Naegleria fowleri, a thermophilic flagellate amoeba known as a “brain‐eating” amoeba, is the aetiological agent of a perilous and devastating waterborne disease known as primary amoebic meningoencephalitis (PAM), both in humans as well as in animals. PAM is a rare but fatal disease affecting young adults all around the world, particularly in the developed world but recently reported from developing countries, with 95%–99% mortality rate. Swimmers and divers are at high risk of PAM as the warm water is the most propitious environment adapted by N. fowleri to cause this infection. Infective amoeba in the trophozoite phase enter the victim's body through the nose, crossing the cribriform plate to reach the human brain and cause severe destruction of the central nervous system (CNS). The brain damage leads to brain haemorrhage and death occurs within 3–7 days in undiagnosed cases and maltreated cases. Though the exact pathogenesis of N. fowleri is still not known, it has exhibited two primary mechanisms, contact‐independent (brain damage through different proteins) and contact‐dependent (brain damage through surface structures food cups), that predominantly contribute to the pathogen invading the host CNS. For the management of this life‐threatening infection different treatment regimens have been applied but still the survival rate is only 5% which is ascribed to its misdiagnosis, as the PAM symptoms closely resembled bacterial meningitis. The main objectives of this review article are to compile data to explore the sources and routes of N. fowleri infection, its association in causing PAM along with its pathophysiology; latest techniques used for accurate diagnosis, management options along with challenges for Pakistan to control this drastic disorder.

Context: Parkinson's disease is the second common progressive neurodegenerative disease, distressing older men and is prevalent Worldwide. Objectives: This paper is aimed to review the epidemiology, etiology, pathogenesis, clinical manifestation, diagnosis and management of Parkinson disease. Methods: A google search was performed to recognize studies that review the characteristics of Parkinson disease. Search terms included " Parkinson's disease", " epidemiology", " etiology", " pathogenesis", " clinical manifestations", " diagnosis" and " management of Parkinson disease". Results: Parkinson's disease is linked to factors such as environmental chemicals, aging, family history and pesticide exposure such as the use of synthetic heroin. Parkinson’s disease is characterized clinically by tremors at rest, postural instability, expressionless countenance, lead pipe rigidity and less commonly cognitive impairment. After 60 years of age, Parkinson’s disease is commonly prevalent in 1% to 2% of the population, no racial differences are apparent, but the prevalence of Parkinson’s disease is more common in men than women. There has also been a better understanding that the disorder may be linked with major non-motor trouble in addition to the additional generally recognized motor complications. There are various management options for the timely management of Parkinson disease. As the ailment advances, further management strategies are existing; however, the management of non-motor manifestations and late stage motor complications remains mainly testing and will advantage from additional clinical studies. Conclusion: In this article we have discussed current progress in the understanding of the epidemiology, clinical manifestations, pathogenesis and management strategies of the disease.

Urinary tract infection (UTI) is one of the most severe public health problem affecting both sexes but females are more susceptible due to the differences in urogenital and reproductive anatomy, physiology and lifestyle. As in UTI, different parts of the urinary tract are affected and morbidity due to UTI is more common in women of all ages and older men. Due to multi‐drug resistant strains and high recurrence rate, UTI has become a major socioeconomic burden. The current review article was aimed to describe the natural therapeutic strategies to manage and cure the UTI. For this purpose, different databases including Google Scholar, Cochrane database, and PubMed etc. were explored. Inclusion criteria were any research article investigating the current therapy of UTI. It was found that microbial infections including Escherichia coli, Enterococcus faecalis and Klebsiella species are the major causes of UTI with different signs and symptoms including painful urination or dysuria, hematuria, urinary urgency, burning micturition, frequent urination, nausea, and vomiting. Antibiotics like trimethoprim, sulfamethoxazole, quinolone etc. as the first choice of the drug are used worldwide. However, due to microbial resistance, several life‐threatening side effects, repeated high doses, high cost and low efficacy of these antibiotics motivated the researchers to explore natural remedies for the treatment of UTI. Herbal medicines are effective to combat bacterial resistance with high efficacy, and easy availability with minimal or no side effects. For these reasons it has attained the attention of researchers wanting to explore the herbal treatment of UTI. Vaccinium macrocarpon, Tribulus terrestris, Trachyspermum copticum, Cinnamomum verum and Hybanthusenn easpermus are some common medicinal plants reported to have therapeutic potential for the management and cure of the UTI. Although herbal medicines have more potential over conventional medicine but more discoveries are required to explore the phytoconstituents and their mechanism of action responsible for the management and cure of UTI.

Soil transmitted helminthes (STH) are among the major public health issues in tropical and sub-tropical countries infecting more than 2 billion humans worldwide. STH causes considerable morbidity in children, affecting their cognitive development and physical growth. Endemic areas with poor sanitation and limited access to good quality water supply have the highest burden of STH infection. Various approaches to reduce and control the worm infections include the intermittent deworming of children with anti-helminthic drugs. Individual patient management and population based studies can only be successful upon using the diagnostic techniques with high accuracy. The lack of reliable tools for the provision of correct diagnostic results about the status and intensity of infection is a major challenge, as these factors varies considerably in areas of low infection intensities. The techniques currently available for the diagnosis of parasitic infections show limited specificity and sensitivity and as such several techniques in combination are normally used in diagnosing the variety of parasite species infection. This review article was planned to study the prevalence, risk factors, and the available diagnostic techniques for soil and water transmitted helminthes infections in humans. This article also discussed the challenges in diagnosis, treatment, and management of worm infections particularly helminthes. The articles available online on important portals like google scholar, PubMed, Digital Libraries, PakMediNet, Science direct, and the Directory of Open Access Journals (DOAJ) were searched for inclusion of the data in this review study. Duplicate studies and irrelevant reports describing the general aspects of parasite infections were excluded. This review study provides a comprehensive report on the prevalence, accurate diagnostic, and chemotherapeutic protocols to reduce the burden of worms infections. WHO suggests the chemotherapy for worm infections as feasible and cost effective strategy in schools due to the lack of proper policy for the prevention of intestinal worms.

This review presents an overview of published studies for a better understanding of the anti-mutagenic potential of medicinal plants and the precise indications for the utilization of natural compounds as chemo-preventive agents. Reports on the anti-mutagenic potential of medicinal plants published from 1997 to 2019 were searched through different scientific databases using the following keywords: medicinal plants and mutagens, carcinogens, the anti-mutagenic potential of medicinal plants. The data relevant to the anti-mutagenic potential of some common medicinal plants is summarized in this mini-review. These medicinal plants include Carum carvi, Withania somnifera, Panax ginseng, Mentha spicata, Curcuma zedoaria, Cassia angustifolia, Cymbopogon citrates, Ipomoea batatas, Glycyrrhiza glabra, Citrullus colocynthis, Capsicum annuum and Asparagus racemosus. An overview of the identified molecules or enzymes being targeted is also presented, with a focus on anti-carcinogenic and/or anti-mutagenic activity. The recent advancements in the research on medicinal plants pave the way for the better understanding and future prospects of the use of natural components as chemo-preventive and chemotherapeutic agents.