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Volume 3, Issue 2, 2025

Abstract

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The pervasive integration of plastic materials into contemporary society has yielded substantial societal and economic advantages, yet has concurrently precipitated growing toxicological concerns with significant implications for human health. This study critically examines the multifaceted health impacts associated with chronic exposure to microplastics and plastic-derived chemical additives, including phthalates, bisphenol A (BPA), flame retardants, and heavy metals. Through a comprehensive synthesis of recent toxicological and epidemiological evidence, the mechanisms through which these contaminants disrupt endocrine regulation, impair immune homeostasis, and compromise cellular function are elucidated. Cumulative exposure has been linked to heightened incidences of hormone-related disorders, carcinogenesis, metabolic syndromes, and neurodevelopmental abnormalities. Recent advances in analytical detection techniques have confirmed the systemic distribution and bioaccumulation of microplastic particles across human organs. Environmental vectors—such as air, water, soil, and food contamination—serve as major conduits of microplastic exposure, amplifying indirect toxicological risks through trophic transfer and persistent environmental deposition. Despite the mounting evidence of harm, current regulatory frameworks remain fragmented and insufficiently stringent, reflecting a lag between scientific understanding and policy enforcement. Addressing these deficiencies requires a paradigm shift from reactive risk management toward proactive prevention, encompassing the development of biodegradable materials, reinforcement of global monitoring systems, and the establishment of harmonized exposure thresholds. The synthesis presented herein highlights the urgent necessity of redefining plastic consumption and waste management practices to safeguard both human and ecological health, advocating for integrative strategies that align environmental sustainability with public health protection.

Abstract

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Diabetic foot infections (DFIs) are a major cause of morbidity and lower-limb amputations among individuals with diabetes mellitus. Inappropriate empirical antibiotic use contributes to treatment failure and elevated amputation risk. This observational study, conducted across six hospitals in Khyber Pakhtunkhwa (KP), Pakistan, involved 341 patients with clinically diagnosed DFIs. The objectives were to evaluate antibiotic efficacy, treatment outcomes, and risk factors for amputation, and to develop a visual risk stratification model correlating antibiotic response with amputation risk. The cohort exhibited a significant male predominance (64.5%, p = 0.003), with the highest prevalence among patients aged 41–50 years (36.7%). Most participants were insulin-independent (92.7%, p < 0.0001). Infection severity was mild in 28.7%, moderate in 47.8%, and severe in 23.5% of cases. Clinical outcomes included complete recovery (39.3%), improvement (31.7%), progression (19.9%), and amputation (9.1%). High-efficacy antibiotics included Levofloxacin (Levaquin, 100%), Colistin (100%), and Linezolid (Zyvox, 86.6%), whereas Ceftriaxone (Cefzone, 33.3%), Ampicillin/Sulbactam (Penro, 38.3%), and Clindamycin (Cleocin HCl, 26.6%) demonstrated limited therapeutic benefit. The visual stratification model showed that exposure to low-efficacy antibiotics significantly increased amputation risk. Logistic regression identified severe baseline infection (odds ratio (OR) ≈3.2), poor glycemic control (OR ≈ 1.9), and treatment with low-efficacy antibiotics (OR ≈ 2.8) as independent predictors of unfavorable outcomes. This study highlights the need for region-specific antibiotic stewardship, continuous resistance surveillance, and evidence-based treatment protocols. The proposed visual model offers a practical framework for guiding empirical therapy and reducing amputation rates in DFI management.

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