Search results for: Jawad Arshad

Authors: Mohammed Khalil Ur Rahman, Mohammed Alsharon, Arshad Muktar, Zahid Shaik

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Any ailment can go into terminal stages, cancer being one such disease which is many times detected in latent stages. Cancer is often characterized by constitutional symptoms which are agonizing in nature which disturbs patients and their family as well. In order to relieve such intolerable symptoms treatment modality employed is known to be ‘Palliative Care’. The goal of palliative care is to enhance patient’s quality of life by relieving or rather reducing the distressing symptoms of patients such as pain, nausea/ vomiting, anorexia/loss of appetite, excessive salivation, mouth ulcers, weight loss, constipation, oral thrush, emaciation etc. which are due to the effect of disease or due to the undergoing treatment such as chemotherapy, radiation etc. Ayurveda and Unani as well as other traditional medicines is getting more and more international attention in recent years and Ayurveda and Unani holistic perspective of the disease, it seems that there are many herbs and herbomineral preparation which can be employed in the treatment of malignancy and also in palliative care. Though many of them have yet to be scientifically proved as anti-cancerous but there is definitely a positive lead that some of these medications relieve the agonising symptoms thereby making life of the patient easy. Health is viewed in Islam in a holistic way. One of the names of the Quran is al-shifa' meaning ‘that which heals’ or ‘the restorer of health’ to refer to spiritual, intellectual, psychological, and physical health. The general aim of medical science, according to Islam, is to secure and adopt suitable measures which, with Allah’s permission, help to preserve or restore the health of the human body. Islam motivates the Physician to view the patient as one organism. The patient has physical, social, psychological, and spiritual dimensions that must be considered in synthesis with an integrated, holistic approach. Aims & Objectives: - To suggest herbs which are mentioned in Ayurveda Unani with potential palliative activity in case of Cancer patients. - Most of tibb nabawi [Prophetic Medicine] is preventive medicine and must have been divinely inspired. - Spiritual Aspects of Healing: Prayer, dua, recitation of the Quran - Remembrance of Allah play a central role.Materials & Method: Literary review of the herbs supported with experiential evidence will be discussed. Discussion: On the basis of collected data subject will be discussed in length. Conclusion: Will be presented in paper.

Keywords: palliative care, holistic, Ayurvedic and Unani traditional system of medicine, Quran, hadith

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Authors: A. Shakoor, M. Arshad

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The utilization of groundwater resources in irrigation has significantly increased during the last two decades due to constrained canal water supplies. More than 70% of the farmers in the Punjab, Pakistan, depend directly or indirectly on groundwater to meet their crop water demands and hence, an unchecked paradigm shift has resulted in aquifer depletion and deterioration. Therefore, a comprehensive research was carried at central Punjab-Pakistan, regarding spatiotemporal variation in groundwater level and quality. Processing MODFLOW for window (PMWIN) and MT3D (solute transport model) models were used for existing and future prediction of groundwater level and quality till 2030. The comprehensive data set of aquifer lithology, canal network, groundwater level, groundwater salinity, evapotranspiration, groundwater abstraction, recharge etc. were used in PMWIN model development. The model was thus, successfully calibrated and validated with respect to groundwater level for the periods of 2003 to 2007 and 2008 to 2012, respectively. The coefficient of determination (R2) and model efficiency (MEF) for calibration and validation period were calculated as 0.89 and 0.98, respectively, which argued a high level of correlation between the calculated and measured data. For solute transport model (MT3D), the values of advection and dispersion parameters were used. The model used for future scenario up to 2030, by assuming that there would be no uncertain change in climate and groundwater abstraction rate would increase gradually. The model predicted results revealed that the groundwater would decline from 0.0131 to 1.68m/year during 2013 to 2030 and the maximum decline would be on the lower side of the study area, where infrastructure of canal system is very less. This lowering of groundwater level might cause an increase in the tubewell installation and pumping cost. Similarly, the predicted total dissolved solids (TDS) of the groundwater would increase from 6.88 to 69.88mg/L/year during 2013 to 2030 and the maximum increase would be on lower side. It was found that in 2030, the good quality would reduce by 21.4%, while marginal and hazardous quality water increased by 19.28 and 2%, respectively. It was found from the simulated results that the salinity of the study area had increased due to the intrusion of salts. The deterioration of groundwater quality would cause soil salinity and ultimately the reduction in crop productivity. It was concluded from the predicted results of groundwater model that the groundwater deteriorated with the depth of water table i.e. TDS increased with declining groundwater level. It is recommended that agronomic and engineering practices i.e. land leveling, rainwater harvesting, skimming well, ASR (Aquifer Storage and Recovery Wells) etc. should be integrated to meliorate management of groundwater for higher crop production in salt affected soils.

Keywords: groundwater quality, groundwater management, PMWIN, MT3D model

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Authors: Khethiwe Mtshali, Zamantungwa T. H. Khumalo, Stanford Kwenda, Ismail Arshad, Oriel M. M. Thekisoe

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Ecologically, the gut, mammary glands and bloodstream consist of distinct microbial communities of commensals, mutualists and pathogens, forming a complex ecosystem of niches. The by-products derived from these body sites i.e. faeces, milk and blood, respectively, have many uses in rural communities where they aid in the facilitation of day-to-day household activities and occasional rituals. Thus, although livestock rearing plays a vital role in the sustenance of the livelihoods of rural communities, it may serve as a potent reservoir of different pathogenic organisms that could have devastating health and economic implications. This study aimed to simultaneously explore the microbial profiles of corresponding faecal, milk and blood samples from lactating cows using 16S rRNA metagenomic sequencing. Bacterial communities were inferred through the Divisive Amplicon Denoising Algorithm 2 (DADA2) pipeline coupled with SILVA database v138. All downstream analyses were performed in R v3.6.1. Alpha-diversity metrics showed significant differences between faeces and blood, faeces and milk, but did not vary significantly between blood and milk (Kruskal-Wallis, P < 0.05). Beta-diversity metrics on Principal Coordinate Analysis (PCoA) and Non-Metric Dimensional Scaling (NMDS) clustered samples by type, suggesting that microbial communities of the studied niches are significantly different (PERMANOVA, P < 0.05). A number of taxa were significantly differentially abundant (DA) between groups based on the Wald test implemented in the DESeq2 package (Padj < 0.01). The majority of the DA taxa were significantly enriched in faeces than in milk and blood, except for the genus Anaplasma, which was significantly enriched in blood and was, in turn, the most abundant taxon overall. A total of 30 phyla, 74 classes, 156 orders, 243 families and 408 genera were obtained from the overall analysis. The most abundant phyla obtained between the three body sites were Firmicutes, Bacteroidota, and Proteobacteria. A total of 58 genus-level taxa were simultaneously detected between the sample groups, while bacterial signatures of at least 8 of these occurred concurrently in corresponding faeces, milk and blood samples from the same group of animals constituting a pool. The important taxa identified in this study could be categorized into four potentially pathogenic clusters: i) arthropod-borne; ii) food-borne and zoonotic; iii) mastitogenic and; iv) metritic and abortigenic. This study provides insight into the microbial composition of bovine faeces, milk, and blood and its extent of overlapping. It further highlights the potential risk of disease occurrence and transmission between the animals and the inhabitants of the sampled rural community, pertaining to their unsanitary practices associated with the use of cattle by-products.

Keywords: microbial profiling, 16S rRNA, NGS, feces, milk, blood, lactating cows, small-scale farmers

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Authors: A. Arshad, M. Lehtonen. M. Humayun

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With the increasing Distributed Generation (DG) penetration, distribution systems are advancing towards the smart grid technology for least latency in tackling voltage control problem in a distributed manner. This paper proposes a Multi-agent based distributed voltage level control. In this method a flat architecture of agents is used and agents involved in the whole controlling procedure are On Load Tap Changer Agent (OLTCA), Static VAR Compensator Agent (SVCA), and the agents associated with DGs and loads at their locations. The objectives of the proposed voltage control model are to minimize network losses and DG curtailments while maintaining voltage value within statutory limits as close as possible to the nominal. The total loss cost is the sum of network losses cost, DG curtailment costs, and voltage damage cost (which is based on penalty function implementation). The total cost is iteratively calculated for various stricter limits by plotting voltage damage cost and losses cost against varying voltage limit band. The method provides the optimal limits closer to nominal value with minimum total loss cost. In order to achieve the objective of voltage control, the whole network is divided into multiple control regions; downstream from the controlling device. The OLTCA behaves as a supervisory agent and performs all the optimizations. At first, a token is generated by OLTCA on each time step and it transfers from node to node until the node with voltage violation is detected. Upon detection of such a node, the token grants permission to Load Agent (LA) for initiation of possible remedial actions. LA will contact the respective controlling devices dependent on the vicinity of the violated node. If the violated node does not lie in the vicinity of the controller or the controlling capabilities of all the downstream control devices are at their limits then OLTC is considered as a last resort. For a realistic study, simulations are performed for a typical Finnish residential medium-voltage distribution system using Matlab ®. These simulations are executed for two cases; simple Distributed Voltage Control (DVC) and DVC with optimized loss cost (DVC + Penalty Function). A sensitivity analysis is performed based on DG penetration. The results indicate that costs of losses and DG curtailments are directly proportional to the DG penetration, while in case 2 there is a significant reduction in total loss. For lower DG penetration, losses are reduced more or less 50%, while for higher DG penetration, loss reduction is not very significant. Another observation is that the newer stricter limits calculated by cost optimization moves towards the statutory limits of ±10% of the nominal with the increasing DG penetration as for 25, 45 and 65% limits calculated are ±5, ±6.25 and 8.75% respectively. Observed results conclude that the novel voltage control algorithm proposed in case 1 is able to deal with the voltage control problem instantly but with higher losses. In contrast, case 2 make sure to reduce the network losses through proposed iterative method of loss cost optimization by OLTCA, slowly with time.

Keywords: distributed voltage control, distribution system, multi-agent systems, smart grids

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Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

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Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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Authors: Anubhav Kumar Dwivedi, Arshad Khan, S. N. Tripathi, Manish Joshi, Gaurav Mishra, Dinesh Nath, Naveen Tiwari, B. K. Sapra

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In a nuclear reactor accident scenario, a large number of fission products may release to the piping system of the primary heat transport. The released fission products, mostly in the form of the aerosol, get deposited on the inner surface of the piping system mainly due to gravitational settling and thermophoretic deposition. The removal processes in the complex piping system are controlled to a large extent by the thermal-hydraulic conditions like temperature, pressure, and flow rates. These parameters generally vary with time and therefore must be carefully monitored to predict the aerosol behavior in the piping system. The removal process of aerosol depends on the size of particles that determines how many particles get deposit or travel across the bends and reach to the other end of the piping system. The released aerosol gets deposited onto the inner surface of the piping system by various mechanisms like gravitational settling, Brownian diffusion, thermophoretic deposition, and by other deposition mechanisms. To quantify the correct estimate of deposition, the identification and understanding of the aforementioned deposition mechanisms are of great importance. These mechanisms are significantly affected by different flow and thermodynamic conditions. Thermophoresis also plays a significant role in particle deposition. In the present study, a series of experiments were performed in the piping system of the National Aerosol Test Facility (NATF), BARC using metal aerosols (zinc) in dry environments to study the spatial distribution of particles mass and number concentration, and their depletion due to various removal mechanisms in the piping system. The experiments were performed at two different carrier gas flow rates. The commercial CFD software FLUENT is used to determine the distribution of temperature, velocity, pressure, and turbulence quantities in the piping system. In addition to the in-built models for turbulence, heat transfer and flow in the commercial CFD code (FLUENT), a new sub-model PBM (population balance model) is used to describe the coagulation process and to compute the number concentration along with the size distribution at different sections of the piping. In the sub-model coagulation kernels are incorporated through user-defined function (UDF). The experimental results are compared with the CFD modeled results. It is found that most of the Zn particles (more than 35 %) deposit near the inlet of the plenum chamber and a low deposition is obtained in piping sections. The MMAD decreases along the length of the test assembly, which shows that large particles get deposited or removed in the course of flow, and only fine particles travel to the end of the piping system. The effect of a bend is also observed, and it is found that the relative loss in mass concentration at bends is more in case of a high flow rate. The simulation results show that the thermophoresis and depositional effects are more dominating for the small and larger sizes as compared to the intermediate particles size. Both SEM and XRD analysis of the collected samples show the samples are highly agglomerated non-spherical and composed mainly of ZnO. The coupled model framed in this work could be used as an important tool for predicting size distribution and concentration of some other aerosol released during a reactor accident scenario.

Keywords: aerosol, CFD, deposition, coagulation

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Authors: Awatef Ahmed Ben Ramadan, Aqsa Arshad

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Background: There is a huge Muslim migration movement to North America and Europe for several reasons, primarily refuge from war areas and partly to search for better work and educational chances. There are always concerns regarding first-Generation Immigrant women's health and computer literacy, an adequate understanding of the health systems, and the use of the existing healthcare technology and services effectively and efficiently. Language proficiency level, preference for cultural and traditional remedies, socioeconomic factors, fear of stereotyping, limited accessibility to health services, and general unfamiliarity with the existing health services and resources are familiar variables among these women. Aims: The current study aims to assess the health and digital literacy of first-generation Muslim women in Atlanta city. Also, the study aims to examine how the COVID-19 pandemic has encouraged the use of health information technology and increased technology awareness among the targeted women. Methods: The study design is cross-sectional correlational research. The study will be conducted to produce preliminary results that the investigators want to have to supplement an NIH grant application about leveraging information technology to reduce the health inequalities amongst the first-generation immigrant Muslim women in Atlanta City. The investigators will collect the study data in two phases using different tools. Phase one was conducted in June 2022; the investigators used tools to measure health and digital literacy amongst 42 first-generation immigrant Muslim women. Phase two was conducted in November 2022; the investigators measured the Knowledge, Attitude, and Practice (KAP) of using health information technology such as telehealth from a sample of 45 first-generation Muslim immigrant women in Atlanta; in addition, the investigators measured how the current pandemic has affected their KAP to use telemedicine and telehealth services. Both phases' study participants were recruited using convenience sampling methodology. The investigators collected around 40 of 18 years old or older first-generation Muslim immigrant women for both study phases. The study excluded Immigrants who hold work visas and second-generation immigrants. Results: At the point of submitting this abstract, the investigators are still analyzing the study data to produce preliminary results to apply for an NIH grant entitled "Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)". This research will be the first step of a comprehensive research project to assess and measure health and digital literacy amongst a vulnerable community group. The targeted group might have different points of view from the U.S.-born inhabitants on how to: promote their health, gain healthy lifestyles and habits, screen for diseases, adhere to health treatment and follow-up plans, perceive the importance of using available and affordable technology to communicate with their providers and improve their health, and help in making serious decisions for their health. The investigators aim to develop an educational and instructional health mobile application considering the language and cultural factors that affect immigrants' ability to access different health and social support sources, know their health rights and obligations in their communities, and improve their health behavior and behavior lifestyles.

Keywords: first-generation immigrant Muslim women, telehealth, COVID-19 pandemic, health information technology, health and digital literacy

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Authors: Sajad Khaliq Dar, Dipanjan Goswami, Arshad H. Khuroo, Mohd. Akhtar, Pulak Kumar Metia, Sudershan Kumar

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Background: Development of modified-release oral dosage formulations (OSD) like tacrolimus in narrow therapeutic categories, together with high levels of intra-individual variability, impose greater challenges. The risk assessment for bioequivalence studies requires developing a suitable design through pilot studies involving the comparison of multiple formulations of the same product with a marketed product to understand the in-vivo behaviour. These formulations could have varying coating levels and other minor quantitative differences to achieve the desired release rate for the final product. Although small-scale studies are critical before the conduct of full-scale Pharmacokinetic (PK) studies, regulatory agencies evaluate critical bioavailability attributes (CBA) before approving the submitted dossiers. Since Tacrolimus is a BCS Class II drug, therefore developing the extended-release formulation, in addition to associated challenges, provides an opportunity to present the In vitro-in vivo correlations (IVIVC) to regulatory agencies, not only to exhibit product quality but also to reduce the burden of additional human trials and cost involved to them for bringing the product to market. Objective: The objective of this study was to develop a Level-A In vitro - In vivo Correlation (IVIVC) model for Sun Pharma’s test formulation Tacrolimus ER tablet 4mg and extend its application to a widened dissolution window of 25% at 2.5 hours (critical release time) sampling time point. Experimental Procedure: Post the conduct of two in-vivo studies, a pilot study evaluating two test prototypes on 24 subjects (under fasting) and a pivotal study having 50 subjects (under fasting), the observed pharmacokinetic profile was used for IVIVC model development. The dissolution media used was 0.005% HPC + 0.25% SLS in Water 900 mL at pH 4.50 using USP II (Paddle) apparatus with alternative sinkers operated at 100 RPM. The sampling time points were chosen to mimic the drug absorption in vivo. The dissolution best fit to data was obtained using Makoid Banakar kinetics. Then deconvolution, anchoring to concepts of the single compartment by Wagner Nelson method was applied for tacrolimus slow-release formulation batch with film coating weight build-up of 5.4% (used in pilot bio study), medium release with Hypromellose (retard-release exhibit batch used in the pivotal study) and fast release formulation batch with film coating weight build-up of 5.05% (used in pilot bio study). Results and Conclusion: The results were deemed acceptable as prediction errors for internal and external validation were < 3% depicting in-vitro drug release mimics in-vivo absorption. Moreover, the prediction result for the Test/Reference ratio was <15% for all test formulations and widening dissolution (i.e., 39%-64% drug release at 2.5hrs) predictions were well within 80-125% when compared against Envarsus XR (reference drug). This IVIVC-validated model can be used in the futuristic exploration of dose titration with 1mg tacrolimus ER OSD as a surrogate for In-vivo bioequivalence trials.

Keywords: pharmacokinetics, BCS, oral dosage form, Bioavailability, intra-individual variability

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Authors: K. Ghosh, S. N. Tripathi, Manish Joshi, Y. S. Mayya, Arshad Khan, B. K. Sapra

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We have developed a CFD coupled aerosol microphysics model in the context of aerosol generation from a glowing wire. The governing equations can be solved implicitly for mass, momentum, energy transfer along with aerosol dynamics. The computationally efficient framework can simulate temporal behavior of total number concentration and number size distribution. This formulation uniquely couples standard K-Epsilon scheme with boundary layer model with detailed aerosol dynamics through residence time. This model uses measured temperatures (wire surface and axial/radial surroundings) and wire compositional data apart from other usual inputs for simulations. The model predictions show that bulk fluid motion and local heat distribution can significantly affect the aerosol behavior when the buoyancy effect in momentum transfer is considered. Buoyancy generated turbulence was found to be affecting parameters related to aerosol dynamics and transport as well. The model was validated by comparing simulated predictions with results obtained from six controlled experiments performed with a laboratory-made hot wire nanoparticle generator. Condensation particle counter (CPC) and scanning mobility particle sizer (SMPS) were used for measurement of total number concentration and number size distribution at the outlet of reactor cell during these experiments. Our model-predicted results were found to be in reasonable agreement with observed values. The developed model is fast (fully implicit) and numerically stable. It can be used specifically for applications in the context of the behavior of aerosol particles generated from glowing wire technique and in general for other similar large scale domains. Incorporation of CFD in aerosol microphysics framework provides a realistic platform to study natural convection driven systems/ applications. Aerosol dynamics sub-modules (nucleation, coagulation, wall deposition) have been coupled with Navier Stokes equations modified to include buoyancy coupled K-Epsilon turbulence model. Coupled flow-aerosol dynamics equation was solved numerically and in the implicit scheme. Wire composition and temperature (wire surface and cell domain) were obtained/measured, to be used as input for the model simulations. Model simulations showed a significant effect of fluid properties on the dynamics of aerosol particles. The role of buoyancy was highlighted by observation and interpretation of nucleation zones in the planes above the wire axis. The model was validated against measured temporal evolution, total number concentration and size distribution at the outlet of hot wire generator cell. Experimentally averaged and simulated total number concentrations were found to match closely, barring values at initial times. Steady-state number size distribution matched very well for sub 10 nm particle diameters while reasonable differences were noticed for higher size ranges. Although tuned specifically for the present context (i.e., aerosol generation from hotwire generator), the model can also be used for diverse applications, e.g., emission of particles from hot zones (chimneys, exhaust), fires and atmospheric cloud dynamics.

Keywords: nanoparticles, k-epsilon model, buoyancy, CFD, hot wire generator, aerosol dynamics

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Authors: Jenny Carpenter, Josh Chan, Persephone MacKinlay, Madeline Chiang, Devlyn Sun, Hiba Syed, Jana Lau, Mariam Arshad, Joy Xu

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Introduction: Psoriasis is a chronic inflammatory skin condition that affects 1 million Canadians and over 8 million Americans. It is associated with psychosocial challenges exacerbated by the presence of visible lesions, which can lead to feelings of embarrassment and social discomfort. Children often experience bullying and lower self-esteem, while adults face workplace discrimination, impaired productivity, and higher rates of comorbid mental health conditions. Understanding these impacts across age groups is vital for tailored interventions. Objective: The main objective is to compare the longitudinal psychological impact of psoriasis between adults and children in Canada and the United States. Methods: This systematic review was conducted following PRISMA guidelines and a PROSPERO-registered protocol. Studies were identified from PubMed, Scopus, ProQuest, PsycINFO, Dermatology Online Journal, JMIR Dermatology, and Embase. The included studies were published between 2014 and 2024, measured standardized psychological outcomes, and had a longitudinal design with at least a one-year follow-up period. Methodological quality was assessed using the GRADE tool. Results: Fifteen studies encompassing 67,964 participants (mean age 49.1 years, 53.3% female) were included. Adults with moderate-to-severe psoriasis demonstrated significant impairments in Dermatology Life Quality Index (DLQI) scores, with a mean baseline score of 9.0 to 10.2 for severe cases, reflecting moderate-to-severe quality of life (QoL) impairments. Treatment with biologic therapies significantly improved outcomes, with DLQI scores decreasing by an average of 7 points (from 9.6 to 2.6; p < 0.001). Key areas of improvement included social functioning, reduced physical symptoms, and increased work productivity. In severe cases, DLQI scores were 7.95 points higher compared to mild cases (p < 0.05), indicating a disproportionate burden of disease severity. Anxiety and depression were common in adults, affecting 16-23% and 18-22%, respectively. These conditions were linked to visible lesions, social stigma, and comorbidities such as hypertension and metabolic syndrome. Children with psoriasis also exhibited similar impairments in QoL, as assessed by the Children’s Life Quality Index (CLDQI). Visible lesions negatively affected school participation and peer interactions, with bullying and stigma consistently reported as major contributors to social isolation and emotional distress. Although biological therapies improved CDLQI scores, children faced persistent challenges in psychological well-being, including lower self-esteem and stigma, which often persisted in adolescence. Disease severity was quantified using the Psoriasis Area and Severity Index (PASI). Among adults, severe cases had a mean baseline PASI score of 13.9, improving by 87.1% (to 1.8, p < 0001) following biologic therapy. Canadian cohorts showed greater PASI improvements, with biologic-naive adults achieving a 95.1% reduction (from 16.3 to 0.7, p < 0.0001). Canadian patients also had higher biologic continuation rates (89.9%). Conclusion: Psoriasis significantly impacts quality of life and psychological well-being across age groups, with notable differences in outcomes between adults and children. Regional differences further highlighted greater work-related impairments in U.S. adults and more pronounced psychological challenges in Canadian children, where bullying and stigma delayed recovery. These findings emphasize the need for age- and region-specific strategies to address both the physical and psychosocial dimensions of psoriasis and support long-term well-being.

Keywords: psoriasis, psychological impact, mental health, quality of life, self-esteem, autoimmune, chronic skin condition

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