated from online databases by using keywords such as water–energy nexus, MENA region, Power Generation, Fuel Manufacturing, Energy-intensive, Energy Management Decisions, and Desalination Systems. Drip irrigation in Morocco played a vital role in the water–energy nexus for resource conservation and their better utilization. From the findings, it was revealed that distorted coupling with a relatively low reliance on freshwater energy systems has a high reliance on conceptual water and energy production systems. For Saudi Arabia, extraction and desalination of groundwater are projected to be up to 9% of total annual electricity use. Policymakers should consider energy implications for water-intensive food imports and possible water demand restructuring. This would lead to more coordinated water and energy management decisions. A comprehensive evaluation in some cases promotes the reuse of water and improvements in the agricultural sector rather than the development of energy-intensive and expensive desalination systems. One of the limitations for water–energy nexus in the MENA region is its unintelligible patterns for policy and decision-makers, and this quantitative review can be a major advancement in this regard. This study also highlights the use of water as an energy production source as well as the energy that is being utilized in water treatment and processing and their interrelationship. Cohesive and strategic tactics can lead technology’s research and development to reporting local issues of water and energy issues. Improving and participating models and data will better assist scholars, decision-makers, and the community. This water–energy nexus study mounts relevant challenges and areas of improvement for future research.

High levels of stress are expected when crises affect people’s lives. Therefore, this Web-based, cross-sectional study was conducted among university students from Pakistan to investigate the psychological impairment and coping strategies during the coronavirus disease 2019 (COVID-19) pandemic. Google Forms were used to disseminate the online questionnaire to assess anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and coping strategies (Brief-COPE). A total of 1134 responses (age, 21.7 ± 3.5 y) were included. The frequency of students having moderate-severe anxiety and depression (score ≥ 10) were ≈ 34% and 45%, respectively. The respondents’ aged ≥ 31 y had significantly lower depression score than those ≤ 20 y (P = 0.047). Males had significantly less anxiety (6.62 ± 5.70 vs 7.84 ± 5.60; P = 0.001) and depression (8.73 ± 6.84 vs 9.71 ± 7.06; P = 0.031) scores. Those having family members, friends, or acquaintances infected with disease had significantly higher anxiety scores (8.89 ± 5.74 vs 7.09 ± 5.56; P < 0.001). Regarding coping strategies, the majority of respondents were found to have adopted religious/spiritual coping (6.45 ± 1.68) followed by acceptance (5.58 ± 1.65), self-distraction (4.97 ± 1.61), and active coping (4.81 ± 1.57). In conclusion, COVID-19 caused significant impairment on mental health of the students. The most frequent coping strategies adopted by students were religious/spiritual and acceptance coping. During epidemics, mental health of students should not be neglected.

Rising XDR-Typhoid Fever Cases in Pakistan: Are We Heading Back to the Pre-antibiotic Era?

Type 2 Diabetes mellitus is a major public health concern with an alarming global growth rate. According to the World Health Organization (WHO), Saudi Arabia ranks seventh in the world and second in the Middle East for the largest estimated burden of diabetic cases. Evidence shows that pharmacist-led care programs can be beneficial for the effective treatment of diabetes mellitus. Current study was aimed to evaluate the impact of Pharmacist-Based Diabetic Intervention (PDIM) for Type 2 Diabetes patients on knowledge of the disease, adherence to medications and self-care practices during the first wave of COVID-19. A multi-arm pre-post study was conducted among type 2 diabetic patients from April to October 2021 in Sakaka, Saudi Arabia. Patients were randomly divided into an intervention and a control group. The intervention group received the PDIM, whereas the control group only received the usual care. The pharmacist-based diabetes intervention model consisted of a diabetic educational module and medication improvement strategies. Furthermore, the intervention group also received specific telepharmacy services (calls, messages or emails) to address their medication-related problems, inquire about medication adherence and follow-up. At the end of six months, disease knowledge, self-care practices, and medication adherence score were analyzed. Furthermore, HbA1c and lipid profile were also compared. A total of 109 patients were included in the study. A significant difference was observed in the knowledge score between the intervention and control group (16.89 ± 2.01 versus 15.24 ± 2.03, p-value < 0.001). Similarly, self-care practices also improved in the intervention group as compared to the control group (4.39 ± 1.10 versus 3.16 ± 0.97, p-value < 0.001). Furthermore, the medication adherence and HbA1c significantly improved during between the group analysis (p < 0.05). Our study demonstrates that pharmacist-based diabetes intervention model is effective in improving patients’ knowledge of diabetes, self-care practices, medication adherence and glycemic control.

Ticagrelor (TCG) is a BCS class IV antiplatelet drug used to prevent platelet aggregation in patients with acute coronary syndrome, having poor solubility and permeability. The goal of this study was to develop a self-nanoemulsifying drug delivery system (SNEDDS) of TCG to improve its solubility and permeability. The excipients were selected based on the maximum solubility of TCG and observed by UV spectrophotometer. Different combinations of oil, surfactant, and co-surfactant (1:1, 2:1, and 3:1) were used to prepare TCG-SNEDDS formulations, and pseudo-ternary phase diagrams were plotted. The nanoemulsion region was observed. Clove oil (10–20%), Tween-80 (45–70%), and PEG-400 (20–45%) were used as an oil, surfactant, and co-surfactant, respectively. The selected formulations (F1, F2, F3, F4, F5, and F6) were analyzed for ζ potential, polydispersity index (PDI), ζ size, self-emulsification test, cloud point determination, thermodynamic studies, entrapment efficiency, Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), in vitro dissolution, ex vivo permeation, and pharmacodynamic study. The TCG-SNEDDS formulations exhibited ζ potential from −9.92 to −6.23 mV, a ζ average of 11.85–260.4 nm, and good PDI. The in vitro drug release in phosphate buffer pH 6.8 from selected TCG-SNEDDS F4 was about 98.45%, and F6 was about 97.86%, displaying improved dissolution of TCG in 0.1 N HCl and phosphate buffer pH 6.8, in comparison to 28.05% of pure TCG suspension after 12 h. While the in vitro drug release in 0.1 N HCl from F4 was about 62.03%, F6 was about 73.57%, which is higher than 10.35% of the pure TCG suspension. In ex vivo permeability studies, F4 also exhibited an improved apparent permeability of 2.7 × 10–6versus 0.6708 × 10–6 cm2/s of pure drug suspension. The pharmacodynamic study in rabbits demonstrated enhanced antiplatelet activity from TCG-SNEDDS F4 compared to that from pure TCG suspension. These outcomes imply that the TCG-SNEDDS may serve as an effective means of enhancing TCG’s antiplatelet activity by improving the solubility and permeability of TCG.